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To slow down the spread of the SARS-Cov-2 virus, countries worldwide severely restricted public and social life. In addition to the physical threat posed by the viral disease (COVID-19), the pandemic also has implications for psychological well-being. Using a small sample (N = 51), we examined how Big Five personality traits relate to coping with contact restrictions during three consecutive weeks in the first wave of the COVID-19 pandemic in Germany. We showed that extraversion was associated with suffering from severe contact restrictions and with benefiting from their relaxation. Individuals with high neuroticism did not show a change in their relatively poor coping with the restrictions over time, whereas conscientious individuals seemed to experience no discomfort and even positive feelings during the period of contact restrictions. Our results support the assumption that neuroticism is a vulnerability factor in relation to psychological wellbeing but also show an influence of contact restrictions on extraverted individuals.
Purpose
Despite much improved preoperative planning techniques accurate intraoperative assessment of the high tibial valgus osteotomy (HTO) remains challenging and often results in coronal over- and under-corrections as well as unintended changes of the posterior tibial slope. Noyes et al. reported a novel method for accurate intraoperative coronal and sagittal alignment correction based on a three-dimensional mathematical model. This is the first study examining preliminary data via the proposed Noyes approach for accurate intraoperative coronal and sagittal alignment correction during HTO.
Methods
From 2016 to 2020 a total of 24 patients (27 knees) underwent HTO applying the proposed Noyes method (Noyes-Group). Radiographic data was analyzed retrospectively and matched to patients that underwent HTO using the conventional method, i.e., gradual medial opening using a bone spreader under fluoroscopic control (Conventional-Group). All operative procedures were performed by an experienced surgeon at a single orthopaedic university center.
Results
From the preoperative to the postoperative visit no statistically significant changes of the posterior tibial slope were noted in the Noyes-Group compared to a significant increase in the Conventional-Group (p = 0.01). Regarding the axial alignment no significant differences between both groups were observed pre- and postoperatively. The number of over- and under-corrections did not differ significantly between both groups. Linear regression analysis showed a significant correlation of the postoperative medial proximal tibial angle (MPTA) with the position of the weightbearing line on the tibial plateau.
Conclusion
The 3-triangle method by Noyes seems to be a promising approach for preservation of the posterior tibial slope during HTO.
This work investigates the correlations between spin states and the light emission properties of organic light-emitting diodes (OLEDs), which are based on the principle of thermally activated delayed fluorescence. The spin-spin interactions responsible for this mechanism are investigated in this work using methods based on spin-sensitive electron paramagnetic resonance (EPR). In particular, this method has been applied to electrically driven OLEDs. The magnetic resonance has been detected by electroluminescence, giving this method its name: electroluminescence detected magnetic resonance (ELDMR).
Initial investigations on a novel deep blue TADF emitter were performed. Furthermore, the ELDMR method was used in this work to directly detect the spin states in the OLED. These measurements were further underlined by time-resolved experiments such as transient electro- and photoluminescence.
Methionine is the first amino acid of every newly synthesised protein. In combination with its role as precursor for the vital methyl-group donor S-adenosylmethionine, methionine is essential for every living cell. The opportunistic human pathogen Staphylococcus aureus is capable of synthesising methionine de novo, when it becomes scarce in the environment. All genes required for the de novo biosynthesis are encoded by the metICFE-mdh operon, except for metX. Expression is controlled by a hierarchical network with a methionyl-tRNA-specific T-box riboswitch (MET-TBRS) as centrepiece, that is also referred to as met leader (RNA). T-box riboswitches (TBRS) are regulatory RNA elements located in the 5’-untranslated region (5’-UTR) of genes. The effector molecule of T-box riboswitches is uncharged cognate tRNA. The prevailing mechanism of action is premature termination of transcription of the nascent RNA in the absence of the effector (i.e. uncharged cognate tRNA) due to formation of a hairpin structure, the Terminator stem. In presence of the effector, a transient stabilisation of the alternative structure, the Antiterminator, enables transcription of the downstream genes (‘read-through’). Albeit, after the read-through the thermodynamically more stable Terminator eventually forms. The Terminator and the Antiterminator are two mutually exclusive structures. Previous work of the research group showed that in staphylococci the MET-TBRS ensures strictly methionine-dependent control of met operon expression. Uncharged methionyl-tRNA that activates the system is only present in sufficient amounts under methionine-deprived conditions. In contrast to other bacterial TBRS, the staphylococcal MET-TBRS has some characteristic features regarding its length and predicted secondary structure whose relevance for the function are yet unkown.
Aim of the present thesis was to experimentally determine the structure of the met leader RNA and to investigate the stability of the met operon-specific transcripts in the context of methionine biosynthesis control. Furthermore, the yet unknown function of the mdh gene within the met operon was to be determined.
In the context of this thesis, the secondary structure of the met leader was determined employing in-line probing. The structural analysis revealed the presence of almost all highly conserved T-box riboswitch structural characteristics. Furthermore, three additional stems, absent in all T-box riboswitches analysed to date, could be identified. Particularly remarkable is the above average length of the Terminator stem which renders it a potential target of the double-strand-specific endoribonuclease III (RNase III). The RNase III-dependent cleavage of the met leader could be experimentally verified by the use of suitable mutants. Moreover, the exact cleavage site within the Terminator was determined.
The unusual immediate separation of the met leader from the met operon mRNA via the RNase III cleavage within the Terminator stem induces the rapid degradation of the met leader RNA and, most likely, that of the 5’-region of the met mRNA. The met mRNA is degraded from its 5’-end by the exoribonuclease RNase J. The stability of the met mRNA was found to vary over the length of the transcript with an instable 5’-end (metI and metC) and a longer half-life towards the 3’-end (metE and mdh). The varying transcript stability is reflected by differences in the available cellular protein levels. The obtained data suggest that programmed mRNA degradation is another level of regulation in the complex network of staphylococcal de novo methionine biosynthesis control.
In addition, the MET-TBRS was studied with regard to a future use as a drug target for novel antimicrobial agents. To this end, effects of a dysregulated methionine biosynthesis on bacterial growth and survival were investigated in met leader mutants that either caused permanent transcription of the met operon (‘ON’) or prevented operon transcription (‘OFF’), irrespective of the methionine status in the cell. Methionine deprivation turned out to be a strong selection pressure, as ‘OFF’ mutants acquired adaptive mutations within the met leader to restore met operon expression that subsequently re-enabled growth.
The second part of the thesis was dedicated to the characterisation of the Mdh protein that is encoded by the last gene of the met operon and whose function is unknown yet. At first, co-transcription and -expression with the met operon could be demonstrated. Next, the Mdh protein was overexpressed and purified and the crystal structure of Mdh was solved to high resolution by the Kisker research group (Rudolf-Virchow-Zentrum Würzburg). Analysis of the structure revealed the amino acid residues crucial for catalytic activity, and zinc was identified as a co-factor of Mdh. Also, Mdh was shown to exist as a dimer. However, identification of the Mdh substrate was, in the context of this thesis, (still) unsuccessful. Nevertheless, interactions of Mdh with enzymes of the met operon could be demonstrated by employing the bacterial two-hybrid system. This fact and the high conservation of mdh/Mdh on nucleotide and amino acid level among numerous staphylococcal species suggests an important role of Mdh within the methionine metabolism that should be a worthwhile subject of future research.
The extragalactic gamma-ray sky is dominated by blazars, active galactic nuclei (AGN) with a relativistic jet that is closely aligned with the line of sight. Galaxies develop an active nucleus if the central supermassive black hole (BH) accretes large amounts of ambient matter and magnetic flux. The inflowing mass accumulates around the plane perpendicular to the accretion flow's angular momentum. The flow is heated through viscous friction and part of the released energy is radiated as blackbody or non-thermal radiation, with luminosities that can dominate the accumulated stellar luminosity of the host galaxy. A fraction of the accretion flow luminosity is reprocessed in a surrounding field of ionised gas clouds. These clouds, revolving around the central BH, emit Doppler-broadened atomic emission lines. The region where these broad-line-emitting clouds are located is called broad-line region (BLR).
About one in ten AGN forms an outflow of radiation and relativistic particles, called a relativistic jet. According to the Blandford-Znajek mechanism, this is facilitated through electromagnetic processes in the magnetosphere of a spinning BH. The latter induces a magnetospheric poloidal current circuit, generating a decelerating torque on the BH and inducing a toroidal magnetic field. Consequently, rotational energy of the BH is converted to Poynting flux streaming away mainly along the rotational axis and starting the jet. One possibility for particle acceleration near the jet base is realised by magnetospheric vacuum gaps, regions temporarily devoid of plasma, such that an intermittent electric field arises parallel to the magnetic field lines, enabling particle acceleration and contributing to the mass loading of the jets.
Magnetised structures, containing bunches of relativistic electrons, propagate away from the galactic nucleus along the jets. Assuming that these electrons emit synchrotron radiation and that they inverse-Compton (IC) up-scatter abundant target photons, which can either be the synchrotron photons themselves or photons from external emitters, the emitted spectrum can be theoretically determined. Additionally taking into account that these emission regions move relativistically themselves and that the emission is Doppler-boosted and beamed in forward direction, the typical two-hump spectral energy distribution (SED) of blazars is recovered.
There are however findings that challenge this well-established model. Short-time variability, reaching down to minute scales at very high energy gamma rays, is today known to be a widespread phenomenon of blazars, calling for very compact emission regions. In most models of such optically thick emission regions, the gamma-ray flux is usually pair-absorbed exponentially, without considering the cascade evolving from the pair-produced electrons. From the observed flux, it is often concluded that emission emanates from larger distances where the region is optically thin, especially from outside of the BLR. Only in few blazars gamma-ray attenuation associated with pair absorption in the BLR was clearly reported.
With the advent of sophisticated high-energy or very high energy gamma-ray detectors, like the Fermi Large Area Telescope or the Major Atmospheric Gamma-ray Imaging Cherenkov telescopes, besides the extraordinarily fast variability spectral features have been found that cannot be explained by conventional models reproducing the two-hump SED. Two such narrow spectral features are discussed in this work. For the nearby blazar Markarian 501, hints to a sharp peak around 3 TeV have been reported from a multi-wavelength campaign carried out in July 2014, while for 3C 279 a spectral dip was found in 2018 data, that can hardly be described with conventional fitting functions. In this work it is examined whether these spectral peculiarities of blazar jet emission can be explained, if the full radiation reprocessing through an IC pair cascade is accounted for.
Such a cascade is the multiple concatenation of IC scattering events and pair production events. In the cascades generally considered in this work, relativistic electrons and high-energy photons are injected into a fixed soft target photon field. A mathematical description for linear IC pair cascades with escape terms is delivered on the basis of preliminary works. The steady-state kinetic equations for the electrons and for the photons are determined, whereby it is paid attention to an explicit formulation and to motivating the correct integration borders of all integrals from kinematic constraints. In determining the potentially observable gamma-ray flux, both the attenuated injected flux and the flux evolving as an effect of IC up-scattering, pair absorption and escape are incorporated, giving the emerging spectra very distinct imprints.
Much effort is dedicated to the numerical solution of the electrons' kinetic equation via iterative schemes. It is explained why pointwise iteration from higher to lower Lorentz factors is more efficient than iterating the whole set of sampling points. The algorithm is parallelised at two positions. First, several workers can perform pointwise iterations simultaneously. Second, the most demanding integral is cut into a number of part integrals which can be determined by multiple workers. Through these measures, the Python code can be readily applied to simulate steady-state IC pair cascades with escape.
In the case of Markarian 501 the developed framework is as follows. The AGN hosts an advection-dominated accretion flow with a normalised accretion rate of several \(10^{-4}\) and an electron temperature near \(10^{10}\) K. On the one hand, the accretion flow illuminates the few ambient gas clouds with approximate radius \(10^{11}\) m, which reprocess a fraction 0.01 of the luminosity into hydrogen and helium emission lines. On the other hand, the gamma rays from the accretion flow create electrons and positrons in a sporadically active vacuum gap in the BH magnetosphere. In the active gap, a power of roughly 0.001 of the Blandford-Znajek power is extracted from the rotating BH through a gap potential drop of several \(10^{18}\) V, generating ultra-relativistic electrons, which subsequently are multiplied by a factor of about \(10^6\) through interaction with the accretion flow photons. This electron beam propagates away from the central engine and encounters the photon field of one passing ionised cloud. The resulting IC pair cascade is simulated and the evolving gamma-ray spectrum is determined. Just above the absorption troughs due to the hydrogen lines, the spectrum exhibits a narrow bump around 3 TeV. When the cascaded emission is added to the emission generated at larger distances, the observed multi-wavelength SED including the sharp peak at 3 TeV is reproduced, underlining that radiation processes beyond conventional models are motivated by distinct spectral features.
The dip in the spectrum of 3C 279 is addressed by a similar cascade model. Three types of injection are considered, varying in the ratio of the photon density to the electron density and varying in the spectral shape. The IC pair cascade is assumed to happen either in the dense BLR photon field with a luminosity of several \(10^{37}\) W and a radial size of few \(10^{14}\) m or in the diluted photon field outside of the BLR. The latter scenario is however rejected as the spectral slope around several 100 MeV and the dip at few 10 GeV cannot be reconciled within this model. The radiation cascaded in the BLR can explain the observational data, irrespective of the assumed injected rate. It is therefore concluded that for this period of gamma-ray emission, the radiation production happens at the edge of the BLR of 3C 279.
Both investigations show that IC pair cascades can account for fine structure seen in blazar SEDs. It is insufficient to restrict the radiation transport to pure exponential absorption of an injection term. Pair production and IC up-scattering by all generations of photons and electrons in the optically thick regime critically shape the emerging spectra. As the advent of future improved detectors will provide more high-precision spectra, further observations of narrow spectral features can be expected. It seems therefore recommendable to incorporate cascading into conventional radiation production models or to extend the model developed in this work by synchrotron radiation.
Background: Eosinophils appear to contribute to the efficacy of immunotherapy and their frequency was suggested as a predictive biomarker. Whether this observation could be transferred to patients treated with targeted therapy remains unknown. Methods: Blood and serum samples of healthy controls and 216 patients with advanced melanoma were prospectively and retrospectively collected. Freshly isolated eosinophils were phenotypically characterized by flow cytometry and co-cultured in vitro with melanoma cells to assess cytotoxicity. Soluble serum markers and peripheral blood counts were used for correlative studies. Results: Eosinophil-mediated cytotoxicity towards melanoma cells, as well as phenotypic characteristics, were similar when comparing healthy donors and patients. However, high relative pre-treatment eosinophil counts were significantly associated with response to MAPKi (p = 0.013). Eosinophil-mediated cytotoxicity towards melanoma cells is dose-dependent and requires proximity of eosinophils and their target in vitro. Treatment with targeted therapy in the presence of eosinophils results in an additive tumoricidal effect. Additionally, melanoma cells affected eosinophil phenotype upon co-culture. Conclusion: High pre-treatment eosinophil counts in advanced melanoma patients were associated with a significantly improved response to MAPKi. Functionally, eosinophils show potent cytotoxicity towards melanoma cells, which can be reinforced by MAPKi. Further studies are needed to unravel the molecular mechanisms of our observations.
Background
The GMP-compliant production of radiopharmaceuticals has been performed using disposable units (cassettes) with a dedicated synthesis module. To expand this “plug ‘n’ synthesize” principle to a broader scope of modules we developed a pressure controlled setup that offers an alternative to the usual stepper motor controlled rotary valves. The new concept was successfully applied to the synthesis of N-methyl-[\(^{11}\)C]choline, L-S-methyl-[\(^{11}\)C]methionine and [11C]acetate.
Results
The target gas purification of cyclotron produced [\(^{11}\)C]CO\(_2\) and subsequent conversion to [\(^{11}\)C]MeI was carried out on a TRACERlab Fx C Pro module. The labelling reactions were controlled with a TRACERlab Fx FE module. With the presented modular principle we were able to produce N-methyl-[\(^{11}\)C]choline and L-S-methyl-[\(^{11}\)C]methionine by loading a reaction loop with neat N,N'-dimethylaminoethanol (DMAE) or an ethanol/water mixture of NaOH and L-homocysteine (L-HC), respectively and a subsequent reaction with [\(^{11}\)C]MeI. After 18 min N-methyl-[\(^{11}\)C]choline was isolated with 52% decay corrected yield and a radiochemical purity of > 99%. For L-S-methyl-[\(^{11}\)C]methionine the total reaction time was 19 min reaction, yielding 25% of pure product (> 97%). The reactor design was used as an exemplary model for the technically challenging [\(^{11}\)C]acetate synthesis. The disposable unit was filled with 1 mL MeMgCl (0.75 M) in tetrahydrofuran (THF) bevore [\(^{11}\)C]CO\(_2\) was passed through. After complete release of [\(^{11}\)C]CO\(_2\) the reaction mixture was quenched with water and guided through a series of ion exchangers (H\(^+\), Ag\(^+\) and OH\(^−\)). The product was retained on a strong anion exchanger, washed with water and finally extracted with saline. The product mixture was acidified and degassed to separate excess [\(^{11}\)C]CO\(_2\) before dispensing. Under these conditions the total reaction time was 18 ± 2 min and pure [\(^{11}\)C]acetate (n = 10) was isolated with a decay corrected yield of 51 ± 5%.
Conclusion
Herein, we described a novel single use unit for the synthesis of carbon-11 labelled tracers for preclinical and clinical applications of N-methyl-[\(^{11}\)C]choline, L-S-methyl-[\(^{11}\)C]methionine and [11C]acetate.
Backround: In February 2021, the first formal evidence and consensus-based (S3) guidelines for the inpatient treatment of patients with COVID-19 were published in Germany and have been updated twice during 2021. The aim of the present study is to re-evaluate the dissemination pathways and strategies for ICU staff (first evaluation in December 2020 when previous versions of consensus-based guidelines (S2k) were published) and question selected aspects of guideline adherence of standard care for patients with COVID-19 in the ICU. Methods: We conducted an anonymous online survey among German intensive care staff from 11 October 2021 to 11 November 2021. We distributed the survey via e-mail in intensive care facilities and requested redirection to additional intensive care staff (snowball sampling). Results: There was a difference between the professional groups in the number, selection and qualitative assessment of information sources about COVID-19. Standard operating procedures were most frequently used by all occupational groups and received a high quality rating. Physicians preferred sources for active information search (e.g., medical journals), while nurses predominantly used passive consumable sources (e.g., every-day media). Despite differences in usage behaviour, the sources were rated similarly in terms of the quality of the information on COVID-19. The trusted organizations have not changed over time. The use of guidelines was frequently stated and highly recommended. The majority of the participants reported guideline-compliant treatment. Nevertheless, there were certain variations in the use of medication as well as the criteria chosen for discontinuing non-invasive ventilation (NIV) compared to guideline recommendations. Conclusions: An adequate external source of information for nursing staff is lacking, the usual sources of physicians are only appropriate for the minority of nursing staff. The self-reported use of guidelines is high.
This paper presents a novel approach to Thrust Vector Control (TVC) for small Unmanned Aerial Vehicles (UAVs). The difficulties associated with conventional feed-forward TVC are outlined, and a practical solution to conquer these challenges is derived. The solution relies on observing boom deformations that are created by different thrust vector directions and high-velocity air inflow. The paper describes the required measurement electronics as well as the implementation of a dedicated testbed that allows the evaluation of mid-flight force measurements. Wind-tunnel tests show that the presented method for active thrust vector determination is able to quantify the disturbances due to the incoming air flow.
Deep convolutional generative adversarial networks (GAN) allow for creating images from existing databases. We applied a modified light-weight GAN (FastGAN) algorithm to cerebral blood flow SPECTs and aimed to evaluate whether this technology can generate created images close to real patients. Investigating three anatomical levels (cerebellum, CER; basal ganglia, BG; cortex, COR), 551 normal (248 CER, 174 BG, 129 COR) and 387 pathological brain SPECTs using N-isopropyl p-I-123-iodoamphetamine (123I-IMP) were included. For the latter scans, cerebral ischemic disease comprised 291 uni- (66 CER, 116 BG, 109 COR) and 96 bilateral defect patterns (44 BG, 52 COR). Our model was trained using a three-compartment anatomical input (dataset ‘A’; including CER, BG, and COR), while for dataset ‘B’, only one anatomical region (COR) was included. Quantitative analyses provided mean counts (MC) and left/right (LR) hemisphere ratios, which were then compared to quantification from real images. For MC, ‘B’ was significantly different for normal and bilateral defect patterns (P < 0.0001, respectively), but not for unilateral ischemia (P = 0.77). Comparable results were recorded for LR, as normal and ischemia scans were significantly different relative to images acquired from real patients (P ≤ 0.01, respectively). Images provided by ‘A’, however, revealed comparable quantitative results when compared to real images, including normal (P = 0.8) and pathological scans (unilateral, P = 0.99; bilateral, P = 0.68) for MC. For LR, only uni- (P = 0.03), but not normal or bilateral defect scans (P ≥ 0.08) reached significance relative to images of real patients. With a minimum of only three anatomical compartments serving as stimuli, created cerebral SPECTs are indistinguishable to images from real patients. The applied FastGAN algorithm may allow to provide sufficient scan numbers in various clinical scenarios, e.g., for “data-hungry” deep learning technologies or in the context of orphan diseases.
Numerous experiments have shown that an evaluative and passive process, known as validation, accompanies activation and integration, which are fundamental processes of text comprehension. During the construction of a mental model, validation implicitly assesses the plausibility of incoming information by checking its consistency with world knowledge, prior beliefs, and contextual information (e.g., the broader discourse context). However, research on potential influences that shape validation processes has just started. One branch of research is investigating how world knowledge and contextual information contribute to integration and validation. World knowledge usually influences validation more strongly because information plausibility is the primary criterion for validation, but strong contextual information can yield influences as well.
Contextual information that may be specifically relevant for routine validation is the credibility of a source providing text information. Source credibility bears a strong conceptual relationship to the validity of information. However, a dearth of research has investigated joint effects of plausibility and source credibility for routine validation. To fill this research gap, the aim of the present dissertation was to examine the role of source credibility in routine validation processes of text information. This dissertation argues that both source credibility and plausibility are considered in these processes. In particular, information plausibility is proposed as the primary criterion, but source credibility may modulate validation as an additional criterion. To this end, three studies with five self-paced reading experiments were conducted in which reading times served as an implicit indicator of validation and plausibility judgments as an explicit indicator, and the convergence or divergence between the two indicators was interpreted.
The first study examined the interplay of plausibility and source credibility for the validation of world-knowledge consistent versus inconsistent text information embedded in short narratives. This highly plausible or highly implausible information was provided by a high- or low-expertise source. In Study 1, plausibility dominated validation as suggested by faster reading times and higher plausibility judgments for world-knowledge consistent information. Importantly, source credibility modulated the validation of highly implausible information but seemed to not matter for plausible information. High-credible sources increased the implausibility of highly implausible information to a greater extent compared with low-credible sources as indicated by longer reading times and lower plausibility judgments. These results diverged from recent findings from Foy et al. (2017).
The second study investigated whether the modulating role of source credibility depends on the degree of implausibility of an information. Thus, Study 2 extended Study 1 by an intermediate, somewhat implausible level of plausibility (comparable to the implausible claims in Foy et al., 2017). Similar to Study 1, plausibility dominated validation as indicated by lower reading times and plausibility judgments with higher world-knowledge inconsistency. Again, source credibility had no effect on the routine validation of plausible information. However, high-credible sources mitigated the implausibility of somewhat implausible information as indicated by faster reading times and higher plausibility judgments but exacerbated the implausibility of highly implausible information as indicated by slower reading times and lower plausibility judgments.
In short, Study 2 findings not only integrates the seemingly divergent results of Study 1 and Foy et al. (2017) but also provides strong support for the assumption that the degree of implausibility determines the modulating role of source credibility for validation.
The third study examined the relationship of source credibility and plausibility in an ecologically valid social media setting with short Twitter messages varying in world-knowledge and text-belief consistency by trustworthy and untrustworthy sources. In sum, plausibility and to a lesser extent source credibility mattered for routine validation and explicit evaluation of text information as indicated by reading times and plausibility judgments. However, the pattern partly diverged from Study 1 and 2, possibly because the source information was more salient.
In sum, the present dissertation yielded three insights. First, the findings further extends evidence for routine validation based on world-knowledge and prior beliefs. Second, the studies suggest that source credibility can modulate validation. Readers used source credibility cues for routine validation and the explicit evaluation of text information in all studies. Third, the impact of source credibility seems to depend on the degree of implausibility of information.
The present findings have theoretical implications for theories of validation and text comprehension as well as practical implications for targeting threats associated with the prevalence of inaccurate information, for example, on the World Wide Web. Future research using eye-tracking methodology could further disentangle the routine and strategic underlying processes of the relationship between source credibility and plausibility.
Background
Student performance is a mirror of teaching quality. The pre-/post-test design allows a pragmatic approach to comparing the effects of interventions. However, the calculation of current knowledge gain scores introduces varying degrees of distortion. Here we present a new metric employing a linear weighting coefficient to reduce skewness on outcome interpretation.
Methods
We compared and contrasted a number of common scores (raw and relative gain scores) with our new method on two datasets, one simulated and the other empirical from a previous intervention study (n = 180) employing a pre-/post-test design.
Results
The outcomes of the common scores were clearly different, demonstrating a significant dependency on pre-test scores. Only the new metric revealed a linear relationship to the knowledge baseline, was less skewed on the upper or lower extremes, and proved well suited to allow the calculation of negative learning gains. Employing the empirical dataset, the new method also confirmed the interaction effect of teaching formats with specific subgroups of learner characteristics.
Conclusion
This work introduces a new weighted metric enabling meaningful comparisons between interventions based on a linear transformation. This method will form the basis to intertwine the calculation of test performance closely with the outcome of learning as an important factor reflecting teaching quality and efficacy. Its regular use can improve the transparency of teaching activities and outcomes, contribute to forming rounded judgements of students' acquisition of knowledge and skills and enable valuable feedforward to develop and enhance curricular concepts.
The COVID-19 pandemic has resulted in large numbers of patients requiring critical care management. With the established association between severe respiratory virus infection and invasive pulmonary aspergillosis (7.6% for COVID-19-associated pulmonary aspergillosis (CAPA)), the pandemic places a significant number of patients at potential risk from secondary invasive fungal disease. We described a case of CAPA with substantial supporting mycological evidence, highlighting the need to employ strategic diagnostic algorithms and weighted definitions to improve the accuracy in diagnosing CAPA.
Robotic-assisted colon surgery may contain advantages over the laparoscopic approach, but clear evidence is sparse. This study aimed to analyze postoperative inflammation status, short-term outcome and cost-effectiveness of robotic-assisted versus laparoscopic left hemicolectomy. All consecutive patients who received minimal-invasive left hemicolectomy at the Department of Surgery I at the University Hospital of Wuerzburg in 2021 were prospectively included. Importantly, no patient selection for either procedure was carried out. The robotic-assisted versus laparoscopic approaches were compared head to head for postoperative short-term outcomes as well as cost-effectiveness. A total of 61 patients were included, with 26 patients having received a robotic-assisted approach. Baseline characteristics did not differ among the groups. Patients receiving a robotic-assisted approach had a significantly decreased length of hospital stay as well as lower rates of complications in comparison to patients who received laparoscopic surgery (n = 35). In addition, C-reactive protein as a marker of systemic stress response was significantly reduced postoperatively in patients who were operated on in a robotic-assisted manner. Consequently, robotic-assisted surgery could be performed in a cost-effective manner. Thus, robotic-assisted left hemicolectomy represents a safe and cost-effective procedure and might improve patient outcomes in comparison to laparoscopic surgery.
Background and purpose
Pediatric adrenocortical carcinoma (pACC) is a rare disease with poor prognosis. Publications on radiotherapy (RT) are scarce. This review summarizes the current data on RT for pACC and possibly provides first evidence to justify its use in this setting.
Materials and methods
We searched the PubMed and Embase database for manuscripts regarding RT for pACC.
Results
We included 17 manuscripts reporting on 76 patients treated with RT, after screening 2961 references and 269 full articles. In addition, we added data of 4 unreported pACC patients treated by co-authors. All reports based on retrospective data. Median age at first diagnosis was 11.1 years (70% female); 78% of patients presented with hormonal activity. RT was mostly performed for curative intent (78%). 88% of RT were administered during primary therapy. The site of RT was predominantly the local tumor bed (76%). Doses of RT ranged from 15 to 62 Gy (median 50 Gy). Information on target volumes or fractionation were lacking. Median follow-up was 6,9 years and 64% of the patients died of disease, with 33% alive without disease. In 16 of 48 patients with available follow-up data after adjuvant RT (33%) no recurrence was reported and in 3 of 9 patients palliative RT seemed to induce some benefit for the patient.
Conclusions
Our first systematic review on RT for pACC provides too few data for any general recommendation, but adjuvant RT in patients with high risk might be considered. International collaborative studies are urgently needed to establish better evidence on the role of RT in this rare malignancy.
With the increasing adaptability and complexity of advisory artificial intelligence (AI)-based agents, the topics of explainable AI and human-centered AI are moving close together. Variations in the explanation itself have been widely studied, with some contradictory results. These could be due to users’ individual differences, which have rarely been systematically studied regarding their inhibiting or enabling effect on the fulfillment of explanation objectives (such as trust, understanding, or workload). This paper aims to shed light on the significance of human dimensions (gender, age, trust disposition, need for cognition, affinity for technology, self-efficacy, attitudes, and mind attribution) as well as their interplay with different explanation modes (no, simple, or complex explanation). Participants played the game Deal or No Deal while interacting with an AI-based agent. The agent gave advice to the participants on whether they should accept or reject the deals offered to them. As expected, giving an explanation had a positive influence on the explanation objectives. However, the users’ individual characteristics particularly reinforced the fulfillment of the objectives. The strongest predictor of objective fulfillment was the degree of attribution of human characteristics. The more human characteristics were attributed, the more trust was placed in the agent, advice was more likely to be accepted and understood, and important needs were satisfied during the interaction. Thus, the current work contributes to a better understanding of the design of explanations of an AI-based agent system that takes into account individual characteristics and meets the demand for both explainable and human-centered agent systems.
Lack of acid sphingomyelinase (ASM) activity, either through genetic deficiency or through pharmacological inhibition, is linked with increased activity and frequency of Foxp3+ regulatory T cells (Treg) among cluster of differentiation (CD) 4+ T cells in mice in vivo and in vitro1. Thus, pharmacological blockade of ASM activity, which catalyzes the cleavage of sphingomyelin to ceramide and phosphocholine, might be used as a new therapeutic mechanism to correct numeric and/ or functional Treg de-ficiencies in diseases like multiple sclerosis or major depression.
In the present study, the effect of pharmacological inhibition of ASM in humans, in vitro and in vivo, was analyzed. In the in vitro experiments, peripheral blood mono-nuclear cells (PBMC) of healthy human blood donors were treated with two widely prescribed antidepressants with high (sertraline, Ser) or low (citalopram, Cit) capaci-ty to inhibit ASM activity. Similar to the findings in mice an increase in the frequency of Treg among human CD4+ T cells upon inhibition of ASM activity was observed. For the analysis in vivo, a prospective study of the composition of the CD4+ T cell com-partment of patients treated for major depression was done. The data show that pharmacological inhibition of ASM activity was superior to antidepressants with little or no ASM-inhibitory activity in increasing CD45RA- CD25high effector Treg (efTreg) frequencies among CD4+ T cells to normal levels. Independently of ASM inhibition, correlating the data with the clinical response, i.e. improvement of the Hamilton rat-ing scale for depression (HAMD) by at least 50 per cent (%) after four weeks of treatment, it was found that an increase in efTreg frequencies among CD4+ cells dur-ing the first week of treatment identified patients with a clinical response.
Regarding the underlying mechanism, it could be found that the positive effect of ASM inhibition on Treg required CD28 co-stimulation suggesting that enhanced CD28 co-stimulation was the driver of the observed increase in the frequency of Treg among human CD4+ T cells. Inhibition of ASM activity was further associated with changes in the expression and shuttling of CTLA-4, a key inhibitory molecule ex-pressed by Treg, between cellular compartments but the suppressive activity of CTLA-4 through its transendocytosis activity was unaffected by the inhibition of ASM activity.
In summary, the frequency of (effector) Treg among CD4+ T cells in mice and in hu-mans is increased after inhibition of ASM activity suggesting that ASM blockade might beneficially modulate autoimmune diseases and depression-promoting in-flammation.
Landslide susceptibility assessment in the Chiconquiaco Mountain Range area, Veracruz (Mexico)
(2022)
In Mexico, numerous landslides occur each year and Veracruz represents the state with the third highest number of events. Especially the Chiconquiaco Mountain Range, located in the central part of Veracruz, is highly affected by landslides and no detailed information on the spatial distribution of existing landslides or future occurrences is available. This leaves the local population exposed to an unknown threat and unable to react appropriately to this hazard or to consider the potential landslide occurrence in future planning processes.
Thus, the overall objective of the present study is to provide a comprehensive assessment of the landslide situation in the Chiconquiaco Mountain Range area. Here, the combination of a site-specific and a regional approach enables to investigate the causes, triggers, and process types as well as to model the landslide susceptibility for the entire study area.
For the site-specific approach, the focus lies on characterizing the Capulín landslide, which represents one of the largest mass movements in the area. In this context, the task is to develop a multi-methodological concept, which concentrates on cost-effective, flexible and non-invasive methods. This approach shows that the applied methods complement each other very well and their combination allows for a detailed characterization of the landslide.
The analyses revealed that the Capulín landslide is a complex mass movement type. It comprises rotational movement in the upper parts and translational movement in the lower areas, as well as flow processes at the flank and foot area and therefore, is classified as a compound slide-flow according to Cruden and Varnes (1996). Furthermore, the investigations show that the Capulín landslide represents a reactivation of a former process. This is an important new information, especially with regard to the other landslides identified in the study area. Both the road reconstructed after the landslide, which runs through the landslide mass, and the stream causing erosion processes at the foot of the landslide severely affect the stability of the landslide, making it highly susceptible to future reactivation processes. This is particularly important as the landslide is located only few hundred meters from the village El Capulín and an extension of the landslide area could cause severe damage.
The next step in the landslide assessment consists of integrating the data obtained in the site-specific approach into the regional analysis. Here, the focus lies on transferring the generated data to the entire study area. The developed methodological concept yields applicable results, which is supported by different validation approaches.
The susceptibility modeling as well as the landslide inventory reveal that the highest probability of landslides occurrence is related to the areas with moderate slopes covered by slope deposits. These slope deposits comprise material from old mass movements and erosion processes and are highly susceptible to landslides. The results give new insights into the landslide situation in the Chiconquiaco Mountain Range area, since previously landslide occurrence was related to steep slopes of basalt and andesite.
The susceptibility map is a contribution to a better assessment of the landslide situation in the study area and simultaneously proves that it is crucial to include specific characteristics of the respective area into the modeling process, otherwise it is possible that the local conditions will not be represented correctly.
The solvatochromic behavior of two donor-π bridge-acceptor (D-π-A) compounds based on the 2-(3-boryl-2-thienyl)thiazole π-linker and indandione acceptor moiety are investigated. DFT/TD-DFT calculations were performed in combination with steady-state absorption and emission measurements, along with electrochemical studies, to elucidate the effect of two different strongly electron-donating hydrazonyl units on the solvatochromic and fluorescence behavior of these compounds. The Lippert–Mataga equation was used to estimate the change in dipole moments (Δµ) between ground and excited states based on the measured spectroscopic properties in solvents of varying polarity with the data being supported by theoretical studies. The two asymmetrical D-π-A molecules feature strong solvatochromic shifts in fluorescence of up to ~4300 cm\(^{−1}\) and a concomitant change of the emission color from yellow to red. These changes were accompanied by an increase in Stokes shift to reach values as large as ~5700–5800 cm\(^{−1}\). Quantum yields of ca. 0.75 could be observed for the N,N-dimethylhydrazonyl derivative in nonpolar solvents, which gradually decreased along with increasing solvent polarity, as opposed to the consistently reduced values obtained for the N,N-diphenylhydrazonyl derivative of up to ca. 0.20 in nonpolar solvents. These two push–pull molecules are contrasted with a structurally similar acceptor-π bridge-acceptor (A-π-A) compound.