6112 research outputs found
Sort by
Management and outcome of patients with chronic myeloid leukemia in blast phase in the tyrosine kinase inhibitor era – analysis of the European LeukemiaNet Blast Phase Registry
Get PDFBlast phase (BP) of chronic myeloid leukemia (CML) still represents an unmet clinical need with a dismal prognosis. Due to the rarity of the condition and the heterogeneity of the biology and clinical presentation, prospective trials and concise treatment recommendations are lacking. Here we present the analysis of the European LeukemiaNet Blast Phase Registry, an international collection of the clinical presentation, treatment and outcome of blast phases which had been diagnosed in CML patients after 2015. Data reveal the expected heterogeneity of the entity, lacking a clear treatment standard. Outcomes remain dismal, with a median overall survival of 23.8 months (median follow up 27.8 months). Allogeneic stem cell transplantation (alloSCT) increases the rate of deep molecular responses. De novo BP and BP evolving from a previous CML do show slightly different features, suggesting a different biology between the two entities. Data show that outside clinical trials and in a real-world setting treatment of blast phase is individualized according to disease- and patient-related characteristics, with the aim of blast clearance prior to allogeneic stem cell transplantation. AlloSCT should be offered to all patients eligible for this procedure
Analysen zur Wirksamkeit der gezielten individuellen Förderung von sozial-emotionalen Kompetenzen in Kindertageseinrichtungen in Mecklenburg-Vorpommern nach dem Kindertagesförderungsgesetz M-V auf die Erhöhung der Chancengleichheit zum Schulbeginn
Get PDFSozial-emotionale Kompetenzen sind valide Prädiktoren für die Schulfähigkeit und den anschließenden Schulerfolg. Aus diesem Grund ist es sinnvoll, möglichst frühzeitig die sozial-emotionale Entwicklung von Kindern zu screenen und gezielte Fördermaßnahmen einzuleiten. Hierfür eignet sich das Setting Kita, da aufgrund der hohen Betreuungsquote fast alle Kinder unabhängig von dem Sozialstatus oder anderen Faktoren erreicht werden können.
Das Kindertagesförderungsgesetz M-V stellt zusätzliche Landemittel für die gezielte individuelle Förderung von Kindern mit Entwicklungsverzögerungen im u.a. im sozial-emotionalen Bereich speziell für Kinder in Kitas aus sozialen Brennpunkten bereit. Ein Kriterium für den Erhalt dieser zusätzlichen Landesmittel ist die jährliche Durchführung des standardisierten und validen Screening-Instrumentes „DESK 3-6 R“ zur Früherkennung von Entwicklungsgefährdungen bei allen 3- bis 6-Jähirgen über einen Zeitraum von mindestens 3 Jahren. Weiterhin sollen Kinder mit einer Entwicklungsgefä
Effects of occlusal wear on 16‐year progression of non‐carious cervical lesions–Results of the study of health in Pomerania (SHIP‐START)
Get PDFBackground
It is still discussed whether occlusal wear (OW) affects the formation of non‐carious cervical lesions (NCCLs).
Objective
To estimate effects of OW on the presence and development of NCCLs, using 16‐year follow‐up data from a cohort study.
Methods
Occlusal and cervical defects were measured in 728 cast models (one from the upper jaw and one from the lower jaw) of 364 participants. Adjusted mixed‐effects ordinal logistic models analysing estimated cross‐sectional (N = 1308 teeth/291 subjects) and longitudinal (N = 718 teeth/226 subjects) associations of OW with NCCLs using tooth level data.
Results
OW size was cross‐sectionally (OR = 1.74; 95% CI: 1.27–2.38 for OW size; OR = 0.97; 95% CI: 0.94–0.99 for squared OW size), but not longitudinally (OR = 1.14; 95% CI: 0.99–1.30) associated with odds of higher NCCL sizes. For cross‐sectional analyses, predicted probabilities of an NCCL size of 0 decreased from about 0.996 to 0.010 for OW sizes of 0 to 25.
Conclusion
Results suggest an association between OW and NCCL size. However, as longitudinal results were non‐significant, while consistent in direction, large‐scaled cohort studies are demanded to more precisely estimate effect strength
About the quantum‐kinetic derivation of boundary conditions for quasiparticle Boltzmann equations at interfaces
Get PDFQuite a many electron transport problems in condensed matter physics are analyzed with a quasiparticle Boltzmann equation. For sufficiently slowly varying weak external potentials it can be derived from the basic equations of quantum kinetics, provided quasiparticles can be defined and lead to a pole in the quantum‐mechanical propagators. The derivation breaks down, however, in the vicinity of an interface which constitutes an abrupt strong perturbation of the system. In this contribution we discuss in a tutorial manner a particular technique to systematically derive, for a planar, nonideal interface, matching conditions for the quasi‐particle Boltzmann equation. The technique is based on pseudizing the transport problem by two auxiliary interface‐free systems and matching Green functions at the interface. Provided quasiparticles exist in the auxiliary systems, the framework can be put onto the semiclassical level and the desired boundary conditions result. For ideal interfaces, the conditions can be guessed from flux conservation, but for complex interfaces this is no longer the case. The technique presented in this work is geared toward such interfaces
Changes in MRI Workflow of Multiple Sclerosis after Introduction of an AI-Software: A Qualitative Study
Get PDFThe purpose of this study was to explore the effects of the integration of machine learning into daily radiological diagnostics, using the example of the machine learning software mdbrain ® (Mediaire GmbH, Germany) in the diagnostic MRI workflow of patients with multiple sclerosis at the University Medicine Greifswald. The data were assessed through expert interviews, a comparison of analysis times with and without the machine learning software, as well as a process analysis of MRI workflows. Our results indicate a reduction in the screen-reading workload, improved decision-making regarding contrast administration, an optimized workflow, reduced examination times, and facilitated report communication with colleagues and patients. Our results call for a broader and quantitative analysis
Lipidation of pneumococcal proteins enables activation of human antigen-presenting cells and initiation of an adaptive immune response
Get PDFStreptococcus pneumoniae remains a significant global threat, with existing vaccines having important limitations such as restricted serotype coverage and high manufacturing costs. Pneumococcal lipoproteins are emerging as promising vaccine candidates due to their surface exposure and conservation across various serotypes. While prior studies have explored their potential in mice, data in a human context and insights into the impact of the lipid moiety remain limited. In the present study, we examined the immunogenicity of two pneumococcal lipoproteins, DacB and MetQ, both in lipidated and non-lipidated versions, by stimulation of primary human immune cells. Immune responses were assessed by the expression of common surface markers for activation and maturation as well as cytokines released into the supernatant. Our findings indicate that in the case of MetQ lipidation was crucial for activation of human antigen-presenting cells such as dendritic cells and macrophages, while non-lipidated DacB demonstrated an intrinsic potential to induce an innate immune response. Nevertheless, immune responses to both proteins were enhanced by lipidation. Interestingly, following stimulation of dendritic cells with DacB, LipDacB and LipMetQ, cytokine levels of IL-6 and IL-23 were significantly increased, which are implicated in triggering potentially important Th17 cell responses. Furthermore, LipDacB and LipMetQ were able to induce proliferation of CD4+ T cells indicating their potential to induce an adaptive immune response. These findings contribute valuable insights into the immunogenic properties of pneumococcal lipoproteins, emphasizing their potential role in vaccine development against pneumococcal infections
Normative Values for Sternoclavicular Joint and Clavicle Anatomy Based on MR Imaging: A Comprehensive Analysis of 1591 Healthy Participants
Get PDFBackground: The clavicle remains one of the most fractured bones in the human body, despite the fact that little is known about the MR imaging of it and the adjacent sternoclavicular joint. This study aims to establish standardized values for the diameters of the clavicle as well as the angles of the sternoclavicular joint using whole-body MRI scans of a large and healthy population and to examine further possible correlations between diameters and angles and influencing factors like BMI, weight, height, sex, and age. Methods: This study reviewed whole-body MRI scans from the Study of Health in Pomerania (SHIP), a German population-based cross-sectional study in Mecklenburg–Western Pomerania. Descriptive statistics, as well as median-based regression models, were used to evaluate the results. Results: We could establish reference values based on a shoulder-healthy population for each clavicle parameter. Substantial differences were found for sex. Small impacts were found for height, weight, and BMI. Less to no impact was found for age. Conclusions: This study provides valuable reference values for clavicle and sternoclavicular joint-related parameters and shows the effects of epidemiological features, laying the groundwork for future studies. Further research is mandatory to determine the clinical implications of these findings
Enhanced dispersal capacity in edge population individuals of a rapidly expanding butterfly
Get PDFNatural range shifts offer the opportunity to study the phenotypic and genetic changes contributing to colonization success. The recent range shift of the Southern small white butterfly (Pieris mannii) from the South to the North of Europe offers a prime example to examine a potential dispersal syndrome in range-expanding individuals. We compared butterflies from the core and edge populations using a multimodal approach addressing behavioral, physiological, and morphological traits related to dispersal capacity. Relative to individuals from the core range (France), individuals from the edge (Germany) showed a higher capacity and motivation to fly, and a higher flight metabolic rate. They were also smaller, which may enhance their flight maneuverability and help them cope with limited resource availability, thereby increasing their settlement success in novel environments. Altogether, the behavioral, physiological, and morphological differences observed between core and edge populations in P. mannii suggest the existence of a dispersal syndrome in range-expanding individuals. Whether these differences result from genetic and/or phenotypic responses remains, however, to be determined
Urine-Based Biomarker Test Uromonitor® in the Detection and Disease Monitoring of Non-Muscle-Invasive Bladder Cancer—A Systematic Review and Meta-Analysis of Diagnostic Test Performance
Get PDFSimple Summary
Better tests are needed to detect serious bladder cancer (BC), additionally avoiding unnecessary follow-up tests. This study looked at Uromonitor®, a urine-based test, which checks for specific changes in DNA related to BC. Previous tests were good but not perfect, and more information is needed to use this new one in daily routine. We gathered and analyzed data from four studies using Uromonitor®, involving nearly 1200 urine tests. Results showed that Uromonitor® detects existing BC with an accuracy of over 90%. It rarely indicates BC in cases where BC is absent (reaching 97% accuracy). In comparison with urinary cytology, Uromonitor® spotted BC better. If applied in a group of 1000 people including around 15% with active BC, this test could prevent about 825 unnecessary cystoscopies while missing around 30 BC cases. However, more studies are needed to finally confirm the performance of Uromonitor®.
Abstract
Optimal urine-based diagnostic tests (UBDT) minimize unnecessary follow-up cystoscopies in patients with non-muscle-invasive bladder-cancer (NMIBC), while accurately detecting high-grade bladder-cancer without false-negative results. Such UBDTs have not been comprehensively described upon a broad, validated dataset, resulting in cautious guideline recommendations. Uromonitor®, a urine-based DNA-assay detecting hotspot alterations in TERT, FGFR3, and KRAS, shows promising initial results. However, a systematic review merging all available data is lacking. Studies investigating the diagnostic performance of Uromonitor® in NMIBC until November 2023 were identified in PubMed, Embase, Web-of-Science, Cochrane, Scopus, and medRxiv databases. Within aggregated analyses, test performance and area under the curve/AUC were calculated. This project fully implemented the PRISMA statement. Four qualifying studies comprised a total of 1190 urinary tests (bladder-cancer prevalence: 14.9%). Based on comprehensive analyses, sensitivity, specificity, positive-predictive value/PPV, negative-predictive value/NPV, and test accuracy of Uromonitor® were 80.2%, 96.9%, 82.1%, 96.6%, and 94.5%, respectively, with an AUC of 0.886 (95%-CI: 0.851–0.921). In a meta-analysis of two studies comparing test performance with urinary cytology, Uromonitor® significantly outperformed urinary cytology in sensitivity, PPV, and test accuracy, while no significant differences were observed for specificity and NPV. This systematic review supports the use of Uromonitor® considering its favorable diagnostic performance. In a cohort of 1000 patients with a bladder-cancer prevalence of ~15%, this UBDT would avert 825 unnecessary cystoscopies (true-negatives) while missing 30 bladder-cancer cases (false-negatives). Due to currently limited aggregated data from only four studies with heterogeneous quality, confirmatory studies are needed
Broadband Alfvénic excitation & mode characterization in the Wendelstein 7-X stellarator plasmas
Get PDFShear Alfvén waves (SAWs) can be important in plasma magnetohydrodynam-
ics (MHD) stability. In the Wendelstein 7-X (W7-X) stellarator plasmas, Alfvénic
fluctuations have been identified in routine plasma scenarios of the opera-
tional phase (OP) known as OP1.2b. Magnetic fluctuations between f = 100 −
200 kHz are measured using a system of Mirnov coils. The work presented
in the thesis aims to contribute to the physics understanding of SAWs in fu-
sion plasmas without externally driven fast ions. The dynamics of a broad
frequency range of SAWs in W7-X plasmas are analyzed. The time variations
of frequency, amplitude, and width of frequency bands of the magnetic fluc-
tuations’ spectra are determined using a new analysis method, the so-called
tracking method. The SAW variations are correlated to global plasma param-
eters during W7-X plasmas. The new tracking method enabled determining
the role of different plasma parameters in the observed variations of the SAW
spectral properties. This thesis furthermore discusses potential couplings be-
tween SAWs and ITG-driven turbulent modes to explain amplitude variations
of SAWs.Scher-Alfvén-Wellen (SAWs) können für die Stabilität der Magnetohydrodynamik (MHD) in Plasmen von Bedeutung sein. In den Stellaratorplasmen von Wendelstein 7-X (W7-X) wurden Alfvénische Fluktuationen in routinemäßigen Plasmaszenarien der Betriebsphase (OP), bekannt als OP1.2b, identifiziert. Magnetische Fluktuationen im Bereich von f = 100 − 200 kHz werden mit einem System von Mirnov-Spulen gemessen. Die in dieser Arbeit vorgestellten Untersuchungen zielen darauf ab, zum physikalischen Verständnis von SAWs in Fusionsplasmen ohne extern getriebene schnelle Ionen beizutragen. Die Dynamik eines breiten Frequenzspektrums von SAWs in den W7-X-Plasmen wird analysiert. Zeitliche Schwankungen von Frequenz, Amplitude und Bandbreite der Spektren der magnetischen Fluktuationen werden mit einer neuen Analysemethode, der sogenannten Tracking-Methode, ermittelt. Die SAW-Variationen werden mit globalen Plasmaparametern in den W7-X-Plasmen korreliert. Durch die neue Tracking-Methode konnte die Rolle verschiedener Plasmaparameter bei den beobachteten Variationen der SAW-Spektraleigenschaften bestimmt werden. Darüber hinaus werden in dieser Arbeit mögliche Kopplungen zwischen SAWs und ITG-getriebenen turbulenten Moden diskutiert, um die Amplitudenvariationen der SAWs zu erklären