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Effects of Chemical Pressure on Superconductivity in Electrochemically Intercalated (TMA)yFe2(Se1−xSx)2 (TMA = Tetramethylammonium)
Get PDFThe β-modification of FeSe, which has an anti-PbO type structure, achieves superconductivity at 8 K without external doping or pressure and exhibits a nematic phase, which has been crucial for studies of unconventional pairing mechanisms. Although the critical temperature (Tc) in FeSe increases significantly with applied pressure, intercalation, and in thin films, the effect of chemical pressure by replacing selenium with sulfur in FeSe1−xSx has remained unclear. To investigate the effects of chemical pressure, we have synthesized FeSe1−xSx crystals (up to x = 0.52) and intercalated them with tetramethylammonium ions (TMA+). These results show that both Tc and unit cell volume decrease linearly with sulfur content in both host and intercalated (TMA)yFe2(Se1-xSx)2. The remarkable common rate of normalized decrease of Tc suggests that chemical pressure affects the electron-doped intercalates in the same way as the host compounds. This result highlights the unique role of chemical pressure and electron doping in tuning superconductivity in FeSe systems and provides new insights into their complex behavior
World-wide survey on the treatment of peripheral vestibular disorders
Get PDFObjective: The aim of this world-wide survey was to evaluate the currently applied treatment options for the six most frequent peripheral vestibular disorders: benign paroxysmal positional vertigo (BPPV), acute unilateral vestibulopathy (AUVP)/vestibular neuritis, Menière’s disease (MD), bilateral vestibulopathy (BVP), vestibular paroxysmia (VP) and superior canal dehiscence syndrome (SCDS).
Background: For the therapy of vestibular disorders, there are four treatment options: vestibular physical therapy (canalith repositioning maneuvers or balance training), pharmacotherapy, surgery, and psychotherapy. Since there are very few state-of-the-art RCTs, the treatment of vestibular disorders is so far not standardized and various methods are applied with heterogeneous efficacy.
Design/methods: A web-based standardized survey questionnaire on the treatment of the six most frequent peripheral vestibular disorders was used to collect data.
Results: 234 replies from five continents, 47 countries, 162 cities and 188 centers were received: (% from all 234 replies; multiple answers possible): BPPV: posterior canal BPPV: 71% Epley, 40% Semont, and 12% others. Horizontal canal BPPV canalolithiasis: 58% Lempert (roll-over) maneuver, 33% Gufoni, 7% prolonged rest, and 9% others. Horizontal canal BPPV cupulolithiasis: 35% Gufoni, 27% Lempert (roll-over) maneuver, 9% Zuma, and 7% head shaking: AUVP: 79% pharmacotherapy, namely 47% glucocorticoids, 39% antiemetics, and 24% betahistine; 67% vestibular physical therapy. MD: 85% pharmacotherapy, namely 65% betahistine, 21% diuretics, 20% steroids, 16% antiemetics, 14% gentamicin; 37% surgery. VP: 65% pharmacotherapy, namely 57% anticonvulsants; 7% surgery. BVP: 77% vestibular physical therapy. SCDS: 50% surgery, namely 38.8% canal plugging, 23.3% capping and 15.5% resurfacing.
Conclusion: In this world-wide survey with 234 replies from 188 centers, widely heterogeneous applied treatment options were reported for the six most frequent peripheral vestibular disorders. This study shows in particular that certain drugs are often used despite low or very low evidence. Namely in AUVP, MD and VP well-designed controlled trials with clinically meaningful endpoints are needed
Management of high-risk acute pulmonary embolism: an emulated target trial analysis
Get PDFBackground
High-risk acute pulmonary embolism (PE) is a life-threatening condition necessitating hemodynamic stabilization and rapid restoration of pulmonary perfusion. In this context, evidence regarding the benefit of advanced circulatory support and pulmonary recanalization strategies is still limited.
Methods
In this observational study, we assessed data of 1060 patients treated for high-risk acute PE with 991 being included in a target trial emulation to investigate all-cause in-hospital mortality estimates with different advanced treatment strategies. The four treatment groups consisted of patients undergoing (I) veno-arterial extracorporeal membrane oxygenation (VA-ECMO) alone (n = 126), (II) intrahospital systemic thrombolysis (SYS) (n = 643), (III) surgical thrombectomy (ST) (n = 49), and (IV) percutaneous catheter-directed treatment (PCDT) (n = 173). VA-ECMO was allowed as bridging to pulmonary recanalization in groups II, III, and IV. Marginal causal contrasts were estimated using the g-formula with logistic regression models as the primary approach. Sensitivity analyses included targeted maximum likelihood estimation (TMLE) with machine learning, inverse probability of treatment weighting (IPTW), as well as variations of estimands, handling of missing values, and a complete target trial emulation excluding the VA-ECMO alone group.
Results
In the overall target trial population, the median age was 62.0 years, and 53.3% of patients were male. The estimated probability of in-hospital mortality from the primary target trial intention-to-treat analysis for VA-ECMO alone was 57% (95% confidence interval [CI] 47%; 67%), compared to 48% (95% CI 44%; 53%) for intrahospital SYS, 34% (95%CI 18%; 50%) for ST, and 43% (95% CI 35%; 51%) for PCDT. The mortality risk ratios were largely in favor of any advanced recanalization strategy over VA-ECMO alone. The robustness of these findings was supported by all sensitivity analyses. In the crude outcome analysis, patients surviving to discharge had a high probability of favorable neurologic outcome in all treatment groups.
Conclusion
Advanced recanalization by means of SYS, ST, and several promising catheter-directed systems may have a positive impact on short-term survival of patients presenting with high-risk PE compared to the use of VA-ECMO alone as a bridge to recovery
Acetabular Home Run Screw Guidance for Transiliac Fixation in Cup Revision Arthroplasty
Get PDFBackground/Objectives: The growing incidence of acetabular revisions has highlighted the importance of achieving reliable fixation to the remaining bone. Proximal transiliac fixation (TIF) of pelvic implants is becoming an increasingly common approach for managing extensive bone defects. This study seeks to provide guidance on TIF implantation by analyzing the optimal screw placement in partial pelvic replacements for acetabular defects.
Methods: Between 2014 and 2024, a cohort of 96 consecutive patients (65 females and 31 males) who underwent customized partial pelvic replacement (PPR) with transiliac fixation (TIF) were examined. The angle and entry point of the ideal TIF were determined using preoperative three-dimensional planning and compared with potential influencing factors.
Results: All PPRs were successfully implanted, with an average TIF length of 77 mm. The mean anteroposterior angle for TIF was 18° medially and 27° dorsally.
Conclusions: Analysis of the entry point showed concentration around the second radius and between the eleven o'clock and one o'clock positions. The AP angle is notably affected by gender and height. Considering the precision of human judgment, a recommendation for TIF placement would be 20° medial and 30° dorsal deviation, with the entry point around the twelve o'clock position and the second ring from the center of the cup
Does the habitual dietary intake of adults in Bavaria, Germany, match dietary intake recommendations? Results of the 3rd Bavarian Food Consumption Survey
Get PDFRegional variations in healthcare in people living with dementia in Germany: protocol for a mixed-methods study
Get PDFIntroduction: Care for people living with dementia is both important and complex, and there is evidence of large regional variations in the quality of care. This study protocol describes design, methods and objectives of an investigation of regional variations in the utilisation, the quality and the costs of care for people living with dementia in Germany.
Methods and analysis: An exploratory, naturalistic, mixed-methods study is being conducted with three modules: Module A: A quantitative analysis of claims data of statutory health insurance will be conducted to investigate regional variations in the utilisation and costs of care. Module B: In selected regions of interest that deviate significantly from the average in terms of utilisation in Module A, the quality of care and patient characteristics, variations and possible causes of these variations in care will be examined in more detail using quantitative and qualitative assessments. Module C: The claims and primary data from modules A and B will be combined, synthesised and evaluated to elicit recommendations for regional healthcare using a participatory consensus method.
Ethics and dissemination: The study is overseen by the German Alzheimer's Association. The study's ethics and data protection plan was approved by the data and ethics committee of the leading university, Brandenburg Medical School Theodor Fontane (reference number: 152092023-BO-E) as well as the data committee of the three participating health insurances. Dissemination plans include dissemination of our main results to the general public, people affected, the scientific community and funding-, policy- and decision makers. Study outcomes and conclusions will be published on our own and the funder's websites, through presentations at conferences and in scientific journals. The funder ensures dissemination of main study results and recommendations for action to relevant organisations and institutions. Publication of the study's main results is planned within 6 months of the study's conclusion.
Trial registration number: DRKS00031944 (https://trialsearch.who.int/Trial2.aspx?TrialID=DRKS00031944)
Weaponizing Wedge Issues: Strategies of Populism and Illiberalism in European Election Campaigning on Facebook
Get PDFImpact of heat stress and protective clothing on healthcare workers: health, performance, and well-being in hospital settings
Get PDFDas Erstarken der türkischen Rechten in Deutschland: Eine Analyse aus politisch-theoretischer Perspektive
Get PDFHelicobacter pylori CagT4SS proteins CagN and CagM bind DNA and CagN is involved in heptose-independent pro-inflammatory substrate translocation by the T4SS
Get PDFThe Cag type 4 secretion system (CagT4SS) of Helicobacter pylori is encoded on the cag pathogenicity island (cagPAI) that is present in about 60 % of all strains. It translocates the effector protein CagA, DNA and small bacterial metabolites into human cells. The transport mechanisms of these substrates are not clear and may involve Cag proteins still in search of a function. CagN is a partially surface-exposed CagT4SS protein with a poorly described function. The cagN gene is present in all cagPAI-positive strains and thus likely to be of importance and indispensable for the functionality of the T4SS. CagM is an essential structural component located within the outer membrane core complex of the CagT4SS in the bacterial outer membrane. CagM has a close genomic association and interacts directly with CagN. In this study, we addressed two questions on the basis of prior findings of T4SS-dependent DNA transport and TLR9 activation by H. pylori in host cells. First, we analyzed the role of CagN and CagM in the binding of the presumed CagT4SS substrate DNA. Second, we attempted to elucidate a presumed functional role of CagN in heptose-independent T4SS substrate translocation which may lead to pro-inflammatory activation in human cells. Using electrophoretic mobility shift assays (EMSA) and thermal shift assays (TSA), we found that both CagM and CagN interact with dsDNA. They can also act as nucleases and cleave DNA. Since the transport of substrates through the CagT4SS is likely ATP-driven, we also determined whether CagM and CagN can process ATP, which tested positive for both proteins. Co-incubating H. pylori with human TIFA-k/o cells, which no longer respond to the bacterial translocated effector heptose, but can still be activated by DNA, we established a phenotype of loss of heptose-independent pro-inflammatory activity with H. pylori cagN mutants that could be reversed by complementation. Our results propose an important role for CagN and CagM to bind DNA which might impact or be involved in the transport of substrates such as DNA, through the CagT4SS