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A literary criticism is presented for German librettist Georg Philipp Harsdörffer's work "Seelewig." Descriptions are given of the allegorical elements of the libretto. The author also discusses the hermeneutics of the piece, while addressing the influence of the Jesuit branch of Roman Catholicism on "Seelewig."

Background: Patients transitioning between different care contexts are at increased risk of experiencing adverse events. In particular, being discharged to home after inpatient treatment involves significant risks. However, there is a lack of valid and internationally comparable assessment tools on patients' experiences of difficulties following hospital discharge. Therefore, this study aimed to adapt and validate the German version of the post-discharge coping difficulty scale (PDCDS-G). Methods: Patients were recruited at a German university hospital. 815 adult patients participated in a self-report survey following an inpatient stay of at least three days. Factorial validity of the PDCDS-G was evaluated via factor analyses. Further, examination of measurement invariance was performed. To establish criterion validity, associations with patients' self-reported health status and occurrence of patient safety were determined. Further, group differences regarding patient characteristics, hospitalization factors, and survey-related variables were examined. Results: Factorial validity of the PDCDS-G was confirmed by a two-factorial model with good model fit. Both factors showed good to excellent reliability. The two-factor model achieved measurement invariance across all patient characteristics, hospitalization factors, and survey-related variables. Significant relationships with patients' health status and the occurrence of patient safety incidents corroborate criterion validity of the PDCDS-G. Differential associations of the two PDCDS-G factors regarding patient characteristics, hospitalization, and survey-related variables were found. Discussion: Construct and criterion validity, as well as the reliability of the PDCDS-G, were verified. Further, instrument's measurement invariance was confirmed allowing use of the scale for the interpretation of group differences and comparisons between studies. Conclusions: The PDCDS-G provides a validated and comparable patient-reported outcomes measure for patient experiences after hospital discharge to home. The PDCDS-G can be used for patient surveys in quality or patient safety improvement in care transition processes. [ABSTRACT FROM AUTHOR]

E-mental health (EMH) interventions gain increasing importance in the treatment of mental health disorders. Their outpatient efficacy is well-established. However, research on EMH in inpatient settings remains sparse and lacks a meta-analytic synthesis. This paper presents a meta-analysis on the efficacy of EMH in inpatient settings. Searching multiple databases (PubMed, ScienceGov, PsycInfo, CENTRAL, references), 26 randomized controlled trial (RCT) EMH inpatient studies (n = 6112) with low or medium assessed risk of bias were included. A small significant total effect of EMH treatment was found (g = 0.3). The effect was significant both for blended interventions (g = 0.42) and post-treatment EMH-based aftercare (g = 0.29). EMH treatment yielded significant effects across different patient groups and types of therapy, and the effects remained stable post-treatment. The results show the efficacy of EMH treatment in inpatient settings. The meta-analysis is limited by the small number of included studies. [ABSTRACT FROM AUTHOR]

Purpose: Metabolic and bariatric surgery (MBS) is the gold standard in treating severe obesity. Previous research implies that different psychological and behavior-related factors might be critical for MBS' sustained success. Yet adherence to dietary behavior recommendations and its impact on weight development is rarely examined. This study investigated the relationship between adherence to dietary behavior recommendations and the percentage of total weight loss (%TWL) after MBS. Materials and Methods: This study is a cohort study (acquisition in Germany). N = 485 patients after MBS, being in grade III of obesity (body mass index (BMI) ≥ 40 kg/m2) pre-MBS, were included. Participants answered a standardized assessment on the relevant constructs, including adherence to dietary behavior recommendations, depression symptoms, weight, diet, and MBS characteristics. Results: BMI pre-MBS, type of MBS, age, regularity of physical activity, and depression symptoms were identified as significant covariates of %TWL and adherence. Within 6 months after MBS, adherence seems to peak, F(5,352) = 12.35, p <.001. Adherence and time since MBS predict %TWL. A higher adherence (moderator) is related to a higher %TWL, R2 = 52.65%, F(13,344) = 31.54, p <.001. Conclusion: After MBS, adherence to dietary behavior recommendations seems crucial for maximizing its success. Implications for the optimization of MBS' success in aftercare management arise. In particular, behavior modification interventions should be routinely implemented. [ABSTRACT FROM AUTHOR]

Objective: This systematic review aims to elucidate the diagnostic capabilities of imaging techniques in identifying Non-Occlusive Hepatic Artery Hypoperfusion Syndrome (NOHAH) and to evaluate the efficacy and outcomes of splenic artery embolization (SAE), including the choice and placement of embolic agents. Materials and methods: A comprehensive literature search was conducted using PubMed, CINAHL, and Scopus databases, adhering to PRISMA guidelines. Fifteen studies encompassing 240 patients treated with embolization (using coils or Amplatzer Vascular Plugs (AVP)) were analyzed. Key metrics assessed included patient demographics, embolization techniques, embolic agents, technical success, radiologic findings pre- and post-embolization, and complication rates. Results: Among the 240 patients studied, 177 (73.8%) were reported by gender, with a majority being male (127/177, 71.7%). Doppler ultrasonography (DUS) emerged as the primary initial screening tool in 80% of studies. The hepatic arterial resistive index (RI) was a critical parameter, with mean values significantly decreasing from 0.84 pre-embolization to 0.70 post-embolization (p < 0.001). All cases confirmed technical success via digital subtraction angiography, revealing delayed hepatic arterial filling without stenosis or thrombosis. Coils were the predominant embolic agent, used in 80.8% of patients, followed by AVP in 16.3%. The overall mortality rate was 4.58%, with 29 major and 3 minor complications noted. Notably, proximal placement of coils in the splenic artery was associated with lower mortality rates compared to distal placement and showed comparable complication rates to AVPs. Conclusion: DUS is a reliable screening modality for NOHAH, with post-SAE assessments showing significant improvements. The choice and location of embolization significantly impact patient outcomes, with proximal placement of coils emerging as a preferable strategy due to lower mortality rates and comparable complication profiles to alternative methods. [ABSTRACT FROM AUTHOR]

Purpose: Monocular SLAM algorithms are the key enabling technology for image-based surgical navigation systems for endoscopic procedures. Due to the visual feature scarcity and unique lighting conditions encountered in endoscopy, classical SLAM approaches perform inconsistently. Many of the recent approaches to endoscopic SLAM rely on deep learning models. They show promising results when optimized on singular domains such as arthroscopy, sinus endoscopy, colonoscopy or laparoscopy, but are limited by an inability to generalize to different domains without retraining. Methods: To address this generality issue, we propose OneSLAM a monocular SLAM algorithm for surgical endoscopy that works out of the box for several endoscopic domains, including sinus endoscopy, colonoscopy, arthroscopy and laparoscopy. Our pipeline builds upon robust tracking any point (TAP) foundation models to reliably track sparse correspondences across multiple frames and runs local bundle adjustment to jointly optimize camera poses and a sparse 3D reconstruction of the anatomy. Results: We compare the performance of our method against three strong baselines previously proposed for monocular SLAM in endoscopy and general scenes. OneSLAM presents better or comparable performance over existing approaches targeted to that specific data in all four tested domains, generalizing across domains without the need for retraining. Conclusion: OneSLAM benefits from the convincing performance of TAP foundation models but generalizes to endoscopic sequences of different anatomies all while demonstrating better or comparable performance over domain-specific SLAM approaches. Future research on global loop closure will investigate how to reliably detect loops in endoscopic scenes to reduce accumulated drift and enhance long-term navigation capabilities. [ABSTRACT FROM AUTHOR]

Purpose: Preoperative imaging plays a pivotal role in sinus surgery where CTs offer patient-specific insights of complex anatomy, enabling real-time intraoperative navigation to complement endoscopy imaging. However, surgery elicits anatomical changes not represented in the preoperative model, generating an inaccurate basis for navigation during surgery progression. Methods: We propose a first vision-based approach to update the preoperative 3D anatomical model leveraging intraoperative endoscopic video for navigated sinus surgery where relative camera poses are known. We rely on comparisons of intraoperative monocular depth estimates and preoperative depth renders to identify modified regions. The new depths are integrated in these regions through volumetric fusion in a truncated signed distance function representation to generate an intraoperative 3D model that reflects tissue manipulation Results: We quantitatively evaluate our approach by sequentially updating models for a five-step surgical progression in an ex vivo specimen. We compute the error between correspondences from the updated model and ground-truth intraoperative CT in the region of anatomical modification. The resulting models show a decrease in error during surgical progression as opposed to increasing when no update is employed. Conclusion: Our findings suggest that preoperative 3D anatomical models can be updated using intraoperative endoscopy video in navigated sinus surgery. Future work will investigate improvements to monocular depth estimation as well as removing the need for external navigation systems. The resulting ability to continuously update the patient model may provide surgeons with a more precise understanding of the current anatomical state and paves the way toward a digital twin paradigm for sinus surgery [ABSTRACT FROM AUTHOR]

The treatment landscape in multiple myeloma (MM) is shifting from genotoxic drugs to immunotherapies. Monoclonal antibodies, immunoconjugates, T-cell engaging antibodies and CART cells have been incorporated into routine treatment algorithms, resulting in improved response rates. Nevertheless, patients continue to relapse and the underlying mechanisms of resistance remain poorly understood. While Impaired death receptor signaling has been reported to mediate resistance to CART in acute lymphoblastic leukemia, this mechanism yet remains to be elucidated in context of novel immunotherapies for MM. Here, we describe impaired death receptor signaling as a novel mechanism of resistance to T-cell mediated immunotherapies in MM. This resistance seems exclusive to novel immunotherapies while sensitivity to conventional anti-tumor therapies being preserved in vitro. As a proof of concept, we present a confirmatory clinical case indicating that the FADD/BID axis is required for meaningful responses to novel immunotherapies thus we report impaired death receptor signaling as a novel resistance mechanism to T-cell mediated immunotherapy in MM. Defect in the death receptor signally caused by impaired FADD/BID expression leads to failure of T-cell mediated immunotherapy in multiple myeloma patients. [ABSTRACT FROM AUTHOR]

Illness representations explain the individual's perception and processing of health-related information. In a chronic condition such as persistent pain, illness representations might influence treatment adherence and outcome. This study aims to exploratively identify illness representations of patients with chronic pain and their association to mental disorders and subjective distress. 95 participants admitted to an inpatient university clinic were included. Validated instruments were used to assess illness representations (IPQ-R), mental health disorders (PHQ-D), and subjective distress (PSQ). Sociodemographic data and scores for the instruments were first inspected descriptively. Correlation, regression, and mediator analyses were conducted. Analyses indicated that the distributions of the IPQ-R range toward higher values. In regard to mental disorders (PHQ-D) and subjective distress (PSQ), we found several significant correlations with subscales of the IPQ-R. A regression analysis showed the IPQ-R subscales personal control, emotional representation and sex (males) to be significant predictors of subjective distress measured with the PSQ (F(11,86) = 11.55, p <.001, adjusted R2 = 0.545). Depression, anxiety, and stress syndromes (PHQ-D) significantly mediated the positive association between emotional representations (IPQ-R, predictor) and subjective distress (PSQ, outcome) with a total effect of c =.005, 95% CI [.005;.129]. Illness representations play a significant role in evaluating patients' subjective distress and mental health. It is advised to incorporate illness representations into standard protocols for psychological interventions to comprehend their influence on targeted therapeutic strategies, particularly those tailored for pain management. [ABSTRACT FROM AUTHOR]

COVID-19, Fatigue, Long COVID, Neurological deficits, Neuropsychological assessment, Post-COVID, Somatization Of note, we have in the meantime examined more than 1000 people with post-COVID-19 syndrome in our post-COVID outpatient center, and the diagnostic results gathered so far are very similar to those published here. Keywords: COVID-19; Fatigue; Long COVID; Neurological deficits; Neuropsychological assessment; Post-COVID; Somatization EN COVID-19 Fatigue Long COVID Neurological deficits Neuropsychological assessment Post-COVID Somatization 333 336 4 01/16/23 20230201 NES 230201 This reply refers to the comment available at DOI https://doi.org/10.1007/s40120-022-00426-9 To the Editors We thank Vink and colleagues [[1]] for their critical appraisal of our study [[2]]. [Extracted from the article]

Bacterial tropone natural products play important roles in symbiotic interactions, e. g., as protective antibiotics or toxins. Remarkably, their biosynthesis relies on an interweaving of primary and secondary metabolism. Accordingly, the sequestration of a shunt product from aromatic catabolism by a non-canonical flavoenzyme leads to an advanced biosynthetic intermediate. The enzyme hereby operates as a novel dioxygenase that activates O2 for CoA thioester bond cleavage and ring epoxidation. [ABSTRACT FROM AUTHOR]

Purpose: Patients with cancer suffer from a wide range of psychological distress. Nevertheless, in the literature low utilization rates of psychooncological services are reported. Various factors may influence the utilization of professional support during inpatient care. Up to now it is unclear to what extent patients' attitude towards psychooncological support and physicians' recommendation for psychooncological care may influence the utilization. Methods: In a multicenter longitudinal observational study in Comprehensive Cancer Centers Germany, 1398 patients with mixed cancer diagnoses were assessed at baseline during their hospital stay with respect to psychooncological distress and the need for and use of psychooncological services. Results: Psychooncological support was used by almost 28.4% of patients up to this time. A positive attitude towards psychooncological support was reported by 41.6%. A recommendation of psychooncological support by a physician was received by 16.2%. These patients reported a significant higher level of distress compared to patients who did not received a recommendation. Multivariable logistic regression detected that the utilization rate was 3.79 times higher among patients with positive attitude towards psychooncological support (OR, 3.79; 95% CI 2.51–5.73, p < 0.001). Utilization was 4.21 times more likely among patients who received a physician´s recommendation (OR, 4.21; 95% CI 2.98–5.95, p < 0.001). Conclusion: The results of the study provide evidence of the relevance of giving more attention to psychooncological distress and attitudes towards psychooncological care. To reduce reservations, patients need low-threshold information about the psychooncological services offered. [ABSTRACT FROM AUTHOR]

Purpose: The availability of real data from areas with high privacy requirements, such as the medical intervention space is low and the acquisition complex in terms of data protection. To enable research for assistance systems in the medical intervention room, new methods for data generation for these areas must be researched. Therefore, this work presents a way to create a synthetic dataset for the medical context, using medical clothing object detection as an example. The goal is to close the reality gap between the synthetic and real data. Methods: Methods of 3D-scanned clothing and designed clothing are compared in a Domain-Randomization and Structured-Domain-Randomization scenario using two different rendering engines. Additionally, a Mixed-Reality dataset in front of a greenscreen and a target domain dataset were used while the latter is used to evaluate the different datasets. The experiments conducted are to show whether scanned clothing or designed clothing produce better results in Domain Randomization and Structured Domain Randomization. Likewise, a baseline will be generated using the mixed reality data. In a further experiment it is investigated whether the combination of real, synthetic and mixed reality image data improves the accuracy compared to real data only. Results: Our experiments show, that Structured-Domain-Randomization of designed clothing together with Mixed-Reality data provide a baseline achieving 72.0% mAP on the test dataset of the clinical target domain. When additionally using 15% (99 images) of available target domain train data, the gap towards 100% (660 images) target domain train data could be nearly closed 80.05% mAP (81.95% mAP). Finally, we show that when additionally using 100% target domain train data the accuracy could be increased to 83.35% mAP. Conclusion: In conclusion, it can be stated that the presented modeling of health professionals is a promising methodology to address the challenge of missing datasets from medical intervention rooms. We will further investigate it on various tasks, like assistance systems, in the medical domain. [ABSTRACT FROM AUTHOR]

Background: Small bowel adenocarcinoma (SBA) remains a rare malignancy accounting for less than 5% of all the gastrointestinal tract cancers. However, only limited data and expert guidelines are available for this entity. As a result, treatment concepts are predominantly derived from colorectal cancer. Methods: To substantiate data on the course of disease, diagnosis and treatment of SBA, we performed a population-based analysis from a Bavarian population of 2.2 million people. Results: We identified 223 patients with SBA. Mean age at diagnosis was 67.8 years and patients were diagnosed rather late (34.5% UICC stage IV). Largest proportion of these patients were diagnosed with adenocarcinoma of the duodenum (132 patients, 59.2%) and most patients were diagnosed with late stage cancer, stage IV (70 patients, 31.4%). With respect to treatment, most patients underwent primary surgery (187 patients, 84.6%). Systemic therapy seemed to have an impact in UICC stage IV patients but not in UICC stage IIB or III. The 5-year survival rate was 29.0%. This was significantly less compared to colon cancer in the same cohort, which was 50.0%. Furthermore, median survival of patients with small bowel cancer was only 2.0 years (95% CI 1.4–2.5) compared to 4.9 years (95% CI 4.8–5.1) of patients with colon cancer. Conclusion: SBA showed a distinct epidemiology compared to colon cancer. Thus, data acquisition particularly on systemic treatment are paramount, with the objective to complement the available guidelines. [ABSTRACT FROM AUTHOR]

Purpose: The effect of the duration of an educational rotation presented at a palliative care unit on the palliative care knowledge gain and the increase of palliative care self-efficacy expectations are unclear. Methods: This national prospective multicenter pre–post survey conducted at twelve German University Comprehensive Cancer Centers prospectively enrolled physicians who were assigned to training rotations in specialized palliative care units for three, six, or twelve months. Palliative care knowledge [in %] and palliative care self-efficacy expectations [max. 57 points] were evaluated before and after the rotation with a validated questionnaire. Results: From March 2018 to October 2020, questionnaires of 43 physicians were analyzed. Physicians participated in a 3- (n = 3), 6- (n = 21), or 12-month (n = 19) palliative care rotation after a median of 8 (0–19) professional years. The training background of rotating physicians covered a diverse spectrum of specialties; most frequently represented were medical oncology (n = 15), and anesthesiology (n = 11). After the rotation, median palliative care knowledge increased from 81.1% to 86.5% (p <.001), and median palliative care self-efficacy expectations scores increased from 38 to 50 points (p <.001). The effect of the 12-month rotation was not significantly greater than that of the 6-month rotation. Conclusion : An educational rotation presented in a specialized palliative care unit for at least six months significantly improves palliative care knowledge and palliative care self-efficacy expectations of physicians from various medical backgrounds. [ABSTRACT FROM AUTHOR]

Electroencephalographic neurofeedback (EEG NF) can improve quality of life (QoL) and reduce distress by modifying the amplitude of selected brain frequencies. This study aims to investigate the effects of NF therapy on QoL and self-efficacy in cancer patients and to explore age-related reactions. In a waitlist control paradigm, psychometric data (EORTC QLQ-C30, General Self-Efficacy Scale) of 20 patients were collected at three different time points, each five weeks apart. An outpatient 10-session NF intervention (mobile) was conducted between the second and third measurement point. QoL and self-efficacy changed significantly over time (QoL: F(2,36) = 5.294, p <.05, η2 =.227; Self-efficacy: F(2,26) = 8.178, p <.05, η2 =.386). While QoL increased in younger patients, older patients initially showed a decrease in QoL, which then increased during intervention. Younger patients did not differ from older patients in QoL in both waitlist control (T0-T1) and intervention phase (T1–T2). QoL in older patients significantly differed between waitlist control and intervention phase (Z = − 2.023, p <.05, d = 1.085). Self-efficacy increased in both age categories. Younger and older patients did not differ in self-efficacy in waitlist control, but in intervention phase (F(1,16) = 7.014, p <.05, η2 =.319). The current findings suggest that NF therapy is a promising treatment modality for improving QoL in cancer patients. Our study reveals NF being a tool to influence self-efficacy, which should receive more appreciation in clinical care. However, the effect of NF in different age groups as well as the influence on further cancer-related symptoms should be investigated in future research. [ABSTRACT FROM AUTHOR]

Physical modeling of precipitation at fine (sub-kilometer) spatial scales is computationally very expensive. This study develops a highly efficient framework for this task by coupling deep learning (DL) and physical modeling. This framework is developed and tested using regional climate simulations performed over a domain covering Montreal and adjoining regions, for the summers of 2015–2020, at 2.5 km and 250 m resolutions. The DL framework uses a recurrent approach and considers atmospheric physical processes, such as advection, to generate high-resolution information from low-resolution data, which enables it to recreate fine details and produce temporally consistent fields. The DL framework generates realistic high-resolution precipitation estimates, including intense short-duration precipitation events, which allows it to be applied in engineering problems, such as evaluating the climate resiliency of urban storm drainage systems. The results portray the value of the proposed DL framework, which can be extended to other resolutions, periods, and regions. [ABSTRACT FROM AUTHOR]

Purpose: Bariatric surgery is established as the gold standard in the treatment of severe obesity. However, a significant proportion of patients experience a substantial weight regain afterwards. Previous research focused predominantly on patients' personal factors. Yet, critical discharge process factors that contribute to patient's adherence after surgical interventions are rarely examined. This study investigated whether high quality of care transitions in discharge management influences weight regain and the likelihood of experiencing adverse patient safety incidents. Materials and Methods: A cross-sectional study with 578 patients after bariatric surgery was conducted. Participants answered a standardized assessment on the quality of care transition from hospital to home-, surgery-, and nutrition-related characteristics as well as patient safety incidents. Results: Significant weight regain was observed 24 months after surgery. The association between time since surgery and weight regain was weaker in patients with high quality of care transitions (B = 2.27, p <.001). Higher quality of care transition was also significantly related to a lower likelihood of unplanned hospital readmissions (OR = 0.67) and fewer medication complications (OR = 0.48) after surgery. Conclusion: This study sheds first light on the key influence of high quality of care transitions after bariatric surgery. Improvement efforts into effective discharge processes may establish smoother care transitions and help patients to assume responsibility and compliance with behavioral recommendations after surgery. Moreover, adverse patient safety incidents are less frequent after high quality care transitions indicating both high quality of health services for patients and reducing costs for the health care system. [ABSTRACT FROM AUTHOR]

We consider a macroscopic quantum system with unitarily evolving pure state ψ t ∈ H and take it for granted that different macro states correspond to mutually orthogonal, high-dimensional subspaces H ν (macro spaces) of H . Let P ν denote the projection to H ν . We prove two facts about the evolution of the superposition weights ‖ P ν ψ t ‖ 2 : First, given any T > 0 , for most initial states ψ 0 from any particular macro space H μ (possibly far from thermal equilibrium), the curve t ↦ ‖ P ν ψ t ‖ 2 is approximately the same (i.e., nearly independent of ψ 0 ) on the time interval [0, T]. And second, for most ψ 0 from H μ and most t ∈ [ 0 , ∞) , ‖ P ν ψ t ‖ 2 is close to a value M μ ν that is independent of both t and ψ 0 . The first is an instance of the phenomenon of dynamical typicality observed by Bartsch, Gemmer, and Reimann, and the second modifies, extends, and in a way simplifies the concept, introduced by von Neumann, now known as normal typicality. [ABSTRACT FROM AUTHOR]

Discourse structure annotation aims at analysing how discourse units (e.g. sentences or clauses) relate to each other and what roles they play in the overall discourse. Several annotation tools for discourse structure have been developed. However, they often only support specific annotation schemes, making their usage limited to new schemes. This article presents TIARA 2.0, an annotation tool for discourse structure and text improvement. Departing from our specific needs, we extend an existing tool to accommodate four levels of annotation: discourse structure, argumentative structure, sentence rearrangement and content alteration. The latter two are particularly unique compared to existing tools. TIARA is implemented on standard web technologies and can be easily customised. It deals with the visual complexity during the annotation process by systematically simplifying the layout and by offering interactive visualisation, including clutter-reducing features and dual-view display. TIARA's text-view allows annotators to focus on the analysis of logical sequencing between sentences. The tree-view allows them to review their analysis in terms of the overall discourse structure. Apart from being an annotation tool, it is also designed to be useful for educational purposes in the teaching of argumentation; this gives it an edge over other existing tools. [ABSTRACT FROM AUTHOR]

Introduction: The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) can affect multiple organs. Reports of persistent or newly emergent symptoms, including those related to the nervous system, have increased over the course of the pandemic, leading to the introduction of post-COVID-19 syndrome. However, this novel syndrome is still ill-defined and structured objectification of complaints is scarce. Therefore, we performed a prospective observational cohort study to better define and validate subjective neurological disturbances in patients with post-COVID-19 syndrome. Methods: A total of 171 patients fulfilling the post-COVID-19 WHO Delphi consensus criteria underwent a comprehensive neurological diagnostic work-up including neurovascular, electrophysiological, and blood analysis. In addition, magnetic resonance imaging (MRI) and lumbar puncture were conducted in subgroups of patients. Furthermore, patients underwent neuropsychological, psychosomatic, and fatigue assessment. Results: Patients were predominantly female, middle-aged, and had incurred mostly mild-to-moderate acute COVID-19. The most frequent post-COVID-19 complaints included fatigue, difficulties in concentration, and memory deficits. In most patients (85.8%), in-depth neurological assessment yielded no pathological findings. In 97.7% of the cases, either no diagnosis other than post COVID-19 syndrome, or no diagnosis likely related to preceding acute COVID-19 could be established. Sensory or motor complaints were more often associated with a neurological diagnosis other than post-COVID-19 syndrome. Previous psychiatric conditions were identified as a risk factor for developing post-COVID-19 syndrome. We found high somatization scores in our patient group that correlated with cognitive deficits and the extent of fatigue. Conclusions: Albeit frequently reported by patients, objectifiable affection of the nervous system is rare in post-COVID-19 syndrome. Instead, elevated levels of somatization point towards a pathogenesis potentially involving psychosomatic factors. However, thorough neurological assessment is important in this patient group in order to not miss neurological diseases other than post-COVID-19. [ABSTRACT FROM AUTHOR]

Purpose: We assessed and compared clinical effects and safety endpoints of three methods of transarterial chemoembolization (TACE), conventional (cTACE), with drug-eluting beads (DEB-TACE), and with degradable starch microspheres (DSM-TACE), used in patients with hepatocellular carcinoma (HCC) in the bridging to liver transplant (LT) and the palliative setting. Methods: In our center, 148 patients with HCC underwent 492 completed TACE procedures between 2008 and 2017 (158 for bridging to LT; 334 for palliative treatment) which we analyzed retrospectively. Of these procedures, 348 were DEB-TACE, 60 cTACE, and 84 DSM-TACE. Results: The cTACE procedure revealed a significantly longer period of hospitalization (p = 0.02), increased occurrence of nausea (p = 0.025), and rise in alanine transaminase (ALT) levels (p = 0.001), especially in the palliative setting. In the bridging to LT cohort, these clinical endpoints did not reach statistical significance. Conclusions: The clinical safety of different TACE methods for HCC in both the palliative and the bridging to LT setting was equivalent. In the palliative setting, the cTACE procedure revealed an increased risk for adverse clinical effects such as nausea, elevation of ALT, and a prolonged period of hospitalization what might either be related to the systemic effects of the chemotherapeutic agent or to the differences in both collectives. Thus, further studies must be conducted on a larger number of TACE procedures to effectively explore the clinical side effects of the various TACE variants. [ABSTRACT FROM AUTHOR]

Infrastructure and transportation systems on which northern communities rely are exposed to a variety of climatic hazards over a broad range of scales. Efforts to adapt these systems to the rapidly warming Arctic climate require high-quality climate projections. Here, a state-of-the-art regional climate model is used to perform simulations at 4-km resolution over the eastern and central Canadian Arctic. These include, for the first time over this region, high-resolution climate projections extending to the year 2040. Validation shows that the model adequately simulates base climate variables, as well as variables hazardous to northern engineering and transportation systems, such as degrading permafrost, extreme rainfall, and extreme wind gust. Added value is found over coarser resolution simulations. A novel approach integrating climate model output and machine learning is used for deriving fog—an important, but complex hazard. Hotspots of change to climatic hazards over the next two decades (2021–2040) are identified. These include increases to short-duration rainfall intensity extremes exceeding 50%, suggesting Super–Clausius–Clapeyron scaling. Increases to extreme wind gust pressure are projected to reach 25% over some regions, while widespread increases in active layer thickness and ground temperature are expected. Overall fog frequency is projected to increase by around 10% over most of the study region by 2040, due to increasing frequency of high humidity conditions. Given that these changes are projected to be already underway, urgent action is required to successfully adapt northern transportation and engineering systems located in regions where the magnitude of hazards is projected to increase. [ABSTRACT FROM AUTHOR]

Peptides play important roles in regulating biological processes and form the basis of a multiplicity of therapeutic drugs. To date, only about 300 peptides in human have confirmed bioactivity, although tens of thousands have been reported in the literature. The majority of these are inactive degradation products of endogenous proteins and peptides, presenting a needle-in-a-haystack problem of identifying the most promising candidate peptides from large-scale peptidomics experiments to test for bioactivity. To address this challenge, we conducted a comprehensive analysis of the mammalian peptidome across seven tissues in four different mouse strains and used the data to train a machine learning model that predicts hundreds of peptide candidates based on patterns in the mass spectrometry data. We provide in silico validation examples and experimental confirmation of bioactivity for two peptides, demonstrating the utility of this resource for discovering lead peptides for further characterization and therapeutic development. Bioactive peptides regulate many physiological functions but progress in discovering them has been slow. Here, the authors use a machine learning framework to predict mammalian peptide candidates from the global and local structure of large-scale tissue-specific mass spectrometry data. [ABSTRACT FROM AUTHOR]

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Introduction: This study investigated the mental health burden of patients with chronic inflammatory demyelinating polyneuropathy (CIDP) or multifocal motor neuropathy (MMN) during the COVID-19 pandemic in comparison to matched healthy controls. Methods: The cross-sectional study included 59 patients with a diagnosis of either CIDP or MMN and 59 propensity score matched healthy controls. All participants completed a survey including demographics, distress (distress thermometer), depressive symptoms (PHQ-2), generalized anxiety (GAD-7), COVID-19-related fear, and risk perception. Additionally, patients with CIDP or MMN were asked about the frequency and type of infections since treatment initiation. Results: Patients with either CIDP or MMN reported experiencing reduced frequency or no differences in infection frequency since immune medication was initiated. Regarding COVID-19, patients with CIDP or MMN rated their risk of infection similar to healthy controls, while they expected a higher probability of the occurrence of symptoms, severe course, and dying of COVID-19. They reported increased depressive symptoms, generalized anxiety, and COVID-19-related fear in comparison to healthy controls. Conclusion: Despite their personal experience of reduced frequency of infection since immune medication was initiated, patients with CIDP or MMN reported increased risk perception and prevalence of depressive symptoms, generalized anxiety, and COVID-19-related fear in comparison to healthy controls. This highlights the need for evidence-driven strategies to protect the mental health of this vulnerable group. [ABSTRACT FROM AUTHOR]

Keywords: Chronic inflammatory demyelinating polyneuropathy; Multifocal motor neuropathy; Anxiety; Mental health; COVID-19; SARS-CoV-2 EN Chronic inflammatory demyelinating polyneuropathy Multifocal motor neuropathy Anxiety Mental health COVID-19 SARS-CoV-2 1453 1455 3 08/02/22 20220901 NES 220901 Eva-Maria Skoda and Mark Stettner share senior authorship. The study assessed the mental health burden of patients with chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) and multifocal motor neuropathy (MMN) - the most common forms of chronic immune-mediated neuropathies - in comparison to propensity score-matched healthy controls during the COVID-19 pandemic [[1]]. [Extracted from the article]

CRISPR SWAPnDROP extends the limits of genome editing to large-scale in-vivo DNA transfer between bacterial species. Its modular platform approach facilitates species specific adaptation to confer genome editing in various species. In this study, we show the implementation of the CRISPR SWAPnDROP concept for the model organism Escherichia coli, the fast growing Vibrio natriegens and the plant pathogen Dickeya dadantii. We demonstrate the excision, transfer and integration of large chromosomal regions between E. coli, V. natriegens and D. dadantii without size-limiting intermediate DNA extraction. CRISPR SWAPnDROP also provides common genome editing approaches comprising scarless, marker-free, iterative and parallel insertions and deletions. The modular character facilitates DNA library applications, and recycling of standardized parts. Its multi-color scarless co-selection system significantly improves editing efficiency and provides visual quality controls throughout the assembly and editing process. The need for diverse chromosomal modifications in biotechnology, synthetic biology and basic research requires the development of new technologies. Here the authors present CRISPR SWAPnDROP, which extends the limits of genome editing to large-scale in-vivo DNA transfer between bacterial species. [ABSTRACT FROM AUTHOR]

Background: It has been suggested that psychosocial functioning improves after bariatric surgery, but the mechanism of this effect remains unclear. We propose that body image mediates the association between %EWL and improvement in depressive symptoms. Materials and Methods: To investigate this hypothesis, we conducted a mediation analysis in longitudinal data from 52 patients after LSG. Results: %EWL had no direct effect on depressive symptoms as assessed through the patient health questionnaire (PHQ-9), but a small indirect effect that was mediated through negative evaluation of the body (BIQ-20). Conclusions: We interpret this observation in the context of complex individual etiologies of obesity and argue for a stronger focus on psychological interventions in aftercare regimes. This may be specifically relevant for patients with eating disorders or a desire for body contouring surgery. [ABSTRACT FROM AUTHOR]

Background: In the phase 3 GRID trial, regorafenib improved progression-free survival (PFS) independent of KIT mutations in exons 9 and 11. In this retrospective, exploratory analysis of the GRID trial, we investigated whether a more comprehensive KIT mutation analysis could identify mutations that impact treatment outcome with regorafenib and a regorafenib-induced mutation pattern. Methods: Archived tumor samples, collected at any time prior to enrollment in GRID, were analyzed by Sanger sequencing (n = 102) and next-generation sequencing (FoundationONE; n = 47). Plasma samples collected at baseline were analyzed by BEAMing (n = 163) and SafeSEQ (n = 96). Results: In archived tumor samples, 67% (68/102) had a KIT mutation; 61% (62/102) had primary KIT mutations (exons 9 and 11) and 12% (12/102) had secondary mutations (exons 13, 14, 17, and 18). At baseline, 81% of samples (78/96) had KIT mutations by SafeSEQ, including the M541L polymorphism (sole event in 6 patients). Coexisting mutations in other oncogenes were rare, as were mutations in PDGFR, KRAS, and BRAF. Regorafenib showed PFS benefit across all primary and secondary KIT mutational subgroups examined. Available patient-matched samples taken at baseline and end of treatment (n = 41; SafeSEQ), revealed heterogeneous KIT mutational changes with no specific mutation pattern emerging upon regorafenib treatment. Conclusion: These data support the results of the GRID trial, and suggest that patients may benefit from regorafenib in the presence of KIT mutations and without the selection of particular mutation patterns that confer resistance. The study was not powered to address biomarker-related questions, and the results are exploratory and hypothesis-generating. [ABSTRACT FROM AUTHOR]

Background: Using the 6-step approach to curriculum development for medical education, we developed a communication skills training (CST) curriculum for oncology and evaluated this curriculum from the perspective of cancer patients. Methods: We conducted a qualitative interview study with cancer patients, collecting data using semi-structured face-to-face or telephone interviews with a short standardized survey. We fully transcribed the audiotaped interviews and conducted the content analysis using MAXQDA 2020. We analyzed the quantitative sociodemographic data descriptively. Results: A total of 22 cancer patients participated, having a mean age of 60.6 (SD, 13.2) years and being predominantly female (55%). The patients believed that the CST curriculum addressed important aspects of patient-centered communication in cancer care. They emphasized the importance of physicians acquiring communication skills to establish a trusting relationship between doctor and patient, show empathy, inform patients, and involve them in treatment decisions. The patients had some doubts concerning the usefulness of strict protocols or checklists (e.g., they feared that protocol adherence might disturb the conversation flow). Discussion: Although it was a challenge for some participants to take the perspective of a trainer and comment on the CST content and teaching methods, the patients provided a valuable perspective that can help overcome blind spots in CST concepts. [ABSTRACT FROM AUTHOR]

Based on a result by Yarotsky (J Stat Phys 118, 2005), we prove that localized but otherwise arbitrary perturbations of weakly interacting quantum spin systems with uniformly gapped on-site terms change the ground state of such a system only locally, even if they close the spectral gap. We call this a strong version of the local perturbations perturb locally (LPPL) principle which is known to hold for much more general gapped systems, but only for perturbations that do not close the spectral gap of the Hamiltonian. We also extend this strong LPPL-principle to Hamiltonians that have the appropriate structure of gapped on-site terms and weak interactions only locally in some region of space. While our results are technically corollaries to a theorem of Yarotsky, we expect that the paradigm of systems with a locally gapped ground state that is completely insensitive to the form of the Hamiltonian elsewhere extends to other situations and has important physical consequences. [ABSTRACT FROM AUTHOR]