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Abstract Background Since May 2016, infection and colonisation with carbapenem non-susceptible Acinetobacter spp. (CRA) and Enterobacterales (CRE) have to be notified to health authorities in Germany. The aim of our study was to assess the epidemiology of CRA and CRE from 2017 to 2019 in Germany, to identify risk groups and to determine geographical differences of CRA and CRE notifications. Methods Cases were notified from laboratories to local public health authorities and forwarded to state and national level. Non-susceptibility was defined as intermediate or resistant to ertapenem, imipenem, or meropenem excluding intrinsic bacterial resistance or the detection of a carbapenemase gene. We analysed CRA and CRE notifications from 2017, 2018 and 2019 per 100,000 inhabitants (notification incidence), regarding their demographic, clinical and laboratory information. The effect of regional hospital-density on CRA and CRE notification incidence was estimated using negative binomial regression. Results From 2017 to 2019, 2278 CRA and 12,282 CRE cases were notified in Germany. CRA and CRE cases did not differ regarding demographic and clinical information, e.g. proportion infected. The notification incidence of CRA declined slightly from 0.95 in 2017 to 0.86 in 2019, whereas CRE increased from 4.23 in 2017 to 5.72 in 2019. The highest CRA and CRE notification incidences were found in the age groups above 70 years. Infants below 1 year showed a high CRE notification incidence, too. Notification incidences varied between 0.10 and 2.86 for CRA and between 1.49 and 9.99 for CRE by federal state. The notification incidence of CRA and CRE cases increased with each additional hospital per district. Conclusion The notification incidence of CRA and CRE varied geographically and was correlated with the number of hospitals.The results support the assumption that hospitals are the main driver for higher CRE and CRA incidence. Preventive strategies and early control measures should target older age groups and newborns and areas with a high incidence.

Abstract Pleomorphic xanthoastrocytoma (PXA) in its classic manifestation exhibits distinct morphological features and is assigned to CNS WHO grade 2 or grade 3. Distinction from glioblastoma variants and lower grade glial and glioneuronal tumors is a common diagnostic challenge. We compared a morphologically defined set of PXA (histPXA) with an independent set, defined by DNA methylation analysis (mcPXA). HistPXA encompassed 144 tumors all subjected to DNA methylation array analysis. Sixty-two histPXA matched to the methylation class mcPXA. These were combined with the cases that showed the mcPXA signature but had received a histopathological diagnosis other than PXA. This cohort constituted a set of 220 mcPXA. Molecular and clinical parameters were analyzed in these groups. Morphological parameters were analyzed in a subset of tumors with FFPE tissue available. HistPXA revealed considerable heterogeneity in regard to methylation classes, with methylation classes glioblastoma and ganglioglioma being the most frequent mismatches. Similarly, the mcPXA cohort contained tumors of diverse histological diagnoses, with glioblastoma constituting the most frequent mismatch. Subsequent analyses demonstrated the presence of canonical pTERT mutations to be associated with unfavorable prognosis among mcPXA. Based on these data, we consider the tumor type PXA to be histologically more varied than previously assumed. Histological approach to diagnosis will predominantly identify cases with the established archetypical morphology. DNA methylation analysis includes additional tumors in the tumor class PXA that share similar DNA methylation profile but lack the typical morphology of a PXA. DNA methylation analysis also assist in separating other tumor types with morphologic overlap to PXA. Our data suggest the presence of canonical pTERT mutations as a robust indicator for poor prognosis in methylation class PXA.

Sulfentrazone was recently registered for use in tomato and strawberry in Florida. Field experiments were conducted at the Gulf Coast Research and Education Center in Wimauma, FL, to evaluate PRE sulfentrazone applications when applied on flat soil 30 days before bed formation (PRE-f), on the bed top immediately before laying plastic mulch (PRE-t), applied PRE-t as a tank mix with other PRE herbicides, or PRE-t followed by POST halosulfuron or rimusulfuron (POST). Sulfentrazone did not damage the tomato and strawberry crop and had no effect on strawberry and tomato fruit yield. It was as effective as the industry standards but none of the evaluated herbicide treatments provided adequate weed control. POST halosulfuron in tomato resulted in significantly greater nutsedge control at 11 (14%) and 13 (27%) weeks after initial treatment (WAIT) compared with other treatments in Fall 2019 and Spring 2020, respectively. However, in tomato, tank-mixing sulfentrazone with S-metolachlor or metribuzin did not enhance nutsedge control. Weed control did not improve with increased rates or with the use of PRE-f followed by (fb) PRE-t applications in tomato. PRE-t sulfentrazone fb POST halosulfuron was an efficient nutsedge management option in tomato. Sulfentrazone alone did not effectively control weeds in tomato or strawberry. Increased rates of sulfentrazone with the use of PRE-f fb PRE-t sulfentrazone applications did reduce (34%) total weed density in strawberry.

Abstract Background Although glioblastoma (GB) is associated with a devastating prognosis, a small proportion of patients achieve long-term survival rates. We herein present a matched-pair analysis of molecular factors found in long- and short-term survivors (LTS, STS). Methods We performed a cross-institutional analysis of 262 patient records and matched a group of 91 LTS (≥ 3 years) with two groups of STS (STS-1, n = 91; STS-2, n = 80). Matching was performed according to age, Karnofsky Performance Status, initial therapy and adjuvant therapy. Molecular factors were compared between LTS (total of 91 patients) v. STS-1, and LTS (subgroup of 80 patients) v. STS-2. We included glial fibrillary acidic protein (GFAP), O6-methylguanine-DNA methyltransferase (MGMT) promoter methylation, isocitrate dehydrogenase 1 (IDH-1); furthermore, the proliferation index was analyzed (Ki-67/MIB-1). Results IDH-1 and decreased Ki-67 were numerically associated with LTS but the difference was only significant compared to STS-1 (n.s. v. STS-2). LTS was associated with MGMT promoter hypermethylation (p = 0.013 and p = 0.022) and GFAP expression (p

This study presents a thermoset moulding compound designed for electrical machines with high power densities. The compound reduces residual stresses induced by the difference in thermal expansion during use and by shrinkage in the compound during the manufacturing process. To reduce the internal stresses in the compound, in the electrical sheet lamination and at their interface, first the moulding's coefficient of thermal expansion (CTE) must match that of the lamination because the CTE of the electrical sheets cannot be altered. Second, the shrinkage of the compound needs to be minimized because the moulding compound is injected around a prefabricated electrical sheet lamination. This provides greater freedom in the design of an electric motor or generator, especially if the thermoset needs to be directly bonded to the electrical sheet. The basic suitability of the material for the injection moulding process was iteratively optimised and confirmed by spiral flow tests. Due to the reduction of the residual stresses, the compound enables efficient cooling solutions for electrical machines with high power densities. This innovative compound can have a significant impact on electric propulsion systems across industries that use laminated electrical sheets. [ABSTRACT FROM AUTHOR]

Accurate predictions of fuel spray behavior and mixture formation in simulations of direct-injection spark-ignition (DISI) engines are fundamental to ensure proper description of all subsequent processes including ignition, combustion, and emissions. In this work, the spray evolution in a single-cylinder optical DISI engine was studied experimentally and numerically with the goal of enabling predictive computational fluid dynamics (CFD) modeling of in-cylinder sprays. The authors explored a wide range of operating conditions characterized by several fuel injection temperatures and engine speeds, using a well-characterized nine-component gasoline surrogate known as PACE-20. The effect of flash boiling and intake crossflow on the spray is discussed, with a focus on evaluating the ability of the spray models to capture highly transient spray behavior. In the experiments, the fuel temperature was varied between 20°C and 80°C, allowing for non-flash- to flash-boiling transition to emerge with enhanced flashing intensity at the highest temperatures. Spray collapse resulted in vapor-rich regions, owing to the locally lower inertia of the fluid. Varying the engine speed from 650 to 1950 rpm promoted increasingly more turbulent in-cylinder crossflow which interacted with the spray during the injection event and resulted in enhanced spray dispersion. The CFD model was able to capture the spray morphology transition at different fuel temperatures and engine speeds adequately. It is shown that the spray breakup model could capture the transitional spray behavior induced by flash boiling atomization and intake flow via proper initialization of the spray cone angle and calibration of the spray models' constants. [ABSTRACT FROM AUTHOR]

Electromobility and autonomous driving has started a transformation in the automotive industry, resulting in new requirements for vehicle systems. Due to its functions, the electrical/electronic (E/E) architecture is one of the essential systems. Zonal E/E architecture is a promising approach to tackle this issue. The research presented in this paper describes a methodology for determining the optimal number of zones, the position of the zone control units (ZCU), and the assignment of electric components to these zones and ZCUs. Therefore, the design of the power supply and the wiring harness is essential. This approach aims to identify the most suitable system architecture for a given vehicle geometry and a set of electric components. For this purpose, the assignment of electric components is accomplished by k-means clustering, and Dijkstra’s algorithm is used to optimize the cable routing. As ZCUs will be the hubs for the in-vehicle data and information transport in zonal architectures, their position and their number are crucial for the architecture and wiring harness development. Simulations show a suitable zonal architecture reduces wiring harness length as well as weight and brings functional benefits. However, the number of zones must be chosen with care, as there may also be functional limitations.

The intent of this prospective study aimed to identify the influence of hypothyroid metabolic status on the coagulation and fibrinolytic system and association with the acquired von Willebrand syndrome (VWS-ac). We compared 54 patients without substitution therapy after radical thyroidectomy with 58 control subjects without pathological thyroid-stimulating-hormone (TSH)-values. Patients with TSH > 17.5 mU/L over a period of >4 weeks were included. The control-collective was selected based on age and sex to match the patient-collective. The data were collected using laboratory coagulation tests and patient questionnaires; a bleeding score was determined. There were significant differences in the measurement of activated-partial-thromboplastin-time (aPTT/p = 0.009), coagulation-factor VIII (p < 0.001) and von-Willebrand-activity (VWF-ac/p = 0.004) between the patient and control groups. The patient cohort showed an increased aPTT and decreased factor VIII and VWF-ac. 29.7% of the patient-collective compared to 17.2% of the control subjects met the definition of VWS-Ac (p = 0.12). The bleeding score showed significantly more bleeding symptoms in patients with a laboratory constellation of VWS-ac (no family history; p = 0.04). Our results suggest hypocoagulability in hypothyroid patients. Hypothyroidism appears to have a higher incidence of VWS-ac. The increased risk of bleeding complications in hypothyroid patients may be of relevant importance for the outcome, especially in the context of invasive interventions.

Fatty acids, such as medium-chain fatty acids (MCFAs) and short-chain fatty acids (SCFAs), both important components of a normal diet, have been reported to play a role in bone-related diseases such as rheumatoid arthritis (RA). However, the role of medium-chain triglycerides (MCTs) has not been investigated in RA to date. The aim of this study was to investigate the effect of supplementation of regular diet with MCT with and without fiber on disease activity as measured with the SDAI (Simplified Disease Activity Index) in RA patients. A total of 61 RA patients on stable drug treatment were randomly assigned to a twice-daily control regimen or to a twice-daily regimen of a formulation containing medium-chain triglycerides (MCTs) 30 g/day for 8 weeks followed by a second twice-daily regimen of combining MCT (30 g/day) plus fiber (30 g/day) for an additional 8 weeks. The control group received a formulation containing long-chain triglycerides (LCTs) instead of MCTs. The preliminary results showed a significant reduction in SDAI from baseline to week 16 in the test group and a significant increase in β-hydroxybutyrate (BHB) levels, while no improvement in SDAI was observed in the control group.

BackgroundThe original equine sepsis score provided a method of identifying foals with sepsis. New variables associated with sepsis have been evaluated, but the sepsis score has not been updated.ObjectivesTo evaluate the sensitivity and specificity of 2 updated sepsis scores and the systemic inflammatory response syndrome (SIRS) criteria in regard to detecting sepsis in foals.AnimalsTwo-hundred and seventy-three ill foals and 25 healthy control foals.MethodsHistorical, physical examination, and clinicopathologic findings were used to calculate the original sepsis score and 2 updated sepsis scores. SIRS criteria were also evaluated. Sepsis scores and positive SIRS scores were statistically compared to foals with sepsis.ResultsOne-hundred and twenty-six foals were septic and 147 sick-nonseptic. The original and updated sepsis scores were significantly higher in septic foals as compared to sick-nonseptic and healthy foals. The sensitivity and specificity of the updated sepsis scores to predict sepsis were not significantly better than those of the original sepsis score. One-hundred and twenty-seven of 273 (46.5%) foals met the original SIRS criteria and 88/273 (32%) foals met the equine neonatal SIRS criteria. The original SIRS criteria had similar sensitivity and specificity for predicting sepsis as did the 3 sepsis scores in our study.Conclusions and clinical importanceThe updated sepsis scores did not provide improved ability in predicting sepsis. Fulfilling the original SIRS criteria provided similar sensitivity and specificity in predicting sepsis as the modified sepsis score and might serve as a diagnostic aid in identifying foals at risk for sepsis.

Accurate pathological diagnosis is crucial for optimal management of patients with cancer. For the approximately 100 known tumour types of the central nervous system, standardization of the diagnostic process has been shown to be particularly challenging-with substantial inter-observer variability in the histopathological diagnosis of many tumour types. Here we present a comprehensive approach for the DNA methylation-based classification of central nervous system tumours across all entities and age groups, and demonstrate its application in a routine diagnostic setting. We show that the availability of this method may have a substantial impact on diagnostic precision compared to standard methods, resulting in a change of diagnosis in up to 12% of prospective cases. For broader accessibility, we have designed a free online classifier tool, the use of which does not require any additional onsite data processing. Our results provide a blueprint for the generation of machine-learning-based tumour classifiers across other cancer entities, with the potential to fundamentally transform tumour pathology.

We present the generation and validation of an updated version of the TanDEM-X digital elevation model (DEM) of Antarctica: the TanDEM-X PolarDEM 90 m of Antarctica. Improvements compared to the global TanDEM-X DEM version comprise filling gaps with newer bistatic synthetic aperture radar (SAR) acquisitions of the TerraSAR-X and TanDEM-X satellites, interpolation of smaller voids, smoothing of noisy areas, and replacement of frozen or open sea areas with geoid undulations. For the latter, a new semi-automatic editing approach allowed for the delineation of the coastline from DEM and amplitude data. Finally, the DEM was transformed into the cartographic Antarctic Polar Stereographic projection with a homogeneous metric spacing in northing and easting of 90 m. As X-band SAR penetrates the snow and ice pack by several meters, a new concept for absolute height adjustment was set up that relies on areas with stable penetration conditions and on ICESat (Ice, Cloud, and land Elevation Satellite) elevations. After DEM generation and editing, a sophisticated height error characterization of the whole Antarctic continent with ICESat data was carried out, and a validation over blue ice achieved a mean vertical height error of just −0.3 m ± 2.5 m standard deviation. The filled and edited Antarctic TanDEM-X PolarDEM 90 m is outstanding due to its accuracy, homogeneity, and coverage completeness. It is freely available for scientific purposes and provides a high-resolution data set as basis for polar research, such as ice velocity, mass balance estimation, or orthorectification.

Measurement(s) C-band radar backscatter • extent of permanent water bodies Technology Type(s) Synthetic Aperture Radar (SAR) • Synthetic Aperture Radar (SAR) normalised mosaic Factor Type(s) radar backscatter Sample Characteristic - Environment land Sample Characteristic - Location global Machine-accessible metadata file describing the reported data: https://doi.org/10.6084/m9.figshare.16432983

Sotorasib is a KRASG12C inhibitor that recently received approval for use in locally advanced or metastatic KRASG12C-mutated NSCLC. CodeBreaK100, the phase 2 clinical trial leading to the approval of sotorasib, excluded patients with untreated brain metastases; there have been no reports describing efficacy of sotorasib on untreated brain metastases. We present a case of a patient with active untreated brain metastases with resulting disorientation and weakness who has radiographic response and complete resolution of neurologic symptoms with sotorasib. Our case illustrates the intracranial activity of sotorasib, but additional studies are needed to characterize the intracranial response rate and duration of response in these patients.

Different environmental conditions can impact the burden of anemia and intestinal parasite infections in human and livestock populations. The objective of this study was to compare the prevalence of anemia and intestinal parasite infections in farmers, family members, and owned sheep in two geographic locations along the Senegal River in June (end of the dry season) and September (rainy season). In Diawara, the prevalence of anemia in humans was high in June (74%) and remained high in September (75%) (p = 0.91). The prevalence of intestinal parasite infections increased from 7% in June to 54% in September (p

Nematodes represent the most abundant group of metazoans on earth. They utilize diverse chemicals to interact with con-specific and hetero-specific organisms, and are also impacted by compounds produced by other interacting organisms. In the first part of this review we discuss how nematode-derived glycolipids modulate their behavior and development, as well as the interactions with other organisms. Furthermore, we provide a short overview about other secondary metabolites produced by nematodes that affect different life traits of free-living nematodes. In the second part of this review we discuss how different bacteria-, nematode-, and plant-derived chemicals such as volatile organic compounds, root exudates, and plant defenses regulate the interaction between entomopathogenic nematodes, their symbiotic bacteria, insect prey, predators, and plants.

Introduction177Lu-DOTATATE, a radionuclide therapy that binds somatostatin type-2A receptors (SST2A), has demonstrated efficacy in neuroendocrine tumors and evidence of central nervous system (CNS) penetration, supporting potential expansion within pediatric neuro-oncology. Understanding the prevalence of SST2A expression across pediatric CNS tumors is essential to identify patients who may benefit from somatostatin receptor-targeted therapy and to further elucidate the oncogenic role of SST2A.MethodsSST2A immunohistochemistry (IHC) was performed on tumor specimens and interpreted by an experienced pathologist (blinded), utilizing semi-quantitative scoring of membranous expression within viable tumor. Immunoreactive cell percentage was visually scored as 0 (none), 1 (80%). Staining intensity was scored as 0 (none), 1 (weak), 2 (moderate), or 3 (strong). Combined scores for each specimen were calculated by multiplying percent immunoreactivity and staining intensity values (Range: 0-12).ResultsA total of 120 tumor samples from 114 patients were analyzed. Significant differences in SST2A IHC scores were observed across histopathologic diagnoses, with consistently high scores in medulloblastoma (mean ± SD: 7.5 ± 3.6 [n=38]) and meningioma (5.7 ± 3.4 [n=15]), compared to minimal or absent expression in ATRT (0.3 ± 0.6 [n=3]), ETMR (1.0 ± 0 [n=3]), ependymoma (grades I-III; 0.2 ± 0.7 [n=27]), and high-grade glioma (grades III-IV; 0.4 ± 0.7 [n=23]). Pineoblastoma (3.8 ± 1.5 [n=4]) and other embryonal tumors (2.0 ± 4.0 [n=7]) exhibited intermediate, variable expression. Among medulloblastomas, SST2A IHC scores were higher in non-SHH (8.5 ± 3.1) than SHH (5.0 ± 3.3) molecular subgroups (p=0.033). In a subset of paired primary and recurrent specimens from four patients, SST2A IHC scores remained largely unchanged.DiscussionHigh membranous SST2A expression was demonstrated in medulloblastoma, meningioma, and some rarer embryonal tumors with potential diagnostic, biologic, and therapeutic implications. Somatostatin receptor-targeted therapy such as 177Lu-DOTATATE deserves further investigation in these highly SST2A-expressing pediatric CNS tumors.

Osimertinib, a third-generation EGFR tyrosine kinase inhibitor, is the frontline standard in the treatment of metastatic EGFR-mutant NSCLC. Although osimertinib is effective, disease progression occurs in virtually all patients, mediated by a heterogeneous array of resistance mechanisms. Activation of the MET signaling pathway by means of amplification has been implicated in resistance to osimertinib, but activation caused by point mutations in MET has not been well described.Here, we present the case of a 65-year-old female with metastatic EGFR-mutant NSCLC whose disease progressed on osimertinib owing to emergence of MET Y1003N mutation. She subsequently received capmatinib in combination with osimertinib and achieved a partial response. This case illustrates a potential role for dual EGFR/MET inhibition in EGFR-mutated NSCLC with resistance driven by activating MET mutations.

Polymer-tethered colloidal particles (aka "particle brush materials") have attracted interest as a platform for innovative material technologies and as a model system to elucidate glass formation in complex structured media. In this contribution, Brillouin light scattering is used to sequentially evaluate the role of brush architecture on the dynamical properties of brush particles in both the individual and assembled (film) state. In the former state, the analysis reveals that brush-brush interactions as well as global chain relaxation sensitively depend on grafting density; i.e., more polymer-like behavior is observed in sparse brush systems. This is interpreted to be a consequence of more extensive chain entanglement. In contrast, the local relaxation of films does not depend on grafting density. The results highlight that relaxation processes in particle brush-based materials span a wider range of time and length scales as compared to linear chain polymers. Differentiation between relaxation on local and global scale is necessary to reveal the influence of molecular structure and connectivity on the aging behavior of these complex systems.