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Background Staphylococci account for approximately 60% of periprosthetic joint infections (PJIs). Rifampicin (RMP) combination therapy is generally considered to be the treatment of choice for staphylococcal PJIs but carries an important risk of adverse events and drug–drug interactions. Rifabutin (RFB) shares many of the properties of rifampicin but causes fewer adverse events. Objectives To compare the minimal inhibitory concentration (MIC), the minimum bactericidal concentrations (MBC), and the minimum biofilm eradication concentrations (MBEC) of rifabutin and rifampicin for staphylococcal clinical strains isolated from PJIs. Methods 132 clinical strains of rifampicin-susceptible staphylococci [51 Staphylococcus aureus (SA), 48 Staphylococcus epidermidis (SE) and 33 other coagulase-negative staphylococci (CoNS)] were studied. The MBC and the MBEC were determined using the MBEC® Assay for rifabutin and rifampicin and were compared. Results When compared with the rifampicin MIC median value, the rifabutin MIC median value was significantly higher for SA (P < 0.05), but there was no statistically significant difference for SE (P = 0.25) and CoNS (P = 0.29). The rifabutin MBC median value was significantly higher than that of rifampicin for SA (P = 0.003) and was lower for SE (P = 0.003) and CoNS (P = 0.03). Rifabutin MBEC median value was statistically lower than that of rifampicin for all strains tested. Conclusions Using the determination of MBEC values, our study suggests that rifabutin is more effective than rifampicin against clinical strains of Staphylococcus spp. obtained from PJIs. Using MBECs instead of MICs seems to be of interest when considering biofilms. In vivo higher efficacy of rifabutin when compared with rifampicin needs to be confirmed.

Sustainable solvent mediated recycling of plastic multilayer packaging by splitting of polyurethane adhesive glue.

On behalf of the Working Group Sustainability of the Leibniz PhD and PostDoc Networks. Order of authorship: First the current WG coordinator, then the three other members who contributed the most to the position paper, and last the other contributing members in alphabetical order.

The radiation pattern within high energy quark- and gluon-initiated jets (jet substructure) is used extensively as a precision probe of the strong force as well as an environment for optimizing event generators with numerous applications in high energy particle and nuclear physics. Looking at electron-proton collisions is of particular interest as many of the complications present at hadron colliders are absent. A detailed study of modern jet substructure observables, jet angularities, in electron-proton collisions is presented using data recorded using the H1 detector at HERA. The measurement is unbinned and multi-dimensional, using machine learning to correct for detector effects. All of the available reconstructed object information of the respective jets is interpreted by a graph neural network, achieving superior precision on a selected set of jet angularities. Training these networks was enabled by the use of a large number of GPUs in the Perlmutter supercomputer at Berkeley Lab. The particle jets are reconstructed in the laboratory frame, using the $k_{\mathrm{T}}$ jet clustering algorithm. Results are reported at high transverse momentum transfer $Q^2>150$ GeV${}^2$, and inelasticity $0.2 < y < 0.7$. The analysis is also performed in sub-regions of $Q^2$, thus probing scale dependencies of the substructure variables. The data are compared with a variety of predictions and point towards possible improvements of such models., 30 pages, 10 figures, 8 tables, corrected authorlist

The presence of amyloid fibrils is a hallmark of several neurodegenerative diseases. Some amyloidogenic proteins, such as α-synuclein and amyloid β, can interact with lipids, and this interaction can strongly favor the formation of amyloid fibrils. In particular the primary nucleation step, i.e. the de novo formation of amyloid fibrils, has been shown to be accelerated by lipids. However, the exact mechanism of this acceleration is still mostly unclear. Here we use a range of scattering methods, such as dynamic light scattering (DLS) and small angle X-ray and neutron scattering (SAXS and SANS) to obtain structural information on the binding of α-synuclein to vesicles formed from negatively charged lipids and their co-assembly into amyloid fibrils. We find that the lipid vesicles do not simply act as a surface that catalyses the nucleation reaction, but that lipid molecules take an active role in the reaction. The binding of α-synuclein to the lipid vesicles immediately induces a major structural change in the lipid assembly, which leads to a break-up into small, cylindrical and disc-like lipid-protein particles. This transition can be largely reversed by temperature changes or proteolytic protein removal. Incubation of these small, cylindrical and disc-like lipid-α-synuclein particles for several hours, however, yields amyloid fibril formation, whereby the lipids are incorporated into the fibrils.

The evolution of a successful strategy for the synthesis of the strained, cage-like antiviral diterpenoids wickerols A and B is described. Initial attempts to access the carbocyclic core were surprisingly challenging and in retrospect, presaged the many detours needed to ultimately arrive at the fully adorned wickerol architecture. In most cases, conditions to trigger desired outcomes with respect to both reactivity and stereochemistry were hard-won. The successful synthesis ultimately leveraged alkenes in virtually all productive bond-forming events. A series of conjugate addition reactions generated the fused tricyclic core, a Claisen rearrangement was used to install an otherwise unmanageable methyl-bearing stereogenic center, and a Prins cyclization closed the strained bridging ring. This final reaction proved enormously interesting because the strain of the ring system permitted diversion of the presumed initial Prins product into several different scaffolds.

A full account of the development of a concise and highly stereoselective synthesis of (+)-7,20-diisocyanoadociane (DICA)─a structurally complex isocyanoditerpene with potent antiplasmodial activity─is described. The strategy that evolved relies on the rapid construction of unsaturated tricyclic precursors designed to undergo stereocontrolled Birch reductions and a subsequent "bay ring" formation to generate the isocycloamphilectane core. This report is divided into three sections: (1) a description of the initial strategy and the results that focused our efforts on a single route to the DICA core, (2) a discussion of the precise choreography needed to enable a first-generation formal synthesis of (±)-DICA, and (3) the execution of a 13-step second-generation synthesis of (+)-DICA that builds on important lessons learned from the first-generation effort.

Background Black pigmentation of the aortic valve and coronary arteries has been reported to be caused by alkaptonuria or minocycline. In patients with liver transplantation it has been described only once, after exposure to minocycline. We report a second case of such pigmentation in a liver transplantation patient, for whom none of the known causes are an adequate explanation for this pigmentation. Case presentation Our 56-year-old male patient showed a complex history of two liver transplantations and sleeve gastrectomy, and had neither alkaptonuria nor a history of minocycline intake. He underwent an urgent coronary bypass grafting and aortic valve replacement because of an acute coronary syndrome based on three-vessel disease and progressive aortic valve stenosis. During this procedure, the aortic valve and coronary arteries had black pigmentation. Conclusions There are causes – other than alkaptonuria and minocycline – that can induce a black pigmentation of the aortic valve and coronary arteries. In patients with a history of liver transplantation, alteration in (dys)functional liver parenchyma or administration of substances related to the procedure of liver transplantation are possible causes. Identifying these is important because they are potentially harmful as they may induce degenerative changes and functional impairment of the aortic valve and coronary arteries. Further research is needed, but proves to be difficult due to the rare nature of this condition.

BACKGROUND: Degenerative diseases of the lumbar spine are often treated with posterior interbody fusion surgery (posterior lumbar interbody fusion [PLIF]) for spinal instability or intractable back pain with neurologic impairment. Several lateral, less invasive procedures have recently been described (lateral lumbar interbody fusion [LLIF]/direct lateral interbody fusion/extreme lateral interbody fusion [XLIF]). The aim of this systematic review is to compare structural and functional outcomes of lateral surgical approaches to PLIF. -METHODS: We conducted a MEDLINE (PubMed), Web of Science, Science-Direct, and Cochrane Library search for studies focusing on outcomes and complications comparing LLIF (direct lateral interbody fusion/XLIF) and PLIF. The systematic review was reported using the PRISMA criteria.RESULTS: In total, 1000 research articles were identified, of which 5 studies were included comparing the outcomes and complications between the lateral and posterior approach. Three studies found significantly less perioperative blood loss with a lateral approach. Average hospital stay was shorter in pop- -lations who underwent the lateral approach compared with PLIF. Functional outcomes (visual analog scale score/Oswestry Disability Index) were similar or better with LLIF. In most of the included studies, complication rates did not differ between the posterior and lateral approach. Most of the neurologic deficits with XLIF/LLIF were temporary and healed completely within 1 year follow-up.CONCLUSIONS: A lateral approach (XLIF/LLIF) is a good and safe alternative for PLIF in single-level degenerative lumbar diseases, with comparable func-tional outcomes, shorter hospital stays, and less blood loss. Future prospective studies are needed to establish the role of lateral minimally invasive approaches in spinal degenerative surgery.

Textile products are composed of various blends of synthetic or natural polymers. Elastane increases the functionality during use phase, but impedes high quality recycling. This study investigates the selective chemical dissolution of elastane from blended textile. Hansen solubility parameters and COSMO-RS were applied for solvent screening. The most recommended biobased solvents were experimentally validated with polyester, polyamide, cotton, wool and elastane for which solubility limits were determined and hence, their selectivity towards elastane dissolution. A TGA-corrected gravimetric method was developed as quantification tool and showed that tetrahydrofurfuryl alcohol and ɣ-valerolactone have comparable elastane dissolution capabilities to classical solvents (5 mg elastane/g solvent). Polyester/elastane and polyamide/elastane blends were subjected to this process as case studies. The LCA study showed that this selective solvent-based dissolution process saves 60% CO2-eq./kg textile waste compared to incineration. This interdisciplinary work can set the benchmark for further developing and upscaling physical/dissolution recycling processes for blended textiles.

Aachen : RWTH Aachen University, Fakultät für Architektur [168] Seiten (2023)., Published by RWTH Aachen University, Fakultät für Architektur, Aachen

Contains fulltext : 291073.pdf (Publisher’s version ) (Open Access) BACKGROUND: Transarterial radioembolization (TARE) is a treatment modality for liver tumors during which radioactive microspheres are injected into the hepatic arterial system. These microspheres distribute throughout the liver as a result of the blood flow until they are trapped in the arterioles because of their size. Holmium-166 ((166) Ho)-loaded microspheres used for TARE can be visualized and quantified with MRI, as holmium is a paramagnetic metal and locally increases the transverse relaxation rate R2∗ . The current (166) Ho quantification method does not take regional differences in baseline R2∗ values (such as between tumors and healthy tissue) into account, which intrinsically results in a systematic error in the estimated absorbed dose distribution. As this estimated absorbed dose distribution can be used to predict response to treatment of tumors and potential toxicity in healthy tissue, a high accuracy of absorbed dose estimation is required. PURPOSE: To evaluate pre-existing differences in R2∗ distributions between tumor tissue and healthy tissue and assess the feasibility and accuracy of voxelwise subtraction-based ΔR2∗ calculation for MRI-based dosimetry of holmium-166 transarterial radioembolization ((166) Ho TARE). METHODS: MRI data obtained in six patients who underwent (166) Ho TARE of the liver as part of a clinical study was retrospectively evaluated. Pretreatment differences in R2∗ distributions between tumor tissue and healthy tissue were characterized. Same-day pre- and post-treatment R2∗ maps were aligned using a deformable registration algorithm and subsequently subtracted to generate voxelwise ΔR2∗ maps and resultant absorbed dose maps. Image registration accuracy was quantified using the dice similarity coefficient (DSC), relative overlay (RO), and surface dice (≤4 mm; SDSC). Voxelwise subtraction-based absorbed dose maps were quantitatively (root-mean-square error, RMSE) and visually compared to the current MRI-based mean subtraction method and routinely used SPECT-based dosimetry. RESULTS: Pretreatment R2∗ values were lower in tumors than in healthy liver tissue (mean 36.8 s(-1) vs. 55.7 s(-1) , P = 0.004). Image registration improved the mean DSC of 0.83 (range: 0.70-0.88) to 0.95 (range: 0.92-0.97), mean RO of 0.71 (range 0.53-0.78) to 0.90 (range: 0.86-0.94), and mean SDSC ≤4 mm of 0.47 (range: 0.28-0.67) to 0.97 (range: 0.96-0.98). Voxelwise subtraction-based absorbed dose maps yielded a higher tumor-absorbed dose (median increase of 9.0%) and lower healthy liver-absorbed dose (median decrease of 13.8%) compared to the mean subtraction method. Voxelwise subtraction-based absorbed dose maps corresponded better to SPECT-based absorbed dose maps, reflected by a lower RMSE in three of six patients. CONCLUSIONS: Voxelwise subtraction presents a robust alternative method for MRI-based dosimetry of (166) Ho microspheres that accounts for pre-existing R2∗ differences, and appears to correspond better with SPECT-based dosimetry compared to the currently implemented mean subtraction method. 01 februari 2023

The cornerstone of a strong profession is the research that supports its knowledge base and practice. However, little is known about the range of international occupational therapy research. We aim to explore the range and diversity of the international occupational therapy research base of published peer reviewed literature during the year 2018. We will review sources from i) health-related search engines using search terms associated with occupational therapy practice, and ii) content pages of occupational therapy publications. Data will be extracted and synthesized according to the study’s origin country, publishing research journal, the characteristics of the represented research, and its alignment with World Federation of Occupational Therapists research priorities.

BACKGROUND: Spondylodiscitis is, after tissue sam-pling, initially managed with intravenous antibiotics. In patients with treatment failure, surgical debridement and stabilization is considered. An anterior or posterior approach has already been reported as a successful sur-gical access, but is associated with a large exposure and a significant morbidity.METHODS: We present a multicenter Belgian case -series on the use of a minimally invasive extreme lateral interbody fusion procedure with add-on percutaneous pedicle screw fixation for patients with a need for surgical debridement and tissue samples or intractable back pain due to spondylodiscitis. Patient characteristics, microbi-ology results, antibiotic treatment, pre-and postoperative Visual Analogue Pain Score (VAS) scores, time to bony consolidation, complications and duration of the hospital stay were collected.RESULTS: Seven patients with one level spondylodisci-tis were included. The mean age 64 years with a mean preoperative VAS score of 8.86 ( +/- 0.90). Postoperative VAS score significantly decreased to 2.57 (L70.3%, P < 0.001). Mean antibiotic treatment duration was 8 weeks. Median duration of the hospital stay was 14 days. Patients were followed for 1 year. Complete bony consolidation was observed in 6 out of 7 patients after 1 year. One patient had a stable pseudarthrosis.CONCLUSIONS: These results indicate that extreme lateral interbody fusion topped off with a percutaneous pedicle screw fixation might be a feasible, safe and valuable choice to surgically treat patients with spondy-lodiscitis with fast and important improvement in VAS. Further prospective research might strengthen the sparsely existing literature of minimally invasive surgery for spon-dylodiscitis to provide the best possible care.

Plastic recycling rate in Europe is low, urging developments in recycling technology and strategies to increase circularity. Mechanical recycling (MR) has been the reference recycling technology for years, but in the near future chemical recycling (CR) options are expected to contribute to improve plastic circularity. This study uses a material flow analysis (MFA) at European level to provide quantitative estimates of the contribution of CR technologies to plastic recycling. Ten most used polymer types from five sectors are selected. A status quo 2018 scenario is modelled and compared to five potential future scenarios (in 2030) of plastic waste treatment, including one that only looks at improved waste collection, sorting, and MR technologies and four exploring developments of CR options. The so-called ‘missing plastics’, i.e., plastic waste generated but currently not accounted for in statistics, is considered in one of the future scenarios. The MFA results are compared by calculating four circularity indicators namely end-of-life recycling rate (EoL-RR), plastic-to-plastic rate, plasticto-chemicals rate, and plastic-to-fuels rate. The results indicate that in the most optimistic scenario the EoL-RR in 2030 is 73–80% (sum of plastic-to-plastic and plastic-to-chemical rates, excluding plastic-to-fuel rate), in which 41–46% is plastic-to-plastic from MR, 15–38% is plastic-to-plastic from CR and 19–35% is plastic-to-chemicals. The highest achievable plastic-to-plastic rate is estimated to be 61% (46% from MR and 15% from CR). In all future scenarios, the plastic-to-fuel rate is estimated to be 3–6%. The MFA results are also used to estimate potential recycled content availability in 2030, which suggest that closed-loop recycling and processing the ‘missing plastics’ will be necessary to achieve the targets.

A "no smoking" policy as part of Rookvrije Voetbalstadions or Smoke-free Football Stadiums Campaign will be applied in all soccer stadiums below the Eredivisie and Keuken Kampioen Divisie starting the season 2020/2021. As one of those soccer stadiums, FC Twente has several problems realizing the "no smoking" policy. First is the online issue; lack of media as a source of information and knowledge. Second is the offline issues; no "no smoking" sign inside the stadium and minimum enforcer source. These problems lead to the reason for the unawareness situation of their smoking visitors. An Awareness Video has been made to help FC Twente raise their smoking visitors' awareness of the "no smoking" policy inside the stadium. The writer has done observation on the stadium, researched FC Twente's fans, and analyzed both, using Design Thinking Methodology as the framework.

The surgical management of breast cancer has been marked by a therapeutic de-escalation from radical surgery to breast conservation and from axillary curage to sentinel lymph node sampling. With regard to breast surgery, the de-escalation of treatment has been largely due to organized screening, which has made it possible to diagnose tumors of smaller volume or at an earlier stage. The indications for conservative surgery have been broadened by the addition of radiotherapy on one hand, and the introduction of adjuvant and neo-adjuvant treatments on the other hand. In an effort to de-escalate surgery, totally non-invasive techniques such as radiofrequency, HIFU (High Intensity Focused Ultrasound) or cryotherapy have been tested. Currently, three trials are underway to evaluate active surveillance, without surgery, in the management of certain low-risk ductal carcinomas in situ (DCIS). Regarding axillary procedures, the sentinel node technique has allowed axillary staging in patients with early breast cancer without clinical or radiological lymph node involvement. Currently, international recommendations (ASCO, NCCN) and the consensus of experts in St Gallen do not recommend additional curage in cases of macro or micrometastatic invasion of the sentinel lymph nodes if the criteria of ACOSOG Z0011 are met. The question now arises as to the relevance of a biopsy of suspected axillary nodes during the initial workup and the usefulness of the sentinel node technique in the case of a negative initial workup.

Antibody therapies are typically based on high-concentration formulations that need to be administered subcutaneously. These conditions induce several challenges, inter alia a viscosity suitable for injection, sufficient solution stability, and preservation of molecular function. To obtain systematic insights into the molecular factors, we study the dynamics on the molecular level under strongly varying solution conditions. In particular, we use solutions of antibodies with poly(ethylene glycol), in which simple cooling from room temperature to freezing temperatures induces a transition from a well-dispersed solution into a phase-separated and macroscopically arrested system. Using quasi-elastic neutron scattering during in situ cooling ramps and in prethermalized measurements, we observe a strong decrease in antibody diffusion, while internal flexibility persists to a significant degree, thus ensuring the movement necessary for the preservation of molecular function. These results are relevant for a more dynamic understanding of antibodies in high-concentration formulations, which affects the formation of transient clusters governing the solution viscosity.

Resume But de l’etude Le carcinome sereux de bas grade (CSBG) de l’ovaire est une entite distincte, d’evolution lente et touchant preferentiellement la femme jeune. L’objectif de cette etude est de decrire les caracteristiques cliniques et la survie d’une population de patientes atteintes de CSBG a un stade avance. Patients et methodes Il s’agit d’une etude retrospective, regroupant les patientes atteintes de CSBG de l’ovaire a un stade avance (FIGO IIIb-IV) ayant eu une chirurgie de cytoreduction macroscopiquement complete, prises en charge a l’Institut Gustave Roussy, Villejuif, entre 2004 et 2017. Resultats Trente-quatre patientes ont ete incluses. Il s’agissait de femmes jeunes (âge moyen 41,3 ans), ayant une maladie diagnostiquee au stade FIGO IIIc (91 %). Le suivi median etait de 41 mois. Une chimiotherapie neoadjuvante a ete administree chez 16 patientes (47,1 %), et n’a jamais permis d’obtenir une reponse complete. La chirurgie extensive comportait dans 90 % des cas un traitement de l’etage sus-mesocolique et dans plus de 80 % des cas une resection digestive. Plus de 90 % des patientes ont recu une chimiotherapie adjuvante, suivie de Bevacizumab en entretien dans plus de 40 % des cas. Au cours du suivi, 9 (26 %) deces sont survenus. La survie globale a 5 ans etait de 70 %, la survie sans recidive de 20 %. Conclusion Le CSBG de l’ovaire est un cancer peu chimiosensible et necessite une prise en charge chirurgicale maximale dans des centres experts.

Diffusion of proteins on length scales of their size is crucial for understanding the machinery of living cells. X-ray photon correlation spectroscopy (XPCS) is currently the only way to access long-time collective diffusion on these length scales, but radiation damage so far limits the use in biological systems. We apply a new approach to use XPCS to measure cage relaxation in crowded α-crystallin solutions. This allows us to correct for radiation effects, obtain missing information on long time diffusion, and support the fundamental analogy between protein and colloid dynamical arrest.