Effectiveness of combined local therapy with antibiotics and fibrin vs. vacuum-assisted wound therapy in soft tissue infections: a retrospective study

PURPOSE

Soft tissue infections can be severe and life-threatening. Their treatment consists currently in radical surgical wound debridement and combined systemic antimicrobial therapy. Different side effects are possible. Local antibiotic therapy represents a new approach to reduce side effects and improve healing. The aim of this study is to assess the effectiveness of the local sprayed use of antibiotics with fibrin sealing compared with negative pressure wound therapy as an established treatment of soft-tissue infections.

METHODS

In this retrospective study, patients with soft tissue infections who underwent surgical treatment were analysed. One group consists of patients, who received local fibrin-antibiotic spray (FAS) (n = 62). Patients treated by vacuum-assisted wound therapy (VAWT) as the established treatment were the control group (n = 57). Main outcomes were differences in the success of healing, the duration until healing and the number of needed operations.

RESULTS

Clinical healing could be achieved for 55 patients (98.21%) in the FAS group vs. 47 patients (92.16%) in the VAWT group (p = 0.19). Time to require this was 10.65 ± 10.38 days in the FAS group and 22.85 ± 14.02 days in the VAWT group (p < 0.001). In the FAS group, patients underwent an average of 1.44 ± 0.72 vs.3.46 ± 1.66 operations in the VAWT group (p < 0.001).

CONCLUSION

Compared to vacuum-assisted wound therapy in soft tissue infections, local fibrin-antibiotic spray shows faster clinical healing and less needed operations. Leading to shorter hospital stays and more satisfied patients. The combination of sprayed fibrin and antibiotics can be seen as a promising and effective method.

AKAP2-anchored protein phosphatase 1 controls prostatic neuroendocrine carcinoma cell migration and invasion

Prostate cancer (PC) is the second leading cause of cancer-related death in men. The growth of primary prostate cancer cells relies on circulating androgens and thus the standard therapy for the treatment of localized and advanced PC is the androgen deprivation therapy. Prostatic neuroendocrine carcinoma (PNEC) is an aggressive and highly metastatic subtype of prostate cancer, which displays poor prognosis and high lethality. Most of PNECs develop from prostate adenocarcinoma in response to androgen deprivation therapy, however the mechanisms involved in this transition and in the elevated biological aggressiveness of PNECs are poorly defined. Our current findings indicate that AKAP2 expression is dramatically upregulated in PNECs as compared to non-cancerous prostate tissues. Using a PNEC cell model, we could show that AKAP2 is localized both intracellularly and at the cell periphery where it colocalizes with F-actin. AKAP2 and F-actin interact directly through a newly identified actin-binding domain located on AKAP2. RNAi-mediated silencing of AKAP2 promotes the phosphorylation and deactivation of cofilin, a protein involved in actin turnover. This effect correlates with a significant reduction in cell migration and invasion. Co-immunoprecipitation experiments and proximity ligation assays revealed that AKAP2 forms a complex with the catalytic subunit of protein phosphatase 1 (PP1) in PNECs. Importantly, AKAP2-mediated anchoring of PP1 to the actin cytoskeleton regulates cofilin dephosphorylation and activation, which, in turn, enhances F-actin dynamics and favors migration and invasion. In conclusion, this study identified AKAP2 as an anchoring protein overexpressed in PNECs that controls cancer cell invasive properties by regulating cofilin phosphorylation.

Heterogeneity of TPIT expression in ACTH-secreting extra-pituitary neuroendocrine tumors (NETs) supports the existence of different cellular programs in pancreatic and pulmonary NETs

Extra-pituitary ACTH secretion is associated with a variety of neoplastic conditions and may cause the so-called ectopic ACTH-dependent Cushing syndrome (CS). The clarification of the mechanisms of extra-pituitary ACTH expression would provide potential therapeutic targets for this complex and severe disease. In the adenohypophysis, the transcription factor TPIT, co-operating with other molecules, induces POMC expression and ACTH production. However, no data are currently available on the presence and role of TPIT expression in extra-pituitary ACTH-producing neoplasms. This study was designed to explore TPIT expression in a series of pulmonary and pancreatic ACTH-producing tumors, either CS-associated or not. Forty-one extra-pituitary ACTH-producing neuroendocrine tumors (NETs) were included in the study, encompassing 32 NETs of the lung (LuNETs), 7 of the pancreas (PanNETs), and 2 pheochromocytomas. Of these, 9 LuNETs, all PanNETs, and the two pheochromocytomas were CS-associated. For comparison, 6 NETs of the pituitary gland (PitNETs; 3 ACTH-secreting and 3 ACTH-negative) and 35 ACTH-negative extra-pituitary NETs (15 Lu-NETs and 20 PanNETs) were analyzed. Immunohistochemistry with specific anti-TPIT antibodies and quantitative real-time PCR (qRT-PCR) were performed using standard protocols. TPIT expression was completely absent (protein and mRNA) in PanNETs, pheochromocytomas, and all ACTH-negative NETs. In contrast, it was expressed in 16/32 LuNETs, although with lower levels than in PitNETs. No definite relationship was found between immunohistochemistry TPIT expression and NET grade or the presence of Cushing syndrome. This study further highlights the clinical and biological heterogeneity of extra-pituitary ACTH secretion and suggests that the differences between ACTH-secreting PanNETs and LuNETs may mirror distinct molecular mechanisms underlying POMC expression. Our results point towards the recognition of a real corticotroph-like phenotype of ACTH-producing LuNETs, that is not a feature of ACTH-producing PanNETs.

Neural bases of reward anticipation in healthy individuals with low, mid, and high levels of schizotypy

A growing body of research has placed the ventral striatum at the center of a network of cerebral regions involved in anticipating rewards in healthy controls. However, little is known about the functional connectivity of the ventral striatum associated with reward anticipation in healthy controls. In addition, few studies have investigated reward anticipation in healthy humans with different levels of schizotypy. Here, we investigated reward anticipation in eighty-four healthy individuals (44 females) recruited based on their schizotypy scores. Participants performed a variant of the Monetary Incentive Delay Task while undergoing event-related fMRI.Participants showed the expected decrease in response times for highly rewarded trials compared to non-rewarded trials. Whole-brain activation analyses replicated previous results, including activity in the ventral and dorsal striatum. Whole-brain psycho-physiological interaction analyses of the left and right ventral striatum revealed increased connectivity during reward anticipation with widespread regions in frontal, parietal and occipital cortex as well as the cerebellum and midbrain. Finally, we found no association between schizotypal personality severity and neural activity and cortico-striatal functional connectivity. In line with the motivational, attentional, and motor functions of rewards, our data reveal multifaceted cortico-striatal networks taking part in reward anticipation in healthy individuals. The ventral striatum is connected to regions of the salience, attentional, motor and visual networks during reward anticipation and thereby in a position to orchestrate optimal goal-directed behavior.

Photoresponsive Nanocarriers Based on Lithium Niobate Nanoparticles for Harmonic Imaging and On-Demand Release of Anticancer Chemotherapeutics

Nanoparticle-based drug delivery systems have the potential for increasing the efficiency of chemotherapeutics by enhancing the drug accumulation at specific target sites, thereby reducing adverse side effects and mitigating patient acquired resistance. In particular, photo-responsive nanomaterials have attracted much interest due to their ability to release molecular cargos on demand upon light irradiation. In some settings, they can also provide complementary information by optical imaging on the (sub)cellular scale. We herein present a system based on lithium niobate harmonic nanoparticles (LNO HNPs) for the decoupled multi-harmonic cell imaging and near-infrared light-triggered delivery of an erlotinib derivative (ELA) for the treatment of epidermal growth factor receptor (EGFR)-overexpressing carcinomas. The ELA cargo was covalently conjugated to the surface of silica-coated LNO HNPs through a coumarinyl photo-cleavable linker, achieving a surface loading of the active molecule of 27 nmol/mg NPs. The resulting nanoconjugates (LNO-CM-ELA NPs) were successfully imaged upon pulsed laser excitation at 1250 nm in EGFR-overexpressing human prostate cancer cells DU145 by detecting the second harmonic emission at 625 nm, in the tissue transparency window. Tuning the laser at 790 nm resulted in the uncaging of the ELA cargo as a result of the second harmonic emission of the inorganic HNP core at 395 nm. This protocol induced a significant growth inhibition in DU145 cells, which was only observed upon specific irradiation at 790 nm, highlighting the promising capabilities of LNO-CM-ELA NPs for theranostic applications.

De Novo Calculation of the Charge Carrier Mobility in Amorphous Small Molecule Organic Semiconductors

Organic semiconductors (OSC) are key components in applications such as organic photovoltaics, organic sensors, transistors and organic light emitting diodes (OLED). OSC devices, especially OLEDs, often consist of multiple layers comprising one or more species of organic molecules. The unique properties of each molecular species and their interaction determine charge transport in OSCs-a key factor for device performance. The small charge carrier mobility of OSCs compared to inorganic semiconductors remains a major limitation of OSC device performance. Virtual design can support experimental R&D towards accelerated R&D of OSC compounds with improved charge transport. Here we benchmark a de novo multiscale workflow to compute the charge carrier mobility solely on the basis of the molecular structure: We generate virtual models of OSC thin films with atomistic resolution, compute the electronic structure of molecules in the thin films using a quantum embedding procedure and simulate charge transport with kinetic Monte-Carlo protocol. We show that for 15 common amorphous OSC the computed zero-field and field-dependent mobility are in good agreement with experimental data, proving this approach to be an effective virtual design tool for OSC materials and devices.

De Novo Simulation of Charge Transport through Organic Single-Carrier Devices

In amorphous organic semiconductor devices, electrons and holes are transported through layers of small organic molecules or polymers. The overall performance of the device depends both on the material and the device configuration. Measuring a single device configuration requires a large effort of synthesizing the molecules and fabricating the device, rendering the search for promising materials in the vast molecular space both nontrivial and time-consuming. This effort could be greatly reduced by computing the device characteristics from the first principles. Here, we compute transport characteristics of unipolar single-layer devices of prototypical hole- and electron-transporting materials, N,N'-di(1-naphthyl)-N,N'-diphenyl-(1,1'-biphenyl)-4,4'-diamine (α-NPD) and 2,2',2″-(1,3,5-benzinetriyl)-tris(1-phenyl-1-H-benzimidazole) (TPBi) using a first-principles multiscale approach that requires only the molecular constituents and the device geometry. This approach of generating a digital twin of the entire device can be extended to multilayer stacks and enables the computer design of materials and devices to facilitate systematic improvement of organic light-emitting diode (OLED) devices.

Introduction of Photolatent Bases for Locally Controlling Dynamic Exchange Reactions in Thermo-Activated Vitrimers

Vitrimers exhibit a covalently crosslinked network structure, as is characteristic of classic thermosetting polymers. However, they are capable of rearranging their network topology by thermo-activated associative exchange reactions when the topology freezing transition temperature (T_v ) is exceeded. Despite the vast number of developed vitrimers, there is a serious lack of methods that enable a (spatially) controlled onset of these rearrangement reactions above T_v . Herein, we highlight the localized release of the efficient transesterification catalyst 1,5,7-triazabicyclo[4.4.0]dec-5-ene (TBD) by the UV-induced cleavage of a photolatent base within a covalently crosslinked thiol-epoxy network. Demonstrated with stress relaxation measurements conducted well above the network's T_v , only the controlled release of TBD facilitates the immediate onset of transesterification in terms of a viscoelastic flow. Moreover, the spatially resolved UV-mediated photoactivation of vitrimeric properties is confirmed by permanent shape changes induced locally in the material.

Apathy in patients with schizophrenia: Treatment perspectives

Apathy occurs in many neuropsychiatric disorders and is a central negative symptom of schizophrenia. Apathy has severe functional consequences for patients with schizophrenia and the development of evidence-based treatments is a major challenge. There is now increasing evidence that dysfunctions in reward processing underly apathy, in particular regarding reward anticipation, cost-benefit computation and reward learning. In addition, metacognitive processes such as defeatist performance beliefs modulate reward processing. Psychological interventions for negative symptoms target these processes. While the evidence for cognitive-behavioral therapy for negative symptoms remains limited, recent findings suggest that specifically targeting reward-related dysfunctions may improve efficacy of these interventions. On the neurobiological level, there is now considerable evidence that a dysregulation of the dopaminergic reward system is related to reward processing dysfunctions. Regarding pharmacological treatment approaches, psychostimulants have successfully been used for apathy in dementia to target the reward system. Pro-dopaminergic drugs to target apathy in schizophrenia seem to be safer than anticipated, but their efficacy remains to be established. At the current state of knowledge, there is no evidence-based treatment that specifically targets apathy in patients with schizophrenia today. However, there are encouraging results from research inspired by basic research in neuroscience and clinical research in patients with other neuropsychiatric disorders.

EPA guidance on treatment of negative symptoms in schizophrenia

Negative symptoms of schizophrenia remain a major therapeutic challenge. The progress in the conceptualization and assessment is not yet fully reflected by treatment research. Nevertheless, there is a growing evidence base regarding the effects of biological and psychosocial interventions on negative symptoms. The importance of the distinction between primary and secondary negative symptoms for treatment selection might seem evident, but the currently available evidence remains limited. Good clinical practice is recommended for the treatment of secondary negative symptoms. Antipsychotic treatment should be optimized to avoid secondary negative symptoms due to side effects and due to positive symptoms. For most available interventions, further evidence is needed to formulate sound recommendations for primary, persistent, or predominant negative symptoms.

However, based on currently available evidence recommendations for the treatment of undifferentiated negative symptoms (including both primary and secondary negative symptoms) are provided. Although it has proven difficult to formulate an evidence-based recommendation for the choice of an antipsychotic, a switch to a second-generation antipsychotic should be considered for patients who are treated with a first-generation antipsychotic. Antidepressant add-on to antipsychotic treatment is an option. Social skills training is recommended as well as cognitive remediation for patients who also show cognitive impairment. Exercise interventions also have shown promise. Finally, access to treatment and to psychosocial rehabilitation should be ensured for patients with negative symptoms. Overall, there is definitive progress in the field, but further research is clearly needed to develop specific treatments for negative symptoms.

EPA guidance on assessment of negative symptoms in schizophrenia

Background

During the last decades, a renewed interest for negative symptoms (NS) was brought about by the increased awareness that they interfere severely with real-life functioning, particularly when they are primary and persistent.

Methods

In this guidance paper, we provide a systematic review of the evidence and elaborate several recommendations for the conceptualization and assessment of NS in clinical trials and practice.

Results

Expert consensus and systematic reviews have provided guidance for the optimal assessment of primary and persistent negative symptoms; second-generation rating scales, which provide a better assessment of the experiential domains, are available; however, NS are still poorly assessed both in research and clinical settings.

This European Psychiatric Association (EPA) guidance recommends the use of persistent negative symptoms (PNS) construct in the context of clinical trials and highlights the need for further efforts to make the definition of PNS consistent across studies in order to exclude as much as possible secondary negative symptoms. We also encourage clinicians to use second-generation scales, at least to complement first-generation ones.

The EPA guidance further recommends the evidence-based exclusion of several items included in first-generation scales from any NS summary or factor score to improve NS measurement in research and clinical settings. Self-rated instruments are suggested to further complement observer-rated scales in NS assessment.

Several recommendations are provided for the identification of secondary negative symptoms in clinical settings.

Conclusions

The dissemination of this guidance paper may promote the development of national guidelines on negative symptom assessment and ultimately improve the care of people with schizophrenia.

Use of carbon dioxide as raw material to close the carbon cycle for the German chemical and polymer industries

This article explores how far the use of CO₂ as raw material could enable the German chemical and polymer industries to contribute to a circular economy. Material Flow Analysis was conducted for all carbon flows for material use in Germany, comprising chemical production, polymer production, domestic use and waste management. For scenario modelling, Carbon Capture and Utilization technologies were included, and key parameters determining carbon flows were altered to show potential corridors for the future development. The results show that current carbon flows are dominated by fossil sources and are highly linear, with a secondary input rate of only 6%. Additionally, 12% (2 Mt/a) of the primary carbon input is lost due to dissipation. Currently available Carbon Capture and Utilization technologies would allow reaching a secondary input rate of 65% for the chemical industry. However, to achieve this rate between 80% (processes of direct synthesis) and 103% (methanol-based processes) of the total net supply for renewable electricity in Germany would be required in 2030 and between 41% and 50% in 2050. In contrast, the unavoidable substance related CO₂-point sources in Germany could probably fulfill the carbon requirement for material use of the chemical industry in 2050. The authors conclude that the utilization of CO₂ as a carbon source is necessary to close the carbon cycle where material or chemical recycling is technically not feasible or reasonable. The very high demand for renewable electricity indicates that the required production facilities for CO₂-based chemicals will probably not be completely based in Germany.

Design and characterisation of vitrimer-like elastomeric composites from HXNBR rubber

The present study aims at the incorporation of vitrimer-like properties into elastomeric composites as a promising approach towards the sustainable production of rubber-based materials. In particular, hydrogenated carboxylated nitrile butadiene rubber (HXNBR), as a technically relevant high-performance rubber, is covalently cross-linked with epoxy group-functionalised calcium silicate (Esilicate) across its pending carboxylic acid moieties. Reaction with the reactive functions attached on the filler surface results in the formation of β-hydroxyl ester linkages at the HXNBR-Esilicate interface, which undergo thermo-activated transesterifications in the presence of a suitable catalyst. Topology rearrangements in the composites are confirmed by stress relaxation measurements at elevated temperatures. Comparison with an unfilled reference network reveals that the extent of stress relaxation can be mostly maintained upon the addition of the reactive filler even at large quantities. The Esilicate serves as both cross-linker and reinforcing filler, leading to a significant enhancement of the mechanical properties.

Epoxy-Anhydride Vitrimers from Aminoglycidyl Resins with High Glass Transition Temperature and Efficient Stress Relaxation

Epoxy-anhydride vitrimers are covalent adaptable networks, which undergo associative bond exchange reactions at elevated temperature. Their service temperature is influenced by the glass transition temperature (Tg) as well as the topology freezing transition temperature (Tv), at which the covalent bond exchange reactions become significantly fast. The present work highlights the design of high-Tg epoxy-anhydride vitrimers that comprise an efficient stress relaxation at elevated temperature. Networks are prepared by thermally curing aminoglycidyl monomers with glutaric anhydride in different stoichiometric ratios. The tertiary amine groups present in the structure of the aminoglycidyl derivatives not only accelerate the curing reaction but also catalyse the transesterification reaction above Tv, as shown in stress relaxation measurements. The topology rearrangements render the networks recyclable, which is demonstrated by reprocessing a grinded powder of the cured materials in a hot press. The epoxy-anhydride vitrimers are characterised by a high Tg (up to 140 °C) and an adequate storage modulus at 25 °C (~2.5 GPa), which makes them interesting candidates for structural applications operating at high service temperature.

Stress relaxation and thermally adaptable properties in vitrimer-like elastomers from HXNBR rubber with covalent bonds

Widening the scope of skeletons in the chemistry of vitrimer(-like) high molecular weight rubbers, the present study highlights the preparation of vitrimer-like elastomers based on a technically relevant rubber that is characterised by high thermal and oxidation stability. In particular, we prepared covalently crosslinked hydrogenated carboxylated nitrile butadiene rubber (HXNBR) networks that can rearrange their topology due to the exchangeable nature of the crosslinks. By crosslinking with a di-functional epoxide, β-hydroxyl ester linkages are incorporated into the rubber, enabling thermo-activated transesterifications in the presence of the catalyst triazabicyclodecene. At moderate temperatures, the covalent linkages ensure good mechanical properties as well as chemical and thermal stability of the rubber, which is essential for most applications. In addition, bond exchange reactions allow for fast and distinctive stress relaxation at elevated temperatures. Due to the enhanced network mobility above the vitrification transition temperature, the materials exhibit thermally adaptable properties. A comparative study throughout all experiments with catalyst-free samples serving as a reference is made. Shape change experiments reveal a certain malleability of the HXNBR elastomers and improved adhesion properties are shown by means of lap shear tests. In the presence of catalyst, the failure mechanism changes from adhesive to cohesive failure proving the weldability of the material. Furthermore, the samples exhibit thermally triggered repair capabilities as demonstrated by stress-rupture tests. In general, it is shown that already low quantities of exchangeable crosslinks of associative nature impart a promising thermal adaptability into high molecular weight HXNBR rubber.

Toward Design of Novel Materials for Organic Electronics

Materials for organic electronics are presently used in prominent applications, such as displays in mobile devices, while being intensely researched for other purposes, such as organic photovoltaics, large-area devices, and thin-film transistors. Many of the challenges to improve and optimize these applications are material related and there is a nearly infinite chemical space that needs to be explored to identify the most suitable material candidates. Established experimental approaches struggle with the size and complexity of this chemical space. Herein, the development of simulation methods is addressed, with a particular emphasis on predictive multiscale protocols, to complement experimental research in the identification of novel materials and illustrate the potential of these methods with a few prominent recent applications. Finally, the potential of machine learning and methods based on artificial intelligence is discussed to further accelerate the search for new materials.

Mortality risk reduction differs according to bisphosphonate class: a 15-year observational study

In this prospective cohort of 6120 participants aged 50+, nitrogen-bisphosphonates but not non-nitrogen bisphosphonates were associated with a significant 34% mortality risk reduction compared to non-treated propensity score matched controls. These findings open new avenues for research into mechanistic pathways.

INTRODUCTION

Emerging evidence suggests that bisphosphonates (BP), first-line treatment of osteoporosis, are associated with reduced risks for all-cause mortality. This study aimed to determine the association between different BP types and mortality risk in participants with or without a fracture.

METHODS

A prospective cohort study of users of different BPs matched to non-users by propensity score (age, gender, co-morbidities, fragility fracture status) and time to starting the BP medication from the population-based Canadian Multicentre Osteoporosis Study from nine Canadian centres followed from 1995 to 2013. Mortality risk for bisphosphonate users vs matched non-users was assessed using pairwise multivariable Cox proportional hazards models.

RESULTS

There were 2048 women and 308 men on BP and 1970 women and 1794 men who did not receive medication for osteoporosis. The relationship between BP and mortality risk was explored in three separate 1:1 propensity score-matched cohorts of BP users and no treatment (etidronate, n = 599, alendronate, n = 498, and risedronate n = 213). Nitrogen BP (n-BP) (alendronate and risedronate) was associated with lower mortality risks [pairwise HR, 0.66 (95% CI, 0.48-0.91)] while the less potent non-n-BP, etidronate, was not [pairwise HR: 0.89 (95% CI, 0.66-1.20)]. A direct comparison between n-BP and etidronate (n = 340 pairs) also suggested a better survival for n-BP [paired HR, 0.47 (95%CI, (95% CI, 031-0.70)] for n-BP vs. etidronate].

CONCLUSION

Compared to no treatment, nitrogen but not non-nitrogen bisphosphonates appear to be associated with better survival.

Superhydrophobic Silicon Nanocrystal-Silica Aerogel Hybrid Materials: Synthesis, Properties, and Sensing Application

Silicon nanocrystals (SiNCs) are abundant and exhibit exquisitely tailorable optoelectronic properties. The incorporation of SiNCs into highly porous and lightweight substrates such as aerogels leads to hybrid materials possessing the attractive features of both materials. This study describes the covalent deposition of SiNCs on and intercalation into silica aerogels, explores the properties, and demonstrates a prototype sensing application of the composite material. SiNCs of different sizes were functionalized with triethoxyvinylsilane (TEVS) via a radical grafting approach and subsequently used for the synthesis of photoluminescent silica hybrids. The resulting SiNC-containing aerogels possess high porosities, SiNC-based size-dependent photoluminescence, transparency, and a superhydrophobic macroscopic surface. The materials were used to examine the photoluminescence response toward low concentrations of 3-nitrotoluene (270 μM), demonstrating their potential as a sensing platform for high-energy materials.

The effects of angiotensin receptor neprilysin inhibition by sacubitril/valsartan on adipose tissue transcriptome and protein expression in obese hypertensive patients

Increased activation of the renin-angiotensin system is involved in the onset and progression of cardiometabolic diseases, while natriuretic peptides (NP) may exert protective effects. We have recently demonstrated that sacubitril/valsartan (LCZ696), a first-in-class angiotensin receptor neprilysin inhibitor, which blocks the angiotensin II type-1 receptor and augments natriuretic peptide levels, improved peripheral insulin sensitivity in obese hypertensive patients. Here, we investigated the effects of sacubitril/valsartan (400 mg QD) treatment for 8 weeks on the abdominal subcutaneous adipose tissue (AT) phenotype compared to the metabolically neutral comparator amlodipine (10 mg QD) in 70 obese hypertensive patients. Abdominal subcutaneous AT biopsies were collected before and after intervention to determine the AT transcriptome and expression of proteins involved in lipolysis, NP signaling and mitochondrial oxidative metabolism. Both sacubitril/valsartan and amlodipine treatment did not significantly induce AT transcriptional changes in pathways related to lipolysis, NP signaling and oxidative metabolism. Furthermore, protein expression of adipose triglyceride lipase (ATGL) (P_time*group = 0.195), hormone-sensitive lipase (HSL) (P_time*group = 0.458), HSL-ser660 phosphorylation (P_time*group = 0.340), NP receptor-A (NPRA) (P_time*group = 0.829) and OXPHOS complexes (P_time*group = 0.964) remained unchanged. In conclusion, sacubitril/valsartan treatment for 8 weeks did not alter the abdominal subcutaneous AT transcriptome and expression of proteins involved in lipolysis, NP signaling and oxidative metabolism in obese hypertensive patients.

In situ IR-spectroscopy as a tool for monitoring the radical hydrosilylation process on silicon nanocrystal surfaces

Among a variety of SiNC functionalization methods, radical initiated grafting is very promising due to its straightforward nature and low propensity to form surface oligomers. In the present study, we employed in situ IR spectroscopy in combination with visible light transmittance measurements to investigate the radical induced grafting process on the well-defined SiNCs. Our findings support the proposed model: unfunctionalized hydride-terminated SiNCs form agglomerates in organic solvents, which break up during the grafting process. However, clearing of the dispersion is not a valid indicator for complete surface functionalization. Furthermore, radical-initiated grafting reactions in which azobisisobutyronitrile (AIBN) is the initiator are strongly influenced by external factors including initiator concentration, grafting temperature, as well as substrate steric demand. The monomer concentration was proven to have a low impact on the grafting process. Based on these new insights an underlying mechanism could be discussed, offering an unprecedented view on the functionalization of SiNC surfaces via radical initiated hydrosilylation.

Primary hyperparathyroidism: review and recommendations on evaluation, diagnosis, and management. A Canadian and international consensus

The purpose of this review is to assess the most recent evidence in the management of primary hyperparathyroidism (PHPT) and provide updated recommendations for its evaluation, diagnosis and treatment. A Medline search of "Hyperparathyroidism. Primary" was conducted and the literature with the highest levels of evidence were reviewed and used to formulate recommendations. PHPT is a common endocrine disorder usually discovered by routine biochemical screening. PHPT is defined as hypercalcemia with increased or inappropriately normal plasma parathyroid hormone (PTH). It is most commonly seen after the age of 50 years, with women predominating by three to fourfold. In countries with routine multichannel screening, PHPT is identified earlier and may be asymptomatic. Where biochemical testing is not routine, PHPT is more likely to present with skeletal complications, or nephrolithiasis. Parathyroidectomy (PTx) is indicated for those with symptomatic disease. For asymptomatic patients, recent guidelines have recommended criteria for surgery, however PTx can also be considered in those who do not meet criteria, and prefer surgery. Non-surgical therapies are available when surgery is not appropriate. This review presents the current state of the art in the diagnosis and management of PHPT and updates the Canadian Position paper on PHPT. An overview of the impact of PHPT on the skeleton and other target organs is presented with international consensus. Differences in the international presentation of this condition are also summarized.

Photo-responsive thiol–ene networks for the design of switchable polymer patterns

Photo-patternable thiol–ene networks are prepared by combining versatile o-NBE chemistry with the distinctive advantages of a typical “click” reaction.

Treatment of a periorbital cyst in a dog by creation of a permanent drainage opening

An inflammatory periorbital cyst with secondary pressure atrophy of the maxilla was treated by surgical creation of a drainage opening to the nasal cavity in a 4-year-old Yorkshire Terrier. Following treatment, clinical signs resolved and computed tomography 5 weeks after surgery confirmed the permanence of the drainage opening. Eight months later, the dog showed no clinical abnormalities. Therefore, the procedure described in this report may offer a suitable treatment option in cases where the cyst's size or localization prevents complete excision.

THz-Frequency Modulation of the Hubbard U in an Organic Mott Insulator

We use midinfrared pulses with stable carrier-envelope phase offset to drive molecular vibrations in the charge transfer salt ET-F_{2}TCNQ, a prototypical one-dimensional Mott insulator. We find that the Mott gap, which is probed resonantly with 10 fs laser pulses, oscillates with the pump field. This observation reveals that molecular excitations can coherently perturb the electronic on-site interactions (Hubbard U) by changing the local orbital wave function. The gap oscillates at twice the frequency of the vibrational mode, indicating that the molecular distortions couple quadratically to the local charge density.

[Severe complications after non-intended usage of octenidine dihydrochloride. A case series with four dogs]

OBJECTIVE

Case series of four dogs in which extensive bite wounds had been treated using octenidine dihydrochloride (Octenivet® or Octenisept®) flushing. The dogs subsequently developed severe local complications.

MATERIAL AND METHODS

Retrospective evaluation of clinical symptoms, diagnostics, therapy and course of the disease.

RESULTS

In four dogs, severe necrosis and persistent edematous changes of the treated area developed after the application of octenidine dihydrochloride. The clinical course was comparable to complications described previously in human medicine. Therapy was protracted and complicated by secondary wound infection.

CONCLUSION AND CLINICAL RELEVANCE

Irrigation of deep wounds, particularly bite wounds, using octenidine dihydrochloride without drainage may lead to persistent edematous changes, inflammatory reactions and necrosis. The inappropriate application of octenidine dihydrochloride for wound irrigation should be avoided in veterinary medicine.

Optically enhanced coherent transport in YBa2Cu3O6.5 by ultrafast redistribution of interlayer coupling

Nonlinear optical excitation of infrared active lattice vibrations has been shown to melt magnetic or orbital orders and to transform insulators into metals. In cuprates, this technique has been used to remove charge stripes and promote superconductivity, acting in a way opposite to static magnetic fields. Here, we show that excitation of large-amplitude apical oxygen distortions in the cuprate superconductor YBa2Cu3O6.5 promotes highly unconventional electronic properties. Below the superconducting transition temperature (Tc = 50 K) inter-bilayer coherence is transiently enhanced at the expense of intra-bilayer coupling. Strikingly, even above Tc a qualitatively similar effect is observed up to room temperature, with transient inter-bilayer coherence emerging from the incoherent ground state and similar transfer of spectral weight from high to low frequency. These observations are compatible with previous reports of an inhomogeneous normal state that retains important properties of a superconductor, in which light may be melting competing orders or dynamically synchronizing the interlayer phase. The transient redistribution of coherence discussed here could lead to new strategies to enhance superconductivity in steady state.

Antidepressant use and 10-year incident fracture risk: the population-based Canadian Multicentre Osteoporosis Study (CaMoS)

We used data from a large, prospective Canadian cohort to assess the association between selective serotonin reuptake inhibitors (SSRIs) and serotonin and noradrenaline reuptake inhibitors (SNRIs) and fracture. We found an increased risk of fractures in individuals who used SSRI or SNRI, even after controlling for multiple risk factors.

INTRODUCTION

Previous studies have suggested an association between SSRIs and increasing risk of fragility fractures. However, the majority of these studies were not long-term analyses or were performed using administrative data and, thus, could not fully control for potential confounders. We sought to determine whether the use of SSRIs and SNRIs is associated with increased risk of fragility fracture, in adults aged 50 + .

METHODS

We used data from the Canadian Multicentre Osteoporosis Study (CaMos), a prospective randomly selected population-based community cohort; our analyses focused on subjects aged 50+. Time to event methodology was used to assess the association between SSRI/SNRI use, modeled time-dependently, and fragility fracture.

RESULTS

Among 6,645 subjects, 192 (2.9%) were using SSRIs or/and SNRIs at baseline. During the 10-year study period, 978 (14.7%) participants experienced at least one fragility fracture. In our main analysis, SSRI/SNRI use was associated with increased risk of fragility fracture (hazard ratio (HR), 1.88; 95% confidence intervals (CI), 1.48-2.39). After controlling for multiple risk factors, including Charlson score, previous falls, and bone mineral density hip and lumbar bone density, the adjusted HR for current SSRI/SNRI use remained elevated (HR, 1.68; 95% CI, 1.32-2.14).

CONCLUSIONS

Our results lend additional support to an association between SSRI/SNRI use and fragility fractures. Given the high prevalence of antidepressants use, and the impact of fractures on health, our findings may have a significant clinical impact.

Pressure-dependent relaxation in the photoexcited mott insulator ET-F2TCNQ: influence of hopping and correlations on quasiparticle recombination rates

We measure the ultrafast recombination of photoexcited quasiparticles (holon-doublon pairs) in the one dimensional Mott insulator ET-F(2)TCNQ as a function of external pressure, which is used to tune the electronic structure. At each pressure value, we first fit the static optical properties and extract the electronic bandwidth t and the intersite correlation energy V. We then measure the recombination times as a function of pressure, and we correlate them with the corresponding microscopic parameters. We find that the recombination times scale differently than for metals and semiconductors. A fit to our data based on the time-dependent extended Hubbard Hamiltonian suggests that the competition between local recombination and delocalization of the Mott-Hubbard exciton dictates the efficiency of the recombination.

[Rehabilitation in persons with schizophrenic spectrum disorders: the impact of cognition and cognitive remediation therapy]

Schizophrenia is a chronic disorder, which severely limits the social and occupational functioning. Employment, education, relationships, housing and health are among the most frequently stated life and treatment goals among persons suffering from schizophrenia. Rehabilitation for persons with schizophrenia aims at preservation and improvement of psychosocial functions in areas such as work, social relationship and independent living skills, promotes recovery-oriented interventions and, therefore, serves the central goals of affected persons. Cognitive functioning, education, negative symptoms, social support and skills, age, work history, and rehabilitation service to restore community functioning have proven to be strong predictors for successful psychiatric rehabilitation. It makes sense to concentrate on these predictors when improvement of psychiatric rehabilitation is targeted. Cognitive remediation produces moderate improvements in cognitive performance and, when combined with functional training and embedded in comprehensive psychiatric rehabilitation, also enhances functional outcome. Germany provides a highly differentiated system of psychosocial support for schizophrenic patients. However, the "German disease" with different care providers being in charge in subsequent stages of recovery hampers efficient organisation of psychiatric rehabilitation. Improvement of overall organisation, i.e., configuration of interfaces, understanding of the complex interactions of measures, design of disease specific programmes, research and economic evaluation constitute major challenges in the field of psychiatric rehabilitation.

Optical properties of a vibrationally modulated solid state Mott insulator

Optical pulses at THz and mid-infrared frequencies tuned to specific vibrational resonances modulate the lattice along chosen normal mode coordinates. In this way, solids can be switched between competing electronic phases and new states are created. Here, we use vibrational modulation to make electronic interactions (Hubbard-U) in Mott-insulator time dependent. Mid-infrared optical pulses excite localized molecular vibrations in ET-F2TCNQ, a prototypical one-dimensional Mott-insulator. A broadband ultrafast probe interrogates the resulting optical spectrum between THz and visible frequencies. A red-shifted charge-transfer resonance is observed, consistent with a time-averaged reduction of the electronic correlation strength U. Secondly, a sideband manifold inside of the Mott-gap appears, resulting from a periodically modulated U. The response is compared to computations based on a quantum-modulated dynamic Hubbard model. Heuristic fitting suggests asymmetric holon-doublon coupling to the molecules and that electron double-occupancies strongly squeeze the vibrational mode.

Photoperiodic effects on reproductive development in male cavies (Cavia aperea)

Age at maturity is a particularly important life history parameter, as it predicts potential life time reproductive success in many small mammal species. Animals should therefore optimize the timing of maturation by reacting to environmental stimuli that predict future environmental conditions. Photoperiod often reliably predicts ecological conditions. Animals born into a photoperiod indicating favorable conditions (spring, summer) may mature earlier and at a lower weight than animals born into conditions indicating unfavorable conditions (autumn, winter). So far most work was done on small, altricial rodent species and we still lack knowledge about their precocial relatives. Precocial animals are born much further developed than altricials and might show less plasticity in their ontogenetic trajectory than the latter. We tested the influence of photoperiod simulated by increasing (spring) or decreasing (autumn) light in climate chambers on important life history parameters in a medium sized rodent, the highly precocial cavy (Cavia aperea). We wanted to determine whether photoperiod influences timing of maturation and early growth in male cavies and whether patterns of testosterone in blood are reflected by patterns of testosterone metabolites in feces.Males born into simulated spring grew faster and matured at an earlier age than males born into simulated autumn conditions. Patterns of testosterone in blood correlated with testosterone metabolites measured in feces. Male cavies strongly react to predictive photoperiod cues by adjusting growth and timing of maturation as we found previously for females, corroborating the importance of seasonal cues for adjustments of life history.

VCSEL-based, high-speed, in situ TDLAS for in-cylinder water vapor measurements in IC engines

We report the first application of a vertical-cavity surfaceemitting laser (VCSEL) for calibration- and sampling-free, high-speed, in situ H2O concentration measurements in IC engines using direct TDLAS (tunable diode laser absorption spectroscopy). Measurements were performed in a single-cylinder research engine operated under motored conditions with a time resolution down to 100 μs (i.e., 1.2 crank angle degrees at 2000 rpm). Signal-to-noise ratios (1σ) up to 29 were achieved, corresponding to a H2O precision of 0.046 vol.% H2O or 39 ppm · m. The modulation frequency dependence of the performance was investigated at different engine operating points in order to quantify the advantages of VCSEL against DFB lasers.