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Comparison of risk prediction models in infarct-related cardiogenic shock.

Eur Heart J Acute Cardiovasc Care 2021 Sep 16. Epub 2021 Sep 16.

Department of Internal Medicine/Cardiology, Heart Center Leipzig at the University of Leipzig, Strümpellstr. 39, D-04289 Leipzig, Germany.

Aims: Several prediction models have been developed to allow accurate risk assessment and provide better treatment guidance in patients with infarct-related cardiogenic shock (CS). However, comparative data between these models are still scarce. The objective of the study is to externally validate different risk prediction models in infarct-related CS and compare their predictive value in the early clinical course. Read More

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September 2021

Bipartite binding and partial inhibition links DEPTOR and mTOR in a mutually antagonistic embrace.

Elife 2021 09 14;10. Epub 2021 Sep 14.

MRC Laboratory of Molecular Biology, Cambridge, United Kingdom.

The mTORC1 kinase complex regulates cell growth, proliferation, and survival. Because mis-regulation of DEPTOR, an endogenous mTORC1 inhibitor, is associated with some cancers, we reconstituted mTORC1 with DEPTOR to understand its function. We find that DEPTOR is a unique mTORC1 inhibitor that may have evolved to preserve feedback inhibition of PI3K. Read More

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September 2021

Functional analysis of peripheral and intratumoral neoantigen-specific TCRs identified in a patient with melanoma.

J Immunother Cancer 2021 Sep;9(9)

Klinik und Poliklinik für Innere Medizin III, Klinikum rechts der Isar der Technischen Universität München, München, Germany

Background: Neoantigens derived from somatic mutations correlate with therapeutic responses mediated by treatment with immune checkpoint inhibitors. Neoantigens are therefore highly attractive targets for the development of therapeutic approaches in personalized medicine, although many aspects of their quality and associated immune responses are not yet well understood. In a case study of metastatic malignant melanoma, we aimed to perform an in-depth characterization of neoantigens and respective T-cell responses in the context of immune checkpoint modulation. Read More

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September 2021

Goal Changes and Healthy Aging.

J Gerontol B Psychol Sci Soc Sci 2021 Sep;76(Supplement_2):S105-S114

Memory Center, CoBTeK lab University Côte d'Azur, Nice, France.

This article discusses ways in which aging individuals respond to physical, social, and environmental changes and constraints by modifying their goals. We review aging-related trends, which we derive from several theoretical approaches, including goal systems theory, the motivational theory of life-span development and its action-phase model, and the Selection, Optimization, and Compensation model. These theories explain how biological and social role changes in later adulthood prompt individuals to make changes to the content, orientation, and composition of their goals, including disengaging from and adjusting previously central goals. Read More

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September 2021

Effort Mobilization and Healthy Aging.

J Gerontol B Psychol Sci Soc Sci 2021 Sep;76(Supplement_2):S135-S144

Department of Economics, University of Zurich, Switzerland.

Healthy aging is in part dependent upon people's willingness and ability to mobilize the effort necessary to support behaviors that promote health and well-being. People may have the best information relating to health along with the best intentions to stay healthy (e.g. Read More

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September 2021

Diagnostic & Therapeutic Challenges.

Retina 2021 Sep 6. Epub 2021 Sep 6.

Vitreous Retina Macula Consultants of New York, New York, New York, USA Ophthalmology Unit of the Department of Medicine, Surgery and Neuroscience, University of Siena, Siena, Italy Department of Ophthalmology, NYU Grossman School of Medicine, New York, New York, USA.

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September 2021

Platelet activation and reactivity in a large cohort of patients with Gaucher disease.

Thromb Haemost 2021 Sep 10. Epub 2021 Sep 10.

Gaucher Unit, Shaare Zedek Medical Center, Jerusalem, Israel.

Patients with Gaucher disease (GD) are at increased risk of bleeding and have varying degrees of thrombocytopenia, making the analysis of platelet function difficult. This study aimed to provide a clinically relevant quantitative assessment of platelet function and determine its relationship with bleeding and GD-related data.

Methods: Unstimulated and stimulated platelet function was measured by whole blood flow cytometry of platelet surface activated αIIbβ3 integrin (detected with monoclonal antibody PAC1), P-selectin (CD62P), and lysosomal-associated membrane protein (LAMP3/CD63) in 149 GD patients. Read More

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September 2021

From Molecules to Frameworks to Superframework Crystals.

Adv Mater 2021 Sep 9:e2103808. Epub 2021 Sep 9.

Department of Chemistry and Center for NanoScience (CeNS), Ludwig-Maximilians-Universität München, Butenandtstraße 11, 81377, Munich, Germany.

Building chemical structures of complexity and functionality approaching the level of biological systems is an ongoing challenge. A general synthetic strategy is proposed by which progressive levels of complexity are achieved through the building block approach whereby molecularly defined constructs at one level serve as constituent units of the next level, all being linked through strong bonds-"augmented reticular chemistry". Specifically, current knowledge of linking metal complexes and organic molecules into reticular frameworks is applied here to linking the crystals of these frameworks into supercrystals (superframeworks). Read More

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September 2021

Catheter-directed therapy in pulmonary embolism.

Herz 2021 Sep 1. Epub 2021 Sep 1.

Department of Internal Medicine/Cardiology, Heart Center Leipzig at the University of Leipzig, Strümpellstr. 39, 04289, Leipzig, Germany.

Acute pulmonary embolism (PE) is a life-threatening condition with high mortality rates and potential long-term sequelae. Systemic thrombolysis has been virtually the only therapeutic option available for patients with hemodynamic instability over decades. Recently, interventional therapy of PE has gained increasing interest. Read More

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September 2021

Angiography after Out-of-Hospital Cardiac Arrest without ST-Segment Elevation.

N Engl J Med 2021 Aug 29. Epub 2021 Aug 29.

From Heart Center Leipzig at the University of Leipzig, Departments of Internal Medicine-Cardiology (S.D., A.F., J.P., M.A.-W., P.L., A.J., H.T.) and Cardiac Surgery (S.W.-T.), Leipzig Heart Institute (S.D., A.F., A.J., H.T.), and University Clinic Leipzig (K.L.), Leipzig, University Heart Center Lübeck (S.D., T.G., I.E., G.F., A.J.) and the Center for Clinical Trials (D.O., S.B., K.K.) and the Institute for Medical Biometry and Statistics (F.S., I.R.K., M.V.), University of Lübeck, Lübeck, the German Center for Cardiovascular Research (S.D., A.F., I.A., M. Behnes, M.R.P., T.A.Z., C.S., U.L., T.G., I.E., G.F., F.H., S.B.F., S.F., J.L., M.J., C.L., C.J., A.J., D.O., F.S., I.R.K., S.B., M.V., K.K.) and University Clinic Charité, Campus Benjamin Franklin (C.S., U.L.), Berlin, University Clinic Mannheim, Mannheim (I.A., M. Behnes), the Department of Cardiology, Angiology, and Pneumology, University Hospital of Heidelberg, Heidelberg (M.R.P., T.A.Z.), Kliniken Maria Hilf, Mönchengladbach (H.H.), University Clinic Würzburg, Würzburg (P.N.), University Clinic Greifswald, Greifswald (F.H., S.B.F.), University Clinic Frankfurt, Frankfurt (S.F.), Rechts der Isar Hospital, Technical University (J.L.), and the Department of Cardiology, German Heart Center (M.J.), Munich, the Department of Cardiology, Pneumology and Intensive Care, St. Vincenz Hospital, Limburg (S.S.), Kerckhoff Clinic, Bad Nauheim (C.L.), the Departments of Acute and Emergency Medicine and of Cardiology and Angiology, Elisabeth Hospital Essen, Essen (I.V.), Klinikum Ludwigshafen, Ludwigshafen (U.Z.), University Clinic Marien Hospital Herne, Klinikum der Ruhr-Universität Bochum, Herne (M. Brand), the University Heart Center, Bad Krozingen (R.S.), Diakonissenkrankenhaus Flensburg, Flensburg (J.H.), University Medicine Göttingen, Göttingen (C.J.), and Vincentius-Diakonissen Hospital, Karlsruhe (C.J.) - all in Germany; the Division of Cardiology, Medical University of Vienna, Vienna (T.A.Z.); and the Department of Cardiology, Rigshospitalet, and the Department of Clinical Medicine, University of Copenhagen - both in Copenhagen (C.H., T.E.).

Background: Myocardial infarction is a frequent cause of out-of-hospital cardiac arrest. However, the benefits of early coronary angiography and revascularization in resuscitated patients without electrocardiographic evidence of ST-segment elevation are unclear.

Methods: In this multicenter trial, we randomly assigned 554 patients with successfully resuscitated out-of-hospital cardiac arrest of possible coronary origin to undergo either immediate coronary angiography (immediate-angiography group) or initial intensive care assessment with delayed or selective angiography (delayed-angiography group). Read More

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An enlarging ischiorectal mass.

Surgery 2021 Sep 2;170(3):e9-e10. Epub 2021 Apr 2.

Department of Colorectal Surgery, Cleveland Clinic Florida, Weston, FL. Electronic address:

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September 2021

Hyperreflective Foci, Optical Coherence Tomography Progression Indicators in Age-Related Macular Degeneration, Include Transdifferentiated Retinal Pigment Epithelium.

Invest Ophthalmol Vis Sci 2021 Aug;62(10):34

Department of Ophthalmology and Visual Sciences, University of Alabama at Birmingham School of Medicine, Birmingham, Alabama, United States.

Purpose: By optical coherence tomography (OCT) imaging, hyperreflective foci (HRF) indicate progression risk for advanced age-related macular degeneration (AMD) and are in part attributable to ectopic retinal pigment epithelium (RPE). We hypothesized that ectopic RPE are molecularly distinct from in-layer cells and that their cross-retinal course follows Müller glia.

Methods: In clinical OCT (61 eyes, 44 patients with AMD, 79. Read More

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The Anticancer Efficacy of Plasma-Oxidized Saline (POS) in the Ehrlich Ascites Carcinoma Model In Vitro and In Vivo.

Biomedicines 2021 Jul 31;9(8). Epub 2021 Jul 31.

ZIK plasmatis, Leibniz Institute for Plasma Science and Technology (INP), Felix-Hausdorff-Str. 2, 17489 Greifswald, Germany.

Cold physical plasma, a partially ionized gas rich in reactive oxygen species (ROS), is receiving increasing interest as a novel anticancer agent via two modes. The first involves its application to cells and tissues directly, while the second uses physical plasma-derived ROS to oxidize liquids. Saline is a clinically accepted liquid, and here we explored the suitability of plasma-oxidized saline (POS) as anticancer agent technology in vitro and in vivo using the Ehrlich Ascites Carcinoma (EAC) model. Read More

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The European Journal of Emergency Medicine in Lisbon, 2021.

Authors:
Yonathan Freund

Eur J Emerg Med 2021 Oct;28(5):329

Emergency Department Hôpital Pitié-Salpêtrière, Sorbonne Université, Assistance Publique - Hôpitaux de Paris, Paris, France.

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October 2021

Are There Two Forms of Multiple Evanescent White Dot Syndrome?

Retina 2021 Aug 21. Epub 2021 Aug 21.

Vitreous Retina Macula Consultants of New York, New York, NY, USA Department of Ophthalmology, New York University Grossman School of Medicine, New York City, NY, USA Department of Ophthalmology, Manhattan Eye, Ear and Throat Hospital, New York, New York, USA Centre Hospitalier Universitaire de l'Hopital Nord, chemin des Bourrely, 13015 Marseille, FRANCE Universite de Paris, Ophthalmology Department, AP-HP, Hopital Larboisiere, F-75010, Paris, FRANCE Policlinico San Orsola Malpighi, University of Bologna, Italy LuEsther T. Mertz Retinal Research Center, Manhattan Eye, Ear, and Throat Hospital, New York, NY, USA Columbia University Irving Medical Center, Edward S. Harkness Eye Institute, New York-Presbyterian Hospital, New York, NY, USA.

Purpose: To analyze the nature of multiple evanescent white dot syndrome (MEWDS) and differentiate an idiopathic or primary form of MEWDS from a secondary form that is seen in association with other clinical conditions affecting the posterior segment of the eye.

Methods: Clinical and multimodal imaging findings including color fundus photography, fundus autofluorescence, fluorescein angiography, indocyanine green angiography, spectral-domain optical coherence tomography and optical coherence tomography angiography of patients with secondary MEWDS are presented.

Results: Seventeen consecutive patients with secondary MEWDS were evaluated. Read More

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The Backup Planning Scale (BUPS): A Brief, Self-Reported Measure of a Person's Tendency to Develop, Reserve, and Use Backup Plans.

J Pers Assess 2021 Aug 25:1-13. Epub 2021 Aug 25.

Department of Psychology, University of Zurich, Zürich, Switzerland.

To mitigate uncertainty in their goal pursuits, people use backup plans, i.e., alternative means that are developed to potentially replace "Plan A. Read More

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Management of cardiogenic shock.

EuroIntervention 2021 Aug;17(6):451-465

Heart Center Leipzig at University of Leipzig, Leipzig, Germany.

Despite the rapidly evolving evidence base in modern cardiology, progress in the area of cardiogenic shock remains slow, with short-term mortality still reaching 40-50%, relatively unchanged in recent years. Despite advances with an increase in the number of clinical trials taking place in this admittedly difficult-to-study area, the evidence base on which we make day-to-day decisions in clinical practice remains relatively sparse. With only definitive evidence for early revascularisation and the relative ineffectiveness of intra-aortic balloon pumping, most aspects of patient management are based on expert consensus, rather than randomised controlled trials. Read More

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Vortex Vein Imaging: What Can It Tell Us?

Clin Ophthalmol 2021 10;15:3321-3331. Epub 2021 Aug 10.

Doheny Eye Institute, Los Angeles, CA, USA.

This review article summarizes the patho-anatomy of the vortex veins, the major drainage channels for the choroid, and describes the various pathways of diseases associated with vortex vein abnormalities. This report also details the technical advancements to image the vortex veins, such as ultra-widefield indocyanine green angiography, which are critical to elucidate the importance of the vortices in various retino-choroidal disorders. Future applications of these advanced imaging systems to better understand the role of the vortex veins in health and disease are also discussed. Read More

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The Dual Mechanisms of Cognitive Control Project.

J Cogn Neurosci 2021 Aug 12:1-26. Epub 2021 Aug 12.

Washington University in St. Louis.

We describe an ambitious ongoing study that has been strongly influenced and inspired by Don Stuss's career-long efforts to identify key cognitive processes that characterize executive control, investigate potential unifying dimensions that define prefrontal function, and carefully attend to individual differences. The Dual Mechanisms of Cognitive Control project tests a theoretical framework positing two key control dimensions: proactive and reactive. The framework's central tenets are that proactive and reactive control modes reflect domain-general dimensions of individual variation, with distinctive neural signatures, involving the lateral pFC as a central node within associated brain networks (e. Read More

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Generic acquisition protocol for quantitative MRI of the spinal cord.

Nat Protoc 2021 Aug 16. Epub 2021 Aug 16.

MR Clinical Science, Philips Healthcare, Markham, Ontario, Canada.

Quantitative spinal cord (SC) magnetic resonance imaging (MRI) presents many challenges, including a lack of standardized imaging protocols. Here we present a prospectively harmonized quantitative MRI protocol, which we refer to as the spine generic protocol, for users of 3T MRI systems from the three main manufacturers: GE, Philips and Siemens. The protocol provides guidance for assessing SC macrostructural and microstructural integrity: T1-weighted and T2-weighted imaging for SC cross-sectional area computation, multi-echo gradient echo for gray matter cross-sectional area, and magnetization transfer and diffusion weighted imaging for assessing white matter microstructure. Read More

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Open-access quantitative MRI data of the spinal cord and reproducibility across participants, sites and manufacturers.

Sci Data 2021 08 16;8(1):219. Epub 2021 Aug 16.

MR Clinical Science, Philips Healthcare, Markham, ON, Canada.

In a companion paper by Cohen-Adad et al. we introduce the spine generic quantitative MRI protocol that provides valuable metrics for assessing spinal cord macrostructural and microstructural integrity. This protocol was used to acquire a single subject dataset across 19 centers and a multi-subject dataset across 42 centers (for a total of 260 participants), spanning the three main MRI manufacturers: GE, Philips and Siemens. Read More

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Association between the dietary regimen and infection-related complications in neutropenic high-risk patients with cancer.

Eur J Cancer 2021 Sep 14;155:281-290. Epub 2021 Aug 14.

University of Cologne, Faculty of Medicine and University Hospital Cologne, Department I for Internal Medicine, Cologne, Germany; German Center for Infection Research (DZIF), Partner Site Bonn-Cologne, Germany; Department of Internal Medicine, Hematology and Oncology, Goethe University Frankfurt, Frankfurt Am Main, Germany. Electronic address:

Background: Many haematology/oncology departments still provide a germ-free diet for neutropenic patients (neutropenic diet, ND) to minimise pathogen exposure, even though evidence on benefits is missing. We analysed the effects of a standard diet (SD) in neutropenic high-risk patients with cancer while focussing on infection-related outcomes.

Patients And Methods: Based on the Cologne Cohort of Neutropenic Patients, we conducted a propensity score-matched case-control study in haematological/oncological patients with a period of neutropenia longer than five days treated at our department between January 2004 and December 2012 (implementation of SD in January 2008). Read More

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September 2021

Search for Displaced Leptons in sqrt[s]=13  TeV pp Collisions with the ATLAS Detector.

Phys Rev Lett 2021 Jul;127(5):051802

CERN, Geneva, Switzerland.

A search for charged leptons with large impact parameters using 139  fb^{-1} of sqrt[s]=13  TeV pp collision data from the ATLAS detector at the LHC is presented, addressing a long-standing gap in coverage of possible new physics signatures. Results are consistent with the background prediction. This search provides unique sensitivity to long-lived scalar supersymmetric lepton partners (sleptons). Read More

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5-ALA in Suspected Low-Grade Gliomas: Current Role, Limitations, and New Approaches.

Front Oncol 2021 30;11:699301. Epub 2021 Jul 30.

Department of Neurosurgery, Medical University of Vienna, Vienna, Austria.

Radiologically suspected low-grade gliomas (LGG) represent a special challenge for the neurosurgeon during surgery due to their histopathological heterogeneity and indefinite tumor margin. Therefore, new techniques are required to overcome these current surgical drawbacks. Intraoperative visualization of brain tumors with assistance of 5-aminolevulinic acid (5-ALA) induced protoporphyrin IX (PpIX) fluorescence is one of the major advancements in the neurosurgical field in the last decades. Read More

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Kappa opioid receptor blockade in the nucleus accumbens shell prevents sex-dependent alcohol deprivation effect induced by inflammatory pain.

Pain 2021 May 4. Epub 2021 May 4.

Department of Pharmacy and Pharmaceutical Technology and Parasitology, University of Valencia, Valencia, Spain.

Abstract: Pain-induced negative affect reduces life quality of patients by increasing psychiatric comorbidities, including alcohol use disorders (AUDs). Indeed, clinical data suggest pain as a risk factor to suffer AUDs, predicting relapse drinking in abstinent patients. Here, we analyse the impact of pain on alcohol relapse and the role of kappa opioid receptor (KOR) activation in mediating these pain-induced effects because KORs play an important role in pain-driven negative affect and AUD. Read More

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Dual Hip DXA. Is it Time to Change Standard Protocol?

J Clin Densitom 2021 Jul 24. Epub 2021 Jul 24.

St Vincent's Hospital, Darlinghurst, Sydney, New South Wales, Australia. Electronic address:

Previous studies have examined the utility of bilateral DXA hip bone mineral density (BMD) scans. While most studies demonstrate an advantage of bilateral hip scanning, the studies have been limited by size, or have not included simultaneous lumbar spine scans. To analyse the utility of dual hip scans in a clinical environment, a large retrospective study was performed of DXA BMD of both hips, and lumbar spine, in 17,169 individuals assessed at one centre over 10 years. Read More

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Volume averaging effect in nonlinear processes of focused laser fields.

J Chem Phys 2021 Aug;155(6):064202

Department of Chemistry, Oregon State University, Corvallis, Oregon 97331-4003, USA.

We report theoretical derivations and experimental results on the volume averaging effect of nonlinear processes in focused laser fields. This effect is considered detrimental in revealing the intensity dependence of a nonlinear process, caused by the intensity variation across the sampled volume of a focused laser. Following the treatment in the literature, we prove that if the signal dependence can be expressed as a simple power function of the laser intensity and if the detection region encompasses effectively the whole volume, volume average does not affect the final conclusion on the derived exponent. Read More

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Demonstration of reduced neoclassical energy transport in Wendelstein 7-X.

Nature 2021 08 11;596(7871):221-226. Epub 2021 Aug 11.

Max-Planck-Institut für Plasmaphysik, Greifswald, Germany.

Research on magnetic confinement of high-temperature plasmas has the ultimate goal of harnessing nuclear fusion for the production of electricity. Although the tokamak is the leading toroidal magnetic-confinement concept, it is not without shortcomings and the fusion community has therefore also pursued alternative concepts such as the stellarator. Unlike axisymmetric tokamaks, stellarators possess a three-dimensional (3D) magnetic field geometry. Read More

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Combined Neurophysiologic and Neuroimaging Approach to Reveal the Structure-Function Paradox in Cervical Myelopathy.

Neurology 2021 Aug 11. Epub 2021 Aug 11.

Spinal Cord Injury Center, Balgrist University Hospital, University of Zurich, Zurich, Switzerland

Objective: To explore the so-called "structure-function paradox" in individuals with focal spinal lesions by means of tract-specific MRI coupled with multi-modal evoked potentials and quantitative sensory testing.

Methods: Individuals with signs and symptoms attributable to cervical myelopathy (i.e. Read More

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