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ABSTRACT Borna disease virus 1 (BoDV-1) was just recently shown to cause predominantly fatal encephalitis in humans. Despite its rarity, bornavirus encephalitis (BVE) can be considered a model disease for encephalitic infections caused by neurotropic viruses and understanding its pathomechanism is of utmost relevance. Aim of this study was to compare the extent and distribution pattern of cerebral inflammation with the clinical course of disease, and individual therapeutic procedures. For this, autoptic brain material from seven patients with fatal BVE was included in this study. Tissue was stained immunohistochemically for pan-lymphocytic marker CD45, the nucleoprotein of BoDV-1, as well as glial marker GFAP and microglial marker Iba1. Sections were digitalized and counted for CD45-positive and BoDV-1-positive cells. For GFAP and Iba1, a semiquantitative score was determined. Furthermore, detailed information about the individual clinical course and therapy were retrieved and summarized in a standardized way. Analysis of the distribution of lymphocytes shows interindividual patterns. In contrast, when looking at the BoDV-1-positive glial cells and neurons, a massive viral involvement in the brain stem was noticeable. Three of the seven patients received early high-dose steroids, which led to a significantly lower lymphocytic infiltration of the central nervous tissue and a longer survival compared to the patients who were treated with steroids later in the course of disease. This study highlights the potential importance of early high-dose immunosuppressive therapy in BVE. Our findings hint at a promising treatment option which should be corroborated in future observational or prospective therapy studies. ABBREVIATIONS: BoDV-1: Borna disease virus 1; BVE: bornavirus encephalitis; Cb: cerebellum; CNS: central nervous system; FL: frontal lobe; GFAP: glial fibrillary acid protein; Hc: hippocampus; Iba1: ionized calcium-binding adapter molecule 1; Iba1 act : general activation of microglial cells; Iba1 nod : formation of microglial nodules; IL: insula; Me: mesencephalon; Mo: medulla oblongata; OL: occipital lobe; pASS: per average of 10 screenshots; pat early : patients treated with early high dose steroid shot; pat late : patients treated with late or none high dose steroid shot; Po: pons; So: stria olfactoria; Str: striatum.

Dynamics at low Reynolds numbers experiences recent revival in the fields of biophysics and active matter. While in bulk isotropic fluids it is exhaustively studied, this is less so in anisotropic fluids and in confined situations. Here, we combine the latter two by studying the rotation of a disk-like inclusion in a uniaxially anisotropic, globally oriented, incompressible two-dimensional fluid film. In terms of a perturbative expansion in parameters that quantify anisotropies in viscosity and in additional linear friction with a supporting substrate or other type of confinement, we derive analytical expressions for the resulting hydrodynamic flow and pressure fields as well as for the resistance and mobility coefficients of the rotating disk. It turns out that, in contrast to translational motion, the solutions remain well-behaved also in the absence of the additional linear friction. Comparison with results from finite-element simulations shows very good agreement with those from our analytical calculations. Besides applications to describe technological systems, for instance, in the area of microfluidics and thin cells of aligned nematic liquid crystals, our solutions are important for quantitative theoretical approaches to fluid membranes and thin films in general featuring a preferred direction., (© 2024. The Author(s).)

To make progress towards the development of a theory on the motion of inclusions in thin structured films and membranes, we here consider as an initial step a circular disk in a two-dimensional, uniaxially anisotropic fluid layer. We assume overdamped dynamics, incompressibility of the fluid, and global alignment of the axis of anisotropy. Motion within this layer is affected by additional linear friction with the environment, for instance, a supporting substrate. We investigate the induced flows in the fluid when the disk is translated parallel or perpendicular to the direction of anisotropy. Moreover, expressions for corresponding mobilities and resistance coefficients of the disk are derived. Our results are obtained within the framework of a perturbative expansion in the parameters that quantify the anisotropy of the fluid. Good agreement is found for moderate anisotropy when compared to associated results from finite-element simulations. At pronounced anisotropy, the induced flow fields are still predicted qualitatively correctly by the perturbative theory, although quantitative deviations arise. We hope to stimulate with our investigations corresponding experimental analyses, for example, concerning fluid flows in anisotropic thin films on uniaxially rubbed supporting substrates., (Creative Commons Attribution license.)

Background: The incidence of inflammatory bowel disease (IBD) in children is on the increase worldwide. Growth disorders are common in pediatric patients with inflammatory bowel disease. The aim of this paper is to investigate anthropometric indicators, including height and weight in children with inflammatory bowel disease in Saxony, one of the German federal states, and to evaluate growth trends in patients by comparing their height and weight with that of healthy children in Germany., Methods: In Saxony, all children and adolescents with IBD were registered in the Saxon Pediatric IBD Registry from 2000 to 2014. The data used are therefore based on a total area-wide survey over 15 years. For this study, 421 datasets of children and adolescents aged 0-14 years with Crohn's disease (CD) (n = 291) or ulcerative colitis (UC) (n = 130) were analyzed. Z-score and percentile calculations were used to compare differences between IBD patients and the general population., Results: The children with CD or UC (both sexes) had a significant lower weight at diagnosis (the mean weight z-score had negative values) versus the general population. The weight values lay mostly below P50 (the 50th percentile, median), more precisely, mostly between P10 and P50 of the body weight child growth curve for corresponding sexes (KiGGS 2003-2006). The height values of both sexes at diagnosis lay also mostly below P50 (the 50th percentile, median) of the child body growth curve for corresponding sexes (KiGGS 2003-2006), i.e. the mean height z-score was negative. But only the children with CD had a significant lower height, more precisely, mostly between P25 and P50 versus the general population (KIGGS). For children with UC the difference was not significant., Conclusion: In pediatric patients with IBD the possibility of growth disturbance, mainly in the form of weight retardation, is very probable., (© 2024. The Author(s).)

The Radar for Europa Assessment and Sounding: Ocean to Near-surface (REASON) is a dual-frequency ice-penetrating radar (9 and 60 MHz) onboard the Europa Clipper mission. REASON is designed to probe Europa from exosphere to subsurface ocean, contributing the third dimension to observations of this enigmatic world. The hypotheses REASON will test are that (1) the ice shell of Europa hosts liquid water, (2) the ice shell overlies an ocean and is subject to tidal flexing, and (3) the exosphere, near-surface, ice shell, and ocean participate in material exchange essential to the habitability of this moon. REASON will investigate processes governing this material exchange by characterizing the distribution of putative non-ice material (e.g., brines, salts) in the subsurface, searching for an ice-ocean interface, characterizing the ice shell's global structure, and constraining the amplitude of Europa's radial tidal deformations. REASON will accomplish these science objectives using a combination of radar measurement techniques including altimetry , reflectometry , sounding , interferometry , plasma characterization , and ranging . Building on a rich heritage from Earth, the moon, and Mars, REASON will be the first ice-penetrating radar to explore the outer solar system. Because these radars are untested for the icy worlds in the outer solar system, a novel approach to measurement quality assessment was developed to represent uncertainties in key properties of Europa that affect REASON performance and ensure robustness across a range of plausible parameters suggested for the icy moon. REASON will shed light on a never-before-seen dimension of Europa and - in concert with other instruments on Europa Clipper - help to investigate whether Europa is a habitable world., Competing Interests: Competing InterestsThe authors have no competing interests to declare that are relevant to the content of this article., (© The Author(s) 2024.)

Objective: In Saxony, the incidence of Crohn's disease (CD) in children and adolescents increased significantly from 3.3 per 100,000 person-years in 2000 to 5.1 in 2014. The aim of this study was to describe the initial characteristics and the clinical course of CD in children and adolescents and to identify drug treatment options associated with an advantage for a mild course or remission., Methods: Clinical data were collected from patients who suffered from inflammatory bowel disease (IBD) and were recruited in the Saxon Pediatric IBD-Registry. All children newly diagnosed with CD in this registry in Saxony between 2000 and 2014 were included in this registry study. Characteristics such as age, disease location and extra-intestinal manifestations at diagnosis were accessed. The severity level of the disease at diagnosis as well as at follow-up were analysed by PCDAI index. Patients were divided into 3 groups according to length of follow-up: 1-3 years, 4-6 years and 7-9 years after diagnosis. A logistic regression model was conducted to examine which baseline parameters are associated with disease progression., Results: There were 338 children and adolescents with CD included in this registry study. At diagnosis, the median age of patients was 12.0 (0.7-14.9), 61.5% (n = 208) of the patients were male. The most common disease location observed in pediatric CD patients was the L3 (55%, n = 176). Patients aged 10-14 years were significantly more likely to present an L2 than patients aged 0-4 years (80.3%, n = 53 vs. 19.7%, n = 13, p = 0.01). During the follow-up, data from 71.3% (n = 241) othe patients were available. Disease activity measured by PCDAI decreased in 47.7% (n = 115) of the patients, 40.7% (n = 98) of the patients were stable and increased in 11.6% (n = 28) of the patients. Patients with intermediate/severe disease at onset were more likely to have an active disease at the end of follow up, too (p = 0.00). Logistic regression analysis of the initial characteristics showed that the age at diagnosis, gender, initial location and initial extra-intestinal manifestation are not associated with the progression of the disease (p>0.05). Furthermore, drug treatment options could be identified from our data, which are associated with benefits for a milder course or remission., Conclusion: From 2000 to 2014, the health status of most pediatric patients with CD had improved or remained stable. Initial characteristics including age at diagnosis, initial localization and initial extra-intestinal manifestation are not associated with the progression of the disease, only the initial activity by PCDAI., Competing Interests: The authors have declared that no competing interest exist., (Copyright: © 2023 Dong et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Aims: An increasing number of children and adolescents worldwide suffer from inflammatory bowel disease (IBD) such as Crohn's disease (CD) and ulcerative colitis (UC). The present work aims to investigate the incidence, prevalence and future trends of IBD in children and adolescents in Saxony, Germany., Methods: The Saxon Pediatric IBD Registry collected data on patients up to 15 years of age from all 31 pediatric hospitals and pediatric gastroenterologists in Saxony over a 15-year period (2000-2014). In 2019, an independent survey estimated a registry completeness of 95.7%. Age-standardized incidence rates (ASR) per 100,000 person-years (PY) and prevalence per 100,000 children and adolescents were calculated. Evaluation was also been performed in sex and age subgroups. Joinpoint and Poisson regression were used for trend analyses and projections., Results: 532 patients with confirmed IBD during 2000-2014 were included in the epidemiological evaluation. 63.5% (n = 338) patients had CD, 33.1% (n = 176) had UC and 3.4% (n = 18) had unclassified IBD (IBD-U). The 15-year IBD prevalence was 111.8 [95%-CI: 102.3-121.3] per 100,000. The incidence ASR of IBD per 100,000 PY over the whole observation period was 7.5 [6.9-8.1]. ASR for the subtypes were 4.8 [4.3-5.3] for CD, 2.5 [2.1-2.9] for UC and 0.3 [0.1-0.4] for IBD-U. The trend analysis of ASR using the joinpoint regression confirmed a significant increase for incidence of IBD as well as CD. For IBD, the ASR per 100,000 PY increased from 4.6 [2.8-6.3] in 2000 to 8.2 [7.5-13.6] in 2014; projected incidence rates for IBD in Germany are 12.9 [6.5-25.5] in the year 2025 and 14.9 [6.7-32.8] in 2030, respectively. Thus, the number of new IBD diagnoses in Germany would more than triple (325%) in 2030 compared to 2000. The increase is expected to be faster in CD than UC, and be more in males than in females. The expected number of newly diagnosed children with IBD in Germany is projected to rise to about 1,584 [1,512-1,655] in 2025, and to about 1,918 [1,807-2,29] in 2030., Conclusion: The incidence of IBD in children and adolescents in Saxony increased at a similar rate as in other developed countries during the observation period. Given this trend, the health care system must provide adequate resources for the care of these young patients in the future., Competing Interests: I have read the journal’s guidelines, and the authors of this manuscript have provided the following: The authors have no competing interests to declare that are relevant to the content of this article. Unrelated to this study, OS served as a consultant for Novartis, JdL acted as a consultant for AbbVie Takeda and received research support from Dr. Falk Pharma. This does not alter our adherence to PLOS ONE policies on sharing data and materials.

We demonstrate accurate estimation of generalized optical signal to noise ratio (GOSNR) for wavelength division multiplexed fiber communication systems using an experimentally trained multi-tasking convolutional neural network while simultaneously estimating linear and nonlinear noise contributions. Using dual-polarized 32-GBaud 16QAM DWDM links we extract learnable features from constellation density matrices and accurately estimate GOSNR while simultaneously estimating linear and nonlinear contributions. Estimation of the OSNR ASE , OSNR NL and GOSNR are demonstrated with < 0.5 dB mean absolute error. We also assess the universality of our model within the regime of metro networks by cross-training with data from such links comprised of different fiber types. We demonstrate a path to a practical universal training method that includes additional link parameters. The methods do not require contiguous high-speed sampling, additional hardware nor transmission of special symbols or patterns and are readily implemented in deployed systems.

Biotech nanocellulose (bacterial nanocellulose, BNC) is a high potential natural polymer. Moreover, it is the only cellulose type that can be produced biotechnologically using microorganisms resulting in hydrogels with high purity, high mechanical strength and an interconnecting micropore system. Recently, the subject of intensive research is to influence this biosynthesis to create function-determining properties. This review reports on the progress in product design and today's state of technical and medical applications. A novel, dynamic, template-based technology, called Mobile Matrix Reservoir Technology (MMR Tech), is highlighted. Thereby, shape, dimensions, surface properties, and nanonetwork structures can be designed in a process-controlled manner. The formed multilayer materials open up new applications in medicine and technology. Especially medical materials for cardiovascular and visceral surgery, and drug delivery systems are developed. The effective production of layer-structured composites and coatings are important for potential applications in the electronics, paper, food and packaging technologies., (Copyright © 2020 Elsevier Ltd. All rights reserved.)

Aims: In developed countries, the incidence of inflammatory bowel disease (IBD) such as Crohn's disease (CD) and ulcerative colitis (UC) is increasing. Therefore, we aimed to investigate the incidence rates and trends over time in the population of children and adolescents in one of the federal states of Germany, in Saxony., Methods: Over the 10-year period 2000-2009 all 31 children's hospitals and pediatric gastroenterologists, respectively in Saxony reported all IBD patients up to 15 years of age to the Saxon Pediatric IBD Registry. The completeness of the registry was estimated as 96.7% by independent surveys in the years 2005-2009. Incidence rates were presented as age-standardized incidence rates (ASR) regarding New European Standard Population 1990 per 100,000 person-years (PY) with 95% confidence intervals [CI]. Joinpoint and linear regression was used for trend analyses., Results: 344 patients with confirmed IBD between 2000-2009 were included in the epidemiological evaluation: 212 (61.6%) patients with CD, 122 (35.6%) with UC and 10 (2.9%) with unclassified IBD (IBD-U). The ASR per 100,000 PY over the whole observation period was 7.2 [6.4-7.9] for IBD, 4.4 [3.8-5.0] for CD, 2.6 [2.1-3.0] for UC and 0.2 [0.1-0.3] for IBD-U. For IBD, the ASR per 100,000 PY increased from 4.6 [2.8-6.3] in 2000 to 10.5 [7.5-13.6] in 2009. The incidence trend analysis of ASRs using the joinpoint regression confirmed a significant increase of IBD as well as UC. The mean age at first diagnosis decreased significantly during the observation period from 11.5 (11.0-13.4) in 2000 to 9.6 (5.1-13.5) years in 2009. The median of the diagnostic latency among IBD patients was 3 months., Conclusion: The incidence of IBD in children and adolescents in Saxony was slightly higher than the average of other countries in the same time period and followed the trend towards a general increase of IBD. The age at diagnosis was subject to a very unfavorable downward trend., Competing Interests: The authors have declared that no competing interests exist.

While traditional image compression algorithms take a full three-component color representation of an image as input, capturing of such images is done in many applications with Bayer CFA pattern sensors that provide only a single color information per sensor element and position. In order to avoid additional complexity at the encoder side, such CFA pattern images can be compressed directly without prior conversion to a full color image. In this paper, we describe a recent activity of the JPEG committee (ISO SC 29 WG 1) to develop such a compression algorithm in the framework of JPEG XS. It turns out that it is important to understand the "development process" from CFA patterns to full color images in order to optimize the image quality of such a compression algorithm, which we will also describe shortly. We introduce (1) a novel decorrelation step upfront processing (the so-called Star-Tetrix transform), along with (2) a pre-emphasis function to improve the compression efficiency of the subsequent compression algorithm (here, JPEG XS). Our experiments clearly indicate a gain over a RGB compression workflow in terms of complexity and quality (between 1.5dB and more than 4dB depending on the target bitrate). A comparison is also made with other state-of-the-art CFA compression techniques.

High-performance polymers such as polymethacrylimides have outstanding properties, for example, a unique strength-to-weight ratio and a high thermal stability, usually coupled to a high glass transition temperature. However, the requirement of high processing temperatures caused by these high glass-transition temperatures is often not desired for melt extrusion processes. Herein, a novel and straightforward imidization process of poly(methacrylic anhydrides) is presented with different ratios of ammonia and N-isopropylamine that is induced by thermal treatment. Therefore, polymethacrylimides with a varying degree of N-substitution, and thus a varying number of hydrogen-bond-donating moieties, are synthesized under facile reaction conditions. An in-depth investigation into the structures obtained with this new methodology is undertaken via a combination of nuclear magnetic resonance spectroscopy (NMR), Fourier-transform infrared spectroscopy (FT-IR), and high-resolution electrospray ionization mass spectrometry (ESI-MS). Additionally, thermal properties of the materials are investigated using thermogravimetric analysis (TGA) and differential scanning calorimetry (DSC) analyses. These latter measurements highlight the key opportunity available with this novel synthesis to tailor the thermal properties of the polymer by providing a clear correlation between hydrogen bond formation, as observed by FT-IR, and the glass transition temperature., (© 2020 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.)

Background & Aims: Celiac disease can be identified by a serologic test for IgA against tissue transglutaminase (IgA-TTG) in a large proportion of children. However, the increased concentrations of antibody rarely normalize within the months after children are placed on a gluten-free diet (GFD). Early serologic predictors of sufficient adherence to GFD are required for optimal treatment., Methods: In a prospective study, we observed the response to a GFD in 345 pediatric patients (67% girls; mean age, 8.4 y) who underwent duodenal biopsy to confirm or refute celiac disease from October 2012 through December 2015. Baseline serum samples were tested centrally for IgA-TTG and IgG against deamidated gliadin. Follow-up serologic analyses of children on a GFD were performed about 3 months later., Results: The geometric mean concentration of IgA-TTG decreased from 72.4-fold to 5.2-fold the upper limit of normal (ULN), or by a factor of 14.0 (95% CI, 12.0-16.4). A substantial response (defined as a larger change than the typical variation in patients not on a GFD) was observed in 80.6% of the children. Only 28.1% of patients had a substantial response in the concentration of IgG against deamidated gliadin. Concentration of IgA-TTG remained above 1-fold the ULN in 83.8% of patients, and above 10-fold the ULN in 26.6% of patients with a substantial response., Conclusions: Serum concentration of IgA-TTG decreases substantially in most children with celiac disease within 3 months after they are placed on a GFD, but does not normalize in most. This information on changes in antibody concentrations can be used to assess patient response to the diet at short-term follow-up evaluations. Patients with a substantial response to a GFD often still have high antibody levels after 3 months. German Clinical Trials Registry no. DRKS00003854., (Copyright © 2018 AGA Institute. Published by Elsevier Inc. All rights reserved.)

Chemical and mechanical pattern formation is fundamental during embryogenesis and tissue development. Yet, the underlying molecular and cellular mechanisms are still elusive in many cases. Most current theories assume that tissue development is driven by chemical processes: either as a sequence of chemical patterns each depending on the previous one, or by patterns spontaneously arising from specific chemical interactions (such as "Turing-patterns"). Within both theories, mechanical patterns are usually regarded as passive by-products of chemical pre-patters. However, several experiments question these theories, and an increasing number of studies shows that tissue mechanics can actively influence chemical patterns during development. In this study, we thus focus on the interplay between chemical and mechanical processes during tissue development. On one hand, based on recent experimental data, we develop new mechanochemical simulation models of evolving tissues, in which the full 3D representation of the tissue appears to be critical for obtaining a realistic mechanochemical behaviour. The presented modelling approach is flexible and numerically studied using state of the art finite element methods. Thus, it may serve as a basis to combine simulations with new experimental methods in tissue development. On the other hand, we apply the developed approach and demonstrate that even simple interactions between tissue mechanics and chemistry spontaneously lead to robust and complex mechanochemical patterns. Especially, we demonstrate that the main contradictions arising in the framework of purely chemical theories are naturally and automatically resolved using the mechanochemical patterning theory., Competing Interests: The authors have declared that no competing interests exist.

Due to their high resolution, dynamic medical 2D+t and 3D+t volumes from computed tomography (CT) and magnetic resonance tomography (MR) reach a size which makes them very unhandy for teleradiologic applications. A lossless scalable representation offers the advantage of a down-scaled version which can be used for orientation or previewing, while the remaining information for reconstructing the full resolution is transmitted on demand. The wavelet transform offers the desired scalability. A very high quality of the lowpass sub-band is crucial in order to use it as a down-scaled representation. We propose an approach based on compensated wavelet lifting for obtaining a scalable representation of dynamic CT and MR volumes with very high quality. The mesh compensation is feasible to model the displacement in dynamic volumes which is mainly given by expansion and contraction of tissue over time. To achieve this, we propose an optimized estimation of the mesh compensation parameters to optimally fit for dynamic volumes. Within the lifting structure, the inversion of the motion compensation is crucial in the update step. We propose to take this inversion directly into account during the estimation step and can improve the quality of the lowpass sub-band by 0.63 and 0.43 dB on average for our tested dynamic CT and MR volumes at the cost of an increase of the rate by 2.4% and 1.2% on average.

Background & Aims: A diagnosis of celiac disease is made based on clinical, genetic, serologic, and duodenal morphology features. Recent pediatric guidelines, based largely on retrospective data, propose omitting biopsy analysis for patients with concentrations of IgA against tissue transglutaminase (IgA-TTG) >10-fold the upper limit of normal (ULN) and if further criteria are met. A retrospective study concluded that measurements of IgA-TTG and total IgA, or IgA-TTG and IgG against deamidated gliadin (IgG-DGL) could identify patients with and without celiac disease. Patients were assigned to categories of no celiac disease, celiac disease, or biopsy required, based entirely on antibody assays. We aimed to validate the positive and negative predictive values (PPV and NPV) of these diagnostic procedures., Methods: We performed a prospective study of 898 children undergoing duodenal biopsy analysis to confirm or rule out celiac disease at 13 centers in Europe. We compared findings from serologic analysis with findings from biopsy analyses, follow-up data, and diagnoses made by the pediatric gastroenterologists (celiac disease, no celiac disease, or no final diagnosis). Assays to measure IgA-TTG, IgG-DGL, and endomysium antibodies were performed by blinded researchers, and tissue sections were analyzed by local and blinded reference pathologists. We validated 2 procedures for diagnosis: total-IgA and IgA-TTG (the TTG-IgA procedure), as well as IgG-DGL with IgA-TTG (TTG-DGL procedure). Patients were assigned to categories of no celiac disease if all assays found antibody concentrations <1-fold the ULN, or celiac disease if at least 1 assay measured antibody concentrations >10-fold the ULN. All other cases were considered to require biopsy analysis. ULN values were calculated using the cutoff levels suggested by the test kit manufacturers. HLA typing was performed for 449 participants. We used models that considered how specificity values change with prevalence to extrapolate the PPV and NPV to populations with lower prevalence of celiac disease., Results: Of the participants, 592 were found to have celiac disease, 345 were found not to have celiac disease, and 24 had no final diagnosis. The TTG-IgA procedure identified patients with celiac disease with a PPV of 0.988 and an NPV of 0.934; the TTG-DGL procedure identified patients with celiac disease with a PPV of 0.988 and an NPV of 0.958. Based on our extrapolation model, we estimated that the PPV and NPV would remain >0.95 even at a disease prevalence as low as 4%. Tests for endomysium antibodies and HLA type did not increase the PPV of samples with levels of IgA-TTG ≥10-fold the ULN. Notably, 4.2% of pathologists disagreed in their analyses of duodenal morphology-a rate comparable to the error rate for serologic assays., Conclusions: In a prospective study, we validated the TTG-IgA procedure and the TTG-DGL procedure in identification of pediatric patients with or without celiac disease, without biopsy. German Clinical Trials Registry no.: DRKS00003854., (Copyright © 2017 AGA Institute. Published by Elsevier Inc. All rights reserved.)

Purpose: To systematically study the number of U.S. resident deaths from all causes, including suicide., Method: The more than 9,900 programs accredited by the Accreditation Council for Graduate Medical Education (ACGME) annually report the status of residents. The authors aggregated ACGME data on 381,614 residents in training during years 2000 through 2014. Names of residents reported as deceased were submitted to the National Death Index to learn causes of death. Person-year calculations were used to establish resident death rates and compare them with those in the general population., Results: Between 2000 and 2014, 324 individuals (220 men, 104 women) died while in residency. The leading cause of death was neoplastic disease, followed by suicide, accidents, and other diseases. For male residents the leading cause was suicide, and for female residents, malignancies. Resident death rates were lower than in the age- and gender-matched general population. Temporal patterns showed higher rates of death early in residency. Deaths by suicide were higher early in training, and during the first and third quarters of the academic year. There was no upward or downward trend in resident deaths over the 15 years of this study., Conclusions: Neoplastic disease and suicide were the leading causes of death in residents. Data for death by suicide suggest added risk early in residency and during certain months of the academic year. Providing trainees with a supportive environment and with medical and mental health services is integral to reducing preventable deaths and fostering a healthy physician workforce.

Background: Immunofluorescence assays of antibodies against endomysium (EmA) on primate oesophagus sections represent the gold standard in serological testing for coeliac disease (CD). As alternative immunofluorescence technique, staining of primate liver tissue is in use. We compared performance and predictive power of IgA- and IgG-EmA on primate oesophagus and primate liver sections., Methods: Sera of 298 paediatric biopsy-proven CD patients under gluten-containing diet and 574 disease controls were investigated. Samples were collected between 2004 and 2013 in six children's hospitals. The antibodies were assayed blinded to diagnoses and histological data. Sensitivity, specificity, and positive (PPV) and negative predictive values (NPV) were calculated for different assays., Results: (Oesophagus vs liver): For IgA-EmA, sensitivity (0.953 vs 0.956) and specificity (0.981 vs 0.972) as well as PPV (0.963 vs 0.947) and NPV (0.976 vs 0.979) were comparable on both tissues. IgG-EmA on liver showed significantly higher sensitivity (0.520 vs 0.631; p=0.006) but significantly lower specificity (0.995 vs 0.963; p=0.002) and PPV (0.981 vs 0.899; p=0.0002) than on oesophagus. NPV on liver was higher than NPV on oesophagus, however, the difference was not statistically significant (0.799 vs 0.834; p=0.099)., Conclusion: Primate liver can be used as alternative, equally well functioning substrate for IgA-EmA testing., (Copyright © 2016 Elsevier B.V. All rights reserved.)

Background: During embryogenesis, chemical (morphogen) and mechanical patterns develop within tissues in a self-organized way. More than 60 years ago, Turing proposed his famous reaction-diffusion model for such processes, assuming chemical interactions as the main driving force in tissue patterning. However, experimental identification of corresponding molecular candidates is still incomplete. Recent results suggest that beside morphogens, also tissue mechanics play a significant role in these patterning processes., Results: Combining continuous finite strain with discrete cellular tissue models, we present and numerically investigate mechanochemical processes, in which morphogen dynamics and tissue mechanics are coupled by feedback loops. We consider three different mechanical cues involved in such feedbacks: strain, stress, and compression. Based on experimental results, for each case, we present a feedback loop spontaneously creating robust mechanochemical patterns. In contrast to Turing-type models, simple mechanochemical interaction terms are sufficient to create de novo patterns., Conclusions: Our results emphasize mechanochemical processes as possible candidates controlling different steps of embryogenesis. To motivate further experimental research discovering related mechanisms in living tissues, we also present predictive in silicio experiments., Reviewers: Reviewer 1 - Marek Kimmel; Reviewer 2 - Konstantin Doubrovinski (nominated by Ned Wingreen); Reviewer 3 - Jun Allard (nominated by William Hlavacek).

In this paper, a model is developed for the evolution of plaques in arteries, which is one of the main causes for the blockage of blood flow. Plaque rupture and spread of torn-off material may cause closures in the down-stream vessel system and lead to ischemic brain or myocardial infarctions. The model covers the flow of blood and its interaction with the vessel wall. It is based on the assumption that the penetration of monocytes from the blood flow into the vessel wall, and the accumulation of foam cells increasing the volume, are main factors for the growth of plaques. The dynamics of the vessel wall is governed by a deformation gradient, which is given as composition of a purely elastic tensor, and a tensor modeling the biologically caused volume growth. An equation for the evolution of the metric is derived quantifying the changing geometry of the vessel wall. To calculate numerically the solutions of the arising free boundary problem, the model system of partial differential equations is transformed to an ALE (Arbitrary Lagrangian-Eulerian) formulation, where all equations are given in fixed domains. The numerical calculations are using newly developed algorithms for ALE systems. The results of the simulations, obtained for realistic system parameters, are in good qualitative agreement with observations. They demonstrate that the basic modeling assumption can be justified. The increase of stresses in the vessel wall can be computed. Medical treatment tries to prevent critical stress values, which may cause plaque rupture and its consequences.

The possibility of all-optical phase-preserving amplitude regeneration for star-8QAM is demonstrated using a modified nonlinear optical loop mirror. Experiments show a reduction in amplitude noise on both amplitude levels simultaneously, considering two different types of signal distortions: deterministic low-frequency amplitude modulation and broadband amplitude noise. Furthermore, using this amplitude regeneration, the robustness against nonlinear phase noise from fiber nonlinearity in a transmission line is increased. The scheme suppresses the conversion of amplitude noise to nonlinear phase noise. This is shown for simultaneous amplitude regeneration of the two amplitude states as well as for amplitude regeneration of the high-power states only. If the transmission is limited by nonlinear phase noise, single-level operation at the more critical higher-power state will benefit because of the wider plateau region. Numerical simulations confirm the experimental results.

We present experimental and numerical investigations of Kerr nonlinearity compensation in a 400-km standard single-mode fiber link with distributed Raman amplification with backward pumping. A dual-pump polarization-independent fiber-based optical parametric amplifier is used for mid-link spectral inversion of 5 × 28-GBd polarization-multiplexed 16-QAM signals. Signal quality factor (Q-factor) improvements of 1.1 dB and 0.8 dB were obtained in the cases of a single-channel and a five-channel wavelength-division multiplexing (WDM) system, respectively. The experimental results are compared to numerical simulations with good agreement. It is also shown with simulations that a maximum transmission reach of 2400 km enabled by the optical phase conjugator is possible for the WDM signal.

The aim of our study was to evaluate the quality of histo- and cytomorphological features of PAXgene-fixed specimens and their suitability for histomorphological classification in comparison to standard formalin fixation. Fifteen colon cancer tissues were collected, divided into two mirrored samples and either formalin fixed (FFPE) or PAXgene fixed (PFPE) before paraffin embedding. HE- and PAS-stained sections were scanned and evaluated in a blinded, randomised ring trial by 20 pathologists from Europe and the USA using virtual microscopy. The pathologists evaluated histological grading, histological subtype, presence of adenoma, presence of lymphovascular invasion, quality of histomorphology and quality of nuclear features. Statistical analysis revealed that the reproducibility with regard to grading between both fixation methods was rather satisfactory (weighted kappa statistic (k w) = 0.73 (95 % confidence interval (CI), 0.41-0.94)), with a higher agreement between the reference evaluation and the PFPE samples (k w = 0.86 (95 % CI, 0.67-1.00)). Independent from preservation method, inter-observer reproducibility was not completely satisfactory (k w = 0.60). Histomorphological quality parameters were scored equal or better for PFPE than for FFPE samples. For example, overall quality and nuclear features, especially the detection of mitosis, were judged significantly better for PFPE cases. By contrast, significant retraction artefacts were observed more frequently in PFPE samples. In conclusion, our findings suggest that the PAXgene Tissue System leads to excellent preservation of histomorphology and nuclear features of colon cancer tissue and allows routine morphological diagnosis.

Background: Tissue-engineered blood vessels (TEBVs) represent an innovative approach for overcoming reconstructive problems associated with vascular diseases by providing small-caliber vascular grafts. This study aimed to evaluate a novel biomaterial of bacterially synthesized cellulose (BC) as a potential scaffold for small-diameter TEBV., Methods: Small-diameter blood vessels with a supramolecular fiber network structure consisting of tubular hydrogels from biodesigned cellulose were created using Gluconacetobacter strains and Matrix reservoir technology. BC tubes (length: 100 mm, inner diameter: 4.0-5.0 mm) were applied to replace the carotid arteries of 10 sheep for a period of 3 mo to gain further insights into (a) functional (in vivo) performance, (b) ability of providing a scaffold for the neoformation of a vascular wall and (c) their proinflammatory potential, and the (d) technical feasibility of the procedure., Results: Preoperative analysis revealed a bursting strength of the grafts of approximately 800 mm Hg and suture retention strength of 4-5 N. Postexplantation analysis showed a patency rate of 50% (n = 5) and physiological performance of the patent grafts at 4, 8, and 12 wk postoperatively, compared with native arteries. Histologic analysis revealed a neoformation of a vascular wall-like structure along the BC scaffold consisting of immigrated vascular smooth muscle cells and a homogeneous endothelialization of the inner graft surface without signs of prothrombogenic or inflammatory potential. Scanning electron microscopy revealed a confluent luminal endothelial cell layer and the immigration of vascular smooth muscle cells into the BC matrix., Conclusions: BC grafts provide a scaffold for the neoformation of a three-layered vascular wall exhibit attractive properties for their use in future TEBV programs for cardiovascular surgery., (Copyright © 2014 Elsevier Inc. All rights reserved.)

Diagnosis of coeliac disease (CD) relies on a combination of clinical, genetic, serological and duodenal morphological findings. The ESPGHAN suggested that biopsy may not be necessary in all cases. New guidelines include omission of biopsy if the concentration of CD-specific antibodies exceeds 10 times the upper limit of normal (10 ULN) and other criteria are met. We analysed the 10 ULN criterion and investigated multiple antibody-assays. Serum was collected from 1071 children with duodenal biopsy (376 CD patients, 695 disease-controls). IgA-antibodies to tissue transglutaminase (IgA-aTTG), IgG-antibodies to deamidated gliadin peptides (IgG-aDGL) and IgA-endomysium antibodies (IgA-EMA) were measured centrally. We considered 3 outcomes for antibody test procedures utilizing IgA-aTTG and/or IgG-aDGL: positive (≥10 ULN, recommend gluten-free diet), negative (<1 ULN, no gluten-free diet) or unclear (perform biopsy). Positive (PPV) and negative (NPV) predictive values were based on clear test results. We required that they and their lower confidence bounds (LCB) be simultaneously very high (LCB >90% and PPV/NPV >95%). These stringent conditions were met for appropriate antibody-procedures over a prevalence range of 9-57%. By combining IgG-aDGL with IgA-aTTG, one could do without assaying total IgA. The PPV of IgG-aDGL was estimated to be extremely high, although more studies are necessary to narrow down the LCB. The proportion of patients requiring a biopsy was <11%. The procedures were either equivalent or even better in children <2 years compared to older children. All 310 of the IgA-aTTG positive children were also IgA-EMA positive. Antibody-assays could render biopsies unnecessary in most children, if experienced paediatric gastroenterologists evaluate the case. This suggestion only applies to the kits used here and should be verified for other available assays. Confirming IgA-aTTG positivity (≥10 ULN) by EMA-testing is unnecessary if performed on the same blood sample. Prospective studies are needed.

Objective: Helicobacter pylori (H.p.) infections play a very important role in the development of ulcerations and malignancies of the gastrointestinal tract. It is assumed that the primary infection occurs during childhood, depending on numerous environmental factors among them hygiene and social status. Our aim was to determine whether treatment with antibiotics affects the persistence of H.p. infection., Methods: In 2006, we conducted an epidemiological study among all grade 8 students in the city of Leipzig (mean age 14.6 years). To determine the prevalence of H.p. infection, a voluntary H.p. test (13C-urea breath test) was performed in all participants., Results: The H.p. prevalence was 6.3% (N = 1,598). A significant difference was found between those students who had been treated with an antibiotic at least once prior to the test and those who had never received any antibiotics (4.0% and 11.1%, respectively, p < 0.001). H.p. prevalence decreased with increasing numbers of antibiotic treatments., Conclusion: In adolescence, treatment with "non-H.p. specific" antibiotics appears to significantly affect H.p. prevalence. Moreover, the actual persistence of H.p. in "chronic persistent" H.p. infections appears to fluctuate at least in younger years. Thus, any "non-H.p. specific" antibiotic treatment should be considered in the diagnosis and treatment of H.p. infections and should be taken into account as an important confounder in future epidemiological studies.

The potential of 2,2';3,2″-terthiophene (3T) as branching units in 3D copolymers is presented with EDOT as an example comonomer. Branched EDOT/3T polythiophenes were prepared by electropolymerization, and their electrochemical and optical properties are discussed. Two different approaches were employed: (i) the direct electropolymerization of a novel branched thiophene monomer (3TE3) consisting of a 3T core that contains three outer EDOT end groups and (ii) the electrochemical copolymerization of a EDOT/3T mixture in different ratios from [1:1] to [1:10]. Cyclic voltammetric and vis spectrometric experiments show that the EDOT content within the polymer has a strong influence on the electronic properties of the material: with increasing EDOT content, the HOMO-LUMO gap is decreased. To prove copolymer formation of EDOT and 3T, chemically synthesized reference copolymers of EDOT and 3T were prepared by oxidative coupling using FeCl3, and their optical and electronic properties were compared to those of the electrodeposited films. In addition, the copolymer formation is indicated by the comparison of the electrochemical and spectroscopic results with those of the homopolymers P3T and PEDOT.

Stable Pb isotope ratios ((206)Pb/(207)Pb, (208)Pb/(206)Pb), (210)Pb, Pb, Al, Ca, Fe, Mn and Si concentrations were measured in 7 sediment cores from the west coast of the Iberian Peninsula to assess the Pb contamination throughout the last 200 years. Independently of their locations, all cores are characterized by increasing Pb/Al rends not related to grain-size changes. Conversely, decreasing trends of (206)Pb/(207)Pb were found towards the present. This tendency suggest a change in Pb sources reflecting an increased proportion derived from anthropogenic activities. The highest anthropogenic Pb inventories for sediments younger than 1950s were found in the two shallowest cores of Cascais and Lisboa submarine canyons, reflecting the proximity of the Tagus estuary. Lead isotope signatures also help demonstrate that sediments contaminated with Pb are not constrained to estuarine-coastal areas and upper parts of submarine canyons, but are also to transferred to a lesser extent to deeper parts of the Portuguese Margin., (Copyright © 2013 Elsevier Ltd. All rights reserved.)

Purpose: To test the image features that may be useful in predicting the visually lossless thresholds (VLTs) of body computed tomographic (CT) images for Joint Photographic Experts Group 2000 (JPEG2000) compression., Materials and Methods: The institutional review board approved this study, with a waiver of informed patient consent. One hundred body CT studies obtained in different patients by using five scanning protocols were obtained, and 100 images, each of which was selected from each of the 100 studies, were collected. Five radiologists independently determined the VLT of each image for JPEG2000 compression by using the QUEST algorithm. The 100 images were randomly divided into two data sets-the training set (50 images) and the testing set (50 images)-and the division was repeated 200 times. For each of the 200 divisions, a multiple linear regression model was constructed on a training set and tested on a testing set regarding each of five image features-standard deviation of image intensity, image entropy, relative percentage of low-frequency (LF) energy, variation in high-frequency (HF) energy, and visual complexity-as independent variables and considering the VLTs determined with the median value of the radiologists' responses as a dependent variable. The root mean square residual and intraclass correlation coefficient (ICC) for the 200 divisions between the VLTs predicted by the models and those determined by radiologists were compared between the models by using repeated-measures analysis of variance with post-hoc comparisons., Results: Mean root-mean-square residuals for multiple linear regression models constructed with variation in HF energy (1.20 ± 0.10 [standard deviation]) and visual complexity (1.09 ± 0.07) were significantly lower than those for standard deviation of image intensity (1.65 ± 0.13), image entropy (1.63 ± 0.14), and relative percentage of LF energy (1.58 ± 0.12) (P < .01). ICCs for variation in HF energy (0.64 ± 0.05) and visual complexity (0.71 ± 0.04) were significantly higher than those for standard deviation of image intensity (0.04 ± 0.02), image entropy (0.05 ± 0.02), and relative percentage of LF energy (0.20 ± 0.04) (P < .01)., Conclusion: Among the five tested image features, variation in HF energy and visual complexity were the most promising in predicting the VLTs of body CT images for JPEG2000 compression.

A NMR method related to 2D CH correlation with an additional double quantum filter for (31)P spin coupling was employed to follow the reaction kinetics of the two anomers of glucose during phosphorylation catalyzed by the enzyme yeast hexokinase. The kinetic parameters according to Michaelis-Menten for these reactions have been determined and it is shown that the β-anomer of glucose is phosphorylated faster by a factor of 1.4 versus the α-anomer. Use of human liver glucokinase as an enzyme yields more complex kinetics., (Copyright © 2013 Elsevier Ltd. All rights reserved.)

Objective: Assays for antibodies against native gliadin (anti-nGli) are still often assumed to perform better in the diagnosis of coeliac disease in young children than tests for antibodies to deamidated gliadin (anti-dGli), tissue transglutaminase (anti-tTG), and endomysium (EmA). We compared the performance of assays for anti-nGli, anti-dGli, anti-tTG, and EmA in this age group., Methods: We investigated retrospectively 184 children (42 with coeliac disease under normal diet and 142 controls) up to 2 years of age. Immunoglobulin (Ig) A- and IgG-anti-dGli, IgA- and IgG-anti-nGli, IgA- and IgG-anti-tTG, and IgA-EmA were measured in serum. Areas under receiver operating characteristics curves, sensitivities, specificities, positive and negative predictive values, positive and negative likelihood ratios, as well as diagnostic odds ratios were calculated., Results: From all of the tests investigated, only assays for IgG-anti-dGli, IgA-anti-tTG, and IgA-EmA had high specificity (≥ 0.96) connected with high sensitivity (≥ 0.86), with high positive predictive values (≥ 0.52 and ≥ 0.69 at pretest probabilities of 0.05 and 0.1, respectively) and negative predictive values (≥ 0.99 and ≥ 0.98 at pretest probabilities of 0.05 and 0.1, respectively). These assays also showed high positive likelihood ratio (≥ 24) at low negative likelihood ratio (≤ 0.15) and high diagnostic odds ratios (≥ 136)., Conclusions: Our results do not support the use of assays of anti-nGli to diagnose coeliac disease in young children. IgA-anti-tTG, IgA-EmA, and IgG-anti-dGli perform better than anti-nGli.

In this paper we present four-wave mixing (FWM) based parametric conversion experiments in p-i-n diode assisted silicon-on-insulator (SOI) nano-rib waveguides using continuous-wave (CW) light around 1550 nm wavelength. Using a reverse biased p-i-n waveguide diode we observe an increase of the wavelength conversion efficiency of more than 4.5 dB compared to low loss nano-rib waveguides without p-i-n junction, achieving a peak efficiency of -1 dB. Conversion efficiency improves also by more than 7 dB compared to previously reported experiments deploying 1.5 µm SOI waveguides with p-i-n structure. To the best of our knowledge, the observed peak conversion efficiency of -1dB is the highest CW efficiency in SOI reported so far.

Branched conjugated architectures should possess the advantage of isotropic charge transport compared to conventional linear conjugated polymers, as for example poly(3-hexylthiophene) (P3HT) which is commonly used in organic solar cells. This contribution investigates the optoelectronic properties of branched poly(thiophene)s p3T and p4T synthesized in a straightforward one-pot procedure by oxidative coupling of branched trithiophene and tetrathiophene monomers with FeCl(3). These polymers can be regarded as model systems for ideal amorphous conjugated materials. Optical characterization in solution and in thin films together with cyclic voltammetry data suggests the applicability of these materials for the use in organic solar cell devices. In particular, the HOMO and LUMO levels of the branched polythiophenes are shifted to lower energy values as compared to linear P3HT. Field effect mobilities are in the order of 10(-4) cm(2)/(V s). A first optimization of solar cell devices based on the branched polythiophene materials in combination with PCBM as acceptor resulted in efficiencies of 0.6% with open-circuit voltages being about 30% higher (up to 714 mV) than normally found with P3HT.

The synthesis of ionically functionalized branched polythiophenes with either carboxylic acid (anionic, P3T-COOH) or methylimidazolium (cationic, P3T-MIM) end groups is presented. Due to the large number of end groups present in the polymer, the functionalization has a major impact on the solubility of the polymers. In the case of P3T-COOH, the polymer shows a fully reversible phase transfer between organic solvents and water, depending on the pH. Remarkably, the ionic-liquid-modified polymer P3T-MIM is soluble in a room-temperature ionic liquid. The absorption properties are unaffected by the functional end groups., (© 2011 American Chemical Society)

A continuous model of two coupled monolayers constituting a fluid bilayer membrane is presented. The model is based on the minimization of a membrane free energy considering in both monolayer leaflets two different molecule types, undergoing lateral phase separation. Differences in the mechanical properties of the molecules, such as shape, stiffness, and length are accounted explicitly by the model. In the presented model, coupling between monolayers is realized via an energy-based model depending on the local distance between the two monolayers as well as the lengths of molecules constituting the local monolayer region. We numerically study different passive mechanisms for molecule sorting and correlation across the bilayer induced by first-order mechanical constraints. Here, we focus on three aspects: First, we find that stretching of the two monolayers in the normal direction yields a sorting of molecules according to their length. Furthermore, we show that the length of molecules can be used to synchronize phases across the bilayer membrane. Moreover, we find that generating curvature in one layer (induced by different curvature creating mechanisms) sorts molecules of the other layer according to their shape and stiffness. Many recent experimental data indicate the importance of specific lipid-protein interactions and the role of the bilayer thickness in membrane protein function and sorting. The presented model proposes different mechanisms leading to a colocalization of different components in different monolayers at the same place at the same time.

Purpose: To propose a preprocessing technique that increases the compressibility in reversible compressions of thin-section chest computed tomographic (CT) images and to measure the increase in compression ratio (CR) in Joint Photographic Experts Group (JPEG) 2000 two-dimensional (2D) and three-dimensional (3D) compressions., Materials and Methods: This study had institutional review board approval, with waiver of informed patient consent. A preprocessing technique that automatically segments pixels outside the body region and replaces their values with a constant value to maximize data redundancy was developed. One hundred CT studies (50 standard-radiation dose and 50 low-radiation dose studies) were preprocessed by using the technique and then reversibly compressed by using the JPEG2000 2D and 3D compression methods. The CRs (defined as the original data size divided by the compressed data size) with and those without use of the preprocessing technique were compared by using paired t tests. The percentage increase in the CR was measured., Results: The CR increased significantly (without vs with preprocessing) in JPEG2000 2D (mean CR, 2.40 vs 3.80) and 3D (mean CR, 2.61 vs 3.99) compressions for the standard-dose studies and in JPEG2000 2D (mean CR, 2.38 vs 3.36) and 3D (mean CR, 2.54 vs 3.55) compressions for the low-dose studies (P < .001 for all). The mean percentage increases in CR with preprocessing were 58.2% (95% confidence interval [CI]: 53.1%, 63.4%) and 52.4% (95% CI: 47.5%, 57.2%) in JPEG2000 2D and 3D compressions, respectively, for the standard-dose studies and 41.1% (95% CI: 38.8%, 43.4%) and 39.4% (95% CI: 37.4%, 41.7%) in JPEG2000 2D and 3D compressions, respectively, for the low-dose studies., Conclusion: The described preprocessing technique considerably increases CRs for reversible compressions of thin-section chest CT studies., (© RSNA, 2011.)

Background: Until the beginning of this decade the assumption was that the Helicobacter pylori prevalence increases with the age of the population under consideration. More and more epidemiological studies have been suggestive of constancy in Helicobacter pylori prevalence, but to date there has been no long-term follow-up study in a large group of children confirming this hypothesis., Methods: Following up our study of H. pylori among school starters and 2nd graders in 1998 and 2000, we conducted a third phase of this study in 2006 using the [13C]-Urea Breath Test and a detailed parent-completed epidemiological questionnaire to evaluate the development of prevalence among the overall population of 8th graders in the city of Leipzig (n = 1,905), and especially of the subgroup of participants who took part in all three study phases (n = 751)., Results: The overall H. pylori prevalence was 6.5% and had not significantly changed since 1998 and 2000 (6.1%, 5.7% respectively). However, we noticed a significant lower prevalence in the subgroup that participated in all study phases (2.7%). Moreover, we observed a dependence of prevalence on distribution of sociodemographic risk factors such as foreign nationality of at least one parent, birth outside of Germany, low parental education and unemployment, and > or = 2 older siblings., Conclusion: The variability in prevalence is most likely a result of unequal sociodemographic family backgrounds.

Background: In July 2003, the Accreditation Council for Graduate Medical Education (ACGME) introduced a set of regulations that mandated a reduction in the number of hours that medical residents can work. These requirements have generated controversy among medical educators, with some expressing concern that reducing resident hours may limit clinical exposure and competency, particularly in surgical specialties., Objective: This study examines the impact of duty hour restrictions on resident operative experience in residents in 2 surgical subspecialties since the implementation of the ACGME duty hour limits., Method: We examined operative log data for vascular surgery and pediatric surgery, using the academic year immediately preceding the duty hour restrictions, 2002 to 2003, as a baseline for comparison to subsequent academic years through 2006 to 2007 for vascular surgery and 2007 to 2008 for pediatric surgery., Results: Graduating fellows in pediatric surgery showed no change in their total operative volume following duty hour restrictions. The pediatric-defined category of neonate procedures showed an increase following duty hour restrictions. Graduating fellows in vascular surgery showed an increase in total major procedures as surgeon. The vascular-defined categories of endovascular-diagnostic, endovascular-therapeutic, and endovascular-graft procedures also increased., Conclusions: The reduction of duty hours has not resulted in a decrease in operative volume as some have predicted. Operative volume in pediatric surgery remained mainly unchanged, whereas operative volume in vascular surgery increased. We explore possible explanations for the observed findings.

Objective: To evaluate whether taking into account anti-deamidated gliadin peptide (DGP) antibody concentrations improves clinical interpretation., Design and Methods: We calculated likelihood ratios (LR) using data from two previously published studies for assays from EUROIMMUN and INOVA., Results: LRs markedly increased with increasing IgG anti-DGP concentrations. LRs also increased with increasing IgA anti-DGP concentrations, although they were lower than for IgG anti-DGP., Conclusions: Use of LRs for different test result intervals improves clinical interpretation., (Copyright © 2010 The Canadian Society of Clinical Chemists. Published by Elsevier Inc. All rights reserved.)

Background: Increased focus on the number and type of physicians delivering health care in the United States necessitates a better understanding of changes in graduate medical education (GME). Data collected by the Accreditation Council for Graduate Medical Education (ACGME) allow longitudinal tracking of residents, revealing the number and type of residents who continue GME following completion of an initial residency. We examined trends in the percent of graduates pursuing additional clinical education following graduation from ACGME-accredited pipeline specialty programs (specialties leading to initial board certification)., Methods: Using data collected annually by the ACGME, we tracked residents graduating from ACGME-accredited pipeline specialty programs between academic year (AY) 2002-2003 and AY 2006-2007 and those pursuing additional ACGME-accredited training within 2 years. We examined changes in the number of graduates and the percent of graduates continuing GME by specialty, by type of medical school, and overall., Results: The number of pipeline specialty graduates increased by 1171 (5.3%) between AY 2002-2003 and AY 2006-2007. During the same period, the number of graduates pursuing additional GME increased by 1059 (16.7%). The overall rate of continuing GME increased each year, from 28.5% (6331/22229) in AY 2002-2003 to 31.6% (7390/23400) in AY 2006-2007. Rates differed by specialty and for US medical school graduates (26.4% [3896/14752] in AY 2002-2003 to 31.6% [4718/14941] in AY 2006-2007) versus international medical graduates (35.2% [2118/6023] to 33.8% [2246/6647])., Conclusion: The number of graduates and the rate of continuing GME increased from AY 2002-2003 to AY 2006-2007. Our findings show a recent increase in the rate of continued training for US medical school graduates compared to international medical graduates. Our results differ from previously reported rates of subspecialization in the literature. Tracking individual residents through residency and fellowship programs provides a better understanding of residents' pathways to practice.

Hyperbranched polythiophenes were synthesized by potentiodynamic electropolymerization of 2,2';3',2''-terthiophene and 5'-(2-thienyl)-2,2';3',2''-terthiophene. The molecular architecture, i.e., the extent of branching of the resulting polymers, could be adjusted by varying the switching potentials. We compare these systems to hyperbranched polythiophenes which we obtained via a simple one-pot synthesis route based on FeCl(3) oxidative polymerization of the monomers. Interestingly, we find that the properties of the electropolymerized materials obtained with high switching potentials are comparable to those of the chemically synthesized polythiophenes. A detailed optical and electrochemical characterization of these systems is performed showing the high potential of this material class for optoelectronic applications. Cyclic voltammetry coupled with in situ conductance measurements further reveal reversible doping upon oxidation (p-doping) and reduction (n-doping) and comparable values for the conductance for the chemically and electrochemically synthesized materials.

This paper presents an investigation into spatial risk differences over small distances for the Helicobacter pylori infection in the city of Leipzig, Germany and two rural districts. A model, using Bayesian inference, was developed that adjusts the risk for individual-specific factors, and for spatial or individual over-dispersion, respectively. Additionally, the model takes into account conditional spatial autocorrelation. We found a significant positive association to the H. pylori infection risk for: "more than three children live in the household" (OR=2.4, p=0.001), "more persons live per sq.m than average" (OR=1.4, p=0.03), "home situated at main road" (OR=1.4, p=0.04) and "using well water" (OR=2.3, p=0.05). A protective effect was identified for "travelled to low prevalence region" (OR=0.4, p<0.0001) and "born in Germany" (OR=0.2, p<0.0001). Three administrative areas with significantly increased spatial risk were identified: one in the rural district and two in the city of Leipzig. The model explained 24.9% of the total deviance. Contrary to expectations, the largest part of deviance of the data was not explained by the identified significant risk factors, but by individual-specific heterogeneities. We conclude that further - so far not discussed - factors influence the risk and the spatial variation of the H.pylori infection. Furthermore, from the results we speculate about a possible impact of long-time air pollution and surface water., (Copyright 2010 Elsevier B.V. All rights reserved.)

This study aimed to evaluate three image fidelity metrics of different computational principles--peak signal-to-noise ratio (PSNR), high-dynamic range visual difference predictor (HDR-VDP), and multiscale structural similarity (MS-SSIM)--in measuring the fidelity of JPEG2000 compressed abdomen computed tomography images from a viewpoint of visually lossless compression. Three hundred images with 0.67- or 5-mm section thickness were compressed to one of five compression ratios ranging from reversible compression to 15:1. The fidelity of each compressed image was measured by five radiologists' visual analyses (distinguishable or indistinguishable from the original) and the three metrics. The Spearman rank correlation coefficients of the PSNR, HDR-VDP, and MS-SSIM values with the number of readers responding as indistinguishable were 0.86, 0.94, and 0.86, respectively. Using the pooled readers' responses as the reference standard, the area under the receiver-operating-characteristic curve for the HDR-VDP (0.99) was significantly greater than that for the PSNR (0.95) (p < 0.001) and for the MS-SSIM (0.96) (p = 0.003), and there was no significant difference between the PSNR and MS-SSIM (p = 0.70). In measuring the image fidelity, the HDR-VDP outperforms the PSNR and MS-SSIM, and the MS-SSIM and PSNR are comparable.

Objective: Resident duty hour restrictions were implemented in 2002-2003. This study examines changes in resident surgical experience since these restrictions were put into place., Method: Operative log data for 3 specialties were examined: general surgery, urology, and plastic surgery. The academic year immediately preceding the duty hour restrictions, 2002-2003, was used as a baseline for comparison to subsequent academic years. Operative log data for graduating residents through 2007-2008 were the primary focus of the analysis. Examination of associated variables that may moderate the relationship between fewer duty hours and surgical volume was also included., Results: Plastic surgery showed no changes in operative volume following duty hour restrictions. Operative volume increased in urology programs. General surgery showed a decrease in volume in some operative categories but an increase in others. Specifically the procedures in vascular, plastic, and thoracic areas showed a consistent decrease. There was no increase in the percentage of programs' graduates falling below minimum requirements. Procedures in pancreas, endocrine, and laparoscopic areas demonstrated an increase in volume. Graduates in larger surgical programs performed fewer procedures than graduates in smaller programs; this was not the case for urology or plastic surgery programs., Conclusions: The reduction of duty hours has not resulted in an across the board decrease in operative volume. Factors other than duty hour reforms may be responsible for some of the observed findings.

We report the simple one-pot synthesis of size tunable zinc oxide nanoparticles (ZnO NPs) out of an organometallic ZnO precursor using the self-assembly of solution phase polystyrene-block-poly(2-vinylpyridine) micelles. The resulting hybrid material could be deposited on various substrates in a straightforward manner with the NPs showing size-dependent absorption and photoluminescence due to the quantum-size effect. We compare the results to the assembly of preformed NPs which are selectively incorporated in the poly(2-vinylpyridine) core of the micelles due to the high affinity of ZnO to vinylpyridine., (Copyright © 2010 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.)

Background: Assays for IgG antibodies against deamidated gliadin (IgG-anti-dGli) are comparable in performance with tests detecting IgA antibodies against tissue transglutaminase (IgA-anti-tTG) in diagnosing celiac disease (CD). IgA-anti-tTG are absent in IgA deficiency, a condition often associated with CD. In IgA deficiency, IgG-anti-tTG, which have a lower overall diagnostic accuracy, are routinely measured. We examined whether IgG-anti-dGli would be useful for diagnosing CD in patients with IgA deficiency., Methods: We studied 34 IgA-deficient CD patients, 185 IgA-competent newly diagnosed children with CD, 316 children without CD, 400 adult blood donors, and 6 control IgA-deficient individuals without CD. Anti-dGli and anti-tTG were measured by ELISA, and endomysium antibodies (EmA) were measured by immunofluorescence on monkey esophagus (IgA as well as IgG class for all antibodies). We calculated diagnostic sensitivity (percentage of patients above cutoff with 95% CIs) according to age-specific cutoffs for 95% diagnostic specificity and according to cutoffs proposed by the manufacturer of the assays., Results: No IgA-deficient CD patients were positive for any IgA-based antibody assay. Diagnostic sensitivity of IgG-anti-tTG was 91.2% (95% CI 76.3%-97.7%) according to age-specific cutoffs and 82.4% (66.1%-92.0%) according to manufacturer cutoffs. The diagnostic sensitivity of IgG-EmA was 75.8% (58.8%-87.4%) and the sensitivity of IgG-anti-dGli was 88.2% (72.8%-95.9%) according to both cutoffs., Conclusions: IgG-anti-dGli and IgG-anti-tTG have comparable diagnostic sensitivities for IgA-deficient celiac patients. IgG-anti-dGli may be useful for diagnosing CD in IgA-deficient patients.

Antibodies to deamidated gliadin present a new tool in the diagnosis of celiac disease (CD). In children, the ELISA for the determination of IgG antibodies to (deamidated) gliadin-analogous fusion peptides (GAF3X) has a superior performance compared to the ELISA for the determination of antibodies against native gliadin and is comparable to assays for IgA antibodies against tissue transglutaminase (IgA-anti-tTG). The combined investigation of IgG antibodies to GAF3X (IgG-anti-GAF3X) and IgA-anti-tTG significantly increases the fraction of children definitely identified as either CD or non-CD patients. The new IgG-anti-GAF3X ELISA was also able to detect CD in three cases of IgA deficiency and in two cases of latent CD and was also useful in the diagnosis of children younger than 2 years of age.

Hyperbranched polythiophenes were prepared via a simple one-pot synthesis approach based on oxidative coupling of branched conjugated monomers. Only small variations in the building unit and architecture lead to large differences of absorption and photoluminescence properties. Interestingly, soluble hyperbranched polythiophenes with relatively small molecular weights show enhanced absorption at low and high wavelengths compared to linear analogues, such as poly(3-hexyl thiophenes) with high molecular weights. With this versatile approach we present a method to design tailor made, functional materials with potential applications in optoelectronics., (Copyright © 2009 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.)