Search Results (29)

Protecting threatened elasmobranch species despite limited data on their distribution and abundance is a critical challenge, particularly in the context of increasing human impacts on marine ecosystems. In the northeastern Atlantic, species such as the leafscale gulper shark, Portuguese dogfish, spurdog, and spotted ray are facing pressures from overfishing, bycatch, habitat degradation, and climate change. The OSPAR Commission has listed these species as threatened and/or declining and aims to protect them by reliably identifying suitable habitats and integrating these areas into Marine Protected Areas (MPAs). In this study, we present a spatial modelling framework using regression-based approaches to identify suitable habitats for these four species. Results show that suitable habitats of the spotted ray (25.8%) and spurdog (18.8%) are relatively well represented within existing MPAs, while those of the deep-water sharks are underrepresented (6.0% for leafscale gulper shark, and 6.8% for Portuguese dogfish). Our findings highlight the need for additional MPAs in deep-sea continental slope areas, particularly west and northwest of Scotland and Ireland. Such expansions would support OSPAR’s goal to protect 30% of its maritime area by 2030 and could benefit broader deep-sea biodiversity, including other vulnerable demersal species and benthic communities. Full article

Background/Objectives: Purinergic signaling, which involves extracellular ATP (eATP), its metabolites, purinergic receptors and ectonucleotidases, plays a pivotal role in the tumor microenvironment (TME), impacting tumor progression and the antineoplastic immune response. In this study, the CD39, CD73, P2X4, and P2X7 expression in NSCLC tumor cells and the surrounding stroma of 139 resected patients was examined. Methods: The study included tissue samples from 139 NSCLC patients. Tissue microarrays (TMAs) were constructed using 1.0 mm cores from annotated tumor regions. Immunohistochemical staining for CD39, CD73, P2X4, and P2X4 was performed on 2 µm sections. TMA slides were digitized and analyzed with QuPath, where staining intensity was evaluated using a semi-quantitative H-score. Statistical analysis, including survival analysis, was performed using R, to assess the impact of biomarker expression on patient outcomes. Results: High CD39 expression in both tumor and stromal cells was significantly associated with prolonged PFS (respectively: p = 0.0058 and p = 0.0067), particularly in adenocarcinoma (ADC) patients (respectively: p = 0.01 and p = 0.023). In the multivariable Cox model, low CD73 expression in tumor cells correlated with longer PFS (HR: 0.47; 95% CI: [0.28, 0.8], p = 0.005), while low CD73 expression in stromal cells was linked to increased progression risk (HR: 4.81; 95% CI: [1.61, 14.4], p = 0.001). Neither P2X7 nor P2X4 demonstrated a consistent effect on PFS in univariable analyses; however, multivariable analyses suggested that P2X4 might play a prognostic role in NSCLCs (HR: 0.37; 95% CI: [0.19, 0.73], p = 0.003). Conclusions: These findings underscore the importance of purinergic signaling in NSCLC prognosis and highlight the role of the ectonucleotidases CD39 and CD73 as potential therapeutic targets to enhance antineoplastic immune responses. Full article

The change in the surface properties of polymer materials used in an extracorporeal membrane oxygenation (ECMO) device due to nitric oxide (NO) treatment was characterized by zeta-potential and dynamic contact-angle measurements. FTIR-ATR was used to determine the stability of these effects during liquid contact. Polymethyl pentene (PMP), methyl methacrylate acrylonitrile butadiene styrene (MABS), and polyurethane (PU) were investigated. The polymer materials were treated with NO (1000 ppm) for 17 h. The samples for FTIR-ATR measurements were submerged in water or physiological sodium chloride solution for 120 and 240 h after the end of the gas treatment. PMP showed no changes at all. MABS showed decreased contact-angles and increased contact-angle hysteresis. In contrast, PU showed decreased contact-angles and a shift in its zeta-potential curve, indicating a more hydrophilic and acidic surface. The FTIR-ATR measurements showed a slight decrease in the signal intensities after liquid contact. The results indicated an improvement in the liquid contact properties of MABS and the PU due to increased surface hydrophilicity caused mainly by the adsorbed nitric acid (HNO₃) molecules formed by the NO treatment. The results presented in this paper point towards a simple and complication-free method of introducing NO into an ECMO circuit. Full article

Background: Surgeries represent a mainstay of medical care globally. Patterns of complications are frequently recognized late and place a considerable burden on health care systems. The aim was to develop and test the first deep learning-adjusted CUSUM program (DL-CUSUM) to predict and monitor in-hospital mortality in real time after liver transplantation. Methods: Data from 1066 individuals with 66,092 preoperatively available data point variables from 2004 to 2019 were included. DL-CUSUM is an application to predict in-hospital mortality. The area under the curve for risk adjustment with Model of End-stage Liver Disease (D-MELD), Balance of Risk (BAR) score, and deep learning (DL), as well as the ARL (average run length) and control limit (CL) for an in-control process over 5 years, were calculated. Results: D-MELD AUC was 0.618, BAR AUC was 0.648 and DL model AUC was 0.857. CL with BAR adjustment was 2.3 with an ARL of 326.31. D-MELD reached an ARL of 303.29 with a CL of 2.4. DL prediction resulted in a CL of 1.8 to reach an ARL of 332.67. Conclusions: This work introduces the first use of an automated DL-CUSUM system to monitor postoperative in-hospital mortality after liver transplantation. It allows for the real-time risk-adjusted monitoring of process quality. Full article

Effective protection of highly mobile and data-poor species constitutes a great challenge amid growing ocean exploitation and use. Blue whales and bowhead whales in the North-East Atlantic face several threats, such as climate change, ship strikes, pollution, and entanglement in fishing gear. Consequently, the OSPAR (“Oslo-Paris Convention for the Protection of the Marine Environment of the North-East Atlantic”) Commission recognised their need for protection and included them on the OSPAR List of Threatened and/or Declining Species. Two actions to protect these endangered species that OSPAR Contracting Parties have agreed on are (i) identifying areas that play an essential role in the species’ life cycle—subsequently called key habitats, and (ii) ensuring that those key habitats are covered by OSPAR marine protected areas (MPAs). In addition, OSPAR has committed to expanding its network of MPAs and other effective area-based conservation measures by 2030 to cover at least 30% of the OSPAR maritime area (termed the 30 × 30 target) from today’s approx. 11%. In this paper, we present the results of modelling key habitats for the bowhead and blue whales in the North-East Atlantic, including Arctic waters. Due to the sparse data situation for these species, we apply presence-only modelling methods. As this method can, in principle, produce somewhat biased results, we recommend that systematic, regular surveys on these species in Arctic waters be significantly intensified for future analyses to overcome the data paucity and allow using presence–absence/count data modelling approaches. Key habitats of blue whales were identified between Iceland and Svalbard, extending to the Azores. For bowhead whales, key habitats were identified in the Fram Strait. However, our findings show that only 11.8% of blue whale key habitats and 4.1% of bowhead whale key habitats are currently covered by OSPAR MPAs. To protect 30% of key habitats for these species in the most efficient way, our analyses suggest that suitable areas to designate new OSPAR MPAs are located around the Azores for blue whales and in the Fram Strait for bowhead whales. With these additional MPAs, OSPAR would substantially improve the protection of the two endangered species and, at the same time, progress towards its 30 × 30 target. Full article

Copper alloys containing chromium and hafnium combine elevated mechanical strength and high electrical and thermal conductivity. For the simultaneous enhancement of both material properties, precipitation hardening is the utilized mechanism. Therefore, the aim is to analyze the influence of chromium and hafnium in binary and ternary low-alloyed copper alloys and to compare the precipitation processes during temperature exposure. Atom probe tomography (APT) and differential scanning calorimetry (DSC) measurements enable to understand the precipitation sequence in detail. CuCr0.7 starts to precipitate directly, whereas CuHf0.7 is highly influenced by prior diffusion facilitating cold rolling. Within the ternary alloy, hafnium atoms accumulate at the shell of mainly Cr-containing precipitates. Increasing the local hafnium concentration results in the formation of intermetallic CuHf precipitates at the sites of mainly Cr-containing precipitates. Indirect methods are utilized to investigate the materials’ properties and show the impact of cold rolling prior to an aging treatment on binary alloys CuCr and CuHf. Finally, ternary alloys combine the benefits of facilitated precipitation processes and decelerated growing and coarsening, which classifies the alloys to be applicable for usage at elevated temperatures. Full article

Purpose: This study aimed to compare the clinical and radiographic outcomes of single posterior screw-retained monolithic implant crowns following a digital and conventional workflow and to report on the survival/complication rate after a mean 4-year follow-up. Materials and Methods: Thirty patients with a single posterior tooth missing were rehabilitated with a bone-level implant. After a healing period of ≥3 months, they were subjected to both a digital and conventional workflow to fabricate two screw-retained monolithic implant crowns. The quantitative clinical adjustments to both crowns (intrasubject comparison) and a questionnaire were recorded at try-in. Thereafter, a crown of the digital and conventional workflows was randomly inserted. At the last follow-up, the marginal bone level (MBL), peri-implant health-related parameters (bleeding on probing (BoP), plaque, pocket probing depth (PPD)), and functional implant prosthodontic score (FIPS) were assessed. Furthermore, the implant survival and success rates and technical complications were evaluated. Results: A total of 27 patients were followed for a mean period of 4.23 ± 1.10 years. There was no significant difference between the digital and conventional workflows regarding clinical adjustments and questionnaire outcomes. More than twice as many participants recommended digital (n = 16) compared to conventional impressions (n = 7) to friends. The implant survival and success rate were 100% and 96.3%, respectively. Furthermore, two de-cementations and one fracture of the ti-base abutment occurred. There were no significant differences in BoP, plaque, and PPD metrics between the two groups. The changes in the MBL between implant crown insertion (baseline) and the last follow-up were 0.07 ± 0.19 mm and 0.34 ± 0.62 mm in the digital and conventional groups, respectively (p = 0.195). The mean overall FIPS score was 8.11 ± 1.37 (range: 5–10). Conclusions: The clinical and radiographic outcomes of single screw-retained monolithic implant crowns were similar between both workflows after a mean of 4 years of service. The patients did not clearly prefer an impression technique for their restoration, although they would recommend the digital impression more often to friends. Thus, decision regarding clinical workflows may be based on the patient’s and/or clinician’s preference. Full article

Consistent lightweight construction in the area of vehicle manufacturing requires the increased use of multi-material combinations. This, in turn, requires an adaptation of standard joining techniques. In multi-material combinations, the importance of integral cast components, in particular, is increasing and poses additional technical challenges for the industry. One approach to solve these challenges is adaptable joining elements manufactured by a thermomechanical forming process. By applying an incremental and thermomechanical joining process, it is possible to react immediately and adapt the joining process inline to reduce the number of different joining elements. In the investigation described in this publication, cast plates made of the cast aluminium alloy EN AC-AlSi9 serve as joining partners, which are processed by sand casting. The joining process of hypoeutectic AlSi alloys is challenging as their brittle character leads to cracks in the joint during conventional mechanical joining. To solve this, the frictional heat of the novel joining process applied can provide a finer microstructure in the hypoeutectic AlSi9 cast alloy. In detail, its Si is finer-grained, resulting in higher ductility of the joint. This study reveals the thermomechanical joining suitability of a hypoeutectic cast aluminium alloy in combination with adaptively manufactured auxiliary joining elements. Full article

Heterostructured materials such as metallic laminates (LMCs) can be specifically tailored to showcase significantly increased mechanical behavior based on the hetero-deformation-induced (HDI) strengthening effect caused by the co-deformation at the vicinity of interfaces. This study introduces a new approach to quantify these co-deformation effects in metallic laminates by characterizing the behavior of inelastic back strain upon unloading. Experimentally, the inelastic back strain (IBS) is determined by cyclic loading–unloading–reloading (LUR) tensile tests. Compared to a linear rule of mixture (ROM) approximation used as a reference, additional amounts of inelastic back strain were measured for different metallic laminate systems, strongly depending on the dissimilarities of yield strength and elastic moduli of constituents and the interface density in the laminates. Conducting finite element analysis, the distribution of residual plastic strain was investigated for the different metallic laminates used in this study. Based on this, a schematic overview of the spatial distribution of the hetero-deformation zone for metallic laminates with dissimilar yield strength and elastic moduli is derived, summarizing the results of this study. As most mechanical components are subject to cyclic stresses during the application, the method provided in this study to characterize the co-deformation behavior of metallic laminates in the microyielding regime enables valuable insights into mechanisms affecting the cyclic deformation behavior of metallic laminates for future applications. Full article

Freeze Foams are cellular, ceramic structures with hierarchical pore structures that are manufactured using the direct foaming process. By tailoring their morphology and strength, these foam structures are able to cover a wide range of application. Earlier works identified that pore-forming influencing factors (water and air content, suspension temperature, as well as pressure reduction rate) dictate the constitution on a macroscopic and microscopic scale. Therefore, the ability to manufacture foams whose properties align with the component requirements would be an important step in advancing towards a widespread application of these promising materials. With this goal in mind, the correlation between the pore-forming influencing factors and the resulting mechanical properties was quantified. Foams with independently adjustable porosities were produced at the micro and macro scales and evaluated according to their material failure behavior under compressive loads. As a result, foams with determined macroporosities between 38 and 62%, microporosities between 25 and 42%, and compression strengths between 1 and 7 MPa with different material failure characteristics were manufactured and systematically investigated. Full article

Non-alcoholic fatty liver disease (NAFLD) is a spectrum of liver disease, ranging from simple steatosis to hepatitis, fibrosis, cirrhosis, and hepatocellular carcinoma (HCC). Liver fibrosis, which portends a poor prognosis in NAFLD, is characterized by the excessive accumulation of extracellular matrix (ECM) proteins resulting from abnormal wound repair response and metabolic disorders. Various metabolic factors play crucial roles in the progression of NAFLD, including abnormal lipid, bile acid, and endotoxin metabolism, leading to chronic inflammation and hepatic stellate cell (HSC) activation. Autophagy is a conserved process within cells that removes unnecessary or dysfunctional components through a lysosome-dependent regulated mechanism. Accumulating evidence has shown the importance of autophagy in NAFLD and its close relation to NAFLD progression. Thus, regulation of autophagy appears to be beneficial in treating NAFLD and could become an important therapeutic target. Full article

(1) Background: Post-reperfusion syndrome (PRS) and electrolyte shifts (ES) represent considerable challenges during liver transplantation (LT) being associated with significant morbidity. We aimed to investigate the impact of hypothermic oxygenated machine perfusion (HOPE) on PRS and ES in LT. (2) Methods: In this retrospective study, we compared intraoperative parameters of 100 LTs, with 50 HOPE preconditioned liver grafts and 50 grafts stored in static cold storage (SCS). During reperfusion phase, prospectively registered serum parameters and vasopressor administration were analyzed. (3) Results: Twelve percent of patients developed PRS in the HOPE cohort vs. 42% in the SCS group (p = 0.0013). Total vasopressor demand in the first hour after reperfusion was lower after HOPE pretreatment, with reduced usage of norepinephrine (−26%; p = 0.122) and significant reduction of epinephrine consumption (−52%; p = 0.018). Serum potassium concentration dropped by a mean of 14.1% in transplantations after HOPE, compared to a slight decrease of 1% (p < 0.001) after SCS. The overall incidence of early allograft dysfunction (EAD) was reduced by 44% in the HOPE group (p = 0.04). (4) Conclusions: Pre-transplant graft preconditioning with HOPE results in higher hemodynamic stability during reperfusion and lower incidence of PRS and EAD. HOPE has the potential to mitigate ES by preventing hyperpotassemic complications that need to be addressed in LT with HOPE-pre-treated grafts. Full article

Background: Osteoporotic fractures are associated with a loss of quality of life, but only few patients receive an appropriate therapy. Therefore, the present study aims to investigate the awareness of musculoskeletal patients to participate in osteoporosis assessment and to evaluate whether there are significant differences between acute care patients treated for major fractures of the hip compared to elective patients treated for hip joint replacement.; Methods: From May 2015 to December 2016 patients who were undergoing surgical treatment for proximal femur fracture or total hip replacement due to osteoarthritis and were at risk for an underlying osteoporosis (female > 60 and male > 70 years) were included in the study and asked to complete a questionnaire assessing the awareness for an underlying osteoporosis. ASA Score, FRAX Score, and demographic information have also been examined. Results: In total 268 patients (female = 194 (72.0%)/male = 74 (28%)), mean age 77.7 years (±7.7) undergoing hip surgery were included. Of these, 118 were treated for fracture-related etiology and 150 underwent total hip arthroplasty in an elective care setting. Patients were interviewed about their need for osteoporosis examination during hospitalization. Overall, 76 of 150 patients receiving elective care (50.7%) considered that an examination was necessary, whereas in proximal femur fracture patients the awareness was lower, and the disease osteoporosis was assessed as threatening by significantly fewer newly fractured patients. By comparison, patients undergoing trauma surgery had a considerably greater risk of developing another osteoporotic fracture than patients undergoing elective surgery determined by the FRAX^® Score (p ≤ 0.001).; Conclusions: The patients’ motivation to endure additional osteoporosis diagnostic testing is notoriously low and needs to be increased. Patients who underwent acute care surgery for a fragility proximal femur fracture, although acutely affected by the potential consequences of underlying osteoporosis, showed lower awareness than the elective comparison population that was also on average 6.1 years younger. Although elective patients were younger and at a lower risk, they seemed to be much more willing to undergo further osteoporosis assessment. In order to better identify and care for patients at risk, interventions such as effective screening, early initiation of osteoporosis therapy in the inpatient setting and a fracture liaison service are important measures. Full article

Background: The “digital era” in the field of medicine is the new “here and now”. Artificial intelligence has entered many fields of medicine and is recently emerging in the field of organ transplantation. Solid organs remain a scarce resource. Being able to predict the outcome after liver transplantation promises to solve one of the long-standing problems within organ transplantation. What is the perfect donor recipient match? Within this work we developed and validated a novel deep-learning-based donor–recipient allocation system for liver transplantation. Method: In this study we used data collected from all liver transplant patients between 2004 and 2019 at the university transplantation centre in Munich. We aimed to design a transparent and interpretable deep learning framework to predict the outcome after liver transplantation. An individually designed neural network was developed to meet the unique requirements of transplantation data. The metrics used to determine the model quality and its level of performance are accuracy, cross-entropy loss, and F1 score as well as AUC score. Results: A total of 529 transplantations with a total of 1058 matching donor and recipient observations were added into the database. The combined prediction of all outcome parameters was 95.8% accurate (cross-entropy loss of 0.042). The prediction of death within the hospital was 94.3% accurate (cross-entropy loss of 0.057). The overall F1 score was 0.899 on average, whereas the overall AUC score was 0.940. Conclusion: With the achieved results, the network serves as a reliable tool to predict survival. It adds new insight into the potential of deep learning to assist medical decisions. Especially in the field of transplantation, an AUC Score of 94% is very valuable. This neuronal network is unique as it utilizes transparent and easily interpretable data to predict the outcome after liver transplantation. Further validation must be performed prior to utilization in a clinical context. Full article

Freeze foams are novel and innovative cellular structures that are based on a direct foaming process and that can be manufactured using any material that can be processed by powder technology. The foam formation process is characterized by the highly complex interaction of various process and material parameters that were chosen empirically and that have so far been difficult to reproduce. To allow properties to be specifically tailored towards certain applications, it is necessary to examine the phenomena observed during foam formation as well as the impact of the process and material parameters on the structural constitution to deduce guidelines for manufacturing and quality assessment (e.g., mechanical strength, cell and pore sizes, pore size distribution). The variety of possible applications are a result of the wide spectrum of initial suspensions and especially the foam structure properties derived from process parameters such as the cell geometry, pore size distribution, fraction of open and closed porosity, and the textures of the cell struts. Due to earlier findings, the focus of this paper focuses on adjusting and tailoring the macrostructure (homogenization of the pore sizes and their distribution inside foam cells) to create load- and application-adapted ceramic foams. To this end, an experiment was designed using previously identified pore and characteristic influencers (air and water content, temperature of the suspension, pressure reduction rate) as influencing parameters. Their interconnected impacts on selected target values were examined during the freeze foaming process using an in situ freeze foaming device inside an X-ray. Full article