Old & New Jager, Frank Peter
2012, 2010, 2012-11-05
eBook
Alt und Neu liefert einen umfassenden Überblick über intelligente Konzepte für den Umgang mit Bestand, gegliedert in die Kategorien Addition, Transformation und Umnutzung. Vorgestellt werden sowohl ...alltägliche Projekte wie die Revitalisierung von Wohnbauten der 50er bis 70er-Jahre als auch spektakuläre Bauaufgaben. Mit Fachbeiträgen zu technischen Aspekten der Sanierung, z.B. energetische Ertüchtigung. Frank Peter Jäger is an architectural journalist and owner of the Archikontext agency in Berlin, which advises architects, landscape architects, and real estate firms in the areas of project presentation, marketing, book production, and public relations work.
Objective
To address the focused question, is there an impact of platform switching (PS) on marginal bone level (MBL) changes around endosseous implants compared to implants with platform matching ...(PM) implant‐abutment configurations?
Material and methods
A systematic literature search was conducted using electronic databases PubMed, Web of Science, Journals@Ovid Full Text and Embase, manual search for human randomized clinical trials (RCTs) and prospective clinical controlled cohort studies (PCCS) reporting on MBL changes at implants with PS‐, compared with PM‐implant‐abutment connections, published between 2005 and June 2013.
Results
Twenty‐two publications were eligible for the systematic review. The qualitative analysis of 15 RCTs and seven PCCS revealed more studies (13 RCTs and three PCCS) showing a significantly less mean marginal bone loss around implants with PS‐ compared to PM‐implant‐abutment connections, indicating a clear tendency favoring the PS technique. A meta‐analysis including 13 RCTs revealed a significantly less mean MBL change (0.49 mm CI95% 0.38; 0.60) at PS implants, compared with PM implants (1.01 mm CI95% 0.62; 1.40 (P < 0.0001).
Conclusions
The meta‐analysis revealed a significantly less mean MBL change at implants with a PS compared to PM‐implant‐abutment configuration. Studies included herein showed an unclear as well as high risk of bias mostly, and relatively short follow‐up periods. The qualitative analysis revealed a tendency favoring the PS technique to prevent or minimize peri‐implant marginal bone loss compared with PM technique. Due to heterogeneity of the included studies, their results require cautious interpretation.
Drug-coated balloons (DCB) are a novel therapeutic strategy for small native coronary artery disease. However, their safety and efficacy is poorly defined in comparison with drug-eluting stents ...(DES).
BASKET-SMALL 2 was a multicentre, open-label, randomised non-inferiority trial. 758 patients with de-novo lesions (<3 mm in diameter) in coronary vessels and an indication for percutaneous coronary intervention were randomly allocated (1:1) to receive angioplasty with DCB versus implantation of a second-generation DES after successful predilatation via an interactive internet-based response system. Dual antiplatelet therapy was given according to current guidelines. The primary objective was to show non-inferiority of DCB versus DES regarding major adverse cardiac events (MACE; ie, cardiac death, non-fatal myocardial infarction, and target-vessel revascularisation) after 12 months. The non-inferiority margin was an absolute difference of 4% in MACE. This trial is registered with ClinicalTrials.gov, number NCT01574534.
Between April 10, 2012, and February 1, 2017, 382 patients were randomly assigned to the DCB group and 376 to DES group. Non-inferiority of DCB versus DES was shown because the 95% CI of the absolute difference in MACE in the per-protocol population was below the predefined margin (−3·83 to 3·93%, p=0·0217). After 12 months, the proportions of MACE were similar in both groups of the full-analysis population (MACE was 7·5% for the DCB group vs 7·3% for the DES group; hazard ratio HR 0·97 95% CI 0·58–1·64, p=0·9180). There were five (1·3%) cardiac-related deaths in the DES group and 12 (3·1%) in the DCB group (full analysis population). Probable or definite stent thrombosis (three 0·8% in the DCB group vs four 1·1% in the DES group; HR 0·73 0·16–3·26) and major bleeding (four 1·1% in the DCB group vs nine 2·4% in the DES group; HR 0·45 0·14–1·46) were the most common adverse events.
In small native coronary artery disease, DCB was non-inferior to DES regarding MACE up to 12 months, with similar event rates for both treatment groups.
Schweizerischer Nationalfonds zur Förderung der Wissenschaftlichen Forschung, Basel Cardiovascular Research Foundation, and B Braun Medical AG.
Antibody pharmacokinetics and pharmacodynamics are often governed by biological processes such as binding to antigens and other cognate receptors. Emphasis must also be placed, however, on ...fundamental physicochemical properties that define antibodies as complex macromolecules, including shape, size, hydrophobicity, and charge. Electrostatic interactions between anionic cell membranes and the predominantly positive surface charge of most antibodies can influence blood concentration and tissue disposition kinetics in a manner that is independent of antigen recognition. In this context, the deliberate modification of antibodies by chemical means has been exploited as a valuable preclinical research tool to investigate the relationship between net molecular charge and biological disposition. Findings from these exploratory investigations may be summarized as follows: (I) shifts in isoelectric point of approximately one pI unit or more can produce measurable changes in tissue distribution and kinetics, (II) increases in net positive charge generally result in increased tissue retention and increased blood clearance, and (III) decreases in net positive charge generally result in decreased tissue retention and increased whole body clearance. Understanding electrostatic interactions between antibodies and biological matrices holds relevance in biotechnology, especially with regard to the development of immunoconjugates. The guiding principles and knowledge gained from preclinical evaluation of chemically modified antibodies will be discussed and placed in the context of therapeutic antibodies that are currently marketed or under development, with a particular emphasis on pharmacokinetic and disposition properties.
In the treatment of de-novo coronary small vessel disease, drug-coated balloons (DCBs) are non-inferior to drug-eluting stents (DESs) regarding clinical outcome up to 12 months, but data beyond 1 ...year is sparse. We aimed to test the long-term efficacy and safety of DCBs regarding clinical endpoints in an all-comer population undergoing percutaneous coronary intervention.
In this prespecified long-term follow-up of a multicentre, randomised, open-label, non-inferiority trial, patients from 14 clinical sites in Germany, Switzerland, and Austria with de-novo lesions in coronary vessels <3 mm and an indication for percutaneous coronary intervention were randomly assigned 1:1 to DCB or second-generation DES and followed over 3 years for major adverse cardiac events (ie, cardiac death, non-fatal myocardial infarction, and target-vessel revascularisation TVR), all-cause death, probable or definite stent thrombosis, and major bleeding (Bleeding Academic Research Consortium bleeding type 3–5). Analyses were performed on the full analysis set according to the modified intention-to-treat principle. Dual antiplatelet therapy was recommended for 1 month after DCB and 6 months after DES with stable symptoms, but 12 months with acute coronary syndromes. The study is registered with ClinicalTrials.gov, NCT01574534 and is ongoing.
Between April 10, 2012, and Feb 1, 2017, of 883 patients assessed, 758 (86%) patients were randomly assigned to the DCB group (n=382) or the DES group (n=376). The Kaplan-Meier estimate of the rate of major adverse cardiac events was 15% in both the DCB and DES groups (hazard ratio HR 0·99, 95% CI 0·68–1·45; p=0·95). The two groups were also very similar concerning the single components of adverse cardiac events: cardiac death (Kaplan-Meier estimate 5% vs 4%, HR 1·29, 95% CI 0·63–2·66; p=0·49), non-fatal myocardial infarction (both Kaplan-Meier estimate 6%, HR 0·82, 95% CI 0·45–1·51; p=0·52), and TVR (both Kaplan-Meier estimate 9%, HR 0·95, 95% CI 0·58–1·56; p=0·83). Rates of all-cause death were very similar in DCB versus DES patients (both Kaplan-Meier estimate 8%, HR 1·05, 95% CI 0·62–1·77; p=0·87). Rates of probable or definite stent thrombosis (Kaplan-Meier estimate 1% vs 2%; HR 0·33, 95% CI 0·07–1·64; p=0·18) and major bleeding (Kaplan-Meier estimate 2% vs 4%, HR 0·43, 95% CI 0·17–1·13; p=0·088) were numerically lower in DCB versus DES, however without reaching significance.
There is maintained efficacy and safety of DCB versus DES in the treatment of de-novo coronary small vessel disease up to 3 years.
Swiss National Science Foundation, Basel Cardiovascular Research Foundation, and B Braun Medical.
•We use a global sensitivity analysis to assess the sensitivity of evapotranspiration to the hydrodynamic parameters.•Hydrodynamic parameter uncertainties lead to 20% to 50% uncertainties in ...simulated evapotranspiration.•Evapotranspiration is sensitive to the permeability in grasslands and the Van Genutchen parameters in forests.
Accurate quantification of the evolution of water resources requires a better understanding of the movements of water and energy from the subsurface to the lower atmosphere; physically-based integrated hydrologic models provide one of the key approaches to build such understanding. However, these models utilize a significant number of parameters that are measured only sparsely if at all—in particular, the hydrodynamic parameters. In this work, we perform a global sensitivity analysis to quantify the sensitivity of evapotranspiration (ET) to the hydrodynamic parameters. We study the East River watershed located in the Coloradobasinand characterized by cold and snowy winters and hot summers, high topographic gradients, and heterogeneous land cover and geology. Our results highlight that hydrodynamic parameter uncertainties lead to 20% to 50% uncertainties in ET.In areas characterized by a disconnection betweengroundwaterand land surface processes (under water-limited conditions),hydrodynamic parameter uncertainties strongly impactETwhich is highly sensitive to the parameters describing the unsaturated zone parameters. Conversely, in energy-limited areas where plants have year-round access to groundwater,ETis mainly sensitive to the effects of saturated hydraulic conductivities. ET uncertainties due to the uncertainties in hydrodynamic parameters were higher than those associated with the river stages and water table depths. Therefore,ETmeasurements could be used to improve the estimation of hydrodynamic parameters.
Cone beam computed tomography (CBCT) is often employed on radiation therapy treatment devices (linear accelerators) used in image-guided radiation therapy (IGRT). For each treatment session, it is ...necessary to obtain the image of the day in order to accurately position the patient and to enable adaptive treatment capabilities including auto-segmentation and dose calculation. Reconstructed CBCT images often suffer from artifacts, in particular those induced by patient motion. Deep-learning based approaches promise ways to mitigate such artifacts.
We propose a novel deep-learning based approach with the goal to reduce motion induced artifacts in CBCT images and improve image quality. It is based on supervised learning and includes neural network architectures employed as pre- and/or post-processing steps during CBCT reconstruction.
Our approach is based on deep convolutional neural networks which complement the standard CBCT reconstruction, which is performed either with the analytical Feldkamp-Davis-Kress (FDK) method, or with an iterative algebraic reconstruction technique (SART-TV). The neural networks, which are based on refined U-net architectures, are trained end-to-end in a supervised learning setup. Labeled training data are obtained by means of a motion simulation, which uses the two extreme phases of 4D CT scans, their deformation vector fields, as well as time-dependent amplitude signals as input. The trained networks are validated against ground truth using quantitative metrics, as well as by using real patient CBCT scans for a qualitative evaluation by clinical experts.
The presented novel approach is able to generalize to unseen data and yields significant reductions in motion induced artifacts as well as improvements in image quality compared with existing state-of-the-art CBCT reconstruction algorithms (up to +6.3 dB and +0.19 improvements in peak signal-to-noise ratio, PSNR, and structural similarity index measure, SSIM, respectively), as evidenced by validation with an unseen test dataset, and confirmed by a clinical evaluation on real patient scans (up to 74% preference for motion artifact reduction over standard reconstruction).
For the first time, it is demonstrated, also by means of clinical evaluation, that inserting deep neural networks as pre- and post-processing plugins in the existing 3D CBCT reconstruction and trained end-to-end yield significant improvements in image quality and reduction of motion artifacts.
An efficient route to architecturally defined, sub‐20 nm soft nanoparticles fabricated from single polymer chains via intramolecular photodimerization of pendant anthracene units is presented. ...Photodimerization is confirmed by the disappearance of the characteristic anthracene π−π* absorption peak at ≈360 nm measured by UV–vis spectroscopy. Size exclusion chromatography (SEC) with UV, multi‐angle light scattering (MALS), and viscometric detection confirms that as photodimers form, the chains fold to form nanoparticles, demonstrated by shifts in the SEC traces to longer retention times as a function of increased irradiation time. These shifts indicate a reduction in hydrodynamic radius, corroborated and quantified by viscometric data. MALS detector traces reveal the presence of a small amount of chain–chain coupling during this process, but confirm that this is primarily a single‐chain phenomenon. Electron microscopy provides visual confirmation of nanoparticle formation.
The intra‐chain photodimerization of anthracene‐functionalized polymers in dilute solution is presented as an efficient route to architecturally defined nanoparticles. UV–vis spectroscopy confirms anthracene photodimerization, triple detection SEC confirms that these intramolecular linkages induce chains to fold into nanoparticles. TEM images reveal architecturally defined, oblong nanoparticles in the sub‐20 nm size regime.
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