The Front Cover illustrates the hyperpolarization of bulk water in a recently established catalytic system. It is called NEPTUN (nuclear exchange polarization by transposing unattached nuclei) and is ...based on a novel non‐pairwise chemical exchange process between single p‐H2 protons and solvent molecules. More information can be found in the Communication by M. Emondts et al. on page 2614 in Issue 20, 2018 (DOI: 10.1002/cphc.201800521).
Hyperpolarization with parahydrogen (p‐H2) is a fast developing field in NMR, which enables overcoming the inherent low sensitivity of this important technique. The hyperpolarization of solvents, ...particularly of water, offers a wide range of applications for structural investigations of macromolecules and biomedical imaging. Until lately, only organic solvents could be polarized by means of parahydrogen via coherent redistribution of polarization (SABRE mechanism). In this study, we investigate in detail the mechanism of the recently reported bulk water hyperpolarization with a combination of theoretical and experimental methods, finally showing a chemical exchange pathway of single protons as basis for the enhancement. The prerequisites for preserving hyperpolarization upon separation of the two hydrogen atoms of p−H2 are demonstrated by theoretical examinations of the boundary conditions for the hyperpolarization experiments in accordance with the OneH−PHIP theory. These findings yielded the proposal of the novel NEPTUN mechanism (Nuclear Exchange Polarization by Transposing Unattached Nuclei) as the non‐hydrogenative equivalent to the established OneH−PHIP and thus the missing link in parahydrogen hyperpolarization theory.
The mechanism of the recently reported bulk water hyperpolarization is investigated. The authors find that polarization is transferred by the exchange of single protons between p‐H2 and water and call their new observation NEPTUN (Nuclear Exchange Polarization by Transposing Unattached Nuclei).
The front cover artwork is provided by Dr. Meike Emondts, Daniel Schikowski, and Prof. Dr. Jürgen Klankermayer (RWTH Aachen University, Germany) as well as by Dr. Philipp Schleker (MPI CEC and FZJ, ...Germany). The image shows the hyperpolarization of HDO via the new NEPTUN mechanism describing a chemical exchange/metathesis reaction between D2O and parahydrogen. Read the full text of the Communication at 10.1002/cphc.201800521.
“The mechanism of bulk water hyperpolarization is investigated with a combination of theoretical and experimental methods, showing a chemical exchange pathway of single protons as a basis for the enhancement …” This and more about the story behind the front cover can be found in the Communication at 10.1002/cphc.201800521.
Fibrotic interstitial lung disease (fILD) is a group of pathologic entities characterized by scarring of the lungs and high morbidity and mortality. Research investigating how socioeconomic and ...residential factors impact outcomes in patients with fILD is lacking.
To determine the association between neighborhood-level disadvantage and presentation severity, disease progression, lung transplantation, and mortality in patients with fILD from the United States and Canada.
We performed a multicenter, international, prospective cohort study of 4,729 patients with fILD from one U.S. and eight Canadian ILD registry sites. Neighborhood-level disadvantage was measured by the area deprivation index in the United States and the Canadian Index of Multiple Deprivation in Canada.
In the U.S. but not in the Canadian cohort, patients with fILD living in neighborhoods with the greatest disadvantage (top quartile) experience the highest risk of mortality (hazard ratio = 1.51,
= 0.002), and in subgroups of patients with idiopathic pulmonary fibrosis, the top quartile of disadvantage experienced the lowest odds of lung transplantation (odds ratio = 0.46,
= 0.04). Greater disadvantage was associated with reduced baseline DL
in both cohorts, but it was not associated with baseline FVC or FVC or DL
decline in either cohort.
Patients with fILD who live in areas with greater neighborhood-level disadvantage in the United States experience higher mortality, and patients with idiopathic pulmonary fibrosis experience lower odds of lung transplantation. These disparities are not seen in Canadian patients, which may indicate differences in access to care between the United States and Canada.
We analyze whether the prevalence of depressive symptoms differs among various migrant and non-migrant populations in Germany and to what extent these differences can be attributed to socioeconomic ...position (SEP) and social relations.
The German National Cohort health study (NAKO) is a prospective multicenter cohort study (N = 204,878). Migration background (assessed based on citizenship and country of birth of both participant and parents) was used as independent variable, age, sex, Social Network Index, the availability of emotional support, SEP (relative income position and educational status) and employment status were introduced as covariates and depressive symptoms (PHQ-9) as dependent variable in logistic regression models.
Increased odds ratios of depressive symptoms were found in all migrant subgroups compared to non-migrants and varied regarding regions of origins. Elevated odds ratios decreased when SEP and social relations were included. Attenuations varied across migrant subgroups.
The gap in depressive symptoms can partly be attributed to SEP and social relations, with variations between migrant subgroups. The integration paradox is likely to contribute to the explanation of the results. Future studies need to consider heterogeneity among migrant subgroups whenever possible.
The pandemic caused by the coronavirus SARS-CoV-2 and the countermeasures taken to protect the public are having a substantial effect on the health of the population. In Germany, nationwide ...protective measures to halt the spread of the virus were implemented in mid-March for 6 weeks.
In May, the impact of the pandemic was assessed in the German National Cohort (NAKO). A total of 113 928 men and women aged 20 to 74 years at the time of the baseline examination conducted 1 to 5 years earlier (53%) answered, within a 30-day period, a follow-up questionnaire on SARS-CoV-2 test status, COVID-19- associated symptoms, and self-perceived health status.
The self-reported SARS-CoV-2 test frequency among the probands was 4.6%, and 344 participants (0.3%) reported a positive test result. Depressive and anxiety-related symptoms increased relative to baseline only in participants under 60 years of age, particularly in young women. The rate of moderate to severe depressive symptoms increased from 6.4% to 8.8%. Perceived stress increased in all age groups and both sexes, especially in the young. The scores for mental state and self-rated health worsened in participants tested for SARS-CoV-2 compared with those who were not tested. In 32% of the participants, however, self-rated health improved.
The COVID-19 pandemic and the protective measures during the first wave had effects on mental health and on self-rated general health.
Zusammenfassung
Übergewicht und Adipositas sind bedeutende Risikofaktoren für verschiedene Erkrankungen. Als Maß zu ihrer Bestimmung wurde in früheren Studien meist nur der Body-Mass-Index (BMI) ...verwendet. Der BMI ist allerdings ein Marker, der den Einfluss auf das Krankheitsrisiko nur unzureichend erfasst. In groß angelegten, bevölkerungsbasierten Studien besteht daher ein vordringlicher Bedarf, verbesserte Messmethoden der Körperzusammensetzung und -fettverteilung einzusetzen.
Der vorliegende Beitrag stellt die in der NAKO (Nationale Kohorte) Gesundheitsstudie eingesetzten Messverfahren zur Beschreibung von Körperzusammensetzung und -fettverteilung und die ersten deskriptiven Ergebnisse vor. Diese beziehen sich auf die Daten zur Halbzeit der Basiserhebung, welche 101.817 Teilnehmende einschließt, die in 18 Studienzentren in Deutschland zwischen März 2014 und März 2017 untersucht worden sind. Die anthropometrischen Messungen umfassten Körpergewicht, Körpergröße und -umfänge, bioelektrische Impedanzanalyse (BIA), Sonographie des Abdominalfettes, 3‑D-Bodyscanner und Magnetresonanztomographie.
Die Analyse des BMI zeigte, dass 46,2 % der Männer sowie 29,7 % der Frauen übergewichtig und 23,5 % der Männer und 21,2 % der Frauen adipös waren. Frauen wiesen im Mittel in fast allen Altersgruppen eine höhere Schichtdicke an subkutanem Fettgewebe auf als Männer. Die mittlere Schichtdicke des viszeralen Fettgewebes lag hingegen bei den Männern in allen Altersgruppen über den Werten der Frauen und stieg bei beiden Geschlechtern über die Altersgruppen kontinuierlich an.
Die umfassenden Daten über die Körperfettverteilung und -zusammensetzung ermöglichen es zukünftig, den Einfluss von Übergewicht und Adipositas auf die Entstehung von chronischen Erkrankungen im Detail zu analysieren.
Background
This multicentre, international, prospective cohort study evaluated whether patients with pulmonary sarcoidosis living in neighbourhoods with greater material and social disadvantage ...experience worse clinical outcomes.
Methods
The area deprivation index and the Canadian Index of Multiple Deprivation evaluate neighbourhood-level disadvantage in the US and Canada, with higher scores reflecting greater disadvantage. Multivariable linear regression evaluated associations of disadvantage with baseline forced vital capacity (FVC) or diffusing capacity of the lung for carbon monoxide (
D
LCO
) and linear mixed effects models for associations with rate of FVC or
D
LCO
decline, and competing hazards models were used for survival analyses in the US cohort, evaluating competing outcomes of death or lung transplantation. Adjustments were made for age at diagnosis, sex, race and smoking history.
Results
We included 477 US and 122 Canadian patients with sarcoidosis. Higher disadvantage was not associated with survival or baseline FVC. The highest disadvantage quartile was associated with lower baseline
D
LCO
in the US cohort (β = −6.80, 95% CI −13.16 to −0.44, p=0.04), with similar findings in the Canadian cohort (β = −7.47, 95% CI −20.28 to 5.33, p=0.25); with more rapid decline in FVC and
D
LCO
in the US cohort (FVC β = −0.40, 95% CI −0.70 to −0.11, p=0.007;
D
LCO
β = −0.59, 95% CI −0.95 to −0.23, p=0.001); and with more rapid FVC decline in the Canadian cohort (FVC β = −0.80, 95% CI −1.37 to −0.24, p=0.003).
Conclusion
Patients with sarcoidosis living in high disadvantage neighbourhoods experience worse baseline lung function and more rapid lung function decline, highlighting the need for better understanding of how neighbourhood-level factors impact individual patient outcomes.
Objective measurement of straylight in the human eye with a Shack-Hartmann (SH) wavefront aberrometer is limited in imaging angle. We propose a measurement principle and a point spread function (PSF) ...reconstruction algorithm to overcome this limitation. In our optical setup, a variable stop replaces the stop conventionally used to suppress reflections and scatter in SH aberrometers. We record images with 21 diameters of the stop. From each SH image, the average intensity of the pupil is computed and normalized. The intensities represent integral values of the PSF. We reconstruct the PSF, which is the derivative of the intensities with respect to the visual angle. A modified Stiles Holladay approximation is fitted to the reconstructed PSF, resulting in a straylight parameter. A proof-of-principle study was carried out on eight healthy young volunteers. Scatter filters were positioned in front of the volunteers' eyes to simulate straylight. The straylight parameter was compared to the C-Quant measurements and the filter values. The PSF parameter shows strong correlation with the density of the filters and a linear relation to the C-Quant straylight parameter. Our measurement and reconstruction techniques allow for objective straylight analysis of visual angles up to 4 deg.
Zusammenfassung
Hintergrund
Untersucht wurden die Auswirkungen der HIV-Präexpositionsprophylaxe (PrEP) als neue Leistung der gesetzlichen Krankenversicherung (GKV) auf das Infektionsgeschehen von HIV ...und anderen sexuell übertragbaren Infektionen (STI) in Deutschland. Zusätzlich wurden PrEP-Bedarfe sowie Zugangsbarrieren analysiert.
Methoden
Im Rahmen des Evaluationsprojektes wurden folgende Daten ausgewertet: HIV- und Syphilis-Meldedaten und erweiterte Surveillance des Robert Koch-Instituts (RKI), Apothekenabrechnungsdaten, GKV-Daten, PrEP-Gebrauch in HIV-Schwerpunktzentren, Checkpoint‑, BRAHMS- und PrApp-Studie sowie ein Community-Beirat.
Ergebnisse
Die PrEP-Nutzenden waren zum größten Teil männlich (98–99 %), zum Großteil im Alter zwischen 25–45 Jahren und überwiegend deutscher Staatsangehörigkeit oder Herkunft (67–82 %). Der Großteil zählte zur Gruppe der Männer, die Sex mit Männern haben (99 %). In Bezug auf HIV-Infektionen zeigte sich die PrEP als hocheffektiv. Es fanden nur vereinzelt HIV-Infektionen statt (HIV-Inzidenzrate 0,08/100 Personenjahre), in den meisten Fällen war der vermutete Grund eine geringe Adhärenz. Die Inzidenzen von Chlamydien, Gonorrhö und Syphilis nahmen nicht zu, sondern blieben nahezu gleich oder gingen sogar zurück. Es zeigte sich Informationsbedarf zur PrEP für Personen in trans*/nichtbinären Communitys, Sexarbeitende, Migrant*innen und Drogengebrauchende. Notwendig wären bedarfsgerechte Angebote für Zielgruppen mit erhöhtem HIV-Risiko.
Diskussion
Die PrEP erwies sich als eine sehr wirkungsvolle HIV-Präventionsmethode. Die teils befürchteten indirekten negativen Einflüsse auf STI-Raten wurden in dieser Untersuchung nicht bestätigt. Aufgrund der zeitlichen Überschneidung mit den Eindämmungsmaßnahmen während der COVID-19-Pandemie wäre für eine abschließende Beurteilung ein längerer Beobachtungszeitraum wünschenswert.
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