Clinical decision making is improved by BioFire Pneumonia Plus in suspected lower respiratory tract infection after lung transplantation: Results of the prospective DBATE‐IT * study

Background: Lower respiratory tract infections (LRTIs) are a significant cause of morbidity and mortality in lung transplant (LTx) recipients. Timely and precise pathogen detection is vital to successful treatment. Multiplex PCR kits with short turnover times like the BioFire Pneumonia Plus (BFPPp) (manufactured by bioMérieux) may be a valuable addition to conventional tests. Methods: We performed a prospective observational cohort study in 60 LTx recipients with suspected LRTI. All patients received BFPPp testing of bronchoalveolar lavage fluid in addition to conventional tests including microbiological cultures and conventional diagnostics for respiratory viruses. Primary outcome was time‐to‐test‐result; secondary outcomes included time‐to‐clinical‐decision and BFPPp test accuracy compared to conventional tests. Results: BFPPp provided results faster than conventional tests (2.3 h [2–2.8] vs. 23.4 h [21–62], p < 0.001), allowing for faster clinical decisions (2.8 [2.2–44] vs. virology 28.1 h [23.1–70.6] and microbiology 32.6 h [4.6–70.9], both p < 0.001). Based on all available diagnostic modalities, 26 (43%) patients were diagnosed with viral LRTI, nine (15 %) with non‐viral LRTI, and five (8 %) with combined viral and non‐viral LRTI. These diagnoses were established by BFPPp in 92%, 78%, and 100%, respectively. The remaining 20 patients (33 %) received a diagnosis other than LRTI. Preliminary therapies based on BFPPp results were upheld in 90% of cases. There were six treatment modifications based on pathogen‐isolation by conventional testing missed by BFPPp, including three due to fungal pathogens not covered by the BFPPp. Conclusion: BFPPp offered faster test results compared to conventional tests with good concordance. The absence of fungal pathogens from the panel is a potential weakness in a severely immunosuppressed population

Investigating human audio-visual object perception with a combination of hypothesis-generating and hypothesis-testing fMRI analysis tools

Primate multisensory object perception involves distributed brain regions. To investigate the network character of these regions of the human brain, we applied data-driven group spatial independent component analysis (ICA) to a functional magnetic resonance imaging (fMRI) data set acquired during a passive audio-visual (AV) experiment with common object stimuli. We labeled three group-level independent component (IC) maps as auditory (A), visual (V), and AV, based on their spatial layouts and activation time courses. The overlap between these IC maps served as definition of a distributed network of multisensory candidate regions including superior temporal, ventral occipito-temporal, posterior parietal and prefrontal regions. During an independent second fMRI experiment, we explicitly tested their involvement in AV integration. Activations in nine out of these twelve regions met the max-criterion (A &lt; AV &gt; V) for multisensory integration. Comparison of this approach with a general linear model-based region-of-interest definition revealed its complementary value for multisensory neuroimaging. In conclusion, we estimated functional networks of uni- and multisensory functional connectivity from one dataset and validated their functional roles in an independent dataset. These findings demonstrate the particular value of ICA for multisensory neuroimaging research and using independent datasets to test hypotheses generated from a data-driven analysis

Demographic, clinical and antibody characteristics of patients with digital ulcers in systemic sclerosis: data from the DUO Registry

OBJECTIVES: The Digital Ulcers Outcome (DUO) Registry was designed to describe the clinical and antibody characteristics, disease course and outcomes of patients with digital ulcers associated with systemic sclerosis (SSc). METHODS: The DUO Registry is a European, prospective, multicentre, observational, registry of SSc patients with ongoing digital ulcer disease, irrespective of treatment regimen. Data collected included demographics, SSc duration, SSc subset, internal organ manifestations, autoantibodies, previous and ongoing interventions and complications related to digital ulcers. RESULTS: Up to 19 November 2010 a total of 2439 patients had enrolled into the registry. Most were classified as either limited cutaneous SSc (lcSSc; 52.2%) or diffuse cutaneous SSc (dcSSc; 36.9%). Digital ulcers developed earlier in patients with dcSSc compared with lcSSc. Almost all patients (95.7%) tested positive for antinuclear antibodies, 45.2% for anti-scleroderma-70 and 43.6% for anticentromere antibodies (ACA). The first digital ulcer in the anti-scleroderma-70-positive patient cohort occurred approximately 5 years earlier than the ACA-positive patient group. CONCLUSIONS: This study provides data from a large cohort of SSc patients with a history of digital ulcers. The early occurrence and high frequency of digital ulcer complications are especially seen in patients with dcSSc and/or anti-scleroderma-70 antibodies

Probabilistic spatial filter estimation for signal enhancement in multi-channel automatic speech recognition

Speech recognition in multi-channel environments requires target speaker localization, multi-channel signal enhancement and robust speech recognition. We here propose a system that addresses these problems: Localization is performed with a recently introduced probabilistic localization method that is based on support-vector machine learning of GCC-PHAT weights and that estimates a spatial source probability map. The main contribution of the present work is the introduction of a probabilistic approach to (re-)estimation of location-specific steering vectors based on weighting of observed inter-channel phase differences with the spatial source probability map derived in the localization step. Subsequent speech recognition is carried out with a DNN-HMM system using amplitude modulation filter bank (AMFB) acoustic features which are robust to spectral distortions introduced during spatial filtering. The system has been evaluated on the CHIME-3 multi-channel ASR dataset. Recognition was carried out with and without probabilistic steering vector re-estimation and with MVDR and delay-and-sum beamforming, respectively. Results indicate that the system attains on real-world evaluation data a relative improvement of 31.98% over the baseline and of 21.44% over a modified baseline. We note that this improvement is achieved without exploiting oracle knowledge about speech/non-speech intervals for noise covariance estimation (which is, however, assumed for baseline processing)

Integrierte Layout- und Routenzugplanung

Mangels durchgängiger Datenstandards für Planungssysteme der Digitalen Fabrik müssen systemspezifische Datenaustauschlösungen implementiert werden. Zur Unterstützung der Planung ist ein durchgängiger Fabrikplanungsprozess mit integrierter Routenplanung sowohl prozess- als auch systemtechnisch erforderlich. Dafür werden beispielhaft ein Fabrik- und ein Routenplanungssystem auf ihre Kompatibilität untersucht, erforderliche Anforderungen abgeleitet und eine Datenaustausch-möglichkeit für den Anwender aufgezeigt.In the absence of consistent data standards for planning systems of the digital factory, system-specific data exchange solutions must be implemented. To support planning, a continuous factory planning process with integrated route planning is re-quired, both in terms of processes and systems. For this purpose, a factory and a route planning system will be examined for compatibility, necessary requirements will be derived, and a data exchange option will be demonstrated

Metal-Free, Multicomponent Synthesis of Pyrrole-Based pi-Conjugated Polymers from Imines, Acid Chlorides, and Alkynes

Multicomponent coupling reactions (MCRs) are becoming increasingly used in the synthesis of macromolecules, as they can allow the rapid generation of libraries of materials as a method to tune properties. MCRs could prove particularly useful in the synthesis of pi-conjugated polymers in which structural changes are necessary for fine-tuning of electronic properties. We describe here the first metal-free multicomponent approach to conjugated polymers. This reaction exploits the coupling of imines, acid chlorides, and (catechyl)PPh to generate phospha-munchnone-containing polymers, which can be converted to poly(pyrroles) via cycloaddition. The platform allows for the efficient synthesis of families of high molecular weight polymers in one step from readily available monomers

The impact of anti-eosinophilic therapy on exercise capacity and inspiratory muscle strength in patients with severe asthma

Introduction Exercise limitation is frequently described among asthmatic patients and could be related to different mechanisms of the pulmonary, cardiovascular and muscular systems. Despite this, cardiopulmonary exercise testing (CPET) does not have an established role in the management of severe asthma. The aim of our study was to investigate the role of CPET and inspiratory pressure measurement in exercise capacity and muscle strength in severe asthmatic patients treated with anti-IL-5 therapy. Methods A monocentric observational study was conducted at Hanover Medical School, Germany, from April 2018 to June 2019. Patients affected by severe asthma treated with either mepolizumab or benralizumab were included. All patients underwent CPET before the initiation of antibody therapy and after 3 months, and follow-up visits were scheduled at 3, 6 and 12 months with plethysmography, inspiratory pressure measurement and blood gas analysis. Results 14 patients were enrolled: 10 (71.4%) females, median age 52 years (IQR 47–61). Seven patients were treated with benralizumab, seven with mepolizumab. Oxygen uptake (V′O2 peak) did not change significantly after 3 months of antibody treatment, while the mean value of the breathing reserve exhaustion reduced significantly from 78% to 60% (p=0.004). Whereas at baseline seven patients depleted the breathing reserve and two of them experienced oxygen desaturation during exercise, at 3 months no one presented any desaturation or breathing reserve exhaustion. The inspiratory pressure remained unchanged before and after the antibody therapy. Conclusion CPET could show hints of alveolar recruitment and ventilatory efficiency in severe asthma patients treated with antibody therapy

Performance enhancement of polymer-free carbon nanotube solar cells via transfer matrix modeling

Polymer-free (6,5) single-walled carbon nanotubes (SWCNTs) prepared using the gel permeation approach are integrated into SWCNT:C60 solar cells. Evaporation-driven self-assembly is used to form large-area SWCNT thin films from the surfactant-stabilized aqueous suspensions. The thicknesses of various layers within the solar cell are optimized by theoretical modeling using transfer matrix calculations, where the distribution of the electric field within the stack is matched to light absorption by the SWCNTs through either their primary (S11) or secondary (S22) absorption peaks, or a combination thereof. The validity of the model is verified experimentally through a detailed parameter study and then used to develop SWCNT:C60 solar cells with high open-circuit voltage (0.44 V) as well as a cutting-edge internal quantum efficiency of up to 86% through the nanotube S11 transition, over an active area of 0.105 cm2