Collaborative European NeuroTrauma Effectiveness Research in Traumatic Brain Injury (CENTER-TBI): A Prospective Longitudinal Observational Study

BACKGROUND: Current classification of traumatic brain injury (TBI) is suboptimal, and management is based on weak evidence, with little attempt to personalize treatment. A need exists for new precision medicine and stratified management approaches that incorporate emerging technologies. OBJECTIVE: To improve characterization and classification of TBI and to identify best clinical care, using comparative effectiveness research approaches. METHODS: This multicenter, longitudinal, prospective, observational study in 22 countries across Europe and Israel will collect detailed data from 5400 consenting patients, presenting within 24 hours of injury, with a clinical diagnosis of TBI and an indication for computed tomography. Broader registry-level data collection in approximately 20 000 patients will assess generalizability. Cross sectional comprehensive outcome assessments, including quality of life and neuropsychological testing, will be performed at 6 months. Longitudinal assessments will continue up to 24 months post TBI in patient subsets. Advanced neuroimaging and genomic and biomarker data will be used to improve characterization, and analyses will include neuroinformatics approaches to address variations in process and clinical care. Results will be integrated with living systematic reviews in a process of knowledge transfer. The study initiation was from October to December 2014, and the recruitment period was for 18 to 24 months. EXPECTED OUTCOMES: Collaborative European NeuroTrauma Effectiveness Research in TBI should provide novel multidimensional approaches to TBI characterization and classification, evidence to support treatment recommendations, and benchmarks for quality of care. Data and sample repositories will ensure opportunities for legacy research. DISCUSSION: Comparative effectiveness research provides an alternative to reductionistic clinical trials in restricted patient populations by exploiting differences in biology, care, and outcome to support optimal personalized patient management

Studien zur Optimierung der Strahlführung von K12 und P42 für zukünftige Beam-Dump-Experimente am CERN

Abweichender Titel nach Übersetzung der Verfasserin/des VerfassersDuring the beam operation years 2021-2025 at CERN the NA62 experiment is expected to reach its goal of making a more precise measurement of the branching ratio of the decay $K^+ \rightarrow \pi^+\nu\bar{\nu}$. There is a number of potential future experiments under consideration which could utilize the beam lines P42 and K12 that currently provide the beam for NA62. One possibility would be to operate the K12 beam line in a beam dump mode. The experiment taking data in such a beam line setting is called NA62 beam dump (NA62-BD) and would be able to use the NA62 detectors to search for dark matter decays downstream the beam dump thereby looking for physics beyond the Standard Model. Additionally, a possible off-axis experiment alongside the K12 beam line called SHADOWS is considered, which would be able to focus on the search for feebly interacting particles. Prior to these experiments preliminary studies need to be performed to optimize the setup and to reduce the backgrounds that blur the signals of the detectors. Therefore, simulations in the Geant4-based software BDSIM have been performed to gain insight on the expected backgrounds and to evaluate the possibilities for reducing them. The BDSIM model of the K12 beam line has been validated in beam dump mode and the simulation data is in good agreement with measurement data provided by NA62. It was confirmed that in beam dump mode the muon background will be the main background and that it needs to be minimized. An optimization study for the magnetic field configuration of BEND1, a dipole configuration near the beam dump in the K12 beam line, showed that the muon background for NA62-BD can be reduced by a factor of 20 compared to the setting that is currently used in $K^+$ mode. Furthermore, the simulations pointed out that the magnetic field optimization of BEND1 is not sufficient to minimize the muon background for SHADOWS and that an off-axis muon sweeping system will be necessary. Several possibilities for such a system have been evaluated and a configuration was found that achieves a muon background reduction by a factor of 7 compared to the simulations without a SHADOWS dedicated muon sweeping system.7

Studies and Optimization for Future Beam Dump Experiments in the K12 and P42 Beams at CERN

During the beam operation years 2021-2025 at CERN the NA62 experiment is expected to reach its goal of making a more precise measurement of the branching ratio of the decay $K^+ \rightarrow \pi^+ \nu \bar{\nu}$ . There is a number of potential future experiments under consideration which could utilize the beam lines P42 and K12 that currently provide the beam for NA62. One possibility would be to operate the K12 beam line in a beam dump mode. The experiment taking data in such a beam line setting is called NA62 beam dump (NA62-BD) and would be able to use the NA62 detectors to search for dark matter decays downstream the beam dump thereby looking for physics beyond the Standard Model. Additionally, a possible off-axis experiment alongside the K12 beam line called SHADOWS is considered, which would be able to focus on the search for feebly interacting particles. Prior to these experiments preliminary studies need to be performed to optimize the setup and to reduce the backgrounds that blur the signals of the detectors. Therefore, simulations in the Geant4-based software BDSIM have been performed to gain insight on the expected backgrounds and to evaluate the possibilities for reducing them. The BDSIM model of the K12 beam line has been validated in beam dump mode and the simulation data is in good agreement with measurement data provided by NA62. It was confirmed that in beam dump mode the muon background will be the main background and that it needs to be minimized. An optimization study for the magnetic field configuration of BEND1, a dipole configuration near the beam dump in the K12 beam line, showed that the muon background for NA62-BD can be reduced by a factor of 20 compared to the setting that is currently used in $K^+$ mode. Furthermore, the simulations pointed out that the magnetic field optimization of BEND1 is not sufficient to minimize the muon background for SHADOWS and that an off-axis muon sweeping system will be necessary. Several possibilities for such a system have been evaluated and a configuration was found that achieves a muon background reduction by a factor of 7 compared to the simulations without a SHADOWS dedicated muon sweeping system

Insights into the use of telemedicine in primary care in times of the SARS-CoV-2 pandemic : a cross-sectional analysis based on the international PRICOV-19 study in Austria

The SARS-CoV2 pandemic as well as the implementation of public health measures to decrease the spread of the virus re-sparked the call for “virtual” health or “distance” treatments. This paper aimed to assess the use of video consultations in publicly-funded primary healthcare facilities in Austria. Hence, a cross-sectional online questionnaire, as part of the PRICOV-19 study, was conducted from December 2020 until July 2021 to verify the status quo. 176 GP practices were randomly recruited across Austria. Descriptive statistics and binary logistic regression models were applied to examine the associations between telemedicine use and practice factors. Compared to the pre-pandemic situation (3.8%), 7.6% of publicly funded GP practices used video consultations since the pandemic. According to this, 93.9% of the practices had no increase in video consultation use. Positive associations with video consultation use were found in practices with fewer patients aged 70 years+ than the average and more patients with chronic diseases than the average practice. The use of video consultations in general practice is very low in Austria. Austria has to follow the example of countries and implement a transparent and comprehensive national digital health strategy that includes video consultation. Without a proper reimbursement system, patient involvement, and support regarding administrative and organizational aspects, no substantial change will occur despite an increase in need due to the pandemic and its long-term effects

FCC-ee design project report

The Future Circular electron-positron Collider (FCC-ee) has been proposed to reach the higher energies, luminosities, and sensitivities, that are needed to observe signs of novel physical processes. The collider is still in its design stage, and this report outlines the work done to finalise many parameters and design several components. Specifically, the report provides a preliminary design study of the FCC’s Booster lattice, three types of magnets to be used in the Booster, and RF cavities for the main collider ring. The design study involves the use of several software programs, and the models were optimised as much as possible to meet all the requirements, as well as keep the cost as low as possible

Insights into the use of telemedicine in primary care in times of the SARS-CoV-2 pandemic : a cross-sectional analysis based on the international PRICOV-19 study in Austria

BackgroundThe SARS-CoV2 pandemic as well as the implementation of public health measures to decrease the spread of the virus re-sparked the call for "virtual" health or "distance" treatments. This paper aimed to assess the use of video consultations, the up-to-dateness of practice websites, and the views of GPs on whether eHealth is a positive aspect for the future of their practices in publicly -funded primary healthcare facilities in Austria.MethodsThe cross-sectional online questionnaire, part of the PRICOV-19 study, was conducted from December 2020 until July 2021. We randomly recruited 176 GP practices across Austria. Descriptive statistics as well as binary logistic regression models were applied to examine the associations between telemedicine use and practice factors.ResultsCompared with before the pandemic (3.8%), 7.6% of publicly funded GP practices have been using video consultations since the pandemic. In line with this, 93.9% of the practices had no increase in video consultation use. Fewer than half (44.3%) had an up-to-date webpage, and 27.8% assumed that the pandemic might have been a positive driver for eHealth in their practices. Positive associations with video consultation use could be found in practices with fewer patients aged 70 years and over than the average and more patients with chronic diseases than the average.ConclusionThe use of video consultations in general practice and the readiness for other telemedicine approaches are both very low in Austria. Austria has to urgently follow the example of countries with a transparent and comprehensive national digital health strategy that includes video consultation. Without a proper payment system, patient inclusion, and support with regard to administrative and organizational aspects, no substantial change will occur in spite of an increase in need due to the pandemic and changes in the patient population

Multimodal Imaging of Patients With Gliomas Confirms C-11-MET PET as a Complementary Marker to MRI for Noninvasive Tumor Grading and Intraindividual Follow-Up After Therapy

The value of combined L-(methyl-[(11) C]) methionine positron-emitting tomography (MET-PET) and magnetic resonance imaging (MRI) with regard to tumor extent, entity prediction, and therapy effects in clinical routine in patients with suspicion of a brain tumor was investigated. In n = 65 patients with histologically verified brain lesions n = 70 MET-PET andMRI (T1-weighted gadolinium-enhanced [T1w-Gd] and fluid-attenuated inversion recovery or T2-weighted [FLAIR/T2w]) examinations were performed. The computer software visualization and analysis framework volume rendering engine (Voreen)'' was used for analysis of extent and intersection of tumor compartments. Binary logistic regressionmodelswere developed to differentiate betweenWorldHealthOrganization (WHO) tumor types/grades. Tumor sizes as defined by thresholding based on tumor-to-background ratios were significantly different as determined byMET-PET (21.6 +/- 36.8 cm(3)), T1w-Gd-MRI (3.9 +/- 7.8 cm(3)), and FLAIR/T2-MRI (64.8 +/- 60.4 cm(3); P < .001). TheMETPET visualized tumor activity whereMRI parameterswere negative: PET positive tumor volumewithout Gd enhancementwas 19.8 +/- 35.0 cm(3) and without changes in FLAIR/T2 10.3 +/- 25.7 cm(3). FLAIR/T2-MRI visualized greatest tumor extentwith differences toMETPET being greater in posttherapy (64.6 +/- 62.7 cm(3)) than in newly diagnosed patients (20.5 +/- 52.6 cm(3)). The binary logistic regression model differentiated betweenWHOtumor types (fibrillary astrocytoma II n - 10 fromother gliomas n - 16) with an accuracy of 80.8% in patients at primary diagnosis. Combined PET and MRI improve the evaluation of tumor activity, extent, type/grade prediction, and therapy-induced changes in patients with glioma and serve information highly relevant for diagnosis and management