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Determination of tibial somatosensory evoked potentials predicts detrusor sphincter dyssynergia in children with neurogenic bladder dysfunction

Tibial somatosensory evoked potentials (SEP) are used to identify the neurological status and tethered cord (TC) in patients with spina bifida (SB). Its significance in contributing to the interpretation of urodynamics to determine bladder status is unknown. This study aimed to determine the correlation between SEP and urodynamics in children with SB. Material and Methods SEP and urodynamic results, for differential diagnosis of TC, were evaluated. SEP scores were correlated with urodynamic findings. SEP results were scored from 1 to 6, with 1, denoting a favorable score and 6, an unfavorable score. Age, gender, detrusor, and sphincter activities in urodynamics were noted. Results were analyzed using the χ 2 test and logistic regression analysis. Receiver operating characteristic (ROC) curve was formed to get a valid threshold for the SEP score to predict the urodynamic condition. Results There were 44 SB patients for whom SEP was done for differential diagnosis of TC. Fifteen patients who did not meet the inclusion criteria were excluded from the study. SB aperta was present in 17 patients and occulta in 12, respectively. The patients had a mean age of 6.6 ± 3.2 years. There were 13 boys and 16 girls. A strong correlation was found between high SEP scores and detrusor sphincter dyssynergia ( p  < 0.001). A SEP score over 3.5 was found to be 93% sensitive and 73% specific to predict this correlation. There was no relationship between detrusor activity and SEP scores ( p  = 0.18). Discussion Tibial SEP is an important noninvasive adjunct tool for the diagnosis of TC in patients with SB. Urodynamic studies are the gold standard in the evaluation of bladder status in neurogenic bladder dysfunction due to SB. Detrusor sphincter dyssynergia may be regarded as a sign of severe spinal cord injury in these patients. Conclusion Our findings suggest that in children with neurogenic bladder, high SEP scores may predict the presence of detrusor sphincter dyssynergia but not the status of detrusor function while providing pathophysiological evidence for neural injury.

Model‐free data‐driven inelasticity in Haigh‐Westergaard space ‐ a study how to obtain data points from measurements

Model‐free data‐driven computational mechanics replace phenomenological models with numerical simulations in strain‐stress space based on sample data sets. The approach has recently been extended to inelasticity problems employing structured data sets, tangent space information, and transition rules. Coverage of qualified data states and calculation of the related tangent space is critical from the standpoint of actual application. This study applies the data‐driven paradigm to elasto‐plasticity with isotropic hardening. We develop our method using Haigh‐Westergaard coordinates, which provide information on the underlying material yield surface. Based on this, we employ a combined tension‐torsion test to cover the yield surface knowledge and a single tensile test to determine the tangent space. Under compatibility and equilibrium requirements, the resulting data‐driven technique minimizes the distance over the Haigh‐Westergaard space augmented by directions in the tangent space.

The clinical yield of bronchoscopy in the management of cystic fibrosis: A retrospective multicenter study

Background Pulmonary disease is the leading cause of morbidity and mortality in people with cystic fibrosis (pwCF). Several studies have shown no benefit for bronchoscopy and bronchoalveolar lavage (BAL) over sputum to obtain microbiological cultures, hence the role of bronchoscopy in pwCF is unclear. Aim To analyze how bronchoscopy results affected clinical decision‐making in pwCF and assess safety. Methods A retrospective analysis of all charts of pwCF from three CF centers in Israel, between the years 2008 and 2019. We collected BAL culture results as well as sputum cultures obtained within 1 month of the BAL sample. A meaningful yield was defined as a decision to start antibiotics, change the antibiotic regimen, hospitalize the patient for treatment, or the resolution of the problem that led to bronchoscopy (e.g., atelectasis or hemoptysis). Results During the study years, of the 428 consecutive patient charts screened, 72 patients had 154 bronchoscopies (2.14 bronchoscopies/patient). Forty‐five percent of the bronchoscopies had a meaningful clinical yield. The finding of copious sputum on bronchoscopy was strongly associated with a change in treatment (OR: 5.25, 95%CI: 2.1−13.07, p  < 0.001). BAL culture results were strongly associated with a meaningful yield, specifically isolation of Aspergillus spp. ( p  = 0.003), Haemophilus influenza ( p  = 0.001). Eight minor adverse events following bronchoscopy were recorded. Conclusions In this multicenter retrospective analysis of bronchoscopy procedures from three CF centers, we have shown that a significant proportion of bronchoscopies led to a change in treatment, with no serious adverse events. Our findings suggest that bronchoscopy is a safe procedure that may assist in guiding treatment in some pwCF. Future studies should evaluate whether BAL‐guided decision‐making may also lead to a change in clinical outcomes in pwCF.

Pediatric respiratory admissions and related viral infections during the COVID‐19 pandemic

The COVID‐19 pandemic has affected the incidence of respiratory viral infections. Our aim was to assess changes in pediatric admissions due to respiratory diseases and associated respiratory viral infections. Methods An observational study including all respiratory admissions to the pediatric departments from January 2015 to August 2021. We compared respiratory admission percentage, respiratory viral panel results and clinical characteristics of these admissions between two study periods, January 2015 to February 2020 (pre‐COVID‐19 era) and March 2020 to August 2021 (COVID‐19 era). Results A total of 8774 respiratory admissions were included, 7157 pre‐COVID‐19 era and 1617 COVID‐19 era. Relative to all pediatric admissions, there was a 17% decrease in respiratory admission percentage during the COVID‐19 era ( p  < 0.001) and a 31% and 22% decreased in the admission percentages due to bronchiolitis ( p  < 0.001) and pneumonia ( p  < 0.001), respectively. However, admission percentages for asthma, wheezing illness, complicated pneumonia, and stridor remained the same. There was a significant decrease in the detection of a respiratory viral pathogen associated with these respiratory admissions ( p  < 0.001). This was related to a significant decrease in the detection of respiratory syncytial virus (RSV) (37% vs. 27%, p  < 0.001) and influenza (5% vs. 0.3%, p  < 0.001), but not other respiratory viruses. An alteration in the circulation pattern of most respiratory viruses, was observed. Conclusions During the COVID‐19 pandemic, a decrease in the prevalence of RSV and influenza was associated with a significant decrease in admissions for bronchiolitis and pediatric pneumonia. This may allow us to estimate the significance of preventive measures for RSV and influenza on pediatric respiratory admissions.

PLENARY SESSIONS

Measuring green technology adoption across countries

In this article, we construct an empirical framework to identify and measure the adoption of green technologies across countries. Using an annual dataset covering 89 countries from 1990 to 2016, we conduct a principal component analysis incorporating the different dimensions of the adoption of green technologies. The analysis allows us both to rank countries for their level of green technology adoption and also recommend policies to improve their current stance.

On the Cyclization of Non‐cyclic Peptides for Biological Applications: Inspiration from Naturally Cyclic Peptides

Peptides are unique class of biomolecules for pharmaceutics and industries, given their structural features that can be applied to many approaches. Although their advantages are known, they suffer from some limitations that need to be overcome. Some disadvantages are peptidic conformations’ flexibility and susceptibility to proteolytic degradation. Research has been in a constant endeavor to provide solutions. The discovery of cyclic peptides in plants opened the door for new insights into peptide‐based applications. These peptides display high stability to physical and chemical conditions. They possess a wide range of biological activities. In addition, cyclic peptides shows enhanced activities compared to linear peptides. Thus, the idea of non‐cyclic peptide cyclization can be of great use in eliminating issues and improving peptide capabilities. Inspired by the naturally found cyclic peptides, many approaches for synthetic cyclization have been proposed. The current review provides an overall discussion of the available methods for cyclization, applications, and characterization techniques. The present review offers a unique source for colleagues newly exposed to the subject and on the verge of entering the field of cyclic peptides by providing an initiating step covering the essential points needed to be considered around peptide cyclization.

Minimum-Link C-Oriented Paths Visiting a Sequence of Regions in the Plane

A house is not a home: a network model perspective on the dynamics between subjective quality of living conditions, social support, and mental health of refugees and asylum seekers

Providing adequate living conditions for forcibly displaced people represents a significant challenge for host countries such as Germany. This study explores refugee mental health's reciprocal, dynamic relationship with post-migration living conditions and social support.