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Long-Term outcome of infantile onset pompe disease patients treated with enzyme replacement therapy
(2024)
Background: Enzyme replacement therapy (ERT) with recombinant human alglucosidase alfa (rhGAA) was approved in Europe in 2006. Nevertheless, data on the long-term outcome of infantile onset Pompe disease (IOPD) patients at school age is still limited.
Objective: We analyzed in detail cardiac, respiratory, motor, and cognitive function of 15 German-speaking patients aged 7 and older who started ERT at a median age of 5 months.
Results: Starting dose was 20 mg/kg biweekly in 12 patients, 20 mg/kg weekly in 2, and 40 mg/kg weekly in one patient. CRIM-status was positive in 13 patients (86.7%) and negative or unknown in one patient each (6.7%). Three patients (20%) received immunomodulation. Median age at last assessment was 9.1 (7.0–19.5) years. At last follow-up 1 patient (6.7%) had mild cardiac hypertrophy, 6 (42.9%) had cardiac arrhythmias, and 7 (46.7%) required assisted ventilation. Seven patients (46.7%) achieved the ability to walk independently and 5 (33.3%) were still ambulatory at last follow-up. Six patients (40%) were able to sit without support, while the remaining 4 (26.7%) were tetraplegic. Eleven patients underwent cognitive testing (Culture Fair Intelligence Test), while 4 were unable to meet the requirements for cognitive testing. Intelligence quotients (IQs) ranged from normal (IQ 117, 102, 96, 94) in 4 patients (36.4%) to mild developmental delay (IQ 81) in one patient (9.1%) to intellectual disability (IQ 69, 63, 61, 3x < 55) in 6 patients (54.5%). White matter abnormalities were present in 10 out of 12 cerebral MRIs from 7 patients.
The utilization of lasers in dentistry expands greatly in recent years. For instance, fs-lasers are effective for both drilling and caries prevention, while cw-lasers are useful for adhesive hardening. A cutting-edge application of lasers in dentistry is the debonding of veneers. While there are pre-existing tools for this purpose, there is still potential for improvement. Initial efforts to investigate laser assisted debonding mechanisms with measurements of the optical and mechanical properties of teeth and prosthetic ceramics are presented. Preliminary tests conducted with a laser system used for debonding that is commercially available showed differences in the output power set at the systems console to that at specified distances from the handpiece. Furthermore, the optical properties of the samples (human teeth and ceramics) were characterised. The optical properties of the ceramics should closely resemble those of teeth in terms of look and feel, but they also influence the laser assisted debonding technique and thus must be taken into account. In addition first attempts were performed to investigate the mechanical properties of the samples by means of pump-probe-elastography under a microscope. By analyzing the sample surface up to 20 ns after a fs-laser pulse impact, pressure and shock waves could be detected, which can be utilized to determine the elastic constants of specific materials. Together such investigations are needed to shape the basis for a purely optical approach of debonding of veneers utilizing acoustic waves.
Open tracing tools
(2023)
Background: Coping with the rapid growing complexity in contemporary software architecture, tracing has become an increasingly critical practice and been adopted widely by software engineers. By adopting tracing tools, practitioners are able to monitor, debug, and optimize distributed software architectures easily. However, with excessive number of valid candidates, researchers and practitioners have a hard time finding and selecting the suitable tracing tools by systematically considering their features and advantages. Objective: To such a purpose, this paper aims to provide an overview of popular Open tracing tools via comparison. Methods: Herein, we first identified 30 tools in an objective, systematic, and reproducible manner adopting the Systematic Multivocal Literature Review protocol. Then, we characterized each tool looking at the 1) measured features, 2) popularity both in peer-reviewed literature and online media, and 3) benefits and issues. We used topic modeling and sentiment analysis to extract and summarize the benefits and issues. Specially, we adopted ChatGPT to support the topic interpretation. Results: As a result, this paper presents a systematic comparison amongst the selected tracing tools in terms of their features, popularity, benefits and issues. Conclusion: The result mainly shows that each tracing tool provides a unique combination of features with also different pros and cons. The contribution of this paper is to provide the practitioners better understanding of the tracing tools facilitating their adoption.
Creating a schedule to perform certain actions in a realworld environment typically involves multiple types of uncertainties. To create a plan which is robust towards uncertainties, it must stay flexible while attempting to be reliable and as close to optimal as possible. A plan is reliable if an adjustment to accommodate for a new requirement causes only a few disruptions. The system needs to be able to adapt to the schedule if unforeseen circumstances make planned actions impossible, or if an unlikely event would enable the system to follow a better path. To handle uncertainties, the used methods need to be dynamic and adaptive. The planning algorithms must be able to re-schedule planned actions and need to adapt the previously created plan to accommodate new requirements without causing critical disruptions to other required actions.
Vast amounts of oily wastewater are byproducts of the petrochemical and the shipping industry and to this day frequently discharged into water bodies either without or after insufficient treatment. To alleviate the resulting pollution, water treatment processes are in great demand. Bubble column humidifiers (BCHs) as part of humidification–dehumidification systems are predestined for such a task, since they are insensitive to different feed liquids, simple in design and have low maintenance requirements. While humidification in a bubble column has been investigated plentiful for desalination, a systematic investigation of oily wastewater treatment is missing in literature. We filled this gap by analyzing the treatment of an oil–water emulsion experimentally to derive recommendations for future design and operation of BCHs. Our humidity measurements indicate that the air stream is always saturated after humidification for a liquid height of only 10 cm. A residual water mass fraction of 3.5 wt% is measured after a batch run of six hours. Furthermore, continuous measurements show that an increase in oil mass fraction leads to a decrease in system productivity especially for high oil mass fractions. This decrease is caused by the heterogeneity of the liquid temperature profile. A lower liquid height mitigates this heterogeneity, therefore decreasing the heat demand and improving the overall efficiency. The oil content of the produced condensate is below 15 ppm, allowing discharge into various water bodies. The results of our systematic investigation prove suitability and indicate a strong future potential for the use of BCHs in oily wastewater treatment.
Organic acidurias (OAs), urea-cycle disorders (UCDs), and maple syrup urine disease (MSUD) belong to the category of intoxication-type inborn errors of metabolism (IT-IEM). Liver transplantation (LTx) is increasingly utilized in IT-IEM. However, its impact has been mainly focused on clinical outcome measures and rarely on health-related quality of life (HRQoL). Aim of the study was to investigate the impact of LTx on HrQoL in IT-IEMs. This single center prospective study involved 32 patients (15 OA, 11 UCD, 6 MSUD; median age at LTx 3.0 years, range 0.8–26.0). HRQoL was assessed pre/post transplantation by PedsQL-General Module 4.0 and by MetabQoL 1.0, a specifically designed tool for IT-IEM. PedsQL highlighted significant post-LTx improvements in total and physical functioning in both patients' and parents' scores. According to age at transplantation (≤3 vs. >3 years), younger patients showed higher post-LTx scores on Physical (p = 0.03), Social (p < 0.001), and Total (p =0.007) functioning. MetabQoL confirmed significant post-LTx changes in Total and Physical functioning in both patients and parents scores (p ≤ 0.009). Differently from PedsQL, MetabQoL Mental (patients p = 0.013, parents p = 0.03) and Social scores (patients p = 0.02, parents p = 0.012) were significantly higher post-LTx. Significant improvements (p = 0.001–0.04) were also detected both in self- and proxy-reports for almost all MetabQoL subscales. This study shows the importance of assessing the impact of transplantation on HrQoL, a meaningful outcome reflecting patients' wellbeing. LTx is associated with significant improvements of HrQol in both self- and parentreports. The comparison between PedsQL-GM and MetabQoL highlighted that MetabQoL demonstrated higher sensitivity in the assessment of diseasespecific domains than the generic PedsQL tool.