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In the last decade, the Climate Limited-area Modeling Community (CLM-Community) has contributed to the Coordinated Regional Climate Downscaling Experiment (CORDEX) with an extensive set of regional climate simulations. Using several versions of the COSMO-CLM-Community model, ERA-Interim reanalysis and eight global climate models from phase 5 of the Coupled Model Intercomparison Project (CMIP5) were dynamically downscaled with horizontal grid spacings of 0.44∘ (∼ 50 km), 0.22∘ (∼ 25 km), and 0.11∘ (∼ 12 km) over the CORDEX domains Europe, South Asia, East Asia, Australasia, and Africa. This major effort resulted in 80 regional climate simulations publicly available through the Earth System Grid Federation (ESGF) web portals for use in impact studies and climate scenario assessments. Here we review the production of these simulations and assess their results in terms of mean near-surface temperature and precipitation to aid the future design of the COSMO-CLM model simulations. It is found that a domain-specific parameter tuning is beneficial, while increasing horizontal model resolution (from 50 to 25 or 12 km grid spacing) alone does not always improve the performance of the simulation. Moreover, the COSMO-CLM performance depends on the driving data. This is generally more important than the dependence on horizontal resolution, model version, and configuration. Our results emphasize the importance of performing regional climate projections in a coordinated way, where guidance from both the global (GCM) and regional (RCM) climate modeling communities is needed to increase the reliability of the GCM–RCM modeling chain.

The Scenario Model Intercomparison Project (ScenarioMIP) defines and coordinates the main set of future climate projections, based on concentration-driven simulations, within the Coupled Model Intercomparison Project phase 6 (CMIP6). This paper presents a range of its outcomes by synthesizing results from the participating global coupled Earth system models. We limit our scope to the analysis of strictly geophysical outcomes: mainly global averages and spatial patterns of change for surface air temperature and precipitation. We also compare CMIP6 projections to CMIP5 results, especially for those scenarios that were designed to provide continuity across the CMIP phases, at the same time highlighting important differences in forcing composition, as well as in results. The range of future temperature and precipitation changes by the end of the century (2081–2100) encompassing the Tier 1 experiments based on the Shared Socioeconomic Pathway (SSP) scenarios (SSP1-2.6, SSP2-4.5, SSP3-7.0 and SSP5-8.5) and SSP1-1.9 spans a larger range of outcomes compared to CMIP5, due to higher warming (by close to 1.5 ∘C) reached at the upper end of the 5 %–95 % envelope of the highest scenario (SSP5-8.5). This is due to both the wider range of radiative forcing that the new scenarios cover and the higher climate sensitivities in some of the new models compared to their CMIP5 predecessors. Spatial patterns of change for temperature and precipitation averaged over models and scenarios have familiar features, and an analysis of their variations confirms model structural differences to be the dominant source of uncertainty. Models also differ with respect to the size and evolution of internal variability as measured by individual models' initial condition ensemble spreads, according to a set of initial condition ensemble simulations available under SSP3-7.0. These experiments suggest a tendency for internal variability to decrease along the course of the century in this scenario, a result that will benefit from further analysis over a larger set of models. Benefits of mitigation, all else being equal in terms of societal drivers, appear clearly when comparing scenarios developed under the same SSP but to which different degrees of mitigation have been applied. It is also found that a mild overshoot in temperature of a few decades around mid-century, as represented in SSP5-3.4OS, does not affect the end outcome of temperature and precipitation changes by 2100, which return to the same levels as those reached by the gradually increasing SSP4-3.4 (not erasing the possibility, however, that other aspects of the system may not be as easily reversible). Central estimates of the time at which the ensemble means of the different scenarios reach a given warming level might be biased by the inclusion of models that have shown faster warming in the historical period than the observed. Those estimates show all scenarios reaching 1.5 ∘C of warming compared to the 1850–1900 baseline in the second half of the current decade, with the time span between slow and fast warming covering between 20 and 27 years from present. The warming level of 2 ∘C of warming is reached as early as 2039 by the ensemble mean under SSP5-8.5 but as late as the mid-2060s under SSP1-2.6. The highest warming level considered (5 ∘C) is reached by the ensemble mean only under SSP5-8.5 and not until the mid-2090s.

For the first time, the Limited-Area Mode of the new ICON (Icosahedral Nonhydrostatic) weather and climate model has been used for a continuous long-term regional climate simulation over Europe. Built upon the Limited-Area Mode of ICON (ICON-LAM), ICON-CLM (ICON in Climate Limited-area Mode, hereafter ICON-CLM, available in ICON release version 2.6.1) is an adaptation for climate applications. A first version of ICON-CLM is now available and has already been integrated into a starter package (ICON-CLM_SP_beta1). The starter package provides users with a technical infrastructure that facilitates long-term simulations as well as model evaluation and test routines. ICON-CLM and ICON-CLM_SP were successfully installed and tested on two different computing systems. Tests with different domain decompositions showed bit-identical results, and no systematic outstanding differences were found in the results with different model time steps. ICON-CLM was also able to reproduce the large-scale atmospheric information from the global driving model. Comparison was done between ICON-CLM and the COnsortium for Small-scale MOdeling (COSMO)-CLM (the recommended model configuration by the CLM-Community) performance. For that, an evaluation run of ICON-CLM with ERA-Interim boundary conditions was carried out with the setup similar to the COSMO-CLM recommended optimal setup. ICON-CLM results showed biases in the same range as those of COSMO-CLM for all evaluated surface variables. While this COSMO-CLM simulation was carried out with the latest model version which has been developed and was carefully tuned for climate simulations on the European domain, ICON-CLM was not tuned yet. Nevertheless, ICON-CLM showed a better performance for air temperature and its daily extremes, and slightly better performance for total cloud cover. For precipitation and mean sea level pressure, COSMO-CLM was closer to observations than ICON-CLM. However, as ICON-CLM is still in the early stage of development, there is still much room for improvement.

Severe precipitation events occur rarely and are often localised in space and of short duration, but they are important for societal managing of infrastructure. Therefore, there is a demand for estimating future changes in the statistics of the occurrence of these rare events. These are often projected using data from regional climate model (RCM) simulations combined with extreme value analysis to obtain selected return levels of precipitation intensity. However, due to imperfections in the formulation of the physical parameterisations in the RCMs, the simulated present-day climate usually has biases relative to observations; these biases can be in the mean and/or in the higher moments. Therefore, the RCM results are adjusted to account for these deficiencies. However, this does not guarantee that the adjusted projected results will match the future reality better, since the bias may not be stationary in a changing climate. In the present work, we evaluate different adjustment techniques in a changing climate. This is done in an inter-model cross-validation set-up in which each model simulation, in turn, performs pseudo-observations against which the remaining model simulations are adjusted and validated. The study uses hourly data from historical and RCP8.5 scenario runs from 19 model simulations from the EURO-CORDEX ensemble at a 0.11∘ resolution. Fields of return levels for selected return periods are calculated for hourly and daily timescales based on 25-year-long time slices representing the present-day (1981–2005) and end-21st-century (2075–2099). The adjustment techniques applied to the return levels are based on extreme value analysis and include climate factor and quantile-mapping approaches. Generally, we find that future return levels can be improved by adjustment, compared to obtaining them from raw scenario model data. The performance of the different methods depends on the timescale considered. On hourly timescales, the climate factor approach performs better than the quantile-mapping approaches. On daily timescales, the superior approach is to simply deduce future return levels from pseudo-observations, and the second-best choice is using the quantile-mapping approaches. These results are found in all European subregions considered. Applying the inter-model cross-validation against model ensemble medians instead of individual models does not change the overall conclusions much.

In this study, we evaluate a set of high-resolution (25–50 km horizontal grid spacing) global climate models (GCMs) from the High-Resolution Model Intercomparison Project (HighResMIP), developed as part of the EU-funded PRIMAVERA (Process-based climate simulation: Advances in high resolution modelling and European climate risk assessment) project, and from the EURO-CORDEX (Coordinated Regional Climate Downscaling Experiment) regional climate models (RCMs) (12–50 km horizontal grid spacing) over a European domain. It is the first time that an assessment of regional climate information using ensembles of both GCMs and RCMs at similar horizontal resolutions has been possible. The focus of the evaluation is on the distribution of daily precipitation at a 50 km scale under current climate conditions. Both the GCM and RCM ensembles are evaluated against high-quality gridded observations in terms of spatial resolution and station density. We show that both ensembles outperform GCMs from the 5th Coupled Model Intercomparison Project (CMIP5), which cannot capture the regional-scale precipitation distribution properly because of their coarse resolutions. PRIMAVERA GCMs generally simulate precipitation distributions within the range of EURO-CORDEX RCMs. Both ensembles perform better in summer and autumn in most European regions but tend to overestimate precipitation in winter and spring. PRIMAVERA shows improvements in the latter by reducing moderate-precipitation rate biases over central and western Europe. The spatial distribution of mean precipitation is also improved in PRIMAVERA. Finally, heavy precipitation simulated by PRIMAVERA agrees better with observations in most regions and seasons, while CORDEX overestimates precipitation extremes. However, uncertainty exists in the observations due to a potential undercatch error, especially during heavy-precipitation events. The analyses also confirm previous findings that, although the spatial representation of precipitation is improved, the effect of increasing resolution from 50 to 12 km horizontal grid spacing in EURO-CORDEX daily precipitation distributions is, in comparison, small in most regions and seasons outside mountainous regions and coastal regions. Our results show that both high-resolution GCMs and CORDEX RCMs provide adequate information to end users at a 50 km scale.

In the German regional climate modeling project ReKliEs-De the existing EURO-CORDEX simulations have been systematically complemented by new simulations to derive more robust ranges of possible future climate change. The focus of the project lay on user tailored results, which are required for the planning of measures to adapt to the changing climate. Changes in temperature and precipitation indices are calculated from a multi model ensemble for the end of the 21st century. The results for the mitigation scenario RCP2.6 are compared to the results of the “business as usual” scenario RCP8.5. Averaged over Germany the increase of mean annual temperature and of the number of summer days will be around 3 times higher for RCP8.5 than for RCP2.6. In summer, the increase of dry days could be twice as high in RCP8.5 compared to RCP2.6.

Abstract Mountain social‐ecological systems (MtSES) are vital to humanity, providing ecosystem services to over half the planet's human population. Despite their importance, there has been no global assessment of threats to MtSES, even as they face unprecedented challenges to their sustainability. With survey data from 57 MtSES sites worldwide, we test a conceptual model of the types and scales of stressors and ecosystem services in MtSES and explore their distinct configurations according to their primary economic orientation and land use. We find that MtSES worldwide are experiencing both gradual and abrupt climatic, economic, and governance changes, with policies made by outsiders as the most ubiquitous challenge. Mountains that support primarily subsistence‐oriented livelihoods, especially agropastoral systems, deliver abundant services but are also most at risk. Moreover, transitions from subsistence‐ to market‐oriented economies are often accompanied by increased physical connectedness, reduced diversity of cross‐scale ecosystem services, lowered importance of local knowledge, and shifting vulnerabilities to threats. Addressing the complex challenges facing MtSES and catalyzing transformations to MtSES sustainability will require cross‐scale partnerships among researchers, stakeholders, and decision makers to jointly identify desired futures and adaptation pathways, assess trade‐offs in prioritizing ecosystem services, and share best practices for sustainability. These transdisciplinary approaches will allow local stakeholders, researchers, and practitioners to jointly address MtSES knowledge gaps while simultaneously focusing on critical issues of poverty and food security.

Communication between providers and users of climate model simulation results still needs to be improved. In the German regional climate modeling project ReKliEs-De a midterm user workshop was conducted to allow the intended users of the project results to assess the preliminary results and to streamline the final project results to their needs. The user feedback highlighted, in particular, the still considerable gap between climate research output and user-tailored input for climate impact research. Two major requests from the user community addressed the selection of sub-ensembles and some condensed, easy to understand information on the strengths and weaknesses of the climate models involved in the project.

A general overall feasibility methodology of batch reactive distillation of multireaction systems is developed to study all the possible configurations of batch reactive distillation. The general model equations are derived for multireaction system with any number of chemical equilibrium-limited reactions and for any number of components. The present methodology is demonstrated with the detailed study of the transesterification of dimethyl carbonate in two reversible cascade reactions in batch reactive distillation process. Pure methanol is produced as distillate, and pure diethyl carbonate is produced at the bottom simultaneously in middle-vessel column; in each section, continuous feeding of ethanol is necessary. The results of feasibility study are successfully validated by rigorous simulations.

The utilization of coffee leaves and flowers has been underestimated over the years. Both by-products can be obtained from coffee trees without adversely affecting the production of coffee beans. To gain fundamental knowledge of their sensorial and aroma profiles, it becomes essential to reintroduce them into the food chain. Accordingly, 24 different coffee leaf samples generated from diverse processing as well as 38 varied species of coffee flowers were analyzed for their sensory characteristics by descriptive analysis and liking tests, and their corresponding aroma profiles were decoded by means of gas chromatography–mass spectrometry–olfactometry. For the coffee leaves, a wide range of different flavors could be detected in the sensory evaluation. The fermented coffee leaf samples clearly showed more sweetish and fruity aroma notes compared to the intense green and vegetable aroma of the non-fermented samples. β-Ionone (honey-like), decanal (citrus-like, floral), α-ionone (floral), octanal (fruity), and hexanal (green) were identified as key volatile compounds but distributed in different ratios. In the predominant coffee flowers, hay-like, hop-like, sage-like, dried apricot-like, and honey-like impressions were identified as major aroma descriptors in addition to a basic floral note. 2-Heptanol (fruity), 2-ethylhexanol (green), nerol (floral), and geraniol (floral) were identified as representative aroma compounds. All in all, a great variety of flavors was detected from the coffee leaves and flowers, which will not only provide an insight into the potential applications for the food market (i.e., coffee leaf tea and coffee flower tea) but will also help make coffee growing more sustainable.

The production of coffee leaf tea (Coffea arabica) in El Salvador and the influences of processing steps on non-volatile compounds and volatile aroma-active compounds were investigated. The tea was produced according to the process steps of conventional tea (Camellia sinensis) with the available possibilities on the farm. Influencing factors were the leaf type (old, young, yellow, shoots), processing (blending, cutting, rolling, freezing, steaming), drying (sun drying, oven drying, roasting) and fermentation (wild, yeast, Lactobacillus). Subsequently, the samples were analysed for the maximum levels of caffeine, chlorogenic acid, and epigallocatechin gallate permitted by the European Commission. The caffeine content ranged between 0.37–1.33 g/100 g dry mass (DM), the chlorogenic acid was between not detectable and 9.35 g/100 g DM and epigallocatechin gallate could not be detected at all. Furthermore, water content, essential oil, ash content, total polyphenols, total catechins, organic acids, and trigonelline were determined. Gas chromatography—mass spectrometry—olfactometry and calculation of the odour activity values (OAVs) were carried out to determine the main aroma-active compounds, which are β-ionone (honey-like, OAV 132-927), decanal (citrus-like, floral, OAV 14-301), α-ionone (floral, OAV 30-100), (E,Z)-2,6-nonadienal (cucumber-like, OAV 18-256), 2,4-nonadienal (melon-like, OAV 2-18), octanal (fruity, OAV 7-23), (E)-2 nonenal (citrus-like, OAV 1-11), hexanal (grassy, OAV 1-10), and 4-heptenal (green, OAV 1-9). The data obtained in this study may help to adjust process parameters directly to consumer preferences and allow coffee farmers to earn an extra income from this by-product.

The leaves of the coffee plant Coffea are traditionally used in several countries worldwide to prepare tea-like beverages using aqueous infusion in hot water. There are currently no tested methods available to check the regulatory compliance of coffee leaf tea according to the European Union (EU) novel food authorization. This study shows that standard ISO methods for tea analysis could be transferred without modifications to coffee leaf tea analysis. The only difference found was a much lower content of some catechins in coffee leaf tea compared to Camellia sinensis tea, but the methods were clearly applicable for use in controlling the EU’s maximum limits for coffee leaf tea.

Segmentation is a critical step in analyzing the developing human fetal brain. There have been vast improvements in automatic segmentation methods in the past several years, and the Fetal Brain Tissue Annotation (FeTA) Challenge 2021 helped to establish an excellent standard of fetal brain segmentation. However, FeTA 2021 was a single center study, limiting real-world clinical applicability and acceptance. The multi-center FeTA Challenge 2022 focused on advancing the generalizability of fetal brain segmentation algorithms for magnetic resonance imaging (MRI). In FeTA 2022, the training dataset contained images and corresponding manually annotated multi-class labels from two imaging centers, and the testing data contained images from these two centers as well as two additional unseen centers. The multi-center data included different MR scanners, imaging parameters, and fetal brain super-resolution algorithms applied. 16 teams participated and 17 algorithms were evaluated. Here, the challenge results are presented, focusing on the generalizability of the submissions. Both in- and out-of-domain, the white matter and ventricles were segmented with the highest accuracy (Top Dice scores: 0.89, 0.87 respectively), while the most challenging structure remains the grey matter (Top Dice score: 0.75) due to anatomical complexity. The top 5 average Dices scores ranged from 0.81-0.82, the top 5 average 95 th percentile Hausdorff distance values ranged from 2.3-2.5mm, and the top 5 volumetric similarity scores ranged from 0.90-0.92. The FeTA Challenge 2022 was able to successfully evaluate and advance generalizability of multi-class fetal brain tissue segmentation algorithms for MRI and it continues to benchmark new algorithms.

Introduction: Despite established knowledge on the morphological and functional asymmetries in the human brain, the understanding of how brain asymmetry patterns change during late fetal to neonatal life remains incomplete. The goal of this study was to characterize the dynamic patterns of inter-hemispheric brain asymmetry over this critically important developmental stage using longitudinally acquired MRI scans., Methods: Super-resolution reconstructed T2-weighted MRI of 20 neurotypically developing participants were used, and for each participant fetal and neonatal MRI was acquired. To quantify brain morphological changes, deformation-based morphometry (DBM) on the longitudinal MRI scans was utilized. Two registration frameworks were evaluated and used in our study: (A) fetal to neonatal image registration and (B) registration through a mid-time template. Developmental changes of cerebral asymmetry were characterized as (A) the inter-hemispheric differences of the Jacobian determinant (JD) of fetal to neonatal morphometry change and the (B) time-dependent change of the JD capturing left-right differences at fetal or neonatal time points. Left-right and fetal-neonatal differences were statistically tested using multivariate linear models, corrected for participants' age and sex and using threshold-free cluster enhancement., Results: Fetal to neonatal morphometry changes demonstrated asymmetry in the temporal pole, and left-right asymmetry differences between fetal and neonatal timepoints revealed temporal changes in the temporal pole, likely to go from right dominant in fetal to a bilateral morphology in neonatal timepoint. Furthermore, the analysis revealed right-dominant subcortical gray matter in neonates and three clusters of increased JD values in the left hemisphere from fetal to neonatal timepoints., Discussion: While these findings provide evidence that morphological asymmetry gradually emerges during development, discrepancies between registration frameworks require careful considerations when using DBM for longitudinal data of early brain development., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Steger, Moatti, Payette, De Silvestro, Nguyen, Coraj, Yakoub, Natalucci, Kottke, Tuura, Knirsch and Jakab.)

This study aimed to understand the impact of shrub encroachment on native species in the Guassa Community Conservation Area in Ethiopia. We assessed the soil seed bank composition and density across different elevations and aspects, and management systems within the area. The vegetation was stratified and eight blocks were selected across a range of elevation (<3350 m and >3350 m) and aspect (northeast, northwest, southeast, southwest). Within each block we established twenty 5m x 5m plots for a total of 160. We then collected soil samples from five subplots (1 m x 1 m) at three depths (0-3 cm, 3-6 cm and 6-9 cm) for a total of 480 samples, which were established in pots in greenhouse. We calculated species abundance by totaling the number of seedlings that emerged from each sample. To determine the variability in the abundance of Festuca macrophylla and Helichrysum splendidum in the soil seed bank along altitudinal gradient, we used two-way ANOVA using SAS statistical software version 9.0.1. Shannon diversity index was used to determine species diversity in the soil seedbank. After counting all the seeds, we identified 74 plant species represented in the soil seedbank which belong to 55 genera and 23 families. Eleven species are endemic to Ethiopia. At the lower elevation range, the effects of aspect (P <0.0088) and soil depth (P <0.005) are not significant to determine the abundance of seeds of H. splendidum and F. macrophylla. But when the factors are segregated, both aspect and soil depth play a significant role (p<0.0001) regarding the abundance of the seeds of the competing species at lower elevation. At higher elevation, only the effect of soil depth is significant (P<0.0001) for determining the abundance of H. splendidum. Soil depth and aspect have no significant effects on soil seed bank abundance at this elevation., Competing Interests: The authors have declared that no competing interests exist., (Copyright: This is an open access article, free of all copyright, and may be freely reproduced, distributed, transmitted, modified, built upon, or otherwise used by anyone for any lawful purpose. The work is made available under the Creative Commons CC0 public domain dedication.)

Objectives: Children with univentricular congenital heart disease undergoing staged surgical palliation are at risk for impaired neurodevelopmental (ND) outcome. Little is known about the long-term effects on brain growth until school age., Methods: In a prospective two-centre study, consecutive patients undergoing stage I (Hybrid or Norwood) to stage III (Fontan procedure) were evaluated by 2 serial cerebral magnetic resonance imaging examinations, somatic growth and ND testing before Fontan procedure at 2 years of age (Bayley-III) and after Fontan at 6-8 years of age (Wechsler Intelligence Scale for Children-third edition). Magnetic resonance imaging findings were compared with 8 healthy controls. Medical and sociodemographic characteristics were documented and related to cerebral and ND findings., Results: We examined 33 children (16 female) at a mean age of 2.3 (0.35) and 6.8 (± 0.7) years. The mean Bayley-III cognitive scales were 99.1 (9.9), language scales 98.4 (11.9) and motor scales 98.5 (13.8) at the first examination. Follow-up at school age showed a mean total IQ of 86.7 (13.6). The rate of structural brain lesions increased from 39% at 2 years to 58% at school age. Bayley-III language scale (P = 0.021) and mean Wechsler Intelligence Scale for Children-third edition (P = 0.019) were lower in children with pathological MR findings. Total brain volume (P < 0.001), total grey matter volume (P = 0.002), deep grey matter volume (P = 0.001) and white matter volume (P < 0.001) were smaller in patients compared to age- and gender-matched healthy controls., Conclusions: Smaller brain volumes and structural brain lesions in complex congenital heart defect patients at school age are associated with impaired ND outcome. For the evaluation of predictive surgical or clinical factors, larger multicentre studies are needed., (© The Author(s) 2023. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.)

Background: Altered neurometabolite ratios in neonates undergoing cardiac surgery for congenital heart defects (CHD) may serve as a biomarker for altered brain development and neurodevelopment (ND)., Methods: We analyzed single voxel 3T PRESS H 1 -MRS data, acquired unilaterally in the left basal ganglia and white matter of 88 CHD neonates before and/or after neonatal cardiac surgery and 30 healthy controls. Metabolite ratios to Creatine (Cr) included glutamate (Glu/Cr), myo-Inositol (mI/Cr), glutamate and glutamine (Glx/Cr), and lactate (Lac/Cr). In addition, the developmental marker N-acetylaspartate to choline (NAA/Cho) was evaluated. All children underwent ND outcome testing using the Bayley Scales of Infant and Toddler Development Third Edition (BSID-III) at 1 year of age., Results: White matter NAA/Cho ratios were lower in CHD neonates compared to healthy controls (group beta estimate: -0.26, std. error 0.07, 95% CI: -0.40 - 0.13, p value <0.001, FDR corrected p value = 0.010). We found no correlation between pre- or postoperative white matter NAA/Cho with ND outcome while controlling for socioeconomic status and CHD diagnosis., Conclusion: Reduced white matter NAA/Cho in CHD neonates undergoing cardiac surgery may reflect a delay in brain maturation. Further long-term MRS studies are needed to improve our understanding of the clinical impact of altered metabolites on brain development and outcome., Impact: NAA/Cho was reduced in the white matter, but not the gray matter of CHD neonates compared to healthy controls. No correlation to the 1-year neurodevelopmental outcome (Bayley-III) was found. While the rapid change of NAA/Cho with age might make it a sensitive marker for a delay in brain maturation, the relationship to neurodevelopmental outcome requires further investigation., (© 2022. The Author(s).)

Objectives: The significance of intraoperative cerebral desaturation (CD) measured by near-infrared spectroscopy (NIRS) to predict neurological outcome after congenital heart surgery is uncertain. The goal of this study was to compare brain structure changes and neurodevelopmental outcome in patients with severe congenital heart disease with and without intraoperative CD., Methods: Neonates requiring congenital heart surgery were enrolled in a cohort study. NIRS data from their first cardiac operation were collected. Pre- and postoperative brain magnetic resonance imaging results and Bayley-III scores at 1 year were compared between patients with and without CD, defined by 2 NIRS thresholds: regional cerebral oxygen saturation (rSO2) of 45% (45%rSO2) and rSO2 below 20% of baseline value (20%BLrSO2)., Results: Thirty-two patients (72% male) with d-transposition of the great arteries (n = 24, 75%) and other complex types of congenital heart diseases (n = 8, 25%) were analysed. Perioperative relative lateral ventricle volume change was increased in patients with versus without intraoperative CD (P = 0.003 for 45%rSO2, P = 0.008 for 20%BLrSO2). For 45%rSO2, the effect of CD remained significant after adjusting for age at postoperative scan, time between scans and cardiac diagnosis (P = 0.019). New intracranial lesions occurred predominantly in CD groups (6/6 patients for 45%rSO2, 5/6 patients for 20%BLrSO2). Neurodevelopmental outcome at 1 year was not associated with intraoperative CD., Conclusions: This study demonstrates the clinical relevance of NIRS monitoring during congenital heart surgery. The occurrence of intraoperative CD is associated with perioperative lateral ventricle volume change and new intracranial lesions., (© The Author(s) 2022. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.)

We co-designed an agent-based model of an Afroalpine grassland in Ethiopia that is experiencing unwanted shrub encroachment. The goal was to enable managers of a community conservation area to better understand the drivers of shrub encroachment and to test possible management actions for controlling shrubs. Due to limited site-specific data, we parameterized this model using insights from published literature, remote sensing, and expert opinion from scientists and local managers. We therefore sought to explore potential future scenarios rather than make highly accurate predictions, focusing on facilitating discussions and learning among the diverse co-management team. We evaluated three social-ecological scenarios with our model, examining: (1) the impact of changing precipitation regimes on vegetation, (2) whether changing the frequency of guassa grass harvests would improve the long-term sustainability of the grassland, and (3) whether the combination of grass harvest and shrub removal would affect shrub encroachment. We found that the model was highly sensitive to the amount of grass harvested each year for local use. Our results indicate that the guassa grass was more resilient than shrubs during persistent dry climatic conditions, whereas a reduction in only the early spring rains (known as the "belg") resulted in considerable loss of grass biomass. While our modeling results lacked the quantitative specificity desired by managers, participants in the collaborative modeling process learned new approaches to planning and management of the conservation area and expanded their knowledge of the ecological complexity of the system. Several participants used the model as a boundary object, interpreting it in ways that reinforced their cultural values and goals for the conservation area. Our work highlights the lack of detailed scientific knowledge of Afroalpine ecosystems, and urges managers to reconnect with traditional ecological management of the conservation area in their pursuit of shrub encroachment solutions. The decline or absence of the belg rains is becoming increasingly common in the Ethiopian highlands, and our results underscore the need for more widespread understanding of how this changing climatic regime impacts local environmental management. This work lays a foundation for social-ecological research to improve both understanding and management of these highly threatened ecosystems., (Copyright © 2022. Published by Elsevier Ltd.)

Differentiating COVID-19 from other causes of viral pneumonia, like herpes simplex (HSV), can be complicated by shared clinical and laboratory features. Viral pneumonia is mostly diagnosed based on molecular or serological techniques. Serological immunoassay interferences, often attributed to concurrent appearance of heterologous (viral) immunoglobulins, is well-known, but has not been studied in COVID-19 patients. Following false positive HSV immunoglobulin M (IgM) results in our index patient, 25 other COVID-19 patients were tested for HSV-1/2 IgM with the chemiluminescent Liaison assay and Euroimmun enzyme-linked immunosorbent assay. Forty-five percent of COVID-19 patients tested positive for HSV IgM with Liaison. No HSV indices were positive with Euroimmun enzyme-linked immunosorbent assay, suggesting immunoassay interference. Significant correlation between HSV IgM and SARS-CoV-2 IgM/IgG positivity was found. Adding 0.5% polyvinylpyrrolidone, inhibiting non-specific solid-phase adsorption, abolished interference in 22% of false positive cases, suggesting interference caused by solid-phase reactive IgM. Hence, serologic immunoassay results should be interpreted with caution in COVID-19 patients., Competing Interests: Declaration of competing interest The authors declare that they have no conflict of interest., (Copyright © 2022 Elsevier Inc. All rights reserved.)

The basal ganglia (BG) are a group of subcortical nuclei responsible for motor and executive function. Central to BG function are striatal cells expressing D1 (D1R) and D2 (D2R) dopamine receptors. D1R and D2R cells are considered functional antagonists that facilitate voluntary movements and inhibit competing motor patterns, respectively. However, whether they maintain a uniform function across the striatum and what influence they exert outside the BG is unclear. Here, we address these questions by combining optogenetic activation of D1R and D2R cells in the mouse ventrolateral caudoputamen with fMRI. Striatal D1R/D2R stimulation evokes distinct activity within the BG-thalamocortical network and differentially engages cerebellar and prefrontal regions. Computational modeling of effective connectivity confirms that changes in D1R/D2R output drive functional relationships between these regions. Our results suggest a complex functional organization of striatal D1R/D2R cells and hint toward an interconnected fronto-BG-cerebellar network modulated by striatal D1R and D2R cells., Competing Interests: Declaration of interests The authors declare no competing interests., (Copyright © 2021 The Author(s). Published by Elsevier Inc. All rights reserved.)

Graft vasculopathy is the main feature of chronic rejection in organ transplantation, with oxidative stress being a major trigger. Inflammation-associated prooxidant processes may be controlled by antioxidants; however, interference with redox-regulated mechanisms is a complex endeavor. An essential feature of the cellular immune response is the acceleration of tryptophan (Trp) breakdown, leading to the formation of several bioactive catabolites. Long-term activation of this immunobiochemical pathway contributes to the establishment of a tolerogenic environment, thereby supporting allograft survival. Herein, the impact of the antioxidant sodium sulfite on the development of graft vasculopathy was assessed in murine aortic transplantation. Allogeneic (BALB/c to C57BL/6) heterotopic murine aortic transplantations were performed. Animals were left untreated or were treated with 10  μ l of 0.1 M, of 0.01 M sodium sulfite, or of 0.1 M sodium sulfate, intraperitoneally once/day, until postoperative day (POD) 100. Grafts were assessed by histology, immunohistochemistry, and adhesion molecule gene expression. Serum concentrations of tryptophan and its catabolite kynurenine (Kyn) were measured. On day 100, graft vasculopathy was significantly increased upon treatment with 0.1 M sodium sulfite, compared to allogeneic untreated controls ( p = 0.004), which correlated with a significant increase of α -smooth-muscle-actin, Vcam-1, and P-selectin. Serum Kyn concentrations increased in the allogeneic control group over time ( p < 0.05, POD ≥ 50), while low-dose sodium sulfite treatment (0.01 M) treatment resulted in a decrease in Kyn levels over time ( p < 0.05, POD ≥ 10), compared to the respective baselines ( p < 0.05). Longitudinal analysis of serum metabolite concentrations in the different treatment groups further identified an overall effect of sodium sulfite on Kyn concentrations. Antioxidative treatment may result in ambivalent consequences. Our data reveal that an excess of antioxidants like sodium sulfite can aggravate allograft vasculopathy, which further highlights the challenges associated with interventions that interfere with the complex interplay of redox-regulated inflammatory processes.

Transplant vasculopathy (TV) represents a major obstacle to long-term graft survival and correlates with severity of ischemia reperfusion injury (IRI). Donor administration of the nitric oxide synthases (NOS) co-factor tetrahydrobiopterin has been shown to prevent IRI. Herein, we analysed whether tetrahydrobiopterin is also involved in TV development. Using a fully allogeneic mismatched (BALB/c to C57BL/6) murine aortic transplantation model grafts subjected to long cold ischemia time developed severe TV with intimal hyperplasia (α-smooth muscle actin positive cells in the neointima) and endothelial activation (increased P-selectin expression). Donor pretreatment with tetrahydrobiopterin significantly minimised these changes resulting in only marginal TV development. Severe TV observed in the non-treated group was associated with increased protein oxidation and increased occurrence of endothelial NOS monomers in the aortic grafts already during graft procurement. Tetrahydrobiopterin supplementation of the donor prevented all these early oxidative changes in the graft. Non-treated allogeneic grafts without cold ischemia time and syngeneic grafts did not develop any TV. We identified early protein oxidation and impaired endothelial NOS homodimer formation as plausible mechanistic explanation for the crucial role of IRI in triggering TV in transplanted aortic grafts. Therefore, targeting endothelial NOS in the donor represents a promising strategy to minimise TV.

A hallmark of the waking state is a shift in EEG power to higher frequencies with epochs of synchronized intracortical gamma activity (30-60 Hz) - a process associated with high-level cognitive functions. The ascending arousal system, including cholinergic laterodorsal (LDT) and pedunculopontine (PPT) tegmental neurons and serotonergic dorsal raphe (DR) neurons, promotes this state. Recently, this system has been proposed as a gamma wave generator, in part, because some neurons produce high-threshold, Ca(2+)-dependent oscillations at gamma frequencies. However, it is not known whether arousal-related inputs to these neurons generate such oscillations, or whether such oscillations are ever transmitted to neuronal targets. Since key arousal input arises from hypothalamic orexin (hypocretin) neurons, we investigated whether the unusually noisy, depolarizing orexin current could provide significant gamma input to cholinergic and serotonergic neurons, and whether such input could drive Ca(2+)-dependent oscillations. Whole-cell recordings in brain slices were obtained from mice expressing Cre-induced fluorescence in cholinergic LDT and PPT, and serotonergic DR neurons. After first quantifying reporter expression accuracy in cholinergic and serotonergic neurons, we found that the orexin current produced significant high frequency, including gamma, input to both cholinergic and serotonergic neurons. Then, by using a dynamic clamp, we found that adding a noisy orexin conductance to cholinergic neurons induced a Ca(2+)-dependent resonance that peaked in the theta and alpha frequency range (4-14 Hz) and extended up to 100 Hz. We propose that this orexin current noise and the Ca(2+) dependent resonance work synergistically to boost the encoding of high-frequency synaptic inputs into action potentials and to help ensure cholinergic neurons fire during EEG activation. This activity could reinforce thalamocortical states supporting arousal, REM sleep, and intracortical gamma.

Background: Many diseases and pathological conditions are characterized by transient or constitutive overproduction of reactive oxygen species (ROS). ROS are causal for ischemia/reperfusion (IR)-associated tissue injury (IRI), a major contributor to organ dysfunction or failure. Preventing IRI with antioxidants failed in the clinic, most likely due to the difficulty to timely and efficiently target them to the site of ROS production and action. IR is also characterized by changes in the activity of intracellular signaling molecules including the stress kinase p38MAPK. While ROS can cause the activation of p38MAPK, we recently obtained in vitro evidence that p38MAPK activation is responsible for elevated mitochondrial ROS levels, thus suggesting a role for p38MAPK upstream of ROS and their damaging effects., Results: Here we identified p38MAPKα as the predominantly expressed isoform in HL-1 cardiomyocytes and siRNA-mediated knockdown demonstrated the pro-oxidant role of p38MAPKα signaling. Moreover, the knockout of the p38MAPK effector MAPKAP kinase 2 (MK2) reproduced the effect of inhibiting or knocking down p38MAPK. To translate these findings into a setting closer to the clinic a stringent kidney clamping model was used. p38MAPK activity increased upon reperfusion and p38MAPK inhibition by the inhibitor BIRB796 almost completely prevented severe functional impairment caused by IR. Histological and molecular analyses showed that protection resulted from decreased redox stress and apoptotic cell death., Conclusions: These data highlight a novel and important mechanism for p38MAPK to cause IRI and suggest it as a potential therapeutic target for prevention of tissue injury.

Background: The purpose of this study was to investigate and identify predictors for idiopathic macular hole persistence after pars plana vitrectomy with dye-assisted internal limiting membrane peeling., Methods: In a retrospective case series, 160 eyes underwent identical vitreoretinal procedures performed by the same surgeon. Baseline characteristics and preoperative optical coherence tomography were evaluated regarding the postoperative anatomical outcome., Results: n overall closure rate of 86.3% (138/160) was achieved. According to the Gass classification system, the closure rates were 100.0% (11/11) in Stage 2, 95.0% (57/60) in Stage 3, and 78.7% (70/89) in Stage 4. Thereby, a significant influence of preoperative best-corrected visual acuity and basal hole diameter was observed. Especially, idiopathic macular hole with a basal hole diameter of ≥800 μm and a best-corrected visual acuity of ≤20/100 had a 4 and 6 times higher risk to persist, respectively. On the other hand, age, gender, bilateral occurrence, symptom duration, and lens status did not have an effect on the surgical outcome. Furthermore, perifoveal pseudocysts were associated with a higher closure rate in Stage 4 idiopathic macular hole., Conclusion: Simple clinical parameters such as best-corrected visual acuity, basal diameter, and perifoveal pseudocysts are efficient predictors and might be used to expand the validity of the Gass classification.

In cystic fibrosis (CF), the most frequent life threatening inherited disease in Caucasians, sinonasal mucosa is regularly affected by defective mucociliary clearance. This facilitates pathogen colonization into CF airways and causes frequent symptoms of rhinosinusitis, including an impaired sense of smell. Despite probable effects on nutrition and overall health, CF-rhinosinusitis is little understood: CF-associated smelling deficiencies reported in literature vary between 12 and 71 %. The aim of this study was to assess olfactory and gustatory function in relation to sinonasal symptoms and sinonasal colonization, and lung function and nutrition. Thirty-five CF patients of different ages were compared to 35 age-matched healthy controls. Olfactory function was assessed by 'Sniffin'Sticks', gustatory qualities by "Taste-strips", and symptoms by sino-nasal outcome test 20 (SNOT-20). Normosmia was found in 62.8 % of healthy controls but only in 28.6 % of CF patients. In contrast the majority of CF patients exhibited a smell loss; almost 62.9 % of them were hyposmic, and 8.6 % functionally anosmic. Importantly, reduced olfactory function only affected odor thresholds, which were significantly increased in CF, not odor identification. This suggests that the olfactory dysfunction in CF results from the olfactory periphery due to either problems in conduction and/or a functional lesion due to the inflammatory process. SNOT-20 scores increased continuously from normosmic to hyposmic and anosmic CF patients (means 7.2/11.1/28.3 points). Neither sinonasal pathogen colonization, gender, pulmonary function, nor allergy or sinonasal surgery appeared to have significant effects on olfactory function and taste. Olfactory disorders are considerably more frequent in CF patients than in age-matched healthy controls. Assessing these parameters within CF-routine care should be considered because of their importance to nutrition and, thus, overall therapy outcome.

Background: Left ventricular noncompaction is associated with arrhythmias. The indication for implantation of devices for primary prophylaxis of sudden cardiac death in noncompaction is controversial, especially for patients without severe systolic dysfunction. The use of implantable loop-recorders to detect arrhythmias has not been reported so far., Methods: A retrospective analysis of indications and results of implantation of loop-recorders in patients with left ventricular noncompaction., Results: Loop-recorders were implanted in 3 patients with noncompaction and moderately or preserved left ventricular systolic function. The recorders revealed pauses N3 s, leading to pacemaker implantation in one patient, and tachycardia leading to radiofrequency ablation in another patient. In the third patient, no arrhythmias have so far been detected., Conclusion: From our limited experience we consider monitoring by a loop-recorder as a useful tool to detect arrhythmias in noncompaction-patients.

A 23-year-old male with Duchenne muscular dystrophy (DMD) experienced self-limiting palpitations at age 19 years for the first time. Palpitations recurred not earlier than at age 23 years, and were attributed to narrow complex tachycardia, which could be terminated with adenosine. Since electrocardiography showed a delta-wave, Wolff-Parkinson-White (WPW) syndrome was diagnosed, ajmaline prescribed and radio-frequency catheter ablation of three accessory pathways carried out one week later. One day after ablation, however, a relapse of the supraventricular tachycardia occurred and was terminated with ajmaline. Re-entry tachycardia occurred a second time six days after ablation, and as before, it was stopped only with ajmaline. Despite administration of verapamil to prevent tachycardia, it occurred a third time four months after ablation. This case shows that cardiac involvement in DMD may manifest also as WPW-syndrome. In these patients, repeated radio-frequency catheter ablation of accessory pathways may be necessary to completely block the re-entry mechanism.

Background: Secretoneurin is a neuropeptide located in nerve fibers along blood vessels, is upregulated by hypoxia, and induces angiogenesis. We tested the hypothesis that secretoneurin gene therapy exerts beneficial effects in a rat model of myocardial infarction and evaluated the mechanism of action on coronary endothelial cells., Methods and Results: In vivo secretoneurin improved left ventricular function, inhibited remodeling, and reduced scar formation. In the infarct border zone, secretoneurin induced coronary angiogenesis, as shown by increased density of capillaries and arteries. In vitro secretoneurin induced capillary tubes, stimulated proliferation, inhibited apoptosis, and activated Akt and extracellular signal-regulated kinase in coronary endothelial cells. Effects were abrogated by a vascular endothelial growth factor (VEGF) antibody, and secretoneurin stimulated VEGF receptors in these cells. Secretoneurin furthermore increased binding of VEGF to endothelial cells, and binding was blocked by heparinase, indicating that secretoneurin stimulates binding of VEGF to heparan sulfate proteoglycan binding sites. Additionally, secretoneurin increased binding of VEGF to its coreceptor neuropilin-1. In endothelial cells, secretoneurin also stimulated fibroblast growth factor receptor-3 and insulin-like growth factor-1 receptor, and in coronary vascular smooth muscle cells, we observed stimulation of VEGF receptor-1 and fibroblast growth factor receptor-3. Exposure of cardiac myocytes to hypoxia and ischemic heart after myocardial infarction revealed increased secretoneurin messenger RNA and protein., Conclusions: Our data show that secretoneurin acts as an endogenous stimulator of VEGF signaling in coronary endothelial cells by enhancing binding of VEGF to low-affinity binding sites and neuropilin-1 and stimulates further growth factor receptors like fibroblast growth factor receptor-3. Our in vivo findings indicate that secretoneurin may be a promising therapeutic tool in ischemic heart disease.

This paper describes an approach for recognizing instances of a 3D object in a single camera image and for determining their 3D poses. A hierarchical model is generated solely based on the geometry information of a 3D CAD model of the object. The approach does not rely on texture or reflectance information of the object's surface, making it useful for a wide range of industrial and robotic applications, e.g., bin-picking. A hierarchical view-based approach that addresses typical problems of previous methods is applied: It handles true perspective, is robust to noise, occlusions, and clutter to an extent that is sufficient for many practical applications, and is invariant to contrast changes. For the generation of this hierarchical model, a new model image generation technique by which scale-space effects can be taken into account is presented. The necessary object views are derived using a similarity-based aspect graph. The high robustness of an exhaustive search is combined with an efficient hierarchical search. The 3D pose is refined by using a least-squares adjustment that minimizes geometric distances in the image, yielding a position accuracy of up to 0.12 percent with respect to the object distance, and an orientation accuracy of up to 0.35 degree in our tests. The recognition time is largely independent of the complexity of the object, but depends mainly on the range of poses within which the object may appear in front of the camera. For efficiency reasons, the approach allows the restriction of the pose range depending on the application. Typical runtimes are in the range of a few hundred ms.

Objectives: We aimed to determine the extent of acute endothelial cell loss and neointimal proliferation in the long-term in saphenous vein grafts (SVGs) exposed to defined distension pressures., Methods: During routine competence testing of SVGs for coronary artery bypass grafting (CABG), blinded peak pressure measurements were performed in 10 patients. In an experimental set-up, distension pressure-related endothelial damage was studied in the SVGs of 20 patients. In a subgroup (n = 10), each patient's SVG was divided into segments and subjected to four constant pressures (50, 100, 150 and 300 mmHg) for 30 min each. In another subgroup (n = 10), SVGs were exposed to a short phase of high pressure (low pressure followed by 300 mmHg for 5 min). Acute endothelial cell loss was quantified by CD31-immunostaining. After 2 weeks of organ culture, the neointimal proliferation was evaluated using histomorphometry. Pressure-related damage was compared with damage at baseline (0 mmHg)., Results: During routine competence testing for CABG, we revealed a median peak pressure of 355 mmHg (range: 240-639 mmHg). In the experimental set-up, significant acute endothelial cell loss occurred at all tested distension pressures: at 50 mmHg, the median endothelial cell loss was 29% (range: 20-51%, P = 0.015), at 100 mmHg 54% (range: 37-69%, P < 0.001), at 150 mmHg 75% (range: 41-88%, P < 0.001), at 300 mmHg 91% (range: 63-100%, P < 0.001) and at short high-pressure exposure 65% (range: 49-82%, P < 0.001) in comparison with 20% (range: 0-44%) at baseline. Significant neointimal proliferation occurred when a distension pressure of 50 mmHg was exceeded: at 50 mmHg, median neointimal proliferation was 97 µm (range: 60-380 µm, P = 0.176), at 100 mmHg 168 µm (range: 100-600 µm, P = 0.001), at 150 mmHg 183 µm (range: 160-440 µm, P < 0.001) at 300 mmHg 347 µm (range: 190-590 µm, P < 0.001) and at short high-pressure exposure 130 µm (range: 60-410 µm, P = 0.02) in comparison with 90 µm (range: 60-170 µm) at baseline., Conclusions: In vitro exposure of SVGs to low distension pressure ranges causes significant acute endothelial cell loss and crucial long-term damage, namely neointimal proliferation.

Objective: The 3-bp deletion in exon 2 of the Lamin A/C (LMNA) gene has not been described in association with dilated cardiomyopathy, which is characterized by progressive heart failure, atrioventricular (AV) block, tachyarrhythmias, and variable skeletal muscle involvement., Case Report: In a 43-year-old woman with a long-term history of palpitations and newly diagnosed AV blocks I and II, ventricular ectopic beats, inducible nonsustained ventricular tachycardias (VTs), cardiac arrest, and successful resuscitation, an implantable cardioverter defibrillator was successfully implanted. Her family history was positive for sudden cardiac death (her father and sister), dyspnea and heart failure (her grandmother and sister), palpitations (her brother), and elevated levels of creatine-kinase (CK) (her sister). Two cousins had died of nonspecific muscular dystrophy at ages 10 years and 11 years. Upon neurological investigations revealing sore neck muscles, reduced tendon reflexes, and detached, spot-like white matter lesions bilaterally, a neuromuscular disorder was suspected. The direct sequencing of all exons and flanking intronic regions of the LMNA gene detected the heterozygote 3-bp deletion (AAG) c.367&#95;369del in exon 2 of the gene. This mutation resulted in the deletion of a lysine at position 123 (p.lys123del) in the lamin A/C protein., Conclusions: The novel 3-bp deletion in exon 2 of the LMNA gene may phenotypically manifest as dilated cardiomyopathy, heart failure, severe tachyarrhythmias, and muscular dystrophy. Sudden cardiac death from ventricular fibrillation may be prevented in LMNA mutation carriers if the diagnosis is established early enough to implant a cardioverter defibrillator., (Copyright © 2012 Elsevier Inc. All rights reserved.)

The purpose of this study was to evaluate photodynamic properties of indocyanine green (ICG), brilliant blue G (BBG) and trypan blue (TB) as currently used vital dyes for chromovitrectomy. Under consideration of intraoperative illumination intensities and dye concentrations, a simulative in vitro investigation was set up. Therefore, standardized dilutions of original ICG, BBG and TB vials were irradiated at a wavelength of 366 nm with an intensity of 14 µW/cm2 between 0 and 48 h. After this, all samples were measured spectroscopically in a 220- to 750-nm bandwidth. Analyzing the vital dyes over the time course, an exponential photolysis was observed for ICG, whereas BBG and TB presented photostable properties. Regarding ICG, 5% of the concentration was degraded to toxic metabolites every 20 min. For this reason, our study provides evidence that intraocular dye concentrations and modern endoillumination systems alone cannot fully prevent ICG photodegradation., (Copyright © 2012 S. Karger AG, Basel.)