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Abstract Power systems are highly complex, large‐scale engineering systems subject to many uncertainties, which makes accurate mathematical modeling challenging. This article introduces a novel centralized dynamic state estimator designed specifically for power systems where some component models are missing. Including the available dynamic evolution equations, algebraic network equations, and phasor measurements, the least squares criterion is applied to estimate all dynamic and algebraic states recursively. The approach generalizes the iterated extended Kalman filter and does not require static network observability, relying on the network topology and parameters. Furthermore, a topological criterion is established for placing phasor measurement units (PMUs), termed topological estimability, which guarantees the uniqueness of the solution. A numerical study evaluates the performance under short circuits in the network and load changes and shows superior tracking performance compared to robust procedures from the literature with computational times in accordance with the typical PMU sampling rates.

Abstract The microbes, nutrients and toxins that we are exposed to can have a profound effect on the composition and function of the gut microbiome. Thousands of peer-reviewed publications link microbiome composition and function to health from the moment of birth, right through to centenarians, generating a tantalizing glimpse of what might be possible if we could intervene rationally. Nevertheless, there remain relatively few real-world examples where successful microbiome engineering leads to beneficial health effects. Here we aim to provide a framework for the progress needed to turn gut microbiome engineering from a trial-and-error approach to a rational medical intervention. The workflow starts with truly understanding and accurately diagnosing the problems that we are trying to fix, before moving on to developing technologies that can achieve the desired changes.

In this article, we analyse the processes that contribute to changes in career aspirations among German PhD graduates. Drawing on the concept of cooling out (Goffman 1952; Clark 1960) - which describes semi-intentional practices that can cause a gradual decline in educational or career aspirations -- the paper expands on this by distinguishing between formal and informal processes that contribute to graduates deciding to abandon an academic career path. To explore the phenomenon, we employ a qualitative interview study with 21 PhD graduates from different academic disciplines, all of whom have chosen careers outside the academic realm at different biographical stages - often voluntarily, but occasionally involuntarily. The aim of the study is to paint a more differentiated and empirically underpinned picture of typical cooling out constellations in academia. We conclude by discussing the implications for creating effective PhD support in transition phases.

Movements are performed by motoneurons transforming synaptic inputs into an activation signal that controls muscle force. The control signal emerges from interactions between ionotropic and neuromodulatory inputs to motoneurons. Critically, these interactions vary across motoneuron pools and differ between muscles. To provide the most comprehensive framework to date of motor unit activity during isometric contractions, we identified the firing activity of extensive samples of motor units in the tibialis anterior (129 ± 44 per participant; n=8) and the vastus lateralis (130 ± 63 per participant; n=8) muscles during isometric contractions of up to 80% of maximal force. From this unique dataset, the rate coding of each motor unit was characterised as the relation between its instantaneous firing rate and the applied force, with the assumption that the linear increase in isometric force reflects a proportional increase in the net synaptic excitatory inputs received by the motoneuron. This relation was characterised with a natural logarithm function that comprised two stages. The initial stage was marked by a steep acceleration of firing rate, which was greater for low- than medium- and high-threshold motor units. The second stage comprised a linear increase in firing rate, which was greater for high- than medium- and low-threshold motor units. Changes in firing rate were largely non-linear during the ramp-up and ramp-down phases of the task, but with significant prolonged firing activity only evident for medium-threshold motor units. Contrary to what is usually assumed, our results demonstrate that the firing rate of each motor unit can follow a large variety of trends with force across the pool. From a neural control perspective, these findings indicate how motor unit pools use gain control to transform inputs with limited bandwidths into an intended muscle force.

IntroductionCheckpoint inhibitors are increasingly important in anti-cancer treatment. Therefore, knowledge of immune-related cutaneous adverse events (ir-cAE) is crucial for therapy management and continuation.ObjectiveThe study aimed to analyze the incidence of cutaneous adverse events caused by checkpoint inhibitor therapy, including their clinical presentation, management, and impact on further treatment.MethodsThis is a descriptive, monocentric retrospective study that uses data from the electronic health record system at a tertiary referral hospital in Central Switzerland from September 2019 to September 2022. The electronic health records of patients who received a therapy with checkpoint inhibitors were examined for age, sex, type of immunotherapy, time to occurrence of ir-cAEs, characteristics of the ir-cAEs, the treatment approach, and the continuation or cessation of the therapy due to ir-cAEs.ResultsOut of 431 patients, for 131 patients (30.4%) at least one ir-cAE event was documented. In particular, 109 (25.3%) experienced pruritus and 61 (14.2%) showed a maculopapular exanthema. The severity of the ir-cAE was mild in 88 patients (67.2% out of those with ir-cAEs). Ir-cAE were observed in 10 out of 20 patients (50%) treated with ipilimumab/nivolumab and in 15 out of 24 (62.5%) treated with durvalumab. In 15 patients (3.5%), checkpoint inhibitor therapy had to be discontinued due to cutaneous side effects.ConclusionsThis study showed that approximately one third of the patients experienced ir-cAEs. The most frequently observed ir-cAEs were pruritus, maculopapular exanthema and xerosis cutis. In general, the dermatological manifestations are mild and responsive to topical treatment or self-limiting with no requirement for treatment interruption.

Summary: Background: Real-world data on gene addition therapy (GAT) with onasemnogene abeparvovec (OA), including all age groups and with or without symptoms of the disease before treatment are needed to provide families with evidence-based advice and realistic therapeutic goals. Aim of this study is therefore a population-based analysis of all patients with SMA treated with OA across Germany, Austria and Switzerland (D-A-CH). Methods: This observational study included individuals with Spinal Muscular Atrophy (SMA) treated with OA in 29 specialized neuromuscular centers in the D-A-CH-region. A standardized data set including WHO gross motor milestones, SMA validated motor assessments, need for nutritional and respiratory support, and adverse events was collected using the SMArtCARE registry and the Swiss-Reg-NMD. Outcome data were analyzed using a prespecified statistical analysis plan including potential predictors such as age at GAT, SMN2 copy number, past treatment, and symptom status. Findings: 343 individuals with SMA (46% male, 54% female) with a mean age at OA of 14.0 months (range 0–90, IQR 20.0 months) were included in the analysis. 79 (23%) patients were clinically presymptomatic at the time of treatment. 172 (50%) patients received SMN2 splice-modifying drugs prior to GAT (risdiplam: n = 16, nusinersen: n = 154, both: n = 2). Functional motor improvement correlated with lower age at GAT, with the best motor outcome in those younger than 6 weeks, carrying 3 SMN2 copies, and being clinically presymptomatic at time of treatment. The likelihood of requiring ventilation or nutritional support showed a significantly increase with older age at the time of GAT and remained stable thereafter. Pre-treatment had no effect on disease trajectories. Liver-related adverse events occurred significantly less frequently up to 8 months of age. All other adverse events showed an even distribution across all age and weight groups. Interpretation: Overall, motor, respiratory, and nutritional outcome were dependent on timing of GAT and initial symptom status. It was best in presymptomatic children treated within the first six weeks of life, but functional motor scores also increased significantly after treatment in all age groups up to 24 months. Additionally, OA was best tolerated when administered at a young age. Our study therefore highlights the need for SMA newborn screening and immediate treatment to achieve the best possible benefit-risk ratio. Funding: The SMArtCARE and Swiss-Reg-NMD registries are funded by different sources (see acknowledgements).

The rapid development of AI in the recent years has triggered numerous discussions in the education sector since it offers numerous opportunities, but also challenges. This study addresses one context in which AI might become a relevant tool for different purposes: German secondary education. This study therefore examines the extent to which STEM teachers in German secondary education assess the benefits but also the risks of ChatGPT and how this influences the future use of AI in an educational context. As part of a questionnaire study, 102 STEM teachers were investigated. The current and future use of ChatGPT and various teacher variables were recorded with questionnaires based on classifications of researchers as well as political institutions. Relationships between the variables were explored using a path model investigating hypotheses regarding the affect heuristic, perceived risks and benefits as well as effects on teaching quality. In general, AI is still used relatively rarely, but future usage expectations are high compared to current usage. Results further revealed that perceived competence and benefits of ChatGPT have a positive influence on the use and intention to use it. Perceived risks and concerns have no significant influence on the usefulness of ChatGPT in the classroom, indicating that STEM teachers use AI in the classroom despite potential concerns and perceived risks. Additionally, perceived benefits and risks are negatively associated with each other, indicating that teachers rely on an affect heuristic when judging the usefulness of AI technology in the classroom.

Decoding the activity of individual neural cells during natural behaviours allows neuroscientists to study how the nervous system generates and controls movements. Contrary to other neural cells, the activity of spinal motor neurons can be determined non-invasively (or minimally invasively) from the decomposition of electromyographic (EMG) signals into motor unit firing activities. For some interfacing and neuro-feedback investigations, EMG decomposition needs to be performed in real time. Here, we introduce an open-source software that performs real-time decoding of motor neurons using a blind-source separation approach for multichannel EMG signal processing. Separation vectors (motor unit filters) are optimised for each motor unit from baseline contractions and then re-applied in real time during test contractions. In this way, the firing activity of multiple motor neurons can be provided through different forms of visual feedback. We provide a complete framework with guidelines and examples of recordings to guide researchers who aim to study movement control at the motor neuron level. We first validated the software with synthetic EMG signals generated during a range of isometric contraction patterns. We then tested the software on data collected using either surface or intramuscular electrode arrays from five lower limb muscles (gastrocnemius lateralis and medialis, vastus lateralis and medialis, and tibialis anterior). We assessed how the muscle or variation of contraction intensity between the baseline contraction and the test contraction impacted the accuracy of the real-time decomposition. This open-source software provides a set of tools for neuroscientists to design experimental paradigms where participants can receive real-time feedback on the output of the spinal cord circuits.

Slip, trip and fall (ST&F) events are a cause of significant mortality, hospitalisations and financial expense. Floor conditions are a factor in some portion of ST&F events and thus important to monitor. In commercial buildings, flooring surfaces are often coated with a removable floor finish to protect the floor and provide a consistent walking surface. The relationship between the number of coating layers of a floor finish and the slip resistance, i.e. coefficient of friction, is poorly reported in the literature. In this study, vinyl composite floor tiles were coated with four different floor finishes, varying from 2 to 10 coating layers. The static coefficient of friction (SCOF) was tested using the James Machine and ASTM D2047 to determine whether there was a change in the SCOF/slip resistance and thus the ST&F risk, associated with different numbers of coating layers of finish. The number of coating layers of floor finish did not negatively impact the SCOF/slip resistance of the tiles. This study suggests that maintaining an appropriate layer of floor finish, typically recommended by manufacturers to be four coating layers, provides a slip-resistant walking surface that is not negatively affected by additional coating layers of finish.

Abstract Temperature is a critical factor shaping physiology, life cycle, and behaviour of ectothermic vector insects, as well as the development and multiplication of pathogens within them. However, the influence of pathogen infections on thermal preferences (behavioural thermoregulation) is not well-understood. The present study examined the thermal preferences of mosquitoes (Aedes aegypti and Ae. japonicus) infected with either Sindbis virus (SINV) or Dirofilaria immitis over 12 days post exposure (p.e.) or injected with a non-pathogenic Sephadex bead over 24 h in a thermal gradient (15–30 °C). SINV-infected Ae. aegypti preferred 5 °C warmer temperatures than non-infected ones at day 6 p.e., probably the time of highest innate immune response. In contrast, D. immitis-infected Ae. japonicus preferred 4 °C cooler temperatures than non-infected ones at day 9 p.e., presumably a stress response during the migration of third instar larvae from their development site to the proboscis. Sephadex bead injection also induced a cold preference in the mosquitoes but to a level that did not differ from control-injections. The cold preference thus might be a strategy to escape the risk of desiccation caused by the wound created by piercing the thorax. Further research is needed to uncover the genetic and physiological mechanisms underlying these behaviours.

Obgleich ein Großteil der Promovierten in Deutschland erfolgreich einen Karriereweg außerhalb der Wissenschaft wählt, stößt diese Entscheidung auf ambivalente Reaktionen seitens Universität und Arbeitsmarkt. Für die oftmals kritische Übergangsphase zwischen Promotion und außerakademischer Berufstätigkeit können hochschulische Supportstrukturen eine zentrale Rolle spielen. Die vorliegende Studie liefert – anknüpfend an aktuelle öffentliche Diskussionen – neben Einblicken zur Employability von Promovierten diverse Implikationen für die Identifikation von universitären Unterstützungsbedarfen, die den Abbau von strukturellen und persönlichen Hürden befördern.

Background and purpose: Peer review is an important component of quality assurance in radiotherapy. To our knowledge, there are no studies reporting on the feasibility and outcomes of the peer review process for magnetic resonance (MR) guided radiotherapy (MRgRT) on the MR linear accelerator (MR-Linac) despite the planning complexity involved and its evolving clinical indications. This study aimed to quantify the rate of change in treatment plans post-peer review and the time and resources required. Materials and methods: Fifty-five cases presented at weekly MR-Linac peer review meetings across two centres from 8 June to 21 September 2023 were prospectively collected. Cases were analysed to determine the rate and extent of plan changes based on the Peer Review Audit Tool for radiation oncology (PRAT) developed by the Royal Australian and New Zealand College of Radiologists (RANZCR). Results: Peer review resulted in changes to 36.4 % of treatment plans (n = 20), with 3.6 % (n = 2) having major changes requiring deferment of treatment. The most frequent changes were to organs at risk (OAR) volumes involving both delineation and increased OAR sparing (16.4 %, n = 9), total dose and fractionation (10.9 %, n = 6) and target volume dose coverage (5.5 %, n = 3). Patients with SBRT plans (39.1 % cf 22.2 %), oligometastatic/oligoprogressive sites (38.1 % cf 30.7 %) and reirradiation cases (41.2 % cf 34.2 %) had higher rates of change. Cases took a mean of 7 min (range 2–15 minutes) to discuss. Conclusion: The high rates of plan changes support the value of peer review in MRgRT. We recommend, where possible that all MRgRT cases, particularly those involving SBRT plans, oligometastatic/oligoprogressive sites, and/or reirradiation, be subject to peer review.

OBJECTIVES: Due to the increasing complexity of the healthcare system, effective communication and data exchange between hospitalists (in-hospital physicians) and primary care physicians (PCPs) is both central and challenging. In Switzerland, little is known about hospitalists’ perception of their communication with PCPs. The primary objective was to assess hospitalists’ satisfaction with their communication with PCPs. Secondary objectives addressed all information about the referral process and communication with PCPs during and after the hospital encounter. Lastly, the results of a previous survey among PCPs were juxtaposed to compare their responses to similar questions. METHODS: This study surveyed hospitalists in six hospitals in the Central Switzerland region. The survey was sent via email to hospitalists from November 2021 to February 2022. The questionnaire contained 17 questions with single- and multiple-choice answers and the option of free-text entry. Exploratory multivariable logistic regression was used to analyse independent associations. RESULTS: In total, 276 of 1134 hospitalists responded (response rate 24.3%): (1) the majority of hospitalists are satisfied with the general communication (n = 162, 58.7%) as well as with referral letters (n = 145, 52.5%), (2) preferred information channels for referral letters are email (n = 212, 76.8%) and electronic portals (n = 181, 65.5%), (3) the three most important items of information in referrals are: medication list, diagnoses and reason for referral. In multivariable regression, compared to other clinicians, internists independently favoured informing PCPs of emergency admissions of their patients in a timely manner (OR 2.04; 95%CI 1.21–3.49). Comparing responses from PCPs (n = 109), the most prominent discrepancy was that 67% (n = 184) of hospitalists claimed to “always” inform after an encounter, whereas only 7% (n = 8) of PCPs agreed. CONCLUSION: Most hospitalists are satisfied with the communication with PCPs and prefer electronic communication channels. Room for improvement was found around timely transmission of patient information before and after hospital encounters.

Abstract Temperature is a major ecological driver of mosquito-borne diseases as it influences the life-history of both the mosquito and the pathogen harboured within it. Understanding the mosquitoes’ thermal biology is essential to inform risk prediction models of such diseases. Mosquitoes can respond to temperatures by microhabitat selection through thermal preference. However, it has not yet been considered that mosquitoes are likely to adapt to changing temperatures, for example during climate change, and alter their preference over evolutionary time. We investigated this by rearing six cohorts of the yellow fever mosquito Aedes aegypti at two temperatures (24 °C, 30 °C) for 20 generations and used these cohorts to explicitly separate the effects of long-term evolution and within-generation acclimation on their thermal preferences in a thermal gradient of 20–35 °C. We found that warm-evolved mosquitoes spent 31.5% less time at high temperatures, which affects their efficiency as a vector. This study reveals the complex interplay of experimental evolution, rearing temperatures, and thermal preference in Ae. aegypti mosquitoes. It highlights the significance of incorporating mosquito microhabitat selection in disease transmission models, especially in the context of climate change.

This work introduces a decentralized mechanism for the fair and efficient allocation of limited community-central renewable energy sources (RESs) among consumers with diverse energy demand and risk attitude levels in an energy community. In the proposed non-cooperative game, the self-interested community members independently decide whether to compete or not for access to RESs during peak hours and shift their loads analogously. In the peak hours, a proportional allocation (PA) policy is used to allocate the limited RESs among the competitors. Conditions for the existence of a Nash equilibrium (NE) or dominant strategies in this non-cooperative game are derived, and closed-form expressions of the renewable energy demand and social cost are calculated. Moreover, a decentralized algorithm for choosing consumers’ strategies that lie on NE states is designed. The work shows that the risk attitude of the consumers can have a significant impact on the deviation of the induced social cost from the optimal cost as the latter derives by a centralized minimization with full access to all consumers information. Besides, the proposed decentralized mechanism with the PA policy is shown to attain a much lower social cost than one using the naive equal sharing policy.

For many years, Techbridge Girls focused its weekly sessions on stand-alone lessons that asked participants to develop products that fulfilled specific criteria, such as "create the bounciest rubber ball," "build the tallest paper tower," or "design the largest bubbles." These activities typically lasted one or two sessions. Recently, the organization became eager to expose participants to more comprehensive, and therefore lengthier, design experiences while also wanting to keep the projects manageable for participants, program coordinators, and teachers. How could a larger design experience be implemented so that it would still fit into the two-hour weekly timeframe, the supply budget, and the program's staffing restrictions? That is, how would Techbridge Girls manage the tensions inherent in implementing long-term projects with adolescents? This article explores how Techbridge Girls worked to stimulate long-term engagement and create opportunities for youth empowerment in semester-long community impact projects. It shows how staff and organization leaders used these long-term design projects to give participants opportunities for problem solving, critical thinking, and youth agency. Interview and focus group protocols emphasized the community impact projects that are the subject of this article. Though data was collected for all five years of the initiative from all sites, the analysis in this article relies on data from the 2016-2017 and 2017-2018 school years and on data from six sites.

While moving towards a low-carbon, sustainable electricity system, distribution networks are expected to host a large share of distributed generators, such as photovoltaic units and wind turbines. These inverter-based resources are intermittent, but also controllable, and are expected to amplify the role of distribution networks together with other distributed energy resources, such as storage systems and controllable loads. The available control methods for these resources are typically categorized based on the available communication network into centralized, distributed, and decentralized or local. Standard local schemes are typically inefficient, whereas centralized approaches show implementation and cost concerns. This paper focuses on optimized decentralized control of distributed generators via supervised and reinforcement learning. We present existing state-of-the-art decentralized control schemes based on supervised learning, propose a new reinforcement learning scheme based on deep deterministic policy gradient, and compare the behavior of both decentralized and centralized methods in terms of computational effort, scalability, privacy awareness, ability to consider constraints, and overall optimality. We evaluate the performance of the examined schemes on a benchmark European low voltage test system. The results show that both supervised learning and reinforcement learning schemes effectively mitigate the operational issues faced by the distribution network.

Abstract Background To compare the intermediate-term efficacy of PRESERFLO (PF) MicroShunt implantation with trabeculectomy (TE) in patients with primary open-angle glaucoma, focusing on longitudinal changes of functional and structural parameters. Methods This retrospective comparative study included 104 eyes of 104 patients who underwent TE and 83 eyes of 83 patients that underwent PF implantation between January 2019 and December 2020, with a minimum follow-up of two years. Baseline and postoperative intraocular pressure (IOP), number of IOP-lowering medications, visual field mean defect (MD) and peripapillary retinal nerve fibre layer (RNFL) thickness measured using optical coherence tomography were assessed and compared between groups. Results Baseline characteristics (age, sex, IOP, number of IOP-lowering medications, MD, RNFL thickness) were comparable between the two groups (all P > 0.05). During the two-year of follow-up, mean IOP decreased from 24.09 ± 1.15 mmHg and 21.67 ± 0.77 mmHg to 11.37 ± 1.13 mmHg (P

Background Globally, data on stillbirth is limited. A call to action has been issued to governments to address the data gap by strengthening national policies and strategies to drive urgent action on stillbirth reduction. This study aims to understand the policy environment for stillbirths to advance stillbirth recording and reporting in data systems.Methods A systematic three-step process (survey tool examination, identifying relevant study questions, and reviewing country responses to the survey and national documents) was taken to review country responses to the global 2018-2019 World Health Organization (WHO) Reproductive, Maternal, Neonatal, Child and Adolescent Health (RMNCAH) Policy Survey. Policy Survey responses were reviewed to identify if and how stillbirths were included in national documents. This paper uses descriptive analyses to identify and describe the relationship between multiple variables.Results Responses from 155 countries to the survey were analysed, and over 800 national policy documents submitted by countries in English reviewed. Fewer than one-fifth of countries have an established stillbirth rate (SBR) target, with higher percentages reported for under-5 (71.0%) and neonatal mortality (68.5%). Two-thirds (65.8%) of countries reported a national maternal death review panel. Less than half (43.9%) of countries have a national policy that requires stillbirths to be reviewed. Two-thirds of countries have a national policy requiring review of neonatal deaths. WHO websites and national health statistics reports are the common data sources for stillbirth estimates. Countries that are signatories to global initiatives on stillbirth reduction have established national targets. Globally, nearly all countries (94.8%) have a national policy that requires every death to be registered. However, 45.5% of reviewed national policy documents made mention of registering stillbirths. Only 5 countries had national policy documents recommending training of health workers in filling out death certificates using the International Classification of Diseases (ICD)-10 for stillbirths.Conclusion The current policy environment in countries is not supportive for identifying stillbirths and recording causes of death. This is likely to contribute to slow progress in stillbirth reduction. The paper proposes policy recommendations to make every baby count.

Abstract Landfills generate outsized environmental footprints due to microbial degradation of organic matter in municipal solid waste, which produces the potent greenhouse gas methane. With global solid waste production predicted to increase substantially in the next few decades, there is a pressing need to better understand the temporal dynamics of biogeochemical processes that control methane cycling in landfills. Here, we use metagenomic approaches to characterize microbial methane cycling in waste that was landfilled over 39 years. Our analyses indicate that newer waste supports more diverse communities with similar composition compared to older waste, which contains lower diversity and more varied communities. Older waste contains primarily autotrophic organisms with versatile redox metabolisms, whereas newer waste is dominated by anaerobic fermenters. Methane-producing microbes are more abundant, diverse, and metabolically versatile in new waste compared to old waste. Our findings indicate that predictive models for methane emission in landfills overlook methane oxidation in the absence of oxygen, as well as certain microbial lineages that can potentially contribute to methane sinks in diverse habitats.

Abstract Background Hand hygiene (HH) is an important practice that prevents transmission of infectious diseases, such as COVID-19. However, in resource-limited areas, where water and soap are not always available, it can be difficult to practice HH correctly and at appropriate moments. The purpose of this study was to assess HH knowledge and behaviors among students from six elementary schools in Quetzaltenango, Guatemala to identify gaps that could later inform interventions to improve HH. Methods We conducted knowledge, attitude, and practices (KAP) surveys among primary school students during the COVID-19 pandemic in July 2022. We also observed students’ HH practices at three different moments during the day, making note of the use of the HH station and materials, duration of handwashing, presence of a HH assistant, and the students’ sex. We also used the Quantitative Personal Hygiene Assessment Tool (qPHAT), to measure hand dirtiness before eating, after restroom use, and upon arriving to school. Results We surveyed 109 students across six schools. Mean scores were 4 out of 5 for knowledge, 8 out of 8 for attitudes, and 6 out of 7 for HH practices. Most students identified “before eating” as a critical moment for HH (68.8%), fewer identified “after restroom use” (31.2%), and no students mentioned HH being necessary “after coughing or sneezing”. We observed 326 HH opportunities of which 51.2% performed correct HH (used water and soap for at least 20 s or used alcohol-based hand rub, where materials were available). We collected 82 qPHAT hand swabs. A Kruskal Wallis test revealed a significant difference in hand dirtiness between entering the school and after restroom use (p = 0.017), but no significant difference before eating and after entering the school (p = 0.6988). Conclusions The results from the KAP survey show high scores, however correct identification of key moments for HH was relatively uncommon, especially after restroom use and after coughing or sneezing. Additionally, half of HH opportunities observed had correct HH practices and on average, hands were dirtiest when arriving at school. These findings will inform interventions to improve HH practices and behaviors, which will be evaluated with follow-up data collection.

This paper reports experimental results concerning the corrosion of 316L austenitic stainless steels produced by ball milling and spark plasma sintering in NaCl electrolyte. Specimens with grain sizes ranging from 0.3 µm to 3 µm, without crystallographic texture, were obtained and compared with a cast that is 110 µm in grain size and an annealed reference. The potentiodynamic experiments showed that the reduction in grain size leads to a degradation of the electrochemical passivation behavior. This detrimental effect can be overcome by appropriate passivation in a HNO3 concentrated solution before consolidation. The Mott–Schottky measurements showed that the semiconducting properties of the passive layer do not vary significantly on the grain size, especially the donor density, which is responsible for the chemical passivation breakdown by chloride anions. The total electrical resistance of the layer, measured by impedance spectroscopy is always lower than the one of a cast and annealed 316L, but it slightly increases with a reduction in grain size in the ultrafine grain range. This is followed by a slight increase in the thickness of the oxide layer. The effect of chloride ions is very pronounced in terms of passivation breakdown if the powder is not passivated prior to sintering. This leads to the nucleation and growth of subsurface main pits and the formation of secondary satellite pits, especially for the smallest grain sizes. Passivation of the 316L powder before sintering has been found to be an effective way to prevent this phenomenon.

Abstract Heat pumps (HPs) are a promising option for decarbonizing the residential heating sector. Their use leads to an increased demand for electricity, which can burden the grid in uncontrolled operation, while controlled HPs can provide additional flexibility to the system. In this paper, the integration of HPs through a receding horizon approach into a power market model is presented to study the behavior of HPs considering electricity market prices and network constraints of a low‐voltage grid. In a case study with centralized and self‐consumption optimized control strategies, the effects of HPs are analyzed. Furthermore, the authors investigate how the aggregation of several households into energy communities affects the system. The results show that for the considered grid, the additional power demand of HPs is usually uncritical and a strictly cost‐minimizing operation is often possible from a grid perspective. Typically, critical grid situations occur only at times of high PV feed‐in with low HP flexibility. The formation of energy communities compared to individual households differs primarily in the allocation of cost savings to individual consumers. The difference in the impact of the two control strategies on the grid is negligible in this case.

Abstract Background Primary membranous nephropathy (PMN) frequently causes nephrotic syndrome and declining kidney function. Disease progression is likely modulated by patient-specific and therapy-associated factors awaiting characterization. These cofactors may facilitate identification of risk groups and could result in more individualized therapy recommendations. Methods In this single-center retrospective observational study, we analyze the effect of patient-specific and therapy-associated covariates on proteinuria, hypoalbuminemia, and estimated glomerular filtration rate (eGFR) in 74 patients diagnosed with antibody positive PMN and nephrotic-range proteinuria (urine-protein-creatinine-ratio [UPCR] ≥ 3.5 g/g), treated at the University of Freiburg Medical Center between January 2000 – November 2022. The primary endpoint was defined as time to proteinuria / serum-albumin response (UPCR ≤ 0.5 g/g or serum-albumin ≥ 3.5 g/dl), the secondary endpoint as time to permanent eGFR decline (≥ 40% relative to baseline). Results The primary endpoint was reached after 167 days. The secondary endpoint was reached after 2413 days. Multivariate time-to-event analyses showed significantly faster proteinuria / serum-albumin response for higher serum-albumin levels (HR 2.7 [95% CI: 1.5 – 4.8]) and cyclophosphamide treatment (HR 3.6 [95% CI: 1.3 – 10.3]). eGFR decline was significantly faster in subjects with old age at baseline (HR 1.04 [95% CI: 1 – 1.1]). Conclusion High serum-albumin levels, and treatment with cyclophosphamide are associated with faster proteinuria reduction and/or serum-albumin normalization. Old age constitutes a risk factor for eGFR decline in subjects with PMN.

AIM OF THE STUDY: The COVID-19 pandemic has drawn attention to the benefit of wastewater-based epidemiology, particularly when case numbers are underreported. Underreporting may be an issue with mpox, where biological reasons and stigma may prevent patients from getting tested. Therefore, we aimed to assess the validity of wastewater surveillance for monitoring mpox virus DNA in wastewater of a Central European city and its association with official case numbers. METHODS: Wastewater samples were collected between 1 July and 28 August 2022 in the catchment area of Basel, Switzerland, and the number of mpox virus genome copies they contained was determined by real-time quantitative PCR. Logistic regression analyses were used to determine the odds of detectability of mpox virus DNA in wastewater, categorised as detectable or undetectable. Mann–Whitney U tests were used to determine associations between samples that tested positive for the mpox virus and officially reported cases and patients’ recorded symptomatic phases. RESULTS: Mpox virus DNA was detected in 15 of 39 wastewater samples. The number of positive wastewater samples was associated with the number of symptomatic cases (odds ratio [OR] = 2.18, 95% confidence interval (CI) = 1.38–3.43, p = 0.001). The number of symptomatic cases differed significantly between days with positive versus negative wastewater results (median = 11 and 8, respectively, p = 0.0024). CONCLUSION: Mpox virus DNA was detectable in wastewater, even when officially reported case numbers were low (0–3 newly reported mpox cases corresponding to 6–12 symptomatic patients). Detectability in wastewater was significantly associated with the number of symptomatic patients within the catchment area. These findings illustrate the value of wastewater-based surveillance systems when assessing the prevalence of emerging and circulating infectious diseases.

Background: The measurement of aortic dimensions and their evolution are key in the management of patients with aortic diseases. Manual assessment, the current guideline-recommended method and clinical standard, is subjective, poorly reproducible, and time-consuming, limiting the capacity to track aortic growth in everyday practice. Aortic geometry mapping (AGM) via image registration of serial computed tomography angiograms outperforms manual assessment, providing accurate and reproducible 3D maps of aortic diameter and growth rate. This observational study aimed to evaluate the accuracy and reproducibility of AGM on non-gated contrast-enhanced (CE-) and cardiac- and respiratory-gated (GN-) magnetic resonance angiographies (MRA). Methods: Patients with thoracic aortic disease followed with serial CE-MRA (n = 30) or GN-MRA (n = 15) acquired at least 1 year apart were retrospectively and consecutively identified. Two independent observers measured aortic diameters and growth rates (GR) manually at several thoracic aorta reference levels and with AGM. Agreement between manual and AGM measurements and their inter-observer reproducibility were compared. Reproducibility for aortic diameter and GR maps assessed with AGM was obtained. Results: Mean follow-up was 3.8 ± 2.3 years for CE- and 2.7 ± 1.6 years for GN-MRA. AGM was feasible in the 93% of CE-MRA pairs and in the 100% of GN-MRA pairs. Manual and AGM diameters showed excellent agreement and inter-observer reproducibility (ICC>0.9) at all anatomical levels. Agreement between manual and AGM GR was more limited, both in the aortic root by GN-MRA (ICC=0.47) and in the thoracic aorta, where higher accuracy was obtained with GN- than with CE-MRA (ICC=0.55 vs 0.43). The inter-observer reproducibility of GR by AGM was superior compared to manual assessment, both with CE- (thoracic: ICC= 0.91 vs 0.51) and GN-MRA (root: ICC=0.84 vs 0.52; thoracic: ICC=0.93 vs 0.60). AGM-based 3D aortic size and growth maps were highly reproducible (median ICC >0.9 for diameters and >0.80 for GR). Conclusion: Mapping aortic diameter and growth on MRA via 3D image registration is feasible, accurate and outperforms the current manual clinical standard. This technique could broaden the possibilities of clinical and research evaluation of patients with aortic thoracic diseases.