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Background: Transatrial approach is the standard method in repairing ventricular septal defects (VSD) in the pediatric population. However, the tricuspid valve (TV) apparatus might obscure the inferior border of the VSD risking the adequacy of repair by leaving residual VSD or heart block. Detachment of the TV chordae has been described as an alternative technique to TV leaflet detachment. The aim of this study is to investigate the safety of such a technique. Methods: Retrospective review of patients who underwent VSD repair between 2015 and 2018. Group A (n = 25) had VSD repair with TV chordae detachment were matched for age and weight to group B (n = 25) without tricuspid chordal or leaflet detachment. Electrocardiogram (ECG) and echocardiogram at discharge and at 3 years of follow-up were reviewed to identify new ECG changes, residual VSD, and TV regurgitation. Results: Median ages in groups A and B were 6.13 (IQR 4.33-7.91) and 6.33 (4.77-7.2) months. New onset right bundle branch block (RBBB) was diagnosed at discharge in 28% (n = 7) of group A versus 56% (n = 14) in group B ( P = .044), while the incidence dropped to 16% (n = 4) in group A versus 40% (n = 10) in group B ( P = .059) in the 3 years follow-up ECG. Echocardiogram at discharge showed moderate tricuspid regurgitation in 16% (n = 4) in group A and 12% (n = 3) in group B ( P = .867). Three years of follow-up echocardiography revealed no moderate or severe tricuspid regurgitation and no significant residual VSD in either group. Conclusion: No significant difference in operative time was observed between the two techniques. TV chordal detachment technique reduces the incidence of postoperative RBBB without increasing the incidence of TV regurgitation at discharge.

The high voltage Padova test facility (HVPTF) is an experimental device for the study of HV insulation in vacuum, in support of the realization of the prototype of a neutral beam injector for International Thermonuclear Experimental Reactor (ITER), named megavolt ITER injector and concept advancement (MITICA). The facility investigates the physical phenomena underlying voltage holding in vacuum, in particular the mechanisms causing breakdowns and the electrode conditioning process. At HVPTF, inside a high vacuum chamber, two stainless steel electrodes, separated by a few centimeters gap, can achieve HV values for a maximum potential difference of 800 kV. During the voltage conditioning of the electrodes, current MicroDischarges (MDs) and high-energy X-rays are observed and analyzed. In this work, we present a characterization of the MD dynamics occurring during the conditioning process, with the aim to gain information on the reason of the growing difference between the current contributions measured by the two electrodes. The analysis will be performed due to two new X-rays detectors recently installed: an lutetium yttrium orthosilicate (LYSO) and a LaBr3(Ce) scintillating crystal. The new diagnostics indeed provide the fine dynamics of a single MD, recording energy and time of each single detected X-ray. In particular, we compare the MD dynamics at the beginning and at the end of the conditioning process and try to give a preliminary interpretation of the observations.

Prenatal diagnosis of congenital disease improves clinical outcomes; however, as many as 50% of congenital heart disease cases are missed by current ultrasound screening methods. This indicates a need for improved screening technology. Extracellular vesicles (EVs) have attracted enormous interest in recent years for their potential in diagnostics. EVs mediate endocrine signalling in health and disease and are known to regulate aspects of embryonic development. Here, we critically evaluate recent evidence suggesting that EVs released from the foetus are able to cross the placenta and enter the maternal circulation. Furthermore, EVs from the mother appear to be transported in the reverse direction, whilst the placenta itself acts as a source of EVs. Experimental work utilising rodent models employing either transgenically encoded reporters or application of fluorescent tracking dyes provide convincing evidence of foetal-maternal crosstalk. This is supported by clinical data demonstrating expression of placental-origin EVs in maternal blood, as well as limited evidence for the presence of foetal-origin EVs. Together, this work raises the possibility that foetal EVs present in maternal blood could be used for the diagnosis of congenital disease. We discuss the challenges faced by researchers in translating these basic science findings into a clinical non-invasive prenatal test.

Purpose To compare hearing results and complication rates between two groups of patients operated on by endoscopic stapes surgery (ESS) for otosclerosis, either with CO2 fiber laser or microdrill. Methods A case–control study was performed. All consecutive cases of CO2 fiber laser ESS operated at a single center during the period 2017–2020 (case group) were matched to a control group of patients operated by traditional technique, according to year of surgery, preoperative mean air–bone gap, sex and age. Audiological data from preoperative and postoperative examinations and complication rates were compared. Results 46 cases were included. Mean operative time was significantly longer in the laser cohort (65 min) than in the drill one (45 min) (p = 0.003). Similar results were found in the two groups regarding the mean postoperative BC-PTA. The high-frequency bone conduction resulted significantly higher in the laser group (p = 0.002), suggesting an overclosure effect in the laser group. Consistently, a significant improvement of the BC-PTA threshold at 2000 Hz postoperatively was found in the laser group (p = 0.034). The postoperative AC-PTA significantly improved in both groups at all frequencies (p Conclusion This study is the first to compare hearing results and complications between CO2 fiber laser and microdrill in ESS. Our results demonstrated similar functional outcomes between the two groups, confirming ESS as safe and effective, regardless of the technique used.

A 9-year-old girl presented with a recent history of shortness of breath, fatigue, visual disturbances, and gastrointestinal symptoms. Echocardiography demonstrated three large intracardiac masses in the right and left atria protruding into the mitral and tricuspid valve orifices causing bilateral inflow obstruction. She underwent urgent surgical excision of the masses. Histology revealed rare intracardiac Burkitt's Lymphoma.

This month's instalment of the BANCC column considers the need for alternative models to meet the rising demand for placements and ensure that research is embedded into practice.

Leptospirosis is a zoonotic disease with a high burden in Latin America, including northeastern Argentina, where flooding events linked to El Niño are associated with leptospirosis outbreaks. The aim of this study was to evaluate the value of using hydrometeorological indicators to predict leptospirosis outbreaks in this region. We quantified the effects of El Niño, precipitation, and river height on leptospirosis risk in Santa Fe and Entre Ríos provinces between 2009 and 2020, using a Bayesian modelling framework. Based on several goodness of fit statistics, we selected candidate models using a long-lead El Niño 3.4 index and shorter lead local climate variables. We then tested predictive performance to detect leptospirosis outbreaks using a two-stage early warning approach. Three-month lagged Niño 3.4 index and one-month lagged precipitation and river height were positively associated with an increase in leptospirosis cases in both provinces. El Niño models correctly detected 89% of outbreaks, while short-lead local models gave similar detection rates with a lower number of false positives. Our results show that climatic events are strong drivers of leptospirosis incidence in northeastern Argentina. Therefore, a leptospirosis outbreak prediction tool driven by hydrometeorological indicators could form part of an early warning and response system in the region.

Big data originating from user interactions on social media play an essential role in infodemiology and infoveillance outcomes, supporting the planning and implementation of public health actions. Notably, the extrapolation of these data requires an awareness of different ethical elements. Previous studies have investigated and discussed the adoption of conventional ethical approaches in the contemporary public health digital surveillance space. However, there is a lack of specific ethical guidelines to orient infodemiology and infoveillance studies concerning infodemic on social media, making it challenging to design digital strategies to combat this phenomenon. Hence, it is necessary to explore if traditional ethical pillars can support digital purposes or whether new ones must be proposed since we are confronted with a complex online misinformation scenario. Therefore, this perspective provides an overview of the current scenario of ethics-related issues of infodemiology and infoveillance on social media for infodemic studies.

As the linkages between extreme weather events, changes in climatic conditions and health impacts in exposed populations become clearer, so does the need for climate-smart decisions aimed at making the public health sector more responsive and resilient. By integrating climate and health information, climate services for health provide robust decision-support tools. The Lancet Countdown monitoring system uses global climate reanalyses products to track annual changes in a set of health-related outcomes. In the monitoring system, multiple variables from reanalysis datasets such as ERA5 and ERA5-Land are retrieved and processed to capture heatwaves, precipitation extremes, wildfires, droughts, warming and ecosystem changes across the globe and over multiple decades. This reanalysis-derived information is then input into a hazard–exposure–vulnerability framework that delivers, as outcomes, indicators tracking the year-by-year impacts of climate-related hazards on human mortality, labour capacity, physical activity, sentiment, infectious disease transmission, and food security and undernutrition. Building on the reanalysis gridded format, the indicators create worldwide ‘maps without gaps’ of climate–health linkages. Our experience shows that reanalysis datasets allow standardization across the climate information used in the framework, making the system potentially adaptable to multiple geographical scales. An ongoing challenge is to quantify how the inherent bias of global reanalyses influences indicator outcomes. We foresee the health sector as a key user of reanalysis products. Therefore, public health professionals and health impact modellers should be involved in the co-development of future iterations of reanalysis datasets, to reach finer spatial resolutions and provide a wider set of health-relevant climate variables.

Following the notable success of the supported student placements at this year's British Association of Nusing in Cardiovascular Care conference, the initiative will be expanded on next year, with a focus on early-career nurses. In this article, the students and their mentor reflect on the conference.

Objectives: This study aimed to (1) explore the changes in conspiracy mentality across the four waves of the COVID-19 pandemic; (2) assess the relationship between conspirative mentality and psychological/behavioural variables; (3) identify the predictors of conspirative mentality; and (4) explore the effect of conspirative mentality on COVID-19 protective behaviour. Study design: This was a multiwave survey. Methods: A total of 10,013 Italian individuals, aged 18–70 years, were assessed across the four waves (from January to May 2021) through online survey. We collected information about the sociodemographic characteristics of participants, personal experiences of COVID-19 infection, trust, COVID-19 protective behaviours, COVID-19 risk perception, arousal, auto-efficacy, resilience and well-being. Conspiracy mentality was assessed with the Conspiracy Mentality Questionnaire. The statistical analyses included exploratory factorial analyses, Pearson correlations and multiple linear regressions. Results: The conspiracy mentality score during the COVID-19 pandemic was medium–high (mean 59.0 on a 0–100 scale) and slightly increased from 58.2 to 59.9 across months, in parallel with a slight decrease in trust in health institutions and scientific informational sources. Individuals aged >35 years, poorly educated and particularly scared about their financial situation were at risk of showing higher levels of conspirative mentality. Higher levels of conspirative mentality were risk factors for low levels of COVID-19 protective behaviours. Conclusions: Clear and effective communication may improve trust in health institutions and informational sources, decrease conspirative theories and increase compliance with protective behaviour.

Information relevant to the modelling process, as well as model selection and evaluation.

Context. The BL Lac object 1ES 0647+250 is one of the few distant γ-ray emitting blazars detected at very high energies (VHEs; ≳100 GeV) during a non-flaring state. It was detected with the MAGIC telescopes during a period of low activity in the years 2009−2011 as well as during three flaring activities in the years 2014, 2019, and 2020, with the highest VHE flux in the last epoch. An extensive multi-instrument data set was collected as part of several coordinated observing campaigns over these years. Aims. We aim to characterise the long-term multi-band flux variability of 1ES 0647+250, as well as its broadband spectral energy distribution (SED) during four distinct activity states selected in four different epochs, in order to constrain the physical parameters of the blazar emission region under certain assumptions. Methods. We evaluated the variability and correlation of the emission in the different energy bands with the fractional variability and the Z-transformed discrete correlation function, as well as its spectral evolution in X-rays and γ rays. Owing to the controversy in the redshift measurements of 1ES 0647+250 reported in the literature, we also estimated its distance in an indirect manner through a comparison of the GeV and TeV spectra from simultaneous observations with Fermi-LAT and MAGIC during the strongest flaring activity detected to date. Moreover, we interpret the SEDs from the four distinct activity states within the framework of one-component and two-component leptonic models, proposing specific scenarios that are able to reproduce the available multi-instrument data. Results. We find significant long-term variability, especially in X-rays and VHE γ rays. Furthermore, significant (3−4σ) correlations were found between the radio, optical, and high-energy (HE) γ-ray fluxes, with the radio emission delayed by about ∼400 days with respect to the optical and γ-ray bands. The spectral analysis reveals a harder-when-brighter trend during the non-flaring state in the X-ray domain. However, no clear patterns were observed for either the enhanced states or the HE (30 MeV < E < 100 GeV) and VHE γ-ray emission of the source. The indirect estimation of the redshift yielded a value of z = 0.45 ± 0.05, which is compatible with some of the values reported in the literature. The SEDs related to the low-activity state and the three flaring states of 1ES 0647+250 can be described reasonably well with the both one-component and two-component leptonic scenarios. However, the long-term correlations indicate the need for an additional radio-producing region located about 3.6 pc downstream from the gamma-ray producing region., Astronomy & Astrophysics, 670, ISSN:0004-6361, ISSN:1432-0746

Supplemental material, sj-docx-1-pch-10.1177_21501351231168829 for Combining Congenital Heart Surgical and Interventional Cardiology Outcome Data in a Single Database: The Development of a Patient-Centered Collaboration of the European Congenital Heart Surgeons Association (ECHSA) and the Association for European Paediatric and Congenital Cardiology (AEPC) by Jeffrey P Jacobs, Thomas Krasemann, Claudia Herbst, Zdzislaw Tobota, Bohdan Maruszewski, Jose Fragata, Tjark Ebels, Vladimiro L Vida, Ilkka Mattila, Andrzej Kansy, Boulos Asfour, Jürgen Hörer, Attilio A Lotto, M Sertaç Çiçek, Petru Liuba, Sven Dittrich, Massimo Chessa, Regina Bökenkamp, Gurleen Sharland, Katarina Hanséus, Nico A Blom and George E Sarris in World Journal for Pediatric and Congenital Heart Surgery

Horizontal glottectomy (HG) is a particular type of partial laryngectomy indicated for exclusive glottic tumor with anterior commissure involvement. The purpose of this study is to systematically review the literature about functional and oncological outcome of HG. This systematic review adhered to the recommendations of the PRISMA (Preferred Reporting Items of Systematic Reviews and Meta-analysis) 2009 guidelines. Articles mentioning patients undergoing HG for laryngeal squamous cell carcinoma were included. A total of 14 articles were selected and reviewed from 19 identified. The whole study population consisted of 420 patients who underwent HG. Three hundred and thirty-nine patients out of 359 were staged as T1. The range of post-operative follow-up was 5 months to 10 years. Fifty-five recurrences were experienced, being local, regional and distant in 35, 12 and 8 patients, respectively. Laryngeal preservation rate was 93.6%. Nasogastrict tube was removed on average after 10.1 days. The tracheostomy was maintained for 11.3 days. Mean hospitalization lasted for 11.7 days. According to the results of this systematic review, HG is an oncologically safe surgical option for T1a–T1b glottic tumors with oncological outcomes comparable to other treatment. HG could be a good therapeutical choice whenever poor laryngeal exposure and/or patient’s refusal of radiotherapy are encountered, or when patient’s medical history represents a contraindication for radiation therapy.

BACKGROUND Online misinformation concerning the side effects of fluoridated oral care products and tap water contributes to the onset and propagation of untrue beliefs that culminate in anti-fluoridation movements. OBJECTIVE This study aimed to analyze the fluoride-related misinformation on Twitter automatically. METHODS 21,169 tweets published in English between May 2016 and May 2022 that included the keyword “fluoride-free” were retrieved by Twitter API. Latent Dirichlet Allocation (LDA) topic modeling was applied to identify the salient terms and topics. The similarity between topics was calculated through an intertopic distance map. The total count of misinformation records for each topic and their relevance over time were determined. RESULTS Utilizing a coherence score of 0.542, a total of 3 distinctly distributed salient topics emerged from the LDA topic modeling analysis. Results show that fluoride-related misinformation on Twitter was mainly associated with people’s perception of a healthy lifestyle, followed by the consumption of natural and organic oral care products and recommendations of fluoride-free products and measures. Interest in false content decreased between 2016 and 2019 and increased again after 2020. CONCLUSIONS Fluoride misinformation found on Twitter related to a healthy lifestyle. This misleading content probably contributed to the popularization of fluoride-free oral care products and the suspension of community water fluoridation programs. Strategies are needed to address and limit the spread of misinformation on social media.

BACKGROUND Digital misinformation, primarily on social media, has led to harmful and costly beliefs in the general population. Notably, these beliefs have resulted in public health crises to the detriment of governments around the world and their citizens. However, public health officials currently lack access to a comprehensive system capable of mining and analyzing large volumes of social media data in real time. OBJECTIVE The aim of this study was to design and develop a big data pipeline and ecosystem (UbiLab Infodemics Analysis System (U-IAS) for the identification and analysis of false information disseminated via social media on a certain topic or set of related topics. METHODS U-IAS is a platform-independent ecosystem developed in Python that leverages the Twitter V2 API and the Elastic Stack. The U-IAS expert system has 5 major components: a) Data Extraction Framework; b) Latent Dirichlet Allocation (LDA) Topic Model; c) Sentiment Analyzer; d) Information Disorder Classification Model; e) Elastic Cloud Deployment (Indexing of data and visualizations). The Data Extraction Framework queries data through the Twitter V2 API, with queries identified by public health experts. The LDA Topic Model, Sentiment Analyzer, and Information Disorder Classification Model are independently trained using a small, expert-validated subset of the extracted data. These models are then incorporated into U-IAS to analyze and classify the remaining data. Finally, the analyzed data is loaded into an index in the Elastic Cloud deployment and can then be presented in dashboards with advanced visualizations and analytics pertinent to infodemics analysis. RESULTS Each component in the system is performing as expected. The data extraction framework handles large loads of data within short periods of time. The LDA topic models have achieved relatively high coherence values (0.54) and the predicted topics are accurate and befitting to the data. The sentiment analyzer is performing at a correlation coefficient of 0.61 but could be improved in further iterations. The information disorder classifier has attained a satisfactory correlation coefficient of 0.76 against the expert-validated data. Moreover, the Elastic cloud deployment is efficient in its storage of data and comprehensive in its visualization and analytics capabilities. In fact, investigators have successfully utilized the system to extract interesting and important insights in public health. CONCLUSIONS The novel U-IAS pipeline has the potential to detect and analyze misleading information related to a particular topic or set of related topics. Furthermore, this approach can emphasize on integrating social media data from multiple sources into dashboards for a multiplatform analysis and testing of the ecosystem on other public health use cases.

Background The Internet is a growing source of knowledge and can provide information about oral health. This ecological study aimed to characterize the interests of Google users on toothpaste in different countries. Methods This longitudinal retrospective study analyzed the toothpaste-related interest of Google users from ten distinct countries between January 2004 and December 2020. The monthly variation in Relative Search Volume (RSV) and the main related queries were determined using Google Trends. Autoregressive Integrated Moving Average (ARIMA) forecasting models were built to establish the predictive RSV values for mouthwash for an additional 12 months. Auto-correlation plots and a general additive model (GAM) were used to diagnose trends and seasonality in RSV curves. Additionally, the influence of social isolation during the COVID-19 pandemics was analyzed. Results Although not detected by ACF and PACF analyses, the heuristic analysis showed an increase in the interest in toothpaste-related information in all countries, with a stable trend observed in the 12-month forecasts, except for the increases in the United Kingdom and South Africa. Also, GAM analyses demonstrated a non-significant monthly or quarterly seasonal influence on data. In addition, the social isolation of the COVID-19 pandemic did not influence the online information-seeking behavior of Google Search users linked to this topic. Discussion The heuristic analysis of the time series indicated an increase in the interest of Internet users in toothpaste between January 2004 and December 2020. This increase may reflect the population's growing autonomy for solving their own health problems. The Internet seems to be the most popular source of information. As such, this information may enable the implementation of specific public oral health policies and oral-care communications based on the population´s needs. Along these lines, information monitoring and improvements in oral health literacy may contribute to the reduction of currently existing social and economic barriers. Conclusion The interest of Google Search users in information about toothpaste increased in all ten countries. These trends were not influenced by the outbreak of the COVID-19 pandemic in most countries.

At a Mars analog site in Utah, we tested two science operation methods for data acquisition and decision-making protocols: a scenario where the tactical day is preplanned, but major adjustments may still be made before plan delivery; and a scenario in which the sol path must largely be planned before a given tactical planning day and very few adjustments to the plan may be made. The goal was to provide field-tested insight into operations planning for rover missions where science operations must facilitate the efficient choice of sampling locations at a site relevant to searching for habitability and biosignatures. Results of the test indicate that preplanning sol paths did not result in a sol cost savings nor did it improve science return or optimal biologically relevant sample collection. In addition because facies variations in an environment can be subtle and evident only at scales below orbital resolution, acquiring systematic observations is crucial. We also noted that while spectral data provided insight into the chemical components as a whole at this site, they did not provide a guide to targets for which the traverse should be altered. Finally, strategic science planning must include a special effort to account for terrain.

Adverse childhood experiences negatively impact future violence, victimization, perpetration, health, and lifelong development. The aim of the present study was to systematically review the scientific evidence of empirical studies on the association between maternal childhood adversity in a familial context, including maltreatment, household challenges, and later maternal negative parenting. A search was performed in the PubMed, PsycINFO, Web of Science, SciELO, and LILACS databases, using the combination of the following keywords: (neglect OR abuse OR maltreatment OR harsh parenting OR punishment OR discipline OR negative parenting practices) AND (adverse childhood experiences OR early adversity OR cycle of violence OR cycle of maltreatment OR history of maltreatment) AND (mother OR maternal). The results of 29 studies showed predominantly significant direct associations between maternal childhood adversities and negative parenting with their children (83%). Parental stress was also significantly associated with a maternal history of childhood adversities. Focusing on the type of maltreatment practices, there were similar intergenerational transmission types: homotypic and heterotypic. Few studies have examined the protective factors that could buffer the negative impact of a maternal childhood history of adversities on later negative parenting.

In this month's BANCC feature, Robyn Lotto, senior lecturer, advanced cardiac nurse practitioner and committee member of BANCC, reflects on the educational needs of cardiac nurses caring for patients with congenital heart defects.

The optimal training of the highly specialized congenital heart surgeon is a long and complex process, which is a significant challenge in most parts of the world. The World Society for Pediatric and Congenital Heart Surgery (WSPCHS) has established the Global Council on Education for Congenital Heart Surgery as a nonprofit organization with the goal of assessing current training and certification and ultimately establishing standardized criteria for the training, evaluation, and certification of congenital heart surgeons around the world. The Global Council and the WSPCHS have reviewed the present status of training and certification for congenital cardiac surgery around the world. There is currently lack of consensus and standardized criteria for training in congenital heart surgery, with significant disparity between continents and countries. This represents significant obstacles to international job mobility of competent congenital heart surgeons and to the efforts to improve the quality of care for patients with Congenital Heart Disease worldwide. The purpose of this article is to summarize and document the present state of training and certification in congenital heart surgery around the world.

Malignant pleural mesothelioma (MPM) is a rare and aggressive tumor, with a poor prognosis. MPM needs to find prognostic factors of survival. We provided the management of patients with MPM and sought to determine whether pre-treatment levels of derived neutrophil-to-lymphocyte ratio (dNLR) as well as PD-L1 expression were reliable prognostic factors of survival. We conducted a single-institution retrospective study, including all patients with MPM treated at La Paz University Hospital between December 2009 and March 2018. Baseline disease, demographics, clinical data, treatment characteristics and complete blood cell counts were collected. We examined dNLR at baseline and data for PD-L1 expression were analyzed in tumor cells by immunohistochemistry. We included 25 patients. The median overall survival (OS) was 15.7 months (95% CI 11.3–20.0). 5 patients had a dNLR greater than 3 (20%). Patients with a dNLR greater than 3 had shorter median OS (8.5 months), than patients with a dNLR less than 3 (17.0 months), with statistically significant differences (p = 0.038). Ten patients (40%) had positive PD-L1 expression (≥ 1%). Patients with positive PD-L1 expression had shorter median OS (8.5 months) than patients with negative PDL1 expression (15.7 months), but without statistically significant association (p = 0.319). The survival data obtained in our sample are consistent with those previously reported. Pretreatment levels of dNLR greater than 3 and positive PD-L1 expression could be significant prognostic factors for poor survival in patients with MPM. Further and prospective studies are needed to explore this relationship and to derive definitive conclusions.

To decrease the negative consequences of a road crash, even a small reduction in driving speeds can make a significant difference. We examined the possible application of the left-digit effect as a nudge to reduce road speed. In the marketing field, this effect is based on reporting price tags that are characterized by a low leftmost number and a high rightmost number (e.g., a price tag of €14.99 rather than €15.00). We applied the same strategy to improve road safety. Participants were college students (43.75% female, mean age = 24.06 years in Study 1; 50% female, mean age = 23.53 years in Study 2) who were asked to drive in a simulator on a route that had both usual unmodified road signs (e.g., 50 km/h) and the same road signs increased or decreased by one unit (e.g., 49, 51 km/h). We compared the average median speeds in road segments with unmodified road signs with those in road segments with the corresponding modified signs. The average median speeds in the presence of a sign modified by the reduction of 1 km/h were significantly lower compared with the median average speeds recorded with unmodified signs. We showed that the application of psychological insights can reduce driving speeds and therefore increase road safety.

We previously conducted two experiments investigating the impact of action framing manipulations on ultimatum game players, which consists in priming a player to act in a certain way (preprint available at this address https://psyarxiv.com/xahqp/). In the first experiment, participants played as responders and were asked which offer(s) would either accept or reject (i.e., 1€, 2€, 3€, 4€, 5€, 6€, 7€, 8€ or 9€), while in the second experiment participants played as proposers and were asked which offer(s) would either keep or give. While the result of the first experiment were quite straightforward, with lower minimal acceptable offer in the accept frame than in the reject frame, the results of the second experiment are quite astonishing, with proposers offering more in the keep frame than in the give frame. The aim of present study is twofold: 1) replicating the second experiment in order to confirm or infirm our results (experiment 1); and 2) test the impact of action framing manipulations using another experimental paradigm in which participants would have to choose a single amount (experiment 2 on responders and experiment 3 on proposers).

To compare hearing results and complication rates between two groups of patients operated on by endoscopic stapes surgery (ESS) for otosclerosis, either with COA case-control study was performed. All consecutive cases of CO46 cases were included. Mean operative time was significantly longer in the laser cohort (65 min) than in the drill one (45 min) (p = 0.003). Similar results were found in the two groups regarding the mean postoperative BC-PTA. The high-frequency bone conduction resulted significantly higher in the laser group (p = 0.002), suggesting an overclosure effect in the laser group. Consistently, a significant improvement of the BC-PTA threshold at 2000 Hz postoperatively was found in the laser group (p = 0.034). The postoperative AC-PTA significantly improved in both groups at all frequencies (p 0.05), except for the AC threshold at 8 kHz. Similar rates of complications were found in the two groups.This study is the first to compare hearing results and complications between CO

Introduction Evidence of nationwide and regional morbidity of Lyme borreliosis (LB) in Germany is lacking. Aims We calculated the total number of incident LB cases in Germany in 2019, compared regional variations, investigated the extent of possible under-reporting in notification data and examined the association between high incidence areas and land cover composition. Methods We used outpatient claims data comprising information for people with statutory health insurance who visited a physician at least once between 2010 and 2019 in Germany (n = 71,411,504). The ICD-10 code A69.2 was used to identify incident LB patients. Spatial variations of LB were assessed by means of Global and Local Moran’s Index at district level. Notification data were obtained for nine federal states with mandatory notification from the Robert Koch Institute (RKI). Results Of all insured, 128,177 were diagnosed with LB in 2019, corresponding to an incidence of 179 per 100,000 insured. The incidence varied across districts by a factor of 16 (range: 40–646 per 100,000). We identified four spatial clusters with high incidences. These clusters were associated with a significantly larger proportion of forests and agricultural areas than low incidence clusters. In 2019, 12,264 LB cases were reported to the RKI from nine federal states, while 69,623 patients with LB were found in claims data for those states. This difference varied considerably across districts. Conclusions These findings serve as a solid basis for regionally tailored population-based intervention programmes and can support modelling studies assessing the development of LB epidemiology under various climate change scenarios.

The transcription factor SOX9 is activated at the onset of endothelial-to-mesenchymal transition (EndMT) during embryonic development and in pathological conditions. Its roles in regulating these processes, however, are not clear. Using human umbilical vein endothelial cells (HUVECs) as an EndMT model, we show that SOX9 expression alone is sufficient to activate mesenchymal genes and steer endothelial cells towards a mesenchymal fate. By genome-wide mapping of the chromatin landscape, we show that SOX9 displays features of a pioneer transcription factor, such as opening of chromatin and leading to deposition of active histone modifications at silent chromatin regions, guided by SOX dimer motifs and H2A.Z enrichment. We further observe highly transient and dynamic SOX9 binding, possibly promoted through its eviction by histone phosphorylation. However, while SOX9 binding is dynamic, changes in the chromatin landscape and cell fate induced by SOX9 are persistent. Finally, our analysis of single-cell chromatin accessibility indicates that SOX9 opens chromatin to drive EndMT in atherosclerotic lesions in vivo. This study provides new insight into key molecular functions of SOX9 and mechanisms of EndMT and highlights the crucial developmental role of SOX9 and relevance to human disease.

Prenatal diagnosis of congenital disease improves clinical outcomes; however, as many as 50% of congenital heart disease cases are missed by current ultrasound screening methods. This indicates a need for improved screening technology. Extracellular vesicles (EVs) have attracted enormous interest in recent years for their potential in diagnostics. EVs mediate endocrine signalling in health and disease and are known to regulate aspects of embryonic development. Here, we critically evaluate recent evidence suggesting that EVs released from the foetus are able to cross the placenta and enter the maternal circulation. Furthermore, EVs from the mother appear to be transported in the reverse direction, whilst the placenta itself acts as a source of EVs. Experimental work utilising rodent models employing either transgenically encoded reporters or application of fluorescent tracking dyes provide convincing evidence of foetal-maternal crosstalk. This is supported by clinical data demonstrating expression of placental-origin EVs in maternal blood, as well as limited evidence for the presence of foetal-origin EVs. Together, this work raises the possibility that foetal EVs present in maternal blood could be used for the diagnosis of congenital disease. We discuss the challenges faced by researchers in translating these basic science findings into a clinical non-invasive prenatal test.