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‘Damage control’ is the therapeutic strategy in the treatment of polytraumatized patients and aims at securing vital functions and controlling bleeding with a favorable effect on the post-traumatic immune response. The post-traumatic immune dysfunction is based on a disturbed balance between immunostimulatory and anti-inflammatory mechanisms. The extent of the immunological ‘second hit’ can be limited by delaying deferable surgical therapies until organ stabilization has been achieved by the treating surgeon. Pelvic sling is easy to apply and noninvasive with effective pelvic reduction. Pelvic angiography vs pelvic packing are not antagonistic, but rather should be considered as complementary methods. Operating as early as possible on unstable spinal injuries with confirmed or suspected neurological deficits by decompression and stabilization with a dorsal internal fixator. Dislocations, unstable or open fracture, vascular involvement, and compartment syndrome are considered emergency indications. In extremity fracture treatment, primary definitive osteosynthesis is often dispensed with and instead, temporary stabilization with an external fixator is performed.

La emergencia provocada por la pandemia de la covid-19 reactualizó numerosos debates sobre las protecciones sociales requeridas para los diferentes grupos laborales y la necesidad de garantizar el trabajo y los ingresos de la población. Este artículo se centra en la experiencia de personas que trabajan sin vínculos con un patrón y que se autoidentifican como parte de la economía popular, social y solidaria (EPSS) en Argentina. Se propone abonar al debate académico al respecto identificando aquellas condiciones que favorecieron la sostenibilidad y la organización de sus labores más allá del contexto de la emergencia. En particular, se busca reconocer si la situación abierta por la pandemia devino en nuevos procesos de reconocimiento, institucionalización y protección para estos colectivos laborales. Se desarrolló un trabajo de investigación cualitativo basado en entrevistas a referentes de 14 organizaciones de EPSS del Gran Rosario (fuentes primarias) y la revisión de las medidas de emergencia y los programas implementados por los tres niveles de Gobierno –nacional, provincial y local– desde la declaración de la emergencia sanitaria hasta diciembre de 2021 (fuentes secundarias). En las reflexiones finales se recuperan los principales resultados fundamentando que las respuestas del Estado no dieron lugar a nuevas instituciones, derechos y protecciones, sino que “organizaron” y “administraron” la institucionalidad que ya existía.

Delayed diagnosis of abdominal injuries and hemorrhagic shock leads to secondary complications and high late mortality in severely traumatized patients. The liver fatty acid-binding protein (L-FABP) is expressed in intestine, liver and kidney; the neutrophil gelatinase-associated lipocalin (NGAL) in colon and kidney. We hypothesized that l-FABP is an early biomarker for abdominal injury and hemorrhagic shock and that l-FABP and NGAL are specific markers for detection of liver and/or kidney injuries.Traumatized patients with an age ≥18 years and an abdominal injury (AISAll patient groups had a median ISS≥25. In ER, median l-FABP levels were significantly higher in "HS Abd" group (1209.2 ng/ml [IQR=575.2-1780.3]) compared to "noAbd" group (36.4 ng/ml [IQR=14.8-88.5]), and to "Abd" group (41.4 ng/ml [IQR=18.0-235.5]), p0.001. In matched-pair-analysis l-FABP levels in the group "Abd" were significantly higher (108.3 ng/ml [IQR=31.4-540.9]) compared to "noAbd" (26.4 ng/ml [IQR=15.5-88.8]), p = 0.0016. l-FABP correlated significantly with clinical parameters of hemorrhagic shock; the optimal cut-off level of l-FABP for detection was 334.3 ng/ml (sensitivity: 90%, specificity: 78%). Median l-FABP-levels were significantly higher in patients with isolated liver or kidney injuries and correlated significantly with AST, ALT and creatinine value. Median NGAL levels in the ER were significantly higher in "HS Abd" group (115.9 ng/ml [IQR=90.6-163.8]) compared to "noAbd" group (58.5 ng/ml [IQR=41.0-89.6],p0.001) and "Abd" group (70.5 ng/ml [IQR=53.3-115.5], p0.05). The group "Abd" showed significant higher median NGAL levels compared to "noAbd", p = 0.019. NGAL levels correlated significantly with clinical parameters of hemorrhagic shock.L-FABP and NGAL are novel biomarkers for detection of abdominal trauma and hemorrhagic shock. l-FABP may be a useful and promising parameter in diagnosis of liver and kidney injuries, NGAL failed to achieve the same.

The Italian Neuroimaging Network Initiative (INNI) is an expanding repository of brain MRI data from multiple sclerosis (MS) patients recruited at four Italian MRI research sites. We describe the raw data quality of resting-state functional MRI (RS-fMRI) time-series in INNI and the inter-site variability in functional connectivity (FC) features after unified automated data preprocessing. MRI datasets from 489 MS patients and 246 healthy control (HC) subjects were retrieved from the INNI database. Raw data quality metrics included temporal signal-to-noise ratio (tSNR), spatial smoothness (FWHM), framewise displacement (FD), and differential variation in signals (DVARS). Automated preprocessing integrated white-matter lesion segmentation (SAMSEG) into a standard fMRI pipeline (fMRIPrep). FC features were calculated on pre-processed data and harmonized between sites (Combat) prior to assessing general MS-related alterations. Across centers (both groups), median tSNR and FWHM ranged from 47 to 84 and from 2.0 to 2.5, and median FD and DVARS ranged from 0.08 to 0.24 and from 1.06 to 1.22. After preprocessing, only global FC-related features were significantly correlated with FD or DVARS. Across large-scale networks, age/sex/FD-adjusted and harmonized FC features exhibited both inter-site and site-specific inter-group effects. Significant general reductions were obtained for somatomotor and limbic networks in MS patients (vs. HC). The implemented procedures provide technical information on raw data quality and outcome of fully automated preprocessing that might serve as reference in future RS-fMRI studies within INNI. The unified pipeline introduced little bias across sites and appears suitable for multisite FC analyses on harmonized network estimates.

Objectives: Martini et al. developed a nomogram to predict significant (>25%) renal function loss after robot-assisted partial nephrectomy and identified four risk categories. We aimed to externally validate Martini’s nomogram on a large, national, multi-institutional data set including open, laparoscopic, and robot-assisted partial nephrectomy. Methods: Data of 2584 patients treated with partial nephrectomy for renal masses at 26 urological Italian centers (RECORD2 project) were collected. Renal function was assessed at baseline, on third postoperative day, and then at 6, 12, 24, and 48 months postoperatively. Multivariable models accounting for variables included in the Martini’s nomogram were applied to each approach predicting renal function loss at all the specific timeframes. Results: Multivariable models showed high area under the curve for robot-assisted partial nephrectomy at 6- and 12-month (87.3% and 83.6%) and for laparoscopic partial nephrectomy (83.2% and 75.4%), whereas area under the curves were lower in open partial nephrectomy (78.4% and 75.2%). The predictive ability of the model decreased in all the surgical approaches at 48 months from surgery. Each Martini risk group showed an increasing percentage of patients developing a significant renal function reduction in the open, laparoscopic and robot-assisted partial nephrectomy group, as well as an increased probability to develop a significant estimated glomerular filtration rate reduction in the considered time cutoffs, although the predictive ability of the classes was

Purpose: To date, invasive urodynamic investigations have been used to define most terms and conditions relating to lower urinary tract symptoms. This invasiveness is almost totally due to the urethral catheter. In order to remove this source of discomfort for patients, the present study investigated a noninvasive methodology able to provide diagnostic information on bladder outlet obstruction or detrusor underactivity without any contact with the human body.Methods: The proposed approach is based on simultaneous measurements of flow rate and jet exit velocity. In particular, the jet exit kinetic energy appears to be strongly related to bladder pressure, providing useful information on the lower urinary tract functionality. We developed a new experimental apparatus to simulate the male lower urinary tract, thus allowing extensive laboratory activities. A large amount of data was collected regarding different functional statuses.Results: Experimental results were compared successfully with data in the literature in terms of peak flow rate and jet exit velocity. A new diagram based on the kinetic energy of the exit jet is proposed herein. Using the same notation as a Schäfer diagram, it is possible to perform noninvasive urodynamic studies.Conclusions: A new noninvasive approach based on the measurement of jet exit kinetic energy has been proposed to replace current invasive urodynamic studies. A preliminary assessment of this approach was carried out in healthy men, with a specificity of 91.5%. An additional comparison using a small sample of available pressure-flow studies also confirmed the validity of the proposed approach.

Purpose: Whilst radiotherapy increases cure rates in breast cancer, lung cancer, among others, it may also involve some cardiac exposure, which in turn may increase the risk of different heart diseases. The heart is a complex anatomical organ that involves many different structures making it difficult to contour cardiac sub-structures reproducibly. Contouring, especially for these cases, suffers from inter- and intra-expert variability while being time consuming. Cardiac atlases have been developed to aid in the delineation of cardiac substructures. However, these methods have many shortcomings, including the inability to overcome variations in patient anatomy. In this study, a deep learning based commercial solution for automatic OAR delineation was trained following international guidelines for heart substructures delineation and tested on an unseen cohort of lung and breast patients to evaluate its clinical acceptability. Methods: ART-Net, a CE-marked, FDA-cleared anatomically preserving deep-learning ensemble architecture for automatic annotation of OAR was evaluated using data of 20 breast/lung patients from 2 centers. Automatic annotation of 27 different structures (Ventricles (left and right), atria (left and right), left ventricle (anterior, apical, inferior, lateral, septal), LAD coronary (mid, proximal, distal, total), circumflex coronary (distal, proximal, total), RCA (distal, mid, proximal, total), coronary sinus, left main coronary artery, ascending aorta, pulmonary arteries, vena cava inferior, vena cava superior and the heart) was performed and submitted to 2 experts across 2 centers for qualitative evaluation. Contours were scored as A/acceptable, B/acceptable after minor corrections, and C/not acceptable for clinical use. To avoid any bias, experts were blind to whether the contour were manually, or AI delineated. The DSC between automatic and manual (ground truth) contours of the heart sub-structures were evaluated and compared with interobserver variability from the literature [1,2] using average and min DSC scores. Results: Automatic contours were generated in a mean time of 0.5s per scan slice. Out of the 27 structures, 20 were considered clinically acceptable in the qualitative study. In the inter-expert variability study, 12 structures passed the test successfully using initial acceptance criterion over an acceptable sample size and 9 other structures demonstrated performances above the minimal threshold of inter-expert variability, sometimes on smaller datasets due to lack of manual data. Overall, 16 structures were included in the final model. 13 structures were considered clinically acceptable in 100% of the cases with AI contours rated at the same level as manual contours. For the other 3 structures (coronary sinus, left main coronary artery and vena cava inferior), the performance of the AI contours was slightly below that of the manual contours (within 3.4% difference), with the least performing structure being the coronary sinus (84% for AI vs 87% manual). Conclusion: We show first results for the evaluation of AI-based auto-contouring tool for annotation of the substructures of the heart. The results show very good clinical acceptance, highlighting the high usability of the commercial tool for cardiac cases and its clinical implementation feasibility. The use of this AI tool can facilitate and accelerate future research studies investigating relationships between substructure doses and cardiac outcomes. Future work will include improvement of the sub-structures (mid, proximal, distal) and a retrospective meta-analysis to assess heart sub-structures degree of importance in terms of toxicity. References: 1. Lee J., et al. Development of delineation for the left anterior descending coronary artery region in left breast cancer radiotherapy: An optimized organ at risk. Radiother Oncol. 2017 2. Duane F, et al. A cardiac contouring atlas for radiotherapy. Radiother Oncol. 2017 Table 1. Quantitative and qualitative results of the evaluation. Heart sub-structures evaluated quantitatively with mean DSC compared to a range of DSC found in international guidelines and qualitatively as A or B (i.e. considered clinically acceptable). Highlighted are all structures that met the acceptance criterion of reaching a percentage of at least 85% of A or B, or that fell within the DICE range of interobserver variability found in the literature. Citation Format: Pierre Loap, Angela Botticella, Ludovic De Marzi, Antonin Levy, Stephanie Bolle, Stéphane COLAME, Arthus Cannard, Catherine Martineau-Huynh, Ayoub Oumani, Thais S. Roque, Nikos Paragios, Eric Deutsch, Caroline Luo, Youlia M. Kirova, Sofia Rivera. AI-based cardiac sub-structures segmentation for safer radiotherapy planning [abstract]. In: Proceedings of the 2022 San Antonio Breast Cancer Symposium; 2022 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2023;83(5 Suppl):Abstract nr P1-10-12.

Introduction: Exposition of cardiac conduction system during breast radiotherapy has never been studied, despite increasing use of intensity modulated radiotherapy which expose larger volume to low dose bath. We evaluated conduction node exposure during breast irradiation with volumetric modulated arctherapy (VMAT) and estimated the potential dosimetric benefit with intensity modulated protontherapy (IMPT). Materials and methods: Atrioventricular (AVN) and sinoatrial (SAN) nodes were retrospectively delineated according to published guidelines on the simulation CT scans of twelve breast cancer patients having undergone conserving surgery and adjuvant locoregional VMAT. IMPT treatment was re-planned on the simulation CT scans for all breast cancer patients. Mean and maximum doses to the SAN and the AVN were retrieved and compared. Correlation coefficients were calculated between doses to the SAN or the AVN and to the whole heart. Results: Average mean doses to the SAN and to the AVN were 2.8 Gy and 2.3 Gy respectively for left-sided irradiation and 9.6 Gy and 3.6 Gy respectively for right-sided irradiation. Average maximum doses to the SAN and to the AVN were 3.5 Gy and 2.8 Gy respectively for left-sided irradiation and 13.1 Gy and 4.6 Gy respectively for right-sided irradiation. IMPT significantly reduces doses to conduction nodes. Correlations between doses to the SAN or the AVN and the whole heart were usually significant. Conclusion: SAN and AVN can be substantially exposed during breast VMAT, especially for right-sided irradiation. Cardiotoxicity studies evaluating conduction node exposure might define dose constraints and criteria for additional cardiac sparing techniques, such as respiratory techniques or proton therapy, which could be beneficial to patients with underlying rhythmic or conduction disorders. Citation Format: Pierre Loap, Farid Goudjil, Ludovic De Marzi, Vincent Servois, Krassen Kirov, Alain Fourquet, Youlia M. Kirova. Cardiac conduction system exposure with modern radiotherapy techniques for breast cancer irradiation [abstract]. In: Proceedings of the 2022 San Antonio Breast Cancer Symposium; 2022 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2023;83(5 Suppl):Abstract nr P1-10-16.

Objectives Cardiovascular disease (CVD), lung cancer (LC), and respiratory diseases are main causes of death in smokers and former smokers undergoing low-dose computed tomography (LDCT) for LC screening. We assessed whether quantification of pulmonary emphysematous changes at baseline LDCT has a predictive value concerning long-term mortality. Methods In this longitudinal study, we assessed pulmonary emphysematous changes with densitometry (volume corrected relative area below − 950 Hounsfield units) and coronary artery calcifications (CAC) with a 0–3 visual scale in baseline LDCT of 524 participants in the ITALUNG trial and analyzed their association with mortality after 13.6 years of follow-up using conventional statistics and a machine learning approach. Results Pulmonary emphysematous changes were present in 32.3% of subjects and were mild (6% ≤ RA950 ≤ 9%) in 14.9% and moderate-severe (RA950 > 9%) in 17.4%. CAC were present in 67% of subjects (mild in 34.7%, moderate-severe in 32.2%). In the follow-up, 81 (15.4%) subjects died (20 of LC, 28 of other cancers, 15 of CVD, 4 of respiratory disease, and 14 of other conditions). After adjusting for age, sex, smoking history, and CAC, moderate-severe emphysema was significantly associated with overall (OR 2.22; 95CI 1.34–3.70) and CVD (OR 3.66; 95CI 1.21–11.04) mortality. Machine learning showed that RA950 was the best single feature predictive of overall and CVD mortality. Conclusions Moderate-severe pulmonary emphysematous changes are an independent predictor of long-term overall and CVD mortality in subjects participating in LC screening and should be incorporated in the post-test calculation of the individual mortality risk profile. Key Points • Densitometry allows quantification of pulmonary emphysematous changes in low-dose CT examinations for lung cancer screening. • Emphysematous lung density changes are an independent predictor of long-term overall and cardio-vascular disease mortality in smokers and former smokers undergoing screening. • Emphysematous changes quantification should be included in the post-test calculation of the individual mortality risk profile.

One challenge for railway noise predictions is to characterize noise from various auxiliary equipment, e.g., fans, compressors, transformers. The noise from such sources can be a dominating contribution under low speed operation or stand still. To better handle this problem the EU-project TRANSIT investigates improved methods for acoustic source characterization. As a starting point it is assumed that an acoustic source is enclosed by a control surface. The surface is sub-divided into smaller areas and each area is assumed to act as an acoustic one-port coupled to all the other areas. The properties of each area can then be described by its volume flow and internal impedance. The resulting acoustic pressure at a receiving point, can finally be expressed as a product of the source volume flows and a matrix representing the acoustic installation effects ("source+radiation impedances"). To simplify the method one can assume uncorrelated source surfaces and use an ISO procedure for sound power to determine the volume flows. The acoustic installation effects can be obtained using a monopole point source to measure or calculate the pressure at selected receiving positions. This simplified method has been validated under controlled laboratory conditions and tested on real equipment on trains.

Die häufigsten Traumalokalisationen bei Kindern sind der Unterarm und die Hand. Der Artikel beleuchtet die Diagnostik sowie die konservativen und operativen Therapiemöglichkeiten bei Verletzungen des Radiusköpfchens, des Olekranons, des Unterarms und der Hand.

Electrospun collagen mats were analyzed using circular dichroism, enzymatic digestion, SDS-PAGE, western blotting, and Raman spectroscopy and compared to heat-denaturated and electrospun collagen in HFIP.

Lead dwell time10 years is a recognized predictor for transvenous lead extraction (TLE) failure and complications. Data on the efficacy and safety of TLE using the bidirectional rotational mechanical sheaths in patients with very old leads are lacking. In this multicenter study, we reported the outcomes of transvenous rotational mechanical lead extraction in patients with leads implanted for ≥10 years.A total of 441 leads (median: 159 months [135-197]; range: 120-487) in 189 consecutive patients were removed with the Evolution RL sheaths (Cook Medical, Bloomingtom, IN, USA) and mechanical ancillary tools supporting the procedures.The main indication for TLE was infection in 74% of cases. Complete procedural success rate, clinical success rate, per lead were 94.8% and 98.2%, respectively. Failure of lead extraction was seen in 1.8% of leads. The additional use of a snare via the femoral approach was required in 9% of patients. Lead dwell time was the only predictor of incomplete led removal (odds ratio: 1.009; 95% confidence interval [CI]: 1.003-1.014; p = .002). Four major complication (2%) were encountered. During a mean time follow-up of 31 ± 27 months, 21 patients (11%) died. No procedure-related mortality occurred. Predictors of mortality included severe left ventricular systolic dysfunction (hazard ratio [HR]: 8.06; 95% CI: 2.99-21.73; p = .001), TLE for infection (HR: 8.0; 95% CI: 1.04-62.5; p = .045), diabetes (HR: 3.7; 95% CI: 1.48-9.5; p = .005), and previous systemic infection (HR: 3.1; 95% CI: 1.17-8.24; p = .022). Incomplete lead removal or failure lead extraction did not impact on survival during follow-up.Our findings demonstrated that the use of bidirectional rotational TLE mechanical sheaths combined with different mechanical tools and femoral approach allows reasonable success and safety in patients with very old leads at experienced specialized centers.

As young, active, creative, and authentic people tend to outmigration from the historical contexts of downtown Tehran, the question in this paper has dealt with the ways of place-making through ICT. Hence, the article seeks to find an urban design solution to attract people to the inner parts of the cities. The primary purpose of this study is to enhance public events in the historic zone of Tehran's Citadel by using ICT. In spite of the potentials of the heritage areas in empowering social interactions and nightlife entertainments, many of the historic urban spaces have now fallen into disrepair and decrepitude. The importance of this research is in recreating the morphological, economic, social and historical aspects of vast and sensitive areas in Tehran and other similar cities. Therefore, by studying the evolution of urban fabrics in three historical periods, the physical, social, and historic-cultural features of these periods have been studied and assessed through 3D modeling and fabrication. Volumetric envelopes of historic monuments, some of which are now destroyed, are to be made and virtually displayed in the original location of the buildings by using lighting techniques. The result of this paper indicates that in addition to its instrumental role of digital documentation production, ICT may enhance historical urban sites and aid people in three main place aspects including the functional aspect (enhancing safety, nightlife, and social interaction), the perceptual aspect (enhancing the identity of the place) and the physical aspect (redesigning urban places).

Within feminist geography, there is a growing consensus on the need for research to contribute to social change and transformation beyond the academy, and increased emphasis on the co-production of impact. In this paper I critically reflect and report on how I co-produced impact with a participatory audio-visual research project, conducted in collaboration with women in Bogotá and Medellín and researchers and filmmakers based in the UK and Colombia. I focus particularly on co-producing ‘impact-in-process’, which builds participants’ capacities, creates spaces of reciprocal learning and increases participants’ confidence and sense of ownership both during and beyond the research process. Yet, while co-producing impact-in-process benefits research participants and has the potential to contribute to social change and transformation, this form of impact is rarely recognised as such.

Skin cancer is one of leading cancers globally, divided into two major categories including melanoma and nonmelanoma. Skin cancer is a global concern with an increasing trend, hence novel therapies are essential. The local treatment strategies play a key role in skin cancer therapy. Nanoparticles (NPs) exert potential applications in medicine with huge advantages and have the ability to overcome common chemotherapy problems. Recently, NPs have been used in nanomedicine as promising drug delivery systems. They can enhance the solubility of poorly water-soluble drugs, improve pharmacokinetic properties, modify bioavailability, and reduce drug metabolism. The high-efficient, nontoxic, low-cost, and specific cancer therapy is a promising goal, which can be achieved by the development of nanotechnology. Metallic NPs (MNPs) can act as important platforms. MNPs development seeks to enhance the therapeutic efficiency of medicines through site specificity, prevention of multidrug resistance, and effective delivery of therapeutic factors. MNPs are used as potential arms in the case of cancer recognition, such as Magnetic Resonance Imaging (MRI) and colloidal mediators for magnetic hyperthermia of cancer. The applications of MNPs in the cancer treatment studies are mostly due to their potential to carry a large dose of drug, resulting in a high concentration of anticancer drugs at the target site. Therefore, off-target toxicity and suffering side effects caused by high concentration of the drug in other parts of the body are avoided. MNPs have been applied as drug carriers for the of improvement of skin cancer treatment and drug delivery. The development of MNPs improves the results of many cancer treatments. Different types of NPs, such as inorganic and organic NPs have been investigated in vitro and in vivo for the skin cancer therapy. MNPs advantages mostly include biodegradability, electrostatic charge, good biocompatibility, high drug payload, and low toxicity. However, the use of controlled-release systems stimulated by electromagnetic waves, temperature, pH, and light improves the accumulation in tumor tissues and improves therapeutic outcomes. This study (2019-2022) is aimed at reviewing applications of MNPs in the skin cancer therapy.

The present study applies an approach to analyze the stress induced on people on the autism condition. Dedicated questionnaires were prepared, in order to guarantee an inclusive participation and then applied by means of two different surveys in living and extended care unit environments. Results permit to highlight that: (i) the four comfort domains show similar sensitivity trends, with acoustics having the greatest impact on people with autism spectrum disorder (ASD), while thermo-hygrometric, visual and IAQ sensitivity decreases as the stress scale increases; (ii) Severity of autism influenced the acoustic sensitivity, while age and the considered environment influenced thermo-hygrometric, visual and IAQ sensitivities. The proposed approach can be applied to well-being studies involving people with other types of conditions which could alter their perception of the built environment.

ZusammenfassungNur wenige Kinder erreichen die Bewegungsempfehlungen der Weltgesundheitsorganisation und profitieren von den gesundheitlichen Effekten der körperlichen Aktivität. Die Förderung nicht-organisierter Bewegungsaktivitäten, wie die aktive und eigenständige Mobilität, ist ein relevanter Ansatzpunkt für Interventionen zur Bewegungsförderung bei Kindern im Grundschulalter. Ziel der vorliegenden Studie war es, hinderliche und förderliche Faktoren für die eigenständige und aktive Mobilität auf dem Schulweg zu identifizieren, aus welchen geeignete Interventionsmaßnahmen abgeleitet werden können.Im Rahmen der Studie wurden zwölf Grundschulkinder im Alter von acht bis zehn Jahren qualitativ anhand der Photovoice-Methode zu ihrem Schulweg befragt. Basierend auf dem sozial-ökologischen Modell wurden individuelle, soziale und physische Einflussfaktoren aus den Daten extrahiert. Insbesondere die elterliche Erlaubnis, eine mangelnde fahrrad- und fußgängerfreundliche Infrastruktur und rücksichtslose motorisierte Verkehrsteilnehmer*innen hindern Kinder an einem aktiven und eigenständigen Zurücklegen des Schulwegs.Anhand der Studie wurden vielfältige Faktoren auf unterschiedlichen sozial-ökologischen Ebenen identifiziert, welche in Interventionsmaßnahmen zur Förderung eines aktiven und eigenständigen Schulwegs berücksichtigt werden sollten. Zudem sollten Verbesserungsvorschläge der Grundschüler*innen zur Ermöglichung eines aktiven und eigenständigen Schulwegs in der Stadtplanung und -entwicklung kritisch reflektiert und berücksichtigt werden, um kindgerechte Umwelten zu schaffen.

Irrigation of carbonate-rich agricultural soils with arsenic (As)-contaminated water leads to the accumulation of As in these soils. In this regard, there is an opportunity to adsorb and fix the As in soil and decrease the As transportation to the plants and subsequently the human food chain. So, the present study aimed to investigate the adsorption-desorption characteristics of As in calcareous soils and the potential of As fixation over time. First, to achieve this purpose, 53 soil samples were gathered from the study site and after the laboratory analysis, the soils were categorized into four groups based on their physicochemical properties. Then, four representative samples of these groups were selected, namely soil 1, soil 2, soil 3, and soil 4. Afterward, the As adsorption-desorption was investigated in a lab-scale batch experiment. Next, the effect of age was assessed by incubating the As-adsorbed soils for 60 days, and to study the impact of temperature, the adsorption was performed at four temperature levels (10, 20, 30, and 40 °C). Finally, the isotherm models were fitted to experimental data, and the amount of loosely and tightly held As was quantified. Results revealed that the As adsorption isotherms were L-type, in which As adsorption increased with the increase of As loading. The double-site Langmuir (DSL) estimated that a limited amount of As was adsorbed on high-energy surfaces and a large amount of As was adsorbed on low-energy surfaces. Desorption results showed that a significant amount of As desorbed immediately; however, the desorption significantly decreased with the increase of age, especially at low equilibrium concentrations. By aging the loosely held As transformed into non-labile forms so that in soils 1, 2, 3, and 4, the fraction of As adsorbed on high-energy surfaces increased from 72.5, 93.2, 63.2, and 123 mg/kg to 167, 141, 70.6, and 196 mg/kg, respectively, and the fraction of As adsorbed on low-energy surfaces decreased from 397, 256, 202, and 317 mg/kg to 182, 238, 173, and 172 mg/kg, respectively (after aging for 60 days). Aging proved to be a promising solution for decreasing As transport into the human food chain and could be employed for crops with longer irrigation cycles. ΔH

This work deals with the design of an indoor environment dedicated to autistic individuals, who may suffer from hypersensitivity to acoustic stimuli. Specifically, in this volume customized pieces of furniture are included, containing smart sensors, designed to help people with cognitive deficits to live an independent life. Among the indoor comfort aspects, the acoustic requirements have been investigated, in order to guarantee both the optimal functioning of the acoustic sensors and the acoustic occupants’ well-being. The optimal indoor acoustic levels are based on a literature review. Measurements are performed in order to calibrate a 3D acoustic model. Then diverse scenarios are analysed, and an optimized configuration is proposed and realized. The model is then validated with the final acoustic measurements, which confirm the designed results.

INTRODUCTION: Genetics and omics studies of Alzheimer’s disease and other dementia subtypes enhance our understanding of underlying mechanisms and pathways that can be targeted. METHODS: We identified key remaining challenges: First, can we enhance genetic studies to address missing heritability? Can we identify reproducible omics signatures that differentiate between dementia subtypes? Can high-dimensional omics data identify improved biomarkers? How can genetics inform our understanding of causal status of dementia risk factors? And which biological processes are altered by dementia-related genetic variation? RESULTS: Artificial intelligence (AI) and machine learning approaches give us powerful new tools in helping us to tackle these challenges, and we review possible solutions and examples of best practice. However, their limitations also need to be considered, as well as the need for coordinated multidisciplinary research and diverse deeply phenotyped cohorts. DISCUSSION: Ultimately AI approaches improve our ability to interrogate genetics and omics data for precision dementia medicine.

INTRODUCTION: With the increase in large multimodal cohorts and high throughput technologies, the potential for discovering novel biomarkers is no longer limited by dataset size. METHODS: Artificial intelligence (AI) and machine learning approaches have been developed to detect novel biomarkers and interactions in complex datasets. We discuss exemplar uses and evaluate current applications and limitations of AI to discover novel biomarkers. RESULTS: Remaining challenges include a lack of diversity in the datasets available, the sheer complexity of investigating interactions, the invasiveness and cost of some biomarkers, and poor reporting in some studies. Overcoming these challenges will involve collecting data from underrepresented populations, developing more powerful AI approaches, validating the use of noninvasive biomarkers, and adhering to reporting guidelines. DISCUSSION: By harnessing rich multimodal data through AI approaches and international collaborative innovation, we are well positioned to identify clinically useful biomarkers that are accurate, generalizable, unbiased, and acceptable in clinical practice.

NASA’s Juno spacecraft performed close flybys of the Galilean moons Ganymede in June 2021 and Europa in September 2022. During each of these encounters, the Juno spacecraft passed behind the moons as observed from Earth, providing the geometry for a radio occultation experiment to measure the electron densities of the ionospheres of these moons – the first opportunity to do so since the Galileo mission in the 1990s. Electrons encountered along the radio propagation path advance the signal’s phase. These small changes are detectable in the sensitive receivers of the Deep Space Network antennas. Ganymede’s tenuous ionosphere was detected on occultation ingress but no ionosphere was detected on egress. The interaction of the ionosphere with Ganymede’s intrinsic magnetosphere is believed to be the reason for the variability of the ionosphere, since ingress occurred on an open-field line region where electron impact ionization could be higher. At Europa, the occultation probed the Southern mid-latitudes on ingress and near the equatorial region on egress, with results consistent when compared with the six radio occultations of Europa from Galileo. Future occultation science with Juno will occur in 2023 and 2024 with radio occultations of Jupiter’s atmosphere and ionosphere.

Climate change is projected to increase the frequency and intensity of future droughts particularly affecting the most low-income countries directly dependent on local rainfed food security and livelihoods. Drought risk and its related impacts depend on the drought hazard, the exposure and the vulnerability of the different socioeconomic sectors and/or ecosystems as well as the adaptive capacity of affected locations. The Horn of Africa, which includes Ethiopia, is currently experiencing one of the most severe droughts in the last 40 years. This study applies a storyline approach to investigate changes in drought risk for Ethiopia combining vulnerability, hazard and adaptive capacity information for current and future projected climatic and socio-economic conditions using a subnational level composite indicator. For our analysis, we define drought based on the Standardised Precipitation-Evapotranspiration Index (SPEI) which characterises the deficits in local water availability based on the precipitation and potential evapotranspiration. SPEI is computed using bias corrected Inter-Sectoral Impact Model Intercomparison Project (ISIMIP) project based on the Coupled Model Intercomparison Project Phase 6 (CMIP6). The Drought vulnerability assessment is carried out combining exposure, adaptive capacity and sensitivity indicators, using INFORM index developed by the Joint Research Centre of the European Commission to support humanitarian crisis and disaster decision-making. The analysis shows that future drought will increase people in need of food assistance both under current population and future population projections. If humanitarian aid and assistance are maintained at recent historical levels, these findings show a substantial increase in the required amounts. These conditions are exasperated when humanitarian access is impeded by local conditions such as the current conflict in Ethiopia, when imports are reduced by crises such as those associated with the Russian invasion of the Ukraine, and by pandemics such as COVID-19. Climate change mitigation is shown to reduce the vulnerability of Ethiopia through a reduction in drought hazard frequency and intensity. The framework presented in this study can be used as a policymaking tool to provide information on how to better prioritize future loss and damage funds and adaptation and mitigation investments to reduce population vulnerability and exposure.

In this work, the discovery and description of PF-07321332, a major bioavailable oral SARS-CoV-2 protease inhibitor with in vitro human coronavirus antiviral activity, and excellent selection of off-target and in vivo immune profiles are reported. Various drugs and novel compound candidates for the treatment of the COVID-19 pandemic have been developed. PF-07321332 (or nirmatrelvir) is a new oral antiviral drug developed by Pfizer. In response to the pandemic, Pfizer has developed the COVID vaccine and in 2022 will launch its new major anti-SARS-Cov-2 protease inhibitor (PI). The combination of ritonavir and nirmatrelvir is under study in phase III of the clinical trial with a brand name Paxlovid. Paxlovid is an active 3Cl protease inhibitor. Paxlovid exerts its antiviral efficacy by inhibiting a necessary protease in the viral replication procedure. Proteases of coronavirus cleave several sites in the viral polyprotein where pyrrolidone was replaced by flexible glutamine. Due to the coronavirus pandemic, there is high demand for synthesis and development of this novel drug. Herein, we report the synthetic route and the mechanism of action was recently published on nirmatrelvir. Also, a comparison of the performance of two new oral antiviruses (molnupiravir and nirmatrelvir) for the treatment of COVID-19 is described. This review will be helpful for different disciplines such as biochemistry, organic chemistry, medicinal chemistry, and pharmacology.

3D bioprinting is an emerging biofabrication strategy using bioinks, comprising cells and biocompatible materials, to produce functional tissue models. Despite progress in building increasingly complex objects, biological analyses in printed constructs remain challenging. Especially, methods that allow non-invasive and non-destructive evaluation of embedded cells are largely missing. Here, we implemented Raman imaging for molecular-sensitive investigations on bioprinted objects. Different aspects such as culture formats (2D, 3D-cast, and 3D-printed), cell types (endothelial cells and fibroblasts), and the selection of the biopolymer (alginate, alginate/nanofibrillated cellulose, alginate/gelatin) were considered and evaluated. Raman imaging allowed for marker-independent identification and localization of subcellular components against the surrounding biomaterial background. Furthermore, single-cell analysis of spectral signatures, performed by multivariate analysis, demonstrated discrimination between endothelial cells and fibroblasts and identified cellular features influenced by the bioprinting process. In summary, Raman imaging was successfully established to analyze cells in 3D culture in situ and evaluate them with regard to the localization of different cell types and their molecular phenotype as a valuable tool for quality control of bioprinted objects.