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Background: The occurrence of obstructive and central sleep apnea syndromes, ventilator pump failure and reduced hypercapnic ventilatory drive in myotonic dystrophy type 1 (DM1) is well established, and there are indications for an impairment of the hypoxic ventilator drive, too. Yet, it is still unknown, to which extent the respiratory rhythm is affected by DM1, thus if a central bradypnea, cluster breathing or ataxic (“Biot's”) breathing can occur. Additionally, the causes of the impairment of the central respiratory drive in DM1 are not known. Case Presentation: We present the case of a tracheotomized female patient with DM1 with central bradypnea and ataxic breathing. A 57-year-old woman with DM1 was admitted to our Neurointensive Care Unit (NICU) due to refractory tracheobronchial retention of secretions resulting from aspiration of saliva. Due to a combination of chronic hypercapnic respiratory failure, severe central bradypnea with a minimal breathing frequency of 3 per minute and ataxic breathing a pressure-controlled home ventilation was initiated. Conclusions: In our patient central bradypnea and ataxic breathing possibly were respiratory sequale of DM1, that may have been caused by pontine white matter lesions affecting the pontine respiratory nuclei. From a clinical viewpoint, polygraphy is a suitable tool to objectify disorders of the respiratory rhythm in DM1 even in tracheotomized patients. Clinical studies combining respiratory diagnostics as polygraphy, transcutaneous capnometry and blood gas analysis with brain magnetic resonance imaging (MRI) are required to better understand disorders of respiratory regulation in DM1, and to identify their anatomical correlates.

Parkinson’s disease (PD) can affect speech as well as emotion processing. We employ whole-brain graph-theoretical network analysis to determine how the speech-processing network (SPN) changes in PD, and assess its susceptibility to emotional distraction. Functional magnetic resonance images of 14 patients (aged 59.6 ± 10.1 years, 5 female) and 23 healthy controls (aged 64.1 ± 6.5 years, 12 female) were obtained during a picture-naming task. Pictures were supraliminally primed by face pictures showing either a neutral or an emotional expression. PD network metrics were significantly decreased (mean nodal degree, p < 0.0001; mean nodal strength, p < 0.0001; global network efficiency, p < 0.002; mean clustering coefficient, p < 0.0001), indicating an impairment of network integration and segregation. There was an absence of connector hubs in PD. Controls exhibited key network hubs located in the associative cortices, of which most were insusceptible to emotional distraction. The PD SPN had more key network hubs, which were more disorganized and shifted into auditory, sensory, and motor cortices after emotional distraction. The whole-brain SPN in PD undergoes changes that result in (a) decreased network integration and segregation, (b) a modularization of information flow within the network, and (c) the inclusion of primary and secondary cortical areas after emotional distraction.

This paper presents an improved distributed ant colony optimisation algorithm for routing and spectrum assignment (RSA) on optical burst switched (OBS), flexible spectrum networks, with the spectrum continuity constraint imposed. The improved algorithm incorporates a distributed method for monitoring the congestion along the links and using this information to determine what route-spectrum combination should be selected to minimise the burst loss probability (BLP). Evaluations were performed on an optical burst switching simulator to determine the effect on BLP when a dynamic route congestion measure is considered as opposed to the use of the static route length measure. The evaluations, considering the effects of optical impairments, were made on different network topologies, with multiple spectrum widths provisioned on the network, and with different loads. The incorporation of congestion measures into the algorithm showed improvements in BLP over previous work in the range of 2–32% depending on the evaluation conditions.

Häufiger als erwartet werden in Trinkwasser-Installationen für Krankenhäuser, Seniorenwohnheimen, Kindergärten und Schulen – den sogenannten Risikoinstallationen – Kontaminationen des kalten Trinkwassers mit Legionellen nachgewiesen 1). Diese Kontaminationen lassen sich fast immer auf zu hohe Temperaturen des Kaltwassers in Stagnationsphasen zurückführen. Aufgrund der hohen Lufttemperaturen in Installationsvorwänden sind Stockwerks- und Einzelzuleitungen, an denen Entnahmearmaturen mit geringer Nutzungsfrequenz angeschlossen sind, besonders gefährdet. Die Erfahrung zeigt, dass die ambitionierten Temperaturanforderungen für das kalte Trinkwasser aus neueren Regelwerken mit traditionellen Bau- und Installationsmethoden nicht erfüllt werden können. Damit dadurch das Risiko des Planers beziehungsweise des ausführenden Unternehmens nicht unkalkulierbar wird, sollten mit dem Auftraggeber bereits zu Beginn des Planungsprozesses eindeutige Vereinbarungen zur Temperaturhaltung im kalten Trinkwasser getroffen werden

Since the end of 2018, the Transiting Exoplanet Survey Satellite (TESS) has provided stellar photometry to the astronomical community. We have used TESS data to study rotational modulation in the light curves of a sample of chemically peculiar stars with measured large-scale magnetic fields (mCP stars). In general, mCP stars show inhomogeneous distributions of elements in their atmospheres that lead to spectroscopic (line profile) and photometric (light curve) variations commensurate with the rotational period. We analyzed the available TESS data from 50 sectors for eight targets after post-processing them in order to minimize systematic instrumental trends. Analysis of the light curves allowed us to determine rotational periods for all eight of our targets. For each star, we provide a phase diagram calculated using the derived period from the light curves and from the available measurements of the disc-averaged longitudinal magnetic field 〈Bz〉. In most cases, the phased light curve and 〈Bz〉 measurements show consistent variability. Using our rotation periods, and global stellar parameters derived from fitting Balmer line profiles, and from Geneva and Strömgren–Crawford photometry, we determined the equatorial rotational velocities and calculated the respective critical rotational fractions veq/vcrit. We have shown from our sample that the critical rotational fraction decreases with stellar age, at a rate consistent with the magnetic braking observed in the larger population of mCP stars.

To increase the sustainability of egg production, alternatives to soybean in poultry nutrition are intensively searched for. Black soldier fly larvae (BSFL) could have a great potential, but the comparative protein value to soybean is not well known. The main objective of this study was to facilitate this comparison by using experimental diets clearly limited in calculated supply of sulphurous amino acids and lysine. Fifty laying hens (Lohmann Brown Classic), aged 40 weeks, were fed one of five diets for 7 weeks (n=10). Two diets were based on soybean cake and oil (SS, SS-) as protein and energy sources, and three diets contained partially defatted BSFL meal and fat from two different origins (AA-, AB-, BB-). Different from SS, all other diets were designed to be deficient in methionine and lysine in relation to requirements by >20%. The realised supply with total sulphurous amino acids and lysine was indeed superior with SS even though this diet was analysed to be more deficient in methionine than the BSFL-based diets. Despite the calculated deficiency in limiting amino acids, laying performance of the hens of all groups was similar and ranged between 93 and 97%. Similarly, egg mass, daily feed intake and feed efficiency were not influenced by the BSFL-based diets. The yolks of group BB- were more intensely coloured compared to the others indicating a difference between BSFL origins. Yolks of SS-, but not of the BSFL-based diets, had lower contents of dry matter and ether extract than those of SS. Including BSFL into the diet did not influence the odour of the eggs tested in scrambled form. The results show that soybean-based feeds for laying hens may be completely replaced by BSFL-based feeds and suggest that the recommendations for amino acid supply of laying hens might need revision., Journal of Insects as Food and Feed, 8 (9), ISSN:2352-4588

While the core of Ps 45 (vv. 3–16) clearly bears the stamp of a Phoenician royal court, the beginning and end highlight features that elucidate the psalm’s main body. V. 1 f. present an author who has assumed an Aramaic title (סוֹפֵר מׇהִיר): he reflects on his works, puts his poetry indirectly on a par with a Greek poem by adopting the Greek concept of ποίημα (= מַעֲשֶׂה), and through the superscription »a love song« secondarily reads this idea into the psalm, even though love is nowhere mentioned. V. 17 f. link up organically with the psalm’s main body, but no longer deal with the king alone; the focus is now on his dynasty, whose impact is international, unbounded by time or place.

Whey proteins are being integrated as high-value food product ingredients due to their versatile and tunable techno-functionality. To meet high food quality and clean label expectations by consumers, electric field (EF) technologies have been proposed to open new frontiers in this field. Despite a variety of studies, it remains ambiguous which EF parameters are crucial to achieving targeted whey protein modifications. Reconstituted liquid whey protein concentrate (WPCL) and filtered, non-heat-treated liquid whey (WPL_filt) at low protein dry weight concentrations (0.4% wt/wt) were exposed to microsecond pulsed electric field (μsPEF) treatments at EF intensities between 1.25 and 12.5 kV/cm, pulse repetition frequencies between 0.38 and 85 Hz, and pulse lengths set to 10 or 100 μs. Protein aggregations were quantified spectroscopically. We report here that aggregates formed at lower temperatures for μsPEF compared with purely thermal treatments in identical treatment geometries at similar time-temperature profiles. We suggest that the observed increase in absorbance is linked to protein migration, the isoelectric point, local deprotonation phenomena of thiol groups, and cation precipitation. The μsPEF treatment time, which is dependent on the pulse repetition frequency, pulse length, and time of process, is the main driver of the increase in absorbance. High EF intensities balanced with shorter pulse repetition frequencies to ensure similar energy inputs resulted in no aggregate formation. For WPL_filt, 12.5 kV/cm, 10 μs, 0.38 Hz (620 ± 96 kJ/kg; ± standard deviation) did not result in an increase in absorbance, whereas 1.25 kV/cm, 10 μs, 50 Hz (634 ± 57 kJ/kg) with similar time-temperature profiles increased the absorbance at a wavelength of 380 nm by a factor of 8.2 ± 1.7 compared with untreated WPL_filt. In conclusion, the treatment time seems to dominate over high EF intensities at similar energy inputs for aggregate formation and increase in absorbance., Journal of Dairy Science, 105 (8), ISSN:0022-0302, ISSN:1525-3198

Environmental surfaces can be a source of antimicrobial-resistant (AMR) bacteria that pose a risk to human and animal health. Zoological institutions are unique environments where exotic animals, staff, and visitors intermingle and antimicrobials are used to maintain animal health.

IntroductionGambling can have serious consequences for many aspects of a person’s life. Yet relatively few people with gambling problems seek help. This study examines the extent to which exclusion from casino venues among other factors may act as a motivator for further help-seeking among casino gamblers (both landbased and remote) with at-risk or disordered gambling behavior. In addition, the barriers that prevent gamblers from accepting help are examined.MethodsGamblers from Swiss casinos completed a written questionnaire twice, at 6-month intervals. The questions included whether they had sought help in the past 6 months.ResultsFor those with a SOGS-R rating of 1 or over (n = 173) at the second survey point, a difference in help-seeking was found between the excluded and non-excluded gamblers (p p = .006), recognition of gambling problems (p = .010) and severity of gambling-related problems (p = .004) can be taken to suggest that other motivating factors may also influence help-seeking behavior. With regard to the support sought, the most frequently used forms of support were specialized addiction counseling centers (39.5%), followed by self-help groups (21.1%) and remote counseling centers (10.5%). In terms of barriers, reasons relating to attitude, such as denial, appear to pose greater barriers than treatment-related concerns.DiscussionFrom a public health perspective, an overarching strategy is required to increase the share of help-seekers among casino gamblers through targeted measures.

BackgroundFetal Alcohol Syndrome (FAS) can result in substantial cognitive dysfunction. Many of the cognitive functions affected are subserved by few functional brain networks. Functional connectivity (FC) in these networks can be assessed with resting state functional MRI (rs-fMRI). Alterations of FC have been reported in children and adolescents prenatally exposed to alcohol. However, previous reports varied substantially regarding which exact cognitive networks were affected, their interactions, and the directionalities of FC alterations. Despite persisting deficits, no previous studies have examined FC in older individuals. Purpose of this rs-fMRI study was to assess FC within and between cognition-related networks in young adults with FAS.MethodsCross-sectional study in patients with FAS (n = 39, age: 20.9 ± 3.4 years) and controls without prenatal alcohol exposure (n = 44, age: 22.2 ± 3.4 years). FC was calculated as correlation between cortical regions in ten cognition-related sub-networks. Subsequent modelling of overall FC was based on two-tailed t-tests comparing FC between FAS and controls. Results were subjected to a hierarchical statistical testing approach, first determining whether there is any alteration of FC in FAS (compared with controls) in the full cognitive connectome, subsequently resolving these findings to the level of either FC within each network or between networks, and finally to individual connections. The overall and network-level tests are based on the Higher Criticism (HC) approach for the detection of rare and week effects in high dimensional data. In an additional exploratory time- resolved FC analysis, potential group differences of dynamic FC states were assessed.ResultsComparing FAS subjects with controls, we observed altered FC of cognition-related brain regions globally, within 7 out of 10 networks, and between networks employing the HC statistic. This was most obvious in the dorsal attention A sub-network, followed by the salience / ventral attention A subnetwork. Findings also spanned subcomponents of the fronto-parietal control and default mode networks. None of the single FC alterations within these networks yielded statistical significance in the final high-resolution analysis. The exploratory time-resolved FC analysis did not show significant group differences in the temporal behavior of FC states.ConclusionsFC in cognition-related brain networks was altered in adults with FAS. Effects were widely distributed across these networks, potentially reflecting the diversity of cognitive deficits in these individuals. Findings were pronounced in attention-related networks in line with attentional deficits previously reported. An additional exploratory time-resolved FC analysis did not reveal altered dynamic FC patterns.

Many functional magnetic resonance imaging (fMRI) studies rely on mass-univariate inference with subsequent multiple comparison correction. Statistical results are frequently visualized as thresholded statistical maps. This approach has inherent limitations including the risk of drawing overly-selective conclusions based only on selective results passing such thresholds. This article gives an overview of both established and newly emerging approaches to supplement such conventional analyses by incorporating information about subthreshold effects with the aim to improve interpretation of findings or leverage a wider array of information. Topics covered include neuroimaging data visualization, p-value histogram analysis and the related Higher Criticism approach for detecting rare and weak effects as well as multivariate analyses and dedicated Bayesian approaches.

The neural circuits governing the induction and progression of neurodegeneration and memory impairment in Alzheimer’s disease (AD) are incompletely understood. The mammillary body (MB), a subcortical node of the medial limbic circuit, is one of the first brain regions to exhibit amyloid deposition in the 5xFAD mouse model of AD. Amyloid burden in the MB correlates with pathological diagnosis of AD in human postmortem brain tissue. Whether and how MB neuronal circuitry contributes to neurodegeneration and memory deficits in AD are unknown. Using 5xFAD mice and postmortem MB samples from individuals with varying degrees of AD pathology, we identified two neuronal cell types in the MB harboring distinct electrophysiological properties and long-range projections: lateral neurons and medial neurons. lateral MB neurons harbored aberrant hyperactivity and exhibited early neurodegeneration in 5xFAD mice compared with lateral MB neurons in wild-type littermates. Inducing hyperactivity in lateral MB neurons in wild-type mice impaired performance on memory tasks, whereas attenuating aberrant hyperactivity in lateral MB neurons ameliorated memory deficits in 5xFAD mice. Our findings suggest that neurodegeneration may be a result of genetically distinct, projection-specific cellular dysfunction and that dysregulated lateral MB neurons may be causally linked to memory deficits in AD.

Draix-Bléone critical zone observatory was created in 1983 to study erosion processes in a mountainous badland region of the French Southern Alps. Six catchments of varying size (0.001 to 22 km2) and vegetation cover are equipped to measure water and sediment fluxes, both as bedload and suspended load. This paper presents the core dataset of the observatory, including rainfall and meteorology, high-frequency discharge and suspended sediment concentration and event-scale bedload volumes. The longest records span almost 40 years. Measurement and data processing methods are presented, as well as data quality assessment procedures and examples of results. All the data presented in this paper is available on the open repository https://doi.org/10.17180/obs.draix (Draix-Bleone Observatory, 2015) and a 5-year snapshot is available for review at https://doi.org/10.57745/BEYQFQ (Klotz et al, 2023).

With ongoing climate change, there is a pressing need to better understand how much water is stored as ground ice in areas with extensive permafrost occurrence, as well as how the regional water balance may alter in response to the potential generation of meltwater from permafrost degradation. However, field-based data on permafrost in remote and mountainous areas such as the South American Andes are scarce. Most current ground ice estimates are based on broadly generalized assumptions such as volume–area scaling and mean ground ice content estimates of rock glaciers. In addition, ground ice contents in permafrost areas outside of rock glaciers are usually not considered, resulting in a significant uncertainty regarding the volume of ground ice in the Andes and its hydrological role. In Part 1 of this contribution, Hilbich et al. (2022a) present an extensive geophysical data set based on electrical resistivity tomography and refraction seismic tomography surveys to detect and quantify ground ice of different landforms and surface types in several study regions in the semi-arid Andes of Chile and Argentina with the aim to contribute to the reduction of this data scarcity. In Part 2 we focus on the development of a strategy for the upscaling of geophysics-based ground ice quantification to an entire catchment to estimate the total ground ice volume (and its approximate water equivalent) in the study areas. In addition to the geophysical data, the upscaling approach is based on a permafrost distribution model and classifications of surface and landform types. In this paper, we introduce our upscaling strategy, and we demonstrate that the estimation of large-scale ground ice volumes can be improved by including (i) non-rock-glacier permafrost occurrences and (ii) field evidence through a large number of geophysical surveys and ground truthing information. The results of our study indicate that (i) conventional ground ice estimates for rock-glacier-dominated catchments without in situ data may significantly overestimate ground ice contents and (ii) substantial volumes of ground ice may also be present in catchments where rock glaciers are lacking.

Zusammenfassung Hintergrund Mammakarzinome, die bei Teilnehmerinnen des Mammografie-Screening-Programms (MSP) detektiert werden, zeigen auch unter Berücksichtigung der Intervallkarzinome eine günstigere Verteilung der klassischen Prognosefaktoren und des Hormon-Rezeptor-Status im Vergleich zu Karzinomen bei Nichtteilnehmerinnen. Mit dieser Studie sollen erstmals bevölkerungsbezogene Aussagen zur Verteilung der intrinsischen Subtypen unter Einbeziehung des Ki-67-Proliferationsindexes für Teilnehmerinnen und Nichtteilnehmerinnen des MSP vorgelegt werden. Ergänzend wird darüber hinaus untersucht, in welchem Ausmaß der Ki-67-Index mit den tumorbiologischen Eigenschaften assoziiert ist. Methodik In der retrospektiven Beobachtungsstudie kommen die bevölkerungsbezogenen Daten des Epidemiologischen Krebsregisters Niedersachsen (EKN) für das Diagnosejahr (DJ) 2014 zur Auswertung. 1115 Mammakarzinome (ICD-10 C50 + D05 ohne D05.0) der 50–69-jährigen Frauen mit Wohnort in den Regionen der Screening-Einheiten Hannover und Niedersachsen-Nordwest (n = 285 634 2-jährlich anspruchsberechtigte Frauen) werden in die Studie einbezogen. Die Gruppe der Teilnehmerinnen umfasst sowohl Screening-Fälle als auch Intervallkarzinome, die bis 24 Monate nach unauffälligem Screening auftraten. Als Tumore der Nichtteilnehmerinnen gelten alle Mammakarzinome, die keiner Screening-Teilnehmerin zugeordnet werden konnten. Ergebnisse Für invasive Tumoren (n = 953) zeigt sich, dass Tumore von Teilnehmerinnen – auch unter Einbeziehung der Intervallkarzinome – im Vergleich zu Nichtteilnehmerinnen häufiger in einem kleineren T-Stadium (T1) und ohne regionäre Lymphknotenmetastasen (N0) befundet werden (jeweils p Diskussion Für Mammakarzinome des Luminal-A-Subtyps kann nach aktuellen Empfehlungen der S3-Leitlinie überwiegend auf eine Chemotherapie verzichtet werden. In der Annahme einer leitliniengerechten Therapie dürfte die Gesamtgruppe der Teilnehmerinnen (inklusive derer mit Intervallkarzinomen) somit deutlich häufiger eine schonendere Therapie erfahren haben als die Gruppe der Nichtteilnehmerinnen. Die Analysen zu Ki-67 weisen für beide Gruppen darauf hin, dass der Proliferationsindex ein Prognosefaktor ist, der jedoch nicht unabhängig ist.

Background Devising contextually adapted and sustainable flexitarian diets that integrate alternative proteins and future foods can support sustainable food systems. Scope and approach In this commentary, we critically evaluate the role of alternative proteins and future foods (i.e., microalgae, insects, fungi, cultured meat, and plant-based meat) with respect to tradeoffs between animal- and plant-sourced foods in future flexitarian diets. We focus on four key sustainability dimensions: environmental impacts, nutrition/health, animal welfare, and antibiotic use. We further explore the differentiated role of meat products (e.g., chicken vs. beef), in addition to production practices that simultaneously increase nutrient contents while decreasing environmental impacts. Finally, we illustrate why and how context-specific conditions, namely, environmental, nutritional/health, access, culture, and knowledge boundaries, should be considered when developing these diets. Key findings and conclusions The role of alternative proteins in sustainable flexitarian diets is highly variable depending on the food item and production method (e.g., feed substrate, processing technology). Furthermore, environmental tradeoffs exist (e.g., low land use but high energy demand) as well as nutritional gaps including a lack of certainty regarding nutritional equivalency claims from future foods when compared to their contemporary counterparts. Moreover, strong uncertainties regarding nutrient absorption (e.g., bioavailability) and activity in the body exist. Animal welfare and antibiotic use concerns have the potential to be strongly mitigated with the introduction of alternative proteins. Finally, more standardized and robust sustainability assessments are needed. Overall, future foods hold promise to support sustainable and contextually-adapted flexitarian diets, but significant work and understanding are still needed. ISSN:0924-2244 ISSN:0968-0020

Black soldier fly larvae (BSFL) are widely used in recycling and upcycling of nutrients in agri-food by-products, but low and inconsistent BSFL rearing performance (i.e. larval growth, bioconversion rate, and substrate reduction) has been identified as a key challenge. The aims of this research were two-fold: (1) validate an existing closed rearing system design; and (2) assess whether a microbial inoculum derived from the rearing residue increases rearing performance. In controlled bench-scale experiments, BSFL were reared on tomato pomace (TP) and white wine pomace (WWP), along with food waste as control substrate. The two aims were assessed based on the following response variables: larval mass, substrate reduction, residue properties (i.e. pH, temperature, moisture content), and larval intestinal and residue microbiota. Higher BSFL mass (by 5.1 mg dry mass) at harvest on WWP and substrate reduction on TP (by 11.7% dry mass) in the closed system compared to the open system confirmed the potential of closed systems for rearing performance improvements of agri-food by-products. The rearing system also affected the residual moisture content and temperature, but only had a small effect on microbiota. Performance improvements by the closed rearing system design may be outweighed by insufficient aeration with pasty substrates and higher operational efforts for aeration and larval separation from the high-moisture residues. In contrast to the rearing system design, addition of the residue-derived microbial inoculum did not result in improved performance, nor did it alter intestinal and residue microbiota. Missing performance improvements could have been due to absent or low numbers of probiotic bacteria. The success of microbial substrate supplementation could be improved by studying effects of larval-associated microbes and developing cultivation methods that selectively amplify the beneficial (yet unknown) members of the microbial community. Our investigations aimed to increase the valorisation of low-value agri-food by-products in BSFL rearing.

Antimicrobial resistance (AMR) threatens the effective prevention and treatment of an ever-increasing range of infections caused by microorganisms. On the other hand, infections caused by Mycobacterium abscessus affect people with chronic lung diseases, and their incidence has grown alarmingly in recent years.

Purpose Despite patient safety initiatives, medical errors remain common and devastating. Disclosing errors is not only ethical, but also promotes restoration of the doctor-patient relationship. However, studies show active avoidance of error disclosure and the need for explicit training. In the South African setting, sparse information exists in terms of undergraduate medical training in error disclosure. To address this knowledge gap, the training of error disclosure in an undergraduate medical programme was examined, against the background of the available literature. The objective was to formulate a strategy to improve error disclosure teaching and practice, with the goal of improving patient care. Methods Firstly, the literature was reviewed regarding the training of medical error disclosure. Secondly, the undergraduate medical training in error disclosure was probed, by looking at the pertinent findings from a broader study on undergraduate communication skills training. The design of the study was descriptive and cross-sectional. Anonymous questionnaires were distributed to all fourth- and fifth-year undergraduate medical students. Data were predominantly analysed quantitatively. Open-ended questions were analysed qualitatively using grounded theory coding. Results Out of 132 fifth-year medical students, 106 participated (response rate 80.3%), while 65 out of 120 fourth-year students participated (response rate 54.2%). Of these participants, 48 fourth-year students (73.9%) and 64 fifth-year students (60.4%) reported infrequent teaching in the disclosure of medical errors. Almost half of the fourth-year students (49.2%) considered themselves novices in error disclosure, while 53.3% of fifth-year students rated their ability as average. According to 37/63 (58.7%) fourth-year students and 51/100 (51.0%) fifth-year students, senior doctors seldom or never modelled patient-centred care in the clinical training setting. These results resonated with the findings of other studies that showed lack of patient-centredness, as well as insufficient training in error disclosure, with resultant low confidence in this skill. Conclusion The study findings confirmed a dire need for more frequent experiential training in the disclosure of medical errors, in undergraduate medical education. Medical educators should view errors as learning opportunities to improve patient care and model error disclosure in the clinical learning environment.

We study effective field theories (EFTs) enjoying (maximal) biform symmetries. These are defined by the presence of a conserved (electric) current that has the symmetries of a Young tableau with two columns of equal length. When these theories also have a topological (magnetic) biform current, its conservation law is anomalous. We go on to show that this mixed anomaly uniquely fixes the two-point function between the electric and magnetic currents. We then perform a K\"all\'en-Lehmann spectral decomposition of the current-current correlator, proving that there is a massless mode in the spectrum, whose masslessness is protected by the anomaly. Furthermore, the anomaly gives rise to a universal form of the EFT whose most relevant term, which resembles the linear Einstein action, dominates the infrared physics. As applications of this general formalism, we study the theories of a Galileon superfluid and linearized gravity. Thus, one can view the masslessness of the graviton as being protected by the anomalous biform symmetries. The associated EFT provides an organizing principle for gravity at low energies in terms of physical symmetries, and allows interactions consistent with linearized diffeomorphism invariance. These theories are not ultraviolet-complete, the relevant symmetries can be viewed as emergent, nor do they include the nonlinearities necessary to make them fully diffeomorphism invariant, so there is no contradiction with the expectation that quantum gravity cannot have any global symmetries., Comment: 82 pages, 1 figure, corrected minor error involving Tr(K), results unchanged

À l’aune du Web 3.0, la zone d’ombre autour des définitions qualifiant les violences en ligne constitue un obstacle à leur bonne compréhension : haine en ligne, discours de haine et cyberharcèlement sont des termes qui peuvent autant se distinguer que se confondre. Ce constat nous a conduites à rencontrer, par le biais d’entretiens semi-directifs et selon un échantillon de cas multiples, quatorze Belges francophones âgés entre 15 et 25 ans (les digital natives) ayant été victimes, auteurs et/ou témoins de discours de haine en ligne, et présentant une diversité au niveau de l’origine ethnique, du genre, et de l’orientation sexuelle. L’objectif poursuivi est de connaître leurs expériences subjectives liées au discours de haine en ligne. Les résultats qualitatifs seront discutés selon le profil autorapporté par notre échantillon et mis au regard de la conduite de cyberharcèlement, mais également de l’usage de violences verbales, qui ressortent des entretiens menés. L’article se clôturera par une réflexion sur la multitude de formes de discours de haine en ligne exprimées par un échantillon de digital native et la nécessité de s’interroger sur les aspects définitoires de ces comportements, notamment afin de développer des politiques de prévention ciblées du discours de haine en ligne.

IntroductionAging influences the morphology of the central nervous system. While several previous studies focused on morphometric changes of the supratentorial parts, investigations on age-related cerebellar changes are rare. The literature concerning the morphological changes in the cerebellum is heterogenous depending (i) on the methods used (cerebellar analysis in the context of a whole brain analysis or specific methods for a cerebellar analysis), (ii) the life span that was investigated, and (iii) the analytic approach (i.e., using linear or non-linear methods).MethodsWe fill this research gap by investigating age-dependent cerebellar changes in the aging process occurring before the age of 70 in healthy participants, using non-linear methods and the spatially unbiased infratentorial template (SUIT) toolbox which is specifically developed to examine the cerebellum. Furthermore, to derive an overview of the possible behavioral correlates, we relate our findings to functional maps of the cerebellum. Twenty-four older participants (mean age 64.42 years, SD ± 4.8) and 25 younger participants (mean age 24.6 years, SD ± 2.14) were scanned using a 3 T-MRI, and the resulting data were processed using a SUIT.ResultsGray matter (GM) volume loss was found in older participants in three clusters in the right cerebellar region, namely crus I/II and lobule VI related to the frontoparietal network, with crus I being functionally related to the default-mode network and lobule VI extending into vermis VIIa related to the ventral-attention-network.DiscussionOur results underline an age-related decline in GM volume in the right cerebellar regions that are functionally predominantly related to non-motor networks and cognitive tasks regions of the cerebellum before the age of 70.

The discovery of the neuronal expression of the serine protease tissue-type plasminogen activator (tPA) has opened new avenues of research, with important implications in the physiopathology of the central nervous system. For example, the interaction of tPA with synaptic receptors (NMDAR, LRP1, Annexin II, and EGFR) and its role in the maturation of BDNF have been reported to influence synaptic plasticity and neuronal survival. However, the mechanisms regulating the neuronal trafficking of tPA are unknown. Here, using high-resolution live cell imaging and a panel of innovative genetic approaches, we first unmasked the dynamic characteristics of the dendritic and axonal trafficking of tPA-containing vesicles under different paradigms of neuronal activation or inhibition. We then report a constitutive exocytosis of tPA- and VAMP2-positive vesicles, dramatically increased in conditions of neuronal activation, with a pattern which was mainly dendritic and thus post-synaptic. We also observed that the synaptic release of tPA led to an increase of the exocytosis of VGlut1 positive vesicles containing glutamate. Finally, we described alterations of the trafficking and exocytosis of neuronal tPA in cultured cortical neurons prepared from tau-22 transgenic mice (a preclinical model of Alzheimer’s disease (AD)). Altogether, these data provide new insights about the neuronal trafficking of tPA, contributing to a better knowledge of the tPA-dependent brain functions and dysfunctions.

In ITER, the metallic first mirrors (FMs) will undergo erosion due to their proximity to the fusion plasma and deposition of materials originated from the first walls (mainly beryllium). In-situ plasma cleaning is a promising technique to conserve the FMs optical properties by means of ion sputtering. In this work, the evolution of the optical properties of single-crystal (Sc) and nanocrystalline (Nc) molybdenum (Mo) and rhodium (Rh) mirrors were investigated up to 100 cycles of consecutive contamination and cleaning. Aluminum oxide (AlO) was used as contaminant to replace the toxic beryllium. The plasma cleaning was carried out using a capacitively coupled argon (Ar) plasma excited by a 60 MHz radio-frequency generator resulting in the formation of a self-bias applied on the mirrors of -280 V. The plasma potential being around 30 V, the Ar ion energy was about 310 eV. The optical properties of the mirrors were assessed using ex-situ reflectivity measurements. Moreover, the surface topography was characterized by means of scanning electron microscopy (SEM), focused ion beam (FIB) and roughness measurements using atomic force microscopy (AFM). ScMo and ScRh mirrors formerly exposed to 80 successful cleaning cycles using aluminum/tungsten (Al/W) deposits and air storage exhibit drastic changes in their optical properties after being subject to cleaning cycles using AlO as contaminant. Additionally, freshly polished ScRh were exposed to identical cleaning cycles. All Sc mirrors exhibited pits induced by the polishing procedure using diamond paste in addition of mounds/wavy patterns. The carbon incorporated during the polishing process was demonstrated to be responsible for the pitting of the surface. The Nc mirrors preserved their initial reflectivities after up to 100 cycles. The surface topography was systematically characterized and an average erosion rate for NcRh mirrors of about 59 nm per cycle has been estimated from FIB cross-sections. The optical properties of the Nc mirrors showed a superiority in the present study in comparison to the Sc materials due to the influence of their polishing

Toute étude portant sur la syntaxe diachronique des états anciens du germanique dans une perspective comparative se heurte à des difficultés philologiques importantes, qui tiennent à la fois à la nature de la documentation dont on dispose et aux particularités des traditions linguistiques, philologiques et éditoriales concernant chacune des langues étudiées. Après un bref état des lieux de la bibliographie, on évoque en premier lieu plusieurs limites de nos sources, qui comprennent notamment les inscriptions runiques pour les états les plus anciens du germanique du Nord et, de façon prépondérante, des traductions des langues classiques pour l’ostique et le westique. On évoque également les problèmes soulevés par l’écart chronologique entre les plus anciens textes ostiques, westiques et nordiques, et la question des contacts éventuels entre les différents états anciens du germanique. On présente enfin quelques problèmes liés aux traditions philologiques, en se concentrant sur deux exemples pour lesquels des avancées récentes sont à signaler : le vieil-islandais et le vieux-haut-allemand. Die Erforschung der diachronen Syntax der älteren germanischen Sprachen aus vergleichender Perspektive stößt auf zahlreiche Schwierigkeiten, die sich aus der Natur der Überlieferung sowie den Besonderheiten der jeweiligen sprachwissenschaftlichen, philologischen und editorischen Traditionen ergeben. Nach einer kurzen Darstellung des Forschungstandes betrachten wir zunächst, inwiefern die nordgermanischen Runeninschriften sowie die ost- und westgermanische Übersetzungsliteratur nur als begrenzte Evidenz für die Erforschung der altgermanischen Syntax gelten. Danach stellen wir die Probleme dar, die sich aus den chronologischen Unterschieden in der Überlieferung der verschiedenen Sprachzweige des Germanischen ergeben, und gehen der Frage nach möglichen Sprachkontakten zwischen verschiedenen altgermanischen Sprachen nach. Abschließend wird auf einige Schwierigkeiten hingewiesen, die sich aus den unterschiedlichen philologischen und editorischen Traditionen ergeben, und zwar anhand von zwei Beispielen, bei denen jüngst Fortschritte zu verzeichnen sind: Altwestnordisch (oder Altisländisch) und Althochdeutsch. Research on diachronic syntax of the older stages of Germanic from a comparative perspective is hampered by serious philological difficulties deriving both from the nature of the documentation available to us and from the specificities of linguistic, philological and editorial traditions concerning each of the languages studied. After a brief literature review, we focus on some of the limitations of our sources, which include Runic inscriptions for the oldest stages of North Germanic and predominantly translations from the Classical languages in East and West Germanic. We also discuss the problems stemming from the chronological gap between the oldest texts transmitted in manuscripts in each of the three branches of Germanic, as well as the question of the possible contacts between different varieties of Germanic. We then present some issues raised by the philological tradition by means of two examples where recent progress has been made: Old Norse Icelandic and Old High German.

Objectives Since January 2019, the Belgian National Reference Center for Mycobacteria (NRC) has switched from conventional typing to prospective whole-genome sequencing (WGS) of all submitted Mycobacterium tuberculosis complex (MTB) isolates. The ISO17025 validated procedure starts with semi-automated extraction and purification of gDNA directly from the submitted MGIT tubes, without preceding subculturing. All samples are then sequenced on an Illumina MiSeq sequencer and analyzed using an in-house developed and validated bioinformatics workflow to determine the species and antimicrobial resistance. In this study, we retrospectively compare results obtained via WGS to conventional phenotypic and genotypic testing, for all Belgian MTB strains analyzed in 2019 (n = 306). Results In all cases, the WGS-based procedure was able to identify correctly the MTB species. Compared to MGIT drug susceptibility testing (DST), the sensitivity and specificity of genetic prediction of resistance to first-line antibiotics were respectively 100 and 99% (rifampicin, RIF), 90.5 and 100% (isoniazid, INH), 100 and 98% (ethambutol, EMB) and 61.1 and 100% (pyrazinamide, PZA). The negative predictive value was above 95% for these four first-line drugs. A positive predictive value of 100% was calculated for INH and PZA, 80% for RIF and 45% for EMB. Conclusions Our study confirms the effectiveness of WGS for the rapid detection of M. tuberculosis complex and its drug resistance profiles for first-line drugs even when working directly on MGIT tubes, and supports the introduction of this test into the routine workflow of laboratories performing tuberculosis diagnosis.

A bedaquiline resistantMycobacterium abscessusisolate was sequenced and a candidate mutation in theatpEgene was identified as responsible for the antibiotic resistance phenotype. To establish a direct genotype-phenotype relationship of this D29A mutation, we developed a recombineering-based method consisting of the specific replacement of the desired mutation in the bacterial chromosome. As surrogate bacteria, we used twoM. abscessusantibiotic susceptible strains: ATCC19977, and the SL541 clinical isolate. The allelic exchange substrates used in recombineering carried either the sole D29A mutation, or a genetic barcode of silent mutations in codons flanking the D29A mutation. After selection of bedaquiline resistantM. abscessuscolonies, transformed with both substrates, we obtained equivalent numbers of recombinants. These resistant colonies were analyzed by allele-specific PCR, and Sanger sequencing, demonstrating that the presence of the genetic barcode is linked to the targeted incorporation of the desired mutation in its chromosomal location. All recombinants displayed the same minimal inhibitory concentration to bedaquiline than the original isolate, from which the D29A mutation was identified. Finally, to demonstrate the broad applicability of this method, we confirmed the association of bedaquiline resistance with theatpEA64P mutation, performed in independentM. abscessusstrains and by independent researchers.

Because AFSs are diverse, dynamic, and evolve continuously, they require massive continuous investment to enable ongoing discovery and adaptation merely to prevent backsliding.

As detailed in Marshall et al. (Quinn Marshall, Jessica Fanzo, Christopher B. Barrett, Andrew D. Jones, Anna Herforth, and Rebecca McLaren, “Building a global food systems typology: A new tool for reducing complexity in food systems analysis,” Frontiers in Sustainable Food Systems, vol. 5 (November 2021): 746512), the food systemstypologies we and the Food Systems Dashboard use were developed using a method that began with a structured scoping review of the existing food systems literature.

Repeated episodes throughout history remind us that AFSs episodically undergo dramatic transformations, most of them purposeful—guided by incentives prevailing at the time—rather than purely random changes. Typically, these changes have taken decades or centuries. A major shock, like the COVID-19 pandemic, may help spark the more rapid transformation that we desperately need. Hence the value of explicitly envisioning AFS transformation to direct the transformative power unleashed by the pandemic towards desired outcomes.

As we look 25–50 years, or more, into the future, we must also keep in mind how very different tomorrow’s world will inevitably look. Three big, inevitable changes stand out, with serious implications for AFS and AVC innovations.

Sustainable Development Goals Series, ISSN:2523-3084, ISSN:2523-3092, ISBN:978-3-030-88801-5, ISBN:978-3-030-88804-6, ISBN:978-3-030-88802-2

A key implication of the abundance of promising technologies in various stages of development is that AFS transformation is less likely to be limited by science-based discovery than by human agency. What key players do in response to the wealth of options they face will ultimately determine the path(s) we follow.