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Abstract Drinking water contaminated by pathogenic micro-organisms increases the risk of infectious gastrointestinal disease which could potentially lead to acute kidney injury and even death, particularly amongst the young and the elderly. Earlier studies have shown a substantial reduction in the incidence of diarrheal disease over a period of one year using a polysulfone membrane water gravity-powered water filtration device. The current report is a continuation of these studies to assess the long-term effects of the innovative method on diarrheal incidence rates over a 4-year follow-up period. This follow-up study monitored the trend of self-reported diarrheal events in all households in the previously studied villages for 5 months, in the last half of each study year, using the same questionnaire utilized in the earlier study. Three villages that had no device yet installed served as controls. We computed monthly diarrheal incidence rates for all study years (standardized to per 100 person-months) and compared these to the pre-device incidence rate in 2018 and in the control group, using the Wilcoxon rank sum exact test. The average diarrheal incidence rates of 1.5 p100pm in 2019, 2.19 p100pm in 2021, and 0.54p100pm in 2022 were significantly different from an earlier study that reported 17.8 p100pm rates before the devices were installed in 2018, (all p-values

We carry out three-dimensional computations of the accretion rate onto an object (of size R _sink and mass m ) as it moves through a uniform medium at a subsonic speed v _∞ . The object is treated as a fully absorbing boundary (e.g., a black hole). In contrast to early conjectures, we show that for an accretor with ${R}_{\mathrm{sink}}\ll {R}_{A}=2{Gm}/{v}_{\infty }^{2}$ in a gaseous medium with adiabatic index γ = 5/3, the accretion rate is independent of Mach number and is determined only by m and the gas entropy. Our numerical simulations are conducted using two different numerical schemes via the Athena++ and Arepo hydrodynamics solvers, which reach nearly identical steady-state solutions. We find that pressure gradients generated by the isentropic compression of the flow near the accretor are sufficient to suspend much of the surrounding gas in a near-hydrostatic equilibrium, just as predicted from the spherical Bondi–Hoyle calculation. Indeed, the accretion rates for steady flow match the Bondi–Hoyle rate, and are indicative of isentropic flow for subsonic motion where no shocks occur. We also find that the accretion drag may be predicted using the Safronov number, Θ = R _A / R _sink , and is much less than the dynamical friction for sufficiently small accretors ( R _sink ≪ R _A ).

Zirconium mononitride (ZrN), among other nitrides, is of interest as a catalyst in general and especially for the electrochemical nitrogen reduction reaction (NRR). Synthesis of nanoparticulate ZrN is challenging due to the formation of undesired other phases and the need for hazardous precursors or high temperatures. The urea glass method (UGM) was used in this work to synthesise nanoparticulate zirconium nitride. A focused parameter variation of the precursor composition and process conditions lead to an optimised synthesis, greatly improving material purity in regard to minor phase and residual carbon content. The nitride starts to form at a pyrolysis temperature of 900 °C, likely by irreversible decomposition of previously‐formed oxynitride, which forms from amorphous ZrO2 and urea during pyrolysis. An increased pyrolysis temperature improves product purity but slightly lowers nitride purity. Calcium admixture slows the urea decomposition, yielding a more phase‐pure product with less residual carbon at low amounts. A classical carbothermal nitridation (CN) was used in comparison to the UGM to synthesise ZrN. This was successful in synthesising zirconium carbonitride Zr(N, C) without minor phase, but significant carbon remains if added overstoichiometrically. Using less carbon and a longer dwelling time yielded ZrN without significant carbide (ZrC) incorporation or residual carbon, but with some minor ZrO2 phase, proving a promising synthesis route. A limited electrochemical investigation of a synthesised ZrN material was carried out to scope the general material behaviour and to qualitatively derive the potential catalytic activity for the NRR. Higher reductive currents in nitrogen‐saturated electrolyte qualitatively point to NRR activity, but further and more in‐depth examination is required. [ABSTRACT FROM AUTHOR]

Infants born to mothers with phenylketonuria (PKU) may develop congenital abnormalities because of elevated phenylalanine (Phe) levels in the mother during pregnancy. Maintenance of blood Phe levels between 120 and 360 μmol/L reduces risks of birth defects. Sapropterin dihydrochloride helps maintain blood Phe control, but there is limited evidence on its risk–benefit ratio when used during pregnancy. Data from the maternal sub‐registries—KAMPER (NCT01016392) and PKUDOS (NCT00778206; PKU‐MOMs sub‐registry)—were collected to assess the long‐term safety and efficacy of sapropterin in pregnant women in a real‐life setting. Pregnancy and infant outcomes, and the safety of sapropterin were assessed. Final data from 79 pregnancies in 57 women with PKU are reported. Sapropterin dose was fairly constant before and during pregnancy, with blood Phe levels maintained in the recommended target range during the majority (82%) of pregnancies. Most pregnancies were carried to term, and the majority of liveborn infants were reported as 'normal' at birth. Few adverse and serious adverse events were considered related to sapropterin, with these occurring in participants with high blood Phe levels. This report represents the largest population of pregnant women with PKU exposed to sapropterin. Results demonstrate that exposure to sapropterin during pregnancy was well‐tolerated and facilitated maintenance of blood Phe levels within the target range, resulting in normal delivery. This critical real‐world data may facilitate physicians and patients to make informed treatment decisions about using sapropterin in pregnant women with PKU and in women of childbearing age with PKU who are responsive to sapropterin. [ABSTRACT FROM AUTHOR]

The first magnetic field in a star other than the Sun was detected in 1947 in the star 78 Vir. Today, we know that about 10% of these intermediate-mass and high-mass stars have strong, large-scale surface magnetic fields whose origin has remained a mystery till today. It has been suggested that merging of main-sequence and pre-main-sequence stars could produce such strong fields. The massive star τ Sco is a well-known member of the group of magnetic stars and is a blue straggler given its apparently young age compared to that of other members of the Upper Scorpius association. Here, we present 3D magnetohydrodynamic simulations of the coalescence of two massive main-sequence stars and 1D stellar evolution computations of the subsequent evolution of the merger product that can explain τ Sco's magnetic field, apparent youth and other observed characteristics. We argue that field amplification in stellar mergers is a general mechanism to form strongly-magnetised massive stars. Such stars are promising progenitors of magnetars, which may give rise to some of the enigmatic fast radio bursts, and their supernova explosions may be affected by the strong magnetic fields. [ABSTRACT FROM AUTHOR]

Fe‐N‐C catalysts are a promising alternative to replace cost‐intensive Pt‐based catalysts in high temperature polymer electrolyte membrane fuel cell (HT‐PEMFC) electrodes. However, the electrode fabrication needs to be adapted for this new class of catalysts. In this study, gas diffusion electrodes (GDEs) are fabricated using a commercial Fe‐N‐C catalyst and different polytetrafluorethylene (PTFE) binder ratios, varying from 10 to 50 wt % in the catalyst layer (CL). The oxygen reduction reaction performance is investigated under HT‐PEMFC conditions (160 °C, conc. H3PO4 electrolyte) in a half‐cell setup. The acidophilic character of the Fe‐N‐C catalyst leads to intrusion of phosphoric acid electrolyte into the CL. The strength of the acid penetration depends on the PTFE content, which is visible via the contact angles. The 10 wt % PTFE GDE is less capable to withdraw product water and electrolyte and results into the lowest half‐cell performance. Higher PTFE contents counterbalance the acid drag into the CL and impede flooding. The power density at around 130 mA mgCatalyst−2 increases by 34 % from 10 to 50 wt % PTFE. [ABSTRACT FROM AUTHOR]

We implement general relativistic hydrodynamics in the moving-mesh code arepo. We also couple a solver for the Einstein field equations employing the conformal flatness approximation. The implementation is validated by evolving isolated static neutron stars using a fixed metric or a dynamical space–time. In both tests, the frequencies of the radial oscillation mode match those of independent calculations. We run the first moving-mesh simulation of a neutron star merger. The simulation includes a scheme to adaptively refine or derefine cells and thereby adjusting the local resolution dynamically. The general dynamics are in agreement with independent smoothed particle hydrodynamics and static-mesh simulations of neutron star mergers. Coarsely comparing, we find that dynamical features like the post-merger double-core structure or the quasi-radial oscillation mode persist on longer time scales, possibly reflecting a low numerical diffusivity of our method. Similarly, the post-merger gravitational wave emission shows the same features as observed in simulations with other codes. In particular, the main frequency of the post-merger phase is found to be in good agreement with independent results for the same binary system, while, in comparison, the amplitude of the post-merger gravitational wave signal falls off slower, i.e. the post-merger oscillations are less damped. The successful implementation of general relativistic hydrodynamics in the moving-mesh arepo code, including a dynamical space–time evolution, provides a fundamentally new tool to simulate general relativistic problems in astrophysics. [ABSTRACT FROM AUTHOR]

Background and objective: Kidney transplant recipients (KTRs) have an increased risk of developing genitourinary cancers, including prostate cancer (PCa), which is expected to become more prevalent due to an aging KTR population. Thus, knowledge of surgical outcomes, including treatment of PCa, within this unique cohort is required. Methods: Data of 62 KTRs undergoing radical prostatectomy (RP) between 2006 and 2023 at nine urologic transplant centers were analyzed. Complications were assessed using the Clavien-Dindo classification. Perioperative outcomes were evaluated, and a follow-up was conducted. Overall survival (OS), biochemical recurrence–free survival (BRFS), and death-censored graft survival were determined via the Kaplan-Meier method and log-rank testing. Key findings and limitations: Overall, 50 open radical retropubic RPs and 12 robot-assisted RPs (RARPs) were included. The intraoperative blood loss was lower after RARP, but operative time was longer. Of the patients, 50% experienced no postoperative complication, and grade ≥3 complications were observed in 14.5%. There was no graft loss related to RP. A histopathologic analysis revealed pN1 in 8.1% and positive surgical margins in 25.8% of the cases. At a median follow-up of 48.5 mo, the median OS was 128 (95% confidence interval [CI] 71.2–184.8) mo, BRFS was 106 (95% CI 55.8; 156.2) mo, and graft survival was 127 (95% CI 66.7–187.3) mo. Limitations include the retrospective design, and variations between groups and centers. Conclusions and clinical implications: Our findings support RP as a feasible and safe treatment option for localized PCa in KTRs with acceptable oncologic outcome. Special care is required in screening and awareness for the risk of understaging. Patient summary: This study analyzed the safety and effectiveness of two prostate cancer surgery methods—open and robot-assisted surgery—in the special group of kidney transplant recipients. Both surgical methods were performed safely with acceptable oncologic outcomes; however, sample size was too small to draw definite conclusions between the two operative methods.

Abstract Background The TIM-HF2 study demonstrated that remote patient management (RPM) in a well-defined heart failure (HF) population reduced the percentage of days lost due to unplanned cardiovascular hospital admissions or all-cause death during 1-year follow-up (hazard ratio 0.80) and all-cause mortality alone (HR 0.70). Higher rates of hospital admissions and mortality have been reported in HF patients with diabetes compared with HF patients without diabetes. Therefore, in a post-hoc analysis of the TIM-HF2 study, we investigated the efficacy of RPM in HF patients with diabetes. Methods TIM-HF2 study was a randomized, controlled, unmasked (concealed randomization), multicentre trial, performed in Germany between August 2013 and May 2018. HF-Patients in NYHA class II/III who had a HF-related hospital admission within the previous 12 months, irrespective of left ventricular ejection fraction, and were randomized to usual care with or without added RPM and followed for 1 year. The primary endpoint was days lost due to unplanned cardiovascular hospitalization or due to death of any cause. This post-hoc analysis included 707 HF patients with diabetes. Results In HF patients with diabetes, RPM reduced the percentage of days lost due to cardiovascular hospitalization or death compared with usual care (HR 0.66, 95% CI 0.48–0.90), and the rate of all-cause mortality alone (HR 0.52, 95% CI 0.32–0.85). RPM was also associated with an improvement in quality of life (mean difference in change in global score of Minnesota Living with Heart Failure Questionnaire score (MLHFQ): − 3.4, 95% CI − 6.2 to − 0.6). Conclusion These results support the use of RPM in HF patients with diabetes. Clinical trial registration ClinicalTrials.gov NCT01878630.

Abstract Due to their exceptional solubility and stability, nanobodies have emerged as powerful building blocks for research tools and therapeutics. However, their generation in llamas is cumbersome and costly. Here, by inserting an engineered llama immunoglobulin heavy chain (IgH) locus into IgH-deficient mice, we generate a transgenic mouse line, which we refer to as ‘LamaMouse’. We demonstrate that LamaMice solely express llama IgH molecules without association to Igκ or λ light chains. Immunization of LamaMice with AAV8, the receptor-binding domain of the SARS-CoV-2 spike protein, IgE, IgG2c, and CLEC9A enabled us to readily select respective target-specific nanobodies using classical hybridoma and phage display technologies, single B cell screening, and direct cloning of the nanobody-repertoire into a mammalian expression vector. Our work shows that the LamaMouse represents a flexible and broadly applicable platform for a facilitated selection of target-specific nanobodies.

BackgroundRemote patient management may improve prognosis in heart failure. Daily review of transmitted data for early recognition of patients at risk requires substantial resources that represent a major barrier to wide implementation. An automated analysis of incoming data for detection of risk for imminent events would allow focusing on patients requiring prompt medical intervention.MethodsWe analysed data of the Telemedical Interventional Management in Heart Failure II (TIM-HF2) randomized trial that were collected during quarterly in-patient visits and daily transmissions from non-invasive monitoring devices. By application of machine learning, we developed and internally validated a risk score for heart failure hospitalisation within seven days following data transmission as estimate of short-term patient risk for adverse heart failure events. Score performance was assessed by the area under the receiver-operating characteristic (ROCAUC) and compared with a conventional algorithm, a heuristic rule set originally applied in the randomized trial.ResultsThe machine learning model significantly outperformed the conventional algorithm (ROCAUC 0.855 vs. 0.727, p

The recently reported compactified hyperboloidal method has found wide use in the numerical computation of quasinormal modes, with implications for fields as diverse as gravitational physics and optics. We extend this intrinsically relativistic method into the non-relativistic domain, demonstrating its use to calculate the quasinormal modes of the Schrödinger equation and solve related bound-state problems. We also describe how to further generalize this method, offering a perspective on the importance of non-relativistic quasinormal modes for the programme of black hole spectroscopy.

Interlobular septa thickening (ILST) is a common and easily recognized feature on computed tomography (CT) images in many lung disorders. ILST thickening can be smooth (most common), nodular, or irregular. Smooth ILST can be seen in pulmonary edema, pulmonary alveolar proteinosis, and lymphangitic spread of tumors. Nodular ILST can be seen in the lymphangitic spread of tumors, sarcoidosis, and silicosis. Irregular ILST is a finding suggestive of interstitial fibrosis, which is a common finding in fibrotic lung diseases, including sarcoidosis and usual interstitial pneumonia. Pulmonary edema and lymphangitic spread of tumors are the commonly encountered causes of ILST. It is important to narrow down the differential diagnosis as much as possible by assessing the appearance and distribution of ILST, as well as other pulmonary and extrapulmonary findings. This review will focus on the CT characterization of the secondary pulmonary lobule and ILST. Various uncommon causes of ILST will be discussed, including infections, interstitial pneumonia, depositional/infiltrative conditions, inhalational disorders, malignancies, congenital/inherited conditions, and iatrogenic causes. Awareness of the imaging appearance and various causes of ILST allows for a systematic approach, which is important for a timely diagnosis. This study highlights the importance of a structured approach to CT scan analysis that considers ILST characteristics, associated findings, and differential diagnostic considerations to facilitate accurate diagnoses.

This paper deals with the question of how the process of digitalisation on the technical basis of the computer can be described in Marxist categories and what consequences are foreseeable as a result. To this end, the first section shows, based on a historical analysis of the emergence of the computer, that this apparatus was invented as an instrument of a division of human mental labour and thus complementary to the division of physical labour. It is therefore necessary to analyse computers and digitalisation in their relation to human beings and human labour. In the second section, the central ideology of digitalisation is elaborated, which is supposed to make the current form of digitalisation appear meaningful for people and society: The anthropomorphisation of the computer, which was said to be increasingly able to think, speak, and learn like humans, to become more and more intelligent, and to be able to do everything better than humans once the technical singularity had been reached. This claim, which has been propagated again and again, is contradicted on various levels. The computer operates on about two dozen simple mathematical, logical, and technical commands and can do nothing but run one programme at a time, developed and entered by programmers on the basis of behavioural or physical data. This sometimes produces amazing results because the computer can work quickly and systematically as well as reliably. But in contrast to humans, it faces the world as a behaviouristic machine that can neither understand meaning nor reflect its own or human behaviour. The computer also ”sees” and ”hears” its environment only on a physical basis and it ”thinks” at best on a statistical basis if the programme tells it to do so. The apparatus can therefore simulate mechanical machines, but in interaction with humans its actions and reactions are, as any machine, not socially oriented, but dependent on whether humans interpret them as meaningful und useful. The third section elaborates on the complementarity of mental and physical divisions of labour. This would be a central theme of a critical Marxism for an analysis of digitalisation today, which understands the previous capitalism from the division of physical labour. Even though there are some theoreticians who have contributed to this, so far there is no comprehensive theory of it. Therefore, section 4 wants to contribute to such a theory by collecting empirical observations in an interpretive way regarding the related questions. In this way, it becomes clear how the division of people's intellectual labour made possible by the computer is being dealt with today: Capitalism is reorganising more and more areas of human life such as mobility, social relations, education, medicine, etc. through the use of the computer. As a result, first and foremost the business fields of the digital economy are expanding. Moreover, capitalism no longer has to limit itself to controlling the field of production but is increasingly intervening in the whole symbolic world of people. Consequently, according to the thesis, we are heading for an expanded capitalism that will increasingly restrict and reduce both democracy and people's self-realisation. Section 5 emphasises once again that a different digitalisation is also possible, one that serves humanity and not capitalism. Further, some summarising and comments are added there.

IntroductionP2X receptors are a family of homo- and heterotrimeric cation channels gated by extracellular ATP. The P2X4 and P2X7 subunits show overlapping expression patterns and have been involved in similar physiological processes, such as pain and inflammation as well as various immune cell functions. While formation of P2X2/P2X3 heterotrimers produces a distinct pharmacological phenotype and has been well established, functional identification of a P2X4/P2X7 heteromer has been difficult and evidence for and against a physical association has been found. Most of this evidence stems, however, from in vitro model systems.MethodsHere, we used a P2X7-EGFP BAC transgenic mouse model as well as P2X4 and P2X7 knock-out mice to re-investigate a P2X4-P2X7 interaction in mouse lung by biochemical and immunohistochemical experiments as well as quantitative expression analysis.ResultsNo detectable amounts of P2X4 could be co-purified from mouse lung via P2X7-EGFP. In agreement with these findings, immuno-histochemical analysis using a P2X7-specific nanobody revealed only limited overlap in the cellular and subcellular localizations of P2X4 and P2X7 in both the native lung tissue and primary cells. Comparison of P2X4 and P2X7 transcript and protein levels in the respective gene-deficient and wild type mice showed no mutual interrelation between their expression levels in whole lungs. However, a significantly reduced P2rx7 expression was found in alveolar macrophages of P2rx4-/- mice.DiscussionIn summary, our detailed analysis of the cellular and subcellular P2X4 and P2X7 localization and expression does not support a physiologically relevant direct association of P2X4 and P2X7 subunits or receptors in vivo.

Abstract Background The pro-inflammatory ATP-gated P2X7 receptor is widely expressed by immune and non-immune cells. Nanobodies targeting P2X7, with potentiating or antagonistic effects, have been developed. Adeno-associated virus (AAV)-mediated gene transfer represents an efficient approach to achieve long-term in vivo expression of selected nanobody-based biologics. This approach (AAVnano) was used to validate the relevance of P2X7 as a target in dextran sodium sulfate (DSS)-induced colitis in mice. Results Mice received an intramuscular injection of AAV vectors coding for potentiating (14D5-dimHLE) or antagonistic (13A7-Fc) nanobody-based biologics targeting P2X7. Long-term modulation of P2X7 activity was evaluated ex vivo from blood samples. Colitis was induced with DSS in mice injected with AAV vectors coding for nanobody-based biologics. Severity of colitis, colon histopathology and expression of chemokines and cytokines were determined to evaluate the impact of P2X7 modulation. A single injection of an AAV vector coding for 13A7-Fc or 14D5-dimHLE efficiently modulated P2X7 function in vivo from day 15 up to day 120 post-injection in a dose-dependent manner. An AAV vector coding for 13A7-Fc significantly ameliorated DSS-induced colitis and significantly reduced immune cell infiltration and expression of chemokines and proinflammatory cytokines in colonic tissue. Conclusions We have demonstrated the validity of AAVnano methodology to modulate P2X7 functions in vivo. Applying this methodological approach to a DSS-induced colitis model, we have shown that P2X7 blockade reduces inflammation and disease severity. Hence, this study confirms the importance of P2X7 as a pharmacological target and suggests the use of nanobody-based biologics as potential therapeutics in inflammatory bowel disease. Graphical Abstract

CDC42 controls intestinal epithelial (IEC) stem cell (IESC) division. How aberrant CDC42 initiates intestinal inflammation or neoplasia is unclear. We utilized models of inflammatory bowel diseases (IBD), colorectal cancer, aging, and IESC injury to determine the loss of intestinal Cdc42 upon inflammation and neoplasia. Intestinal specimens were collected to determine the levels of CDC42 in IBD or colorectal cancer. Cdc42 floxed mice were crossed with Villin-Cre, Villin-CreERT2 and/or Lgr5-eGFP-IRES-CreERT2, or Bmi1-CreERT2 mice to generate Cdc42 deficient mice. Irradiation, colitis, aging, and intestinal organoid were used to evaluate CDC42 upon mucosal inflammation, IESC/progenitor regenerative capacity, and IEC repair. Our studies revealed that increased CDC42 in colorectal cancer correlated with lower survival; in contrast, lower levels of CDC42 were found in the inflamed IBD colon. Colonic Cdc42 depletion significantly reduced Lgr5+ IESCs, increased progenitors' hyperplasia, and induced mucosal inflammation, which led to crypt dysplasia. Colonic Cdc42 depletion markedly enhanced irradiation- or chemical-induced colitis. Depletion or inhibition of Cdc42 reduced colonic Lgr5+ IESC regeneration. In conclusion, depletion of Cdc42 reduces the IESC regeneration and IEC repair, leading to prolonged mucosal inflammation. Constitutive monogenic loss of Cdc42 induces mucosal inflammation, which could result in intestinal neoplasia in the context of aging.

Mergers of neutron stars and black holes are nowadays observed routinely thanks to gravitational-wave astronomy. In the isolated, binary-evolution channel, a common-envelope phase of a red supergiant and a compact object is crucial to sufficiently shrink the orbit and thereby enable a merger via gravitational-wave emission. Here, we use the outcome of three-dimensional hydrodynamic common-envelope simulations of a 9.4 solar mass red supergiant and a 5 solar mass black-hole to explore the further evolution and final fate of the remnant binary. The binary system undergoes another phase of mass transfer during which it is visible as an X-ray binary. We find that the donor star does not explode as an ultra-stripped supernova because of the large remaining envelope mass, but as a Type Ib/c supernova. Supernova kicks are actually required to sufficiently perturb the orbit and thus facilitate a merger within a Hubble time via gravitational-wave emission. [ABSTRACT FROM AUTHOR]

We introduce a diagrammatic multi-scale approach to the Hubbard model based on the interaction-irreducible (multi-boson) vertex of a small cluster embedded in a self-consistent medium. The vertex captures short-range correlations up to the length scale of the cluster, while long-range correlations are recovered from a set of diagrammatic equations for the Hedin three-leg vertex. By virtue of the crossing symmetry, the Fierz decoupling ambiguity of the Hubbard interaction is resolved exactly. Our benchmarks for the half-filled Hubbard model on the square lattice are in very good agreement with numerically exact diagrammatic Monte Carlo simulations.

CD39 is the major enzyme controlling the levels of extracellular adenosine triphosphate (ATP) via the stepwise hydrolysis of ATP to adenosine diphosphate (ADP) and adenosine monophosphate (AMP). As extracellular ATP is a strong promoter of inflammation, monoclonal antibodies (mAbs) blocking CD39 are utilized therapeutically in the field of immune-oncology. Though anti-CD39 mAbs are highly specific for their target, they lack deep penetration into the dense tissue of solid tumors, due to their large size. To overcome this limitation, we generated and characterized nanobodies that targeted and blocked human CD39. From cDNA-immunized alpacas we selected 16 clones from seven nanobody families that bind to two distinct epitopes of human CD39. Among these, clone SB24 inhibited the enzymatic activity of CD39. Of note, SB24 blocked ATP degradation by both soluble and cell surface CD39 as a 15kD monomeric nanobody. Dimerization via fusion to an immunoglobulin Fc portion further increased the blocking potency of SB24 on CD39-transfected HEK cells. Finally, we confirmed the CD39 blocking properties of SB24 on human PBMCs. In summary, SB24 provides a new small biological antagonist of human CD39 with potential application in cancer therapy.

CD8+ T cells are a crucial part of the adaptive immune system, responsible for combating intracellular pathogens and tumor cells. The initial activation of T cells involves the formation of highly dynamic Ca2+ microdomains. Recently, purinergic signaling was shown to be involved in the formation of the initial Ca2+ microdomains in CD4+ T cells. In this study, the role of purinergic cation channels, particularly P2X4 and P2X7, in CD8+ T cell signaling from initial events to downstream responses was investigated, focusing on various aspects of T cell activation, including Ca2+ microdomains, global Ca2+ responses, NFAT-1 translocation, cytokine expression, and proliferation. While Ca2+ microdomain formation was significantly reduced in the first milliseconds to seconds in CD8+ T cells lacking P2X4 and P2X7 channels, global Ca2+ responses over minutes were comparable between wild-type (WT) and knockout cells. However, the onset velocity was reduced in P2X4-deficient cells, and P2X4, as well as P2X7-deficient cells, exhibited a delayed response to reach a certain level of free cytosolic Ca2+ concentration ([Ca2+]i). NFAT-1 translocation, a crucial transcription factor in T cell activation, was also impaired in CD8+ T cells lacking P2X4 and P2X7. In addition, the expression of IFN-γ, a major pro-inflammatory cytokine produced by activated CD8+ T cells, and Nur77, a negative regulator of T cell activation, was significantly reduced 18h post-stimulation in the knockout cells. In line, the proliferation of T cells after 3 days was also impaired in the absence of P2X4 and P2X7 channels. In summary, the study demonstrates that purinergic signaling through P2X4 and P2X7 enhances initial Ca2+ events during CD8+ T cell activation and plays a crucial role in regulating downstream responses, including NFAT-1 translocation, cytokine expression, and proliferation on multiple timescales. These findings suggest that targeting purinergic signaling pathways may offer potential therapeutic interventions.

IntroductionDuring thermogenesis, adipose tissue (AT) becomes more active and enhances oxidative metabolism. The promotion of this process in white AT (WAT) is called “browning” and, together with the brown AT (BAT) activation, is considered as a promising approach to counteract obesity and metabolic diseases. Transient receptor potential cation channel, subfamily M, member 2 (TRPM2), is an ion channel that allows extracellular Ca2+ influx into the cytosol, and is gated by adenosine diphosphate ribose (ADPR), produced from NAD+ degradation. The aim of this study was to investigate the relevance of TRPM2 in the regulation of energy metabolism in BAT, WAT, and liver during thermogenesis.MethodsWild type (WT) and Trpm2-/- mice were exposed to 6°C and BAT, WAT and liver were collected to evaluate mRNA, protein levels and ADPR content. Furthermore, O2 consumption, CO2 production and energy expenditure were measured in these mice upon thermogenic stimulation. Finally, the effect of the pharmacological inhibition of TRPM2 was assessed in primary adipocytes, evaluating the response upon stimulation with the β-adrenergic receptor agonist CL316,243.ResultsTrpm2-/- mice displayed lower expression of browning markers in AT and lower energy expenditure in response to thermogenic stimulus, compared to WT animals. Trpm2 gene overexpression was observed in WAT, BAT and liver upon cold exposure. In addition, ADPR levels and mono/poly-ADPR hydrolases expression were higher in mice exposed to cold, compared to control mice, likely mediating ADPR generation.DiscussionOur data indicate TRPM2 as a fundamental player in BAT activation and WAT browning. TRPM2 agonists may represent new pharmacological strategies to fight obesity.

AimsThe majority of patients with severe aortic stenosis (AS) planned for transcatheter aortic valve implantation (TAVI) are elective outpatients. During the COVID-19 pandemic, the time between the heart team’s decision and TAVI increased due to limited healthcare resources. We therefore implemented telemedical approaches to identify AS patients at risk for clinical deterioration during the waiting time. The purpose of the prospective, randomized, controlled ResKriVer-TAVI study (DRKS00027842) is to investigate whether a digital concept of telemedical interventional management (TIM) in AS patients waiting for TAVI improves the clinical outcomes. In the present article, we report the study protocol of the ResKriVer-TAVI trial.MethodsResKriVer-TAVI will enroll AS patients planned for elective TAVI. Randomization to the TIM group or standard care will be made on the day of the heart team’s decision. TIM will include a daily assessment of weight, blood pressure, a 2-channel electrocardiogram, peripheral capillary oxygen saturation, and a self-rated health status until admission for TAVI. TIM will allow optimization of medical therapy or an earlier admission for TAVI if needed. Standard care will not include any additional support for patients with AS. All patients of the TIM group will receive a rule-based TIM including standard operating procedures when a patient is crossing prespecified values of a vital sign.ResultsThe primary endpoint consists of days lost due to cardiovascular hospitalization and death of any cause within 180 days after the heart team’s decision. Major secondary endpoints include all-cause mortality within 365 days, the number of telemedical interventions, and adherence to TIM. Follow-up visits will be conducted at admission for TAVI as well as 6 and 12 months after the heart team’s decision.ConclusionsResKriVer-TAVI will be the first randomized, controlled trial investigating a telemedical approach before TAVI in patients with AS. We hypothesize that primary and secondary endpoints of AS patients with TIM will be superior to standard care. The study will serve to establish TIM in the clinical routine and to increase the resilience of TAVI centers in situations with limited healthcare resources.