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Stable isotope analysis has been broadly used to study food webs, but often relies on inaccurate assumptions of trophic isotopic discriminations, which could lead to misinterpretation of obtained results. While many taxa exhibit similar trophic discrimination factors (TDFs), crayfish, exhibit omnivorous feeding strategies, yet TDFs are missing. In this study, we determined TDFs and tissue biokinetic parameters of the marbled crayfish Procambarus virginalis as a model species. Moreover, we compared commonly used TDFs and those determined from this study and applied them across species and ecosystems as a first attempt to compare the effect of species-specific TDFs in Bayesian trophic mixing models. Our results revealed differences between the TDFs of different tissues and biokinetic parameters of crayfish. Our result also revealed TDFs differences between crayfish relying mostly on plants versus those relying on an animal diet. We found differences of TDF suitability among species and ecosystems, highlighting the need for specific TDFs for different crayfish species. This study improves our understanding and the need for species-calibrated TDFs for robust statistical analysis of stable isotope data. Our approach is widely applicable across taxa and ecosystems to reduce the bias introduced by using unspecific TDFs in Bayesian mixing models. [ABSTRACT FROM AUTHOR]

Muscle synergy analyses are used to enhance our understanding of motor control. Spatially fixed synergy weights coordinate multiple co-active muscles through activation commands, known as activation coefficients. To gain a more comprehensive understanding of motor learning, it is essential to understand how activation coefficients vary during a learning task and at different levels of movement proficiency. Participants walked on a line, a beam, and learned to walk on a tightrope—tasks that represent different levels of proficiency. Muscle synergies were extracted from electromyography signals across all conditions and the number of synergies was determined by the knee-point of the total variance accounted for (tVAF) curve. The results indicated that the tVAF of one synergy decreased with task proficiency, with the tightrope task resulting in the highest tVAF compared to the line and beam tasks. Furthermore, with increasing proficiency and after a learning process, trial-to-trial similarity increased and temporal overlap of synergy activation coefficients decreased. Consequently, we propose that precise adjustment and refinement of synergy activation coefficients play a pivotal role in motor learning. [ABSTRACT FROM AUTHOR]

Dietary uptake is key for transferring potentially toxic contaminants, such as mercury (Hg) and essential dietary nutrients, such as polyunsaturated fatty acids (PUFA), to consumers at higher trophic levels of aquatic food webs. We evaluated the role of diet sources for Hg bioaccumulation and PUFA retention in fish across lake food webs in seven Swedish lakes and two Chinese reservoirs. Fish total Hg (THg) and methyl-Hg (MeHg) differed greatly between the two countries: the Chinese fish contained less than 300 ng g−1 dry weight (d.w.) THg with less than 50% as MeHg, versus the Swedish fishes which contained approximately 2000 ng g−1 d.w. THg and nearly 100% as MeHg. Fatty acids enrichment of linoleic acids (LIN) were more prevalent in the Chinese fishes regardless of size (p < 0.05). Here we examined food web length, fish growth rates, and fatty acids patterns in relation to the quality of fish as a food source for both Hg and FA. Contrary to the expectation that biodilution of Hg throughout the food chain would explain these differences, a more complex picture emerged with high levels of Hg at the base of the food web in the Chinese reservoirs, a decoupling of fatty acid and Hg bioaccumulation, and a major role for both fish stocking and fish feed. It is hoped that this work will provide a nuanced picture of fish quality as a food source in different ecosystems. [ABSTRACT FROM AUTHOR]

The efficacy of costimulation blockade with CTLA4-Ig (belatacept) in transplantation is limited due to T cell-mediated rejection, which also persists after induction with anti-thymocyte globulin (ATG). Here, we investigate why ATG fails to prevent costimulation blockade-resistant rejection and how this barrier can be overcome. ATG did not prevent graft rejection in a murine heart transplant model of CTLA4-Ig therapy and induced a pro-inflammatory cytokine environment. While ATG improved the balance between regulatory T cells (Treg) and effector T cells in the spleen, it had no such effect within cardiac allografts. Neutralizing IL-6 alleviated graft inflammation, increased intragraft Treg frequencies, and enhanced intragraft IL-10 and Th2-cytokine expression. IL-6 blockade together with ATG allowed CTLA4-Ig therapy to achieve long-term, rejection-free heart allograft survival. This beneficial effect was abolished upon Treg depletion. Combining ATG with IL-6 blockade prevents costimulation blockade-resistant rejection, thereby eliminating a major impediment to clinical use of costimulation blockers in transplantation. The use of CTLA4-Ig fusion proteins in transplantation remains limited due to co-stimulation blockade-resistant rejection (CBRR). In this study, the authors demonstrate that IL-6 blockade reduces CBRR in murine cardiac transplants in the context of T cell-depleting induction regimens and CTLA4-Ig treatment. [ABSTRACT FROM AUTHOR]

A common theory of motor control posits that movement is controlled by muscle synergies. However, the behavior of these synergies during highly complex movements remains largely unexplored. Skateboarding is a hardly researched sport that requires rapid motor control to perform tricks. The objectives of this study were to investigate three key areas: (i) whether motor complexity differs between skateboard tricks, (ii) the inter-participant variability in synergies, and (iii) whether synergies are shared between different tricks. Electromyography data from eight muscles per leg were collected from seven experienced skateboarders performing three different tricks (Ollie, Kickflip, 360°-flip). Synergies were extracted using non-negative matrix factorization. The number of synergies (NoS) was determined using two criteria based on the total variance accounted for (tVAF > 90% and adding an additional synergy does not increase tVAF > 1%). In summary: (i) NoS and tVAF did not significantly differ between tricks, indicating similar motor complexity. (ii) High inter-participant variability exists across participants, potentially caused by the low number of constraints given to perform the tricks. (iii) Shared synergies were observed in every comparison of two tricks. Furthermore, each participant exhibited at least one synergy vector, which corresponds to the fundamental 'jumping' task, that was shared through all three tricks. [ABSTRACT FROM AUTHOR]

Spatial and temporal zooplankton feeding dynamics across the water column of lakes are key for understanding site-specific acquisition of diet sources. During this 6-week lake study, we examined stable carbon (δ13C) and nitrogen (δ15N) isotopes and conducted compound-specific fatty acid (FA) stable isotope analysis (CSIA) of edible seston in the epi-, meta-, and hypolimnion, and zooplankton of Lake Lunz, Austria. We predicted that CSIA of essential FA can discern the foraging grounds of zooplankton more accurately than the commonly used bulk stable isotopes. The δ13C and δ15N values of seston from different lake strata were similar, whereas a dual CSIA approach using stable carbon and hydrogen isotopes of FA (δ13CFA and δ2HFA) provided sufficient isotopic difference in essential FA to discern different lake strata-specific diet sources throughout the study period. We present a CSIA model that suggests strata-specific foraging grounds for different zooplankton groups, indicating higher preference of cladocerans for feeding on epilimnetic diet sources, while calanoid copepods retained more hypolimnetic resources. The CSIA approach thus yields strata-specific information on foraging strategies of different zooplankton taxa and provides more details on the spatial and temporal trophodynamics of planktonic food webs than commonly used bulk stable isotopes. [ABSTRACT FROM AUTHOR]

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Excessive loads at lower limb joints can lead to pain and degenerative diseases. Altering joint loads with muscle coordination retraining might help to treat or prevent clinical symptoms in a non-invasive way. Knowing how much muscle coordination retraining can reduce joint loads and which muscles have the biggest impact on joint loads is crucial for personalized gait retraining. We introduced a simulation framework to quantify the potential of muscle coordination retraining to reduce joint loads for an individuum. Furthermore, the proposed framework enables to pinpoint muscles, which alterations have the highest likelihood to reduce joint loads. Simulations were performed based on three-dimensional motion capture data of five healthy adolescents (femoral torsion 10°–29°, tibial torsion 19°–38°) and five patients with idiopathic torsional deformities at the femur and/or tibia (femoral torsion 18°–52°, tibial torsion 3°–50°). For each participant, a musculoskeletal model was modified to match the femoral and tibial geometry obtained from magnetic resonance images. Each participant's model and the corresponding motion capture data were used as input for a Monte Carlo analysis to investigate how different muscle coordination strategies influence joint loads. OpenSim was used to run 10,000 simulations for each participant. Root-mean-square of muscle forces and peak joint contact forces were compared between simulations. Depending on the participant, altering muscle coordination led to a maximum reduction in hip, knee, patellofemoral and ankle joint loads between 5 and 18%, 4% and 45%, 16% and 36%, and 2% and 6%, respectively. In some but not all participants reducing joint loads at one joint increased joint loads at other joints. The required alteration in muscle forces to achieve a reduction in joint loads showed a large variability between participants. The potential of muscle coordination retraining to reduce joint loads depends on the person's musculoskeletal geometry and gait pattern and therefore showed a large variability between participants, which highlights the usefulness and importance of the proposed framework to personalize gait retraining. [ABSTRACT FROM AUTHOR]

In temperate lakes, eutrophication and warm temperatures can promote cyanobacteria blooms that reduce water quality and impair food-chain support. Although parasitic chytrids of phytoplankton might compete with zooplankton, they also indirectly support zooplankton populations through the “mycoloop”, which helps move energy and essential dietary molecules from inedible phytoplankton to zooplankton. Here, we consider how the mycoloop might fit into the biodiversity–ecosystem functioning (BEF) framework. BEF considers how more diverse communities can benefit ecosystem functions like zooplankton production. Chytrids are themselves part of pelagic food webs and they directly contribute to zooplankton diets through spore production and by increasing host edibility. The additional way that chytrids might support BEF is if they engage in “kill-the-winner” dynamics. In contrast to grazers, which result in “eat-the-edible” dynamics, kill-the-winner dynamics can occur for host-specific infectious diseases that control the abundance of dominant (in this case inedible) hosts and thus limit the competitive exclusion of poorer (in this case edible) competitors. Thus, if phytoplankton diversity provides functions, and chytrids support algal diversity, chytrids could indirectly favour edible phytoplankton. All three mechanisms are linked to diversity and therefore provide some “insurance” for zooplankton production against the impacts of eutrophication and warming. In our perspective piece, we explore evidence for the chytrid insurance hypothesis, identify exceptions and knowledge gaps, and outline future research directions. [ABSTRACT FROM AUTHOR]

Purpose: Accurate methods to determine dermal pharmacokinetics are important to increase the rate of clinical success in topical drug development. We investigated in an in vivo pig model whether the unbound drug concentration in the interstitial fluid as determined by dermal open flow microperfusion (dOFM) is a more reliable measure of dermal exposure compared to dermal biopsies for seven prescription or investigational drugs. In addition, we verified standard dOFM measurement using a recirculation approach and compared dosing frequencies (QD versus BID) and dose strengths (high versus low drug concentrations). Methods: Domestic pigs were topically administered seven different drugs twice daily in two studies. On day 7, drug exposures in the dermis were assessed in two ways: (1) dOFM provided the total and unbound drug concentrations in dermal interstitial fluid, and (2) clean punch biopsies after heat separation provided the total concentrations in the upper and lower dermis. Results: dOFM showed sufficient intra-study precision to distinguish interstitial fluid concentrations between different drugs, dose frequencies and dose strengths, and had good reproducibility between studies. Biopsy concentrations showed much higher and more variable values. Standard dOFM measurements were consistent with values obtained with the recirculation approach. Conclusions: dOFM pig model is a robust and reproducible method to directly determine topical drug concentration in dermal interstitial fluid. Dermal biopsies were a less reliable measure of dermal exposure due to possible contributions from drug bound to tissue and drug associated with skin appendages. [ABSTRACT FROM AUTHOR]

Long-chain polyunsaturated fatty acids (PUFA) are critical for reproduction and thermal adaptation. Year-round variability in the expression of fads2 (fatty acid desaturase 2) in the liver of European perch (Perca fluviatilis) in a boreal lake was tested in relation to individual variation in size, sex, and maturity, together with stable isotopes values as well as fatty acids (FA) content in different tissues and prey items. ARA and DHA primary production was restricted to the summer months, however, perch required larger amounts of these PUFA during winter, as their ARA and DHA muscle content was higher compared to summer. The expression of fads2 in perch liver increased during winter and was higher in mature females. Mature females stored DHA in their gonads already in late summer and autumn, long before the upcoming spring spawning period in May. Lower δ13CDHA values in the gonads in September suggest that these females actively synthesized DHA as part of this reproductive investment. Lower δ13CARA values in the liver of all individuals during winter suggest that perch were synthesizing essential FA to help cope with over-wintering conditions. Perch seem able to modulate its biosynthesis of physiologically required PUFA in situations of stress (fasting or cold temperatures) or in situations of high energetic demand (gonadal development). Biosynthesis of physiologically required PUFA may be an important part of survival and reproduction in aquatic food webs with long cold periods. [ABSTRACT FROM AUTHOR]

Fishponds, despite being globally abundant, have mainly been considered as food production sites and have received little scientific attention in terms of their ecological contributions to the surrounding terrestrial environment. Emergent insects from fishponds may be important contributors of lipids and essential fatty acids to terrestrial ecosystems. In this field study, we investigated nine eutrophic fishponds in Austria from June to September 2020 to examine how Chlorophyll-a concentrations affect the biomass of emergent insect taxa (i.e., quantity of dietary subsidies; n = 108) and their total lipid and long-chain polyunsaturated fatty acid content (LC-PUFA, i.e., quality of dietary subsidies; n = 94). Chironomidae and Chaoboridae were the most abundant emergent insect taxa, followed by Trichoptera, Ephemeroptera, and Odonata. A total of 1068 kg of emergent insect dry mass were exported from these ponds (65.3 hectares). Chironomidae alone exported 103 kg of total lipids and 9.4 kg of omega-3 PUFA. Increasing Chl-a concentrations were associated with decreasing biomass export and a decrease in total lipid and LC-PUFA export via emergent Chironomidae. The PUFA composition of emergent insect taxa differed significantly from dietary algae, suggesting selective PUFA retention by insects. The export of insect biomass from these eutrophic carp ponds was higher than that previously reported from oligotrophic lakes. However, lower biomass and diversity are exported from the fishponds compared to managed ponds. Nonetheless, our data suggest that fishponds provide crucial ecosystem services to terrestrial consumers by contributing essential dietary nutrients to consumer diets via emergent insects. [ABSTRACT FROM AUTHOR]

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Using stable carbon and nitrogen isotope analysis (δ13C and δ15N) to assess trophic interactions in freshwater ecosystems is a well established method, providing insight into ecosystem functioning. However, the spatial and temporal variability of isotope values, driven by environmental fluctuation is poorly understood and can complicate interpretations. We investigated how the temporal variation of stable isotopes in consumers (fish, crayfish and macrozoobenthos) of a canyon-shaped oligotrophic reservoir is associated with environmental factors such as water temperature, transparency, flooded area, and water quality measures. Consumers and their putative food sources were sampled and analyzed for carbon and nitrogen stable isotopes annually, and environmental parameters were measured monthly from 2014 to 2016. Results revealed significant differences in δ13C and δ15N values in each consumer among studied years. Over the years, fish and crayfish expressed differences in δ13C between 3 and 5‰, whereas in zoobenthos differences were 12‰. Variability in δ15N was similar across all consumers (2–4‰). Moreover, results suggest that the flooded area of the reservoir was a major driver of δ13C stable isotope values variation in consumers, while variation in δ15N was not linked to any of the studied environmental factors. Bayesian mixing models further showed significant changes in the origin of detritivorous zoobenthos carbon sources (reversal shift from terrestrial detritus to algae origin) between years with low water level to years with the standard water level. Other species showed only slight differences in food source utilization among years. Our study highlights the importance of environmental factors as sources of variation in consumer's stable isotope values which should be considered especially when studied ecosystem strongly fluctuate in some environmental factor. [ABSTRACT FROM AUTHOR]

This study examined how 7th to 12th grade students' educational aspirations influenced their school engagement and grade point average (GPA) a year later. Using data (n = 4368) from the National Longitudinal Study of Adolescent to Adult Health, this study used propensity score matching to address confounders due to family, parenting, and individual-level background characteristics, allowing for a minimally biased effect of educational aspirations on the academic performances of White, African American, and Hispanic youths. We found that high educational aspirations helped youths to have better school engagement behaviors above and beyond the positive effects of school climate. White and African American youths with high aspirations attained a higher GPA than those with low aspirations. Yet, even with high aspirations boosting GPA, racial/ethnic group differences in GPA scores persisted. Supporting youths to develop and maintain high levels of aspirations would have a positive effect on their academic performances regardless of racial groups. But improving school learning environment would be important in reducing racial differences in academic performances. Highlights: Higher educational aspirations helped youths to have better school engagement behaviors. White and African American youths with higher educational aspirations achieved higher GPA. Positive effects of educational aspirations remained significant after accounting for school climate. [ABSTRACT FROM AUTHOR]

Zusammenfassung: Die Leitlinien des European Resuscitation Council (ERC), die 2021 veröffentlicht wurden, empfehlen eine aktive Temperaturkontrolle zwischen 32 und 36 °C für alle erwachsenen Patient:innen, die nach Wiedererlangen des Spontankreislaufs nach prä- oder innerklinischer Reanimation das Bewusstsein nicht wiedererlangen. Wenige Wochen nach Veröffentlichung der Leitlinien 2021 wurde die TTM2-Studie publiziert, in der kein signifikanter Unterschied im Hinblick auf das Überleben oder das funktionelle Outcome nach sechs Monaten zwischen einer Zieltemperatur von 33 °C und einer Fiebervermeidung nach außerklinischem Herz-Kreislauf-Stillstand festgestellt worden war. Als Antwort auf die zusätzliche Evidenz durch die TTM2-Studie nahm die Advanced Life Support Task Force des International Liaison Committee on Resuscitation (ILCOR) eine Reevaluation der aktuellen Datenlage vor, die in einer überarbeiteten Empfehlung zur Temperaturkontrolle nach Herz-Kreislauf-Stillstand bei Erwachsenen resultierte. Der aktuelle Artikel fasst die aktualisierten Leitlinien zusammen und diskutiert kritische Aspekte der neuen Empfehlungen. [ABSTRACT FROM AUTHOR]

Purpose: The objective of this study was to determine the influence of postanesthesia care unit (PACU) delirium on self-reported cognitive function and perceived health status 3 months after surgery. Methods: This prospective observational cohort study was performed in a PACU at a high-volume prostate cancer center. We used a convenience sample of patients > 60 years undergoing elective radical prostatectomy. Patients with a history of cerebrovascular or neurodegenerative disease were excluded. Fifteen, 30, 45, and 60 following extubation, patients were screened for signs of delirium with the Confusion Assessment Method for the Intensive Care Unit. Three months after surgery self-reported cognitive function was assessed with the Cognitive Failures Questionnaire, and health status was evaluated with the 36-item Short-Form Health Survey (SF-36). Results: Signs of PACU delirium were present in 32.4% (n = 72/222) of patients, and 80.2% (n = 178/222) completed the 3-month follow-up. The presence of PACU delirium signs was not significantly associated with self-reported cognitive failures (B = 0.60, 95% CI: −1.72; 2.92, p = 0.61) or SF-36 physical component scores (B = 0.19, 95% CI: 0.02; 0.36, p = 0.03) or SF-36 mental component scores (B = −0.03, 95% CI: −0.18, 0.11, p = 0.66) 3 months after radical prostatectomy. Conclusions: In a cohort of educated, highly functioning, elderly male patients who were assessed immediately after surgery and at a 3-month follow-up, we found no association between PACU delirium and self-reported cognitive failures or perceived health status, which implies that PACU delirium may be an event of limited duration and impact. Trial registration: The study was registered at ClinicalTrials.gov (Identifier: NCT04168268, Date of registration: November 19, 2019). [ABSTRACT FROM AUTHOR]

Omega-3 long-chain polyunsaturated fatty acids (n-3 LC-PUFA) are key structural lipids and their dietary intake is essential for brain development of virtually all vertebrates. The importance of n-3 LC-PUFA has been demonstrated in clinical and laboratory studies, but little is known about how differences in the availability of n-3 LC-PUFA in natural prey influence brain development of wild consumers. Consumers foraging at the interface of aquatic and terrestrial food webs can differ substantially in their intake of n-3 LC-PUFA, which may lead to differences in brain development, yet this hypothesis remains to be tested. Here we use the previously demonstrated shift towards higher reliance on n-3 LC-PUFA deprived terrestrial prey of native brown trout Salmo trutta living in sympatry with invasive brook trout Salvelinus fontinalis to explore this hypothesis. We found that the content of n-3 LC-PUFA in muscle tissues of brown trout decreased with increasing consumption of n-3 LC-PUFA deprived terrestrial prey. Brain volume was positively related to the content of the n-3 LC-PUFA, docosahexaenoic acid, in muscle tissues of brown trout. Our study thus suggests that increased reliance on diets low in n-3 LC-PUFA, such as terrestrial subsidies, can have a significant negative impact on brain development of wild trout. Our findings provide the first evidence of how brains of wild vertebrate consumers response to scarcity of n-3 LC-PUFA content in natural prey. [ABSTRACT FROM AUTHOR]

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Summary: Background: Septoplasties and septorhinoplasties are very commonly performed surgical procedures in modern aesthetic and functional medicine. Throughout the surgery, close manipulation to the incisive nerves' course is being executed. This retrospective analysis followed up on potential sensitivity disorders of the anterior palate due to nerve damage. Methods: This retrospective review of 2000 patients' charts, who had undergone the procedure of a septoplasty or septorhinoplasty between June 2013 and January 2019 was conducted at the Department of General Otorhinolaryngology, Medical University of Graz. Medical records of all included patients were reviewed with special attention to postoperative numbness of the anterior palate. Results: Among the 2000 included patients, a septoplasty was performed in 48% (n = 955), a septorhinoplasty in 35% (n = 703) and a septoplasty in combination with a functional endoscopic sinus surgery in 17% (n = 342). In total, 86% (n = 1721) showed no complications at all during the follow-up period. In 0.25% (n = 5) a sensitivity disorder of the anterior palate occurred. Of the five cases with a postoperative numbness of the anterior palate four occurred after a septoplasty and the fifth occurred following a septorhinoplasty. Conclusion: At this current time, this is the largest study investigating postoperative numbness of the anterior palate retracing septoplasty or septorhinoplasty. As a result, the currently used techniques for the operations do not pose a risk for the incisive nerve despite close surgical manipulation to the nerves' course. Nevertheless, patients should be informed and educated about the possibility of an occurring sensitivity disorder regarding the anterior palate during informed consent. [ABSTRACT FROM AUTHOR]

The origin and key details of the making of the ~ 30,000 year old Venus from Willendorf remained a secret since its discovery for more than a hundred years. Based on new micro-computed tomography scans with a resolution of 11.5 µm, our analyses can explain the origin as well as the choice of material and particular surface features. It allowed the identification of internal structure properties and a chronological assignment of the Venus oolite to the Mesozoic. Sampling numerous oolite occurrences ranging ~ 2500 km from France to the Ukraine, we found a strikingly close match for grain size distribution near Lake Garda in the Southern Alps (Italy). This might indicate considerable mobility of Gravettian people and long-time transport of artefacts from South to North by modern human groups before the Last Glacial Maximum. [ABSTRACT FROM AUTHOR]

The current guidelines of the European Resuscitation Council recommend targeted temperature management to improve functional neurological outcome in comatose survivors after cardiac arrest. With the pathophysiological background of hypothermia-induced neuroprotection for prevention of hypoxic-ischemic encephalopathy, targeted temperature management is a key measure and represents a central aspect in postresuscitation care. In the 2021 guidelines the application of targeted temperature management in postresuscitation care has been recommended for all rhythms and irrespective of the location of cardiac arrest. Targeted temperature management is advocated for adult patients who remain unresponsive following return of spontaneous circulation (ROSC) after either out-of-hospital cardiac arrest or in-hospital cardiac arrest. The body temperature should be maintained at a constant value between 32 °C and 36 °C for at least 24 h. To avoid rebound hyperthermia, fever following targeted temperature management, defined as a temperature above 37.7 °C, should be prevented and treated for at least 72 h after ROSC in persistently comatose patients. The routine use of prehospital cooling by rapid infusion of large volumes of cold i.v. fluid immediately after ROSC is not recommended. Based on a systematic review of the current literature, this article summarizes the results of randomized trials and new findings on targeted temperature management in comatose adult patients after cardiac arrest. The review has a particular focus on the most recent evidence regarding the optimum range of target temperatures. Furthermore, recent data on preclinical management, different patient populations, the duration of targeted temperature management, cooling methods and rebound hyperthermia are discussed. The impact of targeted temperature management on neurological outcome after cardiac arrest has been a matter of controversy. Despite contradictory results and heterogeneity of study designs, the current evidence supports the relevance and the necessity of strict temperature control in postresuscitation care for neuroprotection and improvement in functional neurological outcomes. [ABSTRACT FROM AUTHOR]

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Deep vein thrombosis (DVT) is a blood clot most commonly found in the leg, which can lead to fatal pulmonary embolism (PE). Compression ultrasound of the legs is the diagnostic gold standard, leading to a definitive diagnosis. However, many patients with possible symptoms are not found to have a DVT, resulting in long referral waiting times for patients and a large clinical burden for specialists. Thus, diagnosis at the point of care by non-specialists is desired. We collect images in a pre-clinical study and investigate a deep learning approach for the automatic interpretation of compression ultrasound images. Our method provides guidance for free-hand ultrasound and aids non-specialists in detecting DVT. We train a deep learning algorithm on ultrasound videos from 255 volunteers and evaluate on a sample size of 53 prospectively enrolled patients from an NHS DVT diagnostic clinic and 30 prospectively enrolled patients from a German DVT clinic. Algorithmic DVT diagnosis performance results in a sensitivity within a 95% CI range of (0.82, 0.94), specificity of (0.70, 0.82), a positive predictive value of (0.65, 0.89), and a negative predictive value of (0.99, 1.00) when compared to the clinical gold standard. To assess the potential benefits of this technology in healthcare we evaluate the entire clinical DVT decision algorithm and provide cost analysis when integrating our approach into diagnostic pathways for DVT. Our approach is estimated to generate a positive net monetary benefit at costs up to £72 to £175 per software-supported examination, assuming a willingness to pay of £20,000/QALY. [ABSTRACT FROM AUTHOR]

Despite the widespread application of point-of-care lateral flow tests, the viscosity dependence of these assay results remains a significant challenge. Here, we employ centrifugal microfluidic flow control through the nitrocellulose membrane of the strip to eliminate the viscosity bias. The key feature is the balancing of the sample flow into the cassette of the lateral flow test with the air flow out of the cassette. A viscosity-independent flow rate of 3.01 ± 0.18 µl/min (±6%) is demonstrated for samples with viscosities ranging from 1.1 mPas to 24 mPas, a factor greater than 20. In a model human IgG lateral flow assay, signal-intensity shifts caused by varying the sample viscosity from 1.1 mPas to 2.3 mPas could be reduced by more than 84%. [ABSTRACT FROM AUTHOR]

Climate change scenarios predict increases in temperature and organic matter supply from land to water, which affect trophic transfer of nutrients and contaminants in aquatic food webs. How essential nutrients, such as polyunsaturated fatty acids (PUFA), and potentially toxic contaminants, such as methylmercury (MeHg), at the base of aquatic food webs will be affected under climate change scenarios, remains unclear. The objective of this outdoor mesocosm study was to examine how increased water temperature and terrestrially-derived dissolved organic matter supply (tDOM; i.e., lake browning), and the interaction of both, will influence MeHg and PUFA in organisms at the base of food webs (i.e. seston; the most edible plankton size for zooplankton) in subalpine lake ecosystems. The interaction of higher temperature and tDOM increased the burden of MeHg in seston (< 40 μm) and larger sized plankton (microplankton; 40–200 μm), while the MeHg content per unit biomass remained stable. However, PUFA decreased in seston, but increased in microplankton, consisting mainly of filamentous algae, which are less readily bioavailable to zooplankton. We revealed elevated dietary exposure to MeHg, yet decreased supply of dietary PUFA to aquatic consumers with increasing temperature and tDOM supply. This experimental study provides evidence that the overall food quality at the base of aquatic food webs deteriorates during ongoing climate change scenarios by increasing the supply of toxic MeHg and lowering the dietary access to essential nutrients of consumers at higher trophic levels. [ABSTRACT FROM AUTHOR]

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3D free-hand ultrasound (3DFUS) is becoming increasingly popular to assist clinical gait analysis because it is cost- and time-efficient and does not expose participants to radiation. The aim of this study was to evaluate its reliability in localizing the anterior superior iliac spine (ASIS) at the pelvis and the hip joint centers (HJC). Additionally, we evaluated its accuracy to get a rough estimation of the potential to use of 3DFUS to segment bony surface. This could offer potential to register medical images to motion capture data in future. To evaluate reliability, a test–retest study was conducted in 16 lean and 19 obese individuals. The locations of the ASIS were determined by manual marker placement (MMP), an instrumented pointer technique (IPT), and with 3DFUS. The HJC location was also determined with 3DFUS. To quantify reliability, intraclass correlation coefficients (ICCs), the standard error of measurement (SEm), among other statistical parameters, were calculated for the identified locations between the test and retest. To assess accuracy, the surface of a human plastic pelvic phantom was segmented with 3DFUS in a distilled water bath in 27 trials and compared to a 3D laser scan of the pelvis. Regarding reliability, the MMP, but especially the IPT showed high reliability in lean (SEm: 2–3 mm) and reduced reliability in obese individuals (SEm: 6–15 mm). Compared to MMP and IPT, 3DFUS presented lower reliability in the lean group (SEm: 2–4 mm vs. 2–8 mm, respectively) but slightly better values in the obese group (SEm: 7–11 mm vs. 6–16 mm, respectively). Correlations between test–retest reliability and torso body fat mass (% of body mass) indicated a moderate to strong relationship for MMP and IPT but only a weak correlation for the 3DFUS approach. The water-bath experiments indicated an acceptable level of 3.5 (1.7) mm of accuracy for 3DFUS in segmenting bone surface. Despite some difficulties with single trials, our data give further rise to the idea that 3DFUS could serve as a promising tool in future to inform marker placement and hip joint center location, especially in groups with higher amount of body fat. [ABSTRACT FROM AUTHOR]

Extreme heat events are natural hazards affecting many regions of the world. This study uses an example of the six largest cities in Austria to demonstrate the potential of urban climate model simulations applied in prediction mode providing detailed information on thermal conditions. For this purpose, the urban climate model MUKLIMO_3 of the German Meteorological Service (DWD) coupled with the hydrostatic numerical weather prediction model, ALARO, is used to simulate the development of the urban heat island (UHI) in Austrian cities for the summer period of 2019 with a horizontal resolution of 100 m. In addition to the evaluation of UHI predicting skills, other relevant variables, such as humidity and wind characteristics on hourly basis, are also analysed in this paper. Model evaluation confirmed that the MUKLIMO_3 microscale model had the capacity to simulate the main thermal spatiotemporal patterns in urban areas; however, a strong dependence on the input data from the mesoscale model was found. Our results showed large benefit in prediction of maximum air temperatures in urban areas, while the relative humidity predictions of MUKLIMO_3 appear to be much less plausible and show large variety of model prediction skills. Urban climate model simulations using real atmospheric conditions can facilitate better quantification and understanding of day-to-day intra-urban variations in microclimate as well as provide a basis for evaluation of the microclimate prediction skills of mesoscale numerical models with urban extensions. [ABSTRACT FROM AUTHOR]

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This correction notice is from the journal Pharmaceutical Research and provides an updated author list for an article titled "Comparative Study of Dermal Pharmacokinetics Between Topical Drugs Using Open Flow Microperfusion in a Pig Model." The original article had an error in the author list, which has now been corrected to match the submitted author list. The correction was due to a production error and not the fault of the authors. The publisher, Springer Nature, remains neutral regarding jurisdictional claims and institutional affiliations. The corrected article can be found online at the provided link. [Extracted from the article]

Data privacy mechanisms are essential for rapidly scaling medical training databases to capture the heterogeneity of patient data distributions toward robust and generalizable machine learning systems. In the current COVID-19 pandemic, a major focus of artificial intelligence (AI) is interpreting chest CT, which can be readily used in the assessment and management of the disease. This paper demonstrates the feasibility of a federated learning method for detecting COVID-19 related CT abnormalities with external validation on patients from a multinational study. We recruited 132 patients from seven multinational different centers, with three internal hospitals from Hong Kong for training and testing, and four external, independent datasets from Mainland China and Germany, for validating model generalizability. We also conducted case studies on longitudinal scans for automated estimation of lesion burden for hospitalized COVID-19 patients. We explore the federated learning algorithms to develop a privacy-preserving AI model for COVID-19 medical image diagnosis with good generalization capability on unseen multinational datasets. Federated learning could provide an effective mechanism during pandemics to rapidly develop clinically useful AI across institutions and countries overcoming the burden of central aggregation of large amounts of sensitive data. [ABSTRACT FROM AUTHOR]

Summary: Background: Donor kidney function is considered a critical determinant of allograft survival after live donor (LD) kidney transplantation, but its independent impact on the evolution of graft function is less well defined. The objective of this study was to dissect the relative contribution of LD kidney function to baseline estimated glomerular filtration rate (eGFR) of recipients and its decline. Methods: In this study 91 LD kidney transplantations performed between 2007 and 2015 were included. The eGFR of donated kidneys (eGFR-dk) was calculated from total LD eGFR (eGFR-dt) based on the results of isotope nephrography. Recipient eGFR (eGFR-r) determined 6‑monthly until 36 months posttransplantation served as dependent variable in mixed linear models estimating changes in baseline allograft function (intercept) and eGFR‑r slope. Models were adjusted either for eGFR-dk or eGFR-dt, in addition to other potential confounders. Results: Overall, unadjusted mean eGFR‑r at baseline (6 months) and its annual decline in allograft function were 56.5 mL/min/1.73 m2 and −0.2 mL/min/1.73 m2, respectively. In multivariate analysis, eGFR-dk impacted on baseline eGFR‑r (0.6 mL/min/1.73 m2 mean estimated increase per unit; P = 0.02) but not on its slope. In the eGFR-dt-adjusted model, a marginal effect was observed for LD age (P = 0.05). Both models identified antibody-mediated rejection (ABMR) as the strongest risk factor of accelerated loss of allograft function (eGFR‑r slope: approximately −6 mL/min/1.73 m2 per year; P ≤ 0.02). Conclusion: Donor-related characteristics, most prominently the function of donated kidneys and LD age, were predictive of eGFR at baseline. The ABMR was identified as the cardinal cause of progressive deterioration of allograft function. [ABSTRACT FROM AUTHOR]

The River Continuum Concept implies that consumers in headwater streams have greater dietary access to terrestrial basal resources, but recent studies have highlighted the dietary importance of high-quality algae. Algae provide consumers with physiologically important omega-3 (n-3) polyunsaturated fatty acids (PUFA), particularly eicosapentaenoic acid (EPA). However, terrestrial plants and most benthic stream algae lack the long-chain (LC) n-3 PUFA docosahexaenoic acid (DHA, 22:6n-3), which is essential for neural development in fish and other vertebrates. We sampled subalpine streams to investigate how the PUFA composition of neural (brain and eyes), muscle, and liver tissues of freshwater fish is related to their potential diets (macroinvertebrates, epilithon, fresh and conditioned terrestrial leaves). The PUFA composition of consumers was more similar to epilithon than to terrestrial leaves. Storage lipids of eyes most closely resembled dietary PUFA (aquatic invertebrates and algae). However, DHA and arachidonic acid (ARA, 20:4n-6) were not directly available in the diet but abundant in organs. This implies that algal PUFA were selectively retained or were produced internally via enzymatic PUFA conversion by aquatic consumers. This field study demonstrates the nutritional importance of algal PUFA for neural organs in aquatic consumers of headwater regions. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of the present study was to develop a numerical workflow for simulating temperature increase in a high-resolution human head and torso model positioned in a whole-body magnetic resonance imaging (MRI) radio-frequency (RF) coil in the presence of a transcranial electric stimulation (tES) setup. Methods: A customized human head and torso model was developed from medical image data. Power deposition and temperature rise (ΔT) were evaluated with the model positioned in a whole-body birdcage RF coil in the presence of a tES setup. Multiphysics modeling at 3T (123.2 MHz) on unstructured meshes was based on RF circuit, 3D electromagnetic, and thermal co-simulations. ΔT was obtained for (1) a set of electrical and thermal properties assigned to the scalp region, (2) a set of electrical properties of the gel used to ensure proper electrical contact between the tES electrodes and the scalp, (3) a set of electrical conductivity values of skin tissue, (4) four gel patch shapes, and (5) three electrode shapes. Results: Significant dependence of power deposition and ΔT on the skin's electrical properties and electrode and gel patch geometries was observed. Differences in maximum ΔT (> 100%) and its location were observed when comparing the results from a model using realistic human tissue properties and one with an external container made of acrylic material. The electrical and thermal properties of the phantom container material also significantly (> 250%) impacted the ΔT results. Conclusion: Simulation results predicted that the electrode and gel geometries, skin electrical conductivity, and position of the temperature sensors have a significant impact on the estimated temperature rise. Therefore, these factors must be considered for reliable assessment of ΔT in subjects undergoing an MRI examination in the presence of a tES setup. [ABSTRACT FROM AUTHOR]

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Introduction: Semi-occluded vocal tract exercises, such as water resistance therapy (WRT), are widely used in voice therapy. However, the potential positive effects of such a therapy on vocal fold oscillation patterns in patients indicating a need for phonomicrosurgery have not yet been explored. The presented study aims to analyze the effect of WRT in patients suffering from vocal fold mass lesions. Materials and methods: Eight participants with vocal fold mass lesions were asked to sustain a phonation on the vowel /i/ at a comfortable loudness and a fundamental frequency of 250 Hz (females) or 125 Hz (males). During phonation the subjects were simultaneously recorded with transnasal high-speed videoendoscopy (HSV, 20.000 fps), electroglottography, and audio signals. These subjects then performed a WRT (phonation in a silicone tube of 30 cm length, 5 cm below the water surface) for 10 min. Repeated measurements of sustained phonation were performed 0, 10, and 30 min after exercising. From the HSV data the glottal area waveform (GAW) was segmented and GAW parameters were computed. Results: During WRT there was an increase of the GAW related open quotient and closing quotient. Immediately after WRT, there was a drop of both values followed by a rise of these parameters up to 30 min after the intervention. Furthermore, there was no correlation between GAW and electroglottographical open quotients. Conclusions: The effects observed after a single session of WRT on participants with vocal fold mass lesions showed a similar pattern to vocal fatigue. [ABSTRACT FROM AUTHOR]

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Growing evidence suggests that global climate change promotes the dominance of mixotrophic algae especially in oligotrophic aquatic ecosystems. While theory predicts that mixotrophy increases trophic transfer efficiency in aquatic food webs, deleterious effects of some mixotrophs on consumers have also been reported. Here, using a widespread mixotrophic algal genus Dinobryon, we aimed to quantify how colonial taxa contribute to secondary production in lakes. We, therefore, studied the dietary effects of Dinobryon divergens on Cladocera (Daphnia longispina) and Copepoda (Eudiaptomus gracilis), representing two main taxonomic and functional groups of zooplankton. In feeding experiments, we showed that Dinobryon was largely grazing resistant and even inhibited the uptake of the high-quality reference food in Daphnia. Eudiaptomus could to some extent compensate with selective feeding, but a negative long-term food quality effect was also evident. Besides, Eudiaptomus was more sensitive to the pure diet of Dinobryon than Daphnia. Low lipid content and high C:P elemental ratio further supported the low nutritional value of the mixotroph. In a stable isotope approach analysing a natural plankton community, we found further evidence that carbon of Dinobryon was not conveyed efficiently to zooplankton. Our results show that the increasing dominance of colonial mixotrophs can result in reduced dietary energy transfer to consumers at higher trophic levels. In a wider perspective, global climate change favours the dominance of some detrimental mixotrophic algae which may constrain pelagic trophic transfer efficiency in oligotrophic systems, similarly to cyanobacteria in eutrophic lakes. [ABSTRACT FROM AUTHOR]

Purpose: To present a modeling workflow for the evaluation of a lead electromagnetic model (LEM) consisting of a transfer function (TF) and a calibration factor. The LEM represents an analytical relationship between the RF response of a lead and the incident electromagnetic field. The study also highlights the importance of including key geometric details of the lead and the electrode when modeling multi-electrode leads. Methods: The electrical and thermal responses of multi-electrode leads with helical and straight wires were investigated using 3D electromagnetic (EM) and thermal co-simulations. The net dissipated power (P) around each lead electrode and the net temperature increase at the electrodes (ΔT) were obtained for a set of incident EM fields with different spatial distributions. A reciprocity approach was used to determine a TF for each electrode based on the results of the computational model. The evaluation of the calibration factors and the TF validation were performed using the linear regression of P versus the LEM predictions. Results: P and ΔT were investigated for four multi-electrode leads and four single-electrode leads containing either helical or straight wires. All electrodes of the multi-electrode lead were found to be points of high power deposition and temperature rise. The LEMs for the individual electrodes varied substantially. A significant dependence of the calibration factors on the surrounding tissue medium was also found. Finally, the model showed that the TF, the calibration factor, P and ΔT for multi-electrode leads differ significantly from those for single-electrode leads. Conclusion: These results highlight the need to evaluate a LEM for each electrode of a multi-electrode lead as well as for each possible surrounding medium. It is also shown that the results derived from simulations based on simplified single-electrode leads can significantly mislead multi-electrode lead analyses. [ABSTRACT FROM AUTHOR]

Background: We examined the influence of periprocedural blood pressure (BP), especially critical BP drops, on 3-month functional outcome in stroke patients undergoing mechanical thrombectomy (MT) under general anaesthesia (GA). Methods: We screened all patients with anterior circulation large vessel occlusion receiving MT under GA at our centre from January 2011 to June 2016 and selected those who had continuous invasive periinterventional BP monitoring. Clinical and radiological data were prospectively collected as part of an ongoing cohort study, monitoring data were extracted from electronic anaesthesia records. We used uni- and multivariable regression to investigate the association of BP values with unfavourable outcome, defined as modified Rankin Scale scores 3–6 3 months post-stroke. Results: 115 patients were included in this study (mean age 65.3 ± 13.0 years, 55.7% male). Periinterventional systolic, diastolic, and mean arterial BP (MAP) values averaged across MT had no effect on outcome. However, single BP drops were related to unfavourable outcome, with absolute MAP drops showing the highest association compared to both systolic and relative BP drops (with reference to pre-interventional values). The BP value with the strongest association with unfavourable outcome was identified as an MAP ever < 60 mmHg (p = 0.01) with a pronounced effect in patients with poor collaterals. An MAP < 60 mmHg remained independently associated with poor functional outcome in multivariable analysis (p < 0.01). Conclusions: For patients undergoing MT under GA, single MAP drops < 60 mmHg are independently related to unfavourable 3-month outcome. Therefore, every effort should be made to prevent periinterventional hypotensive episodes, especially below this threshold. [ABSTRACT FROM AUTHOR]

The Australian lungfish, Neoceratodus forsteri Krefft, 1870, is a threatened species whose long-term persistence is at risk due to land-use intensification, water resource development, and other human pressures. Changes to the hydrology of rivers has the potential to alter the availability of certain high-quality food resources for this species, that may impact recruitment success, and contribute to population declines. This study analysed the fatty acid (FA) composition of lungfish eggs and fin tissues from two locations upstream and downstream of a large dam in the Brisbane River. We tested the hypothesis that river impoundment and flow alteration associated with the dam have altered the dietary composition and the FA composition of important dietary items for N. forsteri which translates to the body tissues and eggs. The contribution of each food source was estimated with mixing models using carbon and nitrogen stable isotopes. The total FA content in lungfish fin and eggs was significantly higher in downstream sites compared to upstream. Few significant differences in FA contents of the nine potential lungfish food sources were found between sites upstream and downstream of the dam. Stable isotope analyses of lungfish fin tissues revealed the most likely food sources were gastropods, bivalves, and crustaceans, however their relative importance differed upstream and downstream of the dam. Collectively, these results indicate that the dam did not negatively affect food quality for lungfish downstream. The most likely mechanism for potential FA deficiency and subsequent impacts on recruitment success in N. forsteri would be due to changes to the availability of high-quality food sources. This study highlights the need for future research to determine whether the low FA contents we observed in lungfish, is a function of broader environmental changes, or if FA contents are naturally low for this sub-tropical species. [ABSTRACT FROM AUTHOR]

Increasing abundance of microplastics (MP) in marine and freshwaters is currently one of the greatest environmental concerns. Since plastics are fairly resistant to chemical decomposition, breakdown and reutilization of MP carbon complexes requires microbial activity. Currently, only a few microbial isolates have been shown to degrade MPs, and direct measurements of the fate of the MP carbon are still lacking. We used compound-specific isotope analysis to track the fate of fully labelled 13C-polyethylene (PE) MP carbon across the aquatic microbial-animal interface. Isotopic values of respired CO2 and membrane lipids showed that MP carbon was partly mineralized and partly used for cell growth. Microbial mineralization and assimilation of PE-MP carbon was most active when inoculated microbes were obtained from highly humic waters, which contain recalcitrant substrate sources. Mixotrophic algae (Cryptomonas sp.) and herbivorous zooplankton (Daphnia magna) used microbial mediated PE-MP carbon in their cell membrane fatty acids. Moreover, heteronanoflagellates and mixotrophic algae sequestered MP carbon for synthesizing essential ω-6 and ω-3 polyunsaturated fatty acids. Thus, this study demonstrates that aquatic micro-organisms can produce, biochemically upgrade, and trophically transfer nutritionally important biomolecules from PE-MP. [ABSTRACT FROM AUTHOR]

Summary: Background: Iron deficiency anemia is common in pregnancy with a prevalence of approximately 16% in Austria; however, international guideline recommendations on screening and subsequent treatment with iron preparations are inconsistent. The aim of this study was to find out how often pregnant women take iron-containing supplements, and who recommended them. As hemoglobin data were available for a sub-group of women, hemoglobin status during pregnancy and associated consumption of iron-containing medications were also recorded. Methods: This cross-sectional study was conducted at the Mother-Child-Booklet service center of the Styrian Health Insurance Fund in Graz, Austria. A questionnaire containing seven questions was developed. Absolute and relative numbers were determined, and corresponding 95% confidence intervals calculated using bootstrapping techniques. Results: A total of 325 women completed the questionnaire, 11% had been diagnosed with anemia before becoming pregnant, 67% reported taking iron-containing compounds. The women reported taking 45 different products but 61% took 1 of 3 different supplements. Overall, 185 (57%) women had not been diagnosed with anemia before becoming pregnant but reported taking an iron-containing supplement and 89% of the women took supplements on the recommendation of their physician. Of the 202 women whose hemoglobin status was assessed, 92% were found not to be anemic. Conclusion: Overall, 67% of pregnant women took iron-containing compounds, irrespective of whether they were deficient in iron. Physicians were generally responsible for advising them to take them. No standardized procedure is available on which to base the decision whether to take iron during pregnancy, even in guidelines. As most guidelines only recommend taking iron supplements in cases of anemia, the high percentage of women taking them in Austria is incomprehensible. [ABSTRACT FROM AUTHOR]

This study examined the effects of an intervention to support parents and promote skill development in newly diagnosed toddlers with ASD. Participants included 50 children with ASD under 3 and their parents who were randomly assigned to participate in a 6-month intervention, Family Implemented TEACCH for Toddlers (FITT) or 6 months of community services as usual. FITT included 90-min in-home sessions (n = 20) and parent group sessions (n = 4). Results revealed significant treatment effects on parent stress and well-being, with families in the FITT group showing decreased stress and improved well-being over time. While no treatment effects were found for global child measures, there were significant treatment effects on social communication skills. [ABSTRACT FROM AUTHOR]

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Background: Cochlear implantation in patients with functional residual low-frequency hearing is performed according to an established hearing-preserving surgical technique in order to cause minimal trauma of inner ear structures. Due to the increasing number of cochlear implants in children, the preservation of residual hearing is becoming increasingly important in this patient collective. Objectives: Short- and mid-term hearing preservation outcome in pediatric patients is investigated. Materials and methods: A group of 9 children (12 ears) between 5 and 12 years of age were examined after hearing-assisted cochlear implantation with respect to the pure tone audiometric thresholds. Retrospectively, short-term hearing preservation (up to 3 months after surgery) was examined. In a subgroup of 5 children, mid-term hearing preservation (7.5 to 16 months after surgery) was also analyzed. The mean values of hearing preserved (HL%) and hearing loss (HL) due to electrode insertion were calculated as measured values. Results: In the whole group, the mean values of the preoperative PTAlow were 29.8 dB and the short-term postoperative PTAlow 42.6 dB. The mean value of the HL% was 73.6%, corresponding to an HL of 9.4 dB. In the subgroup, the mean PTAlow postoperatively was 46.0 dB in the mid-term and the HL% at 80.7% with a HL of 6.6 dB. Conclusions: The results in children are consistent with the results in adults. Electric-acoustic stimulation (EAS) should be used in the treatment of children with existing low-frequency residual hearing, as good residual hearing preservation can also be achieved in children after implantation. [ABSTRACT FROM AUTHOR]