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Abstract Primary cilia are sensory organelles present in many cell types, partaking in various signaling processes. Primary cilia of pancreatic beta cells play pivotal roles in paracrine signaling and their dysfunction is linked to diabetes. Yet, the structural basis for their functions is unclear. We present three-dimensional reconstructions of beta cell primary cilia by electron and expansion microscopy. These cilia are spatially confined within deep ciliary pockets or narrow spaces between cells, lack motility components and display an unstructured axoneme organization. Furthermore, we observe a plethora of beta cell cilia-cilia and cilia-cell interactions with other islet and non-islet cells. Most remarkably, we have identified and characterized axo-ciliary synapses between beta cell cilia and the cholinergic islet innervation. These findings highlight the beta cell cilia’s role in islet connectivity, pointing at their function in integrating islet intrinsic and extrinsic signals and contribute to understanding their significance in health and diabetes.

The trend towards equipping buildings with active space cooling technology is expected to continue, due to the warming climate. In addition, the electrification of mobility and industry, and the massive rollout of photovoltaics, may put Austria’s power grids under stress if adequate mechanisms are not implemented in time. This study investigates the magnitudes of the loads induced by this increasing demand for cooling, together with the relief that passive cooling measures can provide. Data from current climate models, measured real load profiles from households, building stock models, and dynamic building simulations are utilised, alongside stakeholder and expert opinions, to fine-tune the analysis. This article suggests plausible scenarios for the development of the demand for cooling energy in Austria until 2050, and analyses the aggregated effect of the different options for cooling on the electricity power grid. The integration of cooling loads is expected to cause overloads or voltage violations only for a few types of grid within the periods investigated here. Subsidy programs in the building sector often do not properly consider cooling demand. Building regulations and subsidies should therefore focus on passive measures, and only when these are not sufficient should measures related to active cooling be implemented.

This paper aims to explain potential psychological effects of algorithmic management (AM) on human-centered task design and with that also workers’ mental well-being. For this, we link research on algorithmic management (AM) with Sociomaterial System Theory and Action Regulation Theory (ART). Our main assumption is that psychological effects of sociomaterial systems, such as AM, can be explained by their impact on human action. From the synthesis of the theories, mixed effects on human-centered task design can be derived: It can be expected that AM contributes to fewer action regulation opportunities (i.e., job resources like job autonomy, transparency, predictability), and to lower intellectual demands (i.e., challenge demands like task complexity, problem solving). Moreover, it can be concluded that AM is related with more regulation problems (i.e., hindrance demands like overtaxing regulations) but also fewer regulation problems (like regulation obstacles, uncertainty). Based on these considerations and in line with the majority of current research, it can be assumed that the use of AM is indirectly associated with higher risks to workers’ mental well-being. However, we also identify potential positive effects of AM as some stressful and demotivating obstacles at work are often mitigated. Based on these considerations, the main question of future research is not whether AM is good or bad for workers, but rather how work under AM can be designed to be humane. Our proposed model can guide and support researchers and practitioners in improving the understanding of the next generation of AM systems.

Staff shortages are a global problem in the nursing profession. Negative beliefs about older workers may have detrimental effects on the development and performance capacity of an aging workforce. To date, little is known about the impact of age stereotypes and potential factors on nurses’ intent to leave (ITL). Therefore, the aim of our study was to assess intention to leave and potential predictors (eg, sociodemographic characteristics and age stereotypes) in a large representative sample of nurses in a German university hospital setting. A total of 423 nurses at the University Hospital of Heidelberg participated in a cross-sectional questionnaire study assessing sociodemographic data, age stereotypes using the “Beliefs About Older Workers” questionnaire, and participants’ intentions to leave and give up their profession. Questionnaires were returned by 423 nurses (13.7% response rate). The results revealed that negative age stereotypes were highly prevalent. Significant correlations between age and negative age stereotypes were found, indicating that the younger the nurses were, the more negative their age stereotypes were. Most nurses with negative age stereotypes had no intention to leave their profession; however, the majority of nurses could not imagine working in the profession until they retired. Despite the low response rate, the results of the current study suggest that organizational and societal measures to reduce age stereotypes should be directed at newcomers and young nurses to retain them in the profession in the long term.

The torsional stiffness of I-beams with sinusoidal corrugated web is higher than that of flat web beams and the accuracy of the available hand-calculation methods to determine the elastic critical lateral-torsional buckling moment depends on the geometrical parameters of the beam and the web corrugation. This study proposes different machine learning models to determine the elastic lateral-torsional buckling moments of corrugated web beams. Various machine-learning algorithms such as Decision Tree, Random Forests, Gradient Boosting, Support Vector Regression, Catboost, and Deep Neural Network were employed to develop and train for predicting the elastic-critical lateral-torsional buckling moments of I-beams with corrugated web. An extensive dataset with 2250 pieces was constructed using linear buckling analyses on full-shell finite element models to determine the elastic-critical buckling moment of simply supported beams with sinusoidal web corrugation. Based on the statistical parameters of the predicted and test data, the accuracy and safety assessment of the different machine learning models are examined. The accuracy of the available hand-calculation methods is also investigated. The results of the parametric study showed that the overall performance of the different machine learning models is promising, although, not all are directly suited for the described problem.

Abstract Prognostic factors for overall survival (OS), percutaneous endoscopic gastrostomy (PEG) dependency, and long-term speech rehabilitation via voice prosthesis (VP) after laryngectomy for laryngeal or hypopharyngeal cancer were investigated in a retrospective population-based study in Thuringia, Germany. A total of 617 patients (68.7% larynx; hypopharynx; 31.3%; 93.7% men; median age 62 years; 66.0% stage IV) from 2001 to 2020 were included. Kaplan–Meier and Cox multivariable regression analyses were performed. 23.7% of patients received a PEG. 74.7% received a VP. Median OS was 131 months. Independent factors for lower OS were stage IV (compared to stage II; hazard ratio [HR] = 3.455; confidence interval [CI] 1.395–8.556) and laryngectomy for a recurrent disease (HR = 1.550; CI 1.078–2.228). Median time to PEG removal was 7 months. Prior partial surgery before laryngectomy showed a tendency for independent association for later PEG removal (HR = 1.959; CI 0.921–4.167). Postoperative aspiration needing treatment was an independent risk factor (HR = 2.679; CI 1.001–7.167) for later definitive VP removal. Laryngectomy continuously plays an important role in a curative daily routine treatment setting of advanced laryngeal or hypopharyngeal cancer in Germany. Long-term dependency on nutrition via PEG is an important issue, whereas use of VP is a stable long-term measure for voice rehabilitation.

A new osmiine bee species, Hoplitis (Hoplitis) onosmaevae sp. nov. (Megachilidae), is described. So far, this species is exclusively known from the Mercantour National Park in the southwestern French Alps and from mountainous ranges in Turkey and northern Iraq, two areas separated by at least 2000 km. Phylogenetic analyses based on mitochondrial and nuclear genes revealed that H. onosmaevae is closely related to H. adunca (Panzer, 1798), H. benoisti (Alfken, 1935) and H. manicata (Morice, 1901). Hoplitis onosmaevae is presumably narrowly oligolectic and harvests pollen only on flowers of Onosma L. (Boraginaceae). It has a particularly long proboscis, which is probably an adaptation to collect nectar from the long-tubed flowers of this plant genus. The females collect pollen by buzzing the Onosma flowers, a rare behavior in megachilid bees. The species nests in insect burrows in dead wood, similar to H. adunca and H. manicata but unlike other closely related representatives of the subgenus Hoplitis, suggesting a single origin of nesting in dead wood and hollow stems in this lineage. In France, H. onosmaevae inhabits alpine steppe-like habitats close to forests and appears to be extremely local, since only two populations are currently known. The conservation status of this extremely rare bee species in Europe is discussed.

High vertical ground reaction forces (VGRF) during landings following acrobatic elements in artistic gymnastics is associated with trunk and lower extremity injury risk. As similar data regarding injury risk factors in cheerleading are scarce, the purpose of this study was to assess VGRF in pop-off dismounts of rested and fatigued flyers in cheerleaders. Fifteen German cheerleaders were recruited for this study, including seven female flyers and eight male bases. It was expected that performance would change in fatiguing athletes, potentially increasing the risk for injuries. However, neither the mean VGRF (rested: 6.0±1.9 BW, fatigued: 6.2±1.3 BW, overall range: 2.1–14.9 BW) nor the individual VGRF-time courses of the flyers changed significantly after the workout. Instead, we show that the flyers’ ability to land – but not the bases’ ability to catch – significantly influences the maximum and time-resolved impacts.

We present a novel small molecule antiviral chemotype that was identified by an unconventional cell-free protein synthesis and assembly-based phenotypic screen for modulation of viral capsid assembly. Activity of PAV-431, a representative compound from the series, has been validated against infectious viruses in multiple cell culture models for all six families of viruses causing most respiratory diseases in humans. In animals, this chemotype has been demonstrated efficacious for porcine epidemic diarrhoea virus (a coronavirus) and respiratory syncytial virus (a paramyxovirus). PAV-431 is shown to bind to the protein 14-3-3, a known allosteric modulator. However, it only appears to target the small subset of 14-3-3 which is present in a dynamic multi-protein complex whose components include proteins implicated in viral life cycles and in innate immunity. The composition of this target multi-protein complex appears to be modified upon viral infection and largely restored by PAV-431 treatment. An advanced analog, PAV-104, is shown to be selective for the virally modified target, thereby avoiding host toxicity. Our findings suggest a new paradigm for understanding, and drugging, the host–virus interface, which leads to a new clinical therapeutic strategy for treatment of respiratory viral disease.

ALDH1A3 is a marker for mesenchymal glioblastomas characterized by a greater degree of aggressiveness compared to other major subtypes. ADH1A3 has been implicated in the regulation of stemness and radioresistance mediated by glioblastoma stem cells. Mechanisms by which ALDH1A3 promotes malignant progression of glioblastoma remain elusive posing a challenge for rationalization of ALDH1A3 targeting in glioblastoma, and it is also unclear how ALDH1A3 regulates glioblastoma cells stemness. Usage of different models with diverse genetic backgrounds and often unknown degree of stemness is one possible reason for discrepant views on the role of ALDH1A3 in glioblastoma stem cells. This study clarifies ALDH1A3 impacts on glioblastoma stem cells by modelling ALDH1A3 expression in an otherwise invariable genetic background with consideration of the impacts of inherent plasticity and proliferative changes associated with transitions between cell states. Our main finding is that ALDH1A3 exerts cell-state dependent impact on proliferation of glioblastoma stem cells. We provide evidence that ALDH1A3 augments radiation-induced inhibition of self-renewal and promotes the proliferation of differentiated GSC progenies. Congruent effects ALDH1A3 and radiation on self-renewal and proliferation provides a framework for promoting glioblastoma growth under radiation treatment.

IntroductionIn recent years advances have been made in the microsurgical treatment of congenital or acquired central lymphatic lesions. While acquired lesions can result from any surgery or trauma of the central lymphatic system, congenital lymphatic lesions can have a variety of manifestations, ranging from singular thoracic duct abnormalities to complex multifocal malformations. Both conditions may cause recurrent chylous effusions and downstream lymphatic congestion depending on the anatomical location of the thoracic duct lesion and are associated with an increased mortality due to the permanent loss of protein and fluid.MethodsWe present a case series of eleven patients undergoing central lymphatic reconstruction, consisting of one patient with a cervical iatrogenic thoracic duct lesion and eleven patients with different congenital thoracic duct lesions or thrombotic occlusions.ResultsAnastomosis of the thoracic duct and a nearby vein was performed on different anatomical levels depending on the underlying central lymphatic pathology. Cervical (n = 4), thoracic (n = 1) or abdominal access (n = 5) was used for central lymphatic reconstruction with promising results. In 9 patients a postoperative benefit with varying degrees of symptom regression was reported.ConclusionThe presented case series illustrates the current rapid advances in the field of central microsurgical reconstruction of lymphatic lesions alongside the relevant literature.

Summary: Insulin is packaged into secretory granules that depart the Golgi and undergo a maturation process that involves changes in the protein and lipid composition of the granules. Here, we show that insulin secretory granules form physical contacts with the endoplasmic reticulum and that the lipid exchange protein oxysterol-binding protein (OSBP) is recruited to these sites in a Ca2+-dependent manner. OSBP binding to insulin granules is positively regulated by phosphatidylinositol-4 (PI4)-kinases and negatively regulated by the PI4 phosphate (PI(4)P) phosphatase Sac2. Loss of Sac2 results in excess accumulation of cholesterol on insulin granules that is normalized when OSBP expression is reduced, and both acute inhibition and small interfering RNA (siRNA)-mediated knockdown of OSBP suppress glucose-stimulated insulin secretion without affecting insulin production or intracellular Ca2+ signaling. In conclusion, we show that lipid exchange at endoplasmic reticulum (ER)-granule contact sites is involved in the exocytic process and propose that these contacts act as reaction centers with multimodal functions during insulin granule maturation.

The presented data is based on investigations carried out in the framework of the European RFCS (Research Fund for Coal and Steel) funded project HOLLOSSTAB (2016-2019). The campaign's overall goal is presented in more detail in [1] and [2]. The experiments were performed in the Structural Laboratory at the Bundeswehr University Munich to investigate the cross-section behavior of cold-formed square and rectangular hollow sections (SHS and RHS). Two grades of mild and high-strength steel (S355 and S500) and seven section sizes were examined. The profiles cover all four cross-section classes according to EN1993-1-1 [3]. Monotonic stub column, short beam, and long-beam column tests were performed to investigate the load-bearing capacity. The outputs were load-deformation curves for each specimen. The experimental tests were accomplished by digital image correlation (DIC) to obtain an overview of the full deformation field in the specimens. Recalculations with advanced FE-shell simulations, based on scanned specimen geometries (spatial 3D point clouds) and nonlinear material models obtained from tensile coupon tests, were modeled to reproduce the real behavior obtained during the tests.

We present a checklist of the Swiss bees and provide information on the distribution of every bee species in all 26 Swiss cantons. 632 species are reported, including the European honeybee Apis mellifera Linnaeus, 1758 and the exotic species Megachile sculpturalis Smith, 1853. Species richness in each canton was correlated with the canton area, with the four largest cantons hosting the highest number of species. Bee diversity hotspots were located in some Alpine inner valleys characterized by a dry and warm climate due to the rain shadow effects of surrounding mountains. These hotspots are mostly located in the steppe-like habitats of the Valais and Graubünden cantons. They host diverse wild bee communities which include a unique assemblage of submediterranean faunal elements and subalpine species. In addition, these habitats host rare species with strongly disjunct distributions in Europe, further stressing the conservation priority of these habitats for wild bee conservation. Intensive faunistic surveys performed in the last 20 years have revealed that about 20 bee species, either previously unknown for Switzerland or which had disappeared from the country for several decades, have colonised areas close to the borders of France and Italy. Most of these new or reappeared species were observed in the warmest area of the country and presumably colonized or recolonized the country from neighbouring regions following global warming. Lastly, DNA barcodes are presented for 394 specimens, including for many species so far not represented in the BOLD database. The taxonomic status of numerous unclear taxa is briefly discussed based on combined genetic and morphological analyses.

Abstract Aquaculture solid waste (ASW) is a nutrient rich material that can pose a significant environment challenge if not properly managed. This study investigated the potential of black soldier fly (BSF) larvae in converting this waste into biomass. Five substrates comprising chicken feed supplemented with varying proportions of fresh ASW (0%, 25%, 50%, 75%, 100%) were formulated and evaluated for larval growth and waste bioconversion efficiency. High nutrients retention (N: 23.25 ± 1.40%; C: 21.94 ± 0.99%; S: 12.20 ± 1.33%) and feed conversion ratio (1.78 ± 0.08) were detected on substrate 100ASW, although the limited feeding rate (114.54 ± 5.38 mg dry substrate/larvae) and the high amount of indigestible fibres (ADF = 15.87 ± 0.24%; ADL = 6.36 ± 0.17%) were translated to low larval growth (final larval average weight: 66.17 ± 1.81 mg). Decreasing ASW content resulted in reduced fibres and ash, increase in non-fibrous carbohydrates and C/N ratio, and improved larval growth and substrate utilization. However, high larval metabolic activity suggested higher nutrients loss to the environment. Substrate 75ASW demonstrated the best performances in terms of larval production (final larval average weight: 176.30 ± 12.12 mg), waste reduction (substrate reduction corrected by percentage of ASW: 26.76 ± 0.86%) and nutrients assimilation (N: 22.14 ± 1.14%; C: 15.29 ± 0.82%; S: 15.40 ± 0.99%). This substrate closely aligned with optimal BSF rearing substrates reported in literature. Overall, this study highlights the potential of BSF larvae in managing fresh ASW, offering a dual benefit of waste reduction and insect biomass production.

Abstract Many bioactive plant compounds, known as phytochemicals, have the potential to improve health. Unfortunately, the bioavailability and bioactivity of phytochemicals such as polyphenolic flavonoids are reduced due to conjugation with sugar moieties. Here, we combine acid hydrolysis and tailored fermentation by lactic acid bacteria (Lactiplantibacillus plantarum) to convert the biologically less active flavonoid glycosides hesperidin and naringin into the more active aglycones hesperetin and naringenin. Using a comprehensive approach, we identify the most effective hydrolysis and fermentation conditions to increase the concentration of the aglycones in citrus extracts. The higher cellular transport and bioactivity of the biotransformed citrus extract are also demonstrated in vitro and in vivo. Superior antioxidant, anti-inflammatory and cell migration activities in vitro, as well as intestinal barrier protecting and antioxidant activities in Drosophila melanogaster are identified. In conclusion, the presented biotransformation approach improves the bioactivity of flavonoids, clearly traced back to the increase in aglycone content.

Two nests of Hoplitis curvipes are described from Apulia (Italy) and Dagestan (Russia). Both nests consisted of two brood cells placed side by side under a stone. The cells were neither attached to each other nor to the substrate. They were constructed from leaf fragments, which were imbricately arranged, forming a cone-like structure; each leaf fragment consisted of a basal part that was masticated to leaf pulp and an apical part that protruded freely from the cell wall. The cell wall was formed by the fusion of the masticated basal parts of the leaf fragments and thus entirely consisted of leaf pulp. The cell was sealed with a closing plug made of pure leaf pulp; a few leaf fragments were glued to its outer surface. The cocoon consisted of two layers: the outer layer was restricted to the anterior portion of the cell and had several longitudinal air-exchange slits on its lateral surface, while the inner layer had an air-exchange orifice in its most anterior dome-shaped top. Results of measurements of brood cell dimensions and contents are provided. The nesting biology of species of the H. curvipes group is discussed.

Hoplitis astragali sp. nov., a member of the H. monstrabilis species group, and H. dagestanica sp. nov., a member of the H. adunca species group, are described. The former species is known from Dagestan in Russia, Azerbaijan, and Turkmenistan, the latter only from Dagestan. Nests of H. astragali are described. Females of this species excavated burrows in a vertical clay cliff, but sometimes chose a horizontal surface for nest excavation, particularly at the entrance of old burrows of Xylocopa olivieri (Apidae). The nest burrows of H. astragali were either sub-vertical or sub-horizontal. The nests were composed of one to three brood cells, an empty vestibule in front of the outermost cell, and a closing plug at the nest entrance made of moistened mud. The inner surface of the cells was covered with a thin wall composed of compact soil, most probably built by the female bee after cell excavation. The pollen loaf was very liquid and had a spherical shape. The egg was deposited on its top. The cocoon consisted of a single thin layer, which uniformly covered the whole inner surface of the cell. There was one generation per year. The prepupae hibernated. Sapyga caucasica (Sapygidae) was recorded in the nests as a kleptoparasite. Both females and males of H. astragali exclusively visited flowers of two species of the genus Astragalus (Fabaceae).

Abstract Background The eye care workforce, particularly in lower resource settings, face challenges of limited integration into the health system, limited workforce capacity, mismatch of workforce to population need and poor quality of care. In recognition of these challenges, coupled with a gap in existing tools, provides a strong rationale for the development of the Eye care competency framework (ECCF). Methods A mixed methods approach was utilised to develop and validate the ECCF. Content was developed by extracting relevant components of existing frameworks used both within and outside of eye care. A diverse technical working group provided feedback and guidance on the structure, design, and content to create a preliminary draft. Competencies and activities were validated using a modified-Delphi study, and the framework was then piloted at four sites to understand how the tool can be implemented in different settings. Results The final version of the ECCF included eight outcomes, nine guiding principles, and content of each of the key elements, including the six domains, 22 competencies, 21 activities, 193 behaviours and 234 tasks, and the knowledge and skills that underpin them. 95/112 participants from the six WHO regions completed the modified-Delphi study, yielding an average of 96% agreement across the competencies and activities in the ECCF. The pilot showcased the versatility and flexibility of the ECCF, where each of the four sites had a different experience in implementing the ECCF. All sites found that the ECCF enabled them to identify gaps within their current workforce documentation. Conclusions The ECCF was developed using a collaborative approach, reflecting the opinions of participants and stakeholders from all around the world. The comprehensive competencies and activities developed in the ECCF encompass the diverse roles of eye care workers, and thus encourage multi-disciplinary care and better integration into the health system. It is recommended that eye care workforce planners and developers use the ECCF, and adapt it to their context, to support workforce development and focus on the quality and scope of eye care service provision.

Abstract Objective Hospitals are frequently associated with poor working conditions that can lead to work stress and increase the risk for reduced employee well-being. Managers can shape and improve working conditions and thereby, the health of their teams. Thus, as a prerequisite, managers need to be aware of their employees’ stress levels. This study had two objectives: At first, it aimed to test the criterion validity of the Effort-Reward Imbalance (ERI) questionnaire measuring psychosocial workload in hospital employees. Secondly, mean scales of the ERI questionnaire filled in by employees were compared with mean scales of an adapted ERI questionnaire, in which managers assessed working conditions of their employees. Methods Managers (n = 141) from three hospitals located in Germany assessed working conditions of their employees with an adapted external, other-oriented questionnaire. Employees (n = 197) of the mentioned hospitals completed the short version of the ERI questionnaire to assess their working conditions. Confirmatory factor analyses (CFA) were applied to test factorial validity, using the ERI scales for the two study groups. Criterion validity was assessed with multiple linear regression analysis of associations between ERI scales and well-being among employees. Results The questionnaires demonstrated acceptable psychometric properties in terms of internal consistency of scales, although some indices of model fit resulting from CFA were of borderline significance. Concerning the first objective, effort, reward, and the ratio of effort-reward imbalance were significantly associated with well-being of employees. With regard to the second objective, first tentative findings showed that managers’ ratings of their employees’ effort at work was quite accurate, whereas their reward was overestimated. Conclusions With its documented criterion validity the ERI questionnaire can be used as a screening tool of workload among hospital employees. Moreover, in the context of work-related health promotion, managers’ perceptions of their employees’ workload deserve increased attention as first findings point to some discrepancies between their perceptions and those provided by employees.

A male preterm infant with total anomalous pulmonary venous connection developed progressive respiratory distress but was considered too high risk for surgical repair because of his critical condition. We demonstrated that percutaneous transhepatic stent implantation for portosystemic shunt creation is a feasible bridging procedure when surgery is not possible.

(Series Information) European Papers - A Journal on Law and Integration, 2023 8(1), 99-115 | European Forum Insight of 24 May 2023 | (Abstract) The paper addresses the question whether there exists a specific “Austrian” community of EU law scholars. This forms part of the broader question whether there exists a peculiar German or German-speaking community of EU law scholars (to which the current issue is devoted). To this end, the paper examines three fields – the impact of the legal positivist tradition in the Kelsenian style on EU law re-search in Austria, the constitutional framework for the Austrian participation in the EU as well as empir-ical factors specific to Austrian EU law academia and practice – and concludes that one may well make a case for the existence of a genuinely “Austrian” community of EU law scholars.

Masked or yellow-faced bees of the genus Hylaeus (Colletidae) differ in their mode of pollen transportation from most other bees in that they ingest the pollen directly on the flowers and carry it back to the nest inside the crop located in the anterior half of the metasoma. Due to this hidden mode of pollen transportation, the examination of pollen collected by Hylaeus females requires the dissection of the metasoma. Although this method has never been applied in Europe, the great majority of the Central European Hylaeus species were supposed to be pollen generalists based on observations of flower visits. The microscopical analysis of pollen removed from 30 crops each of 36 Central European Hylaeus species revealed that the proportion of species exhibiting an exclusive or strong preference for pollen from a single plant taxon is much higher than hitherto assumed and that the current assumption of the genus Hylaeus to largely consist of pollen generalists is wrong. Nineteen of the 36 species examined are strictly or largely dependent on a single plant taxon for collecting pollen, such as Apiaceae (n = 11 species), Rosaceae (n = 3), Reseda (Resedaceae) (n = 2), Allium (Amaryllidaceae) (n = 1), Asteraceae (n = 1) and Melilotus (Fabaceae) (n = 1). The 36 Hylaeus species examined collected pollen from the flowers of 31 plant families, of which the Apiaceae and Rosaceae (particularly Potentilla and Rubus) were by far the most important contributing almost 60% to the pollen host spectrum of the entire genus. The comparison between pollen host spectrum and flower visiting records showed that the pollen generalists use the flowers of the Asteraceae as nectar rather than pollen sources, corroborating earlier findings that the digestion of Asteraceae pollen requires physiological adaptations to cope with its unfavourable or protective properties. In summary, the patterns of pollen host use by bees of the genus Hylaeus do not substantially differ from those of other Palaearctic bee taxa despite the masked bees’ unusual habit to ingest the pollen directly on the flowers and to transport it inside their body back to the nest.

BackgroundThe use of decompressive craniectomy in traumatic brain injury (TBI) remains a matter of debate. According to the DECRA trial, craniectomy may have a negative impact on functional outcome, while the RescueICP trial revealed a positive effect of surgical decompression, which is evolving over time. This ambivalence of craniectomy has not been studied extensively in controlled laboratory experiments.ObjectiveThe goal of the current study was to investigate the prolonged effects of decompressive craniectomy (both positive and negative) in an animal model.MethodsMale mice were assigned to the following groups: sham, decompressive craniectomy, TBI and TBI followed by craniectomy. The analysis of functional outcome was performed at time points 3d, 7d, 14d and 28d post trauma according to the Neurological Severity Score and Beam Balance Score. At the same time points, magnetic resonance imaging was performed, and brain edema was analyzed.ResultsAnimals subjected to both trauma and craniectomy presented the exacerbation of the neurological impairment that was apparent mostly in the early course (up to 7d) after injury. Decompressive craniectomy also caused a significant increase in brain edema volume (initially cytotoxic with a secondary shift to vasogenic edema and gliosis). Notably, delayed edema plus gliosis appeared also after decompression even without preceding trauma.ConclusionIn prolonged outcomes, craniectomy applied after closed head injury in mice aggravates posttraumatic brain edema, leading to additional functional impairment. This effect is, however, transient. Treatment options that reduce brain swelling after decompression may accelerate neurological recovery and should be explored in future experiments.

Background Optimizing health‐related quality of life (HRQoL) is an important aim of atrial fibrillation (AF) treatment. Little is known about patients' long‐term HRQoL trajectories and the impact of patient and disease characteristics. The aim of this study was to describe HRQoL trajectories in an observational AF study population and in clusters of patients with similar patient and disease characteristics. Methods and Results We used 5‐year follow‐up data from the Swiss–Atrial Fibrillation prospective cohort, which enrolled 2415 patients with prevalent AF from 2014 to 2017. HRQoL data, collected yearly, comprised EuroQoL‐5 dimension utilities and EuroQoL visual analog scale scores. Patient clusters with similar characteristics at enrollment were identified using hierarchical clustering. HRQoL trajectories were analyzed descriptively and with inverse probability‐weighted regressions. Effects of postbaseline clinical events were additionally assessed using time‐shifted event variables. Among 2412 (99.9%) patients with available baseline HRQoL, 3 clusters of patients with AF were identified, which we characterized as follows: “cardiovascular dominated,” “isolated symptomatic,” and “severely morbid without cardiovascular disease.” Utilities and EuroQoL visual analog scale scores remained stable over time for the full population and the clusters; isolated symptomatic patients showed higher levels of HRQoL. Utilities were reduced after occurrences of stroke, hospitalization for heart failure, and bleeding, by −0.12 (95% CI, −0.18 to −0.06), −0.10 (95% CI, −0.13 to −0.08), and −0.06 (95% CI, −0.08 to −0.04), respectively, on a 0 to 1 utility scale. Utility of surviving patients returned to preevent levels 4 years after heart failure hospitalization; 3 years after bleeding; and 1 year after stroke. Conclusions In patients with prevalent AF, HRQoL was stable over time, irrespective of baseline patient characteristics. Clinical events of hospitalization for heart failure, stroke, and bleeding had only a temporary effect on HRQoL.

The COVID-19 pandemic has presented significant challenges to the workforce, particularly concerning emotional and mental well-being. Given the prolonged periods of work-related stress, unexpected organizational changes, and uncertainties about work faced during the pandemic, it becomes imperative to study occupational health constructs under a dynamic methodological perspective, to understand their stable and unstable characteristics better. In this study, drawing on the Dynamic Structural Equation Modeling (DSEM) framework, we used a combination of multilevel AR(1) models, Residual-DSEM (RDSEM), multilevel bivariate VAR(1) models, and multilevel location-scale models to investigate the autoregression, trend, and (residual) cross-lagged relationships between emotional exhaustion (EmEx) and mental well-being (MWB) over the COVID-19 pandemic. Data were collected weekly on 533 workers from Germany (91.18%) and Italy (8.82%) who completed a self-reported battery (total number of observations = 3,946). Consistent with our hypotheses, results were as follows: (a) regarding autoregression, the autoregressive component for both EmEx and MWB was positive and significant, as well as it was their associated between-level variability; (b) regarding trend, over time EmEx significantly increased, while MWB significantly declined, furthermore both changes had a significant between-level variability; (c) regarding the longitudinal bivariate (cross-lagged) relationships, EmEx and MWB negatively and significantly affected each other from week to week, furthermore both cross-lagged relationships showed to have significant between-level variance. Overall, our study pointed attention to the vicious cycle between EmEx and MWB, even after controlling for their autoregressive component and trend, and supported the utility of DSEM in occupational health psychology studies.

BackgroundEven before the COVID-19 pandemic, hospital workers faced a tremendous workload. The pandemic led to different and additional strain that negatively affected the well-being of employees. This study aims to explore psychosocial resources and strategies that were used by hospital staff.MethodsIn the context of an intervention study, employees of three German hospitals were questioned in writing in summer and fall 2020. Five open-ended questions about the pandemic were asked to capture corresponding effects on daily work routine. Answers of 303 participants were evaluated using structuring qualitative content analysis.ResultsSignificant stressors and resources were identified in the areas of work content and task, social relations at work, organization of work, work environment and individual aspects. Stressors included, for example, emotional demands, conflicts, an increased workload, time and performance pressure. Important resources mentioned were, among others, the exchange with colleagues and mutual support. Sound information exchange, clear processes and guidelines and a positive work atmosphere were also important. In addition, the private environment and a positive mindset were perceived as helpful.ConclusionThis study contributes to a differentiated understanding of existing psychosocial resources of hospital staff in times of crisis. Identifying and strengthening these resources could reduce stress and improve well-being, making hospital staff better prepared for both normal operations and further crisis situations.

The European mining bee species Andrena lathyri (Andrenidae) is a narrow specialist of flowers of Lathyrus and Vicia (Fabaceae), from which both females and males gain nectar by primary nectar robbing. Both sexes are equipped with a unique proboscis, which is much longer and more strongly angled than in most other Andrena bees including the most closely related species. The comparison between the shape of the proboscis and the interior of the host flowers combined with field observations revealed that the specialised mouthparts of A. lathyri precisely correspond to the dimensions of the flower interior and the position of the nectary, representing one of the few known examples of a morphological adaptation to primary nectar robbing in bees. For nectar uptake, the bee’s head is inserted laterally under the standard petal before it is moved towards the flower base, thereby slitting the calyx longitudinally to a depth necessary to reach the nectary from inside the flower with the specialised proboscis. Nectar-robbing individuals of A. lathyri are able to adapt their behaviour to the different calyx lengths of their host flower species by slitting the calyx over varying distances. Except for the slit in the calyx, primary nectar robbing by A. lathyri does not damage any flower parts allowing for normal fruit development.

Objective: CR1447, a novel transdermal formulation of 4-hydroxytestosterone, has aromatase-inhibiting and androgen receptor (AR)-modulating properties (IC50 4.4 nM) with antitumor effects against AR-positive tumor cells in vitro. This trial investigated the efficacy and safety of CR1447 for patients with metastatic estrogen receptor-positive (A) and AR-positive triple-negative breast cancers (B). Design and methods: (A) included patients with at most one prior endocrine therapy line without progression ≥6 months, whereas (B) included patients with ≤2 prior chemotherapy lines, all displaying advanced signs of disease. The primary endpoint was disease control at week 24 (DC24). The null hypothesis was DC24 ≤30% (A) and ≤15% (B). Thirty-seven patients were recruited (29 in (A) and 8 in (B)); accrual was stopped following an interim analysis demonstrating futility in (A) and slow accrual in (B). Results: DC24 was attained in 5/21 (95% CI: 8.2–47.2) patients in (A) and none in (B). The median progression-free survival was 5.1 months (95% CI: 2.5–5.6) in (A) and 2.5 months (95% CI: 0.7–2.6) in (B). The median overall survival was 24.6 months (95% CI: 22.9–not applicable) in (A) and 10.8 months (95% CI: 3.3–10.9) in (B). CR1447 had a favorable safety profile without treatment-related grade 3–5 toxicities in (A). Especially no side effects linked to androgenic effects were observed. Conclusions: Despite this trial being negative, the 24% DC24 rate in a second-line setting, and the prolonged partial response experienced by a patient, indicate activity. Further evaluation of CR1447 in endocrine-sensitive patients or combination trials appears warranted.

Particle physics is an exciting subject for high school students, and there have been various approaches on how to introduce the topic in the classroom. Feynman diagrams (FDs) are an often-used form of representation in particle physics and could play an important role in such an introduction. However, their potential educational value has not yet been investigated. To this end, we interviewed four experts in the field of particle physics education on the opportunities and challenges Feynman diagrams could pose for high school students. We analyzed their answers using a thematic analysis framework, categorizing them into five themes. The results of these interviews show that there are two challenges (FDs elicit and perpetuate inadequate conceptions about particle physics, and FDs can only be treated superficially in school) and three opportunities (FDs can link particle physics and other physics topics in high school education, FDs offer an opportunity for different particle physics topics to be taught, and FDs offer a connection to current research). The results of this expert interview study lead to several suggestions on how to design learning environments that incorporate Feynman diagrams.

AIM: To assess the associations of chocolate consumption with neurocognitive function, brain lesions on magnetic resonance imaging (MRI), and cardiovascular outcome in patients with atrial fibrillation (AF). METHODS: We analysed data from patients of two prospective multicentre Swiss atrial fibrillation cohort studies (Swiss-AF) and (BEAT-AF). Assessments of MRI findings and neurocognitive function were performed only in the Swiss-AF population (in 1727 of 2415 patients [71.5%] with a complete data set), as patients enrolled in BEAT-AF were not systematically evaluated for these outcomes. Otherwise, the two cohorts had an equivalent set of clinical assessments. Clinical outcome analysis was performed in 3931 patients of both cohorts. Chocolate consumption was assessed by questionnaire. Patients were categorised as no/low chocolate consumption (No/Low-Ch) ≤1 servings/week, moderate chocolate consumption (Mod-Ch) >1–6 servings/week, and high chocolate consumption (High-Ch) >6 servings/week, respectively. Brain lesions were evaluated by MRI. Assessment of cognitive function was performed by neurocognitive functional testing and included global cognition measurement with a cognitive construct score. Cerebral MRI and cognition were evaluated at baseline. Cross-sectional associations between chocolate consumption and MRI findings were analysed by multivariate logistic regression models and associations with neurocognitive function by multivariate linear regression models. Clinical outcome events during follow-up were recorded and assessed by a clinical event committee. The associations between chocolate consumption and clinical outcomes were evaluated by Cox regression models. The median follow-up time was 6 years. RESULTS: Chocolate consumption was not associated with prevalence or volume of vascular brain lesions on MRI, nor major adverse cardiac events (ischaemic stroke, myocardial infarction, cardiovascular death). However, No/Low-Ch was independently associated with a lower cognitive construct score compared to Mod-Ch (No/Low-Ch vs. Mod-Ch: coeff. –0.05, 95% CI –0.10–0), whereas other neurocognitive function tests were not independently associated with chocolate consumption categories. In addition, there was a higher risk of heart failure hospitalisation (No/Low-Ch vs. Mod-Ch: HR 1.24, 95% CI 1.01–1.52) and of all-cause mortality (No/Low-Ch vs. Mod-Ch: HR 1.29, 95% CI 1.06–1.58) in No/Low-Ch compared to Mod-Ch. No significant associations with the evaluated outcomes were observed when High-Ch was compared to Mod-Ch. CONCLUSION: While chocolate consumption was not associated with MRI findings and major adverse cardiac events in an atrial fibrillation population, No/Low-Ch was associated with a lower cognitive construct score, higher risk of heart failure hospitalisation and increased all-cause mortality compared to Mod-Ch. ClinicalTrials.gov Identifier: NCT02105844

Besides visceral heterotaxia, Pkd1l1 null mouse embryos exhibit general edema and perinatal lethality. In humans, congenital chylothorax (CCT) is a frequent cause of fetal hydrops. In 2021, Correa and colleagues reported ultrarare compound heterozygous variants in PKD1L1 exhibiting in two consecutive fetuses with severe hydrops, implicating a direct role of PKD1L1 in fetal hydrops formation. Here, we performed an exome survey and identified ultrarare compound heterozygous variants in PKD1L1 in two of the five case–parent trios with CCT. In one family, the affected carried the ultrarare missense variants c.1543G>A(p.Gly515Arg) and c.3845T>A(p.Val1282Glu). In the other family, the affected carried the ultrarare loss-of-function variant (LoF) c.863delA(p.Asn288Thrfs*3) and the ultrarare missense variant c.6549G>T(p.Gln2183His). Investigation of the variants’ impact on PKD1L1 protein localization suggests the missense variants cause protein dysfunction and the LoF variant causes protein mislocalization. Further analysis of Pkd1l1 mutant mouse embryos revealed about 20% of Pkd1l1−/− embryos display general edema and pleural effusion at 14.5 dpc. Immunofluorescence staining at 14.5 dpc in Pkd1l1−/− embryos displayed both normal and massively altered lymphatic vessel morphologies. Together, our studies suggest the implication of PKD1L1 in congenital lymphatic anomalies, including CCTs.

Abstract Background Endoscopic vacuum therapy (EVT) has become a standard treatment method for esophageal perforations in adults. However, experience with EVT in infants is scarce. In this retrospective case series, we report on four very young infants who were successfully treated with EVT for esophageal perforations of different etiology. Methods Four infants were diagnosed with esophageal perforations on day 7, 32, 35 and 159 of life, respectively. The youngest one was prematurely born in the 31st week of pregnancy weighing 980 g only. Three infants had perforations due to foreign body insertion (nasogastric tube or pulling through of percutaneous endoscopic gastrostomy (PEG) tube through the esophagus). One child had an anastomotic dehiscence after Foker’s surgery for atresia. In three children EVT was applied as first-line therapy for perforation, in one child EVT was a rescue therapy due to persisting leakage after surgical closure involving thoracotomy. Depending on the esophageal diameter, either an open-pore drainage film or polyurethane sponge was attached to a single-lumen 8 Fr suction catheter, endoscopically (or fluoroscopically by wire-guidance) placed into the esophagus (intraluminal EVT) and supplied with continuous negative pressure (ranging between 75 and 150 mmHg). The EVT system was exchanged twice per week. Results Complete closure of the perforation/leakage could be achieved in all four infants (100%) after 22 days of continuous EVT (median value; range 7–39) and 4.5 EVT exchanges (median value; range 1–12). No serious adverse events occurred. Conclusions EVT is an effective and safe addition to our therapeutic armamentarium in the management of esophageal perforations irrespective of its etiology. Here we prove the feasibility of EVT even in very young infants. The use of an extra thin vacuum open-pore drainage film is helpful to cope with the small esophageal diameter. EVT settings and exchange rates similar to those known from adult treatment were used.

Building decarbonization has an important role to play in achieving global emissions reductions targets. Here the authors find that stated policy scenarios are insufficient to achieve building decarbonization goals globally, while ambitious decarbonization scenarios are still not sufficient to achieve goals under the 1.5 °C scenario.

Abstract Background The use of webcam technology in neonatal intensive care units (NICUs) enables parents to see their child when the parents cannot be present at the NICU. The webcam’s use has been gaining increasing attention. Lead physicians and lead nursing staff play a key role in the decision of whether to implement webcams. This study investigates factors that are associated with the readiness for the implementation of a webcam system among lead NICU staff. Methods A postal survey was conducted among all lead physicians and lead nursing staff in all German NICUs between December 2020 and April 2021 (total N = 416, one lead physician and one lead nursing staff per NICU, N = 208). On the basis of normalization process theory, personal (technology acceptance) and organizational (innovation climate) attributes were chosen to determine their association with the readiness for the implementation of a webcam system. The association of these factors was determined using multiple linear regression models for both lead physicians and lead nurses. Results Overall, a response rate of 66.59% (n = 277) was achieved. Technology acceptance proved to be a significant factor associated with the readiness for the implementation of a webcam system among lead physicians. Furthermore, staff already working with webcams in their NICUs indicated a significantly higher level of technology acceptance than staff without webcam experience and without any desire to use a webcam in the future. No significant association was found between innovation climate and the readiness for the implementation of a webcam system. Conclusions Technology acceptance was identified as a factor associated with the readiness for the implementation of a webcam system. The insights from this study can be used to manage potential barriers regarding the readiness for implementation of webcams in NICUs. Trial registration The Neo-CamCare study is registered at the German Clinical Trials Register. DRKS-ID: DRKS00017755 . Date of Registration in DRKS: 25-09-2019.

IntroductionDue to the COVID-19 pandemic, teleworking suddenly became a reality for many individuals. Previous research shows that there are contradictory consequences of telework on well-being: while workers have the opportunity for self-directed work, intensified work behavior as well as longer hours being worked might occur at the same time. We expect that the effects of telework vary over time and may be able to explain these contradictions. Moreover, from the perspective of the job demands-resources model besides job resources, personal resources may be relevant. The aim of this study is to investigate how the mental well-being of workers unfolds over time after the onset of the pandemic and the role of telework in this process. Additionally we seek to identify the impact of available job resources and personal resources in this extraordinary situation.MethodsData were collected online from 642 participants in Germany beginning in March 2020, with 8 weekly followup surveys. Mental well-being was measured using the WHO-5 well-being index. For personal resources we looked at occupational self-efficacy; job resources were flexible working hours, job autonomy, and social support. Job demands were telework and work intensification. First we used a group-based trajectory analysis approach to identify different well-being trajectories. Second we applied multinomial regression analysis to identify T1 predictors of well-being trajectory group membership and their interactions.ResultsWe found three groups of mental well-being trajectories: low, medium, and high. Their progress through the investigation period was rather stable: we observed only slight improvements of mental well-being for the high well-being group and a slight deterioration for the other two groups. Only the job demand work intensification and the personal resource occupational self-efficacy had a significant relationship to group assignment. Additionally we found interactions of telework with work intensification and occupational self-efficacy indicating a buffering mechanism of telework on the consequences of high work intensification; and low occupational self-efficacy.DiscussionTelework appears to be a useful resource that buffered high work intensification and compensated for low personal resources during the pandemic. Since data were from self-reports of a convenience sample we can't assume generalization of our results nor absence of common-method bias.

Abstract Background Ovarian insufficiency is a major concern for long-term cancer survivors. Ovarian tissue cryopreservation for fertility preservation is an emerging technique that has proven successful over the past decade through transplantation of frozen-thawed ovarian tissue. Compared to other established techniques, such as oocyte freezing, ovarian tissue cryopreservation preserves actual organ function and thus the production of sex hormones. Endometriosis in perimenopausal women is rare, however it can be surprising diagnosis in the planned transplantation of cryopreserved ovarian tissue and the already thawed tissue may not be transplanted, so that it has to be refrozen. Results Ovarian function returned in the patient two months after transplantation, as shown by estrogen production. Ten months after the ovarian tissue transplantation mild stimulation with FSH was initiated in accordance with a low-dose protocol. When ultrasonography revealed a follicle 17 mm in size in the ovarian graft, hCG was added and after follicular puncture one oocyte was obtained. The oocyte could be fertilized by IVF and transferred to the uterus. On day 14 after embryo-transfer, a positive hCG-Level was detected and after an uncomplicated pregnancy a healthy child was delivered. Conclusions We report the first pregnancy and live birth achieved using transplantation of thawed and refrozen ovarian tissue in a woman treated by chemotherapy and subsequent endometriosis surgery. Refreezing of cryopreserved ovarian tissue is not a hindrance to successful transplantation of ovarian tissue. Against the background of increasing numbers of candidates for transplantation of ovarian tissue is expected that the combination chemotherapy followed by endometriosis will increase.

Abstract Background Sepsis is one of the most important complications in preterm infants. For this reason, most preterm infants receive antibiotics during their first postnatal week. Since 2013, a weekly colonization screening has been installed in German neonatal intensive care units (NICUs), including multi-drug resistant organisms (MDRO) and pathogens with increased epidemic potential. We here investigated the impact of early antibiotic exposure on the colonization with these pathogens. Methods Data from 1407 preterm infants with gestational age 7 days) decreased the risk for acquiring pathogens with increased epidemic potential. Conclusion Early antibiotic exposure did not impact the risk for colonization with MDRO or highly epidemic pathogens in preterm infants. Further studies are needed to identify risk factors for the acquisition of MDRO and highly epidemic pathogens and potential associations with long-term outcome.

[This paper is part of the Focused Collection on Instructional labs: Improving traditions and new directions.] Physics lab courses permanently undergo transformations, in recent times especially to adapt to the emergence of new digital technologies and the COVID-19 pandemic in which digital technologies facilitated distance learning. Since these transformations often occur within individual institutions, it is useful to get an overview of these developments by capturing the status quo of digital technologies and the related acquisition of digital competencies in physics lab courses. Thus, we conducted a survey among physics lab instructors (N=79) at German, Finnish, and Croatian universities. The findings reveal that lab instructors already use a variety of digital technologies and that the pandemic particularly boosted the use of smartphones and tablets, simulations, and digital tools for communication, collaboration, and organization. The participants generally showed a positive attitude toward using digital technologies in physics lab courses, especially due to their potential for experiments and students’ competence acquisition, motivational effects, and contemporaneity. Acquiring digital competencies is rated as less important than established learning objectives, however, collecting and processing data with digital tools was rated as an important competency that students should acquire. The instructors perceived open forms of labwork and particular digital technologies for specific learning objectives (e.g., microcontrollers for experimental skills) as useful for reaching their learning objectives. Our survey contributes to the reflection of what impact the emergence of digital technologies in our society and the COVID-19 pandemic had on physics lab courses and reveals first indications for the future transformation of hands-on university physics education.

Abstract To assess the spectrum of different etiologies, the intrauterine course, outcome and possible prognostic markers in prenatally detected fetal growth restriction (FGR) combined with polyhydramnios. Retrospective study of 153 cases with FGR combined with Polyhydramnios diagnosed by prenatal ultrasound over a period of 17 years. Charts were reviewed for ultrasound findings, prenatal and postnatal outcome. All cases were categorized into etiological groups and examined for differences. Five etiological groups were identified: chromosomal anomalies (n = 64, 41.8%), complex malformation syndromes (n = 37, 24.1%), isolated malformations (n = 24, 15.7%), musculoskeletal disorders (n = 14, 9.2%) and prenatal non-anomalous fetuses (n = 14, 9.2%). Subgroups showed significant disparities in initial diagnosis of combination of both pathologies, Ratio AFI/ gestational weeks and Doppler ultrasound examinations. Overall mortality rate was 64.7%. Fetuses prenatally assigned to be non-anomalous, showed further complications in 42.9% (n = 6). Fetuses prenatally diagnosed with FGR combined with polyhydramnios are affected by a high morbidity and mortality. Five etiologic groups can be differentiated, showing significant disparities in prenatal and postnatal outcome. Even without recognizable patterns prenatally, long-term-follow up is necessary, as neurodevelopmental or growth delay may occur.

Structures enabling transformability of buildings, components and materials at different levels gain significance in view of a sustainable built environment. Such structures are capable of obtaining different shapes in response to varying functional, environmental or loading conditions. Certain limitations of classic tensegrity and scissor-like structures, applied so far in an architectural and engineering context, are attributed to a limited number of possible configurations and a big number of actuators required. In this context, rigid-bar linkages offer a promising alternative with regard to constructability, modularity, transformability and control components integration. In achieving improved flexibility and controllability with a reduced number of actuation devices, a kinematics principle has been previously proposed by the authors that involves the reduction of the system to an externally controlled one degree-of-freedom mechanism in a multistep transformation process. The paper presents application of the kinematics principle in two classes of a transformable spatial rigid-bar linkage structure. Investigation of the system kinematics was conducted using parametric associative design. The kinematics principle is applied on a torus-shaped spatial structural system composed of planar interconnected linkages. Alternative motion sequences of multiple transformation steps by the planar linkages can be implemented for the stepwise adjustment of the joints to their desired values. The actuators employed are positioned at the ground supports and are detached from the main structural body. Thus, minimum structural self-weight, simplicity and reduced energy consumption become possible. The transformation approaches using parametric associative design are exemplified based on a selected motion sequence pattern. The case study demonstrates the high degree of control flexibility and transformability of the system.

Objective The objective of this paper is to establish whether existing eye care competency frameworks (ECCF) are fit for purpose, and set out a comprehensive ECCF that better meets the needs of the eye care workforce and broader population.Methods and analysis We carried out a two-stage process. The first was to conduct a desk review of existing frameworks and models relevant to eye care competencies. The second was to conduct a broad stakeholder consultation of global eye care experts to affirm the gaps found in the first stage, and to inform the development of a comprehensive ECCF.Results We reviewed 52 competency frameworks, competency standards and models related to eye care (including 11 from the UK) and found that there were three types of gaps, such as: (1) narrow in focus on specific occupational groups; (2) limitations in the competencies expected from an eye care worker and (3) limitations in regional focus, such that they could not easily be applied in a global context.Having affirmed these gaps during the stakeholder consultation stage, we developed a more comprehensive ECCF structure, which composed of six domains: practice, professionalism, learning and development, management and leadership, community and advocacy, and evidence. This broader structure seeks to address the gaps found in the desk review.Conclusion The review showed that there was a need to develop a comprehensive ECCF that can be easily contextualised, encapsulate the roles of the diverse eye care workforce, and be a tool for eye care workforce planning and development to meet the needs of a global population.

Background and purposeMaternal circadian rhythms are important for maintaining maternal and fetal homeostasis. The maternal circadian system coordinates the internal clock of the fetus with environmental lighting conditions via the melatonin signal. The intensity and wavelength of daylight influence nocturnal melatonin production. This study aims to evaluate the effect of environmental lighting conditions on melatonin production in pregnant women with reduced mobility during hospitalization.MethodsWe installed a human-centric lighting system with biodynamic effects (BDL, biodynamic lighting) in the patient rooms. The pregnant women in the patient rooms with standard indoor conditions served as a control group. The illuminance (lux) and dose of effective circadian irradiation (Hec) were recorded every 10 seconds by light dosimeters (Lucerne University, Switzerland) attached to the patients` clothing.ResultsWe analyzed the illuminance status of 47 pregnant women with a median (IQR) gestational age of 29.9 (25.4-32.3) weeks of gestation. The median illuminance in the control group was significantly lower (p

Socioemotional selectivity theory and models of lifespan development of resources suggest that older workers may particularly benefit from social resources so as to maintain their well-being throughout their work-life span. However, the age-differential effects of social support at work have been rarely investigated. We hypothesised that age moderates the effects of colleagues' and supervisors' social support on mental strain, with strongest effects for older workers. A two-wave complete panel design (six months' time lag) was used. Self-reports from N = 334 nurses (age: 21–63 years) were gathered with established questionnaires: strain was measured by means of the irritation scale; social support from colleagues and supervisors by using a German adaptation of the social support scales. We proved factorial validity and measurement invariance across time points (CFA) and computed path models (SEM). As expected, age moderated the negative longitudinal effects of colleagues' social support on mental strain. Older nurses (≥45 years) benefited the most from colleagues' social support. However, mental strain in older nurses was associated with reduced social support from colleagues. Surprisingly with middle-aged nurses (35–44 years) an increase in colleagues' social support resulted in higher mental strain. No effects for supervisor support were observed. Results indicate that social support by colleagues is an important resource for older workers, but older workers are less likely to receive social support when mental strain is present. Moreover, the timing of social support across the work lifespan seems to be critical, as it might have detrimental effects in middle-aged workers.

Objective To examine sex differences in prevalence, volume and distribution of vascular brain lesions on MRI among patients with atrial fibrillation (AF).Methods In this cross-sectional analysis, we included 1743 patients with AF (27% women) from the multicentre Swiss Atrial Fibrillation study (SWISS-AF) with available baseline brain MRI. We compared presence and total volume of large non-cortical or cortical infarcts (LNCCIs), small non-cortical infarcts, microbleeds (MB) and white matter hyperintensities (WMH, Fazekas score ≥2 for moderate or severe degree) between men and women with multivariable logistic regression. We generated voxel-based probability maps to assess the anatomical distribution of lesions.Results We found no strong evidence for an association of female sex with the prevalence of all ischaemic infarcts (LNCCI and SNCI combined; adjusted OR 0.86, 95% CI 0.67 to 1.09, p=0.22), MB (adjusted OR 0.91, 95% CI 0.68 to 1.21, p=0.52) and moderate or severe WMH (adjusted OR 1.15, 95% CI 0.90 to 1.48, p=0.27). However, total WMH volume was 17% larger among women than men (multivariable adjusted multiplicative effect 1.17, 95% CI 1.01 to 1.35; p=0.04). Lesion probability maps showed a right hemispheric preponderance of ischaemic infarcts in both men and women, while WMH were distributed symmetrically.Conclusion Women had higher white matter disease burden than men, while volume and prevalence of other lesions did not differ. Our findings highlight the importance of controlling risk factors for cerebral small vessel disease in patients with AF, especially among women.

Although wide-ranging amendments in health and safety regulations at the European and national level oblige employers to conduct psychosocial risk assessment, it is still under debate how psychosocial hazards can be properly evaluated. For psychosocial hazards, an epidemiological, risk-oriented understanding similar to physical hazards is still missing, why most existing approaches for hazard evaluation insufficiently conceive psychosocial risk as a combination of the probability of a hazard and the severity of its consequences (harm), as found in traditional risk matrix approaches (RMA). We aim to contribute to a methodological advancement in psychosocial risk assessment by adapting the RMA from physical onto psychosocial hazards. First, we compare and rate already existing procedures of psychosocial risk evaluation regarding their ability to reliably assess and prioritize risk. Second, we construct a theoretical framework that allows the risk matrix for assessing psychosocial risk. This is done by developing different categories of harm based on psychological theories of healthy work design and classifying hazards through statistical procedures. Taking methodological and theoretical considerations into account, we propose a 3 × 3 risk matrix that scales probability and severity for psychosocial risk assessment. Odds ratios between hazards and harm can be used to statistically assess psychosocial risks. This allows for both risk evaluation and prioritizing to further conduct risk-mitigation. Our contribution advances the RMA as a framework that allows for assessing the relation between psychosocial hazards and harm disregarding which theory of work stress is applied or which tool is used for hazard identification. By this, we also contribute to further possible developments in empirical research regarding how to assess the risk of workplace stress. The risk matrix can help to understand how psychosocial hazards can be evaluated and organizations can use the approach as a guidance to establish a suitable method for psychosocial risk evaluation.

(1) Background: Cerebral MRI plays a significant role in assessing the extent of brain injury in neonates with neonatal encephalopathy after perinatal asphyxia. Over the last decades, several MRI scoring systems were developed to enhance the predictive accuracy of MRI. The aim of this study was to validate the correlation of four established MRI scoring systems with cognitive long-term outcomes in cooled asphyxiated newborns. (2) Methods: Forty neonates with neonatal encephalopathy treated with therapeutic hypothermia were included in this retrospective study. The MRI scans from the second week of life were scored using four existing MRI scoring systems (Barkovich, NICHD, Rutherford, and Weeke). The patients’ outcome was assessed with the Bayley Scales of Infant Development (BSID-III) at the age of 2 years. To evaluate the correlation between the MRI scoring system with the cognitive scores of BSID-III, the correlation coefficient was calculated for each scoring system. (3) Results: All four MRI scoring systems showed a significant correlation with the cognitive scores of BSID-III. The strongest correlation was found between the Weeke Score (r2 = 0.43), followed by the Rutherford score (r2 = 0.39), the NICHD score (r2 = 0.22), and the Barkovich score (r2 = 0.17). (4) Conclusion: Our study confirms previously published results in an independent cohort and indicates that the Weeke and Rutherford scores have the strongest correlation with the cognitive score of BSID-III in cooled asphyxiated newborns.

Due to increasingly stringent limits for NOx emissions, there is now more interest than ever in cost-effective, precise, and durable exhaust gas sensor technology for combustion processes. This study presents a novel multi-gas sensor with resistive sensing principles for the determination of oxygen stoichiometry and NOx concentration in the exhaust gas of a diesel engine (OM 651). A screen-printed porous KMnO4/La-Al2O3 film is used as the NOx sensitive film, while a dense ceramic BFAT (BaFe0.74Ta0.25Al0.01O3–δ) film prepared by the PAD method is used for λ-measurement in real exhaust gas. The latter is also used to correct the O2 cross-sensitivity of the NOx sensitive film. This study presents results under dynamic conditions during an NEDC (new European driving cycle) based on a prior characterization of the sensor films in an isolated sensor chamber with static engine operation. The low-cost sensor is analyzed in a wide operation field and its potential for real exhaust gas applications is evaluated. The results are promising and, all in all, comparable with established, but usually more expensive, exhaust gas sensors.