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Abstract Phosphorylation of cardiac myosin binding protein-C (cMyBP-C) is a determinant of cardiac myofilament function. Although cMyBP-C phosphorylation by various protein kinases has been extensively studied, the influence of protein phosphatases on cMyBP-C’s multiple phosphorylation sites has remained largely obscure. Here we provide a detailed biochemical characterization of cMyBP-C dephosphorylation by protein phosphatases 1 and 2 A (PP1 and PP2A), and develop an integrated kinetic model for cMyBP-C phosphorylation using data for both PP1, PP2A and various protein kinases known to phosphorylate cMyBP-C. We find strong site-specificity and a hierarchical mechanism for both phosphatases, proceeding in the opposite direction of sequential phosphorylation by potein kinase A. The model is consistent with published data from human patients and predicts complex non-linear cMyBP-C phosphorylation patterns that are validated experimentally. Our results suggest non-redundant roles for PP1 and PP2A under both physiological and heart failure conditions, and emphasize the importance of phosphatases for cMyBP-C regulation.

The potential for greater algorithmic efficiency for some problems on quantum computers compared to classical computers is appealing in many fields including, for example, the process systems engineering field. While quantum algorithms have been studied for a variety of applications related to optimization, molecular modeling, and machine learning, there remain many applications in process systems engineering, including process control, where it is not clear how quantum computing algorithms would be beneficial. One idea for attempting to understand when a quantum algorithm might provide benefits for control is to start with algorithms that would be expected to benefit “similar” problems (e.g., optimization problems) and to see if controllers can be implemented within those algorithmic frameworks. Therefore, in this work, we study the use of a quantum computing algorithm related to Grover’s algorithm, which is an amplitude amplification strategy that can search an unordered list with improved efficiency compared to a classical algorithm for the task. It has been extended to perform a search for optimal paths over a graph. Given its potential utility for search and optimization, this is an example of an algorithm where we might wonder if it could be adjusted or used to provide speed-ups for large control problems if the controller could function within this algorithmic framework. This work provides the first steps toward attempting to address this question by investigating how optimization-based control problems would fit into this framework. A process described by ẋ=x+u is considered as a test case. The modified Grover’s algorithm requires the optimization problem to be mapped into quantum gates. We discuss ideas for attempting to represent an optimization-based controller known as model predictive control (MPC) in the modified Grover’s algorithm framework. We test how various parameters of the control and quantum algorithm designs, including fundamental parameters in MPC such as the number of sampling periods and length of the sampling periods, impact the success of using the quantum algorithm for the MPC. We provide analyses regarding why the results are what they are to give perspective on how quantum computing algorithms work and intersect with engineering problems.

We investigate the use of amplitude amplification on the gate-based model of quantum computing as a means for solving combinatorial optimization problems. This study focuses primarily on quadratic unconstrained binary optimization (QUBO) problems, which are well-suited for qubit superposition states. Specifically, we demonstrate circuit designs which encode QUBOs as ‘cost oracle’ operations UC, which distribute phases across the basis states proportional to a cost function. We then show that when UC is combined with the standard Grover diffusion operator Us, one can achieve high probabilities of measurement for states corresponding to optimal and near optimal solutions while still only requiring O(π42N/M) iterations. In order to achieve these probabilities, a single scalar parameter ps is required, which we show can be found through a variational quantum–classical hybrid approach and can be used for heuristic solutions.

Lithium-Ion Batteries (LIBs) usually present several degradation processes, which include their complex Solid-Electrolyte Interphase (SEI) formation process, which can result in mechanical, thermal, and chemical failures. The SEI layer is a protective layer that forms on the anode surface. The SEI layer allows the movement of lithium ions while blocking electrons, which is necessary to prevent short circuits in the battery and ensure safe operation. However, the SEI formation mechanisms reduce battery capacity and power as they consume electrolyte species, resulting in irreversible material loss. Furthermore, it is important to understand the degradation reactions of the LIBs used in Electric Vehicles (EVs), aiming to establish the battery lifespan, predict and minimise material losses, and establish an adequate time for replacement. Moreover, LIBs applied in EVs suffer from two main categories of degradation, which are, specifically, calendar degradation and cycling degradation. There are several studies about battery degradation available in the literature, including different degradation phenomena, but the degradation mechanisms of large-format LIBs have rarely been investigated. Therefore, this review aims to present a systematic review of the existing literature about LIB degradation, providing insight into the complex parameters that affect battery degradation mechanisms. Furthermore, this review has investigated the influence of time, C-rate, depth of discharge, working voltage window, thermal and mechanical stresses, and side reactions in the degradation of LIBs.

Greenhouse gas emissions from transportation harm the environment. In response to these environmental concerns, numerous countries encourage the adoption of electric vehicles (EVs) as a more environmentally friendly option than traditional gasoline-powered vehicles. Advances in battery technology have made batteries an alternative solution for energy storage in stationary applications and for electric mobility. Reduced lithium-ion batteries (LIBs) production costs due to economies of scale, electrode material and cell design developments, and manufacturing process improvements have driven this success. This trend is expected to increase the number of LIBs on the market that may be discarded in the environment at the end of their useful life if more sustainable alternatives are not technologically mature. This coming environmental concern can be mitigated by collecting wasted EV batteries, reconfiguring them, and reusing them for applications with less stringent weight, performance, and size requirements. This method would extend battery life and reduce environmental effects. The present work investigates the main regulatory structures of the second-life battery industry that require rules, technical standards, and laws. To achieve this objective, a systematic review was carried out following a strict protocol that includes identifying relevant studies, extracting data and information, evaluating, and summarizing information. This paper explains the primary rules and technical standards governing the second-life battery business. The findings highlight the need for universities, research institutions, and government agencies to evaluate the second-life battery industry objectively. This would enable the creation of new technological regulations and laws for this burgeoning industry.

Abstract Recent empirical research has confirmed the importance of green infrastructure and outdoor recreation to urban people’s well-being during the COVID-19 pandemic. However, only a few studies provide cross-city analyses. We analyse outdoor recreation behaviour across four Nordic cities ranging from metropolitan areas to a middle-sized city. We collected map-based survey data from residents (n = 469–4992) in spring 2020 and spatially analyse green infrastructure near mapped outdoor recreation sites and respondents’ places of residence. Our statistical examination reveals how the interplay among access to green infrastructure across cities and at respondents’ residential location, together with respondents’ socio-demographic profiles and lockdown policies or pandemic restrictions, affects outdoor recreation behaviour. The results highlight that for pandemic resilience, the history of Nordic spatial planning is important. To support well-being in exceptional situations as well as in the long term, green infrastructure planning should prioritise nature wedges in and close to cities and support small-scale green infrastructure.

Obscurin is a giant muscle protein (>800 kDa) featuring multiple signalling domains, including an SH3-DH-PH domain triplet from the Trio-subfamily of guanosine nucleotide exchange factors (GEFs). While previous research suggests that these domains can activate the small GTPases RhoA and RhoQ in cells, in vitro characterization of these interactions using biophysical techniques has been hampered by the intrinsic instability of obscurin GEF domains. To study substrate specificity, mechanism and regulation of obscurin GEF function by individual domains, we successfully optimized recombinant production of obscurin GEF domains and found that MST-family kinases phosphorylate the obscurin DH domain at Thr5798. Despite extensive testing of multiple GEF domain fragments, we did not detect any nucleotide exchange activity in vitro against 9 representative small GTPases. Bioinformatic analyses show that obscurin differs from other Trio-subfamily GEFs in several important aspects. While further research is necessary to evaluate obscurin GEF activity in vivo, our results indicate that obscurin has atypical GEF domains that, if catalytically active at all, are subject to complex regulation.

This article engages with the role of what one might tentatively call “secondary” urban spaces, in that while they are public, they are not the most vibrant, populated, or active places. These are not the spaces envisioned in many project illustrations. They are not full of people and activity. They are however a crucial part of a wider texture of urban situations, and important to extending our understanding of seclusion, solitude, and tranquility beyond distant parks and recreation areas. My aim here is to understand the emergence of these spaces in-between; those that are close to the vibrant streets and are embedded in city centers yet which offer a respite from the most bustling urbanity. These spaces, I will argue, more easily allow for the kinds of interactions that can lead to bridging and bonding with the unknown, in addition to the important everyday encounters that occur on central streets and squares. Using qualitative methods which build on Lefebvre’s rhythmanalysis, the discussion will draw on observations of the syntactic properties that condition, enable, and characterize such spaces, and address a series of concepts, including capacity, insulation, sequencing, and interface. A better understanding of such places, it is argued, not only allows a richer set of tools for working with urban design and planning, but offers possibilities for more resilient planning in terms of generating social relations, the emergence of communities, and for cities to manage and withstand extraordinary conditions.

Este artigo discute a interação entre leiautes espaciais efêmeros e perenes que, embora observáveis em diversos tipos edilícios, são particularmente evidentes em espaços expositivos, e propõe três modelos descritivos – complexo, genérico e específico – capazes de capturar e relacionar suas possibilidades máximas, mínimas e intermédias de desempenho das funções genéricas de ocupação e movimento. Para tal, utiliza a Bienal de São Paulo como objeto empírico, expressão que designa um conjunto de exposições e um edifício, cuja configuração espacial é simultaneamente descrita como complexa e genérica, e que, desde 1957, é reconfigurado a cada dois anos para sediar o evento – composto por exposições de arte moderna e contemporânea de grande especificidade. A análise de nove casos de leiautes de exposições Bienais e do leiaute de seu edifício no ano correspondente permitiu elaborar e testar tais modelos e sintetizar os resultados por meio de escalas que relacionam os três sistemas e suas sequências de distribuição. Estes modelos e sequências caracterizam a propriedade de mediação espacial da arquitetura (Nóbrega, 2022) e podem suportar a descrição e análise da interação entre leiautes superpostos e o desempenho de suas funções genéricas em edifícios de outros tipos e usos.

Wheat straw is an abundant lignocellulosic residue from wheat cultivation. It is composed of cellulose, hemicellulose, and lignin and offers several possibilities for valorisation. Nowadays, a growing interest in lignocellulosic biomass fractionation and lignin utilisation is observed. Alkaline pretreatment with NaOH is often applied to obtain a high-quality lignin fraction under milder conditions. In this study, alkaline pretreatment of wheat straw using a NaOH solution is simulated in Aspen Plus to determine mass and energy balances producing a lignin fraction. These balances were used as input to perform a life cycle assessment to screen and estimate the environmental impacts underlying 12 different scenarios. According to the impact assessment results, pretreatment with 2 % NaOH solution, reactor temperature 105 ºC, and solid biomass as the thermal energy source, as described in the base case, is the best compromise between low Global Warming, Eutrophication, Human Toxicity potentials, Blue Water Consumption, and resource efficiency.

Background: Harmful in-hospital falls with subsequent injuries often cause longer stays and subsequently higher costs. Early identification of fall risk may help in establishing preventive strategies. Objective: To assess the predictive ability of different clinical scores including the Post-acute care discharge (PACD) score and nutritional risk screening score (NRS), and to develop a new fall risk score (FallRS). Methods: A retrospective cohort study of medical in-patients of a Swiss tertiary care hospital from January 2016 to March 2022. We tested the ability of the PACD score, NRS and FallRS to predict a fall by using the area under curve (AUC). Adult patients with a length of stay of ≥ 2 days were eligible. Results: We included 19,270 admissions (43% females; median age, 71) of which 528 admissions (2.74%) had at least one fall during the hospital stay. The AUC varied between 0.61 (95% confidence interval (CI), 0.55–0.66) for the NRS and 0.69 (95% CI, 0.64–0.75) for the PACD score. The combined FallRS score had a slightly better AUC of 0.70 (95% CI, 0.65–0.75) but was more laborious to compute than the two other scores. At a cutoff of 13 points, the FallRS had a specificity of 77% and a sensitivity of 49% in predicting falls. Conclusions: We found that the scores focusing on different aspects of clinical care predicted the risk of falls with fair accuracy. A reliable score with which to predict falls could help in establishing preventive strategies for reducing in-hospital falls. Whether or not the scores presented have better predictive ability than more specific fall scores do will need to be validated in a prospective study.

Abstract Background Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) disease (COVID-19) has been linked to thrombotic complications and endothelial dysfunction. We assessed the prognostic implications of endothelial activation through measurement of endothelin-I precursor peptide (proET-1), the stable precursor protein of Endothelin-1, in a well-defined cohort of patients hospitalized with COVID-19. Methods We measured proET-1 in 74 consecutively admitted adult patients with confirmed COVID-19 and compared its prognostic accuracy to that of patients with community-acquired pneumonia (n = 876) and viral bronchitis (n = 371) from a previous study by means of logistic regression analysis. The primary endpoint was all-cause 30-day mortality. Results Overall, median admission proET-1 levels were lower in COVID-19 patients compared to those with pneumonia and exacerbated bronchitis, respectively (57.0 pmol/l vs. 113.0 pmol/l vs. 96.0 pmol/l, p

Abstract Background French bulldogs exhibit significantly larger femoral external rotation and abduction than other breeds. We were curious as to whether this peculiar leg kinematic affects patellar motion and/or might induce medial patellar subluxation (MPSL) or medial patellar permanent luxation (MPPL). We hypothesized that the more abducted leg posture during stance causes an unusual medial pull direction of the rectus femoris muscle during stance, and that this may facilitate the occurrence of MPSL or even MPPL during locomotion. To test our hypothesis, we analyzed existing stifle-joint X-ray-sequences collected during the treadmill walk and trot of seven adult female French bulldogs. We estimated 3D-patellar kinematics using Scientific Rotoscoping. Results The three-dimensional motion of the patella comprises rotations and translations. From the seven dogs analyzed, three exhibited MPSL and one MPPL during the gait cycle. Medial patellar luxation (MPL) occurred mostly around toe-off in both gaits studied. Patellar position was generally not gait-related at the analyzed timepoints. In dogs with MPL, the patella was placed significantly more distally (p = 0.037) at touch-down (TD) and at midswing (p = 0.024), and significantly more medial at midswing (p = 0.045) compared to dogs without MPL. Conclusions Medial patellar luxation seems to be the consequence of the far from parasagittal position of the stifle joint during stance due to a broad trunk, and a wide pelvis. This peculiar leg orientation leads to a medial sideway pull caused by the rectus femoris muscle and the quadriceps femoris and may initiate plastic deformation of the growing femur and tibia. Thus, a way to avoid MPL could be to control breeding by selecting dogs with lean bodies and narrow pelvis. Actual breeding control programs based on the orthopedic examination are susceptible to errors. Systematic errors arise from the fact that the grading system is highly dependent on the dog’s condition and the veterinarians’ ability to perform the palpation on the stifle. Based on our results, the position of the patella at TD, or even perhaps during stand might offer a possibility of an objective radioscopic diagnostic of the MPL.

During the Corona pandemic, extensive interventions have been introduced to limit the spread of Covid-19. Authorities, companies, and organisations introduce comprehensive restrictions. To capture new routines, we launched a web questionnaire (PPGIS) including maps in three cities in Sweden; Stockholm, Uppsala and Gothenburg. From the first month results, we see dramatic changes of habits. Places still used are primarily where people find service, while places people avoid are where they normally work or study. Places used more, are where people find seclusion; primarily green spaces and easy to access. This pandemic reinforces existing urban inequalities. Access to urban resources and green spaces becomes even more important in areas characterized by poverty and overcrowding.

BACKGROUND: Hospitals are using nursing-sensitive outcomes (NSOs) based on administrative data to measure and benchmark quality of nursing care in acute care wards. In order to facilitate comparisons between different hospitals and wards with heterogeneous patient populations, proper adjustment procedures are required. In this article, we first identify predictors for common NSOs in acute medical care of adult patients based on administrative data. We then develop and cross-validate an NSO-oriented prediction model. METHODS: We used administrative data from seven hospitals in Switzerland to derive prediction models for each of the following NSO: hospital-acquired pressure ulcer (≥ stage II), hospital-acquired urinary tract infection, non-ventilator hospital-acquired pneumonia and in-hospital mortality. We used a split dataset approach by performing a random 80:20 split of the data into a training set and a test set. We assessed discrimination of the models by area under the receiver operating characteristic curves. Finally, we used the validated models to establish a benchmark between the participating hospitals. RESULTS: We considered 36,149 hospitalisations, of which 51.9% were male patients with a median age of 73 years (with an interquartile range of 59–82). Age and length of hospital stay were independently associated with all four NSOs. The derivation and validation models showed a good discrimination in the training (AUC range: 0.75–0.84) and in the test dataset (AUC range: 0.77–0.81), respectively. Variation among different hospitals was relevant considering the risk for hospital-acquired pressure ulcer (≥ stage II) (adjusted Odds ratio [aOR] range: 0.51 [95% CI: 0.38–0.69] – 1.65 [95% CI: 1.33–2.04]), the risk for hospital-acquired urinary tract infection (aOR range: 0.46 [95% CI: 0.36–0.58] – 1.45 [95% CI: 1.31–1.62]), the risk for non-ventilator hospital-acquired pneumonia (aOR range: 0.28 [95% CI: 0.09–0.89] – 2.87 [95% CI: 2.27–3.64]), and the risk for in-hospital mortality (aOR range: 0.45 [95% CI: 0.36–0.56] – 1.39 [95% CI: 1.23–1.60]). CONCLUSION: The application of risk adjustment when comparing nursing care quality is crucial and enables a more objective assessment across hospitals or wards with heterogeneous patient populations. This approach has potential to establish a set of benchmarks that could allow comparison of outcomes and quality of nursing care between different hospitals and wards.

Background: Physical restraints are frequently used in acute care hospitals. Their application is associated with negative outcomes, while their intended preventive effect is debated. Objectives: To determine the prevalence of physical restraints and associated outcomes on medical wards in a tertiary care hospital. Methods: Retrospective cohort study (January 2018 to December 2021). We included all adult medical in-patients and excluded patients with admission to the intensive care unit, short stays (length of stay (LOS) < 48 h), and patients declining informed consent. Results: Of 11,979 admissions, the prevalence of patients with at least one restraint was 6.4% (n = 772). Sensor mats were used most frequently (73.0%, n = 666), followed by blanket restrictions (14.5%, n = 132), bedrails (8.8%, n = 80) and belts (3.7%, n = 34). On average, restraints were applied 19 h (standard deviation (SD) ± 161) before a fall. Average restraint duration was 42 h (SD ± 57). Patients with a restraint had longer LOS 8 days (IQR 5–14) vs. 5 days (IQR 3–9). Median nurses’ time expenditure was 309 h (IQR 242–402) vs. 182 h (IQR 136–243) for non-restrained patients. Patients with restraints fell more often (22.5% vs. 2.7%) and were more likely to die (13.3% vs. 5.1%). These differences persisted after adjusting a regression model for important clinical confounders. We saw a decline in the duration of restraints over the years, but no variation between wards. Conclusion: Approximately 6% of medical patients, mostly older and severely ill, were affected by restraint use. For the first time, we report data over 4 years up to ward-level granularity.

Electric vehicles’ high-voltage lithium-ion batteries are complex systems and can be sources of several hazards for interacting people. Sophisticated battery management systems (BMS) therefore constantly monitor their characteristics and varying states, to keep the battery within desired operational conditions and to mitigate safety risks as well as excessive degradation. However, there can be several situations where the battery is not in normal operation (e.g., a stand-alone battery) and a fully functional BMS monitoring function is not available. When necessary to interact with the system, its safety state must be deduced to ensure the safety of interactors. This can be a challenging task depending on a situation’s characteristics (time pressure, technical knowledge of involved people). Thus, this article discusses how the safety state of electric vehicle batteries can be evaluated quickly even by untrained people. To develop a solution, different scenarios, which require a battery’s state assessment, and the options for collecting relevant information are motivated and discussed, respectively. Finally, a mobile interface that can evaluate and display the safety state by using BMS-internal data is described and demonstrated.

AIM OF THE STUDY To compare admission characteristics, predictors and outcomes of patients with confirmed coronavirus disease 2019 (COVID-19) hospitalised in a tertiary care hospital in Switzerland during the first and second waves of the pandemic. METHODS This retrospective observational analysis included adult patients with severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) infection confirmed by a real-time reverse transcriptase polymerase chain reaction (RT-PCR) or rapid antigen test and hospitalised at the Cantonal Hospital Aarau from 26 February to 30 April 2020 (first wave) and from 1 October to 31 December 2020 (second wave). The primary endpoint was all-cause in-hospital mortality. The secondary endpoints were transfer to the intensive care unit (ICU) and length of hospital stay (LOS). RESULTS Overall, 486 patients (mean age 65.9 years ± 14.7 SD, 65% male) were included. Ninety-two patients (19%) died during the hospital stay and 92 patients (19%) were transferred to the ICU. Admission characteristics, including comorbidities and frailty, were similar for patients of the first (n = 100) and second wave (n = 386). However, during the second wave the median time from symptom onset to presentation to the emergency department (ED) was shorter (7 days, interquartile range [IQR] 4–9 vs 8 days, IQR 4–11; p = 0.02). In the second wave, most patients received high-dose glucocorticoid treatment (0% vs 76%, p

Summary: Phospholamban (PLN) is an important regulator of cardiac calcium handling due to its ability to inhibit the calcium ATPase SERCA. β-Adrenergic stimulation reverses SERCA inhibition via PLN phosphorylation and facilitates fast calcium reuptake. PLN also forms pentamers whose physiological significance has remained elusive. Using mathematical modeling combined with biochemical and cell biological experiments, we show that pentamers regulate both the dynamics and steady-state levels of monomer phosphorylation. Substrate competition by pentamers and a feed-forward loop involving inhibitor-1 can delay monomer phosphorylation by protein kinase A (PKA), whereas cooperative pentamer dephosphorylation enables bistable PLN steady-state phosphorylation. Simulations show that phosphorylation delay and bistability act as complementary filters that reduce the effect of random fluctuations in PKA activity, thereby ensuring consistent monomer phosphorylation and SERCA activity despite noisy upstream signals. Preliminary analyses suggest that the PLN mutation R14del could impair noise filtering, offering a new perspective on how this mutation causes cardiac arrhythmias.

Abstract Background A comprehensive in-hospital patient management with reasonable and economic resource allocation is arguably the major challenge of health-care systems worldwide, especially in elderly, frail, and polymorbid patients. The need for patient management tools to improve the transition process and allocation of health care resources in routine clinical care particularly for the inpatient setting is obvious. To address these issues, a large prospective trial is warranted. Methods The “Integrative Hospital Treatment in Older patients to benchmark and improve Outcome and Length of stay” (In-HospiTOOL) study is an investigator-initiated, multicenter effectiveness trial to compare the effects of a novel in-hospital management tool on length of hospital stay, readmission rate, quality of care, and other clinical outcomes using a time-series model. The study aims to include approximately 35`000 polymorbid medical patients over an 18-month period, divided in an observation, implementation, and intervention phase. Detailed data on treatment and outcome of polymorbid medical patients during the in-hospital stay and after 30 days will be gathered to investigate differences in resource use, inter-professional collaborations and to establish representative benchmarking data to promote measurement and display of quality of care data across seven Swiss hospitals. The trial will inform whether the “In-HospiTOOL” optimizes inter-professional collaboration and thereby reduces length of hospital stay without harming subjective and objective patient-oriented outcome markers. Discussion Many of the current quality-mirroring tools do not reflect the real need and use of resources, especially in polymorbid and elderly patients. In addition, a validated tool for optimization of patient transition and discharge processes is still missing. The proposed multicenter effectiveness trial has potential to improve interprofessional collaboration and optimizes resource allocation from hospital admission to discharge. The results will enable inter-hospital comparison of transition processes and accomplish a benchmarking for inpatient care quality.

Background: Malnutrition is highly prevalent in medical inpatients and may also negatively influence clinical outcomes of patients hospitalized with COVID-19. We analyzed the prognostic implication of different malnutrition parameters with respect to adverse clinical outcomes in patients hospitalized with COVID-19. Methods: In this observational study, consecutively hospitalized adult patients with confirmed COVID-19 at the Cantonal Hospital Aarau (Switzerland) were included between February and December 2020. The association between Nutritional Risk Screening 2002 (NRS 2002) on admission, body mass index, and admission albumin levels with in-hospital mortality and secondary endpoints was studied by using multivariable regression analyses. Results: Our analysis included 305 patients (median age of 66 years, 66.6% male) with a median NRS 2002-score of 2.0 (IQR 1.0, 3.0) points. Overall, 44 patients (14.4%) died during hospitalization. A step-wise increase in mortality risk with a higher nutritional risk was observed. When compared to patients with no risk for malnutrition (NRS 2002 < 3 points), patients with a moderate (NRS 2002 3–4 points) or high risk for malnutrition (NRS 2002 ≥ 5 points) had a two-fold and five-fold increase in risk, respectively (10.5% vs. 22.7% vs. 50.0%, p < 0.001). The increased risk for mortality was also confirmed in a regression analysis adjusted for gender, age, and comorbidities (odds ratio for high risk for malnutrition 4.68, 95% CI 1.18 to 18.64, p = 0.029 compared to patients with no risk for malnutrition). Conclusions: In patients with COVID-19, the risk for malnutrition was a risk factor for in-hospital mortality. Future studies should investigate the role of nutritional treatment in this patient population.

We study an oracle operation, along with its circuit design, which combined with the Grover diffusion operator boosts the probability of finding the minimum or maximum solutions on a weighted directed graph. We focus on the geometry of sequentially connected bipartite graphs, which naturally gives rise to solution spaces describable by Gaussian distributions. We then demonstrate how an oracle that encodes these distributions can be used to solve for the optimal path via amplitude amplification. And finally, we explore the degree to which this algorithm is capable of solving cases that are generated using randomized weights, as well as a theoretical application for solving the Traveling Salesman problem.

In 2020, the topic “Corona” will be omnipresent in the media. The headlines are dominated by negative reports about death rates, exit restrictions and the economic downturn. However, there are also numerous encouraging reports about “Corona heroes” who are contributing to overcoming the crisis with their self-sacrificing commitment. But it is not only journalists who draw attention to their deeds. On Twitter, Instagram and Co., politicians, companies and private individuals also thank the “heroes of everyday Corona life”. These positive exceptional figures are examined in more detail in the article, with the focus on the communicative patterns of their staging. For a specific use of language does not simply depict reality unchanged, but always provides a perspective on reality. Thus, the investigation not only reveals insights into language, but also provides information about how our society deals with critical events. Because heroes – so the conviction – solve crises. They perform heroic deeds with which they alleviate the needs and worries of the people. At the same time, they show us what values and behaviour are necessary to cope with a delicate situation. Overall, the analyses show that “heroes” have been omnipresent since the beginning of the pandemic at the latest – and they are often portrayed in the style of superheroes. The fact that Germany is repeatedly described as “post-heroic” is difficult to understand against this background. Rather, we seem to live in a “superheroic society”.

Background: A higher risk for severe clinical courses of coronavirus disease 2019 (COVID-19) has been linked to deficiencies of several micronutrients. We therefore studied the prevalence of deficiencies of eight different micronutrients in a cohort of hospitalized COVID-19-patients. Methods: We measured admission serum/plasma levels of vitamins A, B12, D, and E, as well as folic acid, zinc, selenium, and copper in 57 consecutively admitted adult patients with confirmed COVID-19 and analyzed prevalence of micronutrient deficiencies and correlations among micronutrient levels. Further, we studied associations of micronutrient levels with severe disease progression, a composite endpoint consisting of in-hospital mortality and/or need for intensive care unit (ICU) treatment with logistic regression. Results: Median age was 67.0 years (IQR 60.0, 74.2) and 60% (n = 34) were male. Overall, 79% (n = 45) of patients had at least one deficient micronutrient level and 33% (n = 19) had ≥3 deficiencies. Most prevalent deficiencies were found for selenium, vitamin D, vitamin A, and zinc (51%, 40%, 39%, and 39%, respectively). We found several correlations among micronutrients with correlation coefficients ranging from r = 0.27 to r = 0.42. The strongest associations with lower risk for severe COVID-19 disease progression (adjusted odds ratios) were found for higher levels of vitamin A (0.18, 95% CI 0.05–0.69, p = 0.01), zinc (0.73, 95% CI 0.55–0.98, p = 0.03), and folic acid (0.88, 95% CI 0.78–0.98, p = 0.02). Conclusions: We found a high prevalence of micronutrient deficiencies in mostly older patients hospitalized for COVID-19, particularly regarding selenium, vitamin D, vitamin A, and zinc. Several deficiencies were associated with a higher risk for more severe COVID-19 courses. Whether supplementation of micronutrients is useful for prevention of severe clinical courses or treatment of COVID-19 warrants further research.

As superconducting qubits continue to advance technologically, the realization of quantum algorithms from theoretical abstraction to physical implementation requires knowledge of both quantum circuit construction as well as hardware limitations. In this study, we present results from experiments run on IBM’s 20-qubit “Poughkeepsie” architecture, with the goal of demonstrating various qubit qualities and challenges that arise in designing quantum algorithms. These include experimentally measuring T1 and T2 coherence times, gate fidelities, sequential CNOT gates, techniques for handling ancilla qubits, and finally CCNOT and QFT† circuits implemented on several different qubit geometries. Our results demonstrate various techniques for improving quantum circuits, which must compensate for limited connectivity, either through the use of SWAP gates or additional ancilla qubits.

Background: Multimorbidity becomes more prevalent in patients admitted for acute myocardial infarction (AMI). We investigated the association of an increasing number of comorbidities with the excess risk of in-hospital mortality and other clinically outcomes in hospitalized AMI patients. Methods: In this population-based cohort study, we analyzed 104'906 admissions for AMI between 2012 and 2018 in Switzerland. We stratified patients based on four different age categories and investigated the association of the number of five common comorbidities (diabetes, chronic kidney-, chronic obstructive pulmonary-, cerebrovascular-, and peripheral artery disease) and risk of in-hospital mortality and other outcomes. Results: A total of 5'029 admitted AMI patients (4.8%) died during the hospital stay. We found a stepwise increase in mortality risk with each additional comorbidity. Compared to AMI patients with no comorbidity, comorbid patients had a 26% increased risk for mortality (adjusted odds ratio [OR] 1.26, 95% confidence interval [CI] 1.20 to 1.33) with a pronounced association in younger patients. The overall risk for ICU admission, prolonged length of hospital stay (LOS), and 30-day readmission was higher in comorbid patients as compared to those without a comorbidity of interest (ICU: OR 1.19, 95% CI 1.16 to 1.22; LOS: OR 1.84, 95% CI 1.79 to 1.89; Readmission: OR 1.23, 95% CI 1.19 to 1.28), respectively. Again, the association of the numbers of prevalent comorbidities with adverse outcomes was strongest in the youngest patient population. Conclusions: In patients with AMI, the burden of comorbidities has a strong association with in-hospital mortality and other adverse outcomes – especially in younger patients.

AIMS OF THE STUDY To describe admission characteristics, risk factors and outcomes of patients with coronavirus disease 2019 (COVID-19) hospitalised in a tertiary care hospital in Switzerland during the early phase of the pandemic. METHODS This retrospective cohort study included adult patients with a severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection confirmed by polymerase chain reaction (PCR) testing and hospitalised at the cantonal hospital Aarau (Switzerland) between 26 February 2020 and 30 April 2020. Our primary endpoint was severe COVID-19 progression defined as a composite of transfer to the intensive care unit (ICU) and in-hospital mortality. RESULTS A total of 99 patients (median age 67 years [interquartile range 56–76], 37% females) were included and 35% developed severe COVID-19 progression (24% needed ICU treatment, 19% died). Patients had a high burden of comorbidities with a median Charlson comorbidity index of 3 points and a high prevalence of hypertension (57%), chronic kidney disease (28%) and obesity (27%). Baseline characteristics with the highest prognostic value for the primary endpoint by means of area under the receiver operating characteristic curve were male gender (0.63) and initial laboratory values including shock markers (lactate on ambient air 0.67; lactate with O2 supply 0.70), markers of inflammation (C-reactive protein 0.72, procalcitonin 0.80) and markers of compromised oxygenation (pO2 0.75 on ambient air), whereas age and comorbidities provided little prognostic information. CONCLUSION This analysis provides insights into the first consecutively hospitalised patients with confirmed COVID-19 at a Swiss tertiary care hospital during the initial period of the pandemic. Markers of disease progression such as inflammatory markers, markers for shock and impaired respiratory function provided the most prognostic information regarding severe COVID-19 progression in our sample.

Abstract The 2015–2017 global migratory crisis saw unprecedented numbers of people on the move and tremendous diversity in terms of age, gender and medical requirements. This article focuses on key emerging public health issues around migrant populations and their interactions with host populations. Basic needs and rights of migrants and refugees are not always respected in regard to article 25 of the Universal Declaration of Human Rights and article 23 of the Refugee Convention. These are populations with varying degrees of vulnerability and needs in terms of protection, security, rights, and access to healthcare. Their health status, initially conditioned by the situation at the point of origin, is often jeopardised by adverse conditions along migratory paths and in intermediate and final destination countries. Due to their condition, forcibly displaced migrants and refugees face a triple burden of non-communicable diseases, infectious diseases, and mental health issues. There are specific challenges regarding chronic infectious and neglected tropical diseases, for which awareness in host countries is imperative. Health risks in terms of susceptibility to, and dissemination of, infectious diseases are not unidirectional. The response, including the humanitarian effort, whose aim is to guarantee access to basic needs (food, water and sanitation, healthcare), is gripped with numerous challenges. Evaluation of current policy shows insufficiency regarding the provision of basic needs to migrant populations, even in the countries that do the most. Governments around the world need to rise to the occasion and adopt policies that guarantee universal health coverage, for migrants and refugees, as well as host populations, in accordance with the UN Sustainable Development Goals. An expert consultation was carried out in the form of a pre-conference workshop during the 4th International Conference on Prevention and Infection Control (ICPIC) in Geneva, Switzerland, on 20 June 2017, the United Nations World Refugee Day.

This article discusses extended implications of Lefebvre’s The Production of Space in the context of contemporary global neoliberalism, by focus on its presence in architectural space as lived space and spatial practice. The main discussion concerns Lefebvre’s concepts of abstract space, in relation to Felix Guattari’s three ecologies, and the Aristotelean triad of aisthesis, poiesis and techné. The focus here concerns material architectural space and its relation to modes of subjectivity, especially creative-productive versus consuming subjectivities. The argument begins by elaborating on an understanding of abstract space as present in material architectural space as pervasive processes of disassociation of materiality and labor, and proceeds to through these concepts discuss modes of subjectivity—the dependence of abstract space on subjects as consumers—and the way this relates to challenges of sustainability. It further points to the importance of architectural space considered as built material environment for creative-productive modes of subjectivity which challenge abstract space and in extension consumer society, by offering potential dispositions that set subjects in a different relation to the world.

Description of redox reactions is critically important for understanding and rational design of materials for electrochemical technologies, including metal-ion batteries, catalytic surfaces, or redox-flow cells. Most of these technologies utilize redox-active transition metal compounds due to their rich chemistry and their beneficial physical and chemical properties for these types of applications. A century since its introduction, the concept of formal oxidation states (FOS) is still widely used for rationalization of the mechanisms of redox reactions, but there exists a well-documented discrepancy between FOS and the electron density-derived charge states of transition metal ions in their bulk and molecular compounds. We summarize our findings and those of others which suggest that density-driven descriptors are, in certain cases, better suited to characterize the mechanism of redox reactions, especially when anion redox is involved, which is the blind spot of the FOS ansatz.

Nowadays, batteries for electric vehicles are expected to have a high energy density, allow fast charging and maintain long cycle life, while providing affordable traction, and complying with stringent safety and environmental standards. Extensive research on novel materials at cell level is hence needed for the continuous improvement of the batteries coupled towards achieving these requirements. This article firstly delves into future developments in electric vehicles from a technology perspective, and the perspective of changing end-user demands. After these end-user needs are defined, their translation into future battery requirements is described. A detailed review of expected material developments follows, to address these dynamic and changing needs. Developments on anodes, cathodes, electrolyte and cell level will be discussed. Finally, a special section will discuss the safety aspects with these increasing end-user demands and how to overcome these issues.

The degradation of lithium-ion cells is an important aspect, not only for quality management, but also for the customer of the application like, e.g., scooters or electric vehicles. During the lifetime of the system, the overall health on the battery plays a key role in its depreciation. Therefore, it is necessary to monitor the health of the battery during operation, i.e., cycle life, but also during stationary conditions, i.e., calendar aging. In this work, the degradation due to calendar aging is analyzed for six different cell chemistries in terms of capacity degradation and impedance increase and their performance are being compared. In a new proposed metric, the relative deviations between various cells with the exact identical aging history are being analyzed for their degradation effects and their differences, which stands out in comparison to similar research. The capacity loss was found to be most drastic at 60 °C and at higher storage voltages, even for titanate-oxide cells. LiNiMnCoO2 (NMC), LiNiCoAlO2 (NCA) and Li2TiO3 (LTO) cells at 60 °C showed the most drastic capacity decrease. NMC and NCA cells at 60 °C and highest storage voltage did not show any open circuit voltage, as their current interrupt mechanism triggered. The effect of aging shows no uniform impact on the changes in the capacity variance when comparing different aging conditions, with respect to the evaluated standard deviation for all cells. The focus of this work was on the calendar aging effect and may be supplemented in a second study for cyclic aging.

BACKGROUND:Reducing delays in hospital discharge is important to improve transition processes and reduce health care costs. The recently proposed post-acute care discharge score focusing on the self-care abilities before hospital admission allows early identification of patients with a need for post-acute care. New limitations in self-care abilities identified during hospitalization may also indicate a risk. Our aim was to investigate whether the addition of the post-acute care discharge score and a validated self-care instrument would improve the prognostic accuracy to predict post-acute discharge needs in unselected medical inpatients. METHODS:We included consecutive adult medical and neurological inpatients. Logistic regression models with area under the receiver operating characteristic curve were calculated to study associations of post-acute discharge score and self-care index with post-acute discharge risk. We calculated joint regression models and reclassification statistics including the net reclassification index and integrated discrimination improvement to investigate whether merging the self-care index and the post-acute discharge score leads to better diagnostic accuracy. RESULTS:Out of 1342 medical and 402 neurological patients, 150 (11.18%) and 94 (23.38%) have reached the primary endpoint of being discharged to a post-acute care facility. Multivariate analysis showed that the self-care index is an outcome predictor (OR 0.897, 95%CI 0.864-0.930). By combining the self-care index and the post-acute care discharge score discrimination for medical (from area under the curve 0.77 to 0.83) and neurological patients (from area under the curve 0.68 to 0.78) could be significantly improved. Reclassification statistics also showed significant improvements with regard to net reclassification index (14.2%, p

It is a fact that electric vehicles (EVs) are beneficial for climate protection. However, the current challenge is to decide on whether to reuse an EV battery or to recycle it after its first use. This paper theoretically investigates these areas i.e., recycle and reuse. It was found that there are several commercially used recycling processes and also some are under research to regain maximum possible materials and quantity. The concept of reusing (second life) of the battery is promising because, at the end of the first life, batteries from EVs can be used in several applications such as storing energy generated from renewable sources to support the government grid. However, the cost and life-cycle analysis (LCA) demonstrated that there are several aspects involved in battery reuse applications. Henceforth, one LCA generalised method cannot provide an optimal approach for all cases. It is important to have a detailed study on each of the battery reusing applications. Until then, it is safe to say that reusing the battery is a good option as it would give some time to recycling companies to develop cost and energy-efficient methods.

Biomass-derived bioplastic has potential to replace conventional plastic of fossil origin in plastics applications where sufficiently similar material properties can be achieved. The desired result of substitution would support the plastics industry with renewable resources and also lead to a reduction in fossil CO2 emissions. These conditions are necessary for sustainable development and it is equally vital to prevent the shift of the environmental problem. Consequently, it is important to evaluate and consider environmental impacts holistically. For this investigation one option is the Life Cycle Assessment (LCA) method. Plastic is the collective term for polymeric materials, where the diversity and specifications of plastic products in production and application are enormous. In order to support the introduction of bioplastics into the market, it is important to focus on products that have a high potential for environmental sustainability when replacing conventional plastics. The objective of this study is to examine the application of a flexible LCA tool on four different examples, where bioplastic substitutes conventional plastic, to understand the change of environmental performances in the respective replacement. Setting the scope, samples from the following four plastic application fields are considered: Packaging, Building & Construction, Electrical & Electronic and Household. The change in the impact categories global warming potential GWP, acidification potential AP and eutrophication potential EP is taken into account. All assessed scenarios show a reduction in GWP and an increase in AP and EP. The product example from Building & Construction evaluating polyethylene, shows the highest potential of all examples to reduce GWP but simultaneously has the largest increase in AP and EP. This study confirms the concern of the problem shift for a bioplastic industry and encourages that environmental impacts should be made accessible in a transparent way, specifying assumptions and limitations of the quantitative outcome. These findings highlight the importance and need to consider the entire impact on the environment when implementing a novel technology that aims at sustainable development.

Red cell distribution width (RDW) predicts disease outcome in several patient populations, but its prognostic value in addition to other disease parameters in unselected medical inpatients remains unclear. Our aim was to investigate the association of admission RDW levels and mortality adjusted for several disease pathways in unselected medical patients from a previous multicenter study.We included consecutive adult, medical patients at the time point of hospital admission through the emergency department into this observational, cohort study. The primary endpoint was mortality at 30-day. To study association of admission RDW and outcomes, we calculated regression analysis with step-wise inclusion of clinical and laboratory parameters from different biological pathways.The 30-day mortality of the 4273 included patients was 5.6% and increased from 1.4% to 14.3% from the lowest to the highest RDW quartile. There was a strong association of RDW and mortality in unadjusted analysis (OR 1.32; 95%CI 1.27-1.39, p

Rational design of active electrode materials is important for the development of advanced lithium and post-lithium batteries. Ab initio modeling can provide mechanistic understanding of the performance of prospective materials and guide design. We review our recent comparative ab initio studies of lithium, sodium, potassium, magnesium, and aluminum interactions with different phases of several actively experimentally studied electrode materials, including monoelemental materials carbon, silicon, tin, and germanium, oxides TiO2 and VxOy as well as sulphur-based spinels MS2 (M = transition metal). These studies are unique in that they provided reliable comparisons, i.e., at the same level of theory and using the same computational parameters, among different materials and among Li, Na, K, Mg, and Al. Specifically, insertion energetics (related to the electrode voltage) and diffusion barriers (related to rate capability), as well as phononic effects, are compared. These studies facilitate identification of phases most suitable as anode or cathode for different types of batteries. We highlight the possibility of increasing the voltage, or enabling electrochemical activity, by amorphization and p-doping, of rational choice of phases of oxides to maximize the insertion potential of Li, Na, K, Mg, Al, as well as of rational choice of the optimum sulfur-based spinel for Mg and Al insertion, based on ab initio calculations. Some methodological issues are also addressed, including construction of effective localized basis sets, applications of Hubbard correction, generation of amorphous structures, and the use of a posteriori dispersion corrections.

New insight into the biomechanics of cancer cell motility in 3D extracellular matrix (ECM) environments would significantly enhance our understanding of aggressive cancers and help identify new targets for intervention. While several methods for measuring the forces involved in cell-matrix interactions have been developed, previous to this study none have been able to measure forces in a fibrillar environment. We have developed a novel assay for simultaneously measuring cell mechanotransduction and motility in 3D fibrillar environments. The assay consists of a controlled-density fibrillar collagen gel atop a controlled-stiffness polyacrylamide (PAA) surface. Forces generated by living cells and their migration in the 3D collagen gel were measured with the 3D motion of tracer beads within the PAA layer. Here, this 3D fibril force assay is used to study the role of the invasion-associated protein kinase Src in mechanotransduction and motility. Src expression and activation are linked with proliferation, invasion, and metastasis, and have been shown to be required in 2D for invadopodia membranes to direct and mediate invasion. Breast cancer cell line MDA-MD-231 was stably transfected with GFP-tagged constitutively active Src or wild-type Src. In 3D fibrillar collagen matrices we found that, relative to wild-type Src, constitutively active Src: 1) increased the strength of cell-induced forces on the ECM, 2) did not significantly change migration speed, and 3) increased both the duration and the length, but not the number, of long membrane protrusions. Taken together, these results support the hypothesis that Src controls invasion by controlling the ability of the cell to form long lasting cellular protrusions to enable penetration through tissue barriers, in addition to its role in promoting invadopodia matrix-degrading activity.