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Background Heart failure with reduced ejection fraction is associated with potentially deleterious imbalance of the cardiac autonomic nervous system. Sacubitril/valsartan (angiotensin receptor‐neprilysin inhibitor [ARNI]) reduces cardiovascular mortality and hospitalization for heart failure with reduced ejection fraction. Whether ARNI affects the cardiac autonomic nervous system has not been studied. Methods and Results This investigator‐initiated, prospective, single‐center cohort study compared heart rate (HR) variability, HR, deceleration capacity, and periodic repolarization dynamics as noninvasive measures of the cardiac autonomic nervous system before and after initiation of ARNI therapy. Patients underwent standardized 12‐lead Holter‐ECG, echocardiography and laboratory testing before and 3 months after start of therapy. End points were changes in HR variability (SD of normal‐to‐normal intervals, mean square of differences between consecutive R‐R intervals), HR, deceleration capacity, and periodic repolarization dynamics as well as ventricular function and NT‐proBNP (N‐terminal pro‐B‐type natriuretic peptide). Of 63 patients with heart failure with reduced ejection fraction enrolled, 48 (76.2%) patients were still on ARNI at follow‐up. SD of normal‐to‐normal intervals increased from 25 to 36 milliseconds (P

The worldwide dispersal of the ectoparasitic mite Varroa destructor from its Asian origins has fundamentally transformed the relationship of the honey bee (Apis mellifera) with several of its viruses, via changes in transmission and/or host immunosuppression. The extent to which honey bee-virus relationships change after Varroa invasion is poorly understood for most viruses, in part because there are few places in the world with several geographically close but completely isolated honey bee populations that either have, or have not, been exposed long-term to Varroa, allowing for separate ecological, epidemiological, and adaptive relationships to develop between honey bees and their viruses, in relation to the mite's presence or absence. The Azores is one such place, as it contains islands with and without the mite. Here, we combined qPCR with meta-amplicon deep sequencing to uncover the relationship between Varroa presence, and the prevalence, load, diversity, and phylogeographic structure of eight honey bee viruses screened across the archipelago. Four viruses were not detected on any island (ABPV-Acute bee paralysis virus, KBV-Kashmir bee virus, IAPV-Israeli acute bee paralysis virus, BeeMLV-Bee macula-like virus); one (SBV-Sacbrood virus) was detected only on mite-infested islands; one (CBPV-Chronic bee paralysis virus) occurred on some islands, and two (BQCV-Black queen cell virus, LSV-Lake Sinai virus,) were present on every single island. This multi-virus screening builds upon a parallel survey of Deformed wing virus (DWV) strains that uncovered a remarkably heterogeneous viral landscape featuring Varroa-infested islands dominated by DWV-A and -B, Varroa-free islands naïve to DWV, and a refuge of the rare DWV-C dominating the easternmost Varroa-free islands. While all four detected viruses investigated here were affected by Varroa for one or two parameters (usually prevalence and/or the Richness component of ASV diversity), the strongest effect was observed for the multi-strain LSV. Varroa unambiguously led to elevated prevalence, load, and diversity (Richness and Shannon Index) of LSV, with these results largely shaped by LSV-2, a major LSV strain. Unprecedented insights into the mite-virus relationship were further gained from implementing a phylogeographic approach. In addition to enabling the identification of a novel LSV strain that dominated the unique viral landscape of the easternmost islands, this approach, in combination with the recovered diversity patterns, strongly suggests that Varroa is driving the evolutionary change of LSV in the Azores. This study greatly advances the current understanding of the effect of Varroa on the epidemiology and adaptive evolution of these less-studied viruses, whose relationship with Varroa has thus far been poorly defined.

Abstract Infectious and parasitic agents (IPAs) and their associated diseases are major environmental stressors that jeopardize bee health, both alone and in interaction with other stressors. Their impact on pollinator communities can be assessed by studying multiple sentinel bee species. Here, we analysed the field exposure of three sentinel managed bee species (Apis mellifera, Bombus terrestris and Osmia bicornis) to 11 IPAs (six RNA viruses, two bacteria, three microsporidia). The sentinel bees were deployed at 128 sites in eight European countries adjacent to either oilseed rape fields or apple orchards during crop bloom. Adult bees of each species were sampled before their placement and after crop bloom. The IPAs were detected and quantified using a harmonised, high-throughput and semi-automatized qPCR workflow. We describe differences among bee species in IPA profiles (richness, diversity, detection frequencies, loads and their change upon field exposure, and exposure risk), with no clear patterns related to the country or focal crop. Our results suggest that the most frequent IPAs in adult bees are more appropriate for assessing the bees’ IPA exposure risk. We also report positive correlations of IPA loads supporting the potential IPA transmission among sentinels, suggesting careful consideration should be taken when introducing managed pollinators in ecologically sensitive environments.

Abstract Sodium vanadium phosphate Na3V2(PO4)3 (NVP) is a promising next‐generation cathode material for sodium‐ion batteries (SIB) but the practical application as a cathode active material for SIBs is hindered by its poor electronic conductivity. To overcome this limitation and to improve the electrochemical performance in terms of rate capability and cycling stability, carbon coatings are a viable approach. In this work, we utilized a spray‐drying synthesis process and systematically varied the processing parameters to optimize the electrochemical performance of NVP/carbon composite materials. The spray‐drying process yields spherical, porous granules of NVP particles embedded in a carbon matrix, which is formed by the thermal decomposition of polyacrylic acid or β‐lactose.

Invasive vectors can induce dramatic changes in disease epidemiology. While viral emergence following geographical range expansion of a vector is well known, the influence a vector can have at the level of the host's pathobiome is less well understood. Taking advantage of the formerly heterogeneous spatial distribution of the ectoparasitic mite Varroa destructor that acts as potent virus vector among honeybees Apis mellifera, we investigated the impact of its recent global spread on the viral community of honeybees in a retrospective study of historical samples. We hypothesized that the vector has had an effect on the epidemiology of several bee viruses, potentially altering their transmissibility and/or virulence, and consequently their prevalence, abundance, or both. To test this, we quantified the prevalence and loads of 14 viruses from honeybee samples collected in mite-free and mite-infested populations in four independent geographical regions. The presence of the mite dramatically increased the prevalence and load of deformed wing virus, a cause of unsustainably high colony losses. In addition, several other viruses became more prevalent or were found at higher load in mite-infested areas, including viruses not known to be actively varroa-transmitted, but which may increase opportunistically in varroa-parasitized bees.

A heart attack is often a very drastic, sometimes even traumatic, life event for patients, which is frequently associated with fear of death. Not only is the body under enormous stress, a heart attack also means stress for the psyche. “Stressful life events are part of human existence and are compensated for with individual coping strategies or defense mechanisms. However, if the strain is overwhelming or the possible solutions are subjectively exhausted, pathological reactions may occur.”(1) From a psychosomatic perspective, an acute myocardial infarction is a “significant biographical breaking point with far-reaching psychological consequences.”(2) This pilot study investigates whether a psychocardiological intervention integrated into standard therapeutic care in the form of a structured conversation with a biopsychosocial model (in the sense of the WHO understanding of health), adapted to the patient’s level of need, can have a positive effect on quality of life and on psychological comorbidity in the short- and long-term course of recovery. 45 patients with acute myocardial infarction (13 female, 32 male), who were randomly assigned to two intervention groups, were followed for six months after the cardiac event with individualized and collaborative psychocardiological interventions and tested for mental illness. The results of the study show that such individualized care with additional screening for psychological comorbidities in the early phase after a myocardial infarction can significantly help patients to help themselves, provide early indications of the presence of a psychological disorder, and accelerate the initiation of adequate treatment. The integration of a psychocardiological component into the standard therapy of myocardial infarction patients in the early phase after the cardiac event seems to be a valuable contribution to the therapy and should receive encouragement in the future. Furthermore, this pilot study offers new and interesting approaches for future research.

Nanoparticles have many advantages as active materials, such as a short diffusion length, low charge transfer resistance, or a reduced probability of cracking. However, their low packing density makes them unsuitable for commercial battery applications. Hierarchically structured microparticles are synthesized from nanoscale primary particles by targeted aggregation. Due to their open accessible porosity, they retain the advantages of nanomaterials but can be packed much more densely. However, the intrinsic porosity of the secondary particles leads to limitations in processing properties and increases the overall porosity of the electrode, which must be balanced against the improved rate stability and increased lifetime. This is demonstrated for an established cathode material for lithium-ion batteries (LiNi0.33Co0.33Mn0.33O2, NCM111). For active materials with low electrical or ionic conductivity, especially post-lithium systems, hierarchically structured particles are often the only way to produce competitive electrodes.

Abstract This study addresses the improved cycling stability of Li‐ion batteries based on Fe–Ti‐doped LiNi0.5Mn1.5O4 (LNMO) high‐voltage cathode active material and graphite anodes. By using 1 wt% Li3PO4 as cathode additive, over 90% capacity retention for 1000 charge–discharge cycles and remaining capacities of 109 mAh g−1 are reached in a cell with an areal capacity of 2.3 mAh cm−2 (potential range: 3.5–4.9 V). Cells without the additive, in contrast, suffer from accelerated capacity loss and increase polarization, resulting in capacity retention of only 78% over 1000 cycles. An electrolyte consisting of ethylene carbonate, dimethyl carbonate, and LiPF6 is used without additional additives. The significantly improved cycling stability of the full cells is mainly due to two factors, namely, the low MnIII content of the Fe–Ti‐doped LNMO active material and the use of the cathode‐additive Li3PO4. Crystalline Li3PO4 yields a drastic reduction of transition metal deposition on the graphite anode and prevents Li loss and the propagation of cell polarization. Li3PO4 is added to the cathode slurry that makes it a very simple and scalable process, first reported herein. The positive effects of crystalline Li3PO4 as electrode additive, however, should apply to other cell chemistries as well.

Background: Patients with obesity are at higher risk of developing atrial fibrillation (AF) and benefit from radiofrequency ablation. Potentially, cryoballoon ablation (CBA) may be equally effective and safe in such patients. Methods: We conducted a prospective, single-center study to investigate whether CBA for pulmonary vein isolation is as effective and safe in obese patients as it is in non-obese controls. Primary efficacy endpoint was recurrence of AF, atrial flutter or atrial tachycardia after a 90-day blanking period. Safety endpoints were death, stroke or procedure-associated complications. Conduction of a subgroup analysis regarding the impact of additional diabetes was predefined in case the primary efficacy endpoint was met. The study was event driven and powered for noninferiority. Results: A total of 949 patients underwent CBA (251 obese with mean body-mass-index 33.5 ± 3 kg/m2 and 698 non-obese with mean body-mass-index 25.3 ± 3 kg/m2) during a 5-year recruitment period. Median follow-up was 15 months. The primary efficacy endpoint occurred in 78/251 obese and 247/698 non-obese patients (12-months Kaplan-Meier event-rate estimates, hazard ratio 0.79; 95% confidence interval [CI], 0.58 to 1.07; log-rank P = 0.0002 for noninferiority). No differences were observed in safety end point occurrence (P = 0.78). The occurrence of primary efficacy end point was found to be unaffected by the presence of diabetes in the prespecified subgroup analysis (log-rank P = 0.57). Conclusion: CBA is effective and safe in obese and DM patients. Weighing the high cardiovascular risk of obese patients against a reduction of cardiovascular events by early rhythm control, CBA should be offered to this patient population.

IntroductionHeterogeneity in composition and spatial configuration of landscape elements support diversity and abundance of flower-visiting insects, but this is likely dependent on taxonomic group, spatial scale, weather and climatic conditions, and is particularly impacted by agricultural intensification. Here, we analyzed the impacts of both aspects of landscape heterogeneity and the role of climatic and weather conditions on pollinating insect communities in two economically important mass-flowering crops across Europe.MethodsUsing a standardized approach, we collected data on the abundance of five insect groups (honey bees, bumble bees, other bees, hover flies and butterflies) in eight oilseed rape and eight apple orchard sites (in crops and adjacent crop margins), across eight European countries (128 sites in total) encompassing four biogeographic regions, and quantified habitat heterogeneity by calculating relevant landscape metrics for composition (proportion and diversity of land-use types) and configuration (the aggregation and isolation of land-use patches).ResultsWe found that flower-visiting insects responded to landscape and climate parameters in taxon- and crop-specific ways. For example, landscape diversity was positively correlated with honey bee and solitary bee abundance in oilseed rape fields, and hover fly abundance in apple orchards. In apple sites, the total abundance of all pollinators, and particularly bumble bees and solitary bees, decreased with an increasing proportion of orchards in the surrounding landscape. In oilseed rape sites, less-intensively managed habitats (i.e., woodland, grassland, meadows, and hedgerows) positively influenced all pollinators, particularly bumble bees and butterflies. Additionally, our data showed that daily and annual temperature, as well as annual precipitation and precipitation seasonality, affects the abundance of flower-visiting insects, although, again, these impacts appeared to be taxon- or crop-specific.DiscussionThus, in the context of global change, our findings emphasize the importance of understanding the role of taxon-specific responses to both changes in land use and climate, to ensure continued delivery of pollination services to pollinator-dependent crops.

Abstract Li0.35La0.55TiO3 (LLTO) coated spinel LiNi0.5Mn1.5O4 (LNMO) as cathode material is fabricated by a new method using hydrogen‐peroxide as activating agent. The structure of the obtained active materials is investigated using scanning electron microscopy (SEM), transmission electron microscopy (TEM), X‐ray diffraction (XRD), and X‐ray photoelectron spectroscopy (XPS), and the electrochemical properties of the prepared cathodes are probed by the charge–discharge studies. The morphology of the coating material on the surface and the degree of coverage of the coated particles is investigated by the SEM, which shows a fully dense and homogeneous coating (thickness ≈ 7 nm, determined by TEM) on the surface of active material. XRD studies of the coated active materials treated at different temperatures (between 300 °C and 1000 °C) reveal expansion or contraction of the unit cell in dependence of the coating concentration and degree of Ti diffusion. It is concluded, that for the LNMO particles calcined at low temperatures, the LLTO coating layer is still intact and protects the active material from the interaction with the electrolyte. However, for the coated particles treated at high temperatures, Ti ions migrate into the structure of LNMO during the modification process between 500 °C and 800 °C, resulting in “naked” and unprotected particles.

Abstract The global movement of bees for agricultural pollination services can affect local pollinator populations via hybridization. When commercial bumblebees are of the same species but of different geographic origin, intraspecific hybridization may result in beneficial integration of new genetic variation, or alternatively may disrupt locally adapted gene complexes. However, neither the existence nor the extent of genomic introgression and evolutionary divergence between wild and commercial bumblebees is fully understood. We obtained whole‐genome sequencing data from wild and commercial Bombus terrestris collected from sites in Southern Sweden with and without long‐term use of commercially imported B. terrestris. We search for evidence of introgression, dispersal and genome‐wide differentiation in a comparative genomic analysis of wild and commercial bumblebees. Commercial B. terrestris were found in natural environments near sites where commercial bumblebees were used, as well as drifting wild B. terrestris in commercial bumblebee colonies. However, we found no evidence for widespread, recent genomic introgression of commercial B. terrestris into local wild conspecific populations. We found that wild B. terrestris had significantly higher nucleotide diversity (Nei's pi, π), while the number of segregating sites (Watterson's theta, θw) was higher in commercial B. terrestris. A highly divergent region on chromosome 11 was identified in commercial B. terrestris and found to be enriched with structural variants. The genes present in this region are involved in flight muscle contraction and structure and pathogen immune response, providing evidence for differing evolutionary processes operating in wild and commercial B. terrestris. We did not find evidence for recent introgression, suggesting that co‐occurring commercial B. terrestris have not disrupted evolutionary processes in wild B. terrestris populations.

Abstract Viruses are omnipresent, yet the knowledge on drivers of viral prevalence in wild host populations is often limited. Biotic factors, such as sympatric managed host species, as well as abiotic factors, such as climatic variables, are likely to impact viral prevalence. Managed and wild bees, which harbor several multi-host viruses with a mostly fecal–oral between-species transmission route, provide an excellent system with which to test for the impact of biotic and abiotic factors on viral prevalence in wild host populations. Here we show on a continental scale that the prevalence of three broad host viruses: the AKI-complex (Acute bee paralysis virus, Kashmir bee virus and Israeli acute paralysis virus), Deformed wing virus, and Slow bee paralysis virus in wild bee populations (bumble bees and solitary bees) is positively related to viral prevalence of sympatric honey bees as well as being impacted by climatic variables. The former highlights the need for good beekeeping practices, including Varroa destructor management to reduce honey bee viral infection and hive placement. Furthermore, we found that viral prevalence in wild bees is at its lowest at the extreme ends of both temperature and precipitation ranges. Under predicted climate change, the frequency of extremes in precipitation and temperature will continue to increase and may hence impact viral prevalence in wild bee communities.

Abstract In 1977, a sample of diseased adult honeybees (Apis mellifera) from Egypt was found to contain large amounts of a previously unknown virus, Egypt bee virus, which was subsequently shown to be serologically related to deformed wing virus (DWV). By sequencing the original isolate, we demonstrate that Egypt bee virus is in fact a fourth unique, major variant of DWV (DWV-D): more closely related to DWV-C than to either DWV-A or DWV-B. DWV-A and DWV-B are the most common DWV variants worldwide due to their close relationship and transmission by Varroa destructor. However, we could not find any trace of DWV-D in several hundred RNA sequencing libraries from a worldwide selection of honeybee, varroa and bumblebee samples. This means that DWV-D has either become extinct, been replaced by other DWV variants better adapted to varroa-mediated transmission, or persists only in a narrow geographic or host range, isolated from common bee and beekeeping trade routes.