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Abstract To improve our understanding of the perception of odors, researchers are often required to undertake experimental procedures with users exposed to multiple odors in a variety of settings, including to diagnose smell loss in clinics and care homes. Existing smell tests are typically administered using multiple sniffing pens, manually presented to patients by a highly specialized nurse using a time-consuming and complex testing paradigm. Automated odor delivery devices, such as olfactometer systems, exist but are expensive, bulky and typically lab based, making them difficult to use for on the ground odor delivery. Here we have developed a portable, affordable, odor delivery device that can deliver 24 odors through individual channels with high temporal precision and without cross-contamination. The device allows for the rapid, flexible sequencing of odors via digital control using a mobile application and has been experimentally validated in the lab, as well as tested on patients. The design provides several advantages for investigating olfactory perception and offers the possibility that users can one day self-administer smell tests in a range of settings, including at home, allowing smell healthcare services to evolve and become part of a routine practice and self-care culture.

Cities can host significant biological diversity. Yet, urbanisation leads to the loss of habitats, species, and functional groups. Understanding how multiple taxa respond to urbanisation globally is essential to promote and conserve biodiversity in cities. Using a dataset encompassing six terrestrial faunal taxa (amphibians, bats, bees, birds, carabid beetles and reptiles) across 379 cities on 6 continents, we show that urbanisation produces taxon-specific changes in trait composition, with traits related to reproductive strategy showing the strongest response. Our findings suggest that urbanisation results in four trait syndromes (mobile generalists, site specialists, central place foragers, and mobile specialists), with resources associated with reproduction and diet likely driving patterns in traits associated with mobility and body size. Functional diversity measures showed varied responses, leading to shifts in trait space likely driven by critical resource distribution and abundance, and taxon-specific trait syndromes. Maximising opportunities to support taxa with different urban trait syndromes should be pivotal in conservation and management programmes within and among cities. This will reduce the likelihood of biotic homogenisation and helps ensure that urban environments have the capacity to respond to future challenges. These actions are critical to reframe the role of cities in global biodiversity loss.

Abstract Soils are a principal global reservoir of mercury (Hg), a neurotoxic pollutant that is accumulating through anthropogenic emissions to the atmosphere and subsequent deposition to terrestrial ecosystems. The fate of Hg in global soils remains uncertain, however, particularly to what degree Hg is re-emitted back to the atmosphere as gaseous elemental mercury (GEM). Here we use fallout radionuclide (FRN) chronometry to directly measure Hg accumulation rates in soils. By comparing these rates with measured atmospheric fluxes in a mass balance approach, we show that representative Arctic, boreal, temperate, and tropical soils are quantitatively efficient at retaining anthropogenic Hg. Potential for significant GEM re-emission appears limited to a minority of coniferous soils, calling into question global models that assume strong re-emission of legacy Hg from soils. FRN chronometry poses a powerful tool to reconstruct terrestrial Hg accumulation across larger spatial scales than previously possible, while offering insights into the susceptibility of Hg mobilization from different soil environments.

Abstract Deciphering nature's remarkable way of encoding functions in its biominerals holds the potential to enable the rational development of nature‐inspired materials with tailored properties. However, the complex processes that convert solution‐state precursors into solid biomaterials remain largely unknown. In this study, an unconventional approach is presented to characterize these precursors for the diatom‐derived peptides R5 and synthetic Silaffin‐1A1 (synSil‐1A1). These molecules can form defined supramolecular assemblies in solution, which act as templates for solid silica structures. Using a tailored structural biology toolbox, the structure‐function relationships of these self‐assemblies are unveiled. NMR‐derived constraints are employed to enable a recently developed fractal‐cluster formalism and then reveal the architecture of the peptide assemblies in atomistic detail. Finally, by monitoring the self‐assembly activities during silica formation at simultaneous high temporal and residue resolution using real‐time spectroscopy, the mechanism is elucidated underlying template‐driven silica formation. Thus, it is demonstrated how to exercise morphology control over bioinorganic solids by manipulating the template architectures. It is found that the morphology of the templates is translated into the shape of bioinorganic particles via a mechanism that includes silica nucleation on the solution‐state complexes’ surfaces followed by complete surface coating and particle precipitation.

Estuaries are a conduit of mercury (Hg) from watersheds to the coastal ocean, and salt marshes play an important role in coastal Hg cycling. Hg cycling in upland terrestrial ecosystems has been well studied, but processes in densely vegetated salt marsh ecosystems are poorly characterized. We investigated Hg dynamics in vegetation and soils in the Plum Island Sound estuary in Massachusetts, USA, and specifically assessed the role of marsh vegetation for Hg deposition and turnover. Monthly quantitative harvesting of aboveground biomass showed strong linear seasonal increases in Hg associated with plants, with a 4-fold increase in Hg concentration and an 8-fold increase in standing Hg mass from June (3.9 ± 0.2 µg kg−1 and 0.7 ± 0.4 µg m−2, respectively) to November (16.2 ± 2.0 µg kg−1 and 5.7 ± 2.1 µg m−2, respectively). Hg did not increase further in aboveground biomass after plant senescence, indicating physiological controls of vegetation Hg uptake in salt marsh plants. Hg concentrations in live roots and live rhizomes were 11 and 2 times higher than concentrations in live aboveground biomass, respectively. Furthermore, live belowground biomass Hg pools (Hg in roots and rhizomes, 108.1 ± 83.4 µg m−2) were more than 10 times larger than peak standing aboveground Hg pools (9.0 ± 3.3 µg m−2). A ternary mixing model of measured stable Hg isotopes suggests that Hg sources in marsh aboveground tissues originate from about equal contributions of root uptake (∼ 35 %), precipitation uptake (∼ 33 %), and atmospheric gaseous elemental mercury (GEM) uptake (∼ 32 %). These results suggest a more important role of Hg transport from belowground (i.e., roots) to aboveground tissues in salt marsh vegetation than upland vegetation, where GEM uptake is generally the dominant Hg source. Roots and soils showed similar isotopic signatures, suggesting that belowground tissue Hg mostly derived from soil uptake. Annual root turnover results in large internal Hg recycling between soils and plants, estimated at 58.6 µg m−2 yr−1. An initial mass balance of Hg indicates that the salt marsh presently serves as a small net Hg sink for environmental Hg of 5.2 µg m−2 yr−1.

Abstract Microvascular obstruction (MVO) often occurs in ST‐elevation myocardial infarction (STEMI) patients after percutaneous coronary intervention (PCI). Diagnosis and treatment of MVO lack appropriate and established procedures. This study focused on two major points by using an in vitro multiscale flow model, which comprised an aortic root model with physiological blood flow and a microfluidic model of the microcirculation with vessel diameters down to 50 μm. First, the influence of porcine microthrombi (MT), injected into the fluidic microchip, on perfusion was investigated. We found that only 43% of all injected MT were fully occlusive. Second, it could also be shown that the maximal concentration of a dye (representing therapeutic agent) during intracoronary infusion could be increased on average by 58%, when proximally occluding the coronary artery by a balloon during drug infusion. The obtained results and insights enhance the understanding of perfusion in MVO‐affected microcirculation and could lead to improved treatment methods for MVO patients.

As Earth's atmospheric temperatures and human populations increase, more people are becoming vulnerable to natural and human-induced disasters. This is particularly true in Central America, where the growing human population is experiencing climate extremes (droughts and floods), and the region is susceptible to geological hazards, such as earthquakes and volcanic eruptions, and environmental deterioration in many forms (soil erosion, lake eutrophication, heavy metal contamination, etc.). Instrumental and historical data from the region are insufficient to understand and document past hazards, a necessary first step for mitigating future risks. Long, continuous, well-resolved geological records can, however, provide a window into past climate and environmental changes that can be used to better predict future conditions in the region. The Lake Izabal Basin (LIB), in eastern Guatemala, contains the longest known continental records of tectonics, climate, and environmental change in the northern Neotropics. The basin is a pull-apart depression that developed along the North American and Caribbean plate boundary ∼ 12 Myr ago and contains > 4 km of sediment. The sedimentological archive in the LIB records the interplay among several Earth System processes. Consequently, exploration of sediments in the basin can provide key information concerning: (1) tectonic deformation and earthquake history along the plate boundary; (2) the timing and causes of volcanism from the Central American Volcanic Arc; and (3) hydroclimatic, ecologic, and geomicrobiological responses to different climate and environmental states. To evaluate the LIB as a potential site for scientific drilling, 65 scientists from 13 countries and 33 institutions met in Antigua, Guatemala, in August 2022 under the auspices of the International Continental Scientific Drilling Program (ICDP) and the US National Science Foundation (NSF). Several working groups developed scientific questions and overarching hypotheses that could be addressed by drilling the LIB and identified optimal coring sites and instrumentation needed to achieve the project goals. The group also discussed logistical challenges and outreach opportunities. The project is not only an outstanding opportunity to improve our scientific understanding of seismotectonic, volcanic, paleoclimatic, paleoecologic, and paleobiologic processes that operate in the tropics of Central America, but it is also an opportunity to improve understanding of multiple geological hazards and communicate that knowledge to help increase the resilience of at-risk Central American communities.

Abstract Cities can host significant biological diversity. Yet, urbanisation leads to the loss of habitats, species, and functional groups. Understanding how multiple taxa respond to urbanisation globally is essential to promote and conserve biodiversity in cities. Using a dataset encompassing six terrestrial faunal taxa (amphibians, bats, bees, birds, carabid beetles and reptiles) across 379 cities on 6 continents, we show that urbanisation produces taxon-specific changes in trait composition, with traits related to reproductive strategy showing the strongest response. Our findings suggest that urbanisation results in four trait syndromes (mobile generalists, site specialists, central place foragers, and mobile specialists), with resources associated with reproduction and diet likely driving patterns in traits associated with mobility and body size. Functional diversity measures showed varied responses, leading to shifts in trait space likely driven by critical resource distribution and abundance, and taxon-specific trait syndromes. Maximising opportunities to support taxa with different urban trait syndromes should be pivotal in conservation and management programmes within and among cities. This will reduce the likelihood of biotic homogenisation and helps ensure that urban environments have the capacity to respond to future challenges. These actions are critical to reframe the role of cities in global biodiversity loss.

Abstract Sources of neurotoxic mercury in forests are dominated by atmospheric gaseous elemental mercury (GEM) deposition, but a dearth of direct GEM exchange measurements causes major uncertainties about processes that determine GEM sinks. Here we present three years of forest-level GEM deposition measurements in a coniferous forest and a deciduous forest in northeastern USA, along with flux partitioning into canopy and forest floor contributions. Annual GEM deposition is 13.4 ± 0.80 μg m−2 (coniferous forest) and 25.1 ± 2.4 μg m−2 (deciduous forest) dominating mercury inputs (62 and 76% of total deposition). GEM uptake dominates in daytime during active vegetation periods and correlates with CO2 assimilation, attributable to plant stomatal uptake of mercury. Non-stomatal GEM deposition occurs in the coniferous canopy during nights and to the forest floor in the deciduous forest and accounts for 24 and 39% of GEM deposition, respectively. Our study shows that GEM deposition includes various pathways and is highly ecosystem-specific, which complicates global constraints of terrestrial GEM sinks.

Ureteral stents are hollow tubes that are inserted into the ureter to maintain the flow of urine from the kidney to the bladder. However, the use of these indwelling stents is associated with potential complications. Biofilm, an organized consortium of bacterial species embedded within a self-producing extracellular matrix, can attach to the outer and inner surfaces of ureteral stents. Furthermore, encrustation - defined as the buildup of mineral deposits on the stent surface - can occur independently or in parallel with biofilm formation. Both phenomena can cause stent obstruction, which can lead to obstructive pyelonephritis and make stent removal difficult. Understanding the influence of flow on the development of biofilm and encrustation and the impact of small mechanical environmental changes (e.g., wall shear stress distribution) is key to improve the long-term performance of stents. Identifying the optimal stent properties to prevent early bacterial attachment and/or crystal deposition and their growth, would represent a breakthrough in reducing biofilm-/encrustation-associated complications. This review identifies the most prevalent bacterial strains and crystal types associated with ureteral stents, and the process of their association with the stent surface, which often depends on patient comorbidities, stent material, and indwelling time. Furthermore, we focus on the often-overlooked role of fluid dynamics on biofilm and encrustation development in ureteral stents, across a range of physical scales (i.e., from micro- to macro-scale) with the aim of providing a knowledge base to inform the development of safer and more effective ureteral stents.

The etiology of transcatheter heart valve thrombosis (THVT) and the relevance of the aortic root geometry on the occurrence of THVT are largely unknown. The first aim of this pilot study is to identify differences in aortic root geometry between THVT patients and patients without THVT after transcatheter aortic valve implantation (TAVI). Second, we aim to investigate how the observed difference in aortic diameters affects the aortic flow using idealized computational geometric models. Aortic dimension was assessed using pre-TAVI multi-detector computed tomography scans of eight patients with clinical apparent THVT and 16 unaffected patients (two for each THVT patient with same valve type and size) from the Bern-TAVI registry. Among patients with THVT the right coronary artery height was lower (−40%), and sinotubular junction (STJ) and ascending aorta (AAo) diameters tended to be larger (9% and 14%, respectively) compared to the unaffected patients. Fluid–structure interaction (FSI) in two idealized aortic models with the observed differences in STJ and AAo diameter showed higher backflow rate at the STJ (+16%), lower velocity magnitudes in the sinus (−5%), and higher systolic turbulent dissipation rate in the AAo (+8%) in the model with larger STJ and AAo diameters. This pilot study suggests a direct effect of the aortic dimensions on clinically apparent THVT. The FSI study indicates that larger STJ and AAo diameters potentially favor thrombus formation by increased backflow rate and reduced wash-out efficiency of the sinus. The reported observations require clinical validation but could potentially help identifying patients at risk for THVT.

IntroductionWhen we taste, we take in a variety of sensory information that can be completely independent from the properties of the food itself: the ambient lighting and environmental sounds can all influence our taste perception and affective responses. However, current multisensory research is mixed as to whether these In Real Life (IRL) findings also apply to Extended Reality (XR) environments. A potential reason for this may be the limited realism of some XR scenarios, which this study aimed to overcome through an immersive Virtual Reality experience (VR, chosen for its greater realism relative to other XR applications) whilst also expanding the scope to flavour perception.MethodsA total of 34 participants rated food samples under neutral, red, and green ambient lighting in VR. Participants ate either lime flavoured, strawberry flavoured, or “Neutral” (no added flavour) samples.ResultsWhile participants were equally immersed in all three environments, they rated the red and green lighting environments as substantially less natural than the neutral lighting environment. Interestingly, while participants associated sweetness and sourness with red lighting and green lighting respectively, this minimally extended to their behavioural ratings, when sampling the stimuli in VR. Samples eaten under red lighting were rated as significantly sweeter than those eaten under neutral lighting. However, neither red nor green lighting affected sample sourness nor the intensity of strawberry or lime flavour.DiscussionThis study found limited evidence of multisensory integration in XR, wherein taste expectations do not extend to taste experiences. We discuss these results in light of prior works on crossmodal associations and raise a reflection on why multisensory integration of taste may not apply to XR in our study. While there is much excitement about the opportunities XR can offer, we argue that we are only at the beginning of understanding the experiences on the reality-virtuality continuum and that we need to establish a richer understanding of participants' experiences, expectations, and taste/flavour perceptions between IRL and XR.

The importance of food and technology in modern society is undeniable. Technological advances have revolutionized how we produce, distribute and prepare food beyond local boundaries, and even how we eat. Eating is one of the most multisensory experiences in everyday life. All of our five senses (i.e. taste, smell, vision, hearing and touch) are involved. We first eat with our eyes, we can smell the food before we taste it, and then experience its textures and flavours in our mouth. However, the experience does not stop there. The sounds that come both from the environment in which we are immersed in while eating and our interactions with the food (e.g. chewing) and utensils we use to eat further influence our eating experiences. In all that, digital technology plays an increasingly important role, especially using emerging immersive technologies such as virtual and augmented reality (VR/AR). Designing at the intersection between technology and food requires multi-stakeholder commitments and a human experience-centred approach. Furthermore, it is essential to look beyond disciplinary boundaries and account for insights on various levels including the perceptual effects, experiential layers and technological advancements.

Abstract Normothermic machine perfusion (NMP) has emerged as an innovative organ preservation technique. Developing an understanding for the donor organ immune cell composition and its dynamic changes during NMP is essential. We aimed for a comprehensive characterization of immune cell (sub)populations, cell trafficking and cytokine release during liver NMP. Single-cell transcriptome profiling of human donor livers prior to, during NMP and after transplantation shows an abundance of CXC chemokine receptor 1+/2+ (CXCR1+/CXCR2+) neutrophils, which significantly decreased during NMP. This is paralleled by a large efflux of passenger leukocytes with neutrophil predominance in the perfusate. During NMP, neutrophils shift from a pro-inflammatory state towards an aged/chronically activated/exhausted phenotype, while anti-inflammatory/tolerogenic monocytes/macrophages are increased. We herein describe the dynamics of the immune cell repertoire, phenotypic immune cell shifts and a dominance of neutrophils during liver NMP, which potentially contribute to the inflammatory response. Our findings may serve as resource to initiate future immune-interventional studies.

Several organic geochemical proxies within a sediment core from Lake Petén Itzá, Guatemala, suggest intense human-induced degradation of the aquatic environment during the Maya Preclassic period from around 700 BCE to 200 CE

Seeds of “sweet lupins” have been playing an increasing role in the food industry. Lupin proteins may be used for producing a variety of foods, including pasta, bread, cookies, dairy products, and coffee substitutes. In a small percentage of the population, lupin consumption may elicit allergic reactions, either due to primary sensitization to lupin or due to cross-allergy with other legumes. Thus, lupin has to be declared on commercial food products according to EU food regulations. In this study, we investigated the influence of roasting seeds of the L. angustifolius cultivar “Boregine” on the detectability of lupin by sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE), ELISAs, LC-MS/MS, and real-time PCR. Seeds were roasted by fluidized bed roasting, and samples were drawn at seed surface temperatures ranging from 98 °C to 242 °C. With increasing roasting temperature, the extractability of proteins and DNA decreased. In addition, roasting resulted in lower detectability of lupin proteins by ELISAs and LC-MS/MS and lower detectability of DNA by real-time PCR. Our results suggest reduced allergenicity of roasted lupin seeds used for the production of “lupin coffee”; however, this has to be confirmed in in vivo studies.

AimsTo explore the feasibility of using pressure-volume (PV) catheters for cystometry. These catheters are well-established in cardiovascular research for simultaneous pressure and volume measurements in the left ventricle.MethodsUrinary bladders with urethras were collected from domestic pigs for ex-vivo testing. Using a pump, bladders were filled up to 500ml at five different filling rates (15, 20, 25, 30, 35ml/min), and the resulting pressures and volumes were measured using a PV catheter. The bladder were compressed externally in three different areas (central, apex and outlet) to assess the PV catheter’s ability to detect local changes in bladder volume.ResultsBladder pressure remained below 10cmH2O for all bladder filling rates. Volume measurements were compared with the volumes instilled by the pump (ground truth), proving high reproducibility and accuracy of the PV catheter measurements up to 400ml. Using the different sensing units of the PV catheter, local changes in bladder volumes could be identified and quantified.ConclusionThe main advantage of PV catheters, compared to existing technology used in urology (e.g. conventional urodynamic testing), is the possibility to i) simultaneously measure bladder pressure and volumes and ii) identify local changes in bladder volume (e.g. caused by non-voiding contractions). Both could be useful in the clinical setting to improve the diagnosis and treatment of the Lower Urinary Tract Dysfunction (e.g. overactive/underactive bladder).

The aortic valve is the most frequently diseased valve and aortic stenosis (AS) is the most prevalent valvular heart disease in developed countries. The diseased native aortic valve can be replaced by either a biological or mechanical valve prosthesis. The main concerns relate to durability, the need for oral anticoagulants and the incidence of complications related to this medication. Experimental, computational and biomolecular blood flow studies have demonstrated that the systolic forward flow but also the reverse flow phase at the end of the systole and leakage during the diastolic phase is mainly responsible for platelet activation and thrombosis. Better design of mechanical prosthetic heart valves must ensure smooth closing during flow deceleration and must eliminate high-shear hinge flow during diastole to prevent life-threatening thrombosis. A novel tri-leaflet valve should combine the favorable hemodynamics and the durability of existing mechanical heart valves and eliminate the less favorable characteristics, including the extremely rapid closing. In this paper, we discuss some issues of current mechanical heart valve prostheses and present a new valve design with the potential for significant innovation in the field. The TRIFLO Heart Valve, is a rigid, three-leaflet central flow heart valve prosthesis consisting of an alloyed titanium housing, and three rigid polymer (PEEK) cusps. This valve has a physiological operating mode. During the forward flow phase, the intraventricular pressure opens the leaflets so that blood can freely flow through with little obstruction, and with the deceleration of the blood flow, the leaflets close early and smoothly, minimizing blood flow regurgitation, blood cell damage, and activation of the coagulation cascade. Pre-clinical studies have shown pretty favorable results and a first-in-man study should start very soon.

Street lights are important light sources that contribute to artificial light at night (ALAN). To date, ecological impacts of individual LED properties (color temperature, dimmability) have been studied, while interactions between light properties or aspects of luminaire design have not been addressed. However, the design of luminaires can influence ALAN impacts as the shape determines the spatial distribution of light and its visibility in the environment. This may cause amplifying or mitigating effects. We assessed the relative individual and interacting effects of two LED luminaire designs and three LED color temperatures (1750 K, 3000 K, 4000 K) on nocturnal insect abundance, bat foraging and feeding activity. We considered a standard LED luminaire shape with focused light emission and a luminaire shape with a diffusor to scatter the light spatially, leading to increased visibility of the light in the environment. During 104 nights, we trapped 51263 nocturnal insects of which 97% were caught at lights and 3% at dark sites. For bats, up to 44.8% fewer acoustic signals were recorded at dark sites. We caught 31% insects at LEDs with1750 K, 34% and 35% at 3000 K and 4000 K, respectively. Thus, color temperatures of 1750 K proved less detrimental than 3000/4000 K. Effects of luminaire shape led to an increase (16%) of trapped insects for luminaires with diffusors compared to the standard shape. In addition, luminaires with diffusors amplified the effects of LED color (+12% insects at 1750 K/3000 K; +25.6% at 4000 K). In contrast, bat foraging activity was independent of the light treatments while bat feeding activity was increased by 21.5% at standard luminaire shapes. Likely, intense straylight at diffused lights negatively affects the target-focused echolocation by deterring the bats. We concluded that ecological impacts of luminaire shape are an important, yet underestimated variable in light-pollution impact research.

ObjectiveCurrently used patch materials in congenital cardiac surgery do not grow, renew, or remodel. Patch calcification occurs more rapidly in pediatric patients eventually leading to reoperations. Bacterial cellulose (BC) as a biogenic polymer offers high tensile strength, biocompatibility, and hemocompatibility. Thus, we further investigated the biomechanical properties of BC for use as patch material.MethodsThe BC-producing bacteria Acetobacter xylinum were cultured in different environments to investigate optimal culturing conditions. For mechanical characterization, an established method of inflation for biaxial testing was used. The applied static pressure and deflection height of the BC patch were measured. Furthermore, a displacement and strain distribution analysis was performed and compared to a standard xenograft pericardial patch.ResultsThe examination of the culturing conditions revealed that the BC became homogenous and stable when cultivated at 29°C, 60% oxygen concentration, and culturing medium exchange every third day for a total culturing period of 12 days. The estimated elastic modulus of the BC patches ranged from 200 to 530 MPa compared to 230 MPa for the pericardial patch. The strain distributions, calculated from preloaded (2 mmHg) to 80 mmHg inflation, show BC patch strains ranging between 0.6% and 4%, which was comparable to the pericardial patch. However, the pressure at rupture and peak deflection height varied greatly, ranging from 67 to around 200 mmHg and 0.96 to 5.28 mm, respectively. The same patch thickness does not automatically result in the same material properties indicating that the manufacturing conditions have a significant impact on durabilityConclusionsBC patches can achieve comparable results to pericardial patches in terms of strain behavior as well as in the maximum applied pressure that can be withstood without rupture. Bacterial cellulose patches could be a promising material worth further research.

Novel gustatory interfaces offer the potential to use the sense of taste as a feedback modality during the interaction. They are being explored in a wide range of implementations, from chemical to electrical and thermal stimulation of taste. However, the fundamental aspect of gustatory interaction that has yet to be explored is the Sense of Agency (SoA). It is the subjective experience of voluntary control over actions in the external world. This work investigates the SoA in gustatory systems using the intentional binding paradigm to quantify how different taste outcome modalities influence users' SoA. We first investigate such gustatory systems using the intentional binding paradigm to quantify how different tastes influence users' SoA (Experiment 1). The gustatory stimuli were sweet (sucrose 75.31 mg/ml), bitter (caffeine powder 0.97 mg/ml), and neutral (mineral water) as the outcomes of specific keyboard presses. We then investigated how SoA was altered depending on users' sweet liking phenotype, given that sweet is one of the taste outcomes (Experiment 2), and in contrast with audio as a traditional outcome. In Experiment 2, stronger taste concentrations (sweet-sucrose 342.30 g/L, bitter-quinine 0.1 g/L, and neutral) were used, with only participants being moderate sweet likers. We further contrasted tastes with audio as the traditional outcome. Our findings show that all three taste outcomes exhibit similar intentional binding compared to auditory in medium sweet likers. We also show that longer action-outcome duration improved the SoA. We finally discuss our findings and identify design opportunities considering SoA for gustatory interfaces and multisensory interaction.

Abstract Ureteral stents are indispensable devices in urological practice to maintain and reinstate the drainage of urine in the upper urinary tract. Most ureteral stents feature openings in the stent wall, referred to as side holes (SHs), which are designed to facilitate urine flux in and out of the stent lumen. However, systematic discussions on the role of SH and stent lumen size in regulating flux and shear stress levels are still lacking. In this study, we leveraged both experimental and numerical methods, using microscopic‐Particle Image Velocimetry and Computational Fluid Dynamic models, respectively, to explore the influence of varying SH and lumen diameters. Our results showed that by reducing the SH diameter from 1.1 to 0.4mm the median wall shear stress levels of the SHs near the ureteropelvic junction and ureterovesical junction increased by over 150%, even though the flux magnitudes through these SH decreased by about 40%. All other SHs were associated with low flux and low shear stress levels. Reducing the stent lumen diameter significantly impeded the luminal flow and the flux through SHs. By means of zero‐dimensional models and scaling relations, we summarized previous findings on the subject and argued that the design of stent inlet/outlet is key in regulating the flow characteristics described above. Finally, we offered some clinically relevant input in terms of choosing the right stent for the right patient.

Abstract Although heart transplant is the preferred solution for patients suffering from heart failures, cardiac assist devices remain key substitute therapies. Among them, aortic augmentation using dielectric elastomer actuators (DEAs) might be an alternative technological application for the future. The electrically driven actuator does not require bulky pneumatic elements (such as conventional intra‐aortic balloon pumps) and conforms tightly to the aorta thanks to the manufacturing method presented here. In this study, the proposed DEA‐based device replaces a section of the aorta and acts as a counterpulsation device. The feasibility and validation of in vivo implantation of the device into the descending aorta in a porcine model, and the level of support provided to the heart are investigated. Additionally, the influence of the activation profile and delay compared to the start of systole is studied. We demonstrate that an activation of the DEA just before the start of systole (30 ms at 100 bpm) and deactivation just after the start of diastole (0–30 ms) leads to an optimal assistance of the heart with a maximum energy provided by the DEA. The end‐diastolic and left ventricular pressures were lowered by up to 5% and 1%, respectively, compared to baseline. The early diastolic pressure was augmented in average by up to 2%.

Anomalous aortic origin of a coronary artery (AAOCA) is a rare congenital heart condition with fixed and dynamic stenotic elements, potentially causing ischemia. Invasive coronary angiography under stress is the established method for assessing hemodynamics in AAOCA, yet it is costly, technically intricate, and uncomfortable. Computational fluid dynamics (CFD) simulations offer a noninvasive alternative for patient-specific hemodynamic analysis in AAOCA. This systematic review examines the role of CFD simulations in AAOCA, encompassing patient-specific modeling, noninvasive imaging-based boundary conditions, and flow characteristics. Screening articles using AAOCA and CFD-related terms prior to February 2023 yielded 19 publications, covering 370 patients. Over the past four years, 12 (63%) publications (259 patients) employed dedicated CFD models, whereas 7 (37%) publications (111 patients) used general-purpose CFD models. Dedicated CFD models were validated for fixed stenosis but lacked dynamic component representation. General-purpose CFD models exhibited variability and limitations, with fluid–solid interaction models showing promise. Interest in CFD modeling of AAOCA has surged recently, mainly utilizing dedicated models. However, these models inadequately replicate hemodynamics, necessitating novel CFD approaches to accurately simulate pathophysiological changes in AAOCA under stress conditions.

Background In low- and middle-income countries, too, public–private partnerships in health insurance schemes are crucial for improving access to health services. Problems in the public supply chain of medicines often lead to medicine stock-outs which then negatively influence enrolment in and satisfaction with health insurance schemes. To address this challenge, the government of Tanzania embarked on a redesign of the Community Health Fund (CHF) and established a Prime Vendor System (Jazia PVS). Informal and rural population groups, however, rely heavily on another public–private partnership, the Accredited Drug Dispensing Outlets (ADDOs). This study takes up this public demand and explores the potentials, pitfalls, and modalities for linking the improved CHF (iCHF) with ADDOs. Methods This was a qualitative exploratory study employing different methods of data collection: in-depth interviews, focus group discussions, and document reviews. Results Study participants saw a great potential for linking ADDOs with iCHF, following continuous community complaints about medicine stock-out challenges at public health facilities, a situation that also affects the healthcare staff’s working environment. The Jazia PVS was said to have improved the situation of medicine availability at public health facilities, although not fully measuring up to the challenge. Study participants thought linking ADDOs with the iCHF would not only improve access to medicine but also increase member enrolment in the scheme. The main pitfalls that may threaten this linkage include the high price of medicines at ADDOs that cannot be accommodated within the iCHF payment model and inadequate digital skills relevant for communication between iCHF and ADDOs. Participants recommended linking ADDOs with the iCHF by piloting the connection with a few ADDOs meeting the selected criteria, while applying similar modalities for linking private retail outlets with the National Health Insurance Fund (NHIF). Conclusions As the government of Tanzania is moving toward the Single National Health Insurance Fund, there is a great opportunity to link the iCHF with ADDOs, building on established connections between the NHIF and ADDOs and the lessons learnt from the Jazia PVS. This study provides insights into the relevance of expanding public–private partnership in health insurance schemes in low- and middle-income countries.

BackgroundPharmaceutical supply chain management in low- and middle-income countries has received substantial attention to address the shortage of medicines at peripheral facilities. The focus has been on health system interventions, including the establishment of public-private partnerships (PPPs). In 2014, the United Republic of Tanzania began implementing the Jazia prime vendor system (Jazia PVS) with a contracted private wholesale supplier to complement the national medicines supply chain in public facilities. Few studies have investigated the acceptability of such a prime vendor system. This study analyses factors that contributed to the acceptability of Jazia PVS introduced in Tanzania. We used qualitative analytical methods to study experiences of Jazia PVS implementers in 4 districts in mid-2018. MethodsData were drawn from 14 focus group discussions (FGDs), 7 group discussions (GDs) and 30 in-depth interviews (IDIs) with a range of actors involved in Jazia PVS. The study analysed 7 acceptability dimensions as defined in the acceptability framework by Sekhon et al. Framework analysis was adopted to summarise the results using a deductive and an inductive approach. ResultsThe findings show that participants’ acceptability of Jazia PVS was influenced by the increased availability of essential medicines at the facilities, higher order fulfilment rates, and timely delivery of the consignment. Furthermore, acceptability was also influenced by the good reputation of the prime vendor, close collaboration with district managers, and participants’ understanding that the prime vendor was meant to complement the existing supply chain. Intervention coherence, experienced opportunity cost and intervention burden, affective attitude and self-efficacy were also important in explaining the acceptability of the Jazia PVS. ConclusionIn conclusion, the most critical factor contributing to the acceptability of the Jazia PVS was the perceived effectiveness of the system in achieving its intended purpose. Districts purchasing directly from the prime vendor have a policy based on the possibility to increase availability of essential medicines at peripheral facilities in a low income setting; however, it is crucial to select a reputable and competent vendor, as well as to abide by the contractual agreements.

In vitro models are indispensable to study the physio-mechanical characteristics of the urinary tract and to evaluate ureteral stent performances. Yet previous models mimicking the urinary bladder have been limited to static or complicated systems. In this study, we designed a simple in vitro bladder model to simulate the dynamics of filling and voiding. The physio-mechanical condition of the model was verified using a pressure-flow test with different bladder outlet obstruction levels, and a reflux test was performed to qualitatively demonstrate the stent associated vesicoureteral reflux (VUR). Finally, the setup was applied with and without the bladder model to perform encrustation tests with artificial urine on commercially available double-J stents, and the volumes of luminal encrustations were quantified using micro-Computed Tomography and image segmentation. Our results suggest that, VUR is an important factor contributing to the dynamics in the upper urinary tract with indwelling stents, especially in patients with higher bladder outlet obstruction levels. The influence of VUR should be properly addressed in future in vitro studies and clinical analyses.

IntroductionThe aortic valve opening area (AVA), used to quantify aortic stenosis severity, depends on the transvalvular flow rate (Q). The currently accepted clinical echocardiographic method assumes a linear relation between AVA and Q. We studied whether a sigmoid model better describes this relation and determined “isostiffness-lines” across a wide flow spectrum, thus allowing building a nomogram for the non-invasive estimation of valve stiffness.MethodsBoth AVA and instantaneous Q (Qinst) were measured at 10 different mean cardiac outputs of porcine aortic valves mounted in a pulsatile flow loop. The valves' cusps were chemically stiffened to obtain three stiffness grades and the procedure was repeated for each grade. The relative stiffness was defined as the ratio between LV work at grade with the added stiffness and at native stiffness grade. AVApeak¯ corresponding to the selected Qpeak¯ of the highest 3 and 5 cardiac output values was predicted in K-fold cross-validation using sequentially a linear and a sigmoid model. The accuracy of each model was assessed with the Akaike information criterion (AIC).ResultsThe sigmoid model predicted more accurately AVApeak¯ (AIC for prediction of AVA with Qpeak¯ of the 3 highest cardiac output values: –1,743 vs. –1,048; 5 highest cardiac output values: –1,471 vs. –878) than the linear model.ConclusionThis study suggests that the relation between AVA and Q can be better described by a sigmoid than a linear model. This construction of “isostiffness-lines” may be a useful method for the assessment of aortic stenosis in clinical echocardiography.