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The role of veno-venous extracorporeal membrane oxygenation therapy (V-V ECMO) in severe COVID-19 acute respiratory distress syndrome (ARDS) is still under debate and conclusive data from large cohorts are scarce. Furthermore, criteria for the selection of patients that benefit most from this highly invasive and resource-demanding therapy are yet to be defined. In this study, we assess survival in an international multicenter cohort of COVID-19 patients treated with V-V ECMO and evaluate the performance of several clinical scores to predict 30-day survival. This is an investigator-initiated retrospective non-interventional international multicenter registry study (NCT04405973, first registered 28 May 2020). In 127 patients treated with V-V ECMO at 15 centers in Germany, Switzerland, Italy, Belgium, and the United States, we calculated the Sequential Organ Failure Assessment (SOFA) Score, Simplified Acute Physiology Score II (SAPS II), Acute Physiology And Chronic Health Evaluation II (APACHE II) Score, Respiratory Extracorporeal Membrane Oxygenation Survival Prediction (RESP) Score, Predicting Death for Severe ARDS on V‑V ECMO (PRESERVE) Score, and 30-day survival. In our study cohort which enrolled 127 patients, overall 30-day survival was 54%. Median SOFA, SAPS II, APACHE II, RESP, and PRESERVE were 9, 36, 17, 1, and 4, respectively. The prognostic accuracy for all these scores (area under the receiver operating characteristic-AUROC) ranged between 0.548 and 0.605. The use of scores for the prediction of mortality cannot be recommended for treatment decisions in severe COVID-19 ARDS undergoing V-V ECMO; nevertheless, scoring results below or above a specific cut-off value may be considered as an additional tool in the evaluation of prognosis. Survival rates in this cohort of COVID-19 patients treated with V‑V ECMO were slightly lower than those reported in non-COVID-19 ARDS patients treated with V-V ECMO.

We investigated the metalation and coordination reactions of Co with 2H-5,15-bis(para-cyanophenyl)-10,20-bisphenylporphyrin (2HtransDCNPP) on a Ag(111) surface by scanning tunneling microscopy. At room temperature (RT), 2HtransDCNPPs self-assemble into a supramolecular structure stabilized by intermolecular hydrogen bonding. The metalation of 2HtransDCNPP is achieved either by depositing Co atoms onto the supramolecular structure at RT, or, alternatively, by depositing the molecules onto a submonolayer Co-precovered Ag(111) surface with a subsequent heating to 500 K. In addition, the molecules coordinate to Co atoms through the N atoms in the peripheral cyano groups with a preference of isolated 4-fold coordination motifs at RT.

We investigated the metalation and coordination reactions of Co with 2H-5,15-bis(para-cyanophenyl)-10,20-bisphenylporphyrin (2HtransDCNPP) on a Ag(111) surface by scanning tunneling microscopy. At room temperature (RT), 2HtransDCNPPs self-assemble into a supramolecular structure stabilized by intermolecular hydrogen bonding. The metalation of 2HtransDCNPP is achieved either by depositing Co atoms onto the supramolecular structure at RT, or, alternatively, by depositing the molecules onto a submonolayer Co-precovered Ag(111) surface with a subsequent heating to 500 K. In addition, the molecules coordinate to Co atoms through the N atoms in the peripheral cyano groups with a preference of isolated 4-fold coordination motifs at RT.

The reaction rate of the self-metalation of free-base tetraphenylporphyrins (TPPs) on Cu(111) increases with the number of cyano groups (n=0, 1, 2, 4) attached at the para positions of the phenyl rings. The findings are based on isothermal scanning tunneling microscopy (STM) measurements. At room temperature, all investigated free-base TPP derivatives adsorb as individual molecules and are aligned with respect to densely packed Cu substrate rows. Annealing at 400 K leads to the formation of linear dimers and/or multimers via CN-Cu-CN bonds, accompanied by self-metalation of the free-base porphyrins following a first-order rate equation. When comparing the non-cyano-functionalized and the tetracyano-functionalized molecules, we find a decrease of the reaction rate by a factor of more than 20, corresponding to an increase of the activation energy from 1.48 to 1.59 eV. Density functional theory (DFT) calculations give insights into the influence of the peripheral electron-withdrawing cyano groups and explain the experimentally observed effects.

The reaction rate of the self-metalation of free-base tetraphenylporphyrins (TPPs) on Cu(111) increases with the number of cyano groups (n=0, 1, 2, 4) attached at the para positions of the phenyl rings. The findings are based on isothermal scanning tunneling microscopy (STM) measurements. At room temperature, all investigated free-base TPP derivatives adsorb as individual molecules and are aligned with respect to densely packed Cu substrate rows. Annealing at 400 K leads to the formation of linear dimers and/or multimers via CN-Cu-CN bonds, accompanied by self-metalation of the free-base porphyrins following a first-order rate equation. When comparing the non-cyano-functionalized and the tetracyano-functionalized molecules, we find a decrease of the reaction rate by a factor of more than 20, corresponding to an increase of the activation energy from 1.48 to 1.59 eV. Density functional theory (DFT) calculations give insights into the influence of the peripheral electron-withdrawing cyano groups and explain the experimentally observed effects.

BackgroundAnimal studies have revealed seasonal patterns in cerebrospinal fluid (CSF) monoamine (MA) turnover. In humans, no study had systematically assessed seasonal patterns in CSF MA turnover in a large set of healthy adults.Methodology/principal findingsStandardized amounts of CSF were prospectively collected from 223 healthy individuals undergoing spinal anesthesia for minor surgical procedures. The metabolites of serotonin (5-hydroxyindoleacetic acid, 5-HIAA), dopamine (homovanillic acid, HVA) and norepinephrine (3-methoxy-4-hydroxyphenylglycol, MPHG) were measured using high performance liquid chromatography (HPLC). Concentration measurements by sampling and birth dates were modeled using a non-linear quantile cosine function and locally weighted scatterplot smoothing (LOESS, span = 0.75). The cosine model showed a unimodal season of sampling 5-HIAA zenith in April and a nadir in October (p-value of the amplitude of the cosine = 0.00050), with predicted maximum (PC(max)) and minimum (PC(min)) concentrations of 173 and 108 nmol/L, respectively, implying a 60% increase from trough to peak. Season of birth showed a unimodal 5-HIAA zenith in May and a nadir in November (p = 0.00339; PC(max) = 172 and PC(min) = 126). The non-parametric LOESS showed a similar pattern to the cosine in both season of sampling and season of birth models, validating the cosine model. A final model including both sampling and birth months demonstrated that both sampling and birth seasons were independent predictors of 5-HIAA concentrations.ConclusionIn subjects without mental illness, 5-HT turnover shows circannual variation by season of sampling as well as season of birth, with peaks in spring and troughs in fall.

BackgroundAnimal studies have revealed seasonal patterns in cerebrospinal fluid (CSF) monoamine (MA) turnover. In humans, no study had systematically assessed seasonal patterns in CSF MA turnover in a large set of healthy adults.Methodology/principal findingsStandardized amounts of CSF were prospectively collected from 223 healthy individuals undergoing spinal anesthesia for minor surgical procedures. The metabolites of serotonin (5-hydroxyindoleacetic acid, 5-HIAA), dopamine (homovanillic acid, HVA) and norepinephrine (3-methoxy-4-hydroxyphenylglycol, MPHG) were measured using high performance liquid chromatography (HPLC). Concentration measurements by sampling and birth dates were modeled using a non-linear quantile cosine function and locally weighted scatterplot smoothing (LOESS, span = 0.75). The cosine model showed a unimodal season of sampling 5-HIAA zenith in April and a nadir in October (p-value of the amplitude of the cosine = 0.00050), with predicted maximum (PC(max)) and minimum (PC(min)) concentrations of 173 and 108 nmol/L, respectively, implying a 60% increase from trough to peak. Season of birth showed a unimodal 5-HIAA zenith in May and a nadir in November (p = 0.00339; PC(max) = 172 and PC(min) = 126). The non-parametric LOESS showed a similar pattern to the cosine in both season of sampling and season of birth models, validating the cosine model. A final model including both sampling and birth months demonstrated that both sampling and birth seasons were independent predictors of 5-HIAA concentrations.ConclusionIn subjects without mental illness, 5-HT turnover shows circannual variation by season of sampling as well as season of birth, with peaks in spring and troughs in fall.

Using a 'subjectivist' approach to the assessment of happiness, a new 4-item measure of global subjective happiness was developed and validated in 14 studies with a total of 2 732 participants. Data was collected in the United States from students on two college campuses and one high school campus, from community adults in two California cities, and from older adults. Students and community adults in Moscow, Russia also participated in this research. Results indicated that the Subjective Happiness Scale has high internal consistency, which was found to be stable across samples. Test-retest and self-peer correlations suggested good to excellent reliability, and construct validation studies of convergent and discriminant validity confirmed the use of this scale to measure the construct of subjective happiness. The rationale for developing a new measure of happiness, as well as advantages of this scale, are discussed. The happy man is not he who seems thus to others, but who seems thus to himself.

The consonance constraint satisfaction model, recently used to simulate the major paradigms of cognitive dissonance theory, is extended to deal with emotional arousal phenomena in dissonance. The impact of arousing drugs is implemented in the simulations by a scalar that modulates the intensity of unit activations representing the relevant cognitions and the connection weights representing their implications. The simulations show that even exotic dissonance phenomena can be explained in terms of the relatively commn process of constraint satisfaction.

Using a 'subjectivist' approach to the assessment of happiness, a new 4-item measure of global subjective happiness was developed and validated in 14 studies with a total of 2 732 participants. Data was collected in the United States from students on two college campuses and one high school campus, from community adults in two California cities, and from older adults. Students and community adults in Moscow, Russia also participated in this research. Results indicated that the Subjective Happiness Scale has high internal consistency, which was found to be stable across samples. Test-retest and self-peer correlations suggested good to excellent reliability, and construct validation studies of convergent and discriminant validity confirmed the use of this scale to measure the construct of subjective happiness. The rationale for developing a new measure of happiness, as well as advantages of this scale, are discussed. The happy man is not he who seems thus to others, but who seems thus to himself.

The consonance constraint-satisfaction model is applied to Machiavellianism self-concept effects in cognitive dissonance. Networks parameterized for low Machiavellian traits showed the usual dissonance effect, i. e., more attitude change after giving a counterattitudinal speech than after not giving such a speech, whereas networks parameterized for high Machiavellian traits showed the reverse, thus capturing human data. Classical dissonance theory had not accounted for the fact that people with high Machiavellian traits showed less attitude change after giving a counter-attitudinal speech than after not giving such a speech. The model predicts initial dissonance and the course of dissonance reduction in the various experimental conditions. The results underscore the point that cognitive dissonance operates according to the same constraint-satisfaction principles that govern a variety of other psychological phenomena.

A constraint satisfaction network model simulated cognitive dissonance data from the insufficient justification and free choice paradigms. The networks captured the psychological regularities in both paradigms. In the case of finee choice, the model fit the human data better than did cognitive dissonance theory.