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Porous silica was synthesized from cornhusk using the sol–gel polymeric route and compared with ash obtained from the direct combustion process under laboratory conditions. The unmodified ash from the direct combustion process was dissolved in NaOH for 1 h to form sodium silicate, which was subsequently hydrolyzed with citric acid to yield a silica xerogel. The obtained xerogel was characterized using inductively coupled plasma–optical emission spectrometry (ICP-OES), Fourier transforms infrared (FTIR) spectroscopy, X-ray diffraction (XRD), simultaneous thermal analysis (STA), gas sorption techniques to determine their elemental constituents, functional groups, crystalline phases, thermal stability, and porosity, respectively. The results showed that the synthesized silica xerogel exhibited porous network structures with a high-specific surface area and mesopore volume of 384 m2/g and 0.35 cm3/g, respectively. The pore size distribution revealed a complete transformation of the pore network structures of the unmodified ash from a monomodal to a bimodal pore system, with micro- and mesopore peaks centered around 1.5 and 3.8 nm, respectively. The ICP-OES results showed that the silica content significantly increased from 52.93 to 91.96 wt.% db after the sol–gel treatment. XRD diffraction confirmed the amorphicity of the silica particles obtained from the sol–gel extraction method. In addition, the STA data showed that the silica xerogel has high thermal stability compared to the unmodified ash, as the latter exhibited poor thermal stability and low textural properties. The high surface area and narrow pore cavity size distribution of the porous silica xerogel make it an ideal substrate for catalysts and an excellent template for growing other nanoparticles within the pores. [ABSTRACT FROM AUTHOR]

Background: Device-related thrombus (DRT) after left atrial appendage occlusion (LAAO) is potentially linked to adverse events. Although clinical reports suggest an effect of the device type and position on the DRT risk, in-depth studies of its mechanistic basis are needed. This in silico study aimed to assess the impact of the position of non-pacifier (Watchman) and pacifier (Amulet) LAAO devices on surrogate markers of DRT risk. Methods: The LAAO devices were modeled with precise geometry and virtually implanted in different positions into a patient-specific left atrium. Using computational fluid dynamics, the following values were quantified: residual blood, wall shear stress (WSS) and endothelial cell activation potential (ECAP). Results: In comparison to an ostium-fitted device position, deep implantation led to more residual blood, lower average WSS and higher ECAP surrounding the device, especially on the device's atrial surface and the surrounding tissue, suggesting increased risk for potential thrombus. For the non-pacifier device, an off-axis device orientation resulted in even more residual blood, higher ECAP and similar average WSS as compared to an ostium-fitted device position. Overall, the pacifier device showed less residual blood, higher average WSS and lower ECAP, compared to the non-pacifier device. Conclusions: In this in silico study, both LAAO device type and implant position showed an impact on potential markers of DRT in terms of blood stasis, platelet adhesion and endothelial dysfunction. Our results present a mechanistic basis for clinically observed risk factors of DRT and the proposed in silico model may aid in the optimization of device development and procedural aspects. [ABSTRACT FROM AUTHOR]

Background: Within the spectrum of Lewy body disorders (LBD), both Parkinson's disease (PD) and dementia with Lewy bodies (DLB) are characterized by gait and balance disturbances, which become more prominent under dual-task (DT) conditions. The brain substrates underlying DT gait variations, however, remain poorly understood in LBD. Objective: To investigate the relationship between gray matter volume loss and DT gait variations in LBD. Methods: Seventy-nine participants including cognitively unimpaired PD, PD with mild cognitive impairment, PD with dementia (PDD), or DLB and 20 cognitively unimpaired controls were examined across a multi-site study. PDD and DLB were grouped together for analyses. Differences in gait speed between single and DT conditions were quantified by dual task cost (DTC). Cortical, subcortical, ventricle, and cerebellum brain volumes were obtained using FreeSurfer. Linear regression models were used to examine the relationship between gray matter volumes and DTC. Results: Smaller amygdala and total cortical volumes, and larger ventricle volumes were associated with a higher DTC across LBD and cognitively unimpaired controls. No statistically significant interaction between group and brain volumes were found. Adding cognitive and motor covariates or white matter hyperintensity volumes separately to the models did not affect brain volume and DTC associations. Conclusion: Gray matter volume loss is associated with worse DT gait performance compared to single task gait, across cognitively unimpaired controls through and the LBD spectrum. Impairment in DT gait performance may be driven by age-related cortical neurodegeneration. [ABSTRACT FROM AUTHOR]

The timely disengagement of a firm from its old technological achievements and the update of its core technological competencies are important issues for both management scholars and practitioners. However, a firm is naturally reluctant to abandon or replace technologies created internally and on which a large amount of resources has been spent and with which the firm is to a large extent familiar. Addressing the temporal dimension of knowledge inputs, this study develops two hypotheses that examine the effect of the recency of internal knowledge inputs on innovation performance and how this effect is moderated by internal focus. We test these hypotheses on longitudinal economic and patent data from a sample of 139 firms from the pharmaceuticals, biotechnology, and chemicals industries for a 7-year period, using fixed-effects negative binomial regression models. Findings support that the recency of internal knowledge inputs is a positive predictor of both innovation productivity and impact; however, when the recency interacts with internal focus, both the effects become negative. [ABSTRACT FROM AUTHOR]

Ultra-high-energy (UHE) cosmic neutrinos interacting with the Moon's regolith generate particle showers that emit Askaryan radiation. This radiation can be observed from the Earth using ground-based radio telescopes like LOFAR. We simulate the effective detection aperture for UHE neutrinos hitting the Moon. Under the same assumptions, results from this work are in good agreement with previous analytic parameterizations and Monte Carlo codes. The dependence of the effective detection aperture on the observing parameters, such as observing frequency and minimum detection threshold, and lunar characteristics like surface topography have been studied. Using a Monte Carlo simulation, we find that the detectable neutrino energy threshold is lowered when we include a realistic treatment of the inelasticity, transmission coefficient, and surface roughness. Lunar surface roughness at large scales enhances the total aperture for higher observation frequencies ( ν ≥ 1 GHz ) but has no significant effect on the LOFAR aperture. However, roughness at scales small compared to the wavelength reduces the aperture at all frequencies. [ABSTRACT FROM AUTHOR]

Background: Device-related thrombus (DRT) after left atrial appendage closure (LAAC) is associated with adverse outcomes, i.e. ischemic stroke or systemic embolism (SE). Data on predictors of stroke/SE in the context of DRT are limited. Aims: This study aimed to identify predisposing factors for stroke/SE in DRT patients. In addition, the temporal connection of stroke/SE to DRT diagnosis was analyzed. Methods: The EUROC-DRT registry included 176 patients, in whom DRT after LAAC were diagnosed. Patients with symptomatic DRT, defined as stroke/SE in the context of DRT diagnosis, were compared against patients with non-symptomatic DRT. Baseline characteristics, anti-thrombotic regimens, device position, and timing of stroke/SE were compared. Results: Stroke/SE occurred in 25/176 (14.2%) patients diagnosed with DRT (symptomatic DRT). Stroke/SE occurred after a median of 198 days (IQR 37–558) after LAAC. In 45.8% stroke/SE occurred within one month before/after DRT diagnosis (DRT-related stroke). Patients with symptomatic DRT had lower left ventricular ejection fractions (50.0 ± 9.1% vs. 54.2 ± 11.0%, p = 0.03) and higher rates of non-paroxysmal atrial fibrillation (84.0% vs. 64.9%, p = 0.06). Other baseline parameters and device positions were not different. Most ischemic events occurred among patients with single antiplatelet therapy (50%), however, stroke/SE was also observed under dual antiplatelet therapy (25%) or oral anticoagulation (20%). Conclusion: Stroke/SE are documented in 14.2% and occur both in close temporal relation to the DRT finding and chronologically independently therefrom. Identification of risk factors remains cumbersome, putting all DRT patients at substantial risk for stroke/SE. Further studies are necessary to minimize the risk of DRT and ischemic events. [ABSTRACT FROM AUTHOR]

Tunisia is one of the developing countries which faces crucial challenges, the most prominent of which are the production of organic waste, the need for an appropriate waste treatment, and the demand for water and energy conservation. To this end, the present research was designed to develop a technical concept on closed cycle "biowaste to bioenergy" treating food waste (FW) through combined biological processes. In this approach, semi-continuous anaerobic co-digestion (ACoD) of FW, wheat straw (WS), and cattle manure (CM) was tested to investigate the relationship between the effect of the feedstock mixtures and C:N ratio on biogas and digestate generation at different organic loading rates (OLRs) ranging from 2 to 3.6 kg VS/m3.d. Results showed that the mono-digested FW was optimal and reached 565.5 LN/kg VSin at an OLR of 2.4 kg VS/m3.d, and then a drop of biogas production was recorded. However, for co-digested substrates, the optimum mixture ratio was FW:CM 75:25, where 62%, 39.89%, 91.26%, 130.9%, and 119.97% of the biogas yield improved for OLRs ranging from 2 to 3.6 kg VS/m3.d, respectively. Admittedly, the target of this work was to enhance the ACoD process, but it also examined the exploitation of different AD effluents. Therefore, special attention was paid to the generated digestates to decide how it can be efficiently upcycled later. Thus, the closed cycle "biowaste to bioenergy" treatment met two of the major Tunisian concerns: efficient organic waste management and sustainable bioenergy production. [ABSTRACT FROM AUTHOR]

Background: Germany is highly dependent on natural gas, the availability of which has become uncertain due to Russia's invasion of Ukraine. Biogas provision in Germany is realized by more than 9500 mainly farm-side biogas plants that have the potential to increase the security of gas supply. Main text: To assess the potential contribution of biogas to a secure gas supply in Germany, we combine a literature-based analysis of the current status and potentials of the biogas supply chain with calculations of the marginal costs for producing biogas under the current market conditions. Biogas provided 50 TWh of final energy in Germany in 2021, primarily in the form of power and heat. The production of biomethane, which can in principle replace natural gas when fed into the gas grid, amounted to 10 TWh in terms of the lower heating value, which corresponds to a share of about 1% of the German gas market in 2021. However, at the end of 2021, biogas significantly contributed to the provided power (13 TWh or 22% of power supply from natural gas) combined with co-generated heat (13 TWh or 2% of heat supply from natural gas). Increasing flexible power provision from biogas is promising under the current power market conditions. In contrast, the current biogas substrate mix will lead to crucial limitations: 75% of the input into German biogas are energy crops, which are limited in availability under rising agricultural prices. Conclusions and recommendations: In conclusion, biogas can only make up a small share of the current natural gas consumption. An immediate programme to mobilize the use of biogenic by-products, waste, and cultivated biomass without requiring additional land is recommended. We also propose measures to increase the flexibility of power production and heat use and more greenhouse gas-related incentives of biogas supply for the medium term. Finally, we see the need for additional efforts for non-food feedstock mobilization on a European scale by realizing the envisaged tenfold increase in the contribution of biomethane to a production goal of 35 billion cubic metres by 2030 in the REPower EU Plan of the European Commission. [ABSTRACT FROM AUTHOR]

In-ice radio detectors are a promising tool for the discovery of EeV neutrinos. For astrophysics, the implications of such a discovery will rely on the reconstruction of the neutrino arrival direction. This paper describes a first complete neutrino arrival direction reconstruction for detectors employing deep antennas such as RNO-G or planning to employ them like IceCube-Gen2. We will didactically introduce the challenges of neutrino direction reconstruction using radio emission in ice, elaborate on the detail of the algorithm used, and describe the obtainable performance based on a simulation study and discuss its implication for astrophysics. [ABSTRACT FROM AUTHOR]

Purpose: The mobility of left atrial appendage (LAA) thrombi and changes hereof under anticoagulation may serve as a marker of both risk of embolism and efficacy of treatment. In this study, we sought to evaluate thrombus mobility and hypothesized that LAA dynamics and thrombus mobility could serve as a baseline marker of thrombus dissolvability. Methods: Patients with two-dimensional transesophageal echocardiographic images of the LAA, and with evidence of LAA thrombus were included in this study. Using a speckle tracking algorithm, functional information from the LAA and thrombi of different patients was computed. While the LAA motion was quantified through the longitudinal strain, thrombus mobility was evaluated using a novel method by directly tracking the thrombus, isolated from the global cardiac motion. Baseline characteristics and echocardiographic parameters were compared between responders (thrombus resolution) and non-responders (thrombus persistence) to anticoagulation. Results: We included 35 patients with atrial fibrillation with evidence of LAA thrombi. Patients had a mean age of 72.9 ± 14.1 years, exhibited a high risk for thromboembolism (CHA2DS2-VASc-Score 4.1 ± 1.5) and had moderately reduced LVEF (41.7 ± 14.4%) and signs of diastolic dysfunction (E/E′ = 19.7 ± 8.5). While anticoagulation was initiated in all patients, resolution was achieved in 51.4% of patients. Significantly higher LAA peak strain (− 3.0 ± 1.3 vs. − 1.6 ± 1.5%, p < 0.01) and thrombus mobility (0.33 ± 0.13 mm vs. 0.18 ± 0.08 mm, p < 0.01) were observed in patients in whom thrombi resolved (i.e. responders against non-responders). Receiver operating characteristic (ROC) analysis revealed a high discriminatory ability for thrombus mobility with regards to thrombus resolution (AUC 0.89). Conclusion: Isolated tracking of thrombus mobility from echocardiographic images is feasible. In patients with LAA thrombus, higher thrombus mobility appeared to be associated with thrombus resolution. Future studies should be conducted to evaluate the role of the described technique to predict LAA thrombus resolution or persistence. [ABSTRACT FROM AUTHOR]

Background: Data on Device-related Thrombus (DRT) after left atrial appendage closure (LAAC) remain scarce. This study aimed to investigate risk factors for DRT from centers reporting to the EUROC-DRT registry. Methods: We included 537 patients (112 with DRT and 425 without DRT) who had undergone LAAC between 12/2008 and 04/2019. Baseline and implantation characteristics, anti-thrombotic treatment and clinical outcomes were compared between both groups in uni- and multivariate analyses. Additional propensity-score matching (PSM) was conducted to focus on the role of implantation characteristics. Results: Patients with DRT showed higher rates of previous stroke/transient ischemic attack (TIA) (49.1% vs. 34.7%, p < 0.01), spontaneous echocardiographic contrast (SEC) (44.9% vs. 27.7%, p < 0.01) and lower left atrial appendage (LAA) peak emptying velocity (35.4 ± 18.5 vs. 42.4 ± 18.0 cm/s, p = 0.02). Occluders implanted in DRT patients were larger (25.5 ± 3.8 vs. 24.6 ± 3.5 mm, p = 0.03) and implanted deeper in the LAA (mean depth: 7.6 ± 4.7 vs. 5.7 ± 4.7 mm, p < 0.01). Coverage of the appendage ostium was achieved less often in DRT patients (69.5% vs. 81.5%, p < 0.01), while DRT patients were less frequently on oral anticoagulation (7.1% vs. 16.7%, p < 0.01). Multivariate analysis identified age, prior stroke/TIA and SEC as independent risk factors for DRT. After PSM, implantation depth was found to be predictive. Rates of stroke/TIA were higher in DRT patients (13.5% vs. 3.8%, Hazard Ratio: 4.21 [95%-confidence interval: 1.88–9.49], p < 0.01). Conclusions: DRT after LAAC is associated with adverse outcome and appears to be of multifactorial origin, depending on patient characteristics, anticoagulation regimen and device position. [ABSTRACT FROM AUTHOR]

This paper examines higher education efforts linking United Nations Sustainable Development Goals (UNSDGs) and agri-food system sustainability given reports of stagnant movement for SDG2 in Southeast Asia and lack of data for effective monitoring or evaluation to realize the 2030 Agenda. It discusses Thai contexts amid a growing global movement in academic theory, policy and practice to mainstream SDG knowledge and implementation across campuses presenting one case to illustrate broader concerns. Chulalongkorn University policies, faculty awareness, curricula, research, sustainability reporting and partnerships about SDGs have contributed to SDG2 objectives from different disciplines and academic units. However, some faculty still lack understanding of SDGs generally while SDG2 has not been an institutional priority. The university has made welcome progress since a 2017 policy promoting SDGs but still needs to strengthen SDG2 data collection, teaching, research and community outreach capacities including links to government and international reporting to address complex agri-food system sustainability challenges. Comparative studies could also help while critically debating SDG deficiencies and promoting socioeconomic, ecological, agri-food system, community and campus sustainability. [ABSTRACT FROM AUTHOR]

Objectives: To compare immune response evaluation criteria in solid tumors (iRECIST) and response evaluation criteria in solid tumors (RECIST) 1.1 for response assessment of immune checkpoint inhibitor (ICI) therapy in a real-world setting in patients with melanoma and non-small cell lung cancer (NSCLC).Two-hundred fifty-two patients with melanoma and NSCLC who received CTLA-4 inhibitor ipilimumab or PD-1 inhibitors nivolumab or pembrolizumab and who underwent staging CT of the chest and abdomen were retrospectively included. Treatment response evaluation according to the RECIST 1.1 and iRECIST guidelines was performed for all patients. Response patterns, as well as overall response rate (ORR), disease control rate (DCR), and time to progression (TTP), were compared between RECIST 1.1 and iRECIST.Out of 143 patients with progressive disease (PD) according to RECIST 1.1, 48 (33.6%) did not attain confirmation of progression (iCPD) as per iRECIST and six patients who were treated beyond RECIST 1.1 progression reached PD at a later point in time in iRECIST, resulting in a significant difference in TTP between iRECIST and RECIST 1.1 (618.3 ± 626.9 days vs. 538.1 ± 617.9 days, respectively (p < 0.05)). The number of non-responders as per RECIST 1.1 was 79, whereas it was 60 when using iRECIST. ORR was 28.5% for RECIST 1.1 and 34.1% for iRECIST, and corresponding DCR of 67.4% for RECIST 1.1 and 74.6% for iRECIST.iRECIST was more suitable than RECIST 1.1 for capturing atypical response patterns to ICI therapy in patients with melanoma and NSCLC, resulting in differences in the assessment of treatment response.Compared to RECIST 1.1, iRECIST may improve patient care and treatment decisions for patients with NSCLC or melanoma who are treated with immune checkpoint inhibitors in clinical routine.RECIST 1.1 may incorrectly assess atypical treatment patterns to immune checkpoint inhibitors.iRECIST better captured atypical response patterns compared to RECIST 1.1.iRECIST was more suitable for assessing response to immune checkpoint inhibitors in non-small cell lung carcinoma and melanoma.RECIST 1.1 may incorrectly assess atypical treatment patterns to immune checkpoint inhibitors.iRECIST better captured atypical response patterns compared to RECIST 1.1.iRECIST was more suitable for assessing response to immune checkpoint inhibitors in non-small cell lung carcinoma and melanoma.Methods: To compare immune response evaluation criteria in solid tumors (iRECIST) and response evaluation criteria in solid tumors (RECIST) 1.1 for response assessment of immune checkpoint inhibitor (ICI) therapy in a real-world setting in patients with melanoma and non-small cell lung cancer (NSCLC).Two-hundred fifty-two patients with melanoma and NSCLC who received CTLA-4 inhibitor ipilimumab or PD-1 inhibitors nivolumab or pembrolizumab and who underwent staging CT of the chest and abdomen were retrospectively included. Treatment response evaluation according to the RECIST 1.1 and iRECIST guidelines was performed for all patients. Response patterns, as well as overall response rate (ORR), disease control rate (DCR), and time to progression (TTP), were compared between RECIST 1.1 and iRECIST.Out of 143 patients with progressive disease (PD) according to RECIST 1.1, 48 (33.6%) did not attain confirmation of progression (iCPD) as per iRECIST and six patients who were treated beyond RECIST 1.1 progression reached PD at a later point in time in iRECIST, resulting in a significant difference in TTP between iRECIST and RECIST 1.1 (618.3 ± 626.9 days vs. 538.1 ± 617.9 days, respectively (p < 0.05)). The number of non-responders as per RECIST 1.1 was 79, whereas it was 60 when using iRECIST. ORR was 28.5% for RECIST 1.1 and 34.1% for iRECIST, and corresponding DCR of 67.4% for RECIST 1.1 and 74.6% for iRECIST.iRECIST was more suitable than RECIST 1.1 for capturing atypical response patterns to ICI therapy in patients with melanoma and NSCLC, resulting in differences in the assessment of treatment response.Compared to RECIST 1.1, iRECIST may improve patient care and treatment decisions for patients with NSCLC or melanoma who are treated with immune checkpoint inhibitors in clinical routine.RECIST 1.1 may incorrectly assess atypical treatment patterns to immune checkpoint inhibitors.iRECIST better captured atypical response patterns compared to RECIST 1.1.iRECIST was more suitable for assessing response to immune checkpoint inhibitors in non-small cell lung carcinoma and melanoma.RECIST 1.1 may incorrectly assess atypical treatment patterns to immune checkpoint inhibitors.iRECIST better captured atypical response patterns compared to RECIST 1.1.iRECIST was more suitable for assessing response to immune checkpoint inhibitors in non-small cell lung carcinoma and melanoma.Results: To compare immune response evaluation criteria in solid tumors (iRECIST) and response evaluation criteria in solid tumors (RECIST) 1.1 for response assessment of immune checkpoint inhibitor (ICI) therapy in a real-world setting in patients with melanoma and non-small cell lung cancer (NSCLC).Two-hundred fifty-two patients with melanoma and NSCLC who received CTLA-4 inhibitor ipilimumab or PD-1 inhibitors nivolumab or pembrolizumab and who underwent staging CT of the chest and abdomen were retrospectively included. Treatment response evaluation according to the RECIST 1.1 and iRECIST guidelines was performed for all patients. Response patterns, as well as overall response rate (ORR), disease control rate (DCR), and time to progression (TTP), were compared between RECIST 1.1 and iRECIST.Out of 143 patients with progressive disease (PD) according to RECIST 1.1, 48 (33.6%) did not attain confirmation of progression (iCPD) as per iRECIST and six patients who were treated beyond RECIST 1.1 progression reached PD at a later point in time in iRECIST, resulting in a significant difference in TTP between iRECIST and RECIST 1.1 (618.3 ± 626.9 days vs. 538.1 ± 617.9 days, respectively (p < 0.05)). The number of non-responders as per RECIST 1.1 was 79, whereas it was 60 when using iRECIST. ORR was 28.5% for RECIST 1.1 and 34.1% for iRECIST, and corresponding DCR of 67.4% for RECIST 1.1 and 74.6% for iRECIST.iRECIST was more suitable than RECIST 1.1 for capturing atypical response patterns to ICI therapy in patients with melanoma and NSCLC, resulting in differences in the assessment of treatment response.Compared to RECIST 1.1, iRECIST may improve patient care and treatment decisions for patients with NSCLC or melanoma who are treated with immune checkpoint inhibitors in clinical routine.RECIST 1.1 may incorrectly assess atypical treatment patterns to immune checkpoint inhibitors.iRECIST better captured atypical response patterns compared to RECIST 1.1.iRECIST was more suitable for assessing response to immune checkpoint inhibitors in non-small cell lung carcinoma and melanoma.RECIST 1.1 may incorrectly assess atypical treatment patterns to immune checkpoint inhibitors.iRECIST better captured atypical response patterns compared to RECIST 1.1.iRECIST was more suitable for assessing response to immune checkpoint inhibitors in non-small cell lung carcinoma and melanoma.Conclusion: To compare immune response evaluation criteria in solid tumors (iRECIST) and response evaluation criteria in solid tumors (RECIST) 1.1 for response assessment of immune checkpoint inhibitor (ICI) therapy in a real-world setting in patients with melanoma and non-small cell lung cancer (NSCLC).Two-hundred fifty-two patients with melanoma and NSCLC who received CTLA-4 inhibitor ipilimumab or PD-1 inhibitors nivolumab or pembrolizumab and who underwent staging CT of the chest and abdomen were retrospectively included. Treatment response evaluation according to the RECIST 1.1 and iRECIST guidelines was performed for all patients. Response patterns, as well as overall response rate (ORR), disease control rate (DCR), and time to progression (TTP), were compared between RECIST 1.1 and iRECIST.Out of 143 patients with progressive disease (PD) according to RECIST 1.1, 48 (33.6%) did not attain confirmation of progression (iCPD) as per iRECIST and six patients who were treated beyond RECIST 1.1 progression reached PD at a later point in time in iRECIST, resulting in a significant difference in TTP between iRECIST and RECIST 1.1 (618.3 ± 626.9 days vs. 538.1 ± 617.9 days, respectively (p < 0.05)). The number of non-responders as per RECIST 1.1 was 79, whereas it was 60 when using iRECIST. ORR was 28.5% for RECIST 1.1 and 34.1% for iRECIST, and corresponding DCR of 67.4% for RECIST 1.1 and 74.6% for iRECIST.iRECIST was more suitable than RECIST 1.1 for capturing atypical response patterns to ICI therapy in patients with melanoma and NSCLC, resulting in differences in the assessment of treatment response.Compared to RECIST 1.1, iRECIST may improve patient care and treatment decisions for patients with NSCLC or melanoma who are treated with immune checkpoint inhibitors in clinical routine.RECIST 1.1 may incorrectly assess atypical treatment patterns to immune checkpoint inhibitors.iRECIST better captured atypical response patterns compared to RECIST 1.1.iRECIST was more suitable for assessing response to immune checkpoint inhibitors in non-small cell lung carcinoma and melanoma.RECIST 1.1 may incorrectly assess atypical treatment patterns to immune checkpoint inhibitors.iRECIST better captured atypical response patterns compared to RECIST 1.1.iRECIST was more suitable for assessing response to immune checkpoint inhibitors in non-small cell lung carcinoma and melanoma.Clinical relevance statement: To compare immune response evaluation criteria in solid tumors (iRECIST) and response evaluation criteria in solid tumors (RECIST) 1.1 for response assessment of immune checkpoint inhibitor (ICI) therapy in a real-world setting in patients with melanoma and non-small cell lung cancer (NSCLC).Two-hundred fifty-two patients with melanoma and NSCLC who received CTLA-4 inhibitor ipilimumab or PD-1 inhibitors nivolumab or pembrolizumab and who underwent staging CT of the chest and abdomen were retrospectively included. Treatment response evaluation according to the RECIST 1.1 and iRECIST guidelines was performed for all patients. Response patterns, as well as overall response rate (ORR), disease control rate (DCR), and time to progression (TTP), were compared between RECIST 1.1 and iRECIST.Out of 143 patients with progressive disease (PD) according to RECIST 1.1, 48 (33.6%) did not attain confirmation of progression (iCPD) as per iRECIST and six patients who were treated beyond RECIST 1.1 progression reached PD at a later point in time in iRECIST, resulting in a significant difference in TTP between iRECIST and RECIST 1.1 (618.3 ± 626.9 days vs. 538.1 ± 617.9 days, respectively (p < 0.05)). The number of non-responders as per RECIST 1.1 was 79, whereas it was 60 when using iRECIST. ORR was 28.5% for RECIST 1.1 and 34.1% for iRECIST, and corresponding DCR of 67.4% for RECIST 1.1 and 74.6% for iRECIST.iRECIST was more suitable than RECIST 1.1 for capturing atypical response patterns to ICI therapy in patients with melanoma and NSCLC, resulting in differences in the assessment of treatment response.Compared to RECIST 1.1, iRECIST may improve patient care and treatment decisions for patients with NSCLC or melanoma who are treated with immune checkpoint inhibitors in clinical routine.RECIST 1.1 may incorrectly assess atypical treatment patterns to immune checkpoint inhibitors.iRECIST better captured atypical response patterns compared to RECIST 1.1.iRECIST was more suitable for assessing response to immune checkpoint inhibitors in non-small cell lung carcinoma and melanoma.RECIST 1.1 may incorrectly assess atypical treatment patterns to immune checkpoint inhibitors.iRECIST better captured atypical response patterns compared to RECIST 1.1.iRECIST was more suitable for assessing response to immune checkpoint inhibitors in non-small cell lung carcinoma and melanoma.Key Points: To compare immune response evaluation criteria in solid tumors (iRECIST) and response evaluation criteria in solid tumors (RECIST) 1.1 for response assessment of immune checkpoint inhibitor (ICI) therapy in a real-world setting in patients with melanoma and non-small cell lung cancer (NSCLC).Two-hundred fifty-two patients with melanoma and NSCLC who received CTLA-4 inhibitor ipilimumab or PD-1 inhibitors nivolumab or pembrolizumab and who underwent staging CT of the chest and abdomen were retrospectively included. Treatment response evaluation according to the RECIST 1.1 and iRECIST guidelines was performed for all patients. Response patterns, as well as overall response rate (ORR), disease control rate (DCR), and time to progression (TTP), were compared between RECIST 1.1 and iRECIST.Out of 143 patients with progressive disease (PD) according to RECIST 1.1, 48 (33.6%) did not attain confirmation of progression (iCPD) as per iRECIST and six patients who were treated beyond RECIST 1.1 progression reached PD at a later point in time in iRECIST, resulting in a significant difference in TTP between iRECIST and RECIST 1.1 (618.3 ± 626.9 days vs. 538.1 ± 617.9 days, respectively (p < 0.05)). The number of non-responders as per RECIST 1.1 was 79, whereas it was 60 when using iRECIST. ORR was 28.5% for RECIST 1.1 and 34.1% for iRECIST, and corresponding DCR of 67.4% for RECIST 1.1 and 74.6% for iRECIST.iRECIST was more suitable than RECIST 1.1 for capturing atypical response patterns to ICI therapy in patients with melanoma and NSCLC, resulting in differences in the assessment of treatment response.Compared to RECIST 1.1, iRECIST may improve patient care and treatment decisions for patients with NSCLC or melanoma who are treated with immune checkpoint inhibitors in clinical routine.RECIST 1.1 may incorrectly assess atypical treatment patterns to immune checkpoint inhibitors.iRECIST better captured atypical response patterns compared to RECIST 1.1.iRECIST was more suitable for assessing response to immune checkpoint inhibitors in non-small cell lung carcinoma and melanoma.RECIST 1.1 may incorrectly assess atypical treatment patterns to immune checkpoint inhibitors.iRECIST better captured atypical response patterns compared to RECIST 1.1.iRECIST was more suitable for assessing response to immune checkpoint inhibitors in non-small cell lung carcinoma and melanoma. [ABSTRACT FROM AUTHOR]

This study examines the prevalence of marital contracts across marriage cohorts (1990–2019) in Germany. We further investigate the characteristics of spouses who signed a marital contract. Using cross-sectional data from the German Family Panel (pairfam, 2018/19), we employ complementary log–log and multinomial logistic regression models to predict the prevalence and the type of marital contracts. The results show that 5% of all married couples opt out of the default matrimonial property regime by signing a contract in Germany. Differentiating between contract types, most couples either specify a separation of property (40%) or modify the default community of accrued gains (31%). We find an increase in the prevalence of marital contracts across marriage cohorts. The decision to opt out of the default is strongly positively associated with self-employment that often requires the customisation of asset ownership structures within marriage. Married individuals with prior divorce experiences are more likely to opt for the separation of property, indicating that the awareness of the economic consequences of divorce promotes the individualisation of marriage. Our results are in line with the cross-national trend towards customised marriages, although the trend in Germany is less pronounced than in other countries. [ABSTRACT FROM AUTHOR]

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Nowadays, Tunisia faces challenging environmental and energy issues which relate mainly to the implementation of an appropriate solid waste management system capable of dealing with the high production of biowaste on the one hand, and the increased need for water and energy resources on the other. Therefore, the current study is intended to develop a closed cycle technical concept treating mainly food waste (FW) through combined biological processes. In this approach, FW anaerobic digestion (AD) was destined to provide a valuable input material for FW in vessel-composting by exploiting the produced digestates. To this end, the gathered AD-effluents of three systems (D1, D2, D3) were entirely analyzed to select, as a further step, the most suitable one to be subject of the suggested post-treatment. Hence, several physiochemical parameters were examined as key performance indicators. It mainly consisted of moisture content, pH, C:N ratio and heavy metals contents. The current findings depicted that the generated digestates were characterized by a high moisture content which inspired its utilization as an unconventional moisturizing agent (MA) aiming to reduce the fresh water consumption during the composting process. Thus, two experimental setups were carried out to evaluate the effect of the selected digestate on FW-in-vessel composting process performance, as a non-standard MA inserted to A2, comparing to the unamended one (A1) which was moistened by fresh water. In fact, basing on the above-mentioned criteria, the relatively high C:N ratio (of around 15), as well as the relatively significant rate of the required macro- and micro-nutrients promoted the exploitation of biochar-rich digestate (D3) as not only an efficient unconventional MA, but also as a composting process booster. Furthermore, the results revealed that the addition of D3 improved significantly the composting process performance in terms of steering parameters including the attained temperature, MC and pH. When it comes to the maturity and stability assessment, the decreased profiles of C:N ratio, the nitrification index (NI), as well as the respiration activity (AT4) ascertained the fulfilment of the required conditions for both A1 and A2 to produce stable and mature end-products. However, regarding the compost quality, the examined concentrations of heavy metals met the requirement set by German standards and attested that both A1 and A2 generated highly-qualified products, rated as class B and A, respectively. Furthermore, it is noteworthy to mention that even the AD-effluents which were classified as an "inappropriate substrate" to be inserted to the composters, met the required criteria to be applied directly to land as a highly-qualified liquid biofertilizer. This latter ascertained, additionally, the efficiency and feasibility of the suggested closed cycle for a sustainable FW management. [ABSTRACT FROM AUTHOR]

Purpose: The olfactory system can be successfully rehabilitated with regular, intermittent stimulation during multiple daily exposures to selected sets of odors, i.e., olfactory training (OT). OT has been repeatedly shown to be an effective tool of olfactory performance enhancement. Recent advancements in studies on OT suggest that its beneficial effects exceed olfaction and extend to specific cognitive tasks. So far, studies on OT provided compelling evidence for its effectiveness, but there is still a need to search for an optimal OT protocol. The present study examined whether increased frequency of OT leads to better outcomes in both olfactory and cognitive domains. Method: Fifty-five subjects (28 females; Mage = 58.2 ± 11.3 years; 26 patients with impaired olfaction) were randomly assigned to a standard (twice a day) or intense (four times a day) OT. Olfactory and cognitive measurements were taken before and after OT. Results: OT performed twice a day was more effective in supporting olfactory rehabilitation and interventions targeted to verbal semantic fluency than OT performed four times a day, even more so in subjects with lower baseline scores. Conclusions: OT is effective in supporting olfactory rehabilitation and interventions targeted to verbal semantic fluency. However, it may be prone to a ceiling effect, being efficient in subjects presenting with lower baseline olfactory performance and lower verbal semantic fluency. [ABSTRACT FROM AUTHOR]

Maintaining the architecture, size and composition of an intact stem cell (SC) compartment is crucial for tissue homeostasis and regeneration throughout life. In mammalian skin, elevated expression of the anti‐apoptotic Bcl‐2 protein has been reported in hair follicle (HF) bulge SCs (BSCs), but its impact on SC function is unknown. Here, we show that systemic exposure of mice to the Bcl‐2 antagonist ABT‐199/venetoclax leads to the selective loss of suprabasal BSCs (sbBSCs), thereby disrupting cyclic HF regeneration. RNAseq analysis shows that the pro‐apoptotic BH3‐only proteins BIM and Bmf are upregulated in sbBSCs, explaining their addiction to Bcl‐2 and the marked susceptibility to Bcl‐2 antagonism. In line with these observations, conditional knockout of Bcl‐2 in mouse epidermis elevates apoptosis in BSCs. In contrast, ectopic Bcl‐2 expression blocks apoptosis during HF regression, resulting in the accumulation of quiescent SCs and delaying HF growth in mice. Strikingly, Bcl‐2‐induced changes in size and composition of the HF bulge accelerate tumour formation. Our study identifies a niche‐instructive mechanism of Bcl‐2‐regulated apoptosis response that is required for SC homeostasis and tissue regeneration, and may suppress carcinogenesis. Synopsis: Anti‐apoptotic Bcl‐2 protein function is required to maintain a hair follicle subpopulation of stem cells in murine skin. Blocking cell death by Bcl‐2 overexpression affects the hair follicle stem cell niche and hair follicle regeneration. Systemic blocking of Bcl‐2 specifically depletes supra‐basal hair follicle stem cells.Loss of supra‐basal stem cells interferes with the hair follicle regeneration cycle.Ectopic Bcl‐2 expression results in the accumulation of quiescent stem cells and affects hair regeneration.Bcl‐2 overexpression changes the hair follicle stem cell compartments and accelerates skin tumour formation. [ABSTRACT FROM AUTHOR]

Solid waste management and disposal is one of the most significant challenges facing urban communities around the world. There is a wide range of alternative waste management options and strategies available for dealing with the notable increase in the waste stream. Composting is one of the most viable and efficient waste treatment options in terms of the reduction in the negative effects from the application of organic waste to soil. The experimental research aimed to examine the potential of producing compost from different organic waste streams in Tunisia. Two experimental windrow piles made from cooked and uncooked food and garden wastes were initiated and temporally monitored. The composting process was controlled in terms of temperature and moisture. Sampling was carried out over the period of the composting process. All of the collected samples were analyzed in terms of their physical, chemical, and biological properties; pH, C:N ratio, nitrification index (NI), microbiological tests, respiration activity (AT4), and heavy metal content. The quality of the final product was determined and compared with Tunisian and German standards. The findings demonstrated a significant reduction in the initial C:N ratio to about 15 by the end of the process. Additionally, the results showed that the compost produced appeared to be stable and was deemed to be class V finished compost; the NI was found to be around 1, while the AT4 was estimated to be lower than 6 mg O2/g TS. Regarding the heavy metal content, the final products were characterized as having a lower concentration than those values set by Tunisian and German standards. [ABSTRACT FROM AUTHOR]

The common phenomenon of lightning still harbors many secrets such as what are the conditions for lightning initiation and what is driving the discharge to propagate over several tens of kilometers through the atmosphere forming conducting ionized channels called leaders. Since lightning is an electric discharge phenomenon, there are positively and negatively charged leaders. In this work we report on measurements made with the LOFAR radio telescope, an instrument primarily build for radio-astronomy observations. It is observed that a negative leader rather suddenly changes, for a few milliseconds, into a mode where it radiates 100 times more VHF power than typical negative leaders after which it spawns a large number of more typical negative leaders. This mode occurs during the initial stage, soon after initiation, of all lightning flashes we have mapped (about 25). For some flashes this mode occurs also well after initiation and we show one case where it is triggered twice, some 100 ms apart. We postulate that this is indicative of a small (order of 5 km 2 ) high charge pocket. Lightning thus appears to be initiated exclusively in the vicinity of such a small but dense charge pocket. [ABSTRACT FROM AUTHOR]

In the short- and mid-term perspective, drastic measures for the reduction of anthropogenic emissions including extensive decarbonization of the residential and industrial heating sector have to be implemented. To replace fossil fuels, solid biogenic residues and wastes will have to be increasingly utilized. Compared to clean woody biomass, these biomass assortments are commonly characterized by higher Si and alkaline metal contents recognized as major driver for low ash melting temperatures resulting in elevated risk of bottom ash slagging. To facilitate the prediction of bottom ash slagging during combustion, several fuel indices have been proposed. Based on empirical correlations with parameters relevant for slagging behavior, e.g., ash melting temperatures or slag fraction of the bottom ash, these fuel indices were subsequently enhanced and adapted for an increasing range of biomass fuel characteristics. In this study, analysis data of 26 woody and non-woody fuels and experimental data derived from two combustion test campaigns with an automatically stoked small-scale boiler were investigated through principal component analysis. Thus, the complex interdependencies between the fuel composition and the resulting bottom ash characteristics and the applicability of existing fuel indices were evaluated. The chemometric analysis highlighted that Si, Ca, K, Mg, and also the remaining Al and S in the bottom ash are crucial fuel components in the context of bottom ash melting. On this basis, the molar ratio (Si + P + K)/(Ca + Mg) was adapted and correlated with the susceptibility to slag formation which is a new parameter derived from ash content, slag fraction > 16 mm in the bottom ash, and slag category. Thus, the applicability of a newly developed fuel index was evaluated with respect to the bottom ash slagging risk during real-scale combustion. Three ranges were distinguished for the fuel index corresponding to a specific susceptibility to slag formation (i.e., low < 20 mol/g for woody biomass, elevated between 20 and 75 mol/g, and serious > 75 mol/g for straw-like fuels and blends with wood). The linear regression of the fuel index with susceptibility to slag formation exhibits a high coefficient of determination (i.e., 0.99 for woody biomass and 0.84 for straw-like fuels and their blends with wood). [ABSTRACT FROM AUTHOR]

Background: Data on thrombus resolution and clinical outcome data after a therapy of LAA thrombus with novel oral anticoagulants (NOACs) are scarce. Methods: In this single-center study, we retrospectively analyzed 78 patients diagnosed with a solid LAA thrombus by transesophageal echocardiography (TEE). We assessed baseline clinical and echocardiographic characteristics, the anticoagulatory regimens and outcomes of patients with (responders) and without (non-responders) thrombus resolution. Results: Mean age was 76.1 ± 8.3 years, patients were male in 57.7% and presented with a high risk for thromboembolism (CHA2DS2-VASc: 4.3 ± 1.1). At thrombus diagnosis, 44.9% patients were treated with a NOAC, while 41.0% were under therapy with a VKA. Complete thrombus resolution was achieved after a mean of 116 ± 79 days in a total of 51.3% of patients, 35.9% showed a reduction of thrombus size, whereas 12.8% showed no changes in thrombus dimensions. There was no statistically significant difference in the rate of LAA thrombus resolution between VKA and NOACs (41.2 vs. 57.1%, p = 0.18). However, in cases in which only the therapy with a NOAC led to complete thrombus resolution, the time needed was significantly shorter than with VKA (81 ± 38 vs. 129 ± 46 days, p = 0.03). Regarding safety outcomes, no differences in bleeding or thromboembolism were observed between patients with and without thrombus resolution. Conclusions: In this registry, approximately 85% of LAA thrombi were diagnosed in patients with ongoing OAC. Thrombus resolution was observed in nearly 50% of cases. Although there was no difference in the rate of LAA thrombus resolution between VKA and NOACs, the resolution time was shorter in patients prescribed a NOAC. [ABSTRACT FROM AUTHOR]

Aims: Acute kidney injury (AKI) remains a frequent complication after cardiac interventions, such as left atrial appendage closure (LAAC), yet limited data are available on the incidence and clinical implication of AKI in this setting. We sought to assess incidence, predictors and relevance of AKI after LAAC. Methods and results: We retrospectively analyzed 95 LAAC patients in three European centers. AKI was defined according to the Acute Kidney Injury Network (AKIN) classification. The incidence of AKI was 13.7% with mild AKI in 92.3% and AKI stage > II in 7.7%. Total contrast volume was not linked to the occurrence of AKI (AKI: 127 ± 83 vs. no AKI: 109 ± 92 ml, p = 0.41), however increasing contrast volume (CV) to glomerular filtration rate (GFR) ratio (CV/GFR ratio) was associated with an increased risk of AKI (OR, per unit increase: 1.24, 95% CI 0.97–1.58, p = 0.08). ROC-analysis revealed a moderate predictive value of CV/GFR ratio for the prediction of AKI (AUC: 0.67, 95% CI 0.50–0.84, p = 0.05). Furthermore, AKI was associated with significantly increased mortality 6 months and 1 year after LAAC. No significant difference in the incidence of AKI was observed between patients with mere fluoroscopic and additional echocardiographic guidance (16.3% vs. 11.5%, p = 0.56). Conclusion: Whereas mild AKI is common in patients after LAAC, severe AKI is rare. AKI after LAAC is associated with poor baseline renal function, increased doses of contrast (CV/GFR ratio) and impaired outcome. Future studies will be needed to elaborate the benefit of reducing or avoiding contrast volume regarding this endpoint. [ABSTRACT FROM AUTHOR]

The integration of ethics into the day-to-day work of research and innovation (R&I) is an important but difficult challenge. However, with the Aachen method for identification, classification and risk analysis of innovation-based problems (AMICAI) an approach from an engineering perspective is presented that enables the integration of ethical, legal and social implications into the day-to-day work of R&I practitioners. AMICAI appears in particular capable of providing a procedural guidance for R&I practitioners based on a method established in engineering science, breaking down the object of consideration into partial aspects and prioritizing the innovation-based problems in dependence of potential risk. This enables the user to apply AMICAI continuously during all stages of the research and development (R&D) process and to analyze and choose between certain sociotechnical alternatives. In this way, problems that affect ethical, legal, and social aspects can be understood, reflected and considered in the mostly technically focused R&D process. The paper gives a general guidance about AMICAI by describing principles and assumptions, providing the steps of analysis and application aids, giving an example application, explaining the necessary adjustments of AMICAI compared to the methodical basis of failure mode, effects, and criticality analysis and discussing the advantages and limits. AMICAI's simple applications can stimulate interdisciplinary cooperation in the R&D process and be a starting point for the development of an "open RRI risk analysis platform" allowing society to evaluate innovation-based problems. [ABSTRACT FROM AUTHOR]

NuRadioMC is a Monte Carlo framework designed to simulate ultra-high energy neutrino detectors that rely on the radio detection method. This method exploits the radio emission generated in the electromagnetic component of a particle shower following a neutrino interaction. NuRadioMC simulates everything from the neutrino interaction in a medium, the subsequent Askaryan radio emission, the propagation of the radio signal to the detector and finally the detector response. NuRadioMC is designed as a modern, modular Python-based framework, combining flexibility in detector design with user-friendliness. It includes a state-of-the-art event generator, an improved modelling of the radio emission, a revisited approach to signal propagation and increased flexibility and precision in the detector simulation. This paper focuses on the implemented physics processes and their implications for detector design. A variety of models and parameterizations for the radio emission of neutrino-induced showers are compared and reviewed. Comprehensive examples are used to discuss the capabilities of the code and different aspects of instrumental design decisions. [ABSTRACT FROM AUTHOR]

The use of robots in the national economy—especially in industrialized countries—is growing. At the same time, the interdependency between humans and robots is getting increasingly closer: they are engaging in direct contact with each other as more and more organizations let robots and humans work hand-in-hand. One factor that predicts successful human–robot interdependency is the acceptance of the robot by the human. Generally, only when an innovative assistive working system covers human needs and expectations, it is perceived to be useful and hence accepted. Furthermore, it has been found that cultural context has an impact on human–robot interaction, as people feel more comfortable interacting with a robot in a culturally normative way. Therefore this paper aims at presenting a human–robot collaboration acceptance model (HRCAM) with regard to the collaboration between humans and robots that is based on prior acceptance models, while also considering technology affinity and ethical, legal and social implications. Additionally, similarities and differences in robot acceptance are shown for four selected countries—both in comparison to the overall human–robot collaboration acceptance model and between the countries. The HRCAM additionally shows which variables influence perceived usefulness and perceived ease of use, and thus behavioral intention to use and use behavior. A further distinction is made between anchor variables, which can be influenced in the long term, and adjustment variables, which can be influenced in the short to medium term. The model therefore offers practitioners in the field of human–robot collaboration recommendations to increase the acceptance of robots. [ABSTRACT FROM AUTHOR]

Lightning is a dangerous yet poorly understood natural phenomenon. Lightning forms a network of plasma channels propagating away from the initiation point with both positively and negatively charged ends—called positive and negative leaders1. Negative leaders propagate in discrete steps, emitting copious radio pulses in the 30–300-megahertz frequency band2–8 that can be remotely sensed and imaged with high spatial and temporal resolution9–11. Positive leaders propagate more continuously and thus emit very little high-frequency radiation12. Radio emission from positive leaders has nevertheless been mapped13–15, and exhibits a pattern that is different from that of negative leaders11–13,16,17. Furthermore, it has been inferred that positive leaders can become transiently disconnected from negative leaders9,12,16,18–20, which may lead to current pulses that both reconnect positive leaders to negative leaders11,16,17,20–22 and cause multiple cloud-to-ground lightning events1. The disconnection process is thought to be due to negative differential resistance18, but this does not explain why the disconnections form primarily on positive leaders22, or why the current in cloud-to-ground lightning never goes to zero23. Indeed, it is still not understood how positive leaders emit radio-frequency radiation or why they behave differently from negative leaders. Here we report three-dimensional radio interferometric observations of lightning over the Netherlands with unprecedented spatiotemporal resolution. We find small plasma structures—which we call 'needles'—that are the dominant source of radio emission from the positive leaders. These structures appear to drain charge from the leader, and are probably the reason why positive leaders disconnect from negative ones, and why cloud-to-ground lightning connects to the ground multiple times. Radio interferometric observations of lightning over the Netherlands reveal small needle-shaped plasma structures associated with the positive leader channels, explaining why cloud-to-ground lightning connects to the ground multiple times. [ABSTRACT FROM AUTHOR]

Aims: Percutaneous left atrial appendage occlusion (LAAo) is commonly performed under fluoroscopy including the use of contrast dye. In this study, we aimed to assess feasibility and safety of contrast-free, 3D-echo-based LAAo with the use of the AMPLATZER™ Amulet™ device.Methods and results: We analyzed 20 patients (74 ± 10 years, 65% males) at an increased thromboembolic and bleeding risk (CHA2DS2VASC 4.0 ± 1.3; HAS-BLED 3.5 ± 0.9) with chronic renal failure (GFR 41 ± 21 ml/min) undergoing LAAo without the use of contrast dye at our center and compared the results with a propensity-matched cohort (1:1 matching) of conventionally treated patients receiving contrast agent. Contrast-free LAAo was associated with less radiation exposure (13.1 ± 19.2 vs. 32.9 ± 21.2 Gy*cm2, p < 0.01) and fluoroscopy time (5.0 ± 3.4 vs. 11.6 ± 4.9 min, p < 0.01). Procedural success rates were excellent in both groups (100%) without severe periprocedural complications (i.e. procedural death, stroke/systemic embolism, myocardial infarction, cardiac tamponade or major bleeding).Conclusions: Echocardiographically guided LAAo without the use of contrast dye appears safe and feasible. This approach appears to be associated with reduced radiation exposure and may represent an alternative to traditional LAAo, especially in patients in whom the avoidance of contrast dye is warranted. [ABSTRACT FROM AUTHOR]

Wood chip quality is essential for failure-free and low-emission combustion in automatically stoked small-scale biomass boilers (< 100 kW). Screening and drying of wood chips might be suitable to reduce fuel heterogeneity and to guarantee defined qualities according to ISO 17225-4. Six case studies on screening and drying of forest residue wood chips were performed at German biomass terminals. Screening was done using drum, star, or jigger screens. Drying was done in storage piles and in rolling bed, walking floor, belt, and batch container dryer. Throughput rate was assessed on-site. Fuel properties were analyzed according to international standards. Moisture content of fresh wood chips was too high for small-scale biomass boilers (up to 51 w-%). Raw materials did not comply with specifications of ISO 17225-4 (i.e., ash content, particle size) while fuel indices (Fe/Mn, Al/200) implied contamination with soil material. Technical drying provided moisture contents ≤ 15 w-% while natural drying in piles resulted in values often exceeding 35 w-%. Screening reduced ash content, fines, oversized particles, and the share of N, S, Cl, K, and Si. Screening of pre-dried fuels seems to be beneficial compared to screening of fresh wood chips. After processing, chips could usually be classified as specification A2 to B1 according to ISO 17225-4. [ABSTRACT FROM AUTHOR]

Within six case studies, different drying and sieving process steps were employed for the removal of adhering soil and other extraneous impurities from wood chips. Consequently, it was systematically investigated to which extent this strategy can be used to jointly mitigate the risk of bottom ash slagging and high pollutant emission levels during combustion in an automatically stoked small-scale boiler. Throughout all combustion tests, slag and emission formation were recorded. Formation of agglomerates in the bottom ash was not observed in the fuel bed. However, fuel processing resulted in an increase of the ash shrinking-softening range up to 230 K indicating a lower slagging risk in the bottom ash. An asymptotic trend for the ash melting temperatures was observed as a function of the molar (Si + P + K)/(Ca + Mg) ratio. It was also found that potassium is less efficiently retained in the bottom ash with lower Si content in the fuel. Lower moisture contents in the wood chips typically resulted in lower CO emissions and higher boiler efficiencies for the investigated range of moisture content. The sieving of the unprocessed wood chips reduced NOx emission levels up to 28%. However, fuel processing did not necessarily reduce the level of particulate matter emissions. [ABSTRACT FROM AUTHOR]

Objective: To describe percutaneous left atrial appendage closure (LAAc) in a patient with recurrent gastric ulcer bleeding with the help of the TrueFusion™ fusion-imaging system. Method and results: In a patient with paroxysmal atrial fibrillation, the need for an effective oral anticoagulation and recurrent gastrointestinal bleeding, left atrial appendage closure (LAAc) was performed under guidance of the TrueFusion™ fusion-imaging technology (Siemens Healthineers, Erlangen, Germany) to enhance procedural precision, save radiation time and contrast dye. Left atrial appendage closure was performed with the use of a 20 mm Amplatzer Amulet™ (Abbott Laboratories, Chicago, IL, USA) using the TrueFusion™ system under mild sedation with minimal use of contrast. Intraprocedural transesophageal echocardiography revealed complete LAA occlusion without residual flow. The patient was uneventfully discharged on the second postoperative day. Conclusion: LAAc using an integrated approach combining ultrasound and live fluoroscopy, as provided by the TrueFusion™, is safe and feasible. Target-oriented device navigation and synchronized image orientation as provided by fusion imaging may potentially be beneficial regarding radiation time, contrast dye and periprocedural risk of suboptimal device positioning. [ABSTRACT FROM AUTHOR]

This study aimed to monitor the composting process of the first small-scale segregated bio-waste composting scheme in Jordan to divert different types of organic wastes and to evaluate the final product quality, which can be recovered and used as compost. In this study, four experimental windrow piles were first initiated and temporally monitored. The composting process was monitored against temperature, moisture and oxygen content, indicating that the biological conditions were sufficiently developed. The monitored experimental process showed overall decreasing profiles versus composting time for moisture, organic carbon and carbon/nitrogen content, as well as overall increasing profiles for electrical conductivity and total nitrogen, which represented qualitative indications of progress in the process. The product quality was examined and assessed against the quality specifications of EU End of Waste Criteria for bio-waste, which has been subjected to composting, aiming to specify whether the different types of organic wastes that have undergone recovery cease to be waste and can be classified as high quality compost. More specifically, on the one hand the heavy metal concentrations (Cr, Cu, Ni, Cd, Pb, Zn and Hg) were within the set limits and much lower compared to the European standards. On the other hand, compost respiration in the samples varied from 3.6 to 15.3 mgO2/g dm, which, in turn, indicates that all the compost samples appeared to be stable and rated as class IV and V final products. [ABSTRACT FROM AUTHOR]

The aim of this study was to establish in vitro bench-tests of left atrial appendage occlusion (LAAo) devices regarding tug force, radial force and sealing capacity. Two LAAo devices, namely the WATCHMAN™ and the Occlutech®, of three different sizes underwent testing in novel dedicated in vitro setups. Radial force was assessed in a commercial radial force tester. At baseline, tug force of the WATCHMAN™ was significantly higher when compared to Occlutech® for all devices. Repeated resheathing resulted in a reduction of device-diameter in the WATCHMAN™ devices of max. 7.9%, whereas diameters of Occlutech® occluders remained unchanged. Tug force was not significantly impacted by resheathing in both devices. At baseline, sealing capacity in a bench-test using silicone LAA-models did not differ between the devices. Resheathing lead to an in vitro loss of sealing capacity of the WATCHMAN™ devices, increasing with resheathing and resulting in a max. peridevice leak of 91.1 ± 7.9%. Radial force was higher for the Occlutech® devices and decreased for WATCHMAN™ occluders after resheathing. The WATCHMAN™ occluder series showed progressive deformation, increased peridevice leakage and decreased radial force after resheathing, presumably as a result of diameter reduction. Tug force of the WATCHMAN™ was not impaired by resheathing and was significantly higher than that of the Occlutech® device. [ABSTRACT FROM AUTHOR]

Background: Waterweeds (Elodea nuttallii and Elodea canadensis) are invasive neophytes, which have been proliferating at a phenomenal rate during the last decades in German waterways. In case of overgrowth, the strong covering of vegetation can cause problems in hydroelectric power plants and leads to limitations in ship and boat traffic as well as in use for bathing and fishing activities. After vegetation period, dead plants can accumulate and then negatively influence flood protection and water engineering works. For this reason, the aquatic biomass has been periodically removed and disposed without further use. In order to enable the energetic use of this water-containing substrate, the aim of the present study was the optimization of storage methods for an aquatic plant-based feedstock for biogas production. In climatic cold regions, substrate conservation is necessary in order to guarantee a year-round substrate availability. With waterweed (Elodea) taken as an example, the ensiling of aquatic plants was studied. The main focus was to develop practical methods for biomass conservation while producing high biogas yields. Methods: Elodea was harvested in the river Parthe in Leipzig-Schönefeld in October 2015. Silage mixtures of Elodea and wheat straw were tested after 180 days of storage for pH, volatile fermentation products, and methane potentials. The effect of different silage moisture contents and straw particle sizes on the substrate quality was studied. Results: Results show that waterweeds can be stored by ensiling and can achieve considerable biogas yields. However, with a water content of about 95%, the storability of the material is challenging. Mixed silage of waterweeds and wheat straw were suitable for storage in clamp silos. The pH values were between 4.9 and 6.5, and the volatile fatty acid content as lactic acid ranged from 0.0 to 1.9% total solid. The mixed silages achieved methane potentials between 166 and 228 mL g-1 volatile solid (VS), which is equivalent to 52 and 72% of maize silage. Considering a methane potential of 228 mL g-1 VS and costs for material pretreatment, the most promising silage variant was mixed silage from waterweeds and ground straw with 30% total solid content. Conclusions: Long storability of waterweeds could be possible by ensiling fermentation. Mixed silages from Elodea and wheat straw show suitable substrate characteristics for biogas production and can achieve high biogas yields. [ABSTRACT FROM AUTHOR]

Copyright of Forschung im Ingenieurwesen is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The majority of biogas systems uses block heat and power plants to utilize the biogas. The biogas is converted to heat and electric energy in these system parts. A part of both energy shares is necessary to operate the biogas system. Heat consumptions and feeding protocols of 4 agricultural systems spanning up to 10 years could be used for the study regarding the reduction of the infed heat quantity. Furthermore, the temperature of the fermentation substrate and the biogas were logged in 6 biogas systems in a weekly cycle over a period of 15 months. Aside from environment-related temperature fluctuations of the substrate, a not insignificant cooling of the silage could be determined in the reception bunkers and the screw conveyors. Heat quantities for the heating of the substrate were determined based on the temperature measured, which are maximally 81% of the infed heat in the winter months for liquid manure and up to 60% for maize. A heat transfer from the fermentation residues to the liquid manure can be easily implemented as both substrates can be pumped. Depending on the design of the heat exchanger, the heat necessary to achieve the process temperature can be reduced significantly for the liquid manure and no external heat would be necessary in an optimum case scenario. The cooling of the maize silage in the solid storage and in the screw conveyors can be reduced with coverings and insulation. Increasing the inlet temperature by 10 °C would reduce the heat requirement by 25%. [ABSTRACT FROM AUTHOR]

Expenditure on waste collection and transport in developing countries constitutes up to 70% of the total solid waste management budget. In this study, optimized scenarios were developed using the ArcGIS Network Analyst tool in order to improve the efficiency of waste collection and transportation in the cities of Irbid, Karak and Mafraq, Jordan. Geographic Information System (GIS) has been created based on data collection involving GPS tracking (collection route/bin position). Both key performance and key operational costs indicators of the actual state (Scenario S0) were evaluated, and by modifying particular parameters, other scenarios were generated and analyzed to identify optimal routes: S1, route optimized with the same working resources and method as in S0 (change of the daily working hours per shift only); S2, route optimized with a change of collection mode with the same daily working time per shift as in S0 (change the transportation equipment and relocate and/or introduce new transfer stations); and S3, route optimized using a combination of S1 & S2 (change of the daily working hours per shift and collection mode). The results showed that the three scenarios guarantee savings compared to S0 in terms of the total cost of waste collection of 15, 13 and 23% for S1, S2 and S3 respectively in the city of Irbid, 6, 3 and 8% for S1, S2 and S3 respectively in the city of Karak, and 11, 6 and 13% for S1, S2 and S3, respectively in the city of Mafraq. Thus, a direct impact on vehicle operating times can be expected with savings of 30%, without mentioning the additional benefits related to CO emissions, hours of work, vehicle wear/maintenance, and so forth. [ABSTRACT FROM AUTHOR]