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Abstract Myelin oligodendrocyte glycoprotein antibody‐associated disease (MOGAD) is diagnosed by serum MOG‐immunoglobulin G (MOG‐IgG) in association with typical demyelination. 111/1127 patients with paired CSF/serum samples were seropositive for MOG‐IgG. Only 7/1016 (0.7%) seronegative patients had CSF‐restricted MOG‐IgG. While 3/7 patients had longitudinally extensive transverse myelitis, four had a confirmed alternate diagnosis (three multiple sclerosis, one CNS vasculitis). In a national referral setting, CSF‐restricted MOG‐IgG had a low sensitivity (2.63%, 95%CI 0.55–7.50%) and low positive predictive value (1.97%, 95%CI 0.45–8.13%). We strongly recommend serum as the preferred diagnostic biospecimen, and urge caution in the interpretation of CSF‐restricted MOG‐IgG in patients without clinico‐radiological features consistent with MOGAD.

Abstract Aims This study aims to investigate the prevalence of Takotsubo syndrome (TTS) as a percentage of the total number of acute coronary syndrome (ACS), including non‐STE‐elevation myocardial infarction and ST‐elevation myocardial infarction, as well as the short‐term outcome of TTS patients before and during the COVID‐19 pandemic. Methods and results We compared patients from two different periods: (i) Period 1 (before the COVID‐19 pandemic): 1 March to 30 December 2019, and (ii) Period 2 (during the COVID‐19 pandemic): 1 March to 30 December 2020. The retrospective database was created from the archives of the participating hospitals or electronic hospital systems by trained medical personnel. The subjects' medical history, cardiovascular risk factors, laboratory values, echocardiography findings, and an in‐hospital outcome were variables of interest. Furthermore, propensity score matching analysis was performed to evaluate the short‐term prognosis in TTS and ACS patients. Altogether six Austrian centres—(i) 3rd Medical Department of Cardiology and Intensive Care Medicine, Clinic Ottakring, Vienna, Austria; (ii) 5th Medical Department of Cardiology, Clinic Favoriten, Vienna, Austria; (iii) 2nd Medical Department, Hanusch Hospital, Vienna, Austria; (iv) University Clinic of Internal Medicine III, Cardiology and Angiology, Medical University of Innsbruck, Austria; (v) Department of Cardiology, University Hospital Graz, Graz, Austria; (vi) Department of Cardiology and Intensive Medicine, Kepler University Clinic, Linz, Austria—participated in the study. During period 1, 87 (3.5%) patients out of 2482 ACS patients had TTS in all participating centres. During period 2, 71 (2.7%) patients out of 2572 ACS patients had TTS in all participating centres. Accordingly, the prevalence of TTS remained stable irrespective of potential psychologic stress during the COVID pandemic. Furthermore, the baseline characteristics of TTS patients did not change during the COVID‐19 pandemic. The prevalence of in‐hospital complications [cardiogenic shock (4.6% vs. 4.3%, P = 0.925), ventricle thrombus (1.1% vs. 1.4%, P = 0.885) and in‐hospital bleeding (3.4% vs. 1.4%, P = 0.417)] remained stable. The all‐cause in‐hospital mortality of TTS patients did not change during the COVID‐19 pandemic [χ2(2) = 0.058, P = 0.810]. Moreover, a propensity score matching analysis of all‐cause in‐hospital mortality between matched TTS and ACS patients showed higher in‐hospital mortality in ACS patients during COVID‐19 pandemic (P = 0.043). Conclusions Despite the well‐known increased psychologic stress during the COVID‐19 pandemic, the prevalence of TTS during the COVID‐19 pandemic and the short‐term clinical outcome in Austria remained unimpacted.

Background Microvascular obstruction (MVO) and intramyocardial hemorrhage (IMH) are well‐established imaging biomarkers of failed myocardial tissue reperfusion in patients with ST‐segment elevation–myocardial infarction treated with percutaneous coronary intervention. MVO and IMH are associated with an increased risk of adverse outcome independent of infarct size, but whether the size of the culprit lesion vessel plays a role in the occurrence and severity of reperfusion injury is currently unknown. This study aimed to evaluate the association between culprit lesion vessel size and the occurrence and severity of reperfusion injury as determined by cardiac magnetic resonance imaging. Methods and Results Patients (n=516) with first‐time ST‐segment–elevation myocardial infarction underwent evaluation with cardiac magnetic resonance at 4 (3–5) days after infarction. MVO was assessed with late gadolinium enhancement imaging and IMH with T2* mapping. Vessel dimensions were determined using catheter‐based reference. Median culprit lesion vessel size was 3.1 (2.7–3.6) mm. MVO and IMH were found in 299 (58%) and 182 (35%) patients. Culprit lesion vessel size was associated with body surface area, diabetes, total ischemic time, postinterventional thrombolysis in myocardial infarction flow, and infarct size. There was no association between vessel size and MVO or IMH in univariable and multivariable analysis (P>0.05). These findings were consistent across patient subgroups with left anterior descending artery and non–left anterior descending artery infarctions and those with thrombolysis in myocardial infarction 3 flow post–percutaneous coronary intervention. Conclusions Comprehensive characterization of myocardial tissue reperfusion injury by cardiac magnetic resonance revealed no association between culprit lesion vessel size and the occurrence of MVO and IMH in patients treated with primary percutaneous coronary intervention for ST‐segment–elevation myocardial infarction.

Objective Telemedicine and telementoring have had a significant boost across all medical and surgical specialties over the last decade and especially during the COVID-19 pandemic. The aim of this scoping review is to synthesize the current use of telemedicine and telementoring in otorhinolaryngology and head and neck surgery. Data Sources PubMed and Cochrane Library. Review Methods A scoping review search was conducted, which identified 469 articles. Following full-text screening by 2 researchers, 173 articles were eligible for inclusion and further categorized via relevant subdomains. Conclusions Virtual encounters and telementoring are the 2 main applications of telemedicine in otolaryngology. These applications can be classified into 7 subdomains. Different ear, nose, and throat subspecialties utilized certain telemedicine applications more than others; for example, almost all articles on patient engagement tools are rhinology based. Overall, telemedicine is feasible, showing similar concordance when compared with traditional methods; it is also cost-effective, with high patient and provider satisfaction. Implications for Practice Telemedicine in otorhinolaryngology has been widely employed during the COVID-19 pandemic and has a huge potential, especially with regard to its distributing quality care to rural areas. However, it is important to note that with current exponential use, it is equally crucial to ensure security and privacy and integrate HIPAA-compliant systems (Health Insurance Portability and Accountability Act) in the big data era. It is expected that many more applications developed during the pandemic are here to stay and will be refined in years to come.

Abstract Aim To reexamine the associations of NK cell number and function in the peripheral blood with overweight/obesity and the metabolic syndrome in a large, well‐phenotyped human cohort. Methods Cross‐sectional analysis of 273 women in the PPSDiab Study; measurement of absolute and relative number of NK cells in peripheral blood, and of functional parameters CD69 positivity and cytotoxicity against K562 cells; group comparison of NK cell characteristics between lean, overweight, and obese participants, as well as metabolic syndrome scores of 0, 1, 2, and ≥3; Spearman correlation analyses to clinical parameters related to the metabolic syndrome. Results We found no differences in NK cell number and function between lean, overweight, and obese women (relative NK cell number (median (Q1–Q3), [%]) 5.1(2.6–9.4) vs. 4.8 (2.9–8.4) vs. 3.8 (1.7–7.8), p = 0.187; absolute NK cell number [106/L]: 86.9 (44.6–188.8) vs. 92.6 (52.5–154.6) vs. 85.9 (44–153.8), p = 0.632; CD69+ [%]: 27.2 (12.9–44.3) vs. 37.6 (13.2–52.8) vs. 33.6 (16.3–45), p = 0.136; cytotoxicity [%]: 11.0 (7.1–14.5) vs. 8.5 (6.4–13.2) vs. 11.3 (8.7–14.2), p = 0.094), as well as between different metabolic syndrome scores. Nonesterified fatty acids correlated with absolute and relative NK cell number and cytotoxicity (ρ [p‐value]: 0.142 [0.021], 0.119 [0.049], and 0.131 [0.035], respectively). Relative NK cell number further correlated with high‐density lipoprotein cholesterol (0.144 [0.018]) and cytotoxicity with 2 h glucose in oral glucose tolerance testing (0.132 [0.034]). CD69 positivity correlated with body fat (0.141 [0.021]), triglycerides (0.129 [0.033]), and plasma leptin (0.155 [0.010]). After correction for multiple testing, none of the associations remained significant. Conclusion In the present study, we observed no associations of NK cell number and function in the peripheral blood with overweight/obesity and the metabolic syndrome. Extreme phenotypes of obesity and the metabolic syndrome might have caused differing results in previous studies. Further analyses with a focus on compartments other than peripheral blood may help to clarify the relation between NK cells and metabolic diseases.

Abstract Until recently, China's Belt and Road Initiative (BRI) has overlooked many of the social and environmental dimensions of its projects and actions in favor of more immediate economic and sociopolitical considerations. The main focus of investments under BRI has largely been to improve transport, telecommunication, and energy infrastructures. However, in Central Asia, biodiversity is not only foundational for the livelihoods and socioeconomic wellbeing of communities, it also shapes people's culture and identities. Furthermore, ecosystem services derived from functioning landscapes bring enormous benefit for millions of people downstream through integrated and transboundary water systems. Already under pressure from climate‐induced melting of glaciers, the fate of ecologically important areas is considered in light of the potential harm arising from large‐scale linear infrastructure projects and related investments under China‐led BRI. Following review of some of the anticipated impacts of BRI on mountain environments and societies in the region, we highlight several emerging opportunities and then offer recommendations for development programs—aiming fundamentally to enhance the sustainability of BRI investments. Leveraging new opportunities to strengthen partner countries’ priority Sustainable Development Goals and enhancing their agency in the selection of collaborations and the standards to use in environmental impact and risk assessments are recommended.

Abstract Multifunctional landscapes provide critical benefits and are essential for human well‐being. The relationship between multifunctional landscapes and well‐being has mostly been studied using ecosystem services as a linkage. However, there is a challenge of concretizing what human well‐being exactly is and how it can be measured, particularly in relation to ecosystem services, landscape values and related discussions. In this paper, we measure self‐reported well‐being through applying an inductive free‐listing approach to the exploration of the relationships between landscape multifunctionality and human well‐being across 13 rural and peri‐urban sites in Europe. We developed a face‐to‐face online survey (n = 2,301 respondents) integrating subjective perceptions of well‐being (free‐listing method) with mapping perceived ecosystem service benefits (Public Participation GIS, PPGIS approach). Applying content analysis and diverse statistical methods, we explore the links between well‐being (i.e. perceived well‐being items such as tranquillity, social relations and health) and social‐ecological properties (i.e. respondents' sociocultural characteristics and perception of ecosystem service benefits). We identify 40 different well‐being items highlighting prominently landscape values. The items form five distinct clusters: access to services; tranquillity and social capital; health and nature; cultural landscapes; and place attachment. Each cluster is related to specific study sites and explained by certain social‐ecological properties. Results of our inductive approach further specify pre‐defined conceptualizations on well‐being and their connections to the natural environment. Results suggest that the well‐being contributions of multifunctional landscapes are connected to therapeutic well‐being effects, which are largely neglected in the ecosystem services literature. Our results further point to the context‐specific character of linkages between landscapes and human well‐being. The clusters highlight that landscape‐supported well‐being is related to multiple interlinked items that can inform collective visions of well‐being in the future. For landscape planning and management, we highlight the need for place‐specific analysis and consideration of perceptions of local people to identify the contributions to their well‐being. Future research would benefit from considering the experiential qualities of value and well‐being as they relate to direct experiences with the landscape and wider psychological needs, specifically over time. A free Plain Language Summary can be found within the Supporting Information of this article.

Abstract In human‐modified landscapes, important ecological functions such as predation are negatively affected by anthropogenic activities, including the use of pesticides and habitat degradation. Predation of insect pests is an indicator of healthy ecosystem functioning, which provides important ecosystem services, especially for agricultural systems. In this study, we compare predation attempts from arthropods, mammals, and birds on artificial caterpillars in the understory, between three tropical agricultural land‐use types: oil palm plantations, rubber tree plantations, and fruit orchards. We collected a range of local and landscape‐scale data including undergrowth vegetation structure; elevation; proximity to forest; and canopy cover in order to understand how environmental variables can affect predation. In all three land‐use types, our results showed that arthropods and mammals were important predators of artificial caterpillars and there was little predation by birds. We did not find any effect of the environmental variables on predation. There was an interactive effect between land‐use type and predator type. Predation by mammals was considerably higher in fruit orchards and rubber tree than in oil palm plantations, likely due to their ability to support higher abundances of insectivorous mammals. In order to maintain or enhance natural pest control in these common tropical agricultural land‐use types, management practices that benefit insectivorous animals should be introduced, such as the reduction of pesticides, improvement of understory vegetation, and local and landscape heterogeneity.

Abstract Objective Sex‐dependent disturbances of peripheral glucose metabolism are known complications of antipsychotic drug treatment. The influence of long‐term clozapine and haloperidol medication on hypothalamus, maintaining aspects of internal body homeostasis, has not yet been completely clarified. Methods After puberty, male and female Sprague Dawley rats were fed orally with ground pellets containing haloperidol (1 mg/kgBW/day) or clozapine (20 mg/kgBW/day) for 12 weeks. The hypothalamic protein expression of dopamine receptors D2R and D4R, melanocortin receptor MC4R, and glucose transporters Glut1 and Glut3 was examined. Glucose, glycogen, lactate, and pyruvate levels were determined, also malondialdehyde equivalents as markers of oxidative stress. Results D2R expression was increased in the male haloperidol and clozapine group but decreased in females medicated with clozapine. D4R expression was upregulated under clozapine medication. While females showed increased Glut1, Glut3 was elevated in both male and female clozapine‐medicated animals. We found no changes of hypothalamic malondialdehyde, glycogen, and MC4R. Hypothalamic lactate was elevated in the female clozapine group. Conclusion Clozapine sex‐dependently affects the expression of D2R, Glut1, and Glut3. The upregulation of the glucose transporters indicates glucose deprivation in the endothelial cells and consequently in astrocytes and neurons. Increased hypothalamic lactate in females under clozapine points to enhanced glycolysis with a higher glucose demand to produce the required energy. Haloperidol did not change the expression of the glucose transporters and upregulated D2R only in males.