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Abstract Augmented reality (AR) is a new technique enabling interaction with three-dimensional (3D) holograms of cinematic rendering (CR) reconstructions. Research in this field is in its very early steps, and data is scarce. We evaluated image quality, usability, and potential applications of AR in cardiovascular image datasets. Ten CR reconstructions of cardiovascular computed tomography (CT) datasets with complex anatomical abnormalities were presented to six radiologists and three cardiologists first on diagnostic screens and subsequently in AR. Subjective image quality and user experience were rated on 5-point Likert scales to assess usability and potential applications of AR. CR of CT datasets covering multiple images series of the same exam with differing kernels was performed in 143 ± 31 s (mean ± standard deviation); reconstruction of single CT image series took 84 ± 30 s. Mean subjective image quality was excellent, and observers showed high endorsement of the intuitive usability of the AR device and improvement of anatomical comprehensibility. AR devices were expected to have the greatest impact on patient and student education as well as multidisciplinary discussions, with less potential in clinical care. Clinical testing and preclinical implementation of AR seem feasible due to reasonable computation times and intuitive usability even for first-time users. Relevance statement The presentation of 3D cinematic rendering in augmented reality provides excellent image quality, facilitating the comprehension of anatomical structures in CT datasets. Concurrently, reasonable computation times and the intuitive usability of augmented reality devices make preclinical implementation and clinical testing feasible. Key Points 3D cinematic reconstructions presented in augmented reality improve the anatomical comprehensibility of chest CT scans. Augmented reality devices are expected to be highly beneficial in educational settings and multidisciplinary discussions. Usability and computation times are feasible for initial preclinical use cases. Graphical Abstract

Abstract The interlayer interactions in van der Waals (vdW) materials are imprinted in their low-frequency rigid-layer phonon spectra. Investigating the symmetries of these phonon modes offers a pathway to generate optical anisotropy in the terahertz range. Here, we employ polarization-sensitive terahertz time-domain spectroscopy to study a sample of clinochlore, a naturally abundant, large bandgap vdW mineral. Our measurements revealed a pronounced anisotropic feature in the complex refractive index spectrum near 1.13 THz, consistent with shear modes predicted by our density-functional perturbation theory that accounts for impurities in the mineral. Polarimetry analysis revealed that this shear phonon anisotropy reshapes the polarization state of transmitted terahertz waves, inducing both Faraday rotation and ellipticity. Furthermore, we applied Jones formalism to interpret the phononic symmetries and describe our observations in terms of its polarization eigenstates. These results highlight the potential of exploring vdW minerals as central building blocks for vdW heterostructures with compelling technological applications.

Abstract This study forms the basis of a digital twin system of the knee joint, using advanced quantitative MRI (qMRI) and machine learning to advance precision health in osteoarthritis (OA) management and knee replacement (KR) prediction. We combined deep learning-based segmentation of knee joint structures with dimensionality reduction to create an embedded feature space of imaging biomarkers. Through cross-sectional cohort analysis and statistical modeling, we identified specific biomarkers, including variations in cartilage thickness and medial meniscus shape, that are significantly associated with OA incidence and KR outcomes. Integrating these findings into a comprehensive framework represents a considerable step toward personalized knee-joint digital twins, which could enhance therapeutic strategies and inform clinical decision-making in rheumatological care. This versatile and reliable infrastructure has the potential to be extended to broader clinical applications in precision health.

Abstract Science is integral to society because it can inform individual, government, corporate, and civil society decision-making on issues such as public health, new technologies or climate change. Yet, public distrust and populist sentiment challenge the relationship between science and society. To help researchers analyse the science-society nexus across different geographical and cultural contexts, we undertook a cross-sectional population survey resulting in a dataset of 71,922 participants in 68 countries. The data were collected between November 2022 and August 2023 as part of the global Many Labs study “Trust in Science and Science-Related Populism” (TISP). The questionnaire contained comprehensive measures for individuals’ trust in scientists, science-related populist attitudes, perceptions of the role of science in society, science media use and communication behaviour, attitudes to climate change and support for environmental policies, personality traits, political and religious views and demographic characteristics. Here, we describe the dataset, survey materials and psychometric properties of key variables. We encourage researchers to use this unique dataset for global comparative analyses on public perceptions of science and its role in society and policy-making.

Abstract Background This retrospective study aims to evaluate the impact of a content-based image retrieval (CBIR) application on diagnostic accuracy and confidence in interstitial lung disease (ILD) assessment using high-resolution computed tomography CT (HRCT). Methods Twenty-eight patients with verified pattern-based ILD diagnoses were split into two equal datasets (1 and 2). The images were assessed by two radiology residents (3rd and 5th year) and one expert radiologist in four sessions. Dataset 1 was used for sessions A and C, assessing diagnostic accuracy and confidence with mandatory and without CBIR software. Dataset 2 was used for sessions B and D with optional CBIR use, assessing time spending and frequency of CBIR usage. Accuracy was assessed on the CT pattern level, comparing readers’ diagnoses with reference diagnoses and CBIR results with region-of-interest (ROI) patterns. Results Diagnostic accuracy and confidence of readers showed an increasing trend with CBIR use compared to no CBIR use (53.6% versus 35.7% and 50.0% versus 32.2%, respectively). Time for reading significantly decreased in both datasets (A versus C: 104 s versus 54 s, p

Abstract The tropism of adenoviruses (Ads) is significantly influenced by the binding of various blood factors. To investigate differences in their binding, we conducted cryo-EM analysis on complexes of several human adenoviruses with human platelet factor-4 (PF4), coagulation factors FII (Prothrombin), and FX. While we observed EM densities for FII and FX bound to all the species-C adenoviruses examined, no densities were seen for PF4, even though PF4 can co-pellet with various Ads. Similar to FX, the γ-carboxyglutamic acid (Gla) domain of FII binds within the surface cavity of hexon trimers. While FII binds equally to species-C Ads: Ad5, Ad6, and Ad657, FX exhibits significantly better binding to Ad5 and Ad657 compared to Ad6. Although only the FX-Gla domain is observed at high-resolution (3.7 Å), the entire FX is visible at low-resolution bound to Ad5 in three equivalent binding modes consistent with the 3-fold symmetric hexon. Only the Gla and kringle-1 domains of FII are visible on all the species-C adenoviruses, where the rigid FII binds in an upright fashion, in contrast to the flexible and bent FX. These data suggest that differential binding of FII and FX may shield certain species-C adenoviruses differently against immune molecules, thereby modulating their tropism.

BackgroundDark-field chest radiography allows the assessment of the structural integrity of the alveoli by exploiting the wave properties of x-rays.PurposeTo compare the qualitative and quantitative features of dark-field chest radiography in patients with COVID-19 pneumonia with conventional CT imaging.Materials and methodsIn this prospective study conducted from May 2020 to December 2020, patients aged at least 18 years who underwent chest CT for clinically suspected COVID-19 infection were screened for participation. Inclusion criteria were a CO-RADS score ≥4, the ability to consent to the procedure and to stand upright without help. Participants were examined with a clinical dark-field chest radiography prototype. For comparison, a healthy control cohort of 40 subjects was evaluated. Using Spearman's correlation coefficient, correlation was tested between dark-field coefficient and CT-based COVID-19 index and visual total CT score as well as between the visual total dark-field score and the visual total CT score.ResultsA total of 98 participants [mean age 58 ± 14 (standard deviation) years; 59 men] were studied. The areas of signal intensity reduction observed in dark-field images showed a strong correlation with infiltrates identified on CT scans. The dark-field coefficient had a negative correlation with both the quantitative CT-based COVID-19 index (r = −.34, p = .001) and the overall CT score used for visual grading of COVID-19 severity (r = −.44, p

Summary: Background: Despite notable advancements in artificial intelligence (AI) that enable complex systems to perform certain tasks more accurately than medical experts, the impact on patient-relevant outcomes remains uncertain. To address this gap, this systematic review assesses the benefits and harms associated with AI-related algorithmic decision-making (ADM) systems used by healthcare professionals, compared to standard care. Methods: In accordance with the PRISMA guidelines, we included interventional and observational studies published as peer-reviewed full-text articles that met the following criteria: human patients; interventions involving algorithmic decision-making systems, developed with and/or utilizing machine learning (ML); and outcomes describing patient-relevant benefits and harms that directly affect health and quality of life, such as mortality and morbidity. Studies that did not undergo preregistration, lacked a standard-of-care control, or pertained to systems that assist in the execution of actions (e.g., in robotics) were excluded. We searched MEDLINE, EMBASE, IEEE Xplore, and Google Scholar for studies published in the past decade up to 31 March 2024. We assessed risk of bias using Cochrane's RoB 2 and ROBINS-I tools, and reporting transparency with CONSORT-AI and TRIPOD-AI. Two researchers independently managed the processes and resolved conflicts through discussion. This review has been registered with PROSPERO (CRD42023412156) and the study protocol has been published. Findings: Out of 2,582 records identified after deduplication, 18 randomized controlled trials (RCTs) and one cohort study met the inclusion criteria, covering specialties such as psychiatry, oncology, and internal medicine. Collectively, the studies included a median of 243 patients (IQR 124–828), with a median of 50.5% female participants (range 12.5–79.0, IQR 43.6–53.6) across intervention and control groups. Four studies were classified as having low risk of bias, seven showed some concerns, and another seven were assessed as having high or serious risk of bias. Reporting transparency varied considerably: six studies showed high compliance, four moderate, and five low compliance with CONSORT-AI or TRIPOD-AI. Twelve studies (63%) reported patient-relevant benefits. Of those with low risk of bias, interventions reduced length of stay in hospital and intensive care unit (10.3 vs. 13.0 days, p = 0.042; 6.3 vs. 8.4 days, p = 0.030), in-hospital mortality (9.0% vs. 21.3%, p = 0.018), and depression symptoms in non-complex cases (45.1% vs. 52.3%, p = 0.03). However, harms were frequently underreported, with only eight studies (42%) documenting adverse events. No study reported an increase in adverse events as a result of the interventions. Interpretation: The current evidence on AI-related ADM systems provides limited insights into patient-relevant outcomes. Our findings underscore the essential need for rigorous evaluations of clinical benefits, reinforced compliance with methodological standards, and balanced consideration of both benefits and harms to ensure meaningful integration into healthcare practice. Funding: This study did not receive any funding.

Abstract Background Algorithmic decision-making (ADM) utilises algorithms to collect and process data and develop models to make or support decisions. Advances in artificial intelligence (AI) have led to the development of support systems that can be superior to medical professionals without AI support in certain tasks. However, whether patients can benefit from this remains unclear. The aim of this systematic review is to assess the current evidence on patient-relevant benefits and harms, such as improved survival rates and reduced treatment-related complications, when healthcare professionals use ADM systems (developed using or working with AI) compared to healthcare professionals without AI-related ADM (standard care)—regardless of the clinical issues. Methods Following the PRISMA statement, MEDLINE and PubMed (via PubMed), Embase (via Elsevier) and IEEE Xplore will be searched using English free text terms in title/abstract, Medical Subject Headings (MeSH) terms and Embase Subject Headings (Emtree fields). Additional studies will be identified by contacting authors of included studies and through reference lists of included studies. Grey literature searches will be conducted in Google Scholar. Risk of bias will be assessed by using Cochrane’s RoB 2 for randomised trials and ROBINS-I for non-randomised trials. Transparent reporting of the included studies will be assessed using the CONSORT-AI extension statement. Two researchers will screen, assess and extract from the studies independently, with a third in case of conflicts that cannot be resolved by discussion. Discussion It is expected that there will be a substantial shortage of suitable studies that compare healthcare professionals with and without ADM systems concerning patient-relevant endpoints. This can be attributed to the prioritisation of technical quality criteria and, in some cases, clinical parameters over patient-relevant endpoints in the development of study designs. Furthermore, it is anticipated that a significant portion of the identified studies will exhibit relatively poor methodological quality and provide only limited generalisable results. Systematic review registration This study is registered within PROSPERO (CRD42023412156).

Abstract To develop a deep learning-based model capable of segmenting the left ventricular (LV) myocardium on native T1 maps from cardiac MRI in both long-axis and short-axis orientations. Models were trained on native myocardial T1 maps from 50 healthy volunteers and 75 patients using manual segmentation as the reference standard. Based on a U-Net architecture, we systematically optimized the model design using two different training metrics (Sørensen-Dice coefficient = DSC and Intersection-over-Union = IOU), two different activation functions (ReLU and LeakyReLU) and various numbers of training epochs. Training with DSC metric and a ReLU activation function over 35 epochs achieved the highest overall performance (mean error in T1 10.6 ± 17.9 ms, mean DSC 0.88 ± 0.07). Limits of agreement between model results and ground truth were from -35.5 to + 36.1 ms. This was superior to the agreement between two human raters (-34.7 to + 59.1 ms). Segmentation was as accurate for long-axis views (mean error T1: 6.77 ± 8.3 ms, mean DSC: 0.89 ± 0.03) as for short-axis images (mean error ΔT1: 11.6 ± 19.7 ms, mean DSC: 0.88 ± 0.08). Fully automated segmentation and quantitative analysis of native myocardial T1 maps is possible in both long-axis and short-axis orientations with very high accuracy.

Introduction Evidence summaries on the benefits and harms of treatment options support informed decisions under controlled conditions. However, few studies have investigated how such formats support decision-making across different social groups. There is a risk that only disadvantaged people will be able to make informed health decisions—possibly increasing the health equity gap. It is also unclear whether they support decision-making in the field at all. The aim of our study is to assess whether evidence summaries based on the fact box format can help people from different social groups make informed decisions about COVID-19 and influenza vaccinations, and thus reduce inequity in health communication.Methods and analysis In a multi-centre, cluster-randomised, controlled trial, health educators from usual care and outreach work in Germany will be randomised in a 1:1 ratio to provide either usual health communication plus an evidence summary (‘fact box’) or usual health communication. Health educators provide a flyer about COVID-19 or influenza vaccination which contains a link to an online study either with (intervention) or without (control) fact box on the reverse side. Flyer and online study will be available in Arabic, German, Turkish and Russian language. The primary outcome is informed vaccination intention, based on vaccination knowledge, attitudes, intentions and behaviour. Secondary outcomes include risk perception, decisional conflict and shared decision-making. We will use linear mixed models to analyse the influence of both individual (eg, education status) and cluster level factors and account for the expected cluster variability in realising usual health communication or the intervention. The statistical analysis plan includes the selection of appropriate measures of effect size and power calculation, assuming a sample size of 800 patients.Ethics and dissemination The trial has been approved by the Ethics Committee of the University of Potsdam, Germany (application numbers: 34/2021 and 57/2022).Results will be disseminated through peer-reviewed journals, conferences and to relevant stakeholders.Protocol version Version 6 (4 October 2024); Preprint available on Research Square: https://doi.org/10.21203/rs.3.rs-3401234/v3Trial registration number NCT06076421.

Abstract Background Aim of this study was to detect predictors of better adherence to the AgeWell.de-intervention, a two-year randomized multi-domain lifestyle intervention against cognitive decline. Methods Data of 317 intervention group-participants comprising a risk group for dementia (Cardiovascular Risk Factors, Ageing and Dementia (CAIDE) score of ≥ 9; mean age 68.9 years, 49.5% women) from the AgeWell.de intervention study were analysed. Regression models with four blocks of predictors (sociodemographic, cognitive and psychosocial, lifestyle factors and chronic conditions) were run on adherence to the components of nutrition, enhancement of social and physical activity and cognitive training. Adherence to each component was operationalised by assessing the degree of goal achievement per component at up to seven time points during the intervention period, measured using a 5-point Likert scale (mean score of goal achievement). Results Increasing age was negatively associated with adherence, while higher education positively predicted adherence. Participants with better mental state (Montreal Cognitive Assessment (MoCA)-score > 25) at baseline and higher self-efficacy adhered better. Diabetes and cardiovascular conditions were not associated with adherence, whereas smoking negatively affected adherence. Highest education and quitting smoking in the past were the only predictors associated with all four intervention components. Conclusion Results identified predictors for better and worse adherence. Particularly self-efficacy seems to be of considerable influence on adherence. This should be considered when designing future intervention trials. Trial registration German Clinical Trials Register (ref. number: DRKS00013555).

Abstract Objective While risk factors for osteoarthritis (OA) are well known, it is not well understood why certain individuals maintain high mobility and joint health throughout their life while others demonstrate OA at older ages. The purpose of this study was to assess which demographic, clinical and MRI quantitative and semi-quantitative factors are associated with preserving healthy knees in older individuals. Methods This study analyzed data from the OA Initiative (OAI) cohort of individuals at the age of 65 years or above. Participants without OA at baseline (BL) (Kellgren-Lawrence (KL) ≤ 1) were followed and classified as incident cases (KL ≥ 2 during follow-up; n = 115) and as non-incident (KL ≤ 1 over 96-month; n = 391). Associations between the predictor-variables sex, age, BMI, race, clinical scoring systems, T2 relaxation times and Whole-Organ Magnetic Resonance Imaging-Score (WORMS) readings at BL and the preservation of healthy knees (KL ≤ 1) during a 96-month follow-up period were assessed using logistic regression models. Results Obesity and presence of pain showed a significant inverse association with maintaining radiographically normal joints in patients aged 65 and above. T2 relaxation times of the lateral femur and tibia as well as the medial femur were also significantly associated with maintaining radiographically normal knee joints. Additionally, absence of lesions of the lateral meniscus and absence of cartilage lesions in the medial and patellofemoral compartments were significantly associated with maintaining healthy knee joints. Conclusion Overall, this study provides protective clinical parameters as well as quantitative and semi-quantitative MR-imaging parameters associated with maintaining radiographically normal knee joints in an older population over 8 years.

Abstract Background Mosquitoes are important vectors of pathogens. They are usually collected with CO2-baited traps and subsequently identified by morphology. This procedure is very time-consuming. Automatic counting traps could facilitate timely evaluation of the local risk for mosquito-borne pathogen transmission or decision-making on vector control measures, but the counting accuracy of such devices has rarely been validated in the field. Methods The Biogents (BG)-Counter 2 automatically counts mosquitoes by discriminating the size of captured objects directly in the field and transmits the data to a cloud server. To assess the accuracy of this counting device, 27 traps were placed at 19 sampling sites across Germany and used in daily, weekly or bimonthly intervals from April until October 2021. The BG-Counter 2 was attached to a CO2-trap (BG-Pro trap = CO2-Pro) and the same trap was converted to also attract gravid mosquitoes (upside-down BG-Pro trap with a water container beneath = CO2-Pro-gravid). All captured mosquitoes were identified by morphology. The number of females (unfed and gravid), mosquito diversity and the number of identified specimens in relation to the counting data of the BG-Counter were compared between the two trapping devices to evaluate sampling success and counting accuracy. Results In total 26,714 mosquitoes were collected during 854 trap days. The CO2-Pro-gravid trap captured significantly more mosquitoes per trap day for all specimens, gravid females and non-gravid females, while there was no difference in the mosquito diversity. The linear model with the captured mosquitoes as a response and the counted specimens as a predictor explained only a small degree of the variation within the data (R 2 = 0.16), but per individual trap the value could reach up to 0.62 (mean R 2 = 0.23). The counting accuracy for the daily samples had a significant positive correlation with sample size, resulting in higher accuracy for the CO2-Pro-gravid trap and higher accuracy for sites and sampling months with high mosquito abundance. Conclusions While the accuracy of the BG-Counter 2 is quite low, the device is able to depict mosquito phenology and provide information about local population dynamics. Graphical Abstract

Abstract Background Chondrosarcomas are rare malignant bone tumors diagnosed by analyzing radiological images and histology of tissue biopsies and evaluating features such as matrix calcification, cortical destruction, trabecular penetration, and tumor cell entrapment. Methods We retrospectively analyzed 16 cartilaginous tumor tissue samples from three patients (51-, 54-, and 70-year-old) diagnosed with a dedifferentiated chondrosarcoma at the femur, a moderately differentiated chondrosarcoma in the pelvis, and a predominantly moderately differentiated chondrosarcoma at the scapula, respectively. We combined a hematein-based x-ray staining with high-resolution three-dimensional (3D) microscopic x-ray computed tomography (micro-CT) for nondestructive 3D tumor assessment and tumor margin evaluation. Results We detected trabecular entrapment on 3D micro-CT images and followed bone destruction throughout the volume. In addition to staining cell nuclei, hematein-based staining also improved the visualization of the tumor matrix, allowing for the distinction between the tumor and the bone marrow cavity. The hematein-based staining did not interfere with further conventional histology. There was a 5.97 ± 7.17% difference between the relative tumor area measured using micro-CT and histopathology (p = 0.806) (Pearson correlation coefficient r = 0.92, p = 0.009). Signal intensity in the tumor matrix (4.85 ± 2.94) was significantly higher in the stained samples compared to the unstained counterparts (1.92 ± 0.11, p = 0.002). Conclusions Using nondestructive 3D micro-CT, the simultaneous visualization of radiological and histopathological features is feasible. Relevance statement 3D micro-CT data supports modern radiological and histopathological investigations of human bone tumor specimens. It has the potential for being an integrative part of clinical preoperative diagnostics. Key points • Matrix calcifications are a relevant diagnostic feature of bone tumors. • Micro-CT detects all clinically diagnostic relevant features of x-ray-stained chondrosarcoma. • Micro-CT has the potential to be an integrative part of clinical diagnostics. Graphical Abstract

We report a new species of shearwater, Ardenna buchananbrowni sp. nov., from the Pliocene of New Zealand. It is both the smallest and oldest known diving member of the genus, demonstrating that this now abundant form of shearwater has had a long presence in southern oceans. Ardenna buchananbrowni sp. nov. is among the few extinct shearwaters described from the Southern Hemisphere and adds to an increasingly diverse seabird assemblage in the Pliocene of the region.

Abstract Accurate species identification is crucial to assess the medical relevance of a mosquito specimen, but requires intensive experience of the observers and well-equipped laboratories. In this proof-of-concept study, we developed a convolutional neural network (CNN) to identify seven Aedes species by wing images, only. While previous studies used images of the whole mosquito body, the nearly two-dimensional wings may facilitate standardized image capture and reduce the complexity of the CNN implementation. Mosquitoes were sampled from different sites in Germany. Their wings were mounted and photographed with a professional stereomicroscope. The data set consisted of 1155 wing images from seven Aedes species as well as 554 wings from different non-Aedes mosquitoes. A CNN was trained to differentiate between Aedes and non-Aedes mosquitoes and to classify the seven Aedes species based on grayscale and RGB images. Image processing, data augmentation, training, validation and testing were conducted in python using deep-learning framework PyTorch. Our best-performing CNN configuration achieved a macro F1 score of 99% to discriminate Aedes from non-Aedes mosquito species. The mean macro F1 score to predict the Aedes species was 90% for grayscale images and 91% for RGB images. In conclusion, wing images are sufficient to identify mosquito species by CNNs.

Abstract Background The initial idea of functional tissue replacement has shifted to the concept that injected cells positively modulate myocardial healing by a non-specific immune response of the transplanted cells within the target tissue. This alleged local modification of the scar requires assessment of regional properties of the left ventricular wall in addition to commonly applied measures of global morphological and functional parameters. Hence, we aimed at investigating the effect of cardiac cell therapy with cardiovascular progenitor cells, so-called cardiac induced cells, on both global and regional properties of the left ventricle by a multimodal imaging approach in a mouse model. Methods Myocardial infarction was induced in mice by ligation of the left anterior descending artery, the therapy group received an intramyocardial injection of 1 × 106 cardiac induced cells suspended in matrigel, the control group received matrigel only. [18F]FDG positron emission tomography imaging was performed after 17 days, to assess regional glucose metabolism. Three weeks after myocardial infarction, cardiac magnetic resonance imaging was performed for morphological and functional assessment of the left ventricle. Following these measurements, hearts were excised for histological examinations. Results Cell therapy had no significant effect on global morphological parameters. Similarly, there was no difference in scar size and capillary density between therapy and control group. However, there was a significant improvement in contractile function of the left ventricle – left ventricular ejection fraction, stroke volume and cardiac output. Regional analysis of the left ventricle identified changes of wall properties in the scar area as the putative mechanism. Cell therapy reduced the thinning of the scar and significantly improved its radial contractility. Furthermore, the metabolic defect, assessed by [18F]FDG, was significantly reduced by the cell therapy. Conclusion Our data support the relevance of extending the assessment of global left ventricular parameters by a structured regional wall analysis for the evaluation of therapies targeting at modulation of healing myocardium. This approach will enable a deeper understanding of mechanisms underlying the effect of experimental regenerative therapies, thus paving the way for a successful translation into clinical application.

Abstract Background A deep learning (DL) model that automatically detects cardiac pathologies on cardiac MRI may help streamline the diagnostic workflow. To develop a DL model to detect cardiac pathologies on cardiac MRI T1-mapping and late gadolinium phase sensitive inversion recovery (PSIR) sequences were used. Methods Subjects in this study were either diagnosed with cardiac pathology (n = 137) including acute and chronic myocardial infarction, myocarditis, dilated cardiomyopathy, and hypertrophic cardiomyopathy or classified as normal (n = 63). Cardiac MR imaging included T1-mapping and PSIR sequences. Subjects were split 65/15/20% for training, validation, and hold-out testing. The DL models were based on an ImageNet pretrained DenseNet-161 and implemented using PyTorch and fastai. Data augmentation with random rotation and mixup was applied. Categorical cross entropy was used as the loss function with a cyclic learning rate (1e-3). DL models for both sequences were developed separately using similar training parameters. The final model was chosen based on its performance on the validation set. Gradient-weighted class activation maps (Grad-CAMs) visualized the decision-making process of the DL model. Results The DL model achieved a sensitivity, specificity, and accuracy of 100%, 38%, and 88% on PSIR images and 78%, 54%, and 70% on T1-mapping images. Grad-CAMs demonstrated that the DL model focused its attention on myocardium and cardiac pathology when evaluating MR images. Conclusions The developed DL models were able to reliably detect cardiac pathologies on cardiac MR images. The diagnostic performance of T1 mapping alone is particularly of note since it does not require a contrast agent and can be acquired quickly.

Abstract We investigated the effect of deep learning-based image reconstruction (DLIR) compared to iterative reconstruction on image quality in CT pulmonary angiography (CTPA) for suspected pulmonary embolism (PE). For 220 patients with suspected PE, CTPA studies were reconstructed using filtered back projection (FBP), adaptive statistical iterative reconstruction (ASiR-V 30%, 60% and 90%) and DLIR (low, medium and high strength). Contrast-to-noise ratio (CNR) served as the primary parameter of objective image quality. Subgroup analyses were performed for normal weight, overweight and obese individuals. For patients with confirmed PE (n = 40), we further measured PE-specific CNR. Subjective image quality was assessed independently by two experienced radiologists. CNR was lowest for FBP and enhanced with increasing levels of ASiR-V and, even more with increasing strength of DLIR. High strength DLIR resulted in an additional improvement in CNR by 29–67% compared to ASiR-V 90% (p

Ribosomal RNAs are decorated by numerous post-transcriptional modifications whose exact roles in ribosome biogenesis, function, and human pathophysiology remain largely unknown. Here, we report a targeted direct rRNA sequencing approach involving a substrate selection step and demonstrate its suitability to identify differential modification sites in combination with the JACUSA2 software. We compared JACUSA2 to other tools designed for RNA modification detection and show that JACUSA2 outperforms other software with regard to detection of base modifications such as methylation, acetylation and aminocarboxypropylation. To illustrate its widespread usability, we applied our method to a collection of CRISPR-Cas9 engineered colon carcinoma cells lacking specific enzymatic activities responsible for particular rRNA modifications and systematically compared them to isogenic wild-type RNAs. Besides the numerous 2′-O methylated riboses and pseudouridylated residues, our approach was suitable to reliably identify differential base methylation and acetylation events. Importantly, our method does not require any prior knowledge of modification sites or the need to train complex models. We further report for the first time detection of human rRNA modifications by direct RNA-sequencing on Flongle flow cells, the smallest-scale nanopore flow cell available to date. The use of these smaller flow cells reduces RNA input requirements, making our workflow suitable for the analysis of samples with limited availability and clinical work.

Abstract Background Aedes japonicus japonicus (Theobald, 1901) and Aedes koreicus (Edwards, 1917) have rapidly spread in Europe over the last decades. Both species are very closely related and occur in sympatry. Females and males are difficult to distinguish. However, the accurate species discrimination is important as both species may differ in their vectorial capacity and spreading behaviour. In this study, we assessed the potential of geometric wing morphometrics as alternative to distinguish the two species. Methods A total of 147 Ae. j. japonicus specimens (77 females and 70 males) and 124 Ae. koreicus specimens (67 females and 57 males) were collected in southwest Germany. The left wing of each specimen was removed, mounted and photographed. The coordinates of 18 landmarks on the vein crosses were digitalised by a single observer. The resulting two-dimensional dataset was used to analyse the differences in the wing size (i.e. centroid size) and wing shape between Ae. j. japonicus and Ae. koreicus using geometric morphometrics. To analyse the reproducibility of the analysis, the landmark collection was repeated for 20 specimens per sex and species by two additional observers. Results The wing size in female Ae. koreicus was significantly greater than in Ae. j. japonicus but did not differ significantly for males. However, the strong overlap in wing size also for the females would not allow to discriminate the two species. In contrast, the wing shape clustering was species specific and a leave-one-out validation resulted in a reclassification accuracy of 96.5% for the females and 91.3% for the males. The data collected by different observers resulted in a similar accuracy, indicating a low observer bias for the landmark collection. Conclusions Geometric wing morphometrics provide a reliable and robust tool to distinguish female and male specimens of Ae. j. japonicus and Ae. koreicus. Graphical Abstract

Abstract The spatial distribution of mosquito species in the course of globalization and climate warming is highly dynamic. Different studies have demonstrated the spread and establishment of thermophilic mosquito species, potentially increasing the prevalence of ‘nuisance’ mosquitoes and the local transmission of pathogens. Here we report the first recorded sampling of Anopheles hyrcanus in Wrocław, southwest Poland. This is the most northern detection of this species to date in Europe. Future spread and population development of this potential vector of malaria parasites, viruses or zoonotic helminths, such as Dirofilaria spp., must be monitored carefully. Potential factors underlying the spread of this species are discussed. Graphical Abstract

ABSTRACTTwo Wolbachia strains, wMel and wAlbB, have been transinfected into Aedes aegypti mosquitoes for population replacement with the aim of reducing dengue transmission. Epidemiological data from various endemic sites suggest a pronounced decrease in dengue transmission after implementing this strategy. In this study, we investigated the impact of the Wolbachia strains wMel and wAlbB on Ae. aegypti fitness in a common genetic background. We found that Ae. aegypti females infected with the wMel strain exhibited several significant differences compared with those infected with the wAlbB strain. Specifically, wMel-infected females laid significantly fewer eggs, ingested a lower amount of blood, had a reduced egg production rate, and exhibited a decreased Wolbachia density at a later age compared with mosquitoes infected with the wAlbB strain. Conversely, the wAlbB strain showed only mild negative effects when compared with Wolbachia-uninfected specimens. These differential effects on Ae. aegypti fitness following infection with either wMel or wAlbB may have important implications for the success of population replacement strategies in invading native Ae. aegypti populations in endemic settings. Further research is needed to better understand the underlying mechanisms responsible for these differences in fitness effects and their potential impact on the long-term efficacy of Wolbachia-based dengue control programs.IMPORTANCEThe transmission of arboviruses such as dengue, Zika, and chikungunya is on the rise globally. Among the most promising strategies to reduce arbovirus burden is the release of one out of two strains of Wolbachia-infected Aedes aegypti: wMel and wAlbB. One critical aspect of whether this approach will succeed involves the fitness cost of either Wolbachia strains on mosquito life history traits. For instance, we found that wMel-infected Ae. aegypti females laid significantly fewer eggs, ingested a lower amount of blood, had a reduced egg production rate, and exhibited a decreased Wolbachia density at a later age compared with mosquitoes infected with the wAlbB strain. Conversely, the wAlbB strain showed only mild negative effects when compared with Wolbachia-uninfected specimens. These differential effects on mosquito fitness following infection with either wMel or wAlbB may have important implications for the success of population replacement strategies in invading native Ae. aegypti populations.

Vaccine effectiveness and safety concerns can prevent people from receiving their first Covid-19 vaccines or boosters. Understanding the vaccine mechanism may lead people to perceive vaccine effectiveness appropriately. This study tested whether helping people understand the vaccine’s mechanism could improve their perceived vaccine safety and effectiveness. In a preregistered study, N = 1,548 unvaccinated or non-boosted participants were randomly presented with one of three communication formats: a fact box (a benefit-risk profile in tabular format; control condition), an expository text (i.e., a purely factual explanation) plus fact box, or an analogy plus fact box. Participants rated the vaccine’s effectiveness in preventing a Covid-19 disease, their perceived risk of getting vaccinated, and their intention to get vaccinated or boosted (depending on their vaccination status). Reading either additional text about the vaccines’ mechanism increased participants’ effectiveness ratings for the vaccine to prevent Covid-19 but did not affect risk ratings or vaccination intentions. The participants’ vaccine-related perceptions and intentions did not differ between the two text types. Elaborating on the vaccine’s mechanism of protection, in addition to presenting the benefit-risk profile of a vaccine, can lead people to perceive the vaccine effectiveness as slightly higher, yet it is insufficient to increase vaccination intentions.

ABSTRACT Coating medicated fish feed with a polymer minimizes the chances of drug leaching into the water. Tambaqui (Colossoma macropomum) is an economically important Amazonian fish frequently parasitized by the acanthocephalan Neoechinorhynchus buttnerae. In this study, we compared the effect of ethylcellulose (EC 0.75%) coating of feed medicated with the antihelminthic albendazole (ABZ 10 mg kg bw-1) and uncoated feed on treatment efficacy and bioaccumulation of ABZ in naturally parasitized tambaqui during 35 days. Treatment efficacy was 34% and 66% in fish fed uncoated and coated feed, respectively, but did not vary significantly among treatments. Total ABZ residue reached concentrations from 122.0 to 151.7 ng g-1, and did not vary significantly among treatments. The biomagnification factor was low, ranging from 0.0003 to 0.0004. EC coating did not significantly affect the efficacy of ABZ treatment and did not interfere with ABZ bioaccumulation in the edible tissue of tambaqui.

The need to systematically examine emergent literature focusing on the impact of the COVID-19 pandemic on South African tourism is prompted by the contributions of tourism to the South African economy. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA2020) protocols were used to understand and identify recovery strategies. This systematic review extracted literature from five databases: EBSCOhost, ProQuest, Sabinet, Scopus, and Web of Science. The sifting of identified literature was conducted with the aid of Rayyan, a web-based software, while COVID-19 thematic clusters of tourism research, niche tourism and methodological designs were used to synthesise the literature. Findings revealed disproportionate literature among three major clusters, with gaps in the South Africa niche tourism research. Based on the dominant adoption of qualitative designs of the reviewed literature, this study recommends a set of new tourism research agenda that particularly accentuates tourism recovery and resilience.

Frank, Gassert et al. use dark-field chest X-ray imaging to assess COVID-19-pneumonia. Dark-field imaging has a higher sensitivity for COVID-19-pneumonia than attenuation-based imaging and provides an ultralow dose alternative to computed tomography imaging for that purpose.

Bioactive peptides regulate many physiological functions but progress in discovering them has been slow. Here, the authors use a machine learning framework to predict mammalian peptide candidates from the global and local structure of large-scale tissue-specific mass spectrometry data.

The changing career environment in tourism following COVID-19 has piqued the interest of scholars who are curious as to whether such changes have altered perceptions of tourism careers. This study examined undergraduate students' perceptions towards tourism education, careers and the tourism and hospitality industry prospects following COVID-19 in the Sub-Saharan region using a case study of Malawi. The study is guided by the social cognitive career theory (SCCT) and employed qualitative research methods. The findings revealed that the majority of students had favourable views of tourism careers as a result of their optimism regarding tourism recovery. Those who had lost faith in tourism and its careers expressed reservations about countries' economic ability to implement tourism recovery strategies. The study suggests career guidance and counselling, as well as increasing student awareness of government tourism recovery measures and recovery success stories across industry subsectors, as means of restoring student confidence in tourism and tourism-related careers.

CT protocols that diagnose COVID-19 vary in regard to the associated radiation exposure and the desired image quality (IQ). This study aims to evaluate CT protocols of hospitals participating in the RACOON (Radiological Cooperative Network) project, consolidating CT protocols to provide recommendations and strategies for future pandemics. In this retrospective study, CT acquisitions of COVID-19 patients scanned between March 2020 and October 2020 (RACOON phase 1) were included, and all non-contrast protocols were evaluated. For this purpose, CT protocol parameters, IQ ratings, radiation exposure (CTDIvol), and central patient diameters were sampled. Eventually, the data from 14 sites and 534 CT acquisitions were analyzed. IQ was rated good for 81% of the evaluated examinations. Motion, beam-hardening artefacts, or image noise were reasons for a suboptimal IQ. The tube potential ranged between 80 and 140 kVp, with the majority between 100 and 120 kVp. CTDIvol was 3.7 ± 3.4 mGy. Most healthcare facilities included did not have a specific non-contrast CT protocol. Furthermore, CT protocols for chest imaging varied in their settings and radiation exposure. In future, it will be necessary to make recommendations regarding the required IQ and protocol parameters for the majority of CT scanners to enable comparable IQ as well as radiation exposure for different sites but identical diagnostic questions.

Culex pipiens s.s./Culex torrentium belong to the most widespread mosquito taxa in Europe and are the main vectors of Sindbis, West Nile and Usutu virus. The adult overwintering females can act as reservoir for these arthropod-borne viruses (arboviruses), thus contributing to their local persistence when transmission cycles are interrupted during the winter. However, the main overwintering sites of Cx. torrentium are unknown.In a study from 2017, 3455 Cx. pipiens s.s./Cx. torrentium specimens were collected from abandoned animal burrows in Poznan, Poland. These specimens were retrospectively identified to species-level with a PCR assay, which revealed Cx. torrentium as dominant species (> 60%). Motivated by these results, we conducted a field study from February to July 2022 to systematically analyse the overwintering site patterns of Cx. pipiens s.s./Cx. torrentium. Mosquitoes were sampled using pipe traps in abandoned animal burrows (n = 20) and with aspirators in nearby anthropogenic overwintering sites (n = 23). All Cx. pipiens s.s./Cx. torrentium were screened for Flaviviridae RNA.In total, 4710 mosquitoes of five different taxa were collected from anthropogenic sites. 3977 of them were identified as Cx. p. pipiens/Cx. torrentium (Cx. p. pipiens: 85%, Cx torrentium: 1%, pools with both species: 14%). In contrast, only Cx. p. pipiens/Cx. torrentium (1688 specimens) were collected from animal burrows dominated by Cx. torrentium (52%), followed by pools with both species (40%) and Cx. p pipiens (8%). A single pool of 10 Cx. torrentium specimens collected from an animal burrow was positive for Usutu virus.The detection of Usutu virus demonstrates that Cx. torrentium can act as winter reservoir for arboviruses. Abandoned animal burrows may by the primary overwintering site for the species and should be considered in future surveillance programmes, when sampling overwintering mosquitoes.

BackgroundWith the outbreak of COVID-19, government measures including social distancing and restrictions of social contacts were imposed to slow the spread of the virus. Since older adults are at increased risk of severe disease, they were particularly affected by these restrictions. These may negatively affect mental health by loneliness and social isolation, which constitute risk factors for depressiveness. We aimed to analyse the impact of perceived restriction due to government measures on depressive symptoms and investigated stress as mediator in an at-risk-population in Germany.MethodsData were collected in April 2020 from the population of the AgeWell.de-study, including individuals with a Cardiovascular Risk Factors, Aging, and Incidence of Dementia (CAIDE) score ≥9, using the depression subscale of the Brief Symptom Inventory (BSI-18) and the Perceived Stress Scale (PSS-4). Feeling restricted due to COVID-19 government measures was surveyed with a standardized questionnaire. Stepwise multivariate regressions using zero-inflated negative binomial models were applied to analyse depressive symptoms, followed by a general structural equation model to assess stress as mediator. Analysis were controlled for sociodemographic factors as well as social support.ResultsWe analysed data from 810 older adults (mean age = 69.9, SD = 5). Feeling restricted due to COVID-19 government measures was linked to increased depressiveness (b = 0.19; p

We describe a new species of extinct duck, Miotadorna catrionae sp. nov. (Anatidae, Tadornini, Tadorninae), based on a right humerus from the Miocene lacustrine deposits of St Bathans, Otago, New Zealand. Principal component analysis reveals that the new taxon is distinguished by its large size and relative proportions. This is the eighth and largest species of duck described from the St Bathans fossil assemblage and further underscores the global importance of this site for understanding anatid evolution.

The purple corn cob is an agro-industrial by-product that contains high-value bioactive compounds, which makes its use attractive for the development of extraction processes. The aim of this research was to extract the bioactive compounds from the purple corn cob by high isostatic pressure at different processing temperatures. Pressures of 0.01 MPa, 250 MPa, 450 MPa and 650 MPa for 3 minutes and at temperatures of 25 °C, 45 °C and 65 °C were used. High pressure extraction was compared with conventional extraction (2.5 h at 25°C). The purple corn cob extract obtained by isostatic processing at 650 MPa and 65 °C presented high antioxidant activity and content of bioactive compounds, unlike the conventional extraction of 2.5 h and 65 °C (p < 0.05). However, it did not show a significant difference with the extract obtained at 450 MPa and 45 °C (p > 0.05). Seven different anthocyanins were identified by liquid chromatography in the extracts obtained by high isostatic pressure (650 MPa at 65 °C) and hydroalcoholic maceration (2.5 h at 65 °C), mainly cyanidin-3-glucoside, pelargonidin-3-glucoside and peonidin-3-glucoside, and their respective malonyl derivatives. The high isostatic pressure increased the extraction of bioactive compounds by more than 50% and obtained them in shorter times, thus appearing as a new alternative, and eco-friendly method for the extraction of bioactive compounds from plant tissues.

Marine sediments from the western coast of southern Africa record the origin of the Benguela Upwelling System, one of the most productive in the world. High productivity, in turn, is reflected in a diverse marine mammal fossil assemblage, comprising whales, dolphins and a phocid seal. Here, we describe new records of baleen whale (mysticete) fossils from the early Pliocene localities of Saldanha Steel, Milnerton and Langebaanweg, as well as several potentially younger specimens trawled from offshore sediments. The presence of the extinct rorquals Diunatans and Fragilicetus suggests biogeographical links with the eastern North Atlantic and, thus, potentially antitropical population structuring. The trawled specimens also include rorquals (e.g., the blue whale, Balaenoptera cf. musculus), as well as a right whale (Eubalaena) and a pygmy right whale (Caperea). The latter is the first fossil of this family every discovered in Africa, and only the seventh specimen to be reported worldwide.

In yeast, TFIP11 and DHX15 promote the disassembly of spliceosome complex after splicing is completed. Here the authors show that human TFIP11 functions independently of DHX15 and is required for U6 snRNA 2’-O-methylation and U4/U6.U5 tri-snRNP assembly.

Abstract This study provides the first representative analysis of error estimations and willingness to accept errors in a Western country (Germany) with regards to algorithmic decision-making systems (ADM). We examine people’s expectations about the accuracy of algorithms that predict credit default, recidivism of an offender, suitability of a job applicant, and health behavior. Also, we ask whether expectations about algorithm errors vary between these domains and how they differ from expectations about errors made by human experts. In a nationwide representative study (N = 3086) we find that most respondents underestimated the actual errors made by algorithms and are willing to accept even fewer errors than estimated. Error estimates and error acceptance did not differ consistently for predictions made by algorithms or human experts, but people’s living conditions (e.g. unemployment, household income) affected domain-specific acceptance (job suitability, credit defaulting) of misses and false alarms. We conclude that people have unwarranted expectations about the performance of ADM systems and evaluate errors in terms of potential personal consequences. Given the general public’s low willingness to accept errors, we further conclude that acceptance of ADM appears to be conditional to strict accuracy requirements.

Abstract Background It remains controversial whether to include calf veins in the initial ultrasound evaluation of suspected deep venous thrombosis (DVT). We sought to investigate the frequency and clinical characteristics of isolated calf DVT. Materials and methods In this retrospective analysis, we investigated a cohort of 596 patients (median age 69 years, 52.3% women) who had been imaged with complete lower extremity venous duplex ultrasound for suspected acute DVT. Radiology reports were analyzed for the presence and localization of DVT. Clinical information was collected from patients’ electronic charts. Results DVT was found in 157 patients (26.3%), of which 74 patients (47.1%) had isolated calf DVT. Isolated calf DVTs were located in the posterior tibial veins (22 patients, 29.7%), peroneal veins (41 patients, 55.4%) and muscle veins (19 patients, 25.7%). There were no differences in age or sex between patients with isolated calf DVT and patients with proximal DVT. Isolated calf DVT was more commonly associated with leg pain (52.7% vs. 33.7%, p = 0.0234) and less commonly associated with subjective leg swelling (35.1% vs. 55.4%, p = 0.0158) and objectively measured difference in leg circumference (23% vs. 39.8%, p = 0.0268). D-Dimers were significantly lower in patients with isolated lower leg DVT (median 2.3 vs. 6.8 mg/L, p

BackgroundQuantitative magnetic resonance imaging (MRI) techniques such as chemical shift encoding-based water-fat separation techniques (CSE-MRI) are increasingly applied as noninvasive biomarkers to assess the biochemical composition of vertebrae. This study aims to investigate the longitudinal change of proton density fat fraction (PDFF) and T2* derived from CSE-MRI of the thoracolumbar vertebral bone marrow in patients that develop incidental vertebral compression fractures (VCFs), and whether PDFF and T2* enable the prediction of an incidental VCF.MethodsIn this study we included 48 patients with CT-derived bone mineral density (BMD) measurements at baseline. Patients that presented an incidental VCF at follow up (N=12, mean age 70.5 ± 7.4 years, 5 female) were compared to controls without incidental VCF at follow up (N=36, mean age 71.1 ± 8.6 years, 15 females). All patients underwent 3T MRI, containing a significant part of the thoracolumbar spine (Th11-L4), at baseline, 6-month and 12 month follow up, including a gradient echo sequence for chemical shift encoding-based water-fat separation, from which PDFF and T2* maps were obtained. Associations between changes in PDFF, T2* and BMD measurements over 12 months and the group (incidental VCF vs. no VCF) were assessed using multivariable regression models. Mixed-effect regression models were used to test if there is a difference in the rate of change in PDFF, T2* and BMD between patients with and without incidental VCF.ResultsPrior to the occurrence of an incidental VCF, PDFF in vertebrae increased in the VCF group (ΔPDFF=6.3 ± 3.1%) and was significantly higher than the change of PDFF in the group without VCF (ΔPDFF=2.1 ± 2.5%, P=0.03). There was no significant change in T2* (ΔT2*=1.7 ± 1.1ms vs. ΔT2*=1.1 ± 1.3ms, P=0.31) and BMD (ΔBMD=-1.2 ± 11.3mg/cm3 vs. ΔBMD=-11.4 ± 24.1mg/cm3, P= 0.37) between the two groups over 12 months. At baseline, no significant differences were detected in the average PDFF, T2* and BMD of all measured vertebrae (Th11-L4) between the VCF group and the group without VCF (P=0.66, P=0.35 and P= 0.21, respectively). When assessing the differences in rates of change, there was a significant change in slope for PDFF (2.32 per 6 months, 95% confidence interval (CI) 0.31-4.32; P=0.03) but not for T2* (0.02 per 6 months, CI -0.98-0.95; P=0.90) or BMD (-4.84 per 6 months, CI -23.4-13.7; P=0.60).ConclusionsIn our study population, the average change of PDFF over 12 months is significantly higher in patients that develop incidental fractures at 12-month follow up compared to patients without incidental VCF, while T2* and BMD show no significant changes prior to the occurrence of the incidental vertebral fractures. Therefore, a longitudinal increase in bone marrow PDFF may be predictive for vertebral compression fractures.

Abstract We present a method to generate synthetic thorax radiographs with realistic nodules from CT scans, and a perfect ground truth knowledge. We evaluated the detection performance of nine radiologists and two convolutional neural networks in a reader study. Nodules were artificially inserted into the lung of a CT volume and synthetic radiographs were obtained by forward-projecting the volume. Hence, our framework allowed for a detailed evaluation of CAD systems’ and radiologists’ performance due to the availability of accurate ground-truth labels for nodules from synthetic data. Radiographs for network training (U-Net and RetinaNet) were generated from 855 CT scans of a public dataset. For the reader study, 201 radiographs were generated from 21 nodule-free CT scans with altering nodule positions, sizes and nodule counts of inserted nodules. Average true positive detections by nine radiologists were 248.8 nodules, 51.7 false positive predicted nodules and 121.2 false negative predicted nodules. The best performing CAD system achieved 268 true positives, 66 false positives and 102 false negatives. Corresponding weighted alternative free response operating characteristic figure-of-merits (wAFROC FOM) for the radiologists range from 0.54 to 0.87 compared to a value of 0.81 (CI 0.75–0.87) for the best performing CNN. The CNN did not perform significantly better against the combined average of the 9 readers (p = 0.49). Paramediastinal nodules accounted for most false positive and false negative detections by readers, which can be explained by the presence of more tissue in this area.

This paper discusses the governance practices in the Malawi tourism and hospitality sector and their impact on the sustainability of natural resources. The focus of this paper is the National Tourism Policy (NTP) for Malawi and how central and local government structures enforce it to promote environmental sustainability practices in hotels. The paper uses a Case Study approach whereby the Sogecoa Golden Peacock Hotel and the Sunbird Mount Soche Hotel are used to explore how the NTP has ensured sustainable environmental practices are followed. A qualitative research method was used through semi-structured interviews to secure the perceptions of key informants. Through a Grounded Theory analysis, the findings revealed that the NTP does not facilitate the enforcement of sustainable environmental practices. Furthermore, because of this shortfall in the NTP, hotels do not have an environmental management policy to promote sustainable environmental practices. This paper, therefore, recommends an urgent need to revise the NTP and introduce sustainable environmental management guidelines in order for the hotel sector to emulate. It is further recommended that hotel managers should have a thorough understanding of environmental sustainability to ensure that the industry addresses negative environmental impacts.

Electric field enhancement mediated through sharp tips in scattering-type scanning near-field optical microscopy (s-SNOM) enables optical material analysis down to the 10-nm length scale and even below. Nevertheless, the out-of-plane electric field component is primarily considered here due to the lightning rod effect of the elongated s-SNOM tip being orders of magnitude stronger than any in-plane field component. Nonetheless, the fundamental understanding of resonantly excited near-field coupled systems clearly allows us to take profit from all vectorial components, especially from the in-plane ones. In this paper, we theoretically and experimentally explore how the linear polarization control of both near-field illumination and detection can constructively be implemented to (non-)resonantly couple to selected sample permittivity tensor components, e.g., explicitly to the in-plane directions as well. When applying the point-dipole model, we show that resonantly excited samples respond with a strong near-field signal to all linear polarization angles. We then experimentally investigate the polarization-dependent responses for both non-resonant (Au) and phonon-resonant (3C-SiC) sample excitations at a 10.6 µm and 10.7 µm incident wavelength using a tabletop CO2 laser. Varying the illumination polarization angle thus allows one to quantitatively compare the scattered near-field signatures for the two wavelengths. Finally, we compare our experimental data to simulation results and thus gain a fundamental understanding of the polarization’s influence on the near-field interaction. As a result, the near-field components parallel and perpendicular to the sample surface can be easily disentangled and quantified through their polarization signatures, connecting them directly to the sample’s local permittivity.

Abstract Background In patients with peripheral artery disease (PAD), run-off MR-angiography (MRA) is a commonly performed diagnostic test to obtain high-resolution images for evaluation of the arterial system from the aorta through the distal run-off vessels. The aim of this study was to investigate the prevalence of visceral artery involvement (VAI) in patients with PAD and leg symptoms examined with run-off MRA. Methods We retrospectively analyzed 145 patients (median age 68 years, range 27–91) who underwent MRA due to known or suspected PAD at our institution between 2012 and 2018. MRA examinations were re-evaluated for visceral artery stenosis. Patient dossiers were reviewed to determine cardiovascular risk factors, kidney function and Fontaine stage of PAD. Results Involvement of at least one visceral artery with ≥ 50% diameter stenosis was found in 72 (50%) patients. There were no differences in age, gender, MRA indication, Fontaine stage, levels of C-reactive protein (CRP), cardiovascular risk factors or vascular comorbidities between patients with and without VAI. Renal artery (RA) involvement with ≥ 50% diameter stenosis was observed in 28 (20%) of patients. Patients with involvement of the RA were more likely to suffer from hypertension (79 vs. 54%, p = 0.019) and reduced renal function (glomerular filtration rate 70 vs. 88 mL/min/1.73m2, p = 0.014). Conclusion Visceral artery stenosis can be seen in half of patients with known or suspected PAD and leg symptoms on run-off MRA. Investigating for RA stenosis in patients with PAD and hypertension and/or impaired renal function may have high diagnostic yield.

Abstract Novel therapeutic strategies aiming at improving the healing process after an acute myocardial infarction are currently under intense investigation. The mouse model plays a central role for deciphering the underlying mechanisms on a molecular and cellular level. Therefore, we intended to assess in-vivo post-infarct remodeling as comprehensively as possible using an expedient native magnetic resonance imaging (MRI) in the two most prominent infarct models, permanent ligation (PL) of the left anterior descending artery (LAD) versus ischemia reperfusion (I/R). Mice were subjected to either permanent or transient (45 min) occlusion of the LAD. After 3 weeks, examinations were performed with a 7-Tesla small animal MRI system. Data analysis was performed with the freely available software Segment. PL resulted in a massive dilation of the left ventricle, accompanied by hypertrophy of the non-infarcted myocardium and a decline of contractile function. These effects were less pronounced following I/R compared to healthy animals. Single plane assessments were not sufficient to capture the specific differences of left ventricular (LV) properties between the two infarct models. Bulls-eye plots were found to be an ideal tool for qualitative LV wall assessment, whereas a multi-slice sector-based analysis of wall regions is ideal to determine differences in hypertrophy, lateral wall thinning and wall thickening on a quantitative level. We combine the use of polar map-based analysis of LV wall properties with volumetric measurements using simple CINE CMR imaging. Our strategy represents a versatile and easily available tool for serial assessment of the LV during the remodeling process. Our study contributes to a better understanding of the effects of novel therapies targeting the healing of damaged myocardium.