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Lyme disease is a multisystem disease caused by Borrelia burgdorferi infection and accounts for well-defined manifestations, appearing either at an early or late stage. Appropriate antibiotic therapy generally leads to a favorable outcome. Still, unspecific persisting symptoms such as fatigue, myalgia, arthralgia or cognitive dysfunction are reported by several patients months to years after adequate treatment. Their underlying pathophysiologic mechanism is unclear. However, there is no evidence for microbiological persistence in these cases and attempts to resolve the symptoms by repeated or prolonged antibiotic treatment have not been convincingly successful, but they may rather be harmful. To narrow down the controversially handled entity of posttreatment Lyme disease syndrome (PTLDS) and to avoid overdiagnosis and overtreatment, case definitions have been proposed, acknowledging PTLDS as a complex of nonspecific, subjective symptoms, which are neither caused by ongoing infection nor by any other identifiable disease. PTLDS is mainly a diagnosis of exclusion and requires careful evaluation of differential diagnosis followed by counseling about optimal management in light of missing specific therapeutic options.

We present polyphasic taxonomic data to demonstrate that strain 125703-2019

Background To date, few data on paediatric COVID-19 have been published, and most reports originate from China. This study aimed to capture key data on children and adolescents with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection across Europe to inform physicians and health-care service planning during the ongoing pandemic. Methods This multicentre cohort study involved 82 participating health-care institutions across 25 European countries, using a well established research network—the Paediatric Tuberculosis Network European Trials Group (ptbnet)—that mainly comprises paediatric infectious diseases specialists and paediatric pulmonologists. We included all individuals aged 18 years or younger with confirmed SARS-CoV-2 infection, detected at any anatomical site by RT-PCR, between April 1 and April 24, 2020, during the initial peak of the European COVID-19 pandemic. We explored factors associated with need for intensive care unit (ICU) admission and initiation of drug treatment for COVID-19 using univariable analysis, and applied multivariable logistic regression with backwards stepwise analysis to further explore those factors significantly associated with ICU admission. Findings 582 individuals with PCR-confirmed SARS-CoV-2 infection were included, with a median age of 5·0 years (IQR 0·5–12·0) and a sex ratio of 1·15 males per female. 145 (25%) had pre-existing medical conditions. 363 (62%) individuals were admitted to hospital. 48 (8%) individuals required ICU admission, 25 (4%) mechanical ventilation (median duration 7 days, IQR 2–11, range 1–34), 19 (3%) inotropic support, and one ( Interpretation COVID-19 is generally a mild disease in children, including infants. However, a small proportion develop severe disease requiring ICU admission and prolonged ventilation, although fatal outcome is overall rare. The data also reflect the current uncertainties regarding specific treatment options, highlighting that additional data on antiviral and immunomodulatory drugs are urgently needed. Funding ptbnet is supported by Deutsche Gesellschaft für Internationale Zusammenarbeit.

We have produced granular films based on carbon and different transition metals by means of plasma deposition processes. Some of the films possess an increased strain sensitivity compared to metallic films. They respond to strain almost linearly with gauge factors of up to 30 if strained longitudinally, while in the transverse direction about half of the effect is still measured. In addition, the film's thermal coefficient of resistance is adjustable by the metal concentration. The influence of metal concentration was investigated for the elements Ni, Pd, Fe, Pt, W, and Cr, while the elements Co, Au, Ag, Al, Ti, and Cu were studied briefly. Only Ni and Pd have a pronounced strain sensitivity at 55 ± 5 at. % (atomic percent) of metal, among which Ni–C is far more stable. Two phases are identified by transmission electron microscopy and X-ray diffraction: metal-containing nanocolumns densely packed in a surrounding carbon phase. We differentiate three groups of metals, due to their respective affinity to carbon. It turns out that only nickel has the capability to bond and form a stable and closed encapsulation of GLC around each nanoparticle. In this structure, the electron transport is in part accomplished by tunneling processes across the basal planes of the graphitic encapsulation. Hence, we hold these tunneling processes responsible for the increased gauge factors of Ni–C composites. The other elements are unable to form graphitic encapsulations and thus do not exhibit elevated gauge factors.

Background: multisystem inflammatory syndrome in children (MIS-C) is a new disease associated with a recent infection with severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2). Affected children can present predominantly with abdominal symptoms, fever and high inflammatory parameters that might lead to a consult by the pediatric surgeon and an indication for surgery. Methods: clinical data of three patients with MIS-C that underwent surgery were collected. Histopathological analysis of the appendix was performed. Results: we present the clinical course of three children with fever, abdominal pain and vomiting for several days. Clinical examination and highly elevated inflammation markers led to indication for laparoscopy, appendectomy was performed in two patients. Because of intraoperative findings or due to lack of postoperative improvement, all patients were reevaluated and tested positive for MIS-C associated laboratory parameters and were subsequently treated with corticosteroids, intravenous immunoglobulins, acetyl salicylic acid and/or light molecular weight heparin. Conclusions: we discuss the implications of MIS-C as a new differential diagnosis and stress the importance of assessing the previous medical history, identifying patterns of symptoms and critically surveilling the clinical course. We implemented an algorithm for pediatric surgeons to consider MIS-C as a differential diagnosis for acute abdomen that can be integrated into the surgical workflow.

Sleep is ubiquitous in animals and humans, but its function remains to be further determined. The synaptic homeostasis hypothesis of sleep–wake regulation proposes a homeostatic increase in net synaptic strength and cortical excitability along with decreased inducibility of associative synaptic long-term potentiation (LTP) due to saturation after sleep deprivation. Here we use electrophysiological, behavioural and molecular indices to non-invasively study net synaptic strength and LTP-like plasticity in humans after sleep and sleep deprivation. We demonstrate indices of increased net synaptic strength (TMS intensity to elicit a predefined amplitude of motor-evoked potential and EEG theta activity) and decreased LTP-like plasticity (paired associative stimulation induced change in motor-evoked potential and memory formation) after sleep deprivation. Changes in plasma BDNF are identified as a potential mechanism. Our study indicates that sleep recalibrates homeostatic and associative synaptic plasticity, believed to be the neural basis for adaptive behaviour, in humans., Sleep deprivation is believed to lead to homeostatic increases in synaptic strength and reduced inducibility of associative LTP, based mainly on findings from animal studies. Here, Kuhn et al. demonstrate similar sleep-dependent synaptic plasticity changes in humans along with altered plasma BDNF levels.

The strain sensitivity, i.e. the resistivity change due to mechanical strain of thin composite nano-cermet films of Pt–SiO2 was investigated. We prepared films with a thickness of 400 nm by means of co-sputtering processes at substrate temperatures around 400 °C. The specimens respond to uniform strain (ɛ = 0.2‰) with gauge factors up to 18. These gauge factors remained high at least up to 250 °C in air and also after further annealing up to 600 °C in vacuum. Therefore we state these functional films might be suitable for high temperature pressure and force sensors. The films have a relatively high film resistivity of some MΩ/sq and exhibit temperature coefficients of resistance (TCR) in the range of −2000 ppm/K up to −600 ppm/K. X-ray diffraction revealed a single crystalline fcc platinum phase while transmission electron microscopy proved a typical granular structure of the films. Pt-clusters sized 5–10 nm are embedded in an amorphous insulating matrix of silica. The composition of such nano-cermet films displaying high gauge factors is approx. 40 at% Pt, 20 at% Si and 40 at% of O.

The piezoresistive effects of nickel–carbon thin films, i.e., the sensitivity to hydrostatic pressure and uniform strain, are investigated in this study. Thin films, which were obtained by reactive sputtering processes with thicknesses up to 1200 nm, exhibit pressure sensitivity coefficients ( PCR ) about −20 ppm/bar and gauge factors up to 30 on Si/SiO 2 substrates. A linear change of the thin film's resistance in respect to the applied hydrostatic pressure was observed. Additionally, the temperature coefficients of resistance were determined in the range of −300 to 0 ppm/K, while the temperature coefficient of the PCR s was obtained as good as 0 ppm/K.

Ni:a-C:H thin films obtained by reactive sputtering processes were investigated using EXAFS and subsequent wavelet analysis. Depending on overall thin film deposition conditions, the clusters of Ni in Ni:a-C:H can appear as fcc-Ni or as a non-fcc-Ni phase, such as hcp-Ni or Ni3C. While hcp-Ni and Ni3C are hardly distinguishable by XRD, the EXAFS analysis can reveal if carbon is the nearest neighbour of Ni or not, thus if Ni3C is present or hcp-Ni. Our study showed that wavelet transformation analysis of the EXAFS data is necessary to discriminate clearly between hcp-Ni and Ni3C regarding the presence or absence of carbon coordination shells around the X-ray absorbing Ni atoms. Furthermore, we are confident to have identified Ni3C in our thin films, however, we cannot exclude the possibility of the co-existence of hcp-Ni. Finally, calculations of XRD peaks of hcp-Ni and Ni3C showed that a discrimination of these two crystal phases might be feasible when the crystallite size is increased beyond 40 nm.

Nickel containing amorphous hydrogenated carbon (Ni:a-C:H) thin films prepared by reactive sputtering have a high potential for use as piezoresistive sensors. Investigations by means of X-ray diffraction (XRD), transmission electron microscopy, energy-dispersive X-ray spectroscopy, and magnetic characterizations indicate that sputtering parameters and heat treatment influence the film composition, the microscopic structure, and some relevant macroscopic physical properties. The films are heterogeneous in nature and consist of either nanometer sized hcp nickel, nickel carbide (these phases being indistinguishable by XRD), or fcc nickel clusters encapsulated by graphite-like carbon shells. The nature of the metal clusters in the thin films has a strong effect on its magnetic properties. For approximately 55 at.% Ni the electrical resistivity of the film is nearly temperature independent over a broad temperature range from 100 K to 400 K. The strain sensitivity, with a gauge factor of 20, is up to ten times higher than conventional temperature independent strain sensitive films. Compared to industry standard NiCr functional layers used for pressure sensors, Ni:a-C:H films provide a ten fold higher output signal.

The influence of trap concentration on hole transport is investigated by an optical time-of-flight method for the amorphous small molecule organic semiconductor N,N′-bis(1-naphtyl)-N,N′-diphenyl-(1,1′-biphenyl)-4,4′-diamin (α-NPD) doped with neutral hole traps by codeposition of 4,4′,4″-tris-[N-(1-naphtyl)-N-(phenylamino)]-triphenylamine (1-NaphDATA). α-NPD doped with 120ppm 1-NaphDATA exhibits nondispersive hole transport like undoped α-NPD, but trap-controlled with reduced mobility. The trap depth derived from the mobility decrease coincides with the ionization potential difference of α-NPD and 1-NaphDATA. The transition to dispersive transport for increasing trap concentration to 1160ppm is explained by an energetic relaxation of optically generated charge carriers within a density of states broadened by traps.

The influence of charge carrier traps on charge carrier transport is studied in a small molecule organic semiconductor model system by means of an optical time-of-flight method. The model system consists of the hole transport material N,N'-di(1-naphtyl)-N,N'-diphenylbenzidine (α-NPD, sometimes denoted as α-NPB) either undoped or doped with various concentrations of the small molecule 4,4',4”-tris-[N-(1-naphtyl)-N-(phenylamino)]-triphenylamine (1-NaphDATA), which is known to create hole traps in α-NPD.In case of undoped α-NPD, non-dispersive hole transport is observed and the hole mobility is determined as 6·10−4cm2/Vs in the examined electric field range, being in good agreement with published data. Depending on the intensity of the laser light employed for optical charge carrier generation, current transients both in the space-charge regime and in the small signal case are obtained. In the small signal case the current transients do not exhibit the expected flat current plateau before the characteristic kink that marks the transit time, but feature a cusp instead. A tentative mechanism for its formation is proposed.The influence of the trap concentration on charge carrier transport is studied by introducing 1-NaphDATA as a molecular dopant. It is demonstrated that the hole transport in α-NPD can be controlled by varying the doping concentration of 1-NaphDATA. Increasing the trap concentration, a transition from non-dispersive transport in undoped α-NPD to non-dispersive but trap-controlled transport with reduced mobility and further to dispersive transport is observed.