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Abstract Aims There is evidence to suggest that the subtype of aortic stenosis (AS), the degree of myocardial fibrosis (MF), and level of aortic valve calcification (AVC) are associated with adverse cardiac outcome in AS. Because little is known about their respective contribution, we sought to investigate their relative importance and interplay as well as their association with adverse cardiac events following transcatheter aortic valve replacement (TAVR). Methods and results One hundred consecutive patients with severe AS and indication for TAVR were prospectively enrolled between January 2017 and October 2018. Patients underwent transthoracic echocardiography, multidetector computed tomography, and left ventricular endomyocardial biopsies at the time of TAVR. The final study cohort consisted of 92 patients with a completed study protocol, 39 (42.4%) of whom showed a normal ejection fraction (EF) high‐gradient (NEFHG) AS, 13 (14.1%) a low EF high‐gradient (LEFHG) AS, 25 (27.2%) a low EF low‐gradient (LEFLG) AS, and 15 (16.3%) a paradoxical low‐flow, low‐gradient (PLFLG) AS. The high‐gradient phenotypes (NEFHG and LEFHG) showed the largest amount of AVC (807 ± 421 and 813 ± 281 mm3, respectively) as compared with the low‐gradient phenotypes (LEFLG and PLFLG; 503 ± 326 and 555 ± 594 mm3, respectively, P LEFHG > PLFLG > NEFHG, P PLFLG 26.7% > LEFHG 15.4% > NEFHG 2.5%; P = 0.023). In patients with a high MF burden, a higher AVC was associated with a lower mortality following TAVR (P = 0.045, hazard ratio 0.261, 95% confidence interval 0.07–0.97). Conclusions MF is associated with adverse CV outcome following TAVR, which is most prevalent in low EF situations. In the presence of large MF burden, patients with large AVC have better outcome following TAVR. Conversely, worse outcome in large MF and relatively little AVC may be explained by a relative prominence of an underlying cardiomyopathy. The better survival rates in large AVC patients following TAVR indicate TAVR induced relief of severe AS‐associated pressure overload with subsequently improved outcome.

Abstract Transcatheter aortic valve replacement (TAVR) has become the standard treatment for aortic stenosis in older patients. It increasingly relies on accurate pre-procedural planning using multidetector computed tomography (MDCT). Since little is known about the required competence levels for MDCT analyses, we comprehensively assessed MDCT TAVR planning reproducibility and accuracy with regard to valve selection in various healthcare workers. 20 randomly selected MDCT of TAVR patients were analyzed using dedicated software by healthcare professionals with varying backgrounds and experience (two structural interventionalists, one imaging specialist, one cardiac surgeon, one general physician, and one medical student). Following the analysis, the most appropriate Edwards SAPIEN 3™ and Medtronic CoreValve valve size was selected. Intra- and inter-observer variability were assessed. The first structural interventionalist was considered as reference standard for inter-observer comparison. Excellent intra- and inter-observer variability was found for the entire group in regard to the MDCT measurements. The best intra-observer agreement and reproducibility were found for the structural interventionalist, while the medical student had the lowest reproducibility. The highest inter-observer agreement was between both structural interventionalists, followed by the imaging specialist. As to valve size selection, the structural interventionalist showed the highest intra-observer reproducibility, independent of the brand of valve used. Compared to the reference structural interventionalist, the second structural interventionalist showed the highest inter-observer agreement for valve size selection [ICC 0.984, 95% CI 0.969–0.991] followed by the cardiac surgeon [ICC 0.947, 95%CI 0.900–0.972]. The lowest inter-observer agreement was found for the medical student [ICC 0.507, 95%CI 0.067–0.739]. While current state-of-the-art MDCT analysis software provides excellent reproducibility for anatomical measurements, the highest levels of confidence in terms of valve size selection were achieved by the performing interventional physicians. This was most likely attributable to observer experience.

BackgroundNumerous smartphone apps are targeting physical activity (PA) and healthy eating (HE), but empirical evidence on their effectiveness for the initialization and maintenance of behavior change, especially in children and adolescents, is still limited. Social settings influence individual behavior; therefore, core settings such as the family need to be considered when designing mobile health (mHealth) apps. ObjectiveThe purpose of this study was to evaluate the effectiveness of a theory- and evidence-based mHealth intervention (called SMARTFAMILY [SF]) targeting PA and HE in a collective family–based setting. MethodsA smartphone app based on behavior change theories and techniques was developed, implemented, and evaluated with a cluster randomized controlled trial in a collective family setting. Baseline (t0) and postintervention (t1) measurements included PA (self-reported and accelerometry) and HE measurements (self-reported fruit and vegetable intake) as primary outcomes. Secondary outcomes (self-reported) were intrinsic motivation, behavior-specific self-efficacy, and the family health climate. Between t0 and t1, families of the intervention group (IG) used the SF app individually and collaboratively for 3 consecutive weeks, whereas families in the control group (CG) received no treatment. Four weeks following t1, a follow-up assessment (t2) was completed by participants, consisting of all questionnaire items to assess the stability of the intervention effects. Multilevel analyses were implemented in R (R Foundation for Statistical Computing) to acknowledge the hierarchical structure of persons (level 1) clustered in families (level 2). ResultsOverall, 48 families (CG: n=22, 46%, with 68 participants and IG: n=26, 54%, with 88 participants) were recruited for the study. Two families (CG: n=1, 2%, with 4 participants and IG: n=1, 2%, with 4 participants) chose to drop out of the study owing to personal reasons before t0. Overall, no evidence for meaningful and statistically significant increases in PA and HE levels of the intervention were observed in our physically active study participants (all P>.30). ConclusionsDespite incorporating behavior change techniques rooted in family life and psychological theories, the SF intervention did not yield significant increases in PA and HE levels among the participants. The results of the study were mainly limited by the physically active participants and the large age range of children and adolescents. Enhancing intervention effectiveness may involve incorporating health literacy, just-in-time adaptive interventions, and more advanced features in future app development. Further research is needed to better understand intervention engagement and tailor mHealth interventions to individuals for enhanced effectiveness in primary prevention efforts. Trial RegistrationGerman Clinical Trials Register DRKS00010415; https://drks.de/search/en/trial/DRKS00010415 International Registered Report Identifier (IRRID)RR2-10.2196/20534

Background: The lack of resources limits the treatment of craniomaxillofacial fractures (CMF) in low-income countries (LIC). Therefore, Barton bandages and/or interdental wiring are considered in these regions. Fracture reduction is maintained by permanent occlusion for 6 weeks, which often leads to limited compliance and dissatisfying results. The aim of this cadaver-based study is to evaluate the feasibility of the use of an external face fixator (EFF) for the treatment of CMF, its biomechanical values and to define the optimal pin insertion points and angles. Materials and Methods: An AO hand fixator was used. CMF of types Le Fort 1–3 with split fractures of the hard palate were treated with EFF on 13 anatomical specimens. Fractures were created using a chisel, and pins were placed in specific anatomical regions. The maximal pull-out force [N] of pins was analysed by a tensile force gauge, and Fmax of the mandibular pins was evaluated. Computer tomography scans were performed on the healthy, fractured and EFF-treated skulls. Results: The pull-out forces for the single pins were mandibular pins (n = 15, median 488.0 N), supraorbital pins (n = 15, median 455.0 N), zygomatic pins (n = 14, median 269.1 N), medial hard palate pins (n = 12, median 208.4 N) and lateral hard palate pins (n = 8, median 49.6 N). Conclusions: The results indicate that the operation technique is feasible, and the stability of the EFF is sufficient for maintaining the reduction. The required pins can safely be inserted into the described areas with good reduction results. Using EFF offers a feasible alternative to the non-surgical treatment of CMF in LIC.

The Kopernikus ENSURE Co-Demonstration Platform enables the investigation of components and processes for the changing power system with grid models adapted to the respective problem. The platform is developed from the power system's perspective. A central aspect of the platform is to analyze several technical solutions of different stakeholders in shared power system models. Furthermore the platform enables the investigation of interactions between different technologies, the system stability or protection scenarios that cannot be simulated in the real power system or only to a very limited extent. The comparison of solution approaches on a common model basis enables reliable overall systemic statements. To realize this, a multi-domain and multi-vendor approach is pursued, covering electromagnetic transients, electromechanical transients, continuous power flow simulations, and real-time simulators from different manufacturers. The core components of the platform are distributed real-time simulations, including the coupling of different laboratories in Germany and the developed power system models. Investigations with the real-time capable platform can be carried out purely simulatively or, depending on the connected laboratory, as Control/Power-Hardware-in-the-Loop simulations.

Digitale Angebote von Theater sind oft marketinggebtrieben oder beschränken sich auf Streamingangebote mit mehr oder weniger Einsatz von Technik. Am Wiener Burgtheater experimentiert man seit der Spielzeit 2019/20 mit neuen digitalen Erzählformen und kokreaktiven Formaten. Nun auch auf TikTok.

We introduce sparse-ir, a collection of libraries to efficiently handle imaginary-time propagators, a central object in finite-temperature quantum many-body calculations. We leverage two concepts: firstly, the intermediate representation (IR), an optimal compression of the propagator with robust a priori error estimates, and secondly, sparse sampling, near-optimal grids in imaginary time and imaginary frequency from which the propagator can be reconstructed and on which diagrammatic equations can be solved. IR and sparse sampling are packaged into stand-alone, easy-to-use Python, Julia and Fortran libraries, which can readily be included into existing software. We also include an extensive set of sample codes showcasing the library for typical many-body and ab initio methods.

Little is known about the antimicrobial resistance (AMR) status of uropathogens in Western Africa. We performed a retrospective evaluation of urine cultures collected from the rural Margret Marquart Catholic Hospital, Kpando, Ghana during the time period from October 2019–December 2021. Urine samples from 348 patients (median age 40 years, 52.6% male) were examined. Of these, 125 (35.9%) showed either fungal or bacterial growth, including Escherichia coli in 48 (38.4%), Candida species (spp.) in 29 (23.2%), Klebsiella spp. in 27 (21.6%), Proteus spp. in 12 (9.6%), Citrobacter spp. in 10 (8.0%), Salmonella spp. in 4 (3.2%), Staphylococcus spp. in 3 (2.4%), and Pseudomonas spp. in 2 (1.6%) cases. Two bacterial spp. were detected in 7 samples (5.6%). Antibiotic susceptibility testing showed resistance to a mean 8.6 out of 11 tested antibiotics per patient. Significant predictors (p < 0.05) of bacterial growth were age (OR 1.03), female sex (OR 3.84), and the number of pus cells (OR 1.05) and epithelial cells (OR 1.07) in urine microscopy. We observed an alarmingly high AMR rate among the uropathogens detected, even to reserve antibiotics. A similar resistance profile can be expected in West African patients living in high-income countries. These observations warrant the implementation of restrictive antibiotic protocols, together with the expansion of urine culture testing capacities, improvement of documentation and reporting of AMR rates, and continued research and development of new antibiotic therapies in order to stem the progression of AMR in this West African region.

BackgroundThe resurgence of research and public interest in the positive psychological effects of psychedelics, together with advancements in digital data collection techniques, have brought forth a new type of research design, which involves prospectively gathering large-scale naturalistic data from psychedelic users; that is, before and after the use of a psychedelic compound. A methodological limitation of such studies is their high attrition rate, particularly owing to participants who stop responding after initial study enrollment. Importantly, study dropout can introduce systematic biases that may affect the interpretability of results. ObjectiveBased on a previously collected sample (baseline n=654), here we investigated potential determinants of study attrition in web-based prospective studies on psychedelic use. MethodsLogistic regression models were used to examine demographic, psychological trait and state, and psychedelic-specific predictors of dropout. Predictors were assessed 1 week before, 1 day after, and 2 weeks after psychedelic use, with attrition being defined as noncompletion of the key endpoint 4 weeks post experience. ResultsPredictors of attrition were found among demographic variables including age (β=0.024; P=.007) and educational levels, as well as personality traits, specifically conscientiousness (β=–0.079; P=.02) and extraversion (β=0.082; P=.01). Contrary to prior hypotheses, neither baseline attitudes toward psychedelics nor the intensity of acute challenging experiences were predictive of dropout. ConclusionsThe baseline predictors of attrition identified here are consistent with those reported in longitudinal studies in other scientific disciplines, suggesting their transdisciplinary relevance. Moreover, the lack of an association between attrition and psychedelic advocacy or negative drug experiences in our sample contextualizes concerns about problematic biases in these and related data.

Según Giorgio Agamben, caracteriza a ciertas expresiones artísticas durante la Modernidad el anudamiento del artista a su obra y a la operación que pone en marcha. De esta manera, se retrae cualquier sentido productivo o reproductivo en términos de emancipación. A partir de estos conceptos estéticos, exponemos a continuación algunas reflexiones en torno al proceso de investigación y creación realizado en el marco del proyecto “Escrituras performáticas: cuerpo y acción en efimerodramas” durante “Relación I. En Negro. Trayecto Finlandia”, como experiencia situada en la instalación de la artista Mónica Ostchega realizada en el Museo Genaro Pérez entre mayo y junio de 2017. El trabajo realizado articulando el método de los Sistemas Minimalistas Repetitivos (SMR) elaborados por José Sanchis Sinisterra, el arte de acción y la escritura performática permite reformular el planteo agambeniano y proponer que cuando la máquina artista se detiene, se reestablece el vínculo con la vida.

In this contribution, measurement data of phase, neutral, and ground currents from real low voltage (LV) feeders in Germany is presented and analyzed. The data obtained is used to review and evaluate common modeling approaches for LV systems. An alternative modeling approach for detailed cable and ground modeling, which allows for the consideration of typical German LV earthing conditions and asymmetrical cable design, is proposed. Further, analytical calculation methods for model parameters are described and compared to laboratory measurement results of real LV cables. The models are then evaluated in terms of parameter sensitivity and parameter relevance, focusing on the influence of conventionally performed simplifications, such as neglecting house junction cables, shunt admittances, or temperature dependencies. By comparing measurement data from a real LV feeder to simulation results, the proposed modeling approach is validated.

We derive generalized Kronig identities expressing quadratic fermionic terms including momentum transfer to bosonic operators and use them to obtain the exact solution for one-dimensional fermionic models with linear dispersion in the presence of position-dependent local interactions and scattering potential. In these Luttinger droplets, which correspond to Luttinger liquids with spatial variations or constraints, the position dependencies of the couplings break the translational invariance of correlation functions and modify the Luttinger-liquid interrelations between excitation velocities.

The efficient validation of quantum devices is critical for emerging technological applications. In a wide class of use cases the precise engineering of a Hamiltonian is required both for the implementation of gate-based quantum information processing as well as for reliable quantum memories. Inferring the experimentally realized Hamiltonian through a scalable number of measurements constitutes the challenging task of Hamiltonian learning. In particular, assessing the quality of the implementation of topological codes is essential for quantum error correction. Here, we introduce a neural-net-based approach to this challenge. We capitalize on a family of exactly solvable models to train our algorithm and generalize to a broad class of experimentally relevant sources of errors. We discuss how our algorithm scales with system size and analyze its resilience toward various noise sources.

Virtually all interactions that are relevant for atomic and condensed matter physics are mediated by quantum fluctuations of the electromagnetic field vacuum. Consequently, controlling the vacuum fluctuations can be used to engineer the strength and the range of interactions. Recent experiments have used this premise to demonstrate novel quantum phases or entangling gates by embedding electric dipoles in photonic cavities or wave guides, which modify the electromagnetic fluctuations. Here, we show theoretically that the enhanced fluctuations in the antisqueezed quadrature of a squeezed vacuum state allow for engineering interactions between electric dipoles without the need for a photonic structure. Thus, the strength and range of the interactions can be engineered in a time-dependent way by changing the spatial profile of the squeezed vacuum in a traveling-wave geometry, which also allows the implementation of chiral dissipative interactions. Using experimentally realized squeezing parameters and including realistic losses, we predict single-atom cooperativities C of up to 10 for the squeezed-vacuum-enhanced interactions.