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Solid organ transplant (SOT) recipients receive therapeutic immunosuppression that compromises their immune response to infections and vaccines. For this reason, SOT patients have a high risk of developing severe coronavirus disease 2019 (COVID-19) and an increased risk of death from severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection. Moreover, the efficiency of immunotherapies and vaccines is reduced due to the constant immunosuppression in this patient group. Here, we propose adoptive transfer of SARS-CoV-2-specific T cells made resistant to a common immunosuppressant, tacrolimus, for optimized performance in the immunosuppressed patient. Using a ribonucleoprotein approach of CRISPR-Cas9 technology, we have generated tacrolimus-resistant SARS-CoV-2-specific T cell products from convalescent donors and demonstrate their specificity and function through characterizations at the single-cell level, including flow cytometry, single-cell RNA (scRNA) Cellular Indexing of Transcriptomes and Epitopes (CITE), and T cell receptor (TCR) sequencing analyses. Based on the promising results, we aim for clinical validation of this approach in transplant recipients. Additionally, we propose a combinatory approach with tacrolimus, to prevent an overshooting immune response manifested as bystander T cell activation in the setting of severe COVID-19 immunopathology, and tacrolimus-resistant SARS-CoV-2-specific T cell products, allowing for efficient clearance of viral infection. Our strategy has the potential to prevent severe COVID-19 courses in SOT or autoimmunity settings and to prevent immunopathology while providing viral clearance in severe non-transplant COVID-19 cases.
We present proper motion (PM) measurements within the central region of the Large Magellanic Cloud (LMC), using near-infrared data from the VISTA survey of the Magellanic Cloud system (VMC). This work encompasses 18 VMC tiles covering a total sky area of similar to 28 deg(2). We computed absolute stellar PMs from multiepoch observations in the K-s filter over time baselines between similar to 12 and 47 months. Our final catalogue contains similar to 6322 000 likely LMC member stars with derived PMs. We employed a simple flat-rotating disc model to analyse and interpret the PM data. We found a stellar centre of rotation (alpha(0) = 79.95 degrees(+0.22)(-0.23), delta(0) = -69.31 degrees(+0.12)(-0.11)) that is in agreement with that resulting from Hubble Space Telescope data. The inferred viewing angles of the LMC disc (i = 33.5 degrees(+1.2)(-1.3), Theta = 129.8 degrees(+1.9)(-1.9)) are in good agreement with values from the literature but suggest a higher inclination of the central parts of the LMC. Our data confirm a higher rotation amplitude for the young (less than or similar to 0.5 Gyr) stars compared to the intermediate-age/old (greater than or similar to 1 Gyr) population, which can be explained by asymmetric drift. We constructed spatially resolved velocity maps of the intermediate-age/old and young populations. Intermediate-age/old stars follow elongated orbits parallel to the bar's major axis, providing first observational evidence for x(1) orbits within the LMC bar. In the innermost regions, the motions show more chaotic structures. Young stars show motions along a central filamentary bar structure.
A combinatorial study of the effect of in-mixing of various guests on the thermoelectric properties of the host workhorse polymer poly[2,5-bis(3-tetradecylthiophen-2-yl)thieno[3,2-b]thiophene] (PBTTT) is presented. Specifically, the composition and thickness for doped films of PBTTT blended with different polymers are varied. Some blends at guest weight fractions around 10-15% exhibit up to a fivefold increase in power factor compared to the reference material, leading to zT values around 0.1. Spectroscopic analysis of the charge-transfer species, structural characterization using grazing-incidence wide-angle X-ray scattering, differential scanning calorimetry, Raman, and atomic force microscopy, and Monte Carlo simulations are employed to determine that the key to improved performance is for the guest to promote long-range electrical connectivity and low disorder, together with similar highest occupied molecular orbital levels for both materials in order to ensure electronic connectivity are combined.
This study examines the access to healthcare for children and adolescents with three common chronic diseases (type-1 diabetes (T1D), obesity, or juvenile idiopathic arthritis (JIA)) within the 4th (Delta), 5th (Omicron), and beginning of the 6th (Omicron) wave (June 2021 until July 2022) of the COVID-19 pandemic in Germany in a cross-sectional study using three national patient registries. A paper-and-pencil questionnaire was given to parents of pediatric patients (<21 years) during the routine check-ups. The questionnaire contains self-constructed items assessing the frequency of healthcare appointments and cancellations, remote healthcare, and satisfaction with healthcare. In total, 905 parents participated in the T1D-sample, 175 in the obesity-sample, and 786 in the JIA-sample. In general, satisfaction with healthcare (scale: 0–10; 10 reflecting the highest satisfaction) was quite high (median values: T1D 10, JIA 10, obesity 8.5). The proportion of children and adolescents with canceled appointments was relatively small (T1D 14.1%, JIA 11.1%, obesity 20%), with a median of 1 missed appointment, respectively. Only a few parents (T1D 8.6%; obesity 13.1%; JIA 5%) reported obstacles regarding health services during the pandemic. To conclude, it seems that access to healthcare was largely preserved for children and adolescents with chronic health conditions during the COVID-19 pandemic in Germany.
Multijunction solar cells can overcome the fundamental efficiency limits of single-junction devices. The bandgap tunability of metal halide perovskite solar cells renders them attractive for multijunction architectures(1). Combinations with silicon and copper indium gallium selenide (CIGS), as well as all-perovskite tandem cells, have been reported(2-5). Meanwhile, narrow-gap non-fullerene acceptors have unlocked skyrocketing efficiencies for organic solar cells(6,7). Organic and perovskite semiconductors are an attractive combination, sharing similar processing technologies. Currently, perovskite-organic tandems show subpar efficiencies and are limited by the low open-circuit voltage (V-oc) of wide-gap perovskite cells(8) and losses introduced by the interconnect between the subcells(9,10). Here we demonstrate perovskite-organic tandem cells with an efficiency of 24.0 per cent (certified 23.1 per cent) and a high V-oc of 2.15 volts. Optimized charge extraction layers afford perovskite subcells with an outstanding combination of high V-oc and fill factor. The organic subcells provide a high external quantum efficiency in the near-infrared and, in contrast to paradigmatic concerns about limited photostability of non-fullerene cells(11), show an outstanding operational stability if excitons are predominantly generated on the non-fullerene acceptor, which is the case in our tandems. The subcells are connected by an ultrathin (approximately 1.5 nanometres) metal-like indium oxide layer with unprecedented low optical/electrical losses. This work sets a milestone for perovskite-organic tandems, which outperform the best p-i-n perovskite single junctions(12) and are on a par with perovskite-CIGS and all-perovskite multijunctions(13).
Perovskite semiconductors differ from most inorganic and organic semiconductors due to the presence of mobile ions in the material. Although the phenomenon is intensively investigated, important questions such as the exact impact of the mobile ions on the steady-state power conversion efficiency (PCE) and stability remain. Herein, a simple method is proposed to estimate the efficiency loss due to mobile ions via "fast-hysteresis" measurements by preventing the perturbation of mobile ions out of their equilibrium position at fast scan speeds (approximate to 1000 V s(-1)). The "ion-free" PCE is between 1% and 3% higher than the steady-state PCE, demonstrating the importance of ion-induced losses, even in cells with low levels of hysteresis at typical scan speeds (approximate to 100mv s(-1)). The hysteresis over many orders of magnitude in scan speed provides important information on the effective ion diffusion constant from the peak hysteresis position. The fast-hysteresis measurements are corroborated by transient charge extraction and capacitance measurements and numerical simulations, which confirm the experimental findings and provide important insights into the charge carrier dynamics. The proposed method to quantify PCE losses due to field screening induced by mobile ions clarifies several important experimental observations and opens up a large range of future experiments.
We live in an aging society. The change in demographic structures poses a number of challenges, including an increase in age-associated diseases. Delirium, dementia, and depression are considered to be of particular interest in the field of aging and mental health. A common theory regarding healthy aging and mental health is that the highest satisfaction and best performance is achieved when a person's abilities match the demands of their environment. In this context, the person's environment includes both the physical and the social environment. Based on this assumption, this dissertation focuses on the investigation of non-pharmacological interventions that modify environmental factors in order to facilitate the prevention and treatment of mental disorders in older patients and their caregivers. The first part of this dissertation consists of two publications and deals with the prevention of postoperative delirium in elderly patients. The PAWEL study investigated the use of a multimodal, non-pharmacological intervention in the routine care of patients aged 70 years or older undergoing elective surgery. The intervention included an interdepartmental delirium prevention team, daily use of seven manualized “best practice” procedures, structured staff training on delirium, and the adaptation of the hospital environment to the patients’ needs. The second part of the dissertation used a meta-analysis to investigate whether technology-based interventions are a suitable form of support for informal caregivers of people with dementia. Subgroup analyses were conducted to examine the effect of different types of technology on caregiver burden and depressive symptoms. The following main results were found: The PAWEL study showed that the use of a multimodal, non-pharmacological intervention resulted in a significantly lower incidence rate of postoperative delirium and reduced days with delirium in the intervention group compared to the control group. However, this difference could not be observed in the group of patients undergoing elective cardiac surgery. The results of the meta-analysis showed that technology-based interventions offer a promising alternative to traditional “face-to-face” services. Significant effect sizes could be found in relation to both the burden and the depressive symptoms of caregiving relatives. These results provide further important information on the significant impact of non-pharmacological interventions that modify environmental factors on mental health, and support the consideration of such interventions in the prevention and treatment of mental disorders in both older patients and their caregivers.
The prevalence of obesity in the pediatric population has become a major public health issue. Indeed, the dramatic increase of this epidemic causes multiple and harmful consequences, Physical activity, particularly physical exercise, remains to be the cornerstone of interventions against childhood obesity. Given the conflicting findings with reference to the relevant literature addressing the effects of exercise on adiposity and physical fitness outcomes in obese children and adolescents, the effect of duration-matched concurrent training (CT) [50% resistance (RT) and 50% high-intensity-interval-training (HIIT)] on body composition and physical fitness in obese youth remains to be elucidated. Thus, the purpose of this study was to examine the effects of 9-weeks of CT compared to RT or HIIT alone, on body composition and selected physical fitness components in healthy sedentary obese youth. Out of 73 participants, only 37; [14 males and 23 females; age 13.4 +/- 0.9 years; body-mass-index (BMI): 31.2 +/- 4.8 kg center dot m-2] were eligible and randomized into three groups: HIIT (n = 12): 3-4 setsx12 runs at 80-110% peak velocity, with 10-s passive recovery between bouts; RT (n = 12): 6 exercises; 3-4 sets x 10 repetition maximum (RM) and CT (n = 13): 50% serial completion of RT and HIIT. CT promoted significant greater gains compared to HIIT and RT on body composition (p < 0.01, d = large), 6-min-walking test distance (6 MWT-distance) and on 6 MWT-VO2max (p < 0.03, d = large). In addition, CT showed substantially greater improvements than HIIT in the medicine ball throw test (20.2 vs. 13.6%, p < 0.04, d = large). On the other hand, RT exhibited significantly greater gains in relative hand grip strength (p < 0.03, d = large) and CMJ (p < 0.01, d = large) than HIIT and CT. CT promoted greater benefits for fat, body mass loss and cardiorespiratory fitness than HIIT or RT modalities. This study provides important information for practitioners and therapists on the application of effective exercise regimes with obese youth to induce significant and beneficial body composition changes. The applied CT program and the respective programming parameters in terms of exercise intensity and volume can be used by practitioners as an effective exercise treatment to fight the pandemic overweight and obesity in youth.
We present observations with the Cosmic Origins Spectrograph onboard the Hubble Space Telescope of seven compact low-mass star-forming galaxies at redshifts, z, in the range 0.3161-0.4276, with various O3Mg2 = [O III] lambda 5007/Mg II lambda 2796+2803 and Mg-2 = Mg II lambda 2796/Mg II lambda 2803 emission-line ratios. We aim to study the dependence of leaking Lyman continuum (LyC) emission on the characteristics of Mg ii emission together with the dependencies on other indirect indicators of escaping ionizing radiation. LyC emission with escape fractions f(esc)(LyC) = 3.1-4.6 per cent is detected in four galaxies, whereas only 1 sigma upper limits of f(esc)(LyC) in the remaining three galaxies were derived. A strong narrow Ly alpha emission line with two peaks separated by V-sep similar to 298-592 km s(-1) was observed in four galaxies with detected LyC emission and very weak Ly alpha emission is observed in galaxies with LyC non-detections. Our new data confirm the tight anticorrelation between f(esc)(LyC) and V-sep found for previous low-redshift galaxy samples. V-sep remains the best indirect indicator of LyC leakage among all considered indicators. It is found that escaping LyC emission is detected predominantly in galaxies with Mg-2 greater than or similar to 1.3. A tendency of an increase of f(esc)(LyC) with increasing of both the O3Mg2 and Mg-2 is possibly present. However, there is substantial scatter in these relations not allowing their use for reliable prediction of f(esc)(LyC).
Recently, there has been an upsurge of activity in image-based non-photorealistic rendering (NPR), and in particular portrait image stylisation, due to the advent of neural style transfer (NST). However, the state of performance evaluation in this field is poor, especially compared to the norms in the computer vision and machine learning communities. Unfortunately, the task of evaluating image stylisation is thus far not well defined, since it involves subjective, perceptual, and aesthetic aspects. To make progress towards a solution, this paper proposes a new structured, three-level, benchmark dataset for the evaluation of stylised portrait images. Rigorous criteria were used for its construction, and its consistency was validated by user studies. Moreover, a new methodology has been developed for evaluating portrait stylisation algorithms, which makes use of the different benchmark levels as well as annotations provided by user studies regarding the characteristics of the faces. We perform evaluation for a wide variety of image stylisation methods (both portrait-specific and general purpose, and also both traditional NPR approaches and NST) using the new benchmark dataset.