EHR-Based Care Coordination Performance Measures in Ambulatory Care

Describes electronic health record-based measures for assessing coordination in referrals, including information communicated with referral, communication to patient, and specialist report to primary care physician. Offers preliminary evaluation findings

Benefits of Psychological Androgyny in Adolescence: The Role of Gender Role Self-Concept in School-Related Well-Being

It has been repeatedly shown that the extent to which individuals adopt stereotypically masculine and feminine traits in their self-concept impacts their health and well-being. This is especially important in adolescence, when developmental changes and social pressures to conform to stereotypical gender roles can affect psychological functioning. However, previous studies investigating relationship between gender role self-concept and well-being in adolescents focused mostly on general well-being rather than well-being in specific contexts. Given that school is one of the most important contexts for adolescents’ development and well-being, the aim of this study was to investigate differences between adolescents with different gender role self-concepts (masculine, feminine, androgynous and undifferentiated) in school-related well-being. In line with the new conceptualization of well-being uniting hedonic (pleasure attainment and pain avoidance) and eudemonic (self-actualization and having meaningful purpose in one’s life) approaches, the present study used a measure of school-related well-being encompassing five domains suggested in the EPOCH (Engagement, Perseverance, Optimism, Connectedness and Happiness) model as well as a superordinate well-being factor. A total of 999 Austrian adolescents (52.2% girls, M(age) = 13.79, SD(age) = 1.53) answered inventories assessing adolescents’ gender role self-concept (GRI-JUG) and school-related well-being (EPOCH-G-S). The results supported the androgyny model of well-being, showing clear advantages of having both positive masculine and feminine qualities in one’s self-concept for optimal levels of school-related well-being. In addition, our results indicated the strong importance of femininity in adolescence and the school context. Theoretical and practical implications are discussed

Polymer-Supported Photosensitizers for Oxidative Organic Transformations in Flow and under Visible Light Irradiation

A 2,1,3-benzothiadiazole (BTZ)–based vinyl crosslinker was synthesized and copolymerized with large excesses of styrene using free radical polymerization to deliver heterogeneous triplet photosensitizers in three distinct physical formats: gels, beads and monoliths. These photosensitizers were employed for the production of singlet oxygen (1O2) and for the aerobic hydroxylation of aryl boronic acids via superoxide radical anion (O2˙-) whereby the materials demonstrated good chemical and photo stability. BTZ-containing beads and monoliths were exploited as photosensitizers in a commercial flow reactor, and 1O2 production was also demonstrated using direct sunlight irradiation, with a conversion rate comparable to the rates achieved when using a 420 nm LED module as the source of photons

Stochastic microstructure modeling of SOC electrodes based on a pluri-Gaussian method

Zugehörige Dateien: https://zenodo.org/records/7744110 https://doi.org/10.1039/D3YA00132F https://doi.org/10.21256/zhaw-28430Digital Materials Design (DMD) offers new possibilities for data-driven microstructure optimization of solid oxide cells (SOC). Despite the progress in 3D-imaging, experimental microstructure investigations are typically limited to only a few tomography analyses. In this publication, a DMD workflow is presented for extensive virtual microstructure variation, which is based on a limited number of real tomography analyses. Real 3D microstructures, which are captured with FIB-tomography from LSTN-CGO anodes, are used as a basis for stochastic modeling. Thereby, digital twins are constructed for each of the three real microstructures. The virtual structure generation is based on the pluri-Gaussian method (PGM). In order to match the properties of selected virtual microstructures (i.e., digital twins) with real structures, the construction parameters for the PGM-model are determined by interpolation of a database of virtual structures. Moreover, the relative conductivities of the phases are optimized with morphological operations. The digital twins are then used as anchor points for virtual microstructure variation of LSTN-CGO anodes, covering a wide range of compositions and porosities. All relevant microstructure properties are determined using our standardized and automated microstructure characterization procedure, which was recently published. The microstructure properties can then e.g., be used as input for a multiphysics electrode model to predict the corresponding anode performances. This set of microstructure properties with corresponding performances is then the basis to provide design guidelines for improved electrodes. The PGM-based structure generation is available as a new Python app for the GeoDict software package

Standardized microstructure characterization of SOC electrodes as a key element for Digital Materials Design

Performance and durability of solid oxide cell (SOC) electrodes are closely linked to their microstructure properties. Thus, the comprehensive characterization of 3D microstructures e.g., obtained by FIB-SEM tomography is essential for SOC electrode optimization. Recent advances and trends call for a standardized and automated microstructure characterization. Advances in FIB-SEM tomography enable the acquisition of more samples, which are also more frequently shared within the research community due to evolving open science concepts. In addition, the emerging methods for Digital Materials Design (DMD) enable to create numerous virtual but realistic microstructure variations using stochastic microstructure modeling. In this publication, a standardized microstructure characterization tool for SOC electrodes is presented, which is implemented as a Python app for the GeoDict software-package. A large number of microstructure characteristics can be determined with this app, which are relevant for the performance of conventional electrodes like Ni-YSZ and for more recent MIEC-based electrodes. The long list of 3D characteristics that can be determined selectively includes morphological characteristics, interface properties and effective transport properties deduced from morphological predictions and from numerical simulations. The extensive possibilities of the standardized microstructure characterization tool are illustrated for a dataset of three LSTN-CGO anode microstructures reconstructed with FIB-SEM tomography and for a dataset of three virtual sphere-packing structures. The automated microstructure characterization is a key element to exploit the full potential of open science, Digital Materials Design (DMD) and artificial intelligence (AI) for the data-driven optimization of SOC electrodes by providing standardized high quality microstructure property data

Immune Response in Moderate to Critical Breakthrough COVID-19 Infection After mRNA Vaccination

SARS-CoV-2 variants of concern (VOCs) can trigger severe endemic waves and vaccine breakthrough infections (VBI). We analyzed the cellular and humoral immune response in 8 patients infected with the alpha variant, resulting in moderate to fatal COVID-19 disease manifestation, after double mRNA-based anti-SARS-CoV-2 vaccination. In contrast to the uninfected vaccinated control cohort, the diseased individuals had no detectable high-avidity spike (S)-reactive CD4+ and CD8+ T cells against the alpha variant and wild type (WT) at disease onset, whereas a robust CD4+ T-cell response against the N- and M-proteins was generated. Furthermore, a delayed alpha S-reactive high-avidity CD4+ T-cell response was mounted during disease progression. Compared to the vaccinated control donors, these patients also had lower neutralizing antibody titers against the alpha variant at disease onset. The delayed development of alpha S-specific cellular and humoral immunity upon VBI indicates reduced immunogenicity against the S-protein of the alpha VOC, while there was a higher and earlier N- and M-reactive T-cell response. Our findings do not undermine the current vaccination strategies but underline a potential need for the inclusion of VBI patients in alternative vaccination strategies and additional antigenic targets in next-generation SARS-CoV-2 vaccines

Composite conductivity of MIEC-based SOFC anodes : implications for microstructure optimization

Fully ceramic anodes such as LSTN-CGO offer some specific advantages compared to conventional cermet anodes. Ceria- and titanate-based phases are both mixed ionic and electronic conductors (MIEC), which leads to very different reaction mechanisms and associated requirements for the microstructure design compared to e.g. Ni-YSZ. Due to the MIEC-property of both solid phases, the transports of neither the electrons nor the oxygen ions are limited to a single phase. As a consequence, composite MIEC electrodes reveal a remarkable property that can be described as ‘composite conductivity’ (for electrons as well as for ions), which is much higher than the (hypothetical) single phase conductivities of the same microstructure. In composite MIEC anodes, the charge carriers can reach the reaction sites even when the volume fraction of one MIEC phase is below the percolation threshold, because the missing contiguity is automatically bridged by the second MIEC phase. The MIEC properties thus open a much larger design space for microstructure optimization of composite electrodes. In this contribution, the composite conductivities of MIEC-based anodes are systematically investigated based on virtual materials testing and stochastic modeling. For this purpose, a large number of 3D microstructures, representing systematic compositional variations of composite anodes, is created by microstructure modeling. The underlying stochastic model is fitted to experimental data from FIB-SEM tomography. For the fitting of the stochastic model, digital twins of the tomography data are created using the methodology of gaussian random fields. By interpolation between and beyond the digital twin compositions, the stochastic model then allows to create numerous virtual 3D microstructures with different compositions, but with realistic properties. The effect of microstructure variation on the composite conductivity is then determined with transport simulations for each 3D microstructure. Furthermore, the corresponding microstructure effects on the cell-performance are determined with a Multiphysics model that describes the anode reaction mechanism. Especially the impact of the composite conductivities on the cell performance is studied in detail. Finally, microstructure design regions are discussed and compared for three different anode materials systems: titanate-CGO (with composite conductivities), Ni-YSZ (with single-phase conductivities), Ni-CGO (with single-phase ionic and composite electronic conductivities)

Rule-Makers or Rule-Takers? Exploring the Transatlantic Trade and Investment Partnership

The Transatlantic Trade and Investment Partnership (TTIP) is an effort by the United States and the European Union to reposition themselves for a world of diffuse economic power and intensified global competition. It is a next-generation economic negotiation that breaks the mould of traditional trade agreements. At the heart of the ongoing talks is the question whether and in which areas the two major democratic actors in the global economy can address costly frictions generated by their deep commercial integration by aligning rules and other instruments. The aim is to reduce duplication in various ways in areas where levels of regulatory protection are equivalent as well as to foster wide-ranging regulatory cooperation and set a benchmark for high-quality global norms. In this volume, European and American experts explain the economic context of TTIP and its geopolitical implications, and then explore the challenges and consequences of US-EU negotiations across numerous sensitive areas, ranging from food safety and public procurement to economic and regulatory assessments of technical barriers to trade, automotive, chemicals, energy, services, investor-state dispute settlement mechanisms and regulatory cooperation. Their insights cut through the confusion and tremendous public controversies now swirling around TTIP, and help decision-makers understand how the United States and the European Union can remain rule-makers rather than rule-takers in a globalising world in which their relative influence is waning

Experimental Induction of Paromomycin Resistance in Antimony-Resistant Strains of L. donovani: Outcome Dependent on In Vitro Selection Protocol

Paromomycin (PMM) has recently been introduced for treatment of visceral leishmaniasis in India. Although no clinical resistance has yet been reported, proactive vigilance should be warranted. The present in vitro study compared the outcome and stability of experimental PMM-resistance induction on promastigotes and intracellular amastigotes. Cloned antimony-resistant L. donovani field isolates from India and Nepal were exposed to stepwise increasing concentrations of PMM (up to 500 µM), either as promastigotes or intracellular amastigotes. One resulting resistant strain was cloned and checked for stability of resistance by drug-free in vitro passage as promastigotes for 20 weeks or a single in vivo passage in the golden hamster. Resistance selection in promastigotes took about 25 weeks to reach the maximal 97 µM inclusion level that did not affect normal growth. Comparison of the IC50 values between the parent and the selected strains revealed a 9 to 11-fold resistance for the Indian and 3 to 5-fold for the Nepalese strains whereby the resistant phenotype was also maintained at the level of the amastigote. Applying PMM pressure to intracellular amastigotes produced resistance after just two selection cycles (IC50 = 199 µM) compared to the parent strain (IC50 = 45 µM). In the amastigote-induced strains/clones, lower PMM susceptibilities were seen only in amastigotes and not at all in promastigotes. This resistance phenotype remained stable after serial in vitro passage as promastigote for 20 weeks and after a single in vivo passage in the hamster. This study clearly demonstrates that a different PMM-resistance phenotype is obtained whether drug selection is applied to promastigotes or intracellular amastigotes. These findings may have important relevance to resistance mechanism investigations and the likelihood of resistance development and detection in the field