Mountains and Waves: Fontan Circulation in Different Environmental Conditions.

As surgical options and medical care for patients with univentricular heart physiology continue to improve, leading to increased life expectancy and quality of life, a new population of Fontan patients is growing up with the desire to participate in leisure activities, including aquatic activities, high-altitude stays, and air travel. Due to significant data gaps and insufficient experience, current guidelines do not provide clear recommendations, leading to uncertainty and sometimes restrictive patient management. This review summarizes new insights and the current state of research on this subject and provides an overview of the long overdue change in policies toward less restrictive counseling for Fontan patients regarding swimming, diving, high-altitude stays, and air travel.

Looking through the crystal ball feasibility of tele-echocardiography using smart glasses in neonates: a pilot study.

Background: In recent years, the importance of telemedicine has increased significantly. Especially in the field of echocardiography, virtual reality glasses offer the possibility of real-time data transmission without restrictions in the examination process. In particular, the care of critically ill newborns with suspected CHD might be improved by allowing a specialized paediatric cardiologist to remotely guide an echocardiographic examination.

Healthcare workers' views on decentralized primary health care management in Lesotho: a qualitative study.

Background: Lesotho experienced high rates of maternal (566/100,000 live births) and under-five mortality (72.9/1000 live births). A 2013 national assessment found centralized healthcare management in Ministry of Health led to fragmented, ineffective district health team management.

First Real-Life Data on the Diving Response in Healthy Children.

Swimming and diving are popular recreational activities, representing an effective option in maintaining and improving cardiovascular fitness in healthy people. To date, only little is known about the cardiovascular adaption to submersion in children. This study was conducted to improve an understanding thereof.

The social and structural architecture of the yeast protein interactome.

Cellular functions are mediated by protein-protein interactions, and mapping the interactome provides fundamental insights into biological systems. Affinity purification coupled to mass spectrometry is an ideal tool for such mapping, but it has been difficult to identify low copy number complexes, membrane complexes and complexes that are disrupted by protein tagging. As a result, our current knowledge of the interactome is far from complete, and assessing the reliability of reported interactions is challenging.

Open Field Exercise Testing in Pediatric Congenital Heart Disease Patients: A Subsumption of Cardiovascular Parameters.

Heart failure is a common phenomenon in congenital heart disease patients. Cardiopulmonary exercise testing is used for a reliable assessment of heart failure but is still challenging, especially for young children. Implementing mobile cardiopulmonary exercise testing (CPET) can close that diagnostic gap.

Development of an AI based automated analysis of pediatric Apple Watch iECGs.

Introduction: The Apple Watch valuably records event-based electrocardiograms (iECG) in children, as shown in recent studies by Paech et al. In contrast to adults, though, the automatic heart rhythm classification of the Apple Watch did not provide satisfactory results in children. Therefore, ECG analysis is limited to interpretation by a pediatric cardiologist.

Accurate Label-Free Quantification by directLFQ to Compare Unlimited Numbers of Proteomes.

Recent advances in mass spectrometry-based proteomics enable the acquisition of increasingly large datasets within relatively short times, which exposes bottlenecks in the bioinformatics pipeline. Although peptide identification is already scalable, most label-free quantification (LFQ) algorithms scale quadratic or cubic with the sample numbers, which may even preclude the analysis of large-scale data. Here we introduce directLFQ, a ratio-based approach for sample normalization and the calculation of protein intensities.

Investigation of the Damage Phenomenology with Dependence on the Macroporosity and Microporosity of Porous Freeze Foams.

Freeze Foams are cellular, ceramic structures with hierarchical pore structures that are manufactured using the direct foaming process. By tailoring their morphology and strength, these foam structures are able to cover a wide range of application. Earlier works identified that pore-forming influencing factors (water and air content, suspension temperature, as well as pressure reduction rate) dictate the constitution on a macroscopic and microscopic scale.

Metabolism of crown tissue is crucial for drought tolerance and recovery after stress cessation in Lolium/Festuca forage grasses.

A process of plant recovery after drought cessation is a complex trait which has not been fully recognized. The most important organ associated with this phenomenon in monocots, including forage grasses, is the crown tissue located between shoots and roots. The crown tissue is a meristematic crossroads for metabolites and other compounds between these two plant organs.

Accuracy of the Apple Watch Oxygen Saturation Measurement in Adults and Children with Congenital Heart Disease.

As new customer health devices have been spread throughout the consumer market in recent years, it now needs to be evaluated if they also fulfill the requirements of clinical use. The Apple Watch Series 6 provides a new health feature with its oxygen saturation measurement. The aim of this prospective, investigator-initiated, single-arm study was to compare transcutaneous oxygen saturation measurements using the Apple Watch 6 with the conventional method of pulse oximetry in patients with congenital heart disease.

Into the Blue: First in Man Data on Diving Physiology in Fontan Patients.

Swimming and diving are popular recreational activities. As congenital heart disease, especially patients with univentricular hearts after Fontan palliation are thought to have reduced physiologic capacities for compensation of submersion-associated physiologic demands, current guidelines put restraints on this group of patients. Although these restrictions on doctoral advice place a significant burden on affected patients, it is especially interesting that these guideline recommendations are merely based on physiologic assumptions, i.

NASA Global Daily Downscaled Projections, CMIP6.

We describe the latest version of the NASA Earth Exchange Global Daily Downscaled Projections (NEX-GDDP-CMIP6). The archive contains downscaled historical and future projections for 1950-2100 based on output from Phase 6 of the Climate Model Intercomparison Project (CMIP6). The downscaled products were produced using a daily variant of the monthly bias correction/spatial disaggregation (BCSD) method and are at 1/4-degree horizontal resolution.

Study on CerAMfacturing of Novel Alumina Aerospike Nozzles by Lithography-Based Ceramic Vat Photopolymerization (CerAM VPP).

Advanced ceramics are recognized as key enabling materials possessing combinations of properties not achievable in other material classes. They provide very high thermal, chemical and mechanical resistance and typically exhibit lower densities than metals. These properties predestine ceramics for many different applications, especially those in space.

An Unusual Presentation of an Uncommon Drug: A Case Report on Phenibut Overdose.

Phenibut (β-phenyl-γ-aminobutyric acid), a nootropic, gamma-aminobutyric acid receptor agonist, commercially marketed for anxiolysis, is increasingly recognized for its recreational abuse potential. We present the case of a 30-year-old-male with a history of polysubstance abuse, anxiety, and depression, who presented to the Emergency Department by ambulance for altered mental status with severe agitation, requiring both sedation and mechanical ventilation. It was later discovered that he had consumed phenibut, which he purchased through the internet.

Tailoring of Hierarchical Porous Freeze Foam Structures.

Freeze foaming is a method to manufacture cellular ceramic scaffolds with a hierarchical porous structure. These so-called freeze foams are predestined for the use as bone replacement material because of their internal bone-like structure and biocompatibility. On the one hand, they consist of macrostructural foam cells which are formed by the expansion of gas inside the starting suspension.

Use of the Apple Watch iECG in adult congenital heart disease patients.

Introduction: This study evaluates the accuracy of iECGs in comparison to the gold standard ECG in adult patients with congenital heart disease and recommends the appropriate iECG derivation based on the patient's characteristics.

Methods: In 106 adults (51 female, 55 male) with congenital heart disease, a gold standard 12-lead ECG was recorded, followed by three iECGs with the Apple Watch series 4, which correspond to Einthoven leads I, II, and III. Two experienced and independent cardiologists analyzed the time intervals, amplitudes, and polarities of the ECG parameters as well as the rhythm type and correlated the patient characteristics with the iECG parameters.

The Role of Triacylglycerol in the Protection of Cells against Lipotoxicity under Drought in Lolium multiflorum/Festucaarundinacea Introgression Forms.

Triacylglycerol is a key lipid compound involved in maintaining homeostasis of both membrane lipids and free fatty acids (FFA) in plant cells under adverse environmental conditions. However, its role in the process of lipid remodeling has not been fully recognized, especially in monocots, including grass species. For our study, two closely related introgression forms of Lolium multiflorum (Italian ryegrass) and Festuca arundinacea (tall fescue), distinct in their level of drought tolerance, were selected as plant models to study rearrangements in plant lipidome under water deficit and further re-watering.

Intercalation electrochemistry for thermoelectric energy harvesting from temperature fluctuations.

The effective use of energy from sustainable sources is considered a crucial step on the way to a CO-neutral economy. Low-grade waste heat (<100 °C) is widely and ubiquitously available, but difficult to convert into electrical energy with current technologies. Here, we demonstrate an electrochemical cell capable of directly converting ambient temperature fluctuations into electricity.

Open field stress testing: finally an optimal method in young children? Reference values for mobile cardiopulmonary exercise testing in healthy children aged 4-8 years.

Introduction: Cardiopulmonary exercise testing represents the diagnostic tool for determining cardiopulmonary function. Especially in small children, exercise testing is extremely challenging. To address this problem, field testing has been implemented using small mobile devices.

Accuracy of the Apple Watch single-lead ECG recordings in pre-term neonates.

Introduction: Telemedicine gained an increasing use throughout the last years. Lifestyle tools like the Apple watch seem to have an increasing spread even in remote areas and underdeveloped regions. The increasing availability of these tools offers the chance to use the health care functions of these devices to improve provision of professional medical care.

Reaction of LiAlTi(PO) and LiNiCoMnO in Co-Sintered Composite Cathodes for Solid-State Batteries.

All solid-state batteries offer the possibility of increased safety at potentially higher energy densities compared to conventional lithium-ion batteries. In an all-ceramic oxide battery, the composite cathode consists of at least one ion-conducting solid electrolyte and an active material, which are typically densified by sintering. In this study, the reaction of the solid electrolyte LiAlTi(PO) (LATP) and the active material LiNiCoMnO (NCM622) is investigated by cosintering at temperatures between 550 and 650 °C.

A household-based community health worker programme for non-communicable disease, malnutrition, tuberculosis, HIV and maternal health: a stepped-wedge cluster randomised controlled trial in Neno District, Malawi.

Background: Community health worker (CHW) programmes are a valuable component of primary care in resource-poor settings. The evidence supporting their effectiveness generally shows improvements in disease-specific outcomes relative to the absence of a CHW programme. In this study, we evaluated expanding an existing HIV and tuberculosis (TB) disease-specific CHW programme into a polyvalent, household-based model that subsequently included non-communicable diseases (NCDs), malnutrition and TB screening, as well as family planning and antenatal care (ANC).

Evaluation of Clinical Course and Maintenance Drug Treatment of Supraventricular Tachycardia in Children During the First Years of Life. A Cohort Study from Eastern Germany.

Supraventricular tachycardia (SVT) is considered the most common cause of arrhythmia in children and infants. Regarding the likelihood of a spontaneous resolution of SVTs during the first years of life, drug treatment aims to bridge the time until children 'grow out' out of the arrhythmia. The choice of antiarrhythmic agents and the planning of maintenance therapy are mainly based on clinical experience and retrospective single- and multi-institutional analyses and databases from all over the world approaching differently to this topic.