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Background: Repetitive transcranial magnetic stimulation (rTMS) induces long-term changes in synapses, but the mechanisms behind these modifications are not fully understood. Although there has been progress in the development of multi-scale modeling tools, no comprehensive module for simulating rTMS-induced synaptic plasticity in biophysically realistic neurons exists. Objective: We developed a modelling framework that allows the replication and detailed prediction of long-term changes of excitatory synapses in neurons stimulated by rTMS. Methods: We implemented a voltage-dependent plasticity model that has been previously established for simulating frequency-, time-, and compartment-dependent spatio-temporal changes of excitatory synapses in neuronal dendrites. The plasticity model can be incorporated into biophysical neuronal models and coupled to electrical field simulations. Results: We show that the plasticity modelling framework replicates long-term potentiation (LTP)-like plasticity in hippocampal CA1 pyramidal cells evoked by 10-Hz repetitive magnetic stimulation (rMS). In line with previous experimental studies, this plasticity was strongly distance dependent and localised to the proximal synapses of the neuron. We predicted a decrease in the plasticity amplitude for 5 Hz and 1 Hz protocols with decreasing frequency. Finally, we successfully modelled plasticity in distal synapses upon local electrical theta-burst stimulation (TBS) and predicted proximal and distal plasticity for rMS TBS. Notably, the rMS TBS-evoked synaptic plasticity exhibited robust facilitation by dendritic spikes and low sensitivity to inhibitory suppression. Conclusion: The plasticity modelling framework enables precise simulations of LTP-like cellular effects with high spatio-temporal resolution, enhancing the efficiency of parameter screening and the development of plasticity-inducing rTMS protocols.

Anaerobic digestion (AD) is a biological process that breaks down organic matter in the absence of oxygen, producing biogas and nutrient-rich digestate. Various reactor designs and mixing strategies are well-established in AD processes, each with their own advantages and benefits. The presented study summarizes and investigates the state of the art of AD in domestic wastewater treatment plants (WWTPs) in an Austrian alpine region, with a primary focus on finding similarities among the most efficient plants regarding digester design, mixing approaches, and biogas production. By combining surveys and detailed field studies in cooperation with 34 WWTPs, the study provides a comprehensive overview of common AD practices, reactor shapes, and inherent mixing methods, highlighting their potential regarding energetic efficiency and biogas production. The results of the survey reveal qualitative trends in efficient AD design alongside detailed quantitative data derived from the supervised in-field optimization studies. Notably, one of the studies demonstrated energetic savings of 52% with no decrease in biogas production, achieved by transitioning from gas injection to mechanical agitation. Redundant impeller-based overmixing was also practically investigated and demonstrated in another field study. After optimization, the adaptations also resulted in energy savings of 30%, still proving sufficient substrate mixing with biomethane potential analysis. In conclusion, this research emphasizes the economic and environmental importance of energy-refined practices and optimized processes while highlighting the sustainability of AD, particularly for large domestic WWTPs but also for different comparable applications.

Background During the first wave of the coronavirus disease 2019 (COVID-19) pandemic in 2020 outpatient care of neovascular age-related macular degeneration (nAMD) patients was severely reduced due to lockdown. Missed visits are known to be detrimental to patients in need of continued anti-vascular endothelial growth factor (VEGF) intravitreal injections (IVIs). The purpose of the study was to assess the effect of a month-long pause of regular visits and anti-VEGF IVIs in nAMD patients. Methods A retrospective study was performed. Patients were treated in a pro re nata (“as needed”) scheme. Distance (logMAR) and near (logRAD) visual acuity (VA), optical coherence tomography, delay between planned and actual visit date and the indication for IVI were assessed for 3 continous visits in the 6 months before lockdown (V-3, -2, -1) and the 2 visits after lockdown (V0, V + 1). For analysis of long-term impact, records for visits 1 years before and after lockdown (V-3, V + 2) were gathered. Results We included 166 patients (120 female, 46 male) with a median (range) age of 80.88 (59.8–99.36) years. Compared to V-1, distance VA was significantly worse at both V0 (0.27 ± 0.21 vs 0.31 ± 0.23 logMAR, p  < 0.001) and V + 1 (0.27 ± 0.21 vs 0.30 ± 0.23 logMAR, p  = 0.021). Near VA was significantly worse at both V0 (0.31 ± 0.21 vs 0.34 ± 0.22 logRAD, p  = 0.037) and V + 1 (0.31 ± 0.21 vs 0.34 ± 0.22 logRAD, p  = 0.02). Visit delay (VD) at V0 was significantly longer than at V + 1 (30.81 ± 20.44 vs 2.02 ± 6.79 days, p  < 0.0001). Linear regression analysis showed a significant association between visit delay and a reduction of near VA between V-1 and V + 1 ( p  = 0.0223). There was a significant loss of distance VA ( p  = 0.02) in the year after the lockdown period ( n  = 125) compared to the year before. Loss of reading acuity was not significantly increased ( p  = 0.3). One year post lockdown, there was no correlation between VA change and visit delay after lockdown ( p  > 0.05). Conclusions In nAMD patients whose visits and treatment were paused for a month during the first wave of the COVID-19 pandemic, we found a loss of VA immediately after lockdown, which persisted during follow-up despite re-established anti-VEGF treatment. In the short term, length of delay was predictive for loss of reading VA. The comparison of development of VA during the year before and after the lockdown showed a progression of nAMD related VA loss which may have been accelerated by the disruption of regular visits and treatment. Trial registration This article does not report the outcome of a health care intervention. This retrospective study was therefore not registered in a clinical trials database.

Aims Amyloid cardiomyopathy is an underappreciated cause of morbidity and mortality. Recent evidence suggests that ATTR wild‐type cardiomyopathy (ATTRwt‐CM) is probably much more common than widely appreciated. So far, no data are available on comparison of mortality from ATTRwt‐CM and other heart failure aetiologies. Methods and results This was a retrospective, observational, cohort study of 2251 patients and their data collected prospectively from May 2000 to June 2018. Long‐term mortality was the main outcome measure. Underlying cardiomyopathies were classified as amyloid CM (6.1%) [ATTRwt 3.0%; light‐chain amyloidosis (AL) 3.1%], dilated CM (dCMP) (46.4%), ischaemic heart disease (IHD) (24.4%), hypertensive heart disease (HHD) (14.6%), hypertrophic CM (HCM) (5.1%), and valvular heart disease (VHD) (3.4%). Median duration of follow‐up was 7.1 years (interquartile range 3.4–11.3). Five‐year overall survival in the whole cohort was 80.1%. In multivariate analysis, individuals with amyloid CM were 3.74 times [95% confidence interval (CI) 2.72–5.14; P < 0.001] more likely to die of any reason than were individuals with dCMP. Mortality was higher in AL‐CM compared with ATTRwt‐CM [hazard ratio (HR) 2.88; 95% CI 1.48–5.58; P = 0.002]. Mortality rates in patients with ATTRwt‐CM were higher than in patients with dCMP (HR 1.96; 95% CI 1.24–3.22; P = 0.007), HCM (HR 2.94; 95% CI 1.28–6.67; P = 0.011), HHD (HR 2.08; 95% CI 1.27–3.45; P = 0.004), VHD (HR 2.38; 95% CI 1.30–4.35; P = 0.005), or left ventricular ejection fraction ≥ 40% (HR 1.99; 95% CI 1.12–3.52; P = 0.018). Conclusions Our study demonstrates that amyloid CM is independently associated with poor survival among patients with various causes of heart failure. ATTRwt‐CM had a better long‐term prognosis than did AL‐CM, but was associated with higher mortality than were dCMP, HCM, HHD, VHD, and heart failure with preserved or mid‐range ejection fraction.

This study investigates the impact of the social distance between immigrants and Swiss natives on wage inequalities. Social distance is assumed to be high when immigrants come from a different culture, a different education system and speak a different language. By combining these three aspects, this article goes beyond existing studies that only focus on cultural differences. The empirical findings indicate that, net of education, immigrants with a high or very high social distance from the receiving society are strongly disadvantaged in terms of their salaries. Additional analyses show that the impact of typical explanatory factors for labour market success such as education, citizenship and length of stay also vary by the degree of social distance between immigrants and their destination country. The analyses are based on data from the Swiss Labour Force Survey for the years 2010 and 2011, which allow for detailed analyses on individual immigrant groups due to oversampling.

The output of cortical columns is routed to different downstream targets via distinct pathways: cortico-cortical and cortico-subcortical. It is as yet unclear what roles these pathways play in perception, and which cellular and circuit mechanisms regulate their gating. We recently showed that activation of the apical dendrites of layer 5 (L5) pyramidal neurons correlates with the threshold for perception, but these neurons come in two classes that target either other cortical or subcortical areas. In the present study, we took advantage of transgenic mouse lines for these L5 subclasses to determine their relative contributions to the perceptual process. We found that the activation of apical dendrites in neurons of the somatosensory cortex, which project to subcortical regions, almost exclusively determined the detection of tactile stimuli in mice. Our results suggest that dendritic activation drives context-dependent interactions between cortex and subcortical regions, including the higher-order thalamus, superior colliculus and striatum, which are crucial for perception.The authors showed that the ‘moment of perception’ is causally related to dendritic activity in subcortically projecting layer 5 pyramidal neurons that project to the higher-order thalamus, superior colliculus and striatum.

We aimed to ascertain the real-world diagnostic accuracy of bone scintigraphy in combination with free light chain (FLC) assessment for transthyretin (ATTR) cardiac amyloidosis (CA) using the histopathological diagnosis derived from endomyocardial biopsy (EMB) as a reference standard. We retrospectively analyzed 102 patients (22% women) with suspected CA from seven Austrian amyloidosis referral centers. The inclusion criteria comprised the available results of bone scintigraphy, FLC assessment, and EMB with histopathological analysis. ATTR and AL were diagnosed in 60 and 21 patients (59%, 21%), respectively, and concomitant AL and ATTR was identified in one patient. The specificity and positive predictive value (PPV) of Perugini score ≥ 2 for ATTR CA were 95% and 96%. AL was diagnosed in three out of 31 patients (10%) who had evidence of monoclonal proteins and a Perugini score ≥ 2. When excluding all patients with detectable monoclonal proteins (n = 62) from analyses, the PPV of Perugini score ≥ 2 for ATTR CA was 100% and the NPV of Perugini score < 2 for ATTR CA was 79%. Conclusively, ATTR CA can be diagnosed non-invasively in the case of a Perugini score ≥ 2 and an unremarkable FLC assessment. However, tissue biopsy is mandatory in suspected CA in any other constellation of non-invasive diagnostic work-up.

People’s occupations are strongly related to multiple dimensions of inequality, such as inequalities in wages, health, autonomy, or risk of temporary employment. The theories and mechanisms linking occupations to these inequalities are subject to debate. We review the recent evidence on the relationship between occupations and inequality and discuss the following four overarching theoretical perspectives: occupations and skills, occupations and tasks, occupations and institutions, and occupations and culture. We show that each perspective has strong implications for how scholars conceptualize occupations and which occupational characteristics are seen as relevant when explaining inequalities. Building on this, we review and critically examine the relevant theories related to and the mechanisms of the relationship between occupation and wage inequality, as an example. We conclude that there is sound empirical knowledge available on the relationships between occupations and inequality; however, some of the mechanisms are still unclear.

Summary We present the case of a 26-year-old male with acute tonsillitis who was referred for coronary angiography because of chest pain, elevated cardiac biomarkers, and biphasic T waves. The patient had no cardiovascular risk factors. Echocardiography showed no wall motion abnormalities and no pericardial effusion. 2D speckle tracking revealed distinct decreased regional peak longitudinal systolic strain in the lateral and posterior walls. Ischemic disease was extremely unlikely in view of his young age, negative family history regarding coronary artery disease, and lack of regional wall motion abnormalities on the conventional 2D echocardiogram. Coronary angiography was deferred as myocarditis was suspected. To confirm the diagnosis, cardiac magnetic resonance tomography (MRT) was performed, showing subepicardial delayed hyperenhancement in the lateral and posterior walls correlating closely with the strain pattern obtained by 2D speckle tracking echocardiography. With a working diagnosis of acute myocarditis associated with acute tonsillitis, we prescribed antibiotics and nonsteroidal anti-inflammatory drugs. The patient’s clinical signs resolved along with normalization of serum creatine kinase (CK) levels, and the patient was discharged on the third day after admission. Learning points Acute myocarditis can mimic acute coronary syndromes. Conventional 2D echocardiography lacks specific features for detection of subtle regional wall motion abnormalities. 2D speckle tracking expands the scope of echocardiography in identifying myocardial dysfunction derived from edema in acute myocarditis.

PurposeThis article aims to examine whether specific job tasks measured at the individual level or personality traits are associated with wages and whether the relationship between personality traits and wages differs depending on the job tasks that individuals perform.Design/methodology/approachThis study analyzes the association between job tasks and personality traits, and their interaction, with regard to wages using German employee data from 2017/2018.FindingsResults suggest that nonroutine manual, interactive or analytic tasks are associated with significantly higher wages compared to routine manual tasks, and while extraversion and emotional stability are related to higher wages, agreeableness and openness tend to be associated with lower wages also within occupations. Moreover, the association between personality traits and wages varies depending on the job task requirements at the workplace. A high degree of extraversion in particular is associated with higher wages when the employee performs nonroutine manual, interactive or analytic tasks.Originality/valueTo date, especially the interaction between individual job tasks and personality traits on wages has not been extensively studied because data on both job tasks and personality at the employee level are scarce. This study contributes to the understanding of wage differences among employees.