BackgroundVasospasm and delayed cerebral ischemia (DCI) are the leading causes of morbidity and mortality after intracranial aneurysmal subarachnoid hemorrhage (aSAH). Vasospasm detection, prevention and management, especially endovascular management varies from center to center and lacks standardization. We aimed to evaluate this variability via an international survey of how neurointerventionalists approach vasospasm diagnosis and endovascular management.MethodsWe designed an anonymous online survey with 100 questions to evaluate practice patterns between December 2021 and September 2022. We contacted endovascular neurosurgeons, neuroradiologists and neurologists via email and via two professional societies – the Society of NeuroInterventional Surgery (SNIS) and the European Society of Minimally Invasive Neurological Therapy (ESMINT). We recorded the physicians’ responses to the survey questions.ResultsA total of 201 physicians (25% [50/201] USA and 75% non-USA) completed the survey over 10 months, 42% had >7 years of experience, 92% were male, median age was 40 (IQR 35–46). Both high-volume and low-volume centers were represented. Daily transcranial Doppler was the most common screening method (75%) for vasospasm. In cases of symptomatic vasospasm despite optimal medical management, endovascular treatment was directly considered by 58% of physicians. The most common reason to initiate endovascular treatment was clinical deficits associated with proven vasospasm/DCI in 89%. The choice of endovascular treatment and its efficacy was highly variable. Nimodipine was the most common first-line intra-arterial therapy (40%). Mechanical angioplasty was considered the most effective endovascular treatment by 65% of neurointerventionalists.ConclusionOur study highlights the considerable heterogeneity among the neurointerventional community regarding vasospasm diagnosis and endovascular management. Randomized trials and guidelines are needed to improve standard of care, determine optimal management approaches and track outcomes.

ABSTRACT While comprehensive research exists on transnational strategies of universities from the Anglosphere, little is known about why institutions from less marketised higher education systems engage in transnational education provision abroad. Based on semi-structured interviews with decision-makers, we investigate why German public universities have established international branch campuses, and explore the underlying rationales and the consequences for university governance. We contribute to interdisciplinary transnational higher education literature by conceptualising the wider socio-political implications and spatialities of arguably non-market-driven transnational education. By analysing German branch campus projects against the backdrop of Anglosphere branch development, we show that although neoliberalisation has been subtle in German higher education, decision-making processes in university leadership are nonetheless strongly pervaded by a neoliberal paradigm. We argue that German branch campuses both reflect the specific form of German higher education’s neoliberalisation and further accelerate their parent institutions’ neoliberal reconfigurations by exposing them to commercialised higher education landscapes abroad.

Predicting the outcome of ANCA-associated vasculitis (AAV) is a difficult task. One of the most promising prognostic scores, the ANCA Renal Risk Score (ARRS), has recently been updated and renamed to ANCA Kidney Risk Score (AKRiS). We wanted to test its performance in our population. 164 patients were included and categorized in subgroups analogous to that of both scores. Multivariable logistic regression analysis was applied to assess the risk of renal failure. Additionally, baseline data and outcome were compared between the subgroups of each score to retrieve useful clinical information. Stratified by AKRiS risk category, the proportions of patients who developed end-stage kidney disease (ESKD) at 36 months were 9.8%, 29.1%, 63.0%, and 83.3%, respectively (p < 0.001).Those belonging to the higher risk groups showed more pronounced proteinuria and anemia at diagnosis (p=0.001, p<0.001, respectively). Although our patients exhibited a more severe disease phenotype than those of AARS and AKRiS, both scores performed equally well: The Harrell´s C Index was similar (0.8381 vs. 0.8337). Beyond that, we found differences and similarities in the risk associations between the subgroups of both scores and disease activity or patient outcome, with some of them being described for the first time. For example, there was a higher risk of renal failure with anemia but not with C-reactive protein and the Birmingham Vasculitis Activity Score (BVAS) and an increased incidence of relapsing disease in the lower risk categories of ARRS. Here, we present the first external AKRiS validation confirming the improved ESKD prediction of the revised score in our cohort. Furthermore, we highlighted associations between risc score categories and patient mortality or vasculitis relapse.

Studying the metabolic role of non-essential promiscuous enzymes is a challenging task, as genetic manipulations usually do not reveal at which point(s) of the metabolic network the enzymatic activity of such protein is beneficial for the organism. Each of the HAD-like phosphatases YcsE, YitU and YwtE of Bacillus subtilis catalyzes the dephosphorylation of 5-amino-6-ribitylamino-uracil 5'-phosphate, which is essential in the biosynthesis of riboflavin. Using CRISPR technology, we have found that the deletion of these genes, individually or in all possible combinations failed to cause riboflavin auxotrophy and did not result in significant growth changes. Analysis of flavin and adenylate content in B. subtilis knockout mutants showed that (i) there must be one or several still unidentified phosphatases that can replace the deleted proteins; (ii) such replacements, however, cannot fully restore the intracellular content of any of three flavins studied (riboflavin, FMN, FAD); (iii) whereas bacterial fitness was not significantly compromised by mutations, the intracellular balance of flavins and adenylates did show some significant changes.

The growth of ultrathin semiconductors is advantageous for photocatalysis due to improved photophysical properties and reduced charge recombination. Along these lines, templating the growth of semiconductors in confined spaces can allow control over semiconductor growth while also conferring the properties of the template to provide composite nanomaterial hybrids. Herein, the semiconductor In2S3 is grown in the organically‐modified interlayer space of Ti3C2TX MXene, a versatile 2D material with metallic character and broadband light absorption. The growth of 1–2 nm thick layers of In2S3 in the interlayer of MXene leads to a drastic increase in photocatalytic properties and light‐induced charge generation due to decreased interfacial charge transfer resistance. Interestingly, the hydrothermal conditions of In2S3 growth lead to partial oxidation of Ti3C2TX MXene to form anatase TiO2 nanocrystals, although this effect is strongly limited by increased In2S3 precursors due to passivation of the MXene surface. MXenes serve as effective templates for the confined growth of semiconductors, emphasizing the potential of MXene as a template for 2D material heterostructures. Overall, this work further develops MXene‐based 2D material composites, offering insights into the origins of the enhanced photocatalytic and photoelectrochemical properties, toward improvements in energy production and aqueous phase catalysis.

Marine heatwaves are increasing in frequency and intensity as climate change progresses, especially in the highly productive Arctic regions. Although their effects on primary producers will largely determine the impacts on ecosystem services, mechanistic understanding on phytoplankton responses to these extreme events is still very limited. We experimentally exposed Arctic phytoplankton assemblages to stable warming, as well as to repeated heatwaves, and measured temporally resolved productivity, physiology, and composition. Our results show that even extreme stable warming increases productivity, while the response to heatwaves depends on the specific scenario applied and is not predictable from stable warming responses. This appears to be largely due to the underestimated impact of the cool phase following a heatwave, which can be at least as important as the warm phase for the overall response. We show that physiological and compositional adjustments to both warm and cool phases drive overall phytoplankton productivity and need to be considered mechanistically to predict overall ecosystem impacts.

Aging is accompanied by a decline of working memory, an important cognitive capacity that involves stimulus-selective neural activity that persists after stimulus presentation. Here, we unraveled working memory dynamics in older human adults (male and female) including those diagnosed with mild cognitive impairment (MCI) using a combination of behavioral modeling, neuropsychological assessment, and MEG recordings of brain activity. Younger adults (male and female) were studied with behavioral modeling only. Participants performed a visuospatial delayed match-to-sample task under systematic manipulation of the delay and distance between sample and test stimuli. Their behavior (match/nonmatch decisions) was fit with a computational model permitting the dissociation of noise in the internal operations underlying the working memory performance from a strategic decision threshold. Task accuracy decreased with delay duration and sample/test proximity. When sample/test distances were small, older adults committed more false alarms than younger adults. The computational model explained the participants' behavior well. The model parameters reflecting internal noise (not decision threshold) correlated with the precision of stimulus-selective cortical activity measured with MEG during the delay interval. The model uncovered an increase specifically in working memory noise in older compared with younger participants. Furthermore, in the MCI group, but not in the older healthy controls, internal noise correlated with the participants' clinically assessed cognitive integrity. Our results are consistent with the idea that the stability of working memory contents deteriorates in aging, in a manner that is specifically linked to the overall cognitive integrity of individuals diagnosed with MCI.

The reliable transfer of bioprocesses from single-use bioreactors (SUBs) of different scales to conventional stainless steel stirred-tank bioreactors is of steadily growing interest. In this publication, a scale-up study for SUBs with volumes of 200 L and 2000 L and the transfer to an industrial-scale conventional stainless steel stirred-tank bioreactor with a volume of 15,000 L is presented. The scale-up and transfer are based on a comparison of mixing times and the modeling of volumetric mass transfer coefficients kLa, measured in all three reactors in aqueous PBS/Kolliphor solution. The mass transfer coefficients are compared with the widely used correlation of van’t Riet at constant stirrer tip speeds. It can be shown that a van’t Riet correlation enables a robust and reliable prediction of mass transfer coefficients on each scale for a wide range of stirrer tip speeds and aeration rates. The process transfer from single-use bioreactors to conventional stainless steel stirred-tank bioreactors is proven to be uncritical concerning mass transfer performance. This provides higher flexibility with respect to bioreactor equipment considered for specific processes.

In Community of La Oroya v. Peru the IACtHR for the first time found a violation of the autonomous right to a healthy environment in a non-indigenous context related to the long-lasting environmental contamination of a community by toxic substances. La Oroya lays foundational principles that will likely shape the content and direction of environmental and climate change litigation and jurisprudence in the Americas. This historic judgment provides a robust basis for anticipating how the Court will handle the specification of environmental rights within the climate emergency and how it may accordingly inform States’ human rights obligations.