Intramyocardial Inflammation after COVID-19 Vaccination: An Endomyocardial Biopsy-Proven Case Series

Myocarditis in response to COVID-19 vaccination has been reported since early 2021. In particular, young male individuals have been identified to exhibit an increased risk of myocardial inflammation following the administration of mRNA-based vaccines. Even though the first epidemiological analyses and numerous case reports investigated potential relationships, endomyocardial biopsy (EMB)-proven cases are limited. Here, we present a comprehensive histopathological analysis of EMBs from 15 patients with reduced ejection fraction (LVEF = 30 (14–39)%) and the clinical suspicion of myocarditis following vaccination with Comirnaty^® (Pfizer-BioNTech) (n = 11), Vaxzevria^® (AstraZenica) (n = 2) and Janssen^® (Johnson & Johnson) (n = 2). Immunohistochemical EMB analyses reveal myocardial inflammation in 14 of 15 patients, with the histopathological diagnosis of active myocarditis according the Dallas criteria (n = 2), severe giant cell myocarditis (n = 2) and inflammatory cardiomyopathy (n = 10). Importantly, infectious causes have been excluded in all patients. The SARS-CoV-2 spike protein has been detected sparsely on cardiomyocytes of nine patients, and differential analysis of inflammatory markers such as CD4⁺ and CD8⁺ T cells suggests that the inflammatory response triggered by the vaccine may be of autoimmunological origin. Although a definitive causal relationship between COVID-19 vaccination and the occurrence of myocardial inflammation cannot be demonstrated in this study, data suggest a temporal connection. The expression of SARS-CoV-2 spike protein within the heart and the dominance of CD4⁺ lymphocytic infiltrates indicate an autoimmunological response to the vaccination.     

More Than Stories With Buttons: Narrative,Mechanics, and Context as Determinants of Player Experience in Digital Games

Recent research has attempted to describe meaningful experiences with entertainment media that go beyond hedonic enjoyment. Most of this research focuses on noninteractive media, such as film and television. When applied to digital games, however, such research needs to account for not only the content of the medium, but also the unique dimensions of digital games that distinguish them from noninteractive media. Experiences with digital games are shaped by the game mechanics that define the users' interaction with game content, as well as by the opportunities for social interaction that many games offer. We argue that the complex interplay of these dimensions (narrative, mechanics, and context) facilitates or inhibits meaningful user experiences in ways that are unique to digital games.     

Enhancing the efficiency of alternating current driven organic light-emitting devices by optimizing the operation frequency

We report efficient and bright organic light-emitting devices operated by capacitive energy coupling. In this approach, the organic layers are enclosed between sputter-deposited hafnium dioxide layers to prevent charge carrier injection. When a sinusoidal voltage signal is applied to the electrodes, the devices emit bright green light whereas no detectable emission is generated upon application of a constant voltage. The efficiency of the process depends heavily on the frequency of the applied voltage signal. By optimizing the driving scheme, a record luminous efficacy for AC driven OLEDs of 2.7 lm/W at 500 cd/m² is achieved.     

Verbesserung der Floating-Liner Methode zur Messung der Kolbengruppenreibung durch Einsatz doppelschrägverzahnter Zahnriemen

Forschung im Ingenieurwesen - Die mechanischen Verluste von Verbrennungsmotoren hängen maßgeblich von den auftretenden Reibkräften innerhalb der Kolbengruppe ab. Da die Kolbengruppe...     

Flammability of layered silicate epoxy nanocomposites combined with low‐melting inorganic ceepree glass

Tetraphenylphosphonium modified layered silicate epoxy nanocomposite (EP/TPPMMT) combined with low‐melting silicate glass, Ceepree (CP) is investigated by thermal analysis, flammability tests and cone calorimeter at different heat fluxes. Adding CP and TPPMMT does not change the pyrolysis apart from increasing inorganic residue. The total heat evolved (THE) is changed insignificantly, as neither relevant additional carbonaceous charring nor flame inhibition occurs. However, flame retardancy is clearly observed due to an inorganic‐carbonaceous surface protection layer. The peak heat released rate (PHRR) is reduced by around 32–42% when 5 wt% TPPMMT is added, and 51–63% when 10 wt% CP is added. PHRR reduction less than expected is observed when both additives are combined. The reduction is greater than that achieved by using TPPMMT but less than when only CP is used. The morphology of fire residue is investigated by scanning electron microscope on different length scales and turns out to be the key to understanding the efficiency of flame retardancy. The fire residue of EP/CP shows a layered structure, whereas separated columns limit the barrier properties for EP/5%TPPMMT on the micrometer scale. Columns dominating the fire residue structure of EP/5%TPPMMT/10%CP deteriorate the fire retardancy, whereas a more integral structure at the top of the residue causes the improvement over EP/5%TPPMMT. POLYM. ENG. SCI., 2012. © 2011 Society of Plastics Engineers     

Nanostructured supported palladium catalysts—Non-oxidative methane coupling

The Pd on α-Al₂O₃ catalysts with Pd particles in the low nanometer range have been prepared by a sonochemical reduction and a colloidal method, respectively. The two catalysts differ in their particle size, the widths of their particle size distributions and the amount of carbon incorporation in the Pd lattice.The adsorptive properties of the Pd/Al₂O₃ samples are different as a result of the different preparation methods. The methane adsorption capacity of that sample with smaller particles is lower than that of the catalyst with larger particles and the energy of activation is nearly doubled. DRIFTS and TPD results of CO adsorption supported by transmission electron microscopy data indicate that the PdSON catalyst with smaller and more homogeneous particles than PdCOL is highly dispersed which influences the coupling-hydrogenolysis process.The catalytic activity evidenced the formation of different adspecies during methane coupling and chemisorption on both catalysts. During the hydrogenation the carbon adspecies formed mainly methane at low adsorption temperatures. The significant amount of adsorbed methane at 773 K is governed by the highly active coordination unsaturated sites at the surface.     

Microwave-hydrothermal synthesis and characterization of nanostructured copper substituted ZnM2O4 (M = Al, Ga) spinels as precursors for thermally stable Cu catalysts

Nanostructured Cu(x)Zn(1-x)Al(2)O(4) with a Cu:Zn ratio of ?:? has been prepared by a microwave-assisted hydrothermal synthesis at 150 °C and used as a precursor for Cu/ZnO/Al(2)O(3)-based catalysts. The spinel nanoparticles exhibit an average size of approximately 5 nm and a high specific surface area (above 250 m(2) g(-1)). Cu nanoparticles of an average size of 3.3 nm can be formed by reduction of the spinel precursor in hydrogen and the accessible metallic Cu(0) surface area of the reduced catalyst was 8 m(2) g(-1). The catalytic performance of the material in CO(2) hydrogenation and methanol steam reforming was compared with conventionally prepared Cu/ZnO/Al(2)O(3) reference catalysts. The observed lower performance of the spinel-based samples is attributed to a lack of synergetic interaction of the Cu nanoparticles with ZnO due to the incorporation of Zn(2+) in the stable spinel lattice. Despite its lower performance, however, the nanostructured nature of the spinel catalyst was stable after thermal treatment up to 500 °C in contrast to other Cu-based catalysts. Furthermore, a large fraction of the re-oxidized copper migrates back into the spinel upon calcination of the reduced catalyst, thereby enabling a regeneration of sintered catalysts after prolonged usage at high temperatures. Similarly prepared samples with Ga instead of Al exhibit a more crystalline catalyst with a spinel particle size around 20 nm. The slightly decreased Cu(0) surface area of 3.2 m(2) g(-1) due to less copper incorporation is not a significant drawback for the methanol steam reforming.     

Differential Impact of Hyperglycemia in Critically Ill Patients: Significance in Acute Myocardial Infarction but Not in Sepsis?

Hyperglycemia is a common condition in critically ill patients admitted to an intensive care unit (ICU). These patients represent an inhomogeneous collective and hyperglycemia might need different evaluation depending on the underlying disorder. To elucidate this, we investigated and compared associations of severe hyperglycemia (>200 mg/dL) and mortality in patients admitted to an ICU for acute myocardial infarction (AMI) or sepsis as the two most frequent admission diagnoses. From 2006 to 2009, 2551 patients 69 (58–77) years; 1544 male; 337 patients suffering from type 2 diabetes (T2DM)) who were admitted because of either AMI or sepsis to an ICU in a tertiary care hospital were investigated retrospectively. Follow-up of patients was performed between May 2013 and November 2013. In a Cox regression analysis, maximum glucose concentration at the day of admission was associated with mortality in the overall cohort (HR = 1.006, 95% CI: 1.004–1.009; p < 0.001) and in patients suffering from myocardial infarction (HR = 1.101, 95% CI: 1.075–1.127; p < 0.001) but only in trend in patients admitted to an ICU for sepsis (HR = 1.030, 95% CI: 0.998–1.062; p = 0.07). Severe hyperglycemia was associated with adverse intra-ICU mortality in the overall cohort (23% vs. 13%; p < 0.001) and patients admitted for AMI (15% vs. 5%; p < 0.001) but not for septic patients (39% vs. 40%; p = 0.48). A medical history of type 2 diabetes (n = 337; 13%) was not associated with increased intra-ICU mortality (15% vs. 15%; p = 0.93) but in patients with severe hyperglycemia and/or a known medical history of type 2 diabetes considered in combination, an increased mortality in AMI patients (intra-ICU 5% vs. 13%; p < 0.001) but not in septic patients (intra-ICU 38% vs. 41%; p = 0.53) could be evidenced. The presence of hyperglycemia in critically ill patients has differential impact within the different etiological groups. Hyperglycemia in AMI patients might identify a sicker patient collective suffering from pre-diabetes or undiagnosed diabetes with its’ known adverse consequences, especially in the long-term. Hyperglycemia in sepsis might be considered as adaptive survival mechanism to hypo-perfusion and consecutive lack of glucose in peripheral cells. AMI patients with hyperglycemic derailment during an ICU-stay should be closely followed-up and extensively screened for diabetes to improve patients’ outcome.