bluuebunny/crossref_metadata_2025 huggingface dataset:
Survey on Acute and Chronic Complications in Children and Adolescents With Type 1 Diabetes at Muhimbili National Hospital in Dar es Salaam, Tanzania
Authors: Majaliwa Edna S. , Munubhi Emanuel , Ramaiya Kaushik , Mpembeni Rose , Sanyiwa Anna , Mohn Angelika , Chiarelli Francesco
Published: August 2007

OBJECTIVE—The purpose of this study was to assess glycemic control and complications of type 1 diabetes in children and adolescents in Tanzania.

RESEARCH DESIGN AND METHODS—This demographic and clinical survey included 99 children aged between 5 and 18 years attending Muhimbili National Hospital Clinic for Diabetes. A structured questionnaire was used for evaluating socioeconomic data and for estimation of the prevalence of acute complications occurring over the last 6 months. The prevalences of retinopathy and diabetic nephropathy were determined by fundus ophthalmoscopy and by microalbuminuria, respectively.

RESULTS—All of these children were treated with a conventional insulin regimen. The mean ± SD duration of diabetes was 4.76 ± 3.58 years. Only 1 child (1%) had good glycemic control (A1C <7.5%), 60 children (60.6%) had moderate glycemic control (A1C 7.5–10%), 14 children (14.1%) had poor glycemic control (A1C >10–12.5%), and 24 children (24.2%) had very poor glycemic control (A1C >12.5%). At onset of diabetes, 75% of children presented with diabetic ketoacidosis (DKA); 89 children (89.80%) had at least one episode of DKA, and 55 children (55.67%) had symptomatic hypoglycemic episodes. Microalbuminuria was present in 29 (29.3%) and retinopathy in 22 (22.68%) children.

CONCLUSIONS—Although there are some methodological limitations, this survey highlights the difficulties of achieving good metabolic control and the high prevalence of acute and chronic complications in Tanzanian children with type 1 diabetes. These results clearly show that major efforts are needed to improve quality of care in children with type 1 diabetes in Tanzania.
IGF Binding Protein 1 Predicts Cardiovascular Morbidity and Mortality in Patients With Acute Myocardial Infarction and Type 2 Diabetes
Authors: Wallander Märit , Norhammar Anna , Malmberg Klas , Öhrvik John , Rydén Lars , Brismar Kerstin
Published: August 2007

OBJECTIVE—There are indications that the IGF system is related to both type 2 diabetes and cardiovascular disease (CVD). We tested the hypothesis that low IGF-I and high IGF-binding protein (IGFBP)-1 predict future cardiovascular mortality and morbidity in patients with acute myocardial infarction (AMI) and type 2 diabetes.

RESEARCH DESIGN AND METHODS—The Diabetes Mellitus Insulin-Glucose Infusion in Acute Myocardial Infarction (DIGAMI) 2 Trial recruited 1,253 patients with type 2 diabetes and AMI, of whom 575 were enrolled in a biochemical program with repeated blood sampling. Primary and secondary end points included adjudicated cardiovascular mortality and a composite of cardiovascular events (cardiovascular death, reinfarction, or stroke). Multiple Cox proportional hazard regression was used to study the relationship between the end points and the variables. Admission variables were used for the survival analysis and for blood glucose, and A1C updated mean values during follow-up were also available.

RESULTS—During a median follow-up period of 2.2 years, 131 (23%) patients died from all-cause mortality and 102 (18%) from CVD, whereas 175 patients (30%) suffered from at least one cardiovascular event. The independent predictors for cardiovascular death in the Cox regression model were (as hazard ratio [HR] [95% CI]): ln updated mean blood glucose (12.2 [5.8–25.7]), age (+5 years) (1.5 [1.4–1.7]), ln IGFBP-1 (1.4 [1.1–1.8]), and ln serum creatinine at admission (2.4 [1.3–4.2]). The model predicting cardiovascular events contained the same variables (ln IGFBP-1 at admission, 1.2 [1.0–1.4]).

CONCLUSIONS—High levels of IGFBP-1 at admission are associated with increased risk for cardiovascular mortality and morbidity in type 2 diabetes patients with AMI.
Childhood Obesity: Practical Considerations for Prevention and Management
Authors: Ponder Stephen W. , Anderson Meaghan A.
Published: August 2007

In Brief

Treating obesity in the adult, and even more so in the pediatric,population can be a daunting and difficult task. Health care providers need to take a proactive role when treating children and focus on prevention of obesity rather than waiting until the condition exists. Obesity can lead to several complications and comorbidities; this article will address how to make an appropriate and thorough assessment of a child's lifestyle and behaviors and how to implement interventions that will result in improved health.
The Physiology of Body Weight Regulation: Are We Too Efficient for Our Own Good?
Authors: Dokken Betsy B. , Tsao Tsu-Shuen
Published: August 2007

In Brief

Understanding the physiology behind the regulation of body weight can help clinicians treat and educate obese patients. This article reviews the current knowledge of body weight regulation and the metabolic changes that occur in the body in response to weight loss. The physiological basis for the difficult nature of weight loss, and especially maintenance of lost weight, is discussed.
A Theoretical Review of Winne and Hadwin’s Model of Self-Regulated Learning: New Perspectives and Directions
Authors: Greene Jeffrey Alan , Azevedo Roger
Published: August 2007

This theoretical review of Winne and Hadwin’s model of self-regulated learning (SRL) seeks to highlight how the model sheds new light on current research as well as suggests interesting new directions for future work. The authors assert that the model’s more complex cognitive architecture, inclusion of monitoring and control within each phase of learning, and separation of task definition and goal setting into separate phases are all important contributions to the SRL literature. New research directions are outlined, including more nuanced interpretations of judgments of learning and the potential to more thoroughly assess the influence of interactions among cognitive and task conditions on all phases of learning.
Cancer Care in the Era of Artificial Intelligence
Authors: Kurian Matthew , Adashek Jacob J. , West Howard (Jack)
Published: March 2024

This JAMA Oncology Patient Page explains artifical intelligence and what patients should know about how it can be used in oncology.
Machine Learning–Based Prediction of Hospitalization During Chemoradiotherapy With Daily Step Counts
Authors: Friesner Isabel D. , Feng Jean , Kalnicki Shalom , Garg Madhur , Ohri Nitin , Hong Julian C.
Published: March 2024

Importance

Toxic effects of concurrent chemoradiotherapy (CRT) can cause treatment interruptions and hospitalizations, reducing treatment efficacy and increasing health care costs. Physical activity monitoring may enable early identification of patients at high risk for hospitalization who may benefit from proactive intervention.

Objective

To develop and validate machine learning (ML) approaches based on daily step counts collected by wearable devices on prospective trials to predict hospitalizations during CRT.

Design, Setting, and Participants

This study included patients with a variety of cancers enrolled from June 2015 to August 2018 on 3 prospective, single-institution trials of activity monitoring using wearable devices during CRT. Patients were followed up during and 1 month following CRT. Training and validation cohorts were generated temporally, stratifying for cancer diagnosis (70:30). Random forest, neural network, and elastic net–regularized logistic regression (EN) were trained to predict short-term hospitalization risk based on a combination of clinical characteristics and the preceding 2 weeks of activity data. To predict outcomes of activity data, models based only on activity-monitoring features and only on clinical features were trained and evaluated. Data analysis was completed from January 2022 to March 2023.

Main Outcomes and Measures

Model performance was evaluated in terms of the receiver operating characteristic area under curve (ROC AUC) in the stratified temporal validation cohort.

Results

Step counts from 214 patients (median [range] age, 61 [53-68] years; 113 [52.8%] male) were included. EN based on step counts and clinical features had high predictive ability (ROC AUC, 0.83; 95% CI, 0.66-0.92), outperforming random forest (ROC AUC, 0.76; 95% CI, 0.56-0.87; P = .02) and neural network (ROC AUC, 0.80; 95% CI, 0.71-0.88; P = .36). In an ablation study, the EN model based on only step counts demonstrated greater predictive ability than the EN model with step counts and clinical features (ROC AUC, 0.85; 95% CI, 0.70-0.93; P = .09). Both models outperformed the EN model trained on only clinical features (ROC AUC, 0.53; 95% CI, 0.31-0.66; P < .001).

Conclusions and Relevance

This study developed and validated a ML model based on activity-monitoring data collected during prospective clinical trials. Patient-generated health data have the potential to advance predictive ability of ML approaches. The resulting model from this study will be evaluated in an upcoming multi-institutional, cooperative group randomized trial.
Physical Activity Using a Wearable Device as an Alternative to Performance Status in Patients With Advanced Lung Cancer
Authors: Ito Kentaro , Suzuki Yuta , Sakaguchi Tadashi , Fujiwara Kentaro , Nishii Yoichi , Yasui Hiroki , Taguchi Osamu , Hataji Osamu
Published: March 2024

Importance

The Eastern Cooperative Oncology Group Performance Status (ECOG PS) is extensively used to guide treatment decisions in patients with advanced lung cancer. However, its assessment is subjective, potentially leading to discordance among observers.

Objective

To investigate the association between measured physical activity and ECOG PS, as well as the potential prognostic value of physical activity measurements in patients with advanced lung cancer.

Design, Setting, and Participants

This single-institution, prospective observational study enrolled 119 patients with advanced lung cancer scheduled to receive systemic therapy as outpatients at Matsusaka Municipal Hospital in Mie, Japan. Participants wore the wearable device amuelink (Sony) for up to 14 days to measure physical activity, including metabolic equivalent tasks, distance walked, and number of steps taken. ECOG PS was assessed at enrollment, which took place from December 2021 to August 2022.

Main Outcomes And Measures

The primary end point was estimating the area under the curve (AUC) for classification into ECOG PS of 2 or higher using physical activity measurements. An analysis of the association with survival was also conducted.

Results

Among the 119 patients (median [range] age, 72 (32-88) years; 71 [59.7%] male), mean distance walked (MDW) had the highest diagnostic value for classifying an ECOG PS of 2 or greater, with an AUC of 0.818 (95% CI, 0.703-0.934). Moreover, MDW was also associated with 6-month survival, with an AUC of 0.806 (95% CI, 0.694-0.918). Survival curves significantly diverged based on the MDW threshold, indicating a potential association with survival outcome (hazard ratio, 0.17; 95% CI, 0.05-0.57).

Conclusions and Relevance

The cohort study suggests that MDW, as measured by a wearable device, was associated with ECOG PS and may serve as a predictor of health status alongside ECOG PS categories. It demonstrates the potential of objectively measured physical activity in complementing subjective ECOG PS assessments in patients with advanced lung cancer. Further research is needed to confirm the prognostic value of physical activity measurements.
Exogenous Estrogen in the Development of Head and Neck Cancer
Authors: Doll Christian , Hofmann Elena , Preissner Robert , Heiland Max , Seeland Ute , Konietschke Frank , Sehouli Jalid , Preissner Saskia
Published: March 2024

Importance

Sex differences in head and neck cancer (HNC) incidence suggest a potential contribution of sex hormones.

Objective

To assess the role of exogenous estrogen exposure in the development of HNC in female patients.

Design, Settings, and Participants

This large multicenter cohort study using clinical records from the TriNetX real-world database included 20 years of data (through May 31, 2023) from 87 health care organizations. The TriNetX database was searched for medical records for female patients with and without exogenous estrogen exposure according to their chronological age. Cohort 1 included 731 366 female patients aged 18 to 45 years old with regular oral contraceptive (OC) intake and cohort 2 included 3 886 568 patients in the same age group who did not use OC. Cohort 3 comprised 135 875 female patients at least 50 years old receiving hormone replacement therapy (HRT), whereas cohort 4 included 5 875 270 patients at least 50 years old without HRT. Propensity score matching was performed for the confounders age, alcohol dependence, and nicotine dependence. Data analyses were performed in May 2023.

Main Outcome and Measures

Diagnosis of HNC (International Statistical Classification of Diseases and Related Health Problems, Tenth Revision: C00-C14), and after propensity score matching (1:1 nearest-neighbor greedy matching), a risk analysis to investigate risk differences and risk ratios (RRs) with a 95% CI.

Results

Among the 718 101 female patients in each of cohorts 1 and 2 (mean [SD] age at diagnosis, 25.9 [6.7] years), those with OC intake had a higher risk of an HNC diagnosis (RR, 1.47; 95% CI, 1.21-1.78) than those without OC use. Among the 131 835 female patients in each of cohorts 3 and 4 (mean [SD] age, 67.9 [12.0] years), those with postmenopausal HRT intake had a lower risk of an HNC diagnosis (RR, 0.77; 95% CI, 0.64-0.92) than those without HRT use.

Conclusions and Relevance

The findings of this cohort study illustrate a positive association between OC and a negative association between HRT and the development of HNC in female patients. Given the limitations of the TriNetX database, future research should include detailed information on the intake of OC and HRT and reproductive health information (eg, age at menarche/menopause, number of pregnancies) to more accurately define the strength and direction of the possible association between exogeneous estrogen exposure and the development of HNC in female patients.
Depressive Symptoms, Systemic Inflammation, and Survival Among Patients With Head and Neck Cancer
Authors: Cash Elizabeth , Albert Christy , Palmer Iona , Polzin Baylee , Kabithe Alyssa , Crawford Devaughn , Bumpous Jeffrey M. , Sephton Sandra E.
Published: March 2024

Importance

Patients with head and neck cancer experience high rates of depression. Depression and systemic inflammation have been found to be associated in numerous cancer types, often independently from disease status. Depression-related inflammation may elevate the risks for poor tumor response to treatment and early mortality, and comprises a mechanism by which depression is associated with survival in head and neck cancer.

Objective

To assess mediation pathways incorporating pretreatment depressive symptoms, pretreatment inflammation, and tumor response posttreatment on overall survival among patients with head and neck cancer.

Design, Setting, and Participants

This was a prospective observational cohort study of patients with head and neck cancer treated in a single multidisciplinary head and neck cancer clinic from May 10, 2013, to December 30, 2019, and followed up for 2 years. Data analysis was performed from June 29, 2022, to June 23, 2023.

Exposures

Patient-reported depressive symptoms using the Patient Health Questionnaire−9 item (PHQ−9) at treatment planning; pretreatment hematology workup for systemic inflammation index (SII) score; and clinical data review for tumor response (complete vs incomplete) and overall survival.

Main Outcomes

Two-year overall survival.

Results

The total study cohort included 394 patients (mean [SD] age, 62.5 [11.5] years; 277 [70.3%] males) with head and neck cancer. Among 285 patients (72.3%) who scored below the clinical cutoff for depression on the PHQ−9, depressive symptoms were significantly associated with inflammation (partial r, 0.168; 95% CI, 0.007-0.038). In addition, both depression and inflammation were associated with early mortality (PHQ−9: hazard ratio [HR], 1.04; 95% CI, 1.02-1.07; SII: HR, 1.36; 95% CI, 1.08-1.71). The depression-survival association was fully mediated by inflammation (HR, 1.28; 95% CI, 1.00-1.64). Depressive symptoms were also associated with poorer tumor response (odds ratio, 1.05; 95% CI, 1.01-1.08), and the depression-survival association was partially mediated by tumor response (HR, 9.44; 95% CI, 6.23-14.32). Systemic inflammation was not associated with tumor response.

Conclusions

In this cohort study, systemic inflammation emerged as a novel candidate mechanism of the association of depression with mortality. Tumor response partially mediated effects of depression on mortality, replicating prior work. Thus, depression stands out as a highly feasible target for renewed clinical attention. Even mild symptoms of depression during the treatment-planning phase may be associated with higher systemic inflammation in addition to poorer tumor response to treatment and survival outcomes; therefore, depression should be clinically addressed.
Neoadjuvant-Intent Immunotherapy in Advanced, Resectable Cutaneous Squamous Cell Carcinoma
Authors: Kim Emily Y. , Ruiz Emily S. , DeSimone Mia S. , Shalhout Sophia Z. , Hanna Glenn J. , Miller David M. , Schmults Chrysalyne , Rettig Eleni M. , Foreman Ruth K. , Sethi Rosh , Thakuria Manisha , Silk Ann W.
Published: March 2024

Importance

In clinical trials, preoperative immune checkpoint inhibitors (ICIs) have shown clinical activity in advanced cutaneous squamous cell carcinoma (cSCC). However, these studies excluded patients with relevant comorbidities.

Objective

To evaluate radiologic and pathologic response rates to neoadjuvant-intent programed cell death protein 1 (PD-1) ICIs in a clinical population.

Design, Setting, and Participants

This cohort study of patients who were treated with neoadjuvant cemiplimab or pembrolizumab for advanced cSCC from January 2018 to January 2023 was conducted at 2 academic institutions in Boston, Massachusetts. Median follow-up was 9.5 months (range, 1.2-40.5).

Exposures

Cemiplimab or pembrolizumab.

Main Outcomes and Measures

Primary outcomes were radiologic and pathologic response rates. Secondary outcomes were 1-year recurrence-free survival, progression-free survival, disease-specific survival, and overall survival.

Results

This cohort study included 27 patients (including 9 patients [33.3%] with a history of lymphoma). Most patients were male (18 of 27 [66.7%]), with a median age of 72 years (range, 53-87 years). Most primary tumors were located on the head/neck (21 of 27 [77.8%]). There were no unexpected delays in surgery. The median number of doses before surgery was 3.5 (range, 1.0-10.0). Five patients (18.5%) ultimately declined to undergo planned surgery due to clinical responses or stability, and 1 (3.7%) did not undergo surgery due to progressive disease. The overall pathologic response rate (pathological complete response [pCR] or major pathological response) was 47.4% (9 of 19), and the overall radiologic response rate (radiologic complete response or partial response) was 50.0% (8 of 16). The pCR rate (7 of 19 [36.8%]) was higher than the radiologic complete response rate (2 of 16 [12.5%]). The pCR rate among patients with cSCC and concomitant lymphoma was 25.0%. The 1-year recurrence-free survival rate was 90.9% (95% CI, 50.8%-98.7%), progression-free survival was 83.3% (95% CI, 27.3%-97.5%), disease-specific survival was 91.7% (95% CI, 53.9%-98.8%), and overall survival was 84.6% (95% CI, 51.2%-95.9%).

Conclusions and Relevance

The results of this cohort study support the reproducibility of neoadjuvant-intent immunotherapy for cSCC in the clinical setting, including for patients with a history of lymphoma. Outside of clinical trials, it is not infrequent for patients to opt out of surgery for regressing tumors. The inclusion of higher-risk patients and preference for nonsurgical treatment are 2 factors that might explain the numerically lower pathologic response rate in this institutional experience.
DDR2 signaling and mechanosensing orchestrate neuroblastoma cell fate through different transcriptome mechanisms
Authors: Vessella Theadora , Xiang Steven , Xiao Cong , Stilwell Madelyn , Fok Jaidyn , Shohet Jason , Rozen Esteban , Zhou H. Susan , Wen Qi
Published: March 2024

The extracellular matrix (ECM) regulates carcinogenesis by interacting with cancer cells via cell surface receptors. Discoidin Domain Receptor 2 (DDR2) is a collagen‐activated receptor implicated in cell survival, growth, and differentiation. Dysregulated DDR2 expression has been identified in various cancer types, making it as a promising therapeutic target. Additionally, cancer cells exhibit mechanosensing abilities, detecting changes in ECM stiffness, which is particularly important for carcinogenesis given the observed ECM stiffening in numerous cancer types. Despite these, whether collagen‐activated DDR2 signaling and ECM stiffness‐induced mechanosensing exert similar effects on cancer cell behavior and whether they operate through analogous mechanisms remain elusive. To address these questions, we performed bulk RNA sequencing (RNA‐seq) on human SH‐SY5Y neuroblastoma cells cultured on collagen‐coated substrates. Our results show that DDR2 downregulation induces significant changes in the cell transcriptome, with changes in expression of 15% of the genome, specifically affecting the genes associated with cell division and differentiation. We validated the RNA‐seq results by showing that DDR2 knockdown redirects the cell fate from proliferation to senescence. Like DDR2 knockdown, increasing substrate stiffness diminishes cell proliferation. Surprisingly, RNA‐seq indicates that substrate stiffness has no detectable effect on the transcriptome. Furthermore, DDR2 knockdown influences cellular responses to substrate stiffness changes, highlighting a crosstalk between these two ECM‐induced signaling pathways. Based on our results, we propose that the ECM could activate DDR2 signaling and mechanosensing in cancer cells to orchestrate their cell fate through distinct mechanisms, with or without involving gene expression, thus providing novel mechanistic insights into cancer progression.
Cognitive phenotype and neurodegeneration associated with Tau in Huntington's disease
Authors: Martinez‐Horta Saul , Perez‐Perez Jesús , Perez‐Gonzalez Rocío , Sampedro Frederic , Horta‐Barba Andrea , Campolongo Antonia , Rivas‐Asensio Elisa , Puig‐Davi Arnau , Pagonabarraga Javier , Kulisevsky Jaime
Published: March 2024

Objective

The clinical phenotype of Huntington's disease (HD) can be very heterogeneous between patients, even when they share equivalent CAG repeat length, age, or disease burden. This heterogeneity is especially evident in terms of the cognitive profile and related brain changes. To shed light on the mechanisms participating in this heterogeneity, the present study delves into the association between Tau pathology and more severe cognitive phenotypes and brain damage in HD.

Methods

We used a comprehensive neuropsychological examination to characterize the cognitive phenotype of a sample of 30 participants with early‐to‐middle HD for which we also obtained 3 T structural magnetic resonance image (MRI) and cerebrospinal fluid (CSF). We quantified CSF levels of neurofilament light chain (NfL), total Tau (tTau), and phosphorylated Tau‐231 (pTau‐231). Thanks to the cognitive characterization carried out, we subsequently explored the relationship between different levels of biomarkers, the cognitive phenotype, and brain integrity.

Results

The results confirmed that more severe forms of cognitive deterioration in HD extend beyond executive dysfunction and affect processes with clear posterior‐cortical dependence. This phenotype was in turn associated with higher CSF levels of tTau and pTau‐231 and to a more pronounced pattern of posterior‐cortical atrophy in specific brain regions closely linked to the cognitive processes affected by Tau.

Interpretation

Our findings reinforce the association between Tau pathology, cognition, and neurodegeneration in HD, emphasizing the need to explore the role of Tau in the cognitive heterogeneity of the disease.
Sex Differences in Time to Initiate Nonsteroidal Anti‐Inflammatory Drugs or Biologic Disease‐Modifying Antirheumatic Drugs Among Patients With Axial Spondyloarthritis
Authors: Shridharmurthy Divya , Lapane Kate L. , Baek Jonggyu , Nunes Anthony P. , Weisman Michael H. , Kay Jonathan , Liu Shao‐Hsien
Published: March 2024

Objective

We evaluated sex differences in time to initiation of receiving nonsteroidal anti‐inflammatory drugs (NSAIDs) or biologic disease‐modifying antirheumatic drugs (bDMARDs) among patients with axial spondyloarthritis (axSpA).

Methods

Using the 2013 to 2018 IBM MarketScan Database, we identified 174,632 patients with axSpA aged ≥18 years. We evaluated the time between axSpA diagnosis and the first prescription NSAID dispensing (among those with no baseline NSAIDs reception) or bDMARDs infusion/procedure claim (among those who were dispensed two or more different prescription NSAIDs in the baseline period). Adjusted hazard ratios (aHRs) for time to initiation of patients receiving NSAIDs or bDMARDs were computed using survival analyses. Cox proportional hazard models estimated associations between sex and predictors of treatment initiation.

Results

Average age at diagnosis was 48.2 years, 65.7% were female, and 37.8% were dispensed one or more NSAIDs before axSpA diagnosis. Of those who did not receive two or more different prescription NSAIDs before diagnosis, NSAID reception was initiated earlier in female patients than in male patients (NSAID reception initiators: female patients (32.9%), male patients (29.3%); aHR 1.14, 95% confidence interval [CI] 1.11–1.16). Among those who received two or more different prescription NSAIDs in the baseline period, 4.2% received a bDMARD, whereas 77.9% continued receiving NSAIDs after diagnosis. Time to bDMARD reception initiation was longer for female patients than for male patients (aHR 0.61, 95% CI 0.52–0.72), but bDMARDs were received sooner among those who received NSAIDs in the baseline period.

Conclusion

Prescription NSAID reception was more common than initiation of receiving bDMARDs among patients newly diagnosed with axSpA. Female patients appeared more likely to continue receiving NSAIDs after diagnosis, and the time to initiation of receiving bDMARDs was longer for female patients than for male patients.
Design, Additive Manufacturing, and Electromagnetic Characterization of Alumina Cellular Structures for Waveguide Antenna
Authors: Rosa Alice , Poretti Samuel , Milan Giacomo , Ortona Alberto
Published: March 2024

In this work, a design and additive manufacturing approach is successfully implemented to print via digital‐light‐processing cubic cellular alumina structures for antenna waveguides. Cellular structures’ porosity is varied during the design phase and different dielectrics are finally produced and inserted in antenna waveguides with the aim of decreasing the cutoff frequency in the range from 1 to 10 GHz. In parallel, the electromagnetic behavior of the cellular alumina structures into the antenna waveguide as the structure porosity varies is simulated. Printed samples are then tested in a laboratory setup. In the results obtained, it is shown that the antenna cutoff frequency increases as the porosity of the alumina cellular structures increases, also evidencing a linear correlation between their average dielectric constant and porosity. In this study, it is demonstrated that the dimensional accuracy achieved after the sintering process is essential because even a small (1%) deviation of the sintered sample size from the nominal ones, due to nonlinear shrinkage, highly affects their cutoff frequencies.
In Situ Forming Na─Sn Alloy/Na2S Interface Layer for Ultrastable Solid State Sodium Batteries
Authors: Liu Tinghu , Xiang Pan , Li Yunming , Li Zhendong , Sun Huazhang , Yang Jing , Tian Ziqi , Yao Xiayin
Published: March 2024

The poor interfacial compatibility between sodium superionic conductor (NASICON) electrolyte and metallic sodium anode will lead to severe dendrite penetration, impeding the application of NASICON electrolytes for solid state sodium batteries. Herein, a homogeneous SnS2 coating layer is sputtered on the surface of Na3.4Zn0.1Zr1.9Si2.2P0.8O12 electrolyte to in situ construct a kinetically stable Na─Sn alloy/Na2S interlayer, possessing superior Na affinity, low diffusion barrier, and electronic insulating character to suppress dendrite growth, which is confirmed by experiments and density‐functional theory calculations. Benefiting from the Na─Sn alloy/Na2S interphase, the critical current density of Na3.4Zn0.1Zr1.9Si2.2P0.8O12 increases from 2.4 to 9.4 mA cm−2. In addition, the obtained Na3V2(PO4)3/Na3.4Zn0.1Zr1.9Si2.2P0.8O12@SnS2/Na solid state batteries exhibit a high initial reversible discharge capacity of 115.1 mAh g−1 at 0.1 °C with an initial Coulombic efficiency of 93.6%, and a capacity retention rate of 88.1% after 1000 cycles at 1 C.
Point Calculation Detection System Based on In Suit Convolution Transistor for Clinical Diagnosis of Heart Disease
Authors: Cheng Enping , Zhang Xianghong , Wu Jianxin , Chen Hao , Liu Di , Fan Yuyang , Lian Minrui , Guo Tailiang , Chen Huipeng
Published: March 2024

Electrocardiograph signals reflect the current state of the heart and have great significance to the clinical diagnosis of the heart. Convolutional neural networks perform excellently in electrocardiograph pattern recognition. However, CNNs processing ECG signals need to convert them from 1D to 2D, leading to additional circuit and time costs in hardware. Here, a convolution organic transistor (COT) is proposed for monitoring the ECG with CNNs. Based on the surface electric field effect and trap effect, COT can directly process 1D ECG data without complex preprocessing. It can complete the convolution calculation of ECG signals ≈20 000 times per second in theory and reduce the number of devices by 83% compared to conventional arrays. Further, actual ECG signals are measured and input into the COT, which can initially recognize the type of ECG abnormality. Finally, a point calculation detection system is established with 96.2% recognition accuracy in the five‐heartbeat classification task by combining the 1D CNN.
Dual‐gradient Engineering of Urchin‐like Silver@Copper Oxide Heterostructures for Highly Stable Lithium Metal Anodes
Authors: Gao Meng , Dong Qiujiang , Yao Minjie , Wang Xingkai , Li Jinyang , Zhang Wanxing , Huang He , Guo Hao , Sun Zhaoyong , Chen Qiang , Han Xiaopeng , Hu Wenbin
Published: March 2024

Lithium‐metal anodes with excellent theoretical specific capacities (3680 mAh g−1) have attracted considerable attention for overcoming the capacity bottleneck of conventional graphite anodes. However, they often suffer from uncontrolled dendrite growth and undesirable side reactions, considerably limiting their practical application in lithium‐metal batteries. In this study, urchin‐like silver@copper oxide (Ag@CuO) heterostructures with gradient electrical conductivity and lithiophilicity are prepared using a facile liquid‐phase reduction method. The unique amphiphilic lithium mechanism of the alloying and conversion reactions effectively reduces the nucleation overpotential of the lithium metal anode and promotes a uniform lithium deposition process. Meanwhile, the in situ‐generated Li2O‐rich solid electrolyte interphase (SEI) film can further induce uniform and reversible lithium plating/stripping. All these characteristics endow the Ag@CuO anode with a high Coulombic efficiency of 98.89%, even after 1200 cycles, and long cycle life of 2800 h at a current density of 0.2 mA cm−2, thus demonstrating that such modified Li metal anodes exhibit superior compatibility with major commercial cathode materials, such as LiCoO2 (LCO) and LiNi0.8Co0.1Mn0.1O2 (NCM‐811). Hence, this study provides an effective strategy for developing practical lithium metal anodes.
Effective Promotion of the Activity and Stability of Cathodes for Protonic Ceramic Fuel Cells
Authors: Gao Hui , He Fan , Zhu Feng , Xia Jiaojiao , Du Zhiwei , Huang Yixuan , Zhu Liangzhu , Chen Yu
Published: March 2024

Protonic ceramic fuel cells (PCFCs) are emerging as effective devices for their excellent capability of converting energy. However, the sluggish oxygen reduction reaction (ORR) and poor durability of cathodes greatly limit their widespread commercialization. Herein, a multi‐cationic oxide nano‐catalyst with a nominal composition of Pr0.2Ce0.2Ni0.2Co0.2Fe0.2Ox (denoted as PCNCFO) is designed and reported, which significantly enhanced the ORR activity and durability of a typical PrBaCo2O5+δ (PBC) cathode. The PCNCFO‐coated PBC cathode delivered impressive cell performance with a small polarization resistance of only 0.18 Ω cm2 at 600 °C on symmetrical cells and a high peak power density (PPD) of 1.31 W cm−2 at 650 °C on single cells. Meanwhile, the PCNCFO‐coated PBC cathode exhibits excellent operational stability both on symmetrical and single cells. It is indicated that the Ce oxide in the nano‐catalyst coating can react with the segregated Ba to form active species, while others can activate the surface of the cathode, as indicated by the transmission electron microscope (TEM) and distribution of relaxation time (DRT) analyses.
Photostrictive Actuators Based on Freestanding Ferroelectric Membranes
Authors: Ganguly Saptam , Pesquera David , Garcia Daniel Moreno , Saeed Umair , Mirzamohammadi Nona , Santiso José , Padilla Jessica , Roque José Manuel Caicedo , Laulhé Claire , Berenguer Felisa , Villanueva Luis Guillermo , Catalan Gustau
Published: March 2024

Complex oxides offer a wide range of functional properties, and recent advances in the fabrication of freestanding membranes of these oxides are adding new mechanical degrees of freedom to this already rich functional ecosystem. Here, photoactuation is demonstrated in freestanding thin film resonators of ferroelectric Barium Titanate (BaTiO3) and paraelectric Strontium Titanate (SrTiO3). The free‐standing films, transferred onto perforated supports, act as nano‐drums, oscillating at their natural resonance frequency when illuminated by a frequency‐modulated laser. The light‐induced deflections in the ferroelectric BaTiO3 membranes are two orders of magnitude larger than in the paraelectric SrTiO3 ones. Time‐resolved X‐ray micro‐diffraction under illumination and temperature‐dependent holographic interferometry provide combined evidence for the photostrictive strain in BaTiO3 originating from a partial screening of ferroelectric polarization by photo‐excited carriers, which decreases the tetragonality of the unit cell. These findings showcase the potential of photostrictive freestanding ferroelectric films as wireless actuators operated by light.
High Open‐Circuit Voltage Organic Solar Cells with 19.2% Efficiency Enabled by Synergistic Side‐Chain Engineering
Authors: Xu Renjie , Jiang Yuanyuan , Liu Feng , Ran Guangliu , Liu Kerui , Zhang Wenkai , Zhu Xiaozhang
Published: March 2024

Restricted by the energy‐gap law, state‐of‐the‐art organic solar cells (OSCs) exhibit relatively low open‐circuit voltage (VOC) because of large nonradiative energy losses (ΔEnonrad). Moreover, the trade‐off between VOC and external quantum efficiency (EQE) of OSCs is more distinctive; the power conversion efficiencies (PCEs) of OSCs are still <15% with VOCs of >1.0 V. Herein, the electronic properties and aggregation behaviors of non‐fullerene acceptors (NFAs) are carefully considered and then a new NFA (Z19) is delicately designed by simultaneously introducing alkoxy and phenyl‐substituted alkyl chains to the conjugated backbone. Z19 exhibits a hypochromatic‐shifted absorption spectrum, high‐lying lowest unoccupied molecular orbital energy level and ordered 2D packing mode. The D18:Z19‐based blend film exhibits favorable phase separation with face‐on dominated molecular orientation, facilitating charge transport properties. Consequently, D18:Z19 binary devices afford an exciting PCE of 19.2% with a high VOC of 1.002 V, surpassing Y6‐2O‐based devices. The former is the highest PCE reported to date for OSCs with VOCs of >1.0 V. Moreover, the ΔEnonrad of Z19‐ (0.200 eV) and Y6‐2O‐based (0.155 eV) devices are lower than that of Y6‐based (0.239 eV) devices. Indications are that the design of such NFA, considering the energy‐gap law, could promote a new breakthrough in OSCs.
Biocatalytic Regio‐ and Enantiocomplementary Synthesis of Chiral Aryloxazolidinones
Authors: Zhou Xiao‐Ying , Wang Yuan‐Fei , Fu Hong‐Kang , Wang Hui‐Hui , Chen Yong‐Zheng , Wan Nan‐Wei
Published: March 2024

We described the protein engineering of the halohydrin dehalogenase HheG to enhance its R enantioselectivity for the synthesis of chiral 4‐aryloxazolidinones via α‐regioselective ring‐opening of aryl epoxides with cyanate. Additionally, we achieved the inversion of its regioselectivity and enantioselectivity, resulting in a HheG variant tailored for the synthesis of chiral 5‐aryloxazolidinones via β‐regioselective and S‐enantioselective ring‐opening of aryl epoxides with cyanate. Leveraging these engineered mutants, we developed a biocatalytic platform capable of synthesis of both chiral 4‐aryloxazolidinones (up to 47% yield, 98% ee, and 99% regioselectivity) and chiral 5‐aryloxazolidinones (up to 46% yield, >99% ee, and 98% regioselectivity). Furthermore, a collaborative approach utilizing two regio‐ and enantioselective HheG mutants has been demonstrated to enable the simultaneous synthesis of chiral 4‐aryloxazolidinones and chiral 5‐aryloxazolidinones.
Synthesizing Silyl Arylsulfonyl Hydrazones as Silyldiazomethane Precursors and Their Use in Rhodium‐Catalyzed Reactions
Authors: Tsuruda Shuji , Saito Keigo , Matsuzaki Tsuyoshi , Zhou Da‐Yang , Suzuki Takeyuki , Sako Makoto , Arisawa Mitsuhiro , Murai Kenichi
Published: March 2024

A method for synthesizing silyl arylsulfonyl hydrazones as silyldiazomethane precursors has been developed. Although silyldiazomethanes are an important class of diazo compounds, their use in intramolecular cyclization reactions has not been fully explored despite the rich chemistry of diazo compounds, particularly metal carbenoid chemistry. The fundamental challenge underlying the absence of such studies is the lack of a method for synthesizing silyldiazomethanes with functional groups that can react with metal carbenoids. The method reported here provides access to variety of silyl arylsulfonyl hydrazones with functional groups such as ethers, carbamates, and alkynes, which can serve as reaction sites for metal carbenoids. A one‐pot hydrazone formation using unstable formylsilane formed in situ is key to a successful synthesis. The use of 2,4,6‐trimethylbenzenesulfonohydrazide contributed toward achieving broad generality in hydrazone formation. The synthetic potential of this method was demonstrated through the generation of silyldiazomethane and its transformation to several silacycles.
A Natural Peptide from A Traditional Chinese Medicine Has the Potential to Treat Chronic Atrophic Gastritis by Activating Gastric Stem Cells
Authors: Li Ke , Ma Xiuying , Li Zihao , Liu Ya , Shen Guiyan , Luo Zecheng , Wang Dong , Xia Li , Wang Zhengting , Tian Ming , Liu Huijuan , Geng Funeng , Li Baojie
Published: March 2024

Chronic atrophic gastritis (AG) is initiated mainly by Helicobacter pylori infection, which may progress to stomach cancer following the Correa's cascade. The current treatment regimen is H. pylori eradication, yet evidence is lacking that this treatment is effective on later stages of AG especially gastric gland atrophy. Here, using AG mouse model, patient samples, gastric organoids, and lineage tracing, this study unraveled gastric stem cell (GSC) defect as a crucial pathogenic factor in AG in mouse and human. Moreover, a natural peptide is isolated from a traditional Chinese medicine that activated GSCs to regenerate gastric epithelia in experimental AG models and revitalized the atrophic gastric organoids derived from patients. It is further shown that the peptide exerts its functions by stabilizing the EGF‐EGFR complex and specifically activating the downstream ERK and Stat1 signaling. Overall, these findings advance the understanding of AG pathogenesis and open a new avenue for AG treatment.
Indium Nitride Nanowires: Low Redox Potential Anodes for Lithium‐Ion Batteries
Authors: Guo Tianqi , Zhou Yurong , Wang Zhongchang , Cunha Joao , Alves Cristiana , Ferreira Paulo , Hou Zhaohui , Yin Hong
Published: March 2024

Advanced lithium‐ion batteries (LIBs) are crucial to portable devices and electric vehicles. However, it is still challenging to further develop the current anodic materials such as graphite due to the intrinsic limited capacity and sluggish Li‐ion diffusion. Indium nitride (InN), which is a new type of anodic material with low redox potential (<0.7 V vs Li/Li+) and narrow bandgap (0.69 eV), may serve as a new high‐energy density anode material for LIBs. Here, the growth of 1D single crystalline InN nanowires is reported on Au‐decorated carbon fibers (InN/Au‐CFs) via chemical vapor deposition, possessing a high aspect ratio of 400. The binder‐free Au‐CFs with high conductivity can provide abundant sites and enhance binding force for the dense growth of InN nanowires, displaying shortened Li ion diffusion paths, high structural stability, and fast Li+ kinetics. The InN/Au‐CFs can offer stable and high‐rate Li delithiation/lithiation without Li deposition, and achieve a remarkable capacity of 632.5 mAh g−1 at 0.1 A g−1 after 450 cycles and 416 mAh g−1 at a high rate of 30 A g−1. The InN nanowires as battery anodes shall hold substantial promise for fulfilling superior long‐term cycling performance and high‐rate capability for advanced LIBs.
UV‐Triggered Hydrogel Coating of the Double Network Polyelectrolytes for Enhanced Endothelialization
Authors: Wang Xing‐wang , Yin Yi‐jing , Wang Jing , Yu Hong‐mei , Tang Qian , Chen Zhao‐yang , Fu Guo‐sheng , Ren Ke‐feng , Ji Jian , Yu Lu
Published: March 2024

The left atrial appendage (LAA) occluder is an important medical device for closing the LAA and preventing stroke. The device‐related thrombus (DRT) prevents the implantation of the occluder in exerting the desired therapeutic effect, which is primarily caused by the delayed endothelialization of the occluder. Functional coatings are an effective strategy for accelerating the endothelialization of occluders. However, the occluder surface area is particularly large and structurally complex, and the device is subjected to a large shear friction in the sheath during implantation, which poses a significant challenge to the coating. Herein, a hydrogel coating by the in situ UV‐triggered polymerization of double‐network polyelectrolytes is reported. The findings reveal that the double network and electrostatic interactions between the networks resulted in excellent mechanical properties of the hydrogel coating. The sulfonate and Arg‐Gly‐Asp (RGD) groups in the coating promoted hemocompatibility and endothelial growth of the occluder, respectively. The coating significantly accelerated the endothelialization of the LAA occluder in a canine model is further demonstrated. This study has potential clinical benefits in reducing both the incidence of DRT and the postoperative anticoagulant course for LAA closure.
Modernizing smallholder agriculture and achieving food security: An exploration in machinery services and labor reallocation in China
Authors: Zou Baoling , Mishra Ashok K.
Published: March 2024

This study discusses the modernization of smallholder agriculture in China, where most farms are small, and farms' parcels are fragmented. The study puts forward a framework of agricultural modernization by vertical division of labor and specialized production in agriculture. We posit that hiring machinery services could be a pathway to connect smallholders with modern agriculture and achieve food security in China. Using household‐level data from China, this study examines how hiring machinery services affects farm productivity and rural households' welfare. Findings show that mechanization services increased rural Chinese families' food security and agricultural productivity. Hiring machinery services improves smallholders' income by influencing the input efficiency of maize production and increasing participation in off‐farm work. Our findings highlight the importance of technology to improve smallholder agriculture and food security, not only in China but also in other South and Southeast Asian countries.
Experiment and microscopic analysis for the separation of isopropanol‐water using hydrophobic deep eutectic solvents
Authors: Ruan Jiuxu , Wang Yu , Su Zihao , Fan Dingchao , Zhou Mengjin , Zhang Zeyu , Qi Jianguang , Wang Yinglong , Cui Peizhe
Published: March 2024

In this study, a method for separating isopropanol from wastewater using hydrophobic deep eutectic solvents (DESs) synthesized from terpenes and capric acid was proposed. The distribution coefficient and selectivity value of isopropanol (IPA) in the solvents were determined by liquid–liquid extraction experiments, and the extraction performances of the solvents at different molar ratios and temperatures were studied. From the perspective of molecular dynamics simulations, the experimental results were verified by mechanism analysis, the contribution of hydrogen bond donors (HBDs) and hydrogen bond acceptors (HBAs) to the selective separation of isopropanol was explained. The interaction energies, radial distribution functions, normal density distribution, and mean square deviations between the atoms were used to analyze the interactions between the components of the DESs and IPA/water. It was observed that the DESs have a good extraction effect on IPA, which verifies the good application prospects of DESs in wastewater solutions containing alcohol compounds.
Developmental and behavioral phenotypes of pediatric patients with PTEN hamartoma tumor syndrome
Authors: MacFarland Suzanne P. , Duvall Melani , Kemajou Raissa Tchetcho , Baldino Sarah E. , Zelley Kristin , Black Chelsea , Thomas Allison , Thomas Nina H. , Ruffner Melanie , Li Yimei , Miller Judith S. , Brodeur Garrett M. , Shabason Emily
Published: March 2024

Our study characterized the neurodevelopmental spectrum of individuals with PTEN Hamartoma Tumor Syndrome (PHTS), a syndrome that predisposes to both neurodevelopmental phenotypes and cancer risk. We aim to better understand life‐impacting neurodevelopmental features of PHTS. Our study recruited 20 children/adolescents with PHTS, who were then administered assessments for autism spectrum disorder (ASD) and other neurocognitive measures, including assessment of IQ, executive and adaptive functioning, and health‐related quality of life. Thirteen individuals (65%) were identified as having ASD, of which five were newly diagnosed during the study. Of those, ASD symptom severity was in the mild–moderate range for 77%. Overall, IQ was in the average range, with a mean of 92.61 (SD 24.45, p = 0.5), though there was a non‐statistically significant trend toward individuals without ASD having a higher mean IQ (102.7 vs 82.3; p = 0.1). Subjects had significant impairment in processing speed (mean 75.38, SD 24.75, p < 0.05), decreased adaptive functioning skills across all domains, and a trend toward having more executive functioning problems. Individuals with PHTS are at increased risk of neurodevelopmental disorders, including ASD and impaired executive and adaptive functioning. Although clear guidelines exist for cancer surveillance for individuals with PHTS, additional guidelines and screening for neurodevelopmental disorders are warranted.