bluuebunny/crossref_metadata_2025 huggingface dataset:
Estimation of the drying process in porous media using the parallel and series moitrue transfer model
Authors: Ma Xiaoyan , Bennacer Rachid , Benboudjema Farid , Chen Longfei
Published: June 2023

Moisture transfer is a very common phenomenon in a wide range of engineering fields, such as civil engineering (cement-based constructions), food processing, mining and soil penetration, drying and imbibition of porous media (including phase change materials), etc. Based on the diffusion assumptions, the classical adopted model (especially for drying) is completed by the liquid permeation. However, it is still inadequate to compromise the complexity of the porous structures. In this work, a “parallel-series” assumption of moisture transferring pattern is proposed, comprising different forms of moisture presence and the coupling styles, achieved by an interpolation factor to cover all the possible contribution ratios of the two patterns. The drying of porous material is performed under two ambient conditions over 160 days on both local and global parameters, i.e., relative humidity (RH) and mass loss (ML). In the simulation part, a nonlinear diffusion-drying model containing liquid permeation and vapor diffusion in the transfer mechanism is applied to estimate the drying process, and compared with the experiment data. Results show different tendency for the two cases of either the permeation dominating case or the no-dominating case. This approach also clarifies the transition from evaporation of weak permeability for vapor diffusivity (square root behavior) towards the linear and faster behavior, which is observed in more porous and permeable materials for the vapor diffusion.
Advanced Midwifery Practice
Authors: Krahl Astrid
Published: June 2023

Theorie trifft Praxis

Die Akademisierung der Ausbildung zur Hebamme ist in Deutschland erreicht. Mit dem
Bachelorabschluss werden nun weitere akademische Entwicklungsmöglichkeiten
eröffnet. Üblicherweise können dies Studiengänge
sein, die speziell für Management- und Lehrtätigkeiten oder eine
akademische Karriere in Forschung und Wissenschaft qualifizieren. Doch welche
akademischen Entwicklungschancen und Karrierewege sollte es für Hebammen
geben, die gerne weiterhin mit Frauen, ihren Kindern und Familien arbeiten
wollen?
Chancen der Akademisierung für Hebammen – die
Entwicklung eines Profils Advanced Practice Midwife in der
Schweiz
Authors: Friedli Beatrice
Published: June 2023

Die Akademisierung des Hebammenberufs geschieht nicht von heute auf morgen,
sondern etabliert sich über Jahre – so war es auch in der
Schweiz. Beatrice Friedli ist seit 27 Jahren für die Ausbildung von
Hebammen zuständig. In dieser Zeit hat sie die gesamte akademische
Entwicklung des Hebammenberufs in der Schweiz erlebt, mitgestaltet und
begleitet. Hier erzählt sie von ihren Erfahrungen.
Erstvorstellung des Pentafecta-Scores als Qualitätsinstrument der Outcome-Bewertung einer chirurgischen Primärtherapie an Patienten mit Peniskarzinom
Authors: May Matthias , Lebentrau Steffen , Ayres Ben , Spiess Philippe E. , Watkin Nick , Albersen Maarten , Protzel Chris , Chahoud Jad , Brouwer Oscar R. , Pettaway Curtis A. , Pagliaro Lance C. , Necchi Andrea , Hakenberg Oliver W.
Published: June 2023

Hintergrund Aktuell wurde mit dem Tetrafecta-Score das erste Instrument zur Beurteilung der Behandlungsqualität in der chirurgischen Primärtherapie des Peniskarzinoms (PECa) publiziert. Eine externe wissenschaftliche Auseinandersetzung mit den ihn definierenden Einzelkriterien steht bislang noch aus und bildet das Studienziel.

Material und Methode Es wurde eine internationale Arbeitsgruppe bestehend aus 12 Urologen und einem Onkologen mit klinischer und akademisch-wissenschaftlicher Expertise auf dem Gebiet des Peniskarzinoms gegründet. In einem modifizierten vierstufigen Delphi-Prozess wurden unter Einbeziehung der Tetrafecta-Kriterien insgesamt 13 Kriterien für PECa-Patienten in den klinischen AJCC-Stadien 1–4 (T1–3N0–3, aber M0) definiert, von denen in einer geheimen Abstimmung jeder der Experten 5 auswählen musste, um dadurch einen individuellen Pentafecta-Score zu generieren. Anschließend wurde das Rating der Experten aggregiert ausgewertet und dadurch ein finaler Pentafecta-Score gebildet.

Ergebnisse Keines der ursprünglichen Tetrafecta-Kriterien wurde in den finalen Pentafecta-Score übernommen, der sich aus den folgenden Kriterien zusammensetzt: 1.) Organerhalt, sofern immer möglich (≤T2), jedoch stets unter Wahrung eines negativen chirurgischen Schnittrandes, 2.) beidseitige inguinale Lymphadenektomie (ILAE) ab pT1G2N0, 3.) perioperative Chemotherapie sollte erfolgen, sofern durch die Leitlinien indiziert, 4.) ILAE sollte, sofern indiziert, in einem zeitlichen Abstand von maximal 3 Monaten zur Primärtumorresektion erfolgen und 5.) die behandelnde Klinik sollte im Minimum 15 chirurgische Primärtherapien bei PECa-Patienten durchführen. Nur 7 der 13 Experten (54%) zeigten eine starke Korrelation ihres individuellen mit dem finalen Pentafecta-Score (rsp >0.60).

Schlussfolgerung Auf der Basis eines moderierten Abstimmungsprozesses unter internationalen PECa-Experten wurde ein Pentafecta-Score als Qualitätssicherungs-Instrument für die chirurgische Primärtherapie gebildet, der nun anhand von patientenrelevanten und patientenberichteten Endpunkten zu validieren ist.
A Prospective Study of Social Needs Associated with Mental Health among Postpartum Patients Living in Underserved Communities
Authors: Lafferty Ashlyn K. , Duryea Elaine , Martin Robert , Moseley Lisa , Lopez Melissa , McIntire Donald D. , Spong Catherine Y. , Nelson David B.
Published: June 2023

Objective Given the rising rates of maternal morbidity and mortality in the United States and the contribution of mental illness, especially among individuals living in underresourced communities, the objective was to evaluate the prevalence of unmet health-related social needs and their impact on perinatal mental health outcomes.

Study Design This was a prospective observational study of postpartum patients residing within regions with increased rates of poor perinatal outcomes and sociodemographic disparities. Patients were enrolled in a multidisciplinary public health initiative “extending Maternal Care After Pregnancy (eMCAP)” between October 1, 2020 and October 31, 2021. Unmet health-related social needs were assessed at delivery. Symptoms of postpartum depression and anxiety were evaluated at 1 month postpartum utilizing the Edinburgh Postnatal Depression Scale (EPDS) and Generalized Anxiety Disorder-7 (GAD7) screening tools, respectively. Mean EPDS and GAD7 scores and odds of screening positive (scoring ≥ 10) were compared among individuals with and without unmet health-related social needs with p < 0.05 considered significant.

Results Of participants enrolled in eMCAP, 603 completed at least one EPDS or GAD7 at 1 month. Most had at least one social need, most commonly dependence on social programs for food (n = 413/603; 68%). Individuals lacking transportation to medical (odds ratio [OR]: 4.0, 95% confidence interval [CI]: 1.2–13.32) and nonmedical appointments (OR: 4.17, 95% CI: 1.08–16.03) had significantly higher odds of screening positive on EPDS while participants lacking transportation to medical appointments (OR: 2.73, 95% CI: 0.97–7.70) had significantly higher odds of screening positive on GAD7.

Conclusion Among postpartum individuals in underserved communities, social needs correlate with higher depression and anxiety screening scores. This highlights the need to address social needs to improve maternal mental health.

Key Points
Bewegungskontrolle und Bewegungsdysfunktion (2) Tests und Übungen für die Körperwahrnehmung
Authors: Luomajoki Hannu
Published: June 2023

Neben aktivem Training empfiehlt es sich, die Körperwahrnehmung von Patient*innen mit Rückenschmerzen einzuschätzen und gegebenenfalls zu verbessern.
Development of an accurate optical sensor for the in situ real-time determination of the chemical oxygen demand of seawater
Authors: Liu Jialiang , Ma Haikuan , Yuan Guang , Wang Zhaoyu , Ma Ran , Zhang Shuwei , Cao Xuan , Wang Yang , Liu Yan
Published: June 2023

Chemical oxygen demand (COD) is an important indicator for monitoring the quality of seawater. The COD of seawater reflects the levels of organic pollutants in the water. Methods that are commonly used to measure the COD of seawater have high accuracy, good repeatability, and low costs. However, using them for the in situ real-time monitoring of the COD of seawater is unfavorable because they require complex procedures and a long measurement time and may cause pollution to the environment. This paper reports on an optical sensor that accurately determines the COD of seawater in situ. The COD determination is based on the absorption of ultraviolet and visible lights with different wavelengths by organic matter in the water. Single-point LEDs emitting lights with different wavelengths (254, 265, 280, and 546 nm) were used as sources of excitation lights, and photodiodes were used as receiving devices. The optical system, circuit system, and mechanical structure of the sensor were efficiently integrated. The inversion of the COD of seawater was obtained after turbidity correction using the multiple linear regression algorithm. The maximum measurement error, detection limit, and repeatability of the sensor were 5%, 0.05 mg/l, and 0.62%, respectively. Moreover, the R2 values for correlations between COD values and absorbance values measured at three wavelengths (254, 265, and 280 nm) were above 0.99. Overall, the sensor is suitable for the in situ real-time monitoring of the COD of seawater. It requires a short measurement time and generates no pollution.
Finite element analysis of transverse size effect on the pyroelectric Pb(In1/2Nb1/2)O3–Pb(Mg1/3Nb2/3)O3 –PbTiO3 thin film for infrared array applications
Authors: Cao Liang , Wang Jiasheng , Zhang Qiaozhen , Duan Zhihua , Wang Tao , Tang Yanxue , Zhao Xiangyong , Chen Zibin , Wang Feifei
Published: June 2023

Exploring and revealing the influence of the pyroelectric thin film array element size on its structure and pyroelectric performance is crucial for designing integrated pyroelectric infrared detectors. In this work, the transverse size effect on the piezoelectric, dielectric, and especially the pyroelectric properties for a new-generation relaxor ferroelectric material Pb(In1/2Nb1/2)O3–Pb(Mg1/3Nb2/3)O3–PbTiO3 (PIMNT) was studied by a finite element method. The lateral size-dependent piezoelectric and dielectric properties of the PIMNT thin film indicated that with the decrease in the transverse size, the piezoelectric constant d33 and relative dielectric constant εr increased substantially. The piezoelectric constant d33 and relative dielectric constant εr along ⟨001⟩ and ⟨011⟩ orientation increased faster than those along ⟨111⟩. A critical aspect ratio (in this paper, it was defined as radius/thickness) was found around 1:1 for three directions. We further discovered that the pyroelectric coefficient for PIMNT thin film along the ⟨111⟩ direction (the best crystallographic orientation for pyroelectric performance) decreased from 8.5 × 10−4 to 8.0 × 10−4 C/(m2·K) with the aspect ratio down to 0.01. The variation of the piezoelectric, dielectric, and pyroelectric properties originated from the declamping of the PIMNT thin film from the substrate. This finding gives insight into the transverse size effect on the electrical properties of new-generation relaxor PIMNT thin film and provides a guidance for designing high-performance infrared array detectors.
Repartitioned Brillouin-Wigner perturbation theory with a size-consistent second-order correlation energy
Authors: Carter-Fenk Kevin , Head-Gordon Martin
Published: June 2023

Second-order Møller-Plesset perturbation theory (MP2) often breaks down catastrophically in small-gap systems, leaving much to be desired in its performance for myriad chemical applications such as noncovalent interactions, thermochemistry, and dative bonding in transition metal complexes. This divergence problem has reignited interest in Brillouin-Wigner perturbation theory (BWPT), which is regular at all orders but lacks size consistency and extensivity, severely limiting its application to chemistry. In this work, we propose an alternative partitioning of the Hamiltonian that leads to a regular BWPT perturbation series that, through the second order, is size-extensive, size-consistent (provided its Hartree–Fock reference is also), and orbital invariant. Our second-order size-consistent Brillouin-Wigner (BW-s2) approach can describe the exact dissociation limit of H2 in a minimal basis set, regardless of the spin polarization of the reference orbitals. More broadly, we find that BW-s2 offers improvements relative to MP2 for covalent bond breaking, noncovalent interaction energies, and metal/organic reaction energies, although rivaling coupled-cluster with single and double substitutions for thermochemical properties.
Development of a resonant screw-driven piezoelectric motor operating in single-mode vibration
Authors: Pan Qiaosheng , Wang Ya , Wan Aode , Zhao Mingfei , Li Chen , Li Ruijun
Published: June 2023

A resonant screw-driven piezoelectric motor operating in single-mode vibrations is proposed, designed, manufactured, and studied. The motor is constructed with a stator and a threaded rotor. The stator consists of a hollow parallelogram metal elastomer and two piezoelectric ceramic plates. The motor is excited by a single-phase signal to produce two separate vibration modes: the first expansion mode (B1 mode) and the second expansion mode (B2 mode). Each mode drives the threaded rotor in one direction, and the bidirectional motion is achieved by switching the two modes. The construction is designed, and modal simulation is performed using finite element software to determine the structural parameters. A frequency-domain analysis is performed to obtain the frequency response characteristics, and the motion trajectories of the stator are obtained using transient analysis. Finally, a prototype is produced, and experiments are conducted. Experimental results indicate that the no-load speeds of the motor under the 200 Vp-p voltage excitation are 1.67 and 1.04 mm/s in the two modes, which correspond to maximum loads of 35 and 20 mN, respectively.
Influence of carotid tortuosity on the hemodynamics in cerebral aneurysms
Authors: Nagargoje Mahesh S. , Asif S. , Nekkanti Ram Kishan , Krishnakumar K , Kannath Santhosh K. , Sudhir B. J. , Patnaik B. S. V.
Published: June 2023

Clinical observations indicate that the shape and tortuosity of the carotid siphon are some of the contributing factors to the initiation and growth of an aneurysm. The present study explores the validity of this observation by performing systematic numerical simulations. Computational fluid dynamics (CFD) based calculations are performed to compare and contrast four different types of patient-specific carotid siphons, viz., C-, S-, U-, and helical shape, to investigate the hemodynamic influences on flow features, secondary flow patterns, and helicity. Fewer curved regions and the presence of local acute curvature were found to result in higher velocity magnitude, leading to giant sidewall aneurysms in the distal end of this curvature. In contrast, a larger number of curved regions in the parent vessel resulted in disturbed flow and reduced maximum streamwise velocity. When the velocity is lower, smaller aneurysms are observed at the bifurcation carina. The influence of siphon tortuosity, which is exemplified through the Dean number and linked to secondary flows, causes higher helicity when the vessel is more tortuous. It is hypothesized that a highly tortuous vessel protects the further growth of an aneurysm. This is in contrast to a less tortuous vessel with single acute curvature and prone to further expansile behavior of an aneurysm.
Role of the single-particle dynamics in the transverse current autocorrelation function of a liquid metal
Authors: Guarini Eleonora , Bafile Ubaldo , Colognesi Daniele , Cunsolo Alessandro , De Francesco Alessio , Formisano Ferdinando , Montfrooij Wouter , Neumann Martin , Barocchi Fabrizio
Published: June 2023

A recent simulation study of the transverse current autocorrelation of the Lennard-Jones fluid [Guarini et al., Phys. Rev. E 107, 014139 (2023)] revealed that this function can be perfectly described within the exponential expansion theory [Barocchi et al., Phys. Rev. E 85, 022102 (2012)]. However, above a certain wavevector Q, not only transverse collective excitations were found to propagate in the fluid, but a second oscillatory component of unclear origin (therefore called X) must be considered to fully account for the time dependence of the correlation function. Here, we present an extended investigation of the transverse current autocorrelation of liquid Au as obtained by ab initio molecular dynamics in the very wide range of wavevectors 5.7 ≤ Q ≤ 32.8 nm−1 in order to also follow the behavior of the X component, if present, at large Q values. A joint analysis of the transverse current spectrum and its self-portion indicates that the second oscillatory component arises from the longitudinal dynamics, as suggested by its close resemblance with the previously determined component accounting for the longitudinal part of the density of states. We conclude that such a mode, albeit featuring a merely transverse property, fingerprints the effect of longitudinal collective excitations on single-particle dynamics, rather than arising from a possible coupling between transverse and longitudinal acoustic waves.
Light-weight wideband electromagnetic wave absorber based on aramid paper
Authors: Han Ye , Li Qi , Li Bo , Chen Jiayue , Xiu Xin , Che Wenquan , Xue Quan
Published: June 2023

A lightweight wideband honeycomb absorber is theoretically and experimentally investigated. The proposed absorber is constructed of aramid paper, which contains carbon fibers to absorb partially the incident electromagnetic wave. Graded silver paste circuits are also printed on aramid paper to improve the impedance matching properties and, thus, achieve wideband absorption performance. An absorber sample was fabricated and measured to verify the design strategies. The designed absorber has a fractional absorption bandwidth of 133% from 3.6–18 GHz, with a thickness of 0.19λL at the lowest frequency. The total weight of the absorber is 18.2 g, with a density of 28.4 kg/m3.
A wideband absorber working in the L- and S-bands based on magnetic materials
Authors: Shou Haijun , Feng Junlang , Qi Buxiong , Qiao Liang , Niu Tiaoming , Mei Zhonglei
Published: June 2023

In this paper, a multi-layered microwave absorber that can work in the L- and S-bands is proposed. The absorber is composed of a traditional medium and magnetic material coatings. A genetic algorithm is used to achieve rapid design of a multi-layered absorber. The absorptivity of the absorber is more than 90% in 1.13–4.36 GHz under normal incidence, i.e., 117.7% fractional bandwidth. Moreover, the total thickness is 13 mm, corresponding to 0.049λ0 at the lowest operating frequency. Meanwhile, the absorber also has good wide-angle and polarization-independent characteristics. When the incident angle increases to 40°, it still can keep stable absorption in both TE and TM polarization modes. The working mechanism of the absorber is analyzed from the perspective of equivalent complex impedance, transmission line theory, and power loss density. Finally, a sample was fabricated and measured. The experimental results agree well with numerical simulations, achieving ultra-broadband and ultra-low frequency absorption.
A dual-domain 3
ω
method for measuring the in-plane thermal conductivity of high-conductive thin films
Authors: Liu Paiting , Wen Yue , Siah Chun Fei , Pam Mei Er , Xu Baochang , Thean Aaron Voon-Yew , Lim Yeow Kheng , Shin Sunmi
Published: June 2023

The thermal conductivity measurement of films with submicrometer thicknesses is difficult due to their exceptionally low thermal resistance, which makes it challenging to accurately measure the temperature changes that occur as heat flows through the film. Thus, specialized and sensitive measurement techniques are required. 3ω method is a widely used and reliable tool for measuring the thermal conductivity of films. However, the high in-plane thermal conductivity in thin films results in rapid heat dissipation across the thin film, resulting in poor measurement sensitivity and making it difficult to accurately measure the temperature gradient with the traditional 3ω method. Also, the traditional 3ω method requires cross-plane thermal conductivity to derive the in-plane counterpart. Here, we introduce a dual-domain 3ω method that adopts AC-modulated heating and electrode arrays facilitating surface temperature profiling: (1) the sensitivity was significantly improved due to the employment of low-thermal-conductivity-substrate, and (2) cross-plane thermal conductivity is not required for the analysis of in-plane counterpart. This measurement platform allows us to control heat penetration in depth via varied heating frequencies as well as spatial temperature detection through laterally distributed electrodes on the thin film surface. By utilizing the described method, we have determined the in-plane thermal conductivity of a copper film, having a thickness of 300 nm, which was found to be 346 Wm−1K−1 and validated by the Wiedemann–Franz law.
Understanding the yielding behavior of graphene oxide colloids via experimental strain decomposition
Authors: Rogers Simon A.
Published: June 2023

Graphene oxide (GO) has attracted attention in materials science and engineering due to its large aspect ratio and dispersibility in polar solvent including water. It has recently been applied to direct-ink-writing (DIW) printing to realize the fabrication of three-dimensional structures, suggesting a wide variety of potential applications. Without post-processing, DIW printing requires yield stress fluids to fully build three-dimensional objects. The key properties of these inks are the yield stress and the viscoelastic properties during yielding. DIW ink rheology has therefore received significant interest in materials science, as well as mechanical and chemical engineering. Despite this interest, the yielding process has not been clearly elucidated and understanding yielding remains an outstanding problem. In this study, we discuss the yielding behavior of GO colloids via oscillatory rheology by decomposing the total strain into the recoverable and unrecoverable parts through iterative experimental techniques. The recoverable and unrecoverable responses represent viscoelastic solid and plastic properties, respectively, and they are used to determine the averaged storage and dissipation of energies. By mapping these contributions, we more clearly elucidate the yielding behavior of the GO colloids and suggest guidelines for energy efficiency. Beyond the specific lessons learned regarding the DIW-relevant rheology of GO colloids, our study contributes to an evolving development of material-centric and energy-focused methods for understanding the out-of-equilibrium rheological physics associated with the yielding of soft materials.
Graphic contrastive learning analyses of discontinuous molecular dynamics simulations: Study of protein folding upon adsorption
Authors: Zheng Size , Wei Yong , Lin Yuewei , Wei Tao
Published: June 2023

A comprehensive understanding of the interfacial behaviors of biomolecules holds great significance in the development of biomaterials and biosensing technologies. In this work, we used discontinuous molecular dynamics (DMD) simulations and graphic contrastive learning analysis to study the adsorption of ubiquitin protein on a graphene surface. Our high-throughput DMD simulations can explore the whole protein adsorption process including the protein structural evolution with sufficient accuracy. Contrastive learning was employed to train a protein contact map feature extractor aiming at generating contact map feature vectors. Subsequently, these features were grouped using the k-means clustering algorithm to identify the protein structural transition stages throughout the adsorption process. The machine learning analysis can illustrate the dynamics of protein structural changes, including the pathway and the rate-limiting step. Our study indicated that the protein–graphene surface hydrophobic interactions and the π–π stacking were crucial to the seven-stage adsorption process. Upon adsorption, the secondary structure and tertiary structure of ubiquitin disintegrated. The unfolding stages obtained by contrastive learning-based algorithm were not only consistent with the detailed analyses of protein structures but also provided more hidden information about the transition states and pathway of protein adsorption process and structural dynamics. Our combination of efficient DMD simulations and machine learning analysis could be a valuable approach to studying the interfacial behaviors of biomolecules.
Severe, large-scale bushfire threatens metapopulation function of quokka (Setonix brachyurus) in south-western Australia
Authors: Bain Karlene , Halley Merril , Wayne Adrian
Published: June 2023

Background The risk of large, severe bushfires is increasing in Australia, and little is known about their impact on threatened species. Aims This study aimed to investigated the abundance, occupancy and metapopulation structure of the quokka (Setonix brachyurus) for 5 years following a large, severe bushfire in Western Australia. Methods Data collected across spatiotemporally replicated transects were used to estimate probabilities of occupancy and abundance, and to evaluate the influence of covariates. Key results Quokka abundance was reduced to 16% of pre-fire levels, with distances up to 74 km separating subpopulations. Recolonising quokkas occupied habitat in parts of the landscape that had retained some vertical vegetation structure and contained a sedge-dominated understorey, and where damage by feral pigs was low. This coincided with topographic refugia that consisted of deep, mesic riparian systems or perched wetland systems. After 5 years, abundance had increased to 46% of pre-fire levels, with distances of 5–30 km separating subpopulations. Conclusion Quokka recovery rate is slower than expected, and the metapopulation remains vulnerable to further fragmentation arising from disturbances that affect habitat patch suitability and movement corridors. Implications Proactive protection of refugia and spatiotemporal habitat connectivity within and surrounding the fire scar is critical for metapopulation recovery.
China, the Democratic Republic of the Congo, and artisanal cobalt mining from 2000 through 2020
Authors: Gulley Andrew L.
Published: June 2023

From 2000 through 2020, demand for cobalt to manufacture batteries grew 26-fold. Eighty-two percent of this growth occurred in China and China’s cobalt refinery production increased 78-fold. Diminished industrial cobalt mine production in the early-to-mid 2000s led many Chinese companies to purchase ores from artisanal cobalt miners in the Democratic Republic of the Congo (DRC), many of whom have been found to be children. Despite extensive research on artisanal cobalt mining, fundamental questions about its production remain unanswered. This gap is addressed here by estimating artisanal cobalt production, processing, and trade. The results show that, while total DRC cobalt mine production grew from 11,000 metric tons (t) in 2000 to 98,000 t in 2020, artisanal production only grew from 1,000 to 2,000 t in 2000 to 9,000 to 11,000 t in 2020 (with a peak of 17,000 to 21,000 t in 2018). Artisanal production’s share of world and DRC cobalt mine production peaked around 2008 at 18 to 23% and 40 to 53%, respectively, before trending down to 6 to 8% and 9 to 11% in 2020, respectively. Artisanal production was chiefly exported to China or processed within the DRC by Chinese firms. An average of 72 to 79% of artisanal production was processed at facilities within the DRC from 2016 through 2020. As such, these facilities may be potential monitoring points for artisanal production and its downstream consumers. This finding may help to support responsible sourcing initiatives and better address abuses related to artisanal cobalt mining by focusing local efforts at the artisanal processing facilities through which most artisanal cobalt production flows.
Brain-to-brain mechanisms underlying pain empathy and social modulation of pain in the patient-clinician interaction
Authors: Ellingsen Dan-Mikael , Isenburg Kylie , Jung Changjin , Lee Jeungchan , Gerber Jessica , Mawla Ishtiaq , Sclocco Roberta , Grahl Arvina , Anzolin Alessandra , Edwards Robert R. , Kelley John M. , Kirsch Irving , Kaptchuk Ted J. , Napadow Vitaly
Published: June 2023

Social interactions such as the patient–clinician encounter can influence pain, but the underlying dynamic interbrain processes are unclear. Here, we investigated the dynamic brain processes supporting social modulation of pain by assessing simultaneous brain activity (fMRI hyperscanning) from chronic pain patients and clinicians during video-based live interaction. Patients received painful and nonpainful pressure stimuli either with a supportive clinician present (Dyadic) or in isolation (Solo). In half of the dyads, clinicians performed a clinical consultation and intake with the patient prior to hyperscanning (Clinical Interaction), which increased self-reported therapeutic alliance. For the other half, patient—clinician hyperscanning was completed without prior clinical interaction (No Interaction). Patients reported lower pain intensity in the Dyadic, relative to the Solo, condition. In Clinical Interaction dyads relative to No Interaction, patients evaluated their clinicians as better able to understand their pain, and clinicians were more accurate when estimating patients’ pain levels. In Clinical Interaction dyads, compared to No Interaction, patients showed stronger activation of the dorsolateral and ventrolateral prefrontal cortex (dlPFC and vlPFC) and primary (S1) and secondary (S2) somatosensory areas (Dyadic–Solo contrast), and clinicians showed increased dynamic dlPFC concordance with patients’ S2 activity during pain. Furthermore, the strength of S2-dlPFC concordance was positively correlated with self-reported therapeutic alliance. These findings support that empathy and supportive care can reduce pain intensity and shed light on the brain processes underpinning social modulation of pain in patient–clinician interactions. Our findings further suggest that clinicians’ dlPFC concordance with patients’ somatosensory processing during pain can be boosted by increasing therapeutic alliance.
Kindlin stabilizes the talin·integrin bond under mechanical load by generating an ideal bond
Authors: Bodescu Mihai Adrian , Aretz Jonas , Grison Marco , Rief Matthias , Fässler Reinhard
Published: June 2023

Integrin-mediated adhesion is essential for metazoan life. Integrin binding to ligand requires an activation step prior to binding ligand that depends on direct binding of talin and kindlin to the β-integrin cytoplasmic tail and the transmission of force from the actomyosin via talin to the integrin–ligand bonds. However, the affinity of talin for integrin tails is low. It is therefore still unclear how such low-affinity bonds are reinforced to transmit forces up to 10 to 40 pN. In this study, we use single-molecule force spectroscopy by optical tweezers to investigate the mechanical stability of the talin•integrin bond in the presence and absence of kindlin. While talin and integrin alone form a weak and highly dynamic slip bond, the addition of kindlin-2 induces a force-independent, ideal talin•integrin bond, which relies on the steric proximity of and the intervening amino acid sequences between the talin- and kindlin-binding sites in the β-integrin tail. Our findings show how kindlin cooperates with talin to enable transmission of high forces required to stabilize cell adhesion.
Minimal model of quasi-cyclic behaviour in turbulence driven by Taylor–Green forcing
Authors: Araki Ryo , Bos Wouter J T , Goto Susumu
Published: June 2023

We attempt to formulate the simplest possible model mimicking turbulent dynamics, such as quasi-cyclic behaviour (QCB), using only three variables. To this end, we first conduct direct numerical simulations of three-dimensional flow driven by the steady Taylor–Green forcing to find a similarity between a stable periodic orbit (SPO) at a small Reynolds number (Re) and turbulent QCB at higher Re. A close examination of the SPO allows the heuristic formulation of a three-equation model, representing the evolution of Fourier modes in three distinct scales. The model reproduces the continuous bifurcation from SPO to turbulence with QCB when Re is varied. We also demonstrate that, by changing model parameters, the proposed model exhibits a discontinuous transition from steady to chaotic solutions without going through an SPO.
368 Impact of a digital atopic dermatitis educational intervention on Hispanic patients and family members
Authors: Andrade Luis F , Bekhash MaryJo , Choragudi Siri  , Gonzalez Juan M , Valdes Rodrigo  , Yosipovitch Gil
Published: June 2023

With the increasing incidence of atopic dermatitis (AD) in the USA, the highest prevalence of AD being found in Hispanic countries, and the rising Hispanic-American population, educational resources on eczema focused on Spanish-speaking populations are needed more than ever. As such, the primary goal of this project was to assess the beneficial impact of an educational intervention conducted through a virtual platform for Hispanic individuals living with AD. Utilizing WhatsApp, the study enrolled 55 participants diagnosed with AD and/or parents of children diagnosed with AD. Participants were enrolled in a 7-day educational module with daily topics on AD health knowledge. A health knowledge survey was administered prior to the educational program, upon completion of the program and 1 month after completion. The program found a 14% increase in AD health knowledge upon completion of the program (P < 0.001). Most importantly, there was no significant difference found between the health knowledge survey submitted at program completion and 1 month after completion, signaling that health knowledge taught through the course was successfully retained by participants (P = 0.29). Qualitative themes involving atopic disease were additionally explored through group discussions, including mental health and peer stigma. This study is the first of its kind in dermatology utilizing the WhatsApp format. The success of retained health knowledge regarding AD demonstrates that future virtual endeavors can be effective methods of patient education overall, and be accessible interventions for populations that might not have ease of access to major medical centers, are in rural areas and/or in the international setting.
386 Complete/near-complete itch response observed in adult and adolescent patients with moderate-to-severe atopic dermatitis initiating dupilumab treatment in real-world practice
Authors: Bhatia Neal , Lynde Charles W , Fonacier Luz , Tian Tingting , Bosman Kwinten , Korotzer Andrew 
Published: June 2023

Chronic itch (pruritus) is a defining characteristic of atopic dermatitis (AD) and is a significant contributor to poor quality of life in patients. A Pruritus/Peak Pruritus Numerical Rating Scale (NRS) score of 0/1 could be considered a complete or near-complete itch response. This study aims to report Pruritus NRS and Overall Disease Severity (ODS) score of 0/1 over time in patients older than 12 years with moderate-to-severe AD initiating dupilumab treatment in real-world practice. Patients aged ≥12 years with moderate-to-severe AD, initiating real-world dupilumab treatment for AD per approved prescribing information in the USA and Canada, were eligible for entry into PROSE (NCT03428646). Enrolled patients received their first dose of dupilumab at the baseline visit; there were no restrictions on post-baseline dupilumab dosing changes, or concomitant medication use; patients were encouraged to stay in the study if they discontinued dupilumab. Data presented are from an interim analysis (data cut taken as of November 2022); only ≥36 months of patient experience in PROSE at the time of interim analysis is reported. No formal hypothesis testing was performed; descriptive statistics are presented. Among 857 patients [mean (SD) age 40.1 (17.9) years and 42% male], mean (SD) duration of dupilumab treatment was 23.1 (13.7) months. At Month 36, 185 patients (21.6%) had discontinued from the study; the main reason was withdrawal of consent by the patient (76 patients, 8.9%). The proportion of patients with available observations reporting a Pruritus NRS score of 0/1 increased from baseline (2.7%) to Month 3 (28.1%) and continued to increase up to Month 36 (56.3%). Similarly, the proportion of patients with a clinician-reported ODS score of 0/1 also increased from baseline (2.2%) to Month 3 (39.8%) and up to Month 36 (65.1%). Safety was consistent with the known dupilumab safety profile. In this interim analysis of PROSE, a majority of patients reported a complete/near-complete pruritus response and overall disease severity response over a 36-month period.
405 Understanding patient experience and factors influencing patient preference in the treatment of moderate-to-severe atopic dermatitis through in-depth qualitative patient interviews
Authors: Feldman Steven R , Guerin Annie , Gauthier-Loiselle Marjolaine  , Claxton Ami J , Meng Yan  , Hazra Nisha C , Balu Sanjeev
Published: June 2023

Atopic dermatitis (AD) can enormously affect the lives of patients and their caregivers. Treatments for moderate-to-severe AD include phototherapy, topical and systemic corticosteroids, other immunosuppressive agents and biologic therapies. These treatments offer varied levels of efficacy, safety, response times and modes of administration. Patient preferences for these treatment options and attributes influencing their treatment choice are not well characterized. This qualitative interview-based study evaluated treatment attributes important to adult patients with moderate-to-severe AD providing a basis for a future quantitative discrete choice experiment (DCE). Semi-structured interviews were conducted in adults (≥18 years) recruited via a panel of geographically and demographically diverse patients with AD in the USA. Inclusion required (i) diagnosis of AD for at least one year, (ii) inadequate response to prior topical therapy and (iii) self-reported moderate-to-severe AD or experience with systemic therapy. One-on-one, in-depth 60-min phone interviews were conducted by a trained interviewer in AD real-word evidence studies. Subjects with experience with systemic therapy for AD were queried concerning their involvement in initiating, logistics of and general experience with their most recent systemic treatment. Finally, participants were asked to rate the importance (on a 1–5 scale with 5 being the most important) of 17 attributes that could play a role in their treatment decision-making; these attributes were identified from a targeted literature review and expert dermatologist clinical input. Attributes included treatment efficacy, adverse events and treatment logistics. Interviews are ongoing, and results will be ready and presented in the poster upon acceptance. Findings from the interviews will shed light on recent patient experience with treatments for moderate-to-severe AD and elucidate the treatment attributes that most impact patient treatment preferences. These results will guide the design of a subsequent DCE survey, which will help quantify the relative importance of the treatment attributes identified herein.
408 Dupilumab treatment in patients with atopic hand and foot dermatitis: results from a phase 3, randomized, double-blind, placebo-controlled trial
Authors: Simpson Eric L , Silverberg Jonathan I , Worm Margitta  , Honari Golara , Masuda Koji , Sygula Ewa , Maloney Jennifer , Mannent Leda P   , Xiao Jing , Dubost-Brama Ariane , Bansal Ashish 
Published: June 2023

Atopic dermatitis (AD) of the hands and/or feet is often chronic, difficult to treat and substantially impacts patient quality of life. This study aims to report the effect of dupilumab treatment on signs, symptoms and quality of life in patients with atopic hand and foot dermatitis using dedicated clinical and patient reported instruments. The phase 3, randomized, double-blind LIBERTY-AD-HAFT (NCT04417894) trial enrolled patients ≥12 years with moderate-to-severe [Investigator’s Global Assessment (IGA) 3/4] atopic hand and foot dermatitis. Patients were randomized to dupilumab monotherapy 300 mg q2w in adults; 200/300 mg every 2 weeks in adolescents, or placebo for 16 weeks. The primary endpoint was hand and foot IGA 0/1 score at Week 16. Safety/tolerability was assessed. The 133 patients enrolled were randomized to dupilumab (n = 67) or placebo (n = 66). At Week 16, the primary and all secondary endpoints were met. Significantly more patients in the dupilumab vs. placebo group achieved hand and foot IGA 0/1 (40.3% vs. 16.7%; P = 0.003; primary endpoint) and ≥4-point improvement in the hand and foot Peak Pruritus Numerical Rating Scale (52.2% vs. 13.6%; P < 0.0001; a key secondary endpoint). Dupilumab-treated patients experienced significant improvement in percent change from baseline in the modified Total Lesion Sign Score for hand and foot lesions vs. placebo [LS mean (SE) −69.4 (5.8) vs. −31.0 (5.9); P < 0.0001] and Hand Eczema Severity Index [HECSI; LS mean (SE) −74.8 (6.3) vs. −39.9 (6.2); P < 0.0001]. At Week 16, treatment with dupilumab also significantly increased the proportion of patients achieving a 75% improvement in HECSI (46.9% vs. 21.5%; P = 0.0028) and improved Quality of Life in Hand Eczema Questionnaire scores [LS mean (SE) −40.3 (4.0) vs. −16.2 (4.2); P < 0.0001]. The most common TEAEs (≥10%) were nasopharyngitis (16% vs. 11%) and dermatitis atopic (5% vs. 18%). Dupilumab significantly improved signs, symptoms and quality of life in patients with moderate-to-severe atopic hand and foot dermatitis and had an acceptable safety profile.
413 Improvement in itch, symptoms and quality of life with upadacitinib through week 16 in adults and adolescents with atopic dermatitis: results from phase 3 studies (Measure Up 1, Measure Up 2 and AD Up)
Authors: Lio Peter , Eichenfield Lawrence F , Marcoux Danielle  , Lee Wan-Ju , Teixeira Henrique D   , Raymundo Eliza M , Gamelli Amy E  , Grada Ayman , Hu Xiaofei , Irvine Alan D
Published: June 2023

Atopic dermatitis (AD) is characterized by intense itch and symptoms that adversely impact quality of life (QoL). Upadacitinib is a selective Janus kinase-1 inhibitor approved for moderate-to-severe AD. We assessed the effect of once daily oral upadacitinib (15 or 30 mg), with or without concurrent topical corticosteroid treatment, on patient-reported outcomes for adults and adolescents with moderate-to-severe atopic dermatitis during the double-blind, placebo-controlled phase 3 clinical trials, Measure Up 1 (NCT03569293), Measure Up 2 (NCT03607422) and AD Up (NCT03568318). Assessments included itch (Worst Pruritus Numerical Rating Scale), skin pain and symptom severity (AD Symptom Scale), symptom frequency (Patient Oriented Eczema Measure) and sleep, daily activities and emotional state (AD Impact Scale). Post hoc analysis of 2240 adults and 344 adolescents randomized patients was performed. By Week 2, more patients receiving upadacitinib achieved a clinically relevant response in itch, skin pain, symptom severity, symptom frequency, sleep, daily activities and emotional state vs. placebo across studies among adults (upadacitinib 15 mg: 30.8–87.3%; upadacitinib 30 mg: 38.0–89.9%; placebo: 2.1–43.1%; nominal P < 0.001 for all comparisons) and adolescents (upadacitinib 15 mg: 19.4–82.9%; upadacitinib 30 mg: 35.3–97.6%; placebo: 0–41.0%; nominal P < 0.05 for 37/42 comparisons). These trends continued through week 16 where response rates for all outcomes improved with upadacitinib vs. placebo in adults (upadacitinib 15 mg: 42.9–80.4%; upadacitinib 30 mg: 60.9–84.6%; placebo: 10.1–38.1%; nominal P < 0.001 for all comparisons) and adolescents (upadacitinib 15 mg: 33.3–78.0%; upadacitinib 30 mg: 50.0–85.7%; placebo: 2.8–43.6%; nominal P < 0.05 for 41/42 comparisons). These findings highlight the rapid, sustained efficacy of once daily oral upadacitinib in improving symptom burden and QoL in adults and adolescents with moderate-to-severe AD.
426 Efficacy and safety of abrocitinib in adolescents with moderate-to-severe atopic dermatitis from the JADE clinical trial program
Authors: Eichenfield Lawrence F , Flohr Carsten , Bangert Christine  , Irvine Alan D , Weidinger Stephan  , Nesnas John , Koppensteiner Herwig  , Zhang Fan , Rojo Ricardo , Chan Gary
Published: June 2023

Once-daily oral abrocitinib, a Janus kinase 1-selective inhibitor, was effective and well tolerated as a monotherapy in adult and adolescent patients with moderate-to-severe atopic dermatitis (AD), as well as in combination with medicated topical therapy in adolescents with moderate-to-severe AD. This study aims to investigate efficacy and safety of abrocitinib in adolescents with moderate-to-severe AD from the JADE clinical trial program. Patients aged 12–17 years with moderate-to-severe AD and an inadequate response to ≥4 consecutive weeks of topical medication or treatment with systemic therapy for AD, both within the past 6 months, were randomly assigned [2:2:1 JADE MONO-1/MONO-2 (NCT03349060/NCT03575871); 1:1:1 JADE TEEN (NCT03796676)] to receive once-daily oral abrocitinib (200 or 100 mg) or placebo as monotherapy (JADE MONO-1 and JADE MONO-2) or in combination with medicated topical therapy (JADE TEEN) for 12 weeks. Coprimary endpoints were proportion of patients achieving Investigator’s Global Assessment (IGA) response [clear (0) or almost clear (1) with ≥2-grade improvement from baseline] and proportion of patients who achieved ≥75% improvement in Eczema Area and Severity Index score (EASI-75) at Week 12. A key secondary endpoint was the proportion of patients achieving ≥4-point improvement in Peak Pruritus Numerical Rating Scale (PP-NRS4; used with permission from Regeneron Pharmaceuticals and Sanofi) at Week 12. Drug safety was also assessed. Overall, 285 and 124 adolescents in JADE TEEN and JADE MONO-1/MONO-2, respectively, were treated. In JADE TEEN, more abrocitinib-treated (200 mg, 100 mg) than placebo-treated patients achieved IGA (46.2%, 41.6% vs. 24.5%; P < 0.05 for both doses), EASI-75 (72.0%, 68.5% vs. 41.5%; P < 0.05 for both doses) and PP-NRS4 (55.4%, 52.6% vs. 29.8%; P < 0.01 for 200 mg vs. placebo) responses at Week 12. Adverse events (AEs) were reported for 62.8%, 56.8% and 52.1% of patients in 200 mg, 100 mg and placebo groups, respectively; 1 (1.1%), 0 and 2 patients (2.1%) had serious AEs. JADE MONO-1/MONO-2 safety results were similar, but efficacy results were lower, as expected for monotherapies. Results from JADE clinical trials suggest that abrocitinib was effective in adolescents with moderate-to-severe AD, with an acceptable safety profile.