bluuebunny/crossref_metadata_2025 huggingface dataset:
Observing reduced field fluctuation in interfacial engineered organic–inorganic dielectric nanocomposite for enhanced breakdown strength
Authors: Zhang Fengyuan , Zhang Lingyu , Wang Xuyang , Liu Kaixin , Huang Boyuan , Wang Yao , Li Jiangyu
Published: December 2022

Organic–inorganic nanocomposites with superior dielectric energy density are highly sought after for high-power electronics and pulsed power systems, and interfacial engineering turns out to be one of the most successful strategies to improve their breakdown strength. However, a microscopic mechanism responsible for such improvement, thought to be closely related to local field fluctuation in the nanocomposites, has never been directly demonstrated experimentally. Here, we develop a powerful yet readily applicable in situ technique to evaluate the fluctuation of electric field in dielectrics, revealing reduced field fluctuation in interfacial engineered nanocomposites that clearly correlates with its enhanced breakdown strength. This work, thus, validates field fluctuation-based breakdown criterion of nanocomposite proposed more than one decade ago and provides further support to improve organic–inorganic nanocomposites for high density dielectric energy storage.
Regulation of droplet size and flow regime by geometrical confinement in a microfluidic flow-focusing device
Authors: Sontti Somasekhara Goud , Atta Arnab
Published: December 2022

We have developed a coupled level set and volume of fluid-based computational fluid dynamics model to analyze the droplet formation mechanism in a square flow-focusing microchannel. We demonstrate a flexible manipulation of droplet formation and flow regime based on the modified flow-focusing microchannel with a constricted orifice. Furthermore, we have systematically studied the influence of geometrical confinement, flow rate, and interfacial tension on the droplet formation regime, length, volume, velocity, and shape. Three different flow regimes, namely squeezing, dripping, and jetting, are observed, and the flow regime maps are formulated based on the Reynolds and capillary numbers. After an extensive numerical investigation, we described the boundaries between the different regimes. Droplet shape is also quantified based on the deformation index value. Plug-shaped droplets are observed in the squeezing regime, and near spherical droplets are found in the dripping and jetting regimes. Our study provides insights into the transition of a regime under various geometrical confinement and fluid properties. The results reveal that the modified flow-focusing microchannel can substantially enhance dripping while decreasing the squeezing regime, which is of paramount importance from the standpoint of producing high throughput stable and monodisperse microdroplets. Eventually, this work emphasizes the importance of geometrical confinement, fluid properties, and flow conditions on the droplet formation process in a flow-focusing microchannel that can effectively provide helpful guidelines on the design and operations of such droplet-based microfluidic systems.
Achieving glass-like lattice thermal conductivity in PbTe by AgBiTe2 alloying
Authors: Zhu Huaxing , Zhang Bin , Zhao Ting , Zheng Sikang , Wang Guiwen , Wang Guoyu , Lu Xu , Zhou Xiaoyuan
Published: December 2022

Here, we report the thermal transport properties of lead telluride (PbTe)1−x(AgBiTe2)x (x = 0.05 and 0.15) alloys. It is found that the prominent peak in lattice thermal conductivity at 15 K for PbTe disappears after forming solid solution with AgBiTe2, exhibiting a typical glass-like thermal transport behavior. The high energy phonons are scattered by the point defects induced by cationic disorder, while the appearance of soft vibrational modes arises from Ag atoms acting like Einstein oscillators (ΘE1 = 5.4 K, ΘE2 = 67.3 K), which substantially affects the lattice thermal conductivity. Further with nanostructuring, the mid-frequency phonons are scattered by the high-density disc-like Ag2Te precipitates. As a result, an ultralow lattice thermal conductivity (≤1.0 W m−1 K−1) for (PbTe)0.85(AgBiTe2)0.15 is obtained, which is the lowest value ever reported to date for the PbTe-based TE materials. Our work highlights a synthetic route to achieve glass-like lattice thermal conductivity in PbTe over the entire temperature range.
Fano resonance with high Q and figure of merit in terahertz band based on structural perturbation
Authors: Feng Guang , Chen Zhihui , Liu Xin , Wang Xiaowei , Liu Xiao , Sun Fei , Yang Yibiao , Wang Yang , Chen Shuqi
Published: December 2022

Fano resonance with high quality (Q) factor and figure of merit (FoM) has significant application prospects in biosensors and lasers. However, most of the previous studies achieve Fano resonance with high Q and FoM by directly regulating the structural asymmetry, which needs high processing precision. To maximize the Q factor of a given resonator, the best constituent material could be a hypothetical perfect electrical conductor (PEC) without ohmic losses. Here, we can indirectly regulate the asymmetry of the structure by perturbation between structures. At low asymmetry, PEC double split rings can obtain high Q factor of 374 and FoM of 257 by adjusting structural asymmetry based on structural perturbation. These are significant for Fano resonances of extremely low-loss and low ohmic losses practical application in the THz band.
The ‘other’ epidemic: canine ehrlichiosis in Australia
Authors: Irwin Peter , Beadle John
Published: December 2022

Canine monocytic ehrlichiosis (Ehrlichia canis infection) is a serious tick-transmitted disease of dogs that was considered exotic to Australia until recently. The disease was first reported across northern and central Australia in 2020, with significant canine morbidity and mortalities observed at indigenous communities where dog numbers are high, ticks are superabundant, and tick prevention is scant. The date and location of the incursion are unknown, yet comparative genomic analysis suggest the Australian E. canis may have originated from Asia or the Middle East. Veterinarians nationwide are on alert for this notifiable disease since cases have been reported in southern locations as a consequence of moving infected dogs from endemic areas. Acute infections in dogs respond favourably to doxycycline therapy, however chronic disease results in bone marrow failure and death. Tick prophylaxis is key to preventing canine ehrlichiosis and is best achieved using products that repel and kill ticks before they attach. Although reports exist of E. canis as a zoonosis, there is no evidence that the strain involved in the current Australian outbreak poses risk to humans.
Hyperstabilization of T cell microvilli contacts by chimeric antigen receptors
Authors: Beppler Casey , Eichorst John , Marchuk Kyle , Cai En , Castellanos Carlos A. , Sriram Venkataraman , Roybal Kole T. , Krummel Matthew F.
Published: December 2022

T cells typically recognize their ligands using a defined cell biology—the scanning of their membrane microvilli (MV) to palpate their environment—while that same membrane scaffolds T cell receptors (TCRs) that can signal upon ligand binding. Chimeric antigen receptors (CARs) present both a therapeutic promise and a tractable means to study the interplay between receptor affinity, MV dynamics and T cell function. CARs are often built using single-chain variable fragments (scFvs) with far greater affinity than that of natural TCRs. We used high-resolution lattice lightsheet (LLS) and total internal reflection fluorescence (TIRF) imaging to visualize MV scanning in the context of variations in CAR design. This demonstrated that conventional CARs hyper-stabilized microvillar contacts relative to TCRs. Reducing receptor affinity, antigen density, and/or multiplicity of receptor binding sites normalized microvillar dynamics and synapse resolution, and effector functions improved with reduced affinity and/or antigen density, highlighting the importance of understanding the underlying cell biology when designing receptors for optimal antigen engagement.
Microglial pattern recognition via IL-33 promotes synaptic refinement in developing corticothalamic circuits in mice
Authors: Han Rafael T. , Vainchtein Ilia D. , Schlachetzki Johannes C.M. , Cho Frances S. , Dorman Leah C. , Ahn Eunji , Kim Dong Kyu , Barron Jerika J. , Nakao-Inoue Hiromi , Molofsky Ari B. , Glass Christopher K. , Paz Jeanne T. , Molofsky Anna V.
Published: December 2022

Microglia are critical regulators of brain development that engulf synaptic proteins during postnatal synapse remodeling. However, the mechanisms through which microglia sense the brain environment are not well defined. Here, we characterized the regulatory program downstream of interleukin-33 (IL-33), a cytokine that promotes microglial synapse remodeling. Exposing the developing brain to a supraphysiological dose of IL-33 altered the microglial enhancer landscape and increased binding of stimulus-dependent transcription factors including AP-1/FOS. This induced a gene expression program enriched for the expression of pattern recognition receptors, including the scavenger receptor MARCO. CNS-specific deletion of IL-33 led to increased excitatory/inhibitory synaptic balance, spontaneous absence-like epileptiform activity in juvenile mice, and increased seizure susceptibility in response to chemoconvulsants. We found that MARCO promoted synapse engulfment, and Marco-deficient animals had excess thalamic excitatory synapses and increased seizure susceptibility. Taken together, these data define coordinated epigenetic and functional changes in microglia and uncover pattern recognition receptors as potential regulators of postnatal synaptic refinement.
Electronic ring current and magnetic field generation induced by current-carrying states of ring molecules in intense fields
Authors: Xu Qing-Yun , He Yong-Lin , Yan Shu-Juan , Guo Jing
Published: December 2022

The generation of electronic currents and magnetic fields by

H

6

5
+

and

H

4

3
+

molecules with current-carrying states under circularly polarized (CP) and linearly polarized (LP) laser pulses is investigated. Results show that the electronic currents and magnetic fields induced by CP pulses are higher than those by LP pulses for both molecules in the resonance excitation scheme. This can be attributed to the switchable dipole moment of the laser pulses, inducing selective state-to-state electronic transitions. Moreover, it was found that magnetic fields are sensitive to different initial states of the molecules in the ionization scheme. In particular, the magnetic fields induced by the current-carrying states are much higher than that induced by the ground state, which is because the current-carrying states have a stable electronic ring current and the induced magnetic field is contributed by the current-carrying state itself and the laser field. These findings provide a scheme for generating ring-shaped currents and magnetic fields in molecular systems for future research in ultrafast magneto-optics.
Nanomembrane-assembled nanophotonics and optoelectronics: from materials to applications
Authors: Huang Jiayuan , Huang Gaoshan , Zhao Zhe , Wang Chao , Cui Jizhai , Song Enming , Mei Yongfeng
Published: December 2022

Nanophotonics and optoelectronics are the keys to the information transmission technology field. The performance of the devices crucially depends on the light–matter interaction, and it is found that three-dimensional (3D) structures may be associated with strong light field regulation for advantageous application. Recently, 3D assembly of flexible nanomembranes has attracted increasing attention in optical field, and novel optoelectronic device applications have been demonstrated with fantastic 3D design. In this review, we first introduce the fabrication of various materials in the form of nanomembranes. On the basis of the deformability of nanomembranes, 3D structures can be built by patterning and release steps. Specifically, assembly methods to build 3D nanomembrane are summarized as rolling, folding, buckling and pick-place methods. Incorporating functional materials and constructing fine structures are two important development directions in 3D nanophotonics and optoelectronics, and we settle previous researches on these two aspects. The extraordinary performance and applicability of 3D devices show the potential of nanomembrane assembly for future optoelectronic applications in multiple areas.
An ultra-low-dose protocol for computed tomography-guided lung radiofrequency ablations
Authors: Golin Melissa , Izaaryene Jean , Dassa Michael , Piana Gilles , Ferre Marjorie
Published: December 2022

To evaluate the safety and efficacy of ultra-low-dose (ULD) protocol for computed tomography (CT)-guided lung radiofrequency ablation (RFA). Patients who had undergone lung RFA between November 2017 and January 2021 were consecutively and retrospectively included. Thirty patients were treated using a conventional standard protocol (SP), including helical acquisitions with mA automatic adjustment and sequential CT at 80 kVp; and 31, with a ULD protocol defined with helical acquisitions with fixed mA and sequential series at 100 kVp. These parameters were selected from those used for a diagnostic lung low-dose CT scanner. Patient characteristics, dose indicators, technical efficacy (minimal margin [MM], recurrence during follow-up), and complications (pneumothorax, alveolar haemorrhage, and haemoptysis) were recorded. We included 61 patients (median age, 65 [54–73] and 33 women), with no significant differences according to the type of protocol, except for the type of anaesthesia. Even if the number of helical acquisitions did not significantly change, all dose indicators significantly decreased by 1.5-fold–3-fold. The median dose-length-product and effective dose, with their ranges, respectively, were 465 mGy cm (315–554) and 6.5 mSv (4.4–7.8) in the SP group versus 178 mGy cm (154–267) and 2.5 mSv (2.2–3.7) in the ULD group, (p < 001). The ULD group exhibited lower intraoperator variability and better interoperator alignment than those of the SP group. The MM was not significantly different between the two groups (4.6 mm versus 5 mm, p = 16). One local recurrence was observed in each group at 8 months in the SP and at one year in the ULD group (p = 1). The complication rates did not differ significantly. Implementing an ULD protocol during lung RFA may provide similar efficacy, a reduction of dose indicators, and intra- and interoperator variability, without increasing complication rates, compared to those associated with an SP.
A zero-velocity update method based on neural network and Kalman filter for vehicle-mounted inertial navigation system
Authors: Li Qihang , Li Kui , Liang Wenwei
Published: December 2022

Zero-velocity update (ZUPT) is an effective method of restraining the error divergence of the inertial navigation system (INS). The correct detection of zero-velocity points and an appropriate filtering algorithm are the key factors for the success of ZUPT. In this paper, a ZUPT method for vehicle-mounted INS based on a neural network (NN) and Kalman filter is proposed. The efficiency and accuracy of the zero-velocity detection is improved by the NN. The precision of the proposed method can reach 99.19%, and the recall rate is improved by 24% compared with the method based on the support vector machine. In addition, this method has similar accuracy and better real-time performance than the method based on a long short-term memory. Based on the zero-velocity detection by the NN, the navigation error is estimated and compensated by the Kalman filter. The effectiveness of the proposed method is proved by a vehicular experiment that shows that the velocity error is reduced to 24.2% and the position error is reduced to 9.5%.
Effect of surface gallium termination on the formation and emission energy of an InGaAs wetting layer during the growth of InGaAs quantum dots by droplet epitaxy
Authors: Fricker D , Atkinson P , Jin X , Lepsa M , Zeng Z , Kovács A , Kibkalo L , Dunin-Borkowski RE , Kardynał BE
Published: December 2022

Self-assembled quantum dots (QDs) based on III–V semiconductors have excellent properties for applications in quantum optics. However, the presence of a 2D wetting layer (WL) which forms during the Stranski–Krastanov growth of QDs can limit their performance. Here, we investigate WL formation during QD growth by the droplet epitaxy technique. We use a combination of photoluminescence excitation spectroscopy, lifetime measurements, and transmission electron microscopy to identify the presence of an InGaAs WL in these droplet epitaxy QDs, even in the absence of distinguishable WL luminescence. We observe that increasing the amount of Ga deposited on a GaAs (100) surface prior to the growth of InGaAs QDs leads to a significant reduction in the emission wavelength of the WL to the point where it can no longer be distinguished from the GaAs acceptor peak emission in photoluminescence measurements. However increasing the amount of Ga deposited does not suppress the formation of a WL under the growth conditions used here.
Heat index, wet-bulb temperature and psychrometrics: what to expect in the 21st century
Authors: Studnička Filip , Šlégrová Leontýna , Voglová Kateřina , Šlégr Jan
Published: December 2022

In recent years, the world has been facing extreme heat waves, breaking all previous records. Therefore, it is essential to emphasize teaching at least the basic knowledge of psychrometry and its impact on human health and well-being. In this paper, we explain several key concepts from the field of psychometrics as well as instructions on how to assemble a wet-bulb thermometer easily. Methods for calculating heat index, dew point, and other quantities are also mentioned, whether using a wet-bulb thermometer or modern electronic sensors.
Dual- and multi-energy CT for particle stopping-power estimation: current state, challenges and potential
Authors: Yang Ming , Wohlfahrt Patrick , Shen Chenyang , Bouchard Hugo
Published: December 2022

Range uncertainty has been a key factor preventing particle radiotherapy from reaching its full physical potential. One of the main contributing sources is the uncertainty in estimating particle stopping power (ρ

s
) within patients. Currently, the ρ

s
distribution in a patient is derived from a single-energy CT (SECT) scan acquired for treatment planning by converting CT number expressed in Hounsfield units (HU) of each voxel to ρ

s
using a Hounsfield look-up table (HLUT), also known as the CT calibration curve. HU and ρ

s
share a linear relationship with electron density but differ in their additional dependence on elemental composition through different physical properties, i.e. effective atomic number and mean excitation energy, respectively. Because of that, the HLUT approach is particularly sensitive to differences in elemental composition between real human tissues and tissue surrogates as well as tissue variations within and among individual patients. The use of dual-energy CT (DECT) for ρ

s
prediction has been shown to be effective in reducing the uncertainty in ρ

s
estimation compared to SECT. The acquisition of CT data over different x-ray spectra yields additional information on the material elemental composition. Recently, multi-energy CT (MECT) has been explored to deduct material-specific information with higher dimensionality, which has the potential to further improve the accuracy of ρ

s
estimation. Even though various DECT and MECT methods have been proposed and evaluated over the years, these approaches are still only scarcely implemented in routine clinical practice. In this topical review, we aim at accelerating this translation process by providing: (1) a comprehensive review of the existing DECT/MECT methods for ρ

s
estimation with their respective strengths and weaknesses; (2) a general review of uncertainties associated with DECT/MECT methods; (3) a general review of different aspects related to clinical implementation of DECT/MECT methods; (4) other potential advanced DECT/MECT applications beyond ρ

s
estimation.
All-organic lead-free thermochromic and dielectric switchable epoxy microcomposites from singly incorporating leuco dye microcapsules for advanced encryption
Authors: Gao Jian , Wu Kangning , Li Jianying , Yin Guilai , Li Shengtao
Published: December 2022

In this study, an all-organic lead-free thermochromic and dielectric switchable epoxy microcomposite (TEP) is presented from singly incorporating leuco dye microcapsule materials (LDM) into the epoxy matrix. TEP can simultaneously adjust the color and permittivity in response to temperature between 30 °C and 70 °C. Moreover, the switchable dielectric behavior of TEP can be manipulated by LDMs content and voltage frequency. The switchable dielectric behavior of TEP permittivity is proposed to originate from the inner interfacial polarizations in LDMs triggered by the order-disorder phase transition. Before the phase transition, the molecules in LDMs are in ordered and compact arrays with restricted mobility, which can hardly undergo transportations and reorientations, leading to the weak interfacial polarization strength at the inner surfaces of LDMs and the low permittivity of TEP. After the phase transition, the molecules in LDMs are liberated with enhanced intermolecular distances and mobility, facilitating the inner interfacial polarization in LDMs and leading to the high permittivity of TEP. The correlation between the switchable dielectric behavior and the order-disorder phase transition is furtherly verified based on the Lichtenecker’s mixing model. This study unlocks a novel function of switchable permittivity for the LDM materials and provides an innovative strategy for designing the thermochromic and dielectric switchable smart materials.
Altered nonlinear Granger causality interactions in the large-scale brain networks of patients with schizophrenia
Authors: Fu Yu , Niu Meng , Gao Yuanhang , Dong Shunjie , Huang Yanyan , Zhang Zhe , Zhuo Cheng
Published: December 2022

Objective. It has been demonstrated that schizophrenia (SZ) is characterized by functional dysconnectivity involving extensive brain networks. However, the majority of previous studies utilizing resting-state functional magnetic resonance imaging (fMRI) to infer abnormal functional connectivity (FC) in patients with SZ have focused on the linear correlation that one brain region may influence another, ignoring the inherently nonlinear properties of fMRI signals. Approach. In this paper, we present a neural Granger causality (NGC) technique for examining the changes in SZ’s nonlinear causal couplings. We develop static and dynamic NGC-based analyses of large-scale brain networks at several network levels, estimating complicated temporal and causal relationships in SZ patients. Main results. We find that the NGC-based FC matrices can detect large and significant differences between the SZ and healthy control groups at both the regional and subnetwork scales. These differences are persistent and significantly overlapped at various network sparsities regardless of whether the brain networks were built using static or dynamic techniques. In addition, compared to controls, patients with SZ exhibited extensive NGC confusion patterns throughout the entire brain. Significance. These findings imply that the NGC-based FCs may be a useful method for quantifying the abnormalities in the causal influences of patients with SZ, hence shedding fresh light on the pathophysiology of this disorder.
Single trial detection of error-related potentials in brain–machine interfaces: a survey and comparison of methods
Authors: Yasemin Mine , Cruz Aniana , Nunes Urbano J , Pires Gabriel
Published: December 2022

Objective. Error-related potential (ErrP) is a potential elicited in the brain when humans perceive an error. ErrPs have been researched in a variety of contexts, such as to increase the reliability of brain–computer interfaces (BCIs), increase the naturalness of human–machine interaction systems, teach systems, as well as study clinical conditions. Still, there is a significant challenge in detecting ErrP from a single trial, which may hamper its effective use. The literature presents ErrP detection accuracies quite variable across studies, which raises the question of whether this variability depends more on classification pipelines or on the quality of elicited ErrPs (mostly directly related to the underlying paradigms). Approach. With this purpose, 11 datasets have been used to compare several classification pipelines which were selected according to the studies that reported online performance above 75%. We also analyze the effects of different steps of the pipelines, such as resampling, window selection, augmentation, feature extraction, and classification. Main results. From our analysis, we have found that shrinkage-regularized linear discriminant analysis is the most robust method for classification, and for feature extraction, using Fisher criterion beamformer spatial features and overlapped window averages result in better classification performance. The overall experimental results suggest that classification accuracy is highly dependent on user tasks in BCI experiments and on signal quality (in terms of ErrP morphology, signal-to-noise ratio (SNR), and discrimination). Significance. This study contributes to the BCI research field by responding to the need for a guideline that can direct researchers in designing ErrP-based BCI tasks by accelerating the design steps.
Peripheral temperature gradient screening of high-Z impurities in optimised ‘hybrid’ scenario H-mode plasmas in JET-ILW
Authors: Field A.R. , Casson F.J. , Fajardo D. , Angioni C. , Challis C.D. , Hobirk J. , Kappatou A. , Kim Hyun-Tae , Lerche E. , Loarte A. , Mailloux J.
Published: December 2022

Screening of high-Z (W) impurities from the confined plasma by the temperature gradient at the plasma periphery of fusion-grade H-mode plasmas has been demonstrated in the JET-ILW (ITER-like wall) tokamak. Through careful optimisation of the hybrid-scenario, deuterium plasmas with sufficient heating power (

≳

32 MW), high enough ion temperature gradients at the H-mode pedestal top can be achieved for the collisional, neo-classical convection of the W impurities to be directed outwards, expelling them from the confined plasma. Measurements of the W impurity fluxes between and during edge-localised modes (ELMs) based on fast bolometry measurements show that in such plasmas there is a net efflux (loss) between ELMs but that ELMs often allow some W back into the confined plasma. Provided steady, high-power heating is maintained, this mechanism allows such plasmas to sustain high performance, with an average D–D neutron rate of

∼

3.2
×

10

16

 s−1 over a period of ∼3 s, after an initial overshoot (equivalent to a D–T fusion power of ∼9.4 MW), without an uncontrolled rise in W impurity radiation, giving added confidence that impurity screening by the pedestal may also occur in ITER, as has previously been predicted (Dux et al 2017 Nucl. Mater. Energy
12 28–35).
The Cross-Sectional Association of Sleep Disturbance and Sleep Apnea With Complex Multimorbidity Among Chinese and Korean Americans
Authors: Ryu Soomin , Morey Brittany N , Lee Grace E , Kawachi Ichiro , Redline Susan , Lee Sunmin
Published: December 2022

A new concept called complex multimorbidity provides a more reliable measure of disease burden than multimorbidity based on a simple count of diseases, by categorizing diseases according to the body system they affect. This study examined associations between sleep measures and complex multimorbidity among Chinese and Korean Americans in the Baltimore–Washington DC Metropolitan Area, using cross-sectional data (n = 400) from the Screening to Prevent Colorectal Cancer study (2018–2020). Sleep disturbance was measured using the 8-item Patient Reported Outcomes Measurement Information System Sleep Disturbance scale and sleep apnea risk was assessed using the Berlin questionnaire. Complex multimorbidity was defined as the coexistence of 3 or more of body system disorders assessed by self-report of physician-diagnosed diseases. Poisson regression models with adjustments indicated that individuals with sleep disturbance had 2.15 times the prevalence of having complex multimorbidity (95% confidence interval (CI): 1.07, 4.29). Individuals with a high risk of sleep apnea had 1.19 times the prevalence of having complex multimorbidity (95% CI: 0.47, 3.01). These findings suggest a need for interventions to increase awareness of the importance of sleep among health-care providers and the public and to educate them about causes, signs, and treatment of sleep disturbance and sleep apnea.
Technical Dissonance in Home Blood Pressure Monitoring After Stroke: Having the Machine, but Not Using Correctly
Authors: Forman Rachel , Viscoli Catherine M , Meurer Katherine , Sheth Kevin N , Sansing Lauren H , de Havenon Adam , Sharma Richa , Mariscal Melissa , Kernan Walter N
Published: December 2022

Background

In individuals with hypertension (HTN), lowering blood pressure (BP) after a stroke can lower the risk of stroke recurrence, but many patients do not reach the goal. Home blood pressure monitoring (HBPM) can help patients get to the goal, but rates of use and quality of technique have not been evaluated.

Methods

We conducted a cross-sectional study of patients with stroke. Patients were eligible if they had a stroke within 2 years, had HTN, and lived at home. We classified patients as correctly performing HBPM if they used an arm cuff, sat ≥ 1 min before measurement, took ≥ 2 measurements, and use within 6 months. The primary outcome was the proportion of patients who had an HBPM and used it correctly, which we calculated according to race and ethnicity. We also asked patients what they would do if they found results outside the goal.

Results

Among 150 participants, 120 (81%) possessed an HBPM and 29 (21%) used it correctly. We observed no significant disparity in rates of possession or correct use between non-Hispanic White participants and participants from underrepresented groups. Seventy percent of non-Hispanic White patients said they would contact their provider if their BP was above goal vs. 52% of underrepresented patients (P = 0.21).

Conclusions

Most patients after stroke have an HBPM, but only about 1 in 5 use it correctly. Approximately half of the patients from underrepresented racial or ethnic groups do not have a plan for responding to the values above goal. Our results indicate opportunities to improve the dissemination and correct use of HBPM.
Prognostic Implication of Admission Mean and Pulse Pressure in Acute Decompensated Heart Failure With Different Phenotypes
Authors: Chen Chen , Chen Xuwei , Chen Shilan , Wu Yuzhong , He Xin , Zhao Jingjing , Li Bin , He Jiangui , Dong Yugang , Liu Chen , Wei Fang-Fei
Published: December 2022

Background

It remains unknown whether admission mean (MAP) and pulse pressure (PP) pressure are associated with short- and long-term mortality in Chinese patients with heart failure with preserved (HFpEF), mid-range (HFmrEF), and reduced (HFrEF) ejection fraction.

Methods

In 2,706 acute decompensated heart failure (HF) patients, we assessed the risk of 30-day, 1-year, and long-term (>1 year) mortality with 1-SD increment in MAP and PP, using multivariable logistic and Cox regression, respectively.

Results

During a median follow-up of 4.1 years, 1,341 patients died. The 30-day, 1-year, and long-term mortality were 3.5%, 16.7%, and 39.4%, respectively. A lower MAP was associated with a higher risk of 30-day mortality in women (P = 0.023) and a higher risk of 30-day and 1-year mortality in men (P ≤ 0.006), while higher PP predicted long-term mortality in men (P ≤ 0.014) with no relationship observed in women. In adjusted analyses additionally accounted for PP, 1-SD increment in MAP was associated with 30-day mortality in HFpEF (odds ratio [OR], 0.63; 95% CI, 0.43 to 0.92; P = 0.018), with 1-year mortality in HFmrEF (OR, 0.46; 95% CI, 0.32 to 0.66; P < 0.001) and HFrEF (OR, 0.54; 95% CI, 0.40 to 0.72; P < 0.001). In the adjusted model additionally accounted for MAP, 1-SD increment in PP was associated with long-term mortality in HFpEF (hazard ratio, 1.16; 95% CI, 1.05 to 1.28; P = 0.003).

Conclusions

A lower MAP was associated with a higher risk of short-term mortality in all HF subtypes, while a higher PP predicted a higher risk of long-term mortality in men and in HFpEF. Our observations highlight the clinical importance of admission blood pressure for risk stratification in HF subtypes.
Chemical andin vitrobiological formation of octahydrocurcumin stereoisomers, andin vitroactivity of raceme andmeso-octahydrocurcumin
Authors: Niwa Toshio , Kato Yoji , Osawa Toshihiko
Published: December 2022

The PtO2-catalyzed hydrogenation of curcumin produced slightly predominant meso-octahydrocurcumin than raceme octahydrocurcumin. Similar result was found in the product obtained from tetrahydrocurcumin and NaBH4, whereas using palladium carbon as a catalyst increased the meso-octahydrocurcumin ratio. Compared with chemical methods, baker's yeast produced 3S,5S-octahydrocurcumin and meso-octahydrocurcumin from tetrahydrocurcumin. The different activity between raceme and meso-octahydrocurcumin was not found in our experiments.
The COMER web server for protein analysis by homology
Authors: Dapkūnas Justas , Margelevičius Mindaugas
Published: December 2022

Sequence homology is a basic concept in protein evolution, structure and function studies. However, there are not many different tools and services for homology searches being sensitive, accurate and fast at the same time. We present a new web server for protein analysis based on COMER2, a sequence alignment and homology search method that exhibits these characteristics. COMER2 has been upgraded since its last publication to improve its alignment quality and ease of use. We demonstrate how the user can benefit from using it by providing examples of extensive annotation of proteins of unknown function. Among the distinctive features of the web server is the user’s ability to submit multiple queries with one click of a button. This and other features allow for transparently running homology searches—in a command-line, programmatic or graphical environment—across multiple databases with multiple queries. They also promote extensive simultaneous protein analysis at the sequence, structure and function levels.

Availability and implementation

The COMER web server is available at https://bioinformatics.lt/comer.

Supplementary information

Supplementary data are available at Bioinformatics online.
SoK: cross-border criminal investigations and digital evidence
Authors: Casino Fran , Pina Claudia , López-Aguilar Pablo , Batista Edgar , Solanas Agusti , Patsakis Constantinos
Published: December 2022

Digital evidence underpin the majority of crimes as their analysis is an integral part of almost every criminal investigation. Even if we temporarily disregard the numerous challenges in the collection and analysis of digital evidence, the exchange of the evidence among the different stakeholders has many thorny issues. Of specific interest are cross-border criminal investigations as the complexity is significantly high due to the heterogeneity of legal frameworks, which beyond time bottlenecks can also become prohibiting. The aim of this article is to analyse the current state of practice of cross-border investigations considering the efficacy of current collaboration protocols along with the challenges and drawbacks to be overcome. Further to performing a legally oriented research treatise, we recall all the challenges raised in the literature and discuss them from a more practical yet global perspective. Thus, this article paves the way to enabling practitioners and stakeholders to leverage horizontal strategies to fill in the identified gaps timely and accurately.
Associations Between Deaf/Hard of Hearing and Social Participation Among Older Americans
Authors: Cheung Ethan Siu Leung , Zhang Zhe
Published: December 2022

This study investigated the associations between self-reported deaf or hard of hearing (D/HH) and informal and formal social participation among Americans aged 65 or older and how their family resources, health, and community social capital may partially account for these associations. Using cross-sectional data from the National Health and Aging Trends Study, multiple logistic regressions were conducted to test the research questions. Results revealed that older adults who were D/HH had significantly lower odds of attending recreational and clubs and organized activities. Family resources and health significantly explained the disparity for all types of social participation, whereas community social capital contributed more to the disparity in religious service attendance. Findings provide important intervention directions to reduce the disparity in late-life social participation as a result of experiencing D/HH.
540 RAGHIB SYNDROME WITH VERY LATE CLINICAL PRESENTATION.
Authors: Frecentese Francesca , Scatteia Alessandra , Pascale Carmine Emanuele , Russo Giuseppe , Carlomagno Guido , Paolillo Stefania , Librera Mariateresa , Dellegrottaglie Santo
Published: December 2022

A 72-year-old woman who had been diagnosed with pulmonary emphysema and permanent atrial fibrillation was admitted to our emergency department with signs and symptoms of heart failure (NYHA class III). Transthoracic echocardiography (TTE) revealed dilatation of both right and left atria, dilatation and systolic dysfunction of the right ventricle (RV) and severe pulmonary hypertension. Combined severe mitral and tricuspid regurgitation was also noted and, after clinical stabilization, transesophageal echocardiography (TEE) was performed to better assess valvular anatomy and function. TEE revealed clear evidence of a pre-tricuspid left-to-right shunt with signs of significant RV volume overload, but with difficulties in defining the characteristics of a suspected atrial septal defect (ASD). CMR confirmed the presence of a large coronary sinus ASD (Panel A) as responsible for a significant left-to-right shunt (Qp/Qs ∼ 3,5, measured by phase-contrast imaging after correcting for the combined mitral and tricuspid regurgitation; Panel B), as well as severe RV dilatation and dysfunction. Pulmonary venous drainage was normal. Persistent left superior vena cava (SVC; Panel C) draining directly into the left atrium (LA) and a completely unroofed coronary sinus were unveiled.

The extremely rare combination of an unroofed coronary sinus with abnormal systemic venous drainage from double SVC circulation (usually as a persistent left SVC) is also known as Raghib syndrome (or Raghib complex). In the ASD with completely unroofed coronary sinus there is no common wall separating the coronary sinus from the LA, making the depiction of the shunt anatomy particularly difficult to assess with echocardiography. When unrecognized in the perinatal age, clinical natural course of Raghib syndrome can vary based on the severity of RV volume overload, and late (or very late) clinical presentations have been rarely reported. CMR, with its large field-of-view capability and multiparametric approach, provides accurate definition of cardiac and great vessels anatomy and function allowing the full non-invasive depiction of most congenital abnormalities. In many cases, multimodality imaging is the key to reach a full depiction of these complex conditions, particularly when adult patients with possible comorbidities need to be evaluated.
260 EFFICACY OF SGLT2 INHIBITORS IN PATIENTS WITH AND WITHOUT HEART FAILURE AND ACROSS THE SPECTRUM OF LEFT VENTRICULAR EJECTION FRACTION: A SYSTEMATIC REVIEW AND META-ANALYSIS OF RANDOMIZED CONTROLLED TRIALS
Authors: La Porta Ylenia , Cavallari Ilaria , Maddaloni Ernesto , Appetecchia Alessandro , Grigioni Francesco
Published: December 2022

Background

Sodium-glucose cotransporter 2 (SGLT-2) inhibitors have demonstrated to reduce heart failure (HF) and renal outcomes irrespective of diabetes status. The cardiovascular efficacy and the mortality benefit of these agents in patients without HF and across the spectrum of left ventricular ejection fraction (EF) are a matter of debate.

Methods

This study-level meta-analysis included 11 controlled randomized trials and 76,520 patients randomized to a SGLT-2 inhibitor (empagliflozin, dapagliflozin, canagliflozin, ertugliflozin and sotagliflozin) or placebo in different clinical settings including diabetes, HF with reduced or preserved EF and chronic kidney disease. Data were stratified by history of HF, HF with reduced EF (≤40%), mid-range EF (40-49%) and preserved EF (≥50%). The incidence of the following outcomes, when available, was evaluated: HF composite outcome, defined as cardiovascular death or hospitalization/urgent visit for HF, its individual components and all-cause mortality. An additional sensitivity analysis tested the efficacy of SGLT-2 inhibitors in patients with extremely reduced EF (≤30%).

Results

Overall, there were 22,653 patients with HF (33.8%) and 44,304 patients without HF (66.2%). In patients without history of HF, SGLT-2 inhibitors significantly reduced the risk of HF outcomes (HR 0.76, 95% CI 0.68-0.86) and all-cause mortality (HR 0.84, 95% CI 0.73-0.95). In patients with HF, a significant reduction in the composite of cardiovascular death and HF events was consistently observed in those with reduced EF (HR 0.71, 95% CI 0.65-0.78), mid-range EF (HR 0.68, 95% CI 0.57-0.81) and preserved EF (HR 0.78, 95% CI 0.69-0.89; Figure). There was a significant reduction in all-cause mortality also in patients with HF treated with SGLT-2 inhibitors (HR 0.87, 95% CI 0.80-0.95).

Conclusions

SGLT-2 inhibitors demonstrated cardiovascular and mortality benefits irrespective from history of HF and across the spectrum of left ventricular EF.
Effects of climate-related risks and extreme events on health outcomes and health utilization of primary care in rural and remote areas: a scoping review
Authors: Dewi Sari Puspa , Kasim Rosny , Sutarsa I Nyoman , Hunter Arnagretta , Dykgraaf Sally Hall
Published: December 2022

Background

Rural populations are at risk of climate-related impacts due to ecological and geographical determinants, potentially leading to greater morbidity and health utilization. They are often highly dependent on primary care services. However, no rural- or primary care specific synthesis of these issues has ever been conducted. This review aimed to identify, characterize, and summarize existing research on the effects of climate-related events on utilization and health outcomes of primary care in rural and remote areas and identify related adaptation strategies used in primary care to climate-related events.

Methods

A scoping review following PRISMA-ScR guidelines was conducted, examining peer-reviewed English-language articles published up to 31 October 2022. Eligible papers were empirical studies conducted in primary care settings that involved climate-related events as exposures, and health outcomes or utilization as study outcomes. Two reviewers independently screened and extracted relevant information from selected papers. Data were analysed using content analysis and presented using a narrative approach.

Results

We screened 693 non-duplicate papers, of those, 60 papers were analysed. Climate-related events were categorized by type, with outcomes described in terms of primary, secondary, and tertiary effects. Disruption of primary care often resulted from shortages in health resources. Primary care may be ill-prepared for climate-related events but has an important role in supporting the development of community.

Conclusions

Findings suggest various effects of climate-related events on primary care utilization and health outcomes in rural and remote areas. There is a need to prepare rural and remote primary care service before and after climate-related events.
Association Between Alcohol Use Disorders and Dementia in 262,703 Dementia-free Finnish Adults: Is Cardiovascular Disease a Mediator?
Authors: Hu Yaoyue , Korhonen Kaarina , Li Peng , Bobak Martin , Martikainen Pekka , Bijlsma Maarten J
Published: December 2022

Background

The possible mediating role of cardiovascular disease (CVD) in the relationship between alcohol use disorders (AUD) and the risk of early-onset (<age 65) and late-onset (≥age 65) dementia lacks formal investigation.

Methods

Using linked Finnish national register data, a population-based cohort study of 262,703 dementia-free Finnish men and women aged 40 + at baseline (December 31, 1999) was established. AUD and CVD in 1988–2014, and incident dementia in 2000–2014 were identified from Finnish Hospital Discharge Register and/or Drug Reimbursement Register. Causal association and mediation were assessed using mediational g-formula.

Results

AUD was associated with a substantial increase in the risk of early-onset dementia in both men (hazard ratio: 5.67, 95% confidence interval: 4.37–7.46) and women (6.13, 4.20–8.94) after adjustments for confounding; but the elevated risk for late-onset dementia was smaller (men: 2.01, 1.80–2.25; women: 2.03, 1.71–2.40). Mediational g-formula results showed that these associations were causal in men with no mediation by CVD as the virtually identical total effect of AUD (early-onset: 5.26, 3.48–7.48; late-onset: 2.01, 1.41–2.87) and direct effect of AUD (early-onset: 5.24, 3.38–7.64; late-onset: 2.19, 1.61–2.96) were found with no indirect effect via CVD. In women, the results were similar for late-onset dementia (total effect: 2.80, 1.70–4.31; direct effect: 2.92, 1.86–4.62) but underpowered for early-onset dementia.

Conclusion

AUD increased dementia risk, particularly the risk of early-onset dementia. This elevated risk of dementia associated with AUD was not mediated by CVD. Clinicians should consider the increased risk of dementia in the management of middle-aged and older adults with a history and/or current AUD.
Behavioral “nudges” in the electronic health record to reduce waste and misuse: 3 interventions
Authors: Grouse Carrie K , Waung Maggie W , Holmgren A Jay , Mongan John , Neinstein Aaron , Josephson S Andrew , Khanna Raman R
Published: December 2022

Electronic health records (EHRs) offer decision support in the form of alerts, which are often though not always interruptive. These alerts, though sometimes effective, can come at the cost of high cognitive burden and workflow disruption. Less well studied is the design of the EHR itself—the ordering provider’s “choice architecture”—which “nudges” users toward alternatives, sometimes unintentionally toward waste and misuse, but ideally intentionally toward better practice. We studied 3 different workflows at our institution where the existing choice architecture was potentially nudging providers toward erroneous decisions, waste, and misuse in the form of inappropriate laboratory work, incorrectly specified computerized tomographic imaging, and excessive benzodiazepine dosing for imaging-related sedation. We changed the architecture to nudge providers toward better practice and found that the 3 nudges were successful to varying degrees in reducing erroneous decision-making and mitigating waste and misuse.