bluuebunny/crossref_metadata_2025 huggingface dataset:
Gallium Oxide‐Based Field Effect Transistors
Authors: Kachhawa Pharyanshu , Masiul Islam Sk. , Chaturvedi Nidhi
Published: July 2024

The growing interest for power electronics devices demands suitable materials which can perform in harsh conditions. Gallium oxide () has shown tremendous potential in high voltage, high temperature, and gassensing applications due to its unique material properties. is considered to be the next‐generation material for power electronics owing to ultrawide bandgap of 4.5–4.9 eV and high electric field of 8 MV cm−1. These material properties coupled with high‐power figure of merits make a superior material compared to GaN and SiC. Herein, state‐of‐the‐art development and recent breakthroughs in ‐based field‐effect‐ transistors (FETs) highlighting major ongoing research are reviewed. The review describes the material property, band structure, and ‐based field‐effect transistors in detail. Some promising applications capitalizing the epitaxial growth techniques along with the characteristics and performance of ‐based devices are also explained. The prime objective of this review is to provide an up‐to‐date scientific framework pertaining to this niche emerging research area followed by device processing. This survey reveals the potential of ‐based FETs for high‐ voltage and high‐power applications while several critical challenges have to be still overcome. Finally, insights are represented and future perspectives of ‐based transistors along with their hetero‐structures are discussed.
Molecularization of Metasurfaces for Multifunctional Ultrafast All‐Optical Terahertz Waves
Authors: Zhou Qiangguo , Qiu Qinxi , Li Yongzhen , Wu Tuntan , Mao Wangchen , Gao Yanqing , Ren Yingjian , Zhou Wei , Jiang Lin , Yao Niangjuan , Huang Jingguo , Huang Zhiming
Published: July 2024

Hybrid metasurfaces incorporated by active materials hold great promise for state‐of‐the‐art terahertz functional devices. However, it is still a major challenge to achieve ultrafast, dynamic, and multifunctional effective control of THz waves via hybrid metasurfaces. Herein, a modulator consisting of split rings and cut‐wires is first demonstrated, with an amplitude of −35.6 dB at 0.524 THz. By embedding semiconductor silicon into specified locations to form a hybrid metasurface, the ultrastrong connectivity of the silicon bridges leads to rapid optical molecularization. Under photoexcitation, the frequency tuning range is 26.7%, the phase shifting reaches 357.5°, and the maximal modulation depth is 94.54%. Taking advantage of the rapid relaxation of photocarriers in the silicon bridges, the ultrafast frequency switching is within 1400 ps. More interestingly, by changing the positions of the silicon bridges, the frequency tuning range is further promoted to 60%, the phase shifting is 353.5°, the modulation depth of 100% is achieved, and the full recovery time is 1600 ps. Furthermore, the underlying mechanism of the ultrafast tuning process is elucidated. This work demonstrates the feasibility of all‐optical‐controlled hybrid metasurface to achieve multifunctional dynamic modulation of THz waves, which has tremendous potential for applications in optical switching, signal processing, and frequency conversion.
Two‐way feedback between the Madden–Julian Oscillation and diurnal warm layers in a coupled ocean–atmosphere model
Authors: Karlowska Eliza , Matthews Adrian J. , Webber Benjamin G. M. , Graham Tim , Xavier Prince
Published: July 2024

Diurnal warm layers develop in the upper ocean on sunny days with low surface wind speeds. They rectify intraseasonal sea‐surface temperatures (SSTs), potentially impacting intraseasonal weather patterns such as the Madden–Julian Oscillation (MJO). Here we analyse 15‐lead‐day forecast composites of coupled ocean–atmosphere and atmosphere‐only numerical weather prediction (NWP) models of the UK Met Office to reveal that the presence of diurnal warming of SST (dSST) leads to a faster MJO propagation in the coupled model compared with the atmosphere‐only model. To test the feedback between the MJO and the dSST, we designed a set of experiments with instantaneous vertical mixing over the top 5 or of the ocean component of the coupled model. Weaker dSST in the mixing experiments leads to a slower MJO over 15 lead days. The dSST produces a increase in the MJO phase speed between the coupled and the atmosphere‐only model. An additional increase is found for other coupling effects, unrelated to the dSST. A two‐way feedback manifests in the coupled model over the 15 lead days of the forecast between the MJO and the dSST. The MJO regime dictates the strength of the dSST and the dSST rectifies the intraseasonal anomalies of SST in the coupled model. Stronger dSST in the coupled model leads to stronger intraseasonal anomalies of SST. The MJO convection responds to these SSTs on a seven‐lead‐day timescale, and feeds back into the SST anomalies within the next three lead days. Overall, this study demonstrates the importance of high vertical resolution in the upper ocean for predicting the eastward propagation of the MJO in an NWP setting, which is potentially impactful for seasonal predictions and climate projections, should this feedback be unrepresented in the models.
Summer Heatwaves in Southeastern Australia
Authors: Henderson Cameron R. , Reeder Michael J. , Parker Teresa J. , Quinting Julian F. , Jakob Christian
Published: July 2024

Heatwaves in southeastern Australia have characteristic weather patterns that are well understood but are outnumbered by days with similar synoptic‐scale patterns that are not heatwaves. Accordingly, the aim of this study is to identify the key differences between heatwave and non‐heatwave days from 40 years of reanalysis data. A synoptic climatology of seven weather states was constructed by ‐means cluster analysis. Four of these states account for more than 80% of heatwave days across south‐and‐central eastern Australia. Moreover, the spatial maxima in the frequency of the heatwave days are distinct and geographically separated. Heatwave days have a stronger upper anticyclone or ridge that has propagated further equatorward in comparison with non‐heatwave days. The air upstream of the ridge is more humid on heatwave days, whereas downstream of the ridge the air is much drier. These dry anomalies are co‐located with midtropospheric subsidence and the moist anomalies with ascent, and their respective spatial distributions are consistent with regions of adiabatic warming and latent heating identified in recent studies of southeast Australian heatwaves. The corresponding vertical motion on non‐heatwave days is weaker and shifted further poleward. Southeast Queensland heatwave days exhibit increased baroclinicity over the Australian Subtropics and reduced rainfall over Queensland. Further south and west, heatwave days are associated with more amplified Rossby waves and increased rainfall over the Australian Tropics. Anticyclonic Rossby wave breaking is greatly enhanced on heatwave days south of 30°S. For every day in each of these four weather states, the 3‐day‐mean maximum temperature in the region of peak heatwave day frequency is positively correlated with 500 hPa geopotential height anomalies on the equatorward flank of the cluster‐mean upper ridge. These findings underline the importance of equatorward Rossby wave propagation in the dynamics of southeast Australian heatwaves.
Spatio‐temporal distribution of adult Pacific lamprey Entosphenus tridentatus relative to habitat fragmentation
Authors: Anlauf‐Dunn Kara J. , Clemens Benjamin J. , Falcy Matthew R. , Zambory Courtney
Published: July 2024

Pacific lamprey (Entosphenus tridentatus), a fish species native to the Pacific Northwest (USA), have distinctive cultural and ecological value but determining their spatial and temporal distribution is challenging due to a general lack systematic monitoring. In this study, we used counts of Pacific lamprey redds to model the probability of occurrence and abundance of Pacific lamprey based on environmental covariates including artificial barriers, assuming higher predicted lamprey redds translates to more suitable spawning habitats. Using generalized linear mixed zero‐inflated models, results suggest that Pacific lamprey abundance was generally lower in high gradient streams, further from the ocean. Stream reaches with warmer spring water temperatures and greater historical median spring flows supported higher abundances. Lamprey occurrence was primarily influenced by spring water temperatures and distance from the ocean. We further observed that when streams warm beyond 18°C, confidence intervals around the abundance estimates widen and zero‐inflation increases, indicating a decrease in occurrence. One objective of the study was to recommend where barrier removal or restoration should be prioritized to increase passage and thus access to upstream habitats. We considered artificial barriers to primarily influence the probability of occurrence through access. The barrier variable in this model had a negative effect on the probability of lamprey occurrence, but it was not a strong predictor in the model. While we are not able to suggest specific locations that would most benefit barrier removal or improvement based on these model results, we can identify the watersheds with a higher probability to support Pacific lamprey and provide potential additional habitats by improving habitat connectivity. Focusing restoration and/ or removal of barriers on watersheds in the Mid‐South region of the Oregon Coast (i.e., Alsea, Siuslaw, Coos, Coquille, and Sixes rivers) with higher habitat suitability could prioritize use of limited funds, increase the probability of benefiting Pacific lamprey, and potentially other native lampreys and migratory (e.g., salmon, steelhead; Oncorhynchus) species. Although this manuscript focuses on the Oregon Coast region, the methods are transferrable to other regions where Pacific lamprey are present.
Bayesian modeling of spatial ordinal data from health surveys
Authors: Beltrán‐Sánchez Miguel Ángel , Martinez‐Beneito Miguel‐Angel , Corberán‐Vallet Ana
Published: July 2024

Health surveys allow exploring health indicators that are of great value from a public health point of view and that cannot normally be studied from regular health registries. These indicators are usually coded as ordinal variables and may depend on covariates associated with individuals. In this article, we propose a Bayesian individual‐level model for small‐area estimation of survey‐based health indicators. A categorical likelihood is used at the first level of the model hierarchy to describe the ordinal data, and spatial dependence among small areas is taken into account by using a conditional autoregressive distribution. Post‐stratification of the results of the proposed individual‐level model allows extrapolating the results to any administrative areal division, even for small areas. We apply this methodology to describe the geographical distribution of a self‐perceived health indicator from the Health Survey of the Region of Valencia (Spain) for the year 2016.
Biomass and Transparent Supramolecular Elastomers for Green Electronics Enabled by the Controlled Growth and Self‐Assembly of Dynamic Polymer Networks
Authors: Wu Zhaolin , Wang Xiufen , Zhang Liqun
Published: July 2024

Determining the optimal method for preparing supramolecular materials remains a profound challenge. This process requires a combination of renewable raw materials to create supramolecular materials with multiple functions and properties, including simple fabrication, sustainability, a dynamic nature, good toughness, and transparency. In this work, a strategy is presented for toughening supramolecular networks based on solid‐phase chain extension. This toughening strategy is simple and environmentally friendly. In addition, a series of biobased elastomers are designed and prepared with adjustable performance characteristics. This strategy can significantly improve the transparency, tensile strength, and toughness of the synthesized elastomer. The synthesized biobased elastomers have great ductility, repairability, and recyclability, and they show good adhesion and dielectric properties. A biobased ionic skin is assembled from these biobased elastomers. Assembled ionic skin can sensitively detect external stimuli (such as stretching, bending, compression, or temperature changes) and monitor human movement. The conductive and dielectric layers of the biobased ionic skin are both obtained from renewable raw materials. This research provides novel molecular design approaches and material selection methods for promoting the development of green electronic devices and biobased elastomers.
How Adam Smith's banking views influenced Hamilton, Jefferson, and the debate over the Bank of the United States
Authors: Curott Nicholas A. , White Lawrence H.
Published: July 2024

The most sophisticated monetary and banking policy advice available in the decades after 1776 was found in Adam Smith's Wealth of Nations. Smith recommended free competition among nationwide banks of issue with minimal legal restrictions and no legal privileges. Yet neither Alexander Hamilton nor Thomas Jefferson accepted Smith's recommendation, despite their familiarity with his arguments, and despite Scotland's positive experience while following it. We spell out Hamilton's and Jefferson's theoretical disagreements, and explain how Smith's advice did not serve either founder's political agenda. For Hamilton, competitive banking without a single privileged national bank would not do enough to strengthen the federal government. For Jefferson, any federal chartering of banks would strengthen the federal government too much at the expense of the states.
A scratch below a system's surface
Authors: Georgiou Ion
Published: July 2024

Underlying a complex system is an intricate network that encodes the interactions between the system's components. Consequently, understanding of, and effective action upon, a complex system requires exploration and analysis of its underlying network. Recent published research on teaching/training social network analysis gives rise to at least four contributions of relevance to systems research. A synergistic advantage is perceptible, proportional to the methodical and deliberated incorporation of social network analysis into systems research education and training.
Experimental study on the reinforced concrete beams with varied stirrup reinforcement ratio under static and impact loads
Authors: Gu Jianxiao , Li Liancheng , Huang Xin , Chen Hui
Published: July 2024

With the increasing utilization of reinforced concrete (RC) beams in eco‐friendly and fast‐paced construction practices, evaluating their impact performance becomes imperative. These beams are susceptible to unforeseen impact loads resulting from accidents or terrorist incidents throughout their service lifespan. Five groups of RC beams, each subjected to different curing periods, stirrup reinforcement, and drop hammer heights, were fabricated. Among these groups, one underwent static load testing, while the remaining groups were subjected to impact load testing utilizing the drop hammer test system. The failure modes, static response, dynamic response, and energy dissipation of RC beams were analyzed. Static tests revealed that RC beams exhibited a flexure‐governed failure mode with top surface concrete crushing, aligning with expectations. With increased stirrup reinforcement ratios, shear and flexural‐shear cracks during impact tests decreased, with high impact loads causing diagonal shear failure, severe concrete crushing, additional diagonal shear cracks, and a broader crack distribution. Higher drop hammer heights were found to increase overall energy dissipation, whereas increased stirrup reinforcement ratios resulted in moderate decrease. Specifically, the overall energy dissipation increased with higher drop hammer heights. Conversely, an increase in the stirrup reinforcement ratio was linked to a certain degree of decrease in overall energy dissipation.
Evaluating water security in sub‐Saharan Africa: Examining a case study of water supply inventory, accessibility, and predictability on Iwo, Nigeria
Authors: Ogunbode Timothy O. , Oyebamiji Victor O. , Akinkuolie A. Timothy , Adekiya O. Aruna , Oyelami A. Ayobami , Taiwo T. Mary , Ademola Oladokun T. , Ogundele A. John , Ologunagba M. Modupe , Awolola O. Victor , Abidogun A. Michael , Paul Ifabiyi I.
Published: July 2024

The security of nations concerning water accessibility by 2030 is under threat due to climate change, potentially hindering global targets outlined in SDG 6. This study assesses the water security of the sub‐Saharan region, focusing on Iwo, Nigeria. Surveys on household water sources, availability, and use were conducted across 12 months among 937 households. Climatic data spanning 31 years (1992–2022) from the Nigeria Meteorological Agency were analyzed for water supply evaluation. Descriptive and inferential statistical analyses were applied to the datasets. Results revealed a predominant 95% involvement of female heads and individuals above 18 years old. Notably, 92.7% spent less than 10 min obtaining water, with 90.5% not paying water tariffs, indicating a predominantly domestic water use pattern, reflecting the agrarian nature of the study area. Analysis of climatic data highlighted water loss during dry season months and previously rainy months (March, April, and August), confirming climate change manifestations. Household water use consistently exceeded supply, ranging from 348.9 to 444.6 L/month, with a per capita value of 148.6 L (4.95 L/day) falling below the WHO recommendation of 10 to 20 L/day. Regression analysis identified three significant predictive models at p < .005, with Model 3 showing a notable predictability (R value of 42.3 at p < .005 and SE of ±79.05941), and it encompasses more of the variables analyzed. The generally low R value suggests the consideration of additional variables for model validity. Urgent and intentional efforts are required to exploit abundant surface water resources for enhanced justice in water accessibility in aligning with the SDG 6 target.
Exploring the Benefits of a New Force Enabler: Defense AI in Italy
Authors: Gilli Andrea , Gilli Mauro , Zaccagnini Ivan
Published: July 2024

Italy is striving to bridge its gap in defense Artificial Intelligence (AI) despite being a latecomer in the field. This pursuit aligns with broader efforts towards digitalization and modernization, particularly within its Armed Forces. Acknowledging AI’s potential benefits and threats, Italy emphasizes human involvement in decision-making processes while advancing modernization initiatives. Italy sees defense AI as a force multiplier, enhancing Armed Forces capabilities through sensor sophistication, automation, data fusion, and decision-making support.

The commitment to modernize dates back to the early 2000s, notably with the Forza NEC program launched in 2007. Aimed at integrating military assets into a network-centric framework by 2031, this initiative seeks to enhance computation, communication, and situational awareness. In 2021, the Ministry of Defense allocated €190M for AI development until 2035, marking a significant investment exclusively focused on defense AI. However, several programs, including the ambitious Global Combat Air Programme (GCAP) and Robotics and Autonomous Systems Experimentation Campaign (RAS), are going to involve AI technologies.

The Italian Armed Forces collaborate and synergize on their key projects with the country’s whole AI ecosystem, which includes academic institutions, civil and military research labs, startups, and private and public high-tech companies. In addition, most Italian defense AI development projects are designed to optimize resources while also ensuring integrability and interoperability among its Armed Forces branches as well as NATO allies and platforms—this is also true for AI and training. The Italian Armed Forces have set their key goals for 2035, but it remains to be seen if they will be able to accomplish them by that year.
Heavy Thunder, No Rain: Defense AI in Iran
Authors: Javadi Mahmoud
Published: July 2024

Iran’s grand strategy revolves around three key pillars: regime’s survival, security, stability (S3). Viewing the United States, and to a lesser extent Israel, as enduring state threats aiming to disrupt S3, Tehran has increasingly prioritized asymmetric tactics in its defense doctrine. This approach aims to deter adversaries’ kinetic and non-kinetic operations while also positioning Iran to attain regional power status. The integration of AI into defense is seen as a force multiplier. Although Iran’s incorporation of AI into its defense capabilities and infrastructure remains in progress and lacks clarity, the regime is extensively focusing on enhancing its missile systems, proxy forces, Uncrewed Aerial Vehicles (UAVs), and naval power with AI technologies. Beyond state deterrence, Iran’s 360-degree defense doctrine places emphasis on safeguarding national critical infrastructure and ensuring domestic stability, both of which have recently been bolstered through AI. The defense infrastructure in Iran operates through a multi-layered approach, predominantly involving the Islamic Revolutionary Guard Corps (IRGC), the Army, and the Ministry of Defense. Each entity maintains low-profile research and development (R&D) facilities aimed at advancing AI capabilities or integrating AI technologies into existing systems. Given Iran’s practice of denial and deception (D&D) techniques in its defense technology investments, the exact budget allocated for AI remains undisclosed. However, notwithstanding the opacity surrounding defense AI R&D and budgetary allocation, all defense academies currently engage in training students and recruiting researchers in military applications of AI, a testament to Iran’s vision to progressively integrate AI into its arsenals in the future.
A Pragmatic Approach to Understanding the Disease Status of Addiction
Authors: Walker Mary Jean , Rogers Wendy A.
Published: July 2024

Debate about whether or not addiction is a disease has been central to practice and policy responses. In this paper, we aim to move that debate forward by understanding why the disease status of addiction is so unclear and contested, and draw on pragmatic considerations to suggest a partial resolution. To do this, we apply the vague cluster view of ‘disease’. This view is pragmatic since it allows appeal to the practical implications of considering a condition to be a disease in justifying the classification, for particular purposes. After explaining the view, we apply it to addiction to show that whether or not addiction has the typical features of a disease is unclear due to the vagueness and ambiguity of these features. We then examine pragmatic considerations often deemed relevant to deciding addiction’s disease status to see if these can suggest precisification. Pragmatic disease accounts are potentially problematic in that pathologising addiction simultaneously has both positive and negative effects, and it can be difficult to maintain different precisifications across contexts. Nonetheless we argue that the vague cluster approach circumscribes some ways of conceptualising addiction as disease, namely those that conceptualise disease as solely physiological dysfunction. It thus prompts a pragmatic shift to a broader understanding of addiction that partially resolves the negative consequences of disease designation. The discussion suggests that disagreements over whether addiction is a disease are primarily normative and semantic, rather than being disagreements over facts.
A Plea for More History
Authors: Bolt Timo
Published: July 2024

In his Is There An Epistemic Role For History In Medicine? Thinking About Thyroid Cancer Nicholas Binney (Chap. 7, this volume) aims to show how historical work can have its epistemic function, that is: a role in understanding and therefore justifying medical knowledge and practice. From my perspective as a medical historian, Binney’s programmatic text raises three questions: (1) Is this epistemic role for history important?; (2) Is Binney’s argument convincing?; (3) How can a plea for history appear so ahistorical, or more positively put: how can we make Binney’s promising approach even more historical? In what follows, I will try and answer these questions.
Scope Validity in Medicine
Authors: Keuck Lara
Published: July 2024

This chapter introduces scope validity as a conceptual tool to capture the (mis)matching of the scopes of disease operationalizations in different contexts of research and application. Drawing on examples of extrapolating results from animal models to human patient populations, the chapter proposes a shift in perspective away from idealized target constructs that can be hit and towards concrete practices of operationalization that render diseases researchable. It argues that we need to take seriously the locally varying conditions under which disease concepts operate and that impact on the assessment of a model’s validity. Combining an adequacy-for-purpose view towards validity with a practice-oriented, pragmatist and particularistic perspective on disease concepts, the chapter presents scope validity as a relational concept that does not presuppose the extent of a test or model’s generalizability to some hypothetical ideal. This offers us a possibility to distinguish between a model’s high external validity for a small patient population, and a model’s broad scope of applicability. Scope validity thus does not replace other validity concepts, such as predictive validity, external validity and construct validity, but rather helps to clarify and qualify the frame and conditions under which a model or test’s validity should be assessed, putting the question of adequacy in medical research to the forefront.
Axion dark matter from cosmic string network
Authors: Kim Heejoo , Park Junghyeon , Son Minho
Published: July 2024

Abstract

We perform lattice simulations to estimate the axion dark matter abundance radiated from the global cosmic strings in the post-inflationary scenario. The independent numerical confirmation on the recently observed logarithmic growth in both the number of strings per Hubble patch and the spectral index of the power law scaling for the axion spectrum is reported. These logarithmic scalings are checked against two different prescriptions for generating initial random field configurations, namely fat-string type and thermal phase transition. We discuss a possible strong correlation between the axion spectrum and the string evolutions with different initial conditions to support the insensitivity of scaling behaviors against different initial data and we provide a qualitative understanding of it. The impact of various combinations of the power law of the axion spectrum, nonlinearities around the QCD scale, and average inter-string distances on the axion abundance are discussed. Additionally, we introduce a new novel string identification method, based on the tetrahedralization of the space, which guarantees the connectedness of the strings and provides a convenient way of assigning the core location. Finally we derive a lower bound on the axion mass.
Differences in endocrine and reproductive responses to substance exposure across generations: highlighting the importance of complementary findings
Authors: Bichlmaier Ingo
Published: July 2024

This article analyzes the results from 112 Extended One-Generation Reproductive Toxicity studies. The objective was to determine if test animals show consistent endocrine and reproductive effects within the same and across different generations and life stages. The analysis, grounded in a comprehensive Binary Matrix, included 530 observed effects and 193 unique, statistically significant associations. Associations’ strength was quantified using Jaccard (J) coefficients to measure effect co-occurrence in the same study. Associated effects co-occur infrequently across the whole dataset (median J = 0.231). However, specific patterns emerged: associations of same effects across generations exhibited a higher strength (median J = 0.400) compared to associations of different effects (median J = 0.222). Notably, associations with effects observed in both the parental animals of the adult first filial generation (P1) and developing second filial generations (dF2) demonstrated J coefficients (with medians ranging from 0.300 to 0.430) that were approximately twofold higher than those of other associations. Consistently, equivalent life stage associations across generations revealed statistically significant higher association strengths for the P1 and dF2 generations (medians of 0.375 and 0.333, respectively) compared to other generations (medians of 0.200 and 0.174), possibly due to longer exposure duration and altered cross-talk between pregnant P1 dam and its conceptus. Overall, it is concluded that co-occurrence of associated effects in the same study is rather infrequent and that associations with effects in P1 and dF2 are stronger than all other associations. In general, the findings underscore the importance of independently analyzing each effect per generation due to the generally low co-occurrence rates of associated effects, challenging traditional expectations of generational continuity in toxic effects.
The Unfinished Reconstructed Nature of the Last Universal Common Ancestor
Authors: Delaye Luis
Published: July 2024

The ultimate consequence of Darwin’s theory of common descent implies that all life on earth descends ultimately from a common ancestor. Biochemistry and molecular biology now provide sufficient evidence of shared ancestry of all extant life forms. However, the nature of the Last Universal Common Ancestor (LUCA) has been a topic of much debate over the years. This review offers a historical perspective on different attempts to infer LUCA’s nature, exploring the debate surrounding its complexity. We further examine how different methodologies identify sets of ancient protein that exhibit only partial overlap. For example, different bioinformatic approaches have identified distinct protein subunits from the ATP synthetase identified as potentially inherited from LUCA. Additionally, we discuss how detailed molecular evolutionary analysis of reverse gyrase has modified previous inferences about an hyperthermophilic LUCA based mainly on automatic bioinformatic pipelines. We conclude by emphasizing the importance of developing a database dedicated to studying genes and proteins traceable back to LUCA and earlier stages of cellular evolution. Such a database would house the most ancient genes on earth.
Evaluating the safety of bipolar nephrostomy tract cauterization “BNTC” towards a safe tubeless percutaneous nephrolithotomy: a randomized controlled trial
Authors: Omar Mohamed , Ibrahim Tarek Ahmed Amin , Sultan Sultan , El-Gharabawy Mohamed , Noureldin Yasser , Hamri Saeed Bin , Sayedahmed Khaled
Published: July 2024

To assess the safety and effectiveness of tubed versus tubeless percutaneous nephrolithotomy (PCNL) after tract inspection and bipolar cauterization of the significant bleeders. Patients who were scheduled for PCNL were screened for enrollment in this prospective randomized controlled trial. The patients were randomly assigned to one of two groups; Group 1 received tubeless PCNL with endoscopic inspection of the access tract using bipolar cauterization of the significant bleeders only, while Group 2 had a nephrostomy tube was inserted without tract inspection. We excluded patients with multiple tracts, stone clearance failure, and significant collecting system perforation. We recorded blood loss, hemoglobin drop after 6 h, postoperative analgesia requirements, hospital stay, and the need for angioembolization. A total of 110 patients completed the study. There were no significant differences between the two groups in in terms of demographic characteristics. Likewise, there was no significant difference in the mean decrease in hemoglobin after 6 h and the frequency of blood transfusion. However, the incidence of hematuria within the first 6 h (p = 0.008), postoperative pain scale (p = 0.0001), the rate of analgesia requirement (p = 0.0001) and prolonged hospital stay (p = 0.0001) were significantly higher in Group 2. Only 9 cases of tract screened patients (16% of group 1) required cauterization. Tubeless PCNL with tract inspection and cauterization of bleeders can provide a safer tubeless PCNL with less postoperative pain, analgesia requirement, and same-day discharge.
Liver stiffness measurement by magnetic resonance elastography predicts cirrhosis and decompensation in alcohol-related liver disease
Authors: Chen Jingbiao , Xu Peng , Kalutkiewicz Kyle , Sheng Yiyang , Warsame Fatima , Tahboub-Amawi Mahmoud-Adam , Li Jiahui , Wang Jin , Venkatesh Sudhakar K. , Ehman Richard L. , Shah Vijay H. , Simonetto Douglas A. , Yin Meng
Published: July 2024

Purpose

To evaluate magnetic resonance elastography (MRE)—based liver stiffness measurement as a biomarker to predict the onset of cirrhosis in early-stage alcohol-related liver disease (ALD) patients, and the transition from compensated to decompensated cirrhosis in ALD.

Methods

Patients with ALD and at least one MRE examination between 2007 and 2020 were included in this study. Patient demographics, liver chemistries, MELD score (within 30 days of the first MRE), and alcohol abstinence history were collected from the electronic medical records. Liver stiffness and fat fraction were measured. Disease progression was assessed in the records by noting cirrhosis onset in early-stage ALD patients and decompensation in those initially presenting with compensated cirrhosis. Nomograms and cut-off values of liver stiffness, derived from Cox proportional hazards models were created to predict the likelihood of advancing to cirrhosis or decompensation.

Results

A total of 182 patients (132 men, median age 57 years) were included in this study. Among 110 patients with early-stage ALD, 23 (20.9%) developed cirrhosis after a median follow-up of 6.2 years. Among 72 patients with compensated cirrhosis, 33 (45.8%) developed decompensation after a median follow-up of 4.2 years. MRE-based liver stiffness, whether considered independently or adjusted for age, alcohol abstinence, fat fraction, and sex, was a significant and independent predictor for both future cirrhosis (Hazard ratio [HR] = 2.0–2.2, p = 0.002–0.003) and hepatic decompensation (HR = 1.2–1.3, p = 0.0001–0.006). Simplified Cox models, thresholds, and corresponding nomograms were devised for practical use, excluding non-significant or biased variables.

Conclusions

MRE-based liver stiffness assessment is a useful predictor for the development of cirrhosis or decompensation in patients with ALD.

Graphical Abstract
Molecular fingerprints of cardiovascular toxicities of immune checkpoint inhibitors
Authors: Gergely Tamás G. , Drobni Zsófia D. , Sayour Nabil V. , Ferdinandy Péter , Varga Zoltán V.
Published: July 2024

Immune checkpoint inhibitors (ICIs) have revolutionized cancer therapy by unleashing the power of the immune system against malignant cells. However, their use is associated with a spectrum of adverse effects, including cardiovascular complications, which can pose significant clinical challenges. Several mechanisms contribute to cardiovascular toxicity associated with ICIs. First, the dysregulation of immune checkpoints, such as cytotoxic T-lymphocyte-associated protein 4 (CTLA-4) and programmed cell death protein-1 (PD-1) and its ligand (PD-L1), and molecular mimicry with cardiac autoantigens, leads to immune-related adverse events, including myocarditis and vasculitis. These events result from the aberrant activation of T cells against self-antigens within the myocardium or vascular endothelium. Second, the disruption of immune homeostasis by ICIs can lead to autoimmune-mediated inflammation of cardiac tissues, manifesting as cardiac dysfunction and heart failure, arrhythmias, or pericarditis. Furthermore, the upregulation of inflammatory cytokines, particularly tumor necrosis factor-alpha, interferon-γ, interleukin-1β, interleukin-6, and interleukin-17 contributes to cardiac and endothelial dysfunction, plaque destabilization, and thrombosis, exacerbating cardiovascular risk on the long term. Understanding the intricate mechanisms of cardiovascular side effects induced by ICIs is crucial for optimizing patient care and to ensure the safe and effective integration of immunotherapy into a broader range of cancer treatment protocols. The clinical implications of these mechanisms underscore the importance of vigilant monitoring and early detection of cardiovascular toxicity in patients receiving ICIs. Future use of these key pathological mediators as biomarkers may aid in prompt diagnosis of cardiotoxicity and will allow timely interventions.
Ritlecitinib, a JAK3/TEC family kinase inhibitor, stabilizes active lesions and repigments stable lesions in vitiligo
Authors: Yamaguchi Yuji , Peeva Elena , Duca Ester Del , Facheris Paola , Bar Jonathan , Shore Ronald , Cox Lori Ann , Sloan Abigail , Thaçi Diamant , Ganesan Anand , Han George , Ezzedine Khaled , Ye Zhan , Guttman-Yassky Emma
Published: July 2024

The efficacy of ritlecitinib, an oral JAK3/TEC family kinase inhibitor, on active and stable lesions was evaluated in patients with active non-segmental vitiligo in a phase 2b trial (NCT03715829). Patients were randomized to placebo or daily ritlecitinib 50 mg (with or without 4-week 100-mg or 200-mg loading dose), 30 mg, or 10 mg for 24 weeks. Active lesions showed greater baseline expression of inflammatory/immune markers IFNG and CCL5, levels of CD103, and T-cell infiltrates than stable lesions. Patients with more active than stable vitiligo lesions showed higher baseline serum levels of CXCL9 and PD-L1, while patients with more stable than active lesions showed higher baseline serum levels of HO-1. At Week 24, ritlecitinib 50 mg significantly stabilized mean percent change from baseline in depigmentation extent in both active lesions and stable lesions vs. placebo-response, with stable lesions showing greater repigmentation. After 24 weeks of treatment, ritlecitinib 50 mg increased expression of melanocyte markers in stable lesions, while Th1/Th2-related and co-stimulatory molecules decreased significantly in both stable and active lesions. Serum from patients with more active than stable lesions showed decreased levels of ICOS and NK cell activation markers. These data, confirmed at transcription/protein levels, indicate that stable lesion repigmentation occurs early with ritlecitinib, while active lesions require stabilization of inflammation first. ClinicalTrials.gov: NCT03715829.
Incidence of cerebral small vessel disease-related MR markers in the Swedish general population ‘Good Aging in Skåne’(GÅS) study
Authors: Elmståhl Sölve , Ellström Katarina , Siennicki-Lantz Arkadiusz , Lätt Jimmy , Månsson Sven , Månsson Tomas , Abul-Kasim Kasim
Published: July 2024

Background and objectives

Cerebral small vessel disease (CSVD) is associated to cognitive decline and dementia. Neuroimaging changes of CSVD are highly prevalent above 80 years. Only few studies report on incidence of CSVD in high age. We have investigated the incidence and prevalence of magnetic resonance imaging (MRI) markers of CSVD and risk factors in the general older population.

Methods

As part of the general population Good Aging in Skåne cohort study (GÅS), 241 persons (mean age 76.3 years) underwent two brain MRI, 3-T scanner with a mean interval of 5.9 years. The incidence of white matter hyperintensities (WMH), lacunar infarction, cerebral atrophies and cerebral microbleeds (CMB) were calculated and the relationship to risk factors analysed by a multivariate regression analysis. Medial temporal lobe atrophy (MTA) was graded according to Scheltens’18 scale and CMB were defined as having > 1 small (0.2–0.5 cm) hypointense lesion.

Results

The 6-year incidence of CMB, WMH and MTA were, 19%, 17% and 13% respectively, corresponding to 170/1,000 py., 172/1,000 py., and respectively 167/1,000 py. The incidence of CSVD according to the modified STRIVE score was 33%, 169/1,000 py and the prevalence at baseline was 73%. Moderate to high intake of alcohol was related to increased incidence of MTA and higher STRIVE score. Exposure to smoking was related to higher incidence of CMB and higher STRIVE score, adjusted for other known risk factors.

Conclusion

CSVD is highly prevalent in the general older population and the 6-year incidence of WMH, CMB and MTA ranges from 13 to 19 percent. The modifiable lifestyle factors: smoking, and moderate alcohol intake are related to incident CSVD.
Geospatial identification of possible rainwater harvesting locations within a high-altitude Gilgit River basin, Pakistan
Authors: Asif Madiha , Yaseen Muhammad , Shahid Syed Umair , Latif Yasir , Anwar Salma , Abbas Sohail
Published: July 2024

The management of water resources is no longer an option but a necessity especially in countries with a high rate of population growth like Pakistan. Pakistan has a high-water scarcity, an extremely varying topography, and is also one of the countries encountering the problem of climate change. Therefore, prudent utilization of available water resources is a matter in the plains of Pakistan as in its high-altitude regions. Instead of wasting water which is a valuable resource, rainwater harvesting is a way of saving rainwater as an alternative source of fresh water for better use. The aim of this study was to search for potential rainwater-harvesting areas in a high-altitude Gilgit River basin. This research employed the SCS-CN technique in estimating surface runoff in the GIS environment. The geospatial study used four input parameters: slope of the land, land covers, surface runoff and drainage density. The research concluded that some lands, especially those that are deserted in dry area and agricultural lands, can serve as the sites of rainwater harvesting, with only 4% of area that was highly suitable for the purpose. Nevertheless, 37% of the investigated area was shown as totally unviable for rainwater collection installations because of steep slopes and substantial volume of snow. Simultaneously, the rainwater storage design solutions suggested were check dam, percolation tank, and agricultural ponds with the area of 3.5%, 1%, and 0.75% of the given land area, respectively, for rainwater harvesting. The locations of potential catchment and planned rainwater harvesting structures would assist the local authorities and the policy makers to provide plans and design on the construction of water storages and also the optimization of water use.
Berufsverbleib von Diplomierten Rettungssanitäterinnen und -sanitätern HF in der Schweiz
Authors: Regener Helge , Trede Ines
Published: July 2024

Hintergrund

In der Schweiz nimmt der Mangel an rettungsdienstlichem Fachpersonal trotz steigender Ausbildungszahlen stetig zu. Umstände und Gründe dieses Fachkräftemangels wurden bislang nicht differenziert beschrieben.

Ziel der Arbeit

Diese Lücke soll mit dem vorliegenden Beitrag geschlossen werden. Um ein besseres Verständnis der Einflussfaktoren in Bezug auf Berufsverbleib und -ausstieg im Rettungsdienst zu erlangen und um Handlungsfelder zur Reduktion des Fachkräftemangels zu identifizieren, werden verschiedene Faktoren mit Einfluss auf Berufsverbleib und -wechsel nach soziodemografischen Merkmalen wie Geschlecht, Bildungsweg und sprachregionalen Besonderheiten erfasst und analysiert.

Material und Methoden

Erstmals wurden in einer anonymisierten Onlineumfrage mit 23 Items systematisch Daten zum Berufsverbleib von Diplomierten Rettungssanitäterinnen und -sanitätern in allen Landesteilen erhoben. Hierfür wurden die Diplomandinnen und Diplomanden der Abschlussjahre 2008–2023 aller Schweizer Höheren Fachschulen Rettungssanität in drei Landessprachen adressiert (n = 2394).

Ergebnisse und Schlussfolgerung

Bei einem Rücklauf von 61 % (n = 1453) und einer im Vergleich zur Grundgesamtheit repräsentativen Verteilung für Geschlecht und Sprache konnten mehrere potenzielle Ursachen von Berufsausstiegen analysiert werden. So sind fehlende Karrieremöglichkeiten und Unzufriedenheiten mit Arbeitszeit- bzw. Schichtdienstmodellen die häufigsten genannten Gründe dafür, den Beruf zu verlassen. Die unterschiedlichen Anschlusslösungen nach Ausstieg aus dem Rettungsdienst, beispielsweise ein Verbleib im Gesundheitswesen oder ein Branchenwechsel, zeigen verschiedene Handlungsoptionen für die Arbeitgeber auf.
Clinical and multimodal imaging features of adult-onset neuronal intranuclear inclusion disease
Authors: Zhu Rui , Qu Junyu , Xu Guihua , Wu Yongsheng , Xin Jiaxiang , Wang Dawei
Published: July 2024

Objectives

This study aimed to analyze the clinical and multimodal imaging manifestations of adult-onset neuronal intranuclear inclusion disease (NIID) patients and to investigate NIID-specific neuroimaging biomarkers.

Methods

Forty patients were retrospectively enrolled from the Qilu Hospital of Shandong University. We analyzed the clinical and imaging characteristics of 40 adult-onset NIID patients and investigated the correlation between these characteristics and genetic markers and neuropsychological scores. We further explored NIID-specific alterations using multimodal imaging indices, including diffusion tensor imaging (DTI), magnetic resonance spectroscopy (MRS), and brain age estimation. In addition, we summarized the dynamic evolution pattern of NIID by examining the changes in diffusion weighted imaging (DWI) signals over time.

Results

The NIID patients’ ages ranged from 31 to 77 years. Cognitive impairment was the most common symptom (30/40, 75.0%), while some patients (18/40, 45.0%) initially presented with episodic symptoms such as headache (10/40, 25.0%). Patients with cognitive impairment symptoms had more cerebral white matter damage (χ2 = 11.475, P = 0.009). The most prevalent imaging manifestation was a high signal on DWI in the corticomedullary junction area, which was observed in 80.0% (32/40) of patients. In addition, the DWI dynamic evolution patterns could be classified into four main patterns. Diffusion tensor imaging (DTI) revealed extensive thinning of cerebral white matter fibers. The estimated brain age surpassed the patient’s chronological age, signifying advanced brain aging in NIID patients.

Conclusions

The clinical manifestations of NIID exhibit significant variability, usually leading to misdiagnosis. Our results provided new imaging perspectives for accurately diagnosing and exploring this disease’s neuropathological mechanisms.