bluuebunny/crossref_metadata_2025 huggingface dataset:
High‐pressure and high‐temperature synthesis of crystalline Sb3N5
Authors: Ceppatelli Matteo , Serrano‐Ruiz Manuel , Morana Marta , Dziubek Kamil , Scelta Demetrio , Garbarino Gaston , Poręba Tomasz , Mezouar Mohamed , Bini Roberto , Peruzzini Maurizio
Published: December 2023

A chemical reaction between Sb and N2 was induced under high‐pressure (32–35 GPa) and high‐temperature (1600–2200 K) conditions, generated by a laser heated diamond anvil cell. The reaction product was identified by single crystal synchrotron X‐ray diffraction at 35 GPa and room temperature as crystalline antimony nitride with Sb3N5 stoichiometry and structure belonging to orthorhombic space group Cmc21. Only Sb−N bonds are present in the covalent bonding framework, with two types of Sb atoms respectively forming SbN6 distorted octahedra and trigonal prisms and three types of N atoms forming NSb4 distorted tetrahedra and NSb3 trigonal pyramids. Taking into account two longer Sb−N distances, the SbN6 trigonal prisms can be depicted as SbN8 square antiprisms and the NSb3 trigonal pyramids as NSb4 distorted tetrahedra. The Sb3N5 structure can be described as an ordered stacking in the bc plane of bi‐ layers of SbN6 octahedra alternated to monolayers of SbN6 trigonal prisms (SbN8 square antiprisms). The discovery of Sb3N5 finally represents the long sought‐after experimental evidence for Sb to form a crystalline nitride, providing new insights about fundamental aspects of pnictogens chemistry and opening new perspectives for the high‐pressure chemistry of pnictogen nitrides and the synthesis of an entire class of new materials.
A ultra‐low viscosity stearic acid emulsion prepared by lauric acid as waterproof agent for cement mortar
Authors: Huang Haowei , Wu Liangliang , Wang Gang , Wang Xianjun , Xie Yunchuan
Published: December 2023

Safe building structures cannot be achieved without reliable waterproofing engineering. To address the susceptibility of concrete materials to water leakage, a low‐viscosity stearic acid emulsion has been developed as a waterproofing agent for mortar. By introducing lauric acid, the formation of stearic acid crystals in water could be effectively prevented, resulting in a stearic acid emulsion with a viscosity of only 24 mPa·s. It is found that the best overall performance was achieved when the ratio (R) of lauric acid to stearic acid was 2/3. This emulsion has the least effect on mortar fluidity and setting time. The as‐prepared modified mortar possessed the highest compressive strength (127% of the blank) and the lowest water absorption at 48 h (37% of the blank). X‐ray diffraction (XRD), Fourier‐transform infrared spectroscopy (FTIR), energy‐dispersive x‐ray spectroscopy (EDS), scanning electron microscopy (SEM), dynamic light scattering (DLS) particle size analysis, and water contact angle measurements were used to investigate the mechanism of stearic acid emulsion's modification. It is determined that the stearic acid emulsions successfully modified the internal and external hydrophobicity of the mortar by chemical action with calcium hydroxide.
Liquid metal flexible wearable triboelectric nanogenerator device for human energy harvesting
Authors: Liang Shuting , Li Fengjiao , Xie Shunbi , Chen JianYang , Jiang Dabo , Qu Xi , Zhang Haifeng
Published: December 2023

Humans generate a lot of irregular movements in their daily lives, and much of the movement energy is difficult to collect. This paper develops a wearable device based on a liquid metal (LM)‐based frictional electric nanogenerator, including: flexible power‐generating fiber, power‐generating surface, and power‐generating insole. Friction nano power generation fibers are prepared using LM, epoxy resin, and silicone. The power generation device could be formed by weaving the fibers in cross, mesh and spiral arrangement, with a maximum open circuit voltage of 142 mV and current of 1.06 A, which could be coded into intelligent clothing. Power generating surfaces use LM, nylon,polycaprolactone (PCL), and polyethylene terephthalate (PET) as friction electrodes. The LM‐PCL produces a maximum open‐circuit voltage of 2.4 V and a maximum current of 1.23 A when they form a friction electrode. Electricity‐generating insoles are composed of silicone holes filled with LM, and the movement of the human foot generates electricity. With a friction area of 18.75 cm2, a maximum output voltage of 221 mV is obtained. These friction nano power devices have the advantages of a green environment, and low cost, which could be widely used in medical, biological, and clothing formulation fields.
An ultra‐tough, creep‐resistant, wear‐resistant hydrogel for cartilage replacement
Authors: Ren Hanyu , Guo Andi , Wang Wentang , Luo Chunhui
Published: December 2023

As a load‐bearing tissue, natural cartilages possess a compressive stress above 50 MPa, a water content around 60%, and a friction coefficient (FC) less than 0.1, which remains difficult for synthetic materials to realize. Herein, a facile strategy was reported to achieve this goal. The hydrogel was obtained through a three‐step strategy from polyvinyl alcohol (PVA), chitosan (CS), sodium carboxymethyl cellulose (CMC‐Na), lecithin (LS), and deionized water. First, freezing–thawing the aqueous solution of PVA and CS three times generated the precursor gel. Second, immersing it in aqueous solution of CMC‐Na to form multiple linkages (hydrogen bonds, ionic interactions, and crystallize domains). Third, it was coated with LS to form a lubrication layer. Due to the synergy of dynamic interactions, the compressive stress was 115 MPa, superior to most tough hydrogels. Owing to existence of LS, the FC was 0.03, better than the requirement for artificial cartilage. Remarkably, the FC remained stable within 50,000 wear cycles. On account of the reversible break/reformation of physical linkages, the creep recovery efficiency was 93%. The raw materials are all biocompatible and the fabrication process exclude the adoption of toxic additives. All of these features make it an ideal material for cartilage replacement.
Investigation of the size effect of mica sheets on the anticorrosion behavior of UV‐cured coatings
Authors: Xing Zheng , Song Bin , Liu Ren , Sang Xinxin , Luo Jing
Published: December 2023

In this article, four different grades of mica sheets were used to investigate the influence of the size of mica sheet on the UV‐curing process and the anticorrosion performance of UV‐cured coatings. The dispersion of mica sheets in coating matrix was explored by viscosity and morphology measurements. The curing behavior of the composite coatings was studied by gel content and double bond conversion rate. The dispersing behavior of the mica sheets with different grades was investigated by SEM image and rheology measurement. And the anticorrosive performance of the UV‐cured composite coatings was studied by electrochemical measurements and neutral salt spray tests. It was found that the curing degree of the UV‐cured coating was not affected with incorporation of mica sheet as well as its size. Mica sheets with medium size (10 μm) could be more efficiently dispersed in UV‐cured coating than other grades, which helps to form a denser filler pathway and suppresses the diffusion of corrosive agents into the coating matrix, leading to the lowest water adsorption and best anticorrosion performance. After 45 days of immersion in NaCl solution, the impedance modulus of the UV‐cured composite coating with 10 μm mica sheets did not decrease and still maintained at the initial impedance value. After 1500 h's salt spray test, the corresponding coating remained intact without bubbling, peeling, corrosion, and other defects, whereas the coating with other grades of mica sheets all exhibited corrosion pits and blisters, demonstrating that the size of mica sheet played an important role in enhancing the anticorrosion performance of UV‐cured coatings.
Eco‐friendly approach for the determination of moxifloxacin in pharmaceutical formulations and biological fluids based on fluorescence quenching of l‐tryptophan
Authors: Khan Muhammad Naeem , Khan Mashal , Jan Muhammad Noman
Published: December 2023

A rapid, novel and cost‐effective spectrofluorimetric method developed to determine moxifloxacin (MFX) in pharmaceutical preparations because MFX in a pH 10 medium could reduce the fluorescence intensity of l‐tryptophan. The maximum fluorescence excitation and emission wavelengths were found to be 280 and 363 nm respectively. A range of factors affecting fluorescence quenching and the effect of co‐existing substances were investigated. Fluorescence quenching values (ΔF = FL‐tryptophan − FMoxi‐L‐tryptophan) displayed a strong linear relationship with the MFX concentration ranging from 0.2 to 8.0 μg/ml under optimum conditions. The limit of detection was found to be 6.1 × 10−4 μg/ml. The proposed method was shown to be suitable for MFX determination in pharmaceutical tablets and biological fluids by the linearity, recovery and limit of detection. The spectrofluorimetric approach that has been developed is extremely eco‐friendly, as evidenced by the fact that all the experimental components and solvents were safe for the environment.
Engineered extracellular vesicles: A new approach for targeted therapy of tumors and overcoming drug resistance
Authors: Ming‐Kun Chen , Zi‐Xian Chen , Mao‐Ping Cai , Hong Chen , Zhuang‐Fei Chen , Shan‐Chao Zhao
Published: December 2023

Targeted delivery of anti‐tumor drugs and overcoming drug resistance in malignant tumor cells remain significant clinical challenges. However, there are only few effective methods to address these issues. Extracellular vesicles (EVs), actively secreted by cells, play a crucial role in intercellular information transmission and cargo transportation. Recent studies have demonstrated that engineered EVs can serve as drug delivery carriers and showed promising application prospects. Nevertheless, there is an urgent need for further improvements in the isolation and purification of EVs, surface modification techniques, drug assembly processes, and precise recognition of tumor cells for targeted drug delivery purposes. In this review, we summarize the applications of engineered EVs in cancer treatment and overcoming drug resistance, and current challenges associated with engineered EVs are also discussed. This review aims to provide new insights and potential directions for utilizing engineered EVs as targeted delivery systems for anti‐tumor drugs and overcoming drug resistance in the near future.
Is serum‐derived exosomal hTERT transcript a marker of oncogenic activity in primary brain tumors? An exploratory study
Authors: Uziel Orit , Kanner Andrew A. , Beery Einat , Lev Sapir , Lahav Meir , Horn‐Fichman Suzana , Nof Sagi Har , Laviv Yuseph , Yust‐Katz S. , Amiel Alexandra , Shkara Ramez Abu , Siddeeq Mustafa , Levy‐Barda Adva , Raanani Pia , Sela Yaron , Cohen Zvi , Siegal Tali
Published: December 2023

Background

In order to proliferate indefinitely, all tumors require a telomere maintenance mechanism. The expression of human telomerase reverse transcriptase (hTERT) enables telomere maintenance and provides cancer cells with limitless replicative potential. As such, it may serve as an attractive biomarker for oncogenic activity. This study explored whether a liquid biopsy that analyses blood derived exosomal hTERT transcript (e‐hTERT‐trans) may serve as such a biomarker in gliomas and meningiomas when compared to healthy controls.

Methods

Exosomes were isolated from the pre‐operative sera of patients' samples stored in the biobank of both Rabin and Sheba Medical Centers. The levels of e‐hTERT‐trans were measured in 81 healthy controls, 117 meningiomas, 17 low‐grade gliomas, and 61 glioblastomas. Clinical parameters of the patients were collected retrospectively and compared to the levels of the e‐hTERT‐trans.

Results

The upper normal limit of controls e‐hTERT‐trans was 1.85 relative quantitation (RQ). The rate of detection increased with rising tumor grade and correlated with tumor recurrence in meningiomas: mean RQ without recurrence (2.17 ± 11.7) versus with recurrence (3.59 ± 4.42; p = 0.002). In glioblastomas, preoperative measurements correlated with tumor volume and with the disease course on serial sampling.

Conclusions

We demonstrated for the first time that the expression of e‐hTERT‐trans transcript can be measured in the serum of primary brain tumors. This exosomal marker carries the potential to serve as a biomarker once used in conjunction with other clinical and radiological parameters. Future studies are required to investigate whether the sensitivity could be augmented and whether it can be implemented into routine patients care.
Biological Activity and Sterilization Mechanism of Marine Fungi‐derived Aromatic Butenolide Asperbutenolide A Against Staphylococcus aureus
Authors: Jiang Yufeng , Wang Jiule , Zhang Hua , Tian Xuelu , Liang Zhiqiang , Xu Xinli , Bao Jie , Chen Biao
Published: December 2023

Marine fungi represent a huge untapped resource of natural products. The bio‐activity of a new asperbutenolide A from marine fungus Aspergillus terreus was not well known. In the present study, the minimum inhibitory concentration (MIC) and RNA‐Sequencing were used to analyze the bio‐activity and sterilization mechanism of asperbutenolide A against clinical pathogenic microbes. The results showed that the MICs of asperbutenolide A against methicillin‐resistant Staphylococcus aureus (MRSA) were 4.0–8.0 μg/mL. The asperbutenolide A present poor bio‐activity against with candida. The sterilization mechanism of asperbutenolide A against MRSA showed that there were 1426 differentially‐expressed genes (DEGs) between the groups of MRSA treated with asperbutenolide A and negative control. Gene Ontology (GO) classification analysis indicated that the DEGs were mainly involved in cellular process, metabolic process, cellular anatomical entity, binding, catalytic activity, etc. Kyoto Encyclopedia of Genes and Genomes (KEGG) classification analysis showed that these DEGs were mainly enriched in amino acid metabolism, carbohydrate metabolism, membrane transport, etc. Moreover, qRT‐PCR showed similar trends in the expressions of argF, ureA, glmS and opuCA with the RNA‐Sequencing. These results indicated that asperbutenolide A was with ideal bio‐activity against with MRSA and could be as a new antibacterial agent.
Relative Oral Bioavailability and Food Effects of Two Sepiapterin Formulations in Healthy Participants
Authors: Gao Lan , Kaushik Diksha , Xia Yi , Ingalls Kimberly , Milner Sarah , Smith Neil , Kong Ronald
Published: December 2023

Sepiapterin is an orally administered drug in development for the treatment of phenylketonuria, an inborn error of metabolism characterized by the deficiency of the phenylalanine‐metabolizing enzyme phenylalanine hydroxylase. This study characterized the pharmacokinetics, safety, and tolerability of 2 clinical sepiapterin formulations (Phase 1/2, Phase 3) and the effects of food on the pharmacokinetics of the Phase 3 formulation in healthy participants. In Part A, 18 participants were randomized to one of 2 treatment sequences, each with 4 dosing periods comprising a single dose (20 or 60 mg/kg) of the Phase 1/2 or the Phase 3 formulation with a low‐fat diet. In Part B, 14 participants were randomized to one of 2 sequences, each comprising 4 dosing periods of a single dose (20 or 60 mg/kg) of the Phase 3 formulation under fed (high‐fat) or fasted conditions. Following oral administration, sepiapterin was quickly absorbed and rapidly and extensively converted to tetrahydrobiopterin (BH4). BH4 was the major circulating active moiety. Under low‐fat conditions, the Phase 3 formulation was bioequivalent to the Phase 1/2 formulation at 20 mg/kg, while slightly lower BH4 exposure (approximately 0.81×) for the Phase 3 formulation was observed at 60 mg/kg. BH4 exposure increased to approximately 1.7× under the low‐fat condition and approximately 2.8× under the high‐fat condition at a dose of either 20 or 60 mg/kg for the Phase 3 formulation, compared with the fasted condition. Both sepiapterin formulations were well tolerated, with no serious or severe adverse events reported. All treatment‐emergent adverse events were mild or moderate in severity.
Research on hybrid synchronization methods in multi‐user collaborative VR simulation medical surgery training system
Authors: Gong Ao , Cheng Yun , Su Jing , Zhang Li
Published: December 2023

The simulation training system based on VR technology has been applied in clinical medicine due to its immersive interactive experience, economy, and safety. In response to the limitation that most medical surgery training systems can only achieve single user operations, a hybrid synchronous model based multi‐user collaborative framework design is proposed to meet the needs of collaborative training in virtual reality teaching processes. Based on the characteristics of frame synchronization and state synchronization, the synchronization method has been improved. Based on frame synchronization, specific state synchronization is used on interactive events to improve the consistency of operation details and real‐time action. On this basis, a system prototype has been implemented using Unity 3D, and compared with traditional schemes, analysis shows that it has faster response speed for disconnected reconnection and more stable interaction state.
How Not to Play an Indian Mythic: Raji: A Modern Fantasy
Authors: Chaudhury Arkabrata , Chaudhuri Arunoday
Published: December 2023

The current paper analyses the video game Raji: An Ancient Epic (Nodding Head Games 2020) to determine the accuracy of its representation of historical Indian experiences, in the domains of architecture, aesthetics, spatiality, technology, and so on. The ludic elements of the game, including weapon or enemy design and their compatibility with reflecting an Indian ethos in video game mechanisms have also been discussed. The treatment of Indian mythology is extensively explored, with an eye to locating its space in Indian mythic tradition. Through an analysis of narrative storytelling in the game, aspects such as the foregrounding of a female protagonist and the apparent progressive feminist attitude of the game have been scrutinised. The sociocultural depiction of India and its implications and contexts relating to contemporary understanding of the space of the subcontinent has also been taken into consideration. A careful study of the game within the contemporary post‐colonial discourse constitutes a part of the article. We also undertake a comparative study with another Indian mythic video game, Unrest (Pyrodactyl 2014), to better understand the issues surrounding the treatment of mythic and historical elements. The article both contemplates the missed opportunities and future potentials, for example, in terms of more nuanced and accurate representation and the balance between ludic execution and representational possibilities, as experienced in the ludo‐narrative experience offered by the game.
In vitro studies of a novel liposomal formulation for safe and efficient iron delivery
Authors: Szostak‐Paluch Kamila , Drabik Dominik , Jędruchniewicz Natalia , Dwornikowska‐Dąbrowska Mariola
Published: December 2023

Anemia of chronic diseases is the most popular type of anemia. Treatment of such conditions is based on iron supplementation. However, chronic conditions are accompanied by increased activity of hepcidin, which significantly limits iron absorption from traditional supplementation forms. Modern liposomal technologies allow for efficient encapsulation of macromolecules, which can result in a significant absorption improvement. The presented results show an encapsulation efficiency of more than 90% of iron‐dextran complexes, with a decrease in cytotoxicity and reactive oxygen species generation.

Practical Application: These results can be used to prepare novel liposomal iron ion formulation with high encapsulation efficiency due to the appliance of iron(III) oxide complex with dextran.
Fatigue can influence the development of late‐onset pain in post‐COVID‐19 syndrome: An observational study
Authors: Baroni A. , Fregna G. , Lamberti N. , Manfredini F. , Straudi S.
Published: December 2023

Background

Late‐onset pain is frequent following COVID‐19, and many pathogenetic mechanisms have been proposed. Identifying the main features of patients may help in designing tailored rehabilitative interventions.

Methods

We enrolled post‐COVID‐19 patients with an increase in pain intensity of two points on the COVID‐19 Yorkshire Rehabilitation Scale (C19‐YRS) at 52 weeks compared to the pre‐COVID‐19 condition. All subjects were retrospectively monitored at 12, 26, and 52 weeks. A specific pain assessment was performed to determine the characteristics and mechanisms of pain. Catastrophizing, kinesiophobia, and other psychological symptoms were evaluated. The pressure pain threshold (PPT) and temporal summation (TS) were measured and compared in age‐ and sex‐matched healthy controls to analyse pain characteristics.

Results

A total of 67 patients were recruited, with 20 of them presenting an increase in pain at 52 weeks. Subjects of the two subgroups were similar in demographic and clinical characteristics at baseline; significant differences in fatigue, anxiety, mobility, ability to perform daily activities, and general health perception were recorded at 26 weeks. Fatigue significantly predicted pain onset (β = 0.54, p = 0.002). Sixteen different body regions were identified as painful, with a pain intensity of 6.0 ± 1.9. Most of the samples did not show neuropathic or nociplastic mechanisms. No differences in PPT and TS were recorded between patients and healthy controls.

Conclusions

Almost one out of three patients hospitalized for COVID‐19 developed pain 1 year later, and fatigue seems responsible for chronicity. An overlapping of conditions may explain late‐onset post‐COVID‐19 pain, and a comprehensive approach must be considered for patient management.

Significance

Late‐onset pain is frequent in post‐COVID‐19 syndrome and an overlapping of different mechanisms seems to be responsible for its development. Among many predisposing factors, fatigue in the months before seems to be one of the primary causes of pain one year following infection and its management may help to identify new strategies for prevention and treatment of late‐onset pain.
Recurrent neural network and federated learning based channel estimation approach in mmWave massive MIMO systems
Authors: Shahabodini Sajjad , Mansoori Mobina , Abouei Jamshid , Plataniotis Konstantinos N.
Published: December 2023

So far, various data‐driven approaches have been presented to obtain channel state information (CSI) in millimeter wave multiple‐input‐multiple‐output wireless networks. In almost all previous works, training and testing channels were assumed to have the same distribution, which may not be the case in practice. In this article, we address this challenge by proposing a learning framework that is a combination of a recurrent neural network (RNN) model and a deep neural network (DNN) for estimating CSI in a dynamic wireless communication environment. Furthermore, we use federated learning to train the learning‐based channel estimation model. More specifically, we introduce a two‐stage downlink pilot transmission procedure, where in the initial stage, long frame length downlink pilot signals are used to train the introduced RNN‐DNN model. Following that, users will receive shorter‐frame‐length pilot signals that can be used for CSI estimation. To speed up the training procedure of the proposed network, we first generate a pre‐trained model and then modify it according to the collected data samples. Simulation results demonstrate that, when the channel distribution is unavailable, the proposed approach performs significantly better than the most recent channel estimation algorithms in terms of estimation performance and computational complexity.
Ginseng in white and red processed forms: Ginsenosides and cardiac side effects
Authors: Zhou Jiexin , Zhang Jiarui , Jing Pu , Lan Yu , Cao Xiaonian , Feng Huafang , Liu Xiaogang , Liu Qingqing
Published: December 2023

Ginseng (Panax ginseng Meyer) has long been consumed as a medicinal or functional food in East Asia. It is available as dried white ginseng (WG) and steamed red ginseng (RG), which might differ in ginsenoside profiles. We compared ginsenoside types of RG and WG using UPLC‐MS/MS and evaluated how they biologically affected heart of healthy rats by recording electrocardiography, measuring biochemical indicators, analyzing cardiac tissue slides, and Ca2+ signaling pathways. About 25 and 29 ginsenosides were detected in WG and RG, respectively, and the total ginsenoside content of RG contained was nearly 1.8 times higher than that of WG. Among them, ginsenoside Rg4, ginsenoside Rg6, ginsenoside Rh4, ginsenoside Rk1, ginsenoside Rg5, and protopanaxadiol were detected only in RG, while 20(R)‐ginsenoside Rg2 was detected only in WG. Male SD rats treated by intraperitoneal injection of WG or RG extracts were similar to the control in terms of electrocardiography and heart histology, indicating that both may not significantly affect the rats' myocardial function. However, WG and RG may induce mild cardiac injury resulting in increased cardiac collagen and creatine kinase levels. In addition, upregulated p‐CaMKII and PPARδ and downregulated SERCA2a for WG and RG treatments were further associated with increased cardiac contractility. In general, RG had less effect on the heart of healthy rats than WG, which may be due to RG having a high proportion of low‐polar ginsenosides.
Self, context, and power: Introducing the critical campus ecology model
Authors: Noble Chelsea E.
Published: December 2023

In this chapter, I introduce the critical campus ecology model (CCEM) to account for systems of oppression in an individual's ecosystem. Drawing insights from queer geographies and critical whiteness studies, I add “oppressive systems” as the fifth contextual system to the Process‐Person‐Context‐Time model. Forces in the oppressive system, such as racism and cissexism, influence each of the individual's systems and have real, material influence on all aspects of the student's context. Further, I share how I utilized the CCEM as a framework for data collection and analysis for a study of students’ conceptions of their campus LGBTQ+ center. I conclude with implications for research and practice, such as leveraging the CCEM as a tool for reflection, identity exploration, and social critique.

Practical Takeaways

Oppressive systems influence all levels of an individual's ecosystem. Yet, classic ecological models including Bronfenbrenner's Process‐Person‐Context‐Time model, do not attend to power and oppression.

The critical campus ecology model (CCEM) orients scholars and practitioners to the overt and insidious ways that oppressive systems shape an individual's ecology. Additionally, it acknowledges that the individual and their contexts can also act on oppressive systems.

The CCEM can be a powerful tool in research settings to guide participants’ self‐reflection about the contexts and forces shaping their experiences. In practice settings, it can be similarly leveraged as a tool for reflection, identity exploration, and social critique.
An analysis of a rural hospital's investment decision under different payment systems
Authors: Guo Xidong
Published: December 2023

From an economic perspective, large investments in medical equipment are justifiable only when many patients benefit. Although rural hospitals play a crucial role locally, the treatments they can offer are limited. In this study, I characterize investment level that maximizes the total surplus, encompassing patients' welfare and producer surplus, and subtracting treatment costs. Specifically, I account for economic externalities generated by the investment in the rural hospital and for different utility losses that patients suffer when they cannot be treated locally. I demonstrate that the optimal investment level can be implemented if the Health Authority has the power to set specific prices for each disease. Additionally, I explore a decentralized situation wherein the investment decision lies with the rural hospital manager, and the Health Authority can only make a discrete decision between two payment systems: Fee‐for‐service, which covers all treatment costs, or Diagnosis‐Related‐Groups, which reimburses a price per patient based on the overall average cost. I find that the Diagnosis‐Related‐Groups system outperforms the Fee‐for‐service in terms of total surplus when the treatment cost at the rural hospital is lower. However, when the rural hospital has higher costs and the Health Authority seeks to incentivize investment, the Fee‐for‐service system is superior.
Quantitative imaging workshop XIX: Utilizing quantitative thoracic imaging to optimize population health final summary
Authors: Mulshine James L. , Avila Riccardo S. , Rizzo Albert A. , Estepar Raul San Jose , McGlothlin Anita , Pyenson Bruce , Hoyos Jody , Aldigé Carolyn R. , Yankelevitz David F.
Published: December 2023

Lung cancer screening involves the use of thoracic CT for both detection and measurements of suspicious lung nodules to guide the screening management. Since lung cancer screening eligibility typically requires age over 50 years along with >20 pack‐year tobacco exposure, thoracic CT scans also frequently reveal evidence for pulmonary emphysema as well as coronary artery calcification. These three thoracic diseases are collectively three of the leading causes of premature death across the world. Screening for the major thoracic diseases in this heavily tobacco‐exposed cohort is broadening the focus of lung cancer screening to a more comprehensive health evaluation including discussing the relevance of screen‐detected findings of the heart and lung parenchyma. The status and implications of these emerging issues were reviewed in a multidisciplinary workshop focused on the process of quantitative imaging in the lung cancer screening setting to guide the evolution of this important new area of public health.
An efficient lung image classification and detection using spiral‐optimized Gabor filter with convolutional neural network
Authors: Sivakumar V. , Yogesh C. K. , Vatchala S. , Kaliraj S.
Published: December 2023

Lung cancer has a high death rate of around seven million cases every year worldwide. A computed tomography (CT) scan provides certain essential data concerning lung diseases and their diagnosis. The main objective of this work is to classify various lung diseases such as Normal, Bronchiectasis, and Pleural Effusion. The proposed approach consists of three stages, namely pre‐processing, feature extraction, and classification. At first, CT lung images are collected from the dataset and pre‐processed. After pre‐processing, the important texture features are extracted from each image. For feature extraction, spiral‐optimized Gabor filter (SOGF) is utilized. The proposed SOGF is a combination of spiral optimization algorithm (SOA) and Gabor filter (GF). Then, the extracted features are given to the convolutional neural network (CNN) to classify different types of lung diseases. For comparison, we use different classifiers, namely artificial neural network (ANN), Random Tree, and the Naïve Bayes. The experimental results show that our proposed approach attained the maximum accuracy of 93.67% which is high compared to other methods.
Vascularization of PEGylated fibrin hydrogels increases the proliferation of human iPSC‐cardiomyocytes
Authors: Vanderslice Ethan J. , Golding Staunton G. H. , Jacot Jeffrey G.
Published: December 2023

Studies have long sought to develop engineered heart tissue for the surgical correction of structural heart defects, as well as other applications and vascularization of this tissue has presented a challenge. Recent studies suggest that vascular cells and a vascular network may have regenerative effects on implanted cardiomyocytes (CM) and nearby heart tissue separate from perfusion of oxygen and nutrients. The goal of this study was to test whether vascular cells or a formed vascular network in a fibrin‐based hydrogel would alter the proliferation of human iPSC‐derived CM. First, vascular network formation in a slowly degrading PEGylated fibrin hydrogel was optimized by altering the cell ratio of human umbilical vein endothelial cells to human dermal fibroblasts, the inclusion of growth factors, and the total cell concentration. An endothelial to fibroblast ratio of 5:1 and a total cell concentration of 1.1 × 106 cells/mL without additional growth factors generated robust vascular networks while minimizing the number of cells required. Using this optimized system, human iPSC‐derived CM were cultured on hydrogels without vascular cells, hydrogels with unorganized encapsulated vascular cells, or hydrogels with encapsulated vascular cells organized into networks for 7 days. CM proliferation and gene expression were assayed following 7 days of culture on the hydrogels. The presence of vascular cells in the hydrogel, whether unorganized or in vascular networks, significantly increased CM proliferation compared to an acellular hydrogel. Hydrogels with unorganized vascular cells resulted in lower CM maturity evidenced by decreased expression of cardiac troponin t (TNNT2), myosin light chain 7, and phospholamban compared to hydrogels without vascular cells and hydrogels with vascular networks. Altogether, this study details a robust method of forming rudimentary vascular networks in a fibrin‐based hydrogel and shows that a hydrogel containing endothelial cells and fibroblasts can induce proliferation in adjacent CM, and these cells do not hinder CM gene expression when organized into a vascular network.
Comparison of the electrophysiological properties of the pulmonary veins between paroxysmal and persistent atrial fibrillation
Authors: Mori Hitoshi , Hamabe Akira , Kawano Daisuke , Naganuma Tsukasa , Tahara Mai , Gatate Yodo , Kimura Toyokazu , Tabata Hirotsugu , Kato Ritsushi
Published: December 2023

Background

The role of the pulmonary veins (PVs) as triggers in atrial fibrillation (AF) is well‐known; however, their detailed electrophysiological properties have not been thoroughly examined.

Objective

This study aimed to investigate the electrophysiological properties of the PVs between paroxysmal AF (pAF) and persistent AF (perAF).

Methods

Prior to catheter ablation in patients with pAF (n = 51) and perAF (n = 41), a voltage map of the left atrium and PVs was created under sinus rhythm, and the area of the myocardial sleeves in the PVs and their electrophysiological characteristics, including the pacing threshold and effective refractory period (ERP), were compared between the two groups.

Results

Compared with perAF, the myocardial sleeves of PVs for pAF were significantly larger for all PVs. The ERP for perAF was significantly shorter than that for pAF for all PVs. The pacing threshold for perAF was significantly higher than that for pAF for the right and left superior PVs.

Conclusion

In patients with perAF, a decrease in the normal myocardial sleeves and a shortening of the ERP were observed for all PVs. Those changes in the electrophysiological properties of the PVs might be related to the persistence of AF.
All eyes will be on California as voters weigh MH transformation
Authors: Enos Gary
Published: December 2023

California voters in March will consider a massive transformation of the state's mental health service delivery system, a proposal that would direct more resources to the most seriously ill individuals. While there are many nuanced implications to the two legislative measures that are being combined into Proposition 1 on the March 5 ballot, observers said they think voters likely will be swayed by supporters' aim to reduce highly visible and crisis‐level homelessness in many California communities.
Advancing MH: A comprehensive outlook on emerging trends
Authors: Eriksson Hans
Published: December 2023

As the mental health sector progresses into 2024, it stands on the cusp of a transformative journey. Despite potential challenges within the current market conditions, the year promises to be significant, with notable advancements in psychedelic therapies, technological applications, precision psychiatry and evolving therapeutic paradigms converging to elevate mental well‐being to a central position.
Maximizing SNR per unit time in diffusion MRI with multiband T‐Hex spirals
Authors: Engel Maria , Mueller Lars , Döring André , Afzali Maryam , Jones Derek K.
Published: December 2023

Purpose

The characterization of tissue microstructure using diffusion MRI (dMRI) signals is rapidly evolving, with increasing sophistication of signal representations and microstructure models. However, this progress often requires signals to be acquired with very high b‐values (e.g., b > 30 ms/μm2), along many directions, and using multiple b‐values, leading to long scan times and extremely low SNR in dMRI images. The purpose of this work is to boost the SNR efficiency of dMRI by combining three particularly efficient spatial encoding techniques and utilizing a high‐performance gradient system (Gmax ≤ 300 mT/m) for efficient diffusion encoding.

Methods

Spiral readouts, multiband imaging, and sampling on tilted hexagonal grids (T‐Hex) are combined and implemented on a 3T MRI system with ultra‐strong gradients. Image reconstruction is performed through an iterative cg‐SENSE algorithm incorporating static off‐resonance distributions and field dynamics as measured with an NMR field camera. Additionally, T‐Hex multiband is combined with a more conventional EPI‐readout and compared with state‐of‐the‐art blipped‐CAIPIRINHA sampling. The advantage of the proposed approach is furthermore investigated for clinically available gradient performance and diffusion kurtosis imaging.

Results

High fidelity in vivo images with b‐values up to 40 ms/μm2 are obtained. The approach provides superior SNR efficiency over other state‐of‐the‐art multiband diffusion readout schemes.

Conclusion

The demonstrated gains hold promise for the widespread dissemination of advanced microstructural scans, especially in clinical populations.
The effect of and correction for through‐slice dephasing on 2D gradient‐echo double angle B1+ mapping
Authors: Belsley Gabriela , Tyler Damian J. , Robson Matthew D. , Tunnicliffe Elizabeth M.
Published: December 2023

Purpose

To show that variations through slice and slice profile effects are two major confounders affecting 2D dual angle maps using gradient‐echo signals and thus need to be corrected to obtain accurate maps.

Methods

The 2D gradient‐echo transverse complex signal was Bloch‐simulated and integrated across the slice dimension including nonlinear variations in inhomogeneities through slice. A nonlinear least squares fit was used to find the factor corresponding to the best match between the two gradient‐echo signals experimental ratio and the Bloch‐simulated ratio. The correction was validated in phantom and in vivo at 3T.

Results

For our RF excitation pulse, the error in the factor scales by approximately 3.8% for every 10 Hz/cm variation in along the slice direction. Higher accuracy phantom maps were obtained after applying the proposed correction; the root mean square error relative to the gold standard decreased from 6.4% to 2.6%. In vivo whole‐liver maps using the corrected map registered a significant decrease in gradient through slice.

Conclusion

inhomogeneities varying through slice were seen to have an impact on the accuracy of 2D double angle maps using gradient‐echo sequences. Consideration of this confounder is crucial for research relying on accurate knowledge of the true excitation flip angles, as is the case of mapping using a spoiled gradient recalled echo sequence.
Home‐based multi‐sensory and proximal strengthening program to improve balance inCharcot–Marie–Tooth disease Type 1A: Aproof of concept study
Authors: Dudziec Magdalena M. , Lee Laurence E. , Massey Charlotte , Tropman David , Skorupinska Mariola , Laurá Matilde , Reilly Mary M. , Ramdharry Gita M.
Published: December 2023

Introduction/Aims

People with Charcot–Marie–Tooth Disease (CMT) frequently report problems with balance, which lead to an increased risk of falls. Evidence is emerging of training interventions to improve balance for people with CMT, but to date all have relied on clinic‐based treatment and equipment. This proof‐of‐concept study explored whether a multi‐modal program of proprioceptive rehabilitation and strength training can be delivered at home, to improve balance performance in people with CMT Type 1A.

Methods

Fourteen participants with CMT Type 1A were recruited into this randomized, two‐arm study. Baseline assessments included measures of disease severity, posturography, physical function, and patient‐reported outcome measurements. All participants received one falls education session. Participants were randomized to either 12 weeks of balance training or 12 weeks of usual activities. The intervention comprised a home‐based, multi‐sensory balance training and proximal strengthening program, supported by three home visits from a physiotherapist.

Results

Thirteen participants completed the study. The intervention was successfully implemented and well tolerated, with high participation levels. Functional measures of balance and walking showed strong effect sizes in favor of the training group. Posturography testing demonstrated moderate improvements in postural stability favoring the intervention group. Inconsistent changes were seen in lower limb strength measures.

Discussion

The intervention was feasible to implement and safe, with some evidence of improvement in balance performance. This supports future studies to expand this intervention to larger trials of pragmatic, home‐delivered programs through current community rehabilitation services and supported self‐management pathways.
Ultrahigh efficiency and enhanced discharge energy density at low loading of nanofiller in trilayered polyvinylidene fluoride‐Ba0.8Sr0.2TiO3 nanocomposites
Authors: Jaidka Sachin , Singh Dwijendra P.
Published: December 2023

Poly(vinylidene)fluoride‐Ba0.8Sr0.2TiO3 (PVDF‐BST) trilayered nanocomposites (with different vol% loading of BST nanoparticles, i.e. 0.75%, 1.50%, 2.25% and 3.00%) has been processed by the tape casting technique. The upper and lower layers of the nanocomposites are casted in the same direction, whereas the middle layer is casted in the opposite direction. The trilayered PVDF‐BST nanocomposite consisting of 3.00 vol% of BST nanoparticles exhibited high dielectric permittivity (~25), low tangent loss (~0.03) and moderately high breakdown strength (BDS ~282 MV/m). Moreover, it also possesses a high discharge energy density (~7.8 J/cc at 1400 kV/cm) and efficiency (~93%). A mechanism for the excellent energy storage behavior and dielectric properties has been proposed. Where, moderately high BDS and low tangent loss are associated with the spatial distribution of the local electric field at interlayer interfaces of PVDF‐BST trilayered nanocomposites, which restricts the conduction of charge carriers at high electric field. The ultrahigh efficiency and enhanced discharge energy density is attributed to the formation of interfacial dipoles at various interfaces such as interlayer, intralayer (PVDF/PVDF), and PVDF/BST interfaces. These investigations would be adopted as a futuristic strategy for developing excellently efficient polymer‐ceramic nanocomposites for the high energy density capacitors used in pulsed power applications.

Highlights

PVDF‐BST trilayered nanocomposites exhibit high ε′ ~25 and low tanδ ~0.03.

Nanocomposite shows ultra‐high energy efficiency ~93% and enhanced UD ~ 7.8 J/cc.

Mechanism for the excellent energy storage and dielectric properties

Relies on the interfacial dipoles and distribution of the local electric field.
Attention biases the process of risky decision‐making: Evidence from eye‐tracking
Authors: Hu Mengchen , Chang Ruosong , Sui Xue , Gao Min
Published: December 2023

Attention determines what kind of option information is processed during risky choices owing to the limitation of visual attention. This paper reviews research on the relationship between higher‐complexity risky decision‐making and attention as illustrated by eye‐tracking to explain the process of risky decision‐making by the effect of attention. We demonstrate this process from three stages: the pre‐phase guidance of options on attention, the process of attention being biased, and the impact of attention on final risk preference. We conclude that exogenous information can capture attention directly to salient options, thereby altering evidence accumulation. In particular, for multi‐attribute risky decision‐making, attentional advantages increase the weight of specific attributes, thus biasing risk preference in different directions. We highlight the significance of understanding how people use available information to weigh risks from an information‐processing perspective via process data.
Use of pembrolizumab among older adults with cancer in the United States, before and after FDA approval of its tumor‐agnostic indication
Authors: Hong Yoon Duk , Enewold Lindsey , Halpern Michael T. , Zeruto Chris , Mariotto Angela B.
Published: December 2023

Introduction

Pembrolizumab, an anticancer immunotherapy agent, has received multiple approvals since its first approval by the U.S. Food and Drug Administration (FDA) in 2014. Limited data exist on its real‐world use and shifts post tumor‐agnostic approval in 2017 for the treatment of patients with any microsatellite instability‐high/mismatch repair deficient (MSI‐H/dMMR) solid tumors. This study analyzes pembrolizumab's pre and post‐tumor‐agnostic approval use among older U.S. adults, revealing its evolving role in oncology practice.

Methods

Using the Surveillance, Epidemiology and End Results (SEER)‐Medicare data (2014–2019), we examined the cancer sites of pembrolizumab recipients before and after tumor‐agnostic approval. Cancer sites were classified based on the timing of site‐specific approvals (before/after tumor‐agnostic approval) or no site‐specific approval, and inclusion in MSI‐H/dMMR clinical trials.

Results

The total number of pembrolizumab recipients increased from 4221 in the pre‐agnostic period to 20 479 in the post‐agnostic period. Pembrolizumab was used for a broad range of cancer types, including cancers that had no FDA‐approved site‐specific indications at the time of use (25.8% in pre‐ and 24.6% in post‐agnostic periods). The proportion of pembrolizumab recipients receiving pembrolizumab for cancers with site‐specific approvals before tumor‐agnostic approval decreased from 77.3% to 70.8%. The proportion of pembrolizumab recipients receiving pembrolizumab for cancers that gained site‐specific approvals following tumor‐agnostic approval almost doubled (6.8% to 13.0%). The proportion of pembrolizumab recipients with cancers included in MSI‐H/dMMR trials also doubled (12.3% to 25.5%) following tumor‐agnostic approval.

Conclusions

Pembrolizumab use has expanded over time among older adults with cancer, extending beyond those with FDA‐approved site‐specific indications.
A simultaneous eigen valued expression to model the three coupled electronic states with triply and doubly degenerate seams together II
Authors: Xavier F. George D.
Published: December 2023

In part I a novel and yet complicated mathematical model to predict the presence of triply degenerate seam was presented and was illustrated its efficiency using some physical models. Here in this part, a discussion on the the model's ability to account for the triple degeneracy found in the potential energy surface is presented in addition to a discussion on the derivatives and its discontinuities and infiniteness at a specific point. Analytical evaluation of derivatives is possible in principle but in practice, numerical approximation to the exact derivatives is the only way out to solve this problem. Two examples (one being physical and the other being chemically realistic) are taken to the probe the above mentioned properties of the proposed simultaneous model. Integration of model function gives finite values everywhere irrespective of the point of degeneracy being present or not. This is just opposite to derivative evaluation.