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Introduction Although there is an increasing interest in making mental health services (MHS) accessible to youths, there is limited ground-up involvement of youths while designing MHS in Asian settings. Objectives This qualitative study sought to understand what youths considered as important elements of youth centric MHS and how these could be designed to improve access by youths in Singapore. Methods We conducted seven focus group discussions, and four semi-structured interviews with 50 multiracial youths aged 15-35 years in Singapore - a high-income Southeast Asian country. Purposive sampling allowed adequate representation of age, gender, and race (mainly Chinese, Malay, and Indian) groups. Participants reflected on the features of an ideal MHS for youths and how these could improve youths’ attitude and access to services. Participants also shared their preferences and additional opinions for culturally tailored and age appropriate MHS. Framework analysis using the ‘Conceptual Framework of Access to Healthcare’ (Levesque et al. Int J Equity Health 2013, 12:18) was used to code transcripts and identify the key themes (Ritchie & Spencer. In Analyzing qualitative data, 1994). Results The average age of the participants was 24 years. About one third of the participants had accessed MHS in the past. Three key themes were identified – making facilities ‘approachable’, ‘available and appropriate’ and ‘affordable’. (i) Making facilities approachable related to having non-stigmatizing, non-threatening and welcoming aesthetics, organizational culture, and personnel. The participants also recommended a range of professional services, digital tools, and online features to enhance the approachability of MHS designed for youths. (ii) Flexible operating hours, easy appointment management, accessible location, and easy availability to youths with unique needs (e.g., employed youths) or socio-cultural backgrounds were necessary for making facilities available and accessible to youths. (iii) While sharing challenges of family involvement in the help-seeking process, most of the participants, particularly those in the lower ages, talked about tailoring MHS to the ability of youths to pay for the services. Preferences such as having cheaper services for teenagers and initial contacts, offering more non-medical but trained professionals, and considering shorter in-person counselling sessions, followed by free online options were brought up by the participants. Conclusions The study provided insights into multiple aspects of MHS and how these could be designed to cater to the needs of youths in Singapore from their perspective. MHS that incorporate non-stigmatizing, flexible, non-threatening and affordable design approaches could improve help-seeking and early interventions in youths. Disclosure of Interest None Declared

Abstract We propose the terahertz (THz) detectors based on field-effect transistors (FETs) with the graphene channel (GC) and the black-Arsenic (b-As) black-Phosphorus (b-P), or black-Arsenic-Phosphorus (b-As $$_x$$ x P $$_{1-x}$$ 1 - x ) gate barrier layer. The operation of the GC-FET detectors is associated with the carrier heating in the GC by the THz electric field resonantly excited by incoming radiation leading to an increase in the rectified current between the channel and the gate over the b-As $$_x$$ x P $$_{1-x}$$ 1 - x energy barrier layer (BLs). The specific feature of the GC-FETs under consideration is relatively low energy BLs and the possibility to optimize the device characteristics by choosing the barriers containing a necessary number of the b-As $$_x$$ x P $$_{1-x}$$ 1 - x atomic layers and a proper gate voltage. The excitation of the plasma oscillations in the GC-FETs leads to the resonant reinforcement of the carrier heating and the enhancement of the detector responsivity. The room temperature responsivity can exceed the values of $$10^3$$ 10 3 A/W. The speed of the GC-FET detector’s response to the modulated THz radiation is determined by the processes of carrier heating. As shown, the modulation frequency can be in the range of several GHz at room temperatures.

We investigate the response of the micromechanical field-effect transistors (MMFETs) to the impinging terahertz (THz) signals. The MMFET uses the microcantilevers (MC) as a mechanically floating gate and the movable mirror of the Michelson optical interferometer. The MC mechanical oscillations are transformed into optical signals and the MMFET operates as the detector of THz radiation with the optical output. The combination of the mechanical and plasmonic resonances in the MMFET with the optical amplification enables an effective THz detection.

The 2008 Wenchuan earthquake lead to various complex multi-hazard chains that included seismically triggered landslide initiation, landslide runout, river damming, dam breaching, and flooding. The modeling of the interactions between such hazardous processes is challenging due to the complexity and uncertainty. Here we present an event-based physically based model that is able to simulate multi-hazard land surface process chains within a single unified simulation. The final model is used to simulate a multi-hazard chain event in the Hongchun watershed, where co-seismic landslides led to a landslide dam and, 2 years later, a debris flow that breached the landslide dam. While most aspects of the multi-hazard chain are predicted well, the correct prediction of slope failures remains the biggest challenge. Although the results should be treated carefully, the development of such a model provides a significant progress in the applicability of multi-hazard chain simulations.

Similar to a space flying net, the capture field of the space netted pocket system is large and it can be applied to capture space non-cooperative targets flexibly. To maintain the stability of the space netted pocket system, eight inflatable rods are used as the supporting structure of the net surface. In this paper, a space netted pocket system is designed and modeled. Based on ANCF (absolute nodal coordinate formulation), a dynamic model of the complex space rope net system is established, and then an accurate model of closing rope considering the variable length is derived by introducing mass flow element. A double closed-loop sliding control method is designed to maintain the stable attitude of the service spacecraft. An extended observer is applied to estimate and compensate for the disturbances due to the uncertainty of the contact and flexibility in the system. Finally, the dynamic model and control method is verified through the simulation of the virtual prototype. Results show that the service spacecraft can maintain the attitude stability during target captured process and can track the desired angle during attitude maneuver. The flexible deformation and collision cause great disturbance to the service spacecraft, and the extended observer can improve the control accuracy from 10−3 to 10−4.

SUMMARY: This study investigated the effects of fulvic acid (FA) on the growth performance, intestinal function, and fecal ammonia excretion of broilers. A total of 480 1-day-old male broilers were randomly divided into 4 treatments: control (CON) treatment, and the treatment on a basal diet supplemented with 0.15, 0.3, or 0.5% FA. The addition of 0.5% FA increased the feed-to-gain ratio and average daily feed intake during the first 7 d of the experiment, whereas, 0.3% FA addition increased the feed-to-gain ratio at 15 to 21 d, but FA addition had no effect on growth performance at other times. Compared to the CON treatment, 0.5% FA addition increased the serum IgA content, amylase, and lipase activities in the jejunum, as well as the lipase activity and mucin 2 content in the ileum. Feeding broilers with 0.15% FA increased the occludin and zonula occluden-1 content in the ileum, elevated intestinal permeability markers such as diamine oxidase, lipopolysaccharide, and D-lactate dehydrogenase, and further enriched functional pathways including nitrogen metabolism and riboflavin metabolism. Also, FA addition (0.15, 0.3, or 0.5%) increased the jejunum mucin 2 content and maintained the relative stability of the cecal microbiota without detrimental changes to the microbiota composition. Importantly, FA addition decreased the fecal ammonia yield on 2, 4, and 5 d of the fecal ammonia determination in a dose-dependent manner and also lowered the urease activity on 1 and 3 d. Therefore, the addition of 0.15% FA was considered the most effective in maintaining the intestinal health and microbial composition of broilers.

The study provided the major ion chemistry, chemical weathering rates and temporary and net CO2 sinks in the Bei Jiang, which was characterized as a hyperactive region with high chemical weathering rates, carbonate and silicate mixing lithology, and abundant sulfuric acid chemical weathering agent of acid deposition and acid mining drainage (AMD) origins. The total chemical weathering rate of 85.46 t km−2 a−1 was comparable to that of other rivers in the hyperactive zones between the latitudes 0 and 30∘. A carbonate weathering rate of 61.15 t km−2 a−1 contributed to about 70 % of the total. The lithology, runoff, and geomorphology had a significant influence on the chemical weathering rate. The proportion of carbonate outcrops had a significant positive correlation with the chemical weathering rate. Due to the interaction between dilution and compensation effect, a significant positive linear relationship was detected between runoff and total carbonate and silicate weathering rates. The geomorphology factors such as catchment area, average slope, and hypsometric integral value (HI) had nonlinear correlation with chemical weathering rate and showed significant scale effect, which revealed the complexity in chemical weathering processes. Dissolved inorganic carbon (DIC) apportionment showed that CCW (carbonate weathering by CO2) was the dominant origin of DIC (35 %–87 %). SCW (carbonate weathering by H2SO4) (3 %–15 %) and CSW (silicate weathering by CO2) (7 %–59 %) were non-negligible processes. The temporary CO2 sink was 823.41×103 mol km−2 a−1. Compared with the temporary sink, the net sink of CO2 for the Bei Jiang was approximately 23.18×103 mol km−2 a−1 of CO2 and was about 2.82 % of the “temporary” CO2 sink. Human activities (sulfur acid deposition and AMD) dramatically decreased the CO2 net sink, even making chemical weathering a CO2 source to the atmosphere.

Recovering from major earthquakes is a challenge, especially in mountainous environments where postearthquake hazards may cause substantial impacts for prolonged periods of time. Although such impacts were reported in the 1923 Great Kantō earthquake and the 1999 Chi-Chi earthquake, careless reconstruction in hazard-prone areas and consequently huge losses were witnessed following the 2008 Wenchuan earthquake in the Sichuan province of China, as several reconstructed settlements were severely damaged by mass movements and floods. In order to summarize experiences and identify problems in the reconstruction planning, a monitoring of one of the settlements, the town of Longchi, was carried out by image interpretation and field investigation. Seven inventories containing buildings, farmlands, roads and mitigation measures were made to study the dynamics of elements at risk and exposure over a period of 11 years. It was found that the total economic value of the newly reconstructed buildings was several times more than in the preearthquake situation in 2007, because of enormous governmental investment. Postseismic hazards were not sufficiently taken into consideration in the recovery planning before the catastrophic debris flow disaster in 2010. As a result, the direct economic loss from postseismic disasters was slightly more than the loss caused by the Wenchuan earthquake itself. The society showed an impact-adapt pattern, experiencing losses from disasters and then gaining resistance by abandoning buildings in hazard-prone areas and installing mitigation measures. The locations potentially exposed to postearthquake hazards were summarized, and a possible timetable for reconstruction was proposed. Problems might be encountered in hazard assessment, and possible solutions were discussed.

The Ising magnet LiHo0.045Y0.955F4 allows experimental probes of disordered quantum dynamics. Silevitch et al. show that strongly-driven localized spin clusters form effectively decoupled two-level systems whose interactions and coherence can be tuned by external ac and dc magnetic fields.

Precisely controlled growth of oxide interfaces at the atomic layer level is critical for device applications but quite challenging. Here Sun et al. show real time monitoring and control of the surface composition of epitaxial strontium titanate perovskite films by analysing the Kikuchi lines.

Pseudoroegneria libanotica is an important herbage diploid species possessing the St genome. The St genome participates in the formation of nine perennial genera in Triticeae (Poaceae). The whole chloroplast (cp) genome of P. libanotica is 135 026 bp in length. The typical quadripartite structure consists of one large single copy of 80 634 bp, one small single copy of 12 766 bp and a pair of inverted regions (20 813 bp each). The cp genome contains 76 coding genes, four ribosomal RNA and 30 transfer RNA genes. Comparative sequence analysis suggested that: 1) the 737 bp deletion in the cp of P. libanotica was specific in Triticeae species and might transfer into its nuclear genome; 2) hot-spot regions, indels in intergenic regions and protein coding sequences mainly led to the length variation in Triticeae; 3) highly divergence regions combined with negative selection in rpl2, rps12, ccsA, rps8, ndhH, petD, ndhK, psbM, rps3, rps18, and ndhA were identified as effective molecular markers and could be considered in future phylogenetic studies of Triticeae species; and 4) ycf3 gene with rich cpSSRs was suitable for phylogeny analysis or could be used for DNA barcoding at low taxonomic levels. The cpSSRs distribution in the coding regions of diploid Triticeae species was shown for the first time and provided a valuable source for developing primers to study specific simple sequence repeat loci.

An integrated drainage information, analysis and management system (DIAMS) was developed and implemented for the New Jersey Department of Transportation (NJDOT). The purpose of the DIAMS is to provide a useful tool for managers to evaluate drainage infrastructure, to facilitate the determination of the present costs of preserving those infrastructures, and to make decisions regarding the optimal use of their infrastructure budgets. The impetus for DIAMS is the culvert information management system (CIMS), which is developed to manage the data for culvert pipes. DIAMS maintains and summarizes accumulated inspection data for all types of drainage infrastructure assets, including pipes, inlet/outlet structures, outfalls and manufactured treatment devices. DIAMS capabilities include identifying drainage infrastructure, maintaining inspection history, mapping locations, predicting service life based on the current condition states, and assessing present asset value. It also includes unit cost values of 72 standard items to estimate the current cost for new assets with the ability to adjust for future inflation. In addition, DIAMS contains several different repair, rehabilitation and replacement options to remedy the drainage infrastructure. DIAMS can analyze asset information and determine decisions to inspect, rehabilitate, replace or do nothing at the project and network levels by comparing costs with risks and failures. Costs may be optimized to meet annual maintenance budget allocations by prioritizing drainage infrastructure needing inspection, cleaning and repair. DIAMS functional modules include vendor data uploading, asset identification, system administration and financial analysis. Among the significant performance feature of DIAMS is its proactive nature, which affords decision makers the means of conducting a comprehensive financial analysis to determine the optimal proactive schedule for the proper maintenance actions and to prioritize them accordingly. Benefits of DIAMS include long-term savings that accrue by adopting optimized preventive maintenance strategies and facilitating compliance with Governmental Accounting Standards Board (GASB) and federal storm water regulations.

Large earthquakes in mountainous regions may trigger thousands of landslides, some active for years. We analysed the changes in landslide activity near the epicentre of the 2008 Wenchuan earthquake by generating five landslide inventories for different years through stereoscopic digital visual image interpretation. From May 2008 to April 2015, 660 new landslides occurred outside the co-seismic landslide areas. In April 2015, the number of active landslides had gone down to 66, less than 1 % of the co-seismic landslides, but still much higher than the pre-earthquake levels. We expect that the landslide activity will continue to decay, but may be halted if extreme rainfall events occur.

Recently, a new Multi-Angle Implementation of Atmospheric Correction (MAIAC) algorithm was developed for the MODerate Resolution Imaging Spectroradiometer (MODIS), which provides aerosol optical depth (AOD) at 1 km resolution. The relationship between MAIAC AOD and PM2.5 as measured by 84 EPA ground monitoring stations in the entire New England and the Harvard super site during 2002–2008 was investigated and also compared to the AOD–PM2.5 relationship using conventional MODIS 10 km AOD retrieval from Aqua platform (MYD04) for the same days and locations. The correlations for MYD04 and for MAIAC are r = 0.62 and 0.65, respectively, suggesting that AOD is a reasonable proxy for PM2.5 ground concentrations. The slightly higher correlation coefficient (r) for MAIAC can be related to its finer resolution resulting in better correspondence between AOD and EPA monitoring sites. Regardless of resolution, AOD–PM2.5 relationship varies daily, and under certain conditions it can be negative (due to several factors such as an EPA site location (proximity to road) and the lack of information about the aerosol vertical profile). By investigating MAIAC AOD data, we found a substantial increase, by 50–70% in the number of collocated AOD–PM2.5 pairs, as compared to MYD04, suggesting that MAIAC AOD data are more capable in capturing spatial patterns of PM2.5. Importantly, the performance of MAIAC AOD retrievals is slightly degraded but remains reliable under partly cloudy conditions when MYD04 data are not available, and it can be used to increase significantly the number of days for PM2.5 spatial pattern prediction based on satellite observations.

A GIS-based method for the assessment of landslide susceptibility in a selected area of Qingchuan County in China is proposed by using the back-propagation Artificial Neural Network model (ANN). Landslide inventory was derived from field investigation and aerial photo interpretation. 473 landslides occurred before the Wenchuan earthquake (which were thought as rainfall-induced landslides (RIL) in this study), and 885 earthquake-induced landslides (EIL) were recorded into the landslide inventory map. To understand the different impacts of rainfall and earthquake on landslide occurrence, we first compared the variations between landslide spatial distribution and conditioning factors. Then, we compared the weight variation of each conditioning factor derived by adjusting ANN structure and factors combination respectively. Last, the weight of each factor derived from the best prediction model was applied to the entire study area to produce landslide susceptibility maps. Results show that slope gradient has the highest weight for landslide susceptibility mapping for both RIL and EIL. The RIL model built with four different factors (slope gradient, elevation, slope height and distance to the stream) shows the best success rate of 93%; the EIL model built with five different factors (slope gradient, elevation, slope height, distance to the stream and distance to the fault) has the best success rate of 98%. Furthermore, the EIL data was used to verify the RIL model and the success rate is 92%; the RIL data was used to verify the EIL model and the success rate is 53%.

On 7 August 2010, catastrophic debris flows were triggered by a rainstorm in the catchments of the Sanyanyu and Luojiayu torrents, Zhouqu County, Gansu Province northwestern China. These two debris flows originated shortly after a rainstorm with an intensity of 77.3 mm h−1 and transported a total volume of about 2.2 million m3, which was deposited on an existing debris fan and into a river. This catastrophic event killed 1765 people living on this densely urbanised fan. The poorly sorted sediment contains boulders up to 3–4 m in diameter. In this study, the geomorphological features of both debris flow catchment areas are analyzed based on the interpretation of high-resolution remote sensing imagery combined with field investigation. The characteristics of the triggering rainfall and the initiation of the debris flow occurrence are discussed. Using empirical equations, the peak velocities and discharges of the debris flows were estimated to be around 9.7 m s−1 and 1358 m3 s−1 for the Sanyanyu torrent and 11 m s−1 and 572 m3 s−1 for the Luojiayu torrent. The results of this study contribute to a better understanding of the conditions leading to catastrophic debris flow events.

The Tropical Rainfall Measuring Mission (TRMM) carries aboard the Precipitation Radar (TRMMPR) that measures the backscatter (σ°) of the surface. σ° is sensitive to surface soil moisture and vegetation conditions. Due to sparse vegetation in arid and semi-arid regions, TRMMPR σ° primarily depends on the soil water content. In this study we relate TRMMPR σ° measurements to soil water content (ms) in the Lower Colorado River Basin (LCRB). σ° dependence on ms is studied for different vegetation greenness values determined through Normalized Difference Vegetation Index (NDVI). A new model of σ° that couples incidence angle, ms, and NDVI is used to derive parameters and retrieve soil water content. The calibration and validation of this model are performed using simulated and measured ms data. Simulated ms is estimated using the Variable Infiltration Capacity (VIC) model and measured ms is acquired from ground measuring stations in Walnut Gulch Experimental Watershed (WGEW). σ° model is calibrated using VIC and WGEW ms data during 1998 and the calibrated model is used to derive ms during later years. The temporal trends of derived ms are consistent with VIC and WGEW ms data with a correlation coefficient (R) of 0.89 and 0.74, respectively. Derived ms is also consistent with the measured precipitation data with R=0.76. The gridded VIC data is used to calibrate the model at each grid point in LCRB and spatial maps of the model parameters are prepared. The model parameters are spatially coherent with the general regional topography in LCRB. TRMMPR σ° derived soil moisture maps during May (dry) and August (wet) 1999 are spatially similar to VIC estimates with correlation 0.67 and 0.76, respectively. This research provides new insights into Ku-band σ° dependence on soil water content in the arid regions.

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Wakefield excitation has been experimentally studied in a three-cell X-band standing wave photonic band gap (PBG) accelerating structure. Major monopole (TM_{01}- and TM_{02}-like) and dipole (TM_{11}- and TM_{12}-like) modes were identified and characterized by precisely controlling the position of beam injection. The quality factor Q of the dipole modes was measured to be ∼10 times smaller than that of the accelerating mode. A charge sweep, up to 80 nC, has been performed, equivalent to ∼30 MV/m accelerating field on axis. A variable delay low charge witness bunch following a high charge drive bunch was used to calibrate the gradient in the PBG structure by measuring its maximum energy gain and loss. Experimental results agree well with numerical simulations.

Abstract Background Gut microbiome colonization during early life is significant for immunological and physiological development. Maternal microbiome is associated with proper development of infants. The aim of this study was to determine the gut microbiome profiles among Thai healthy pregnant women and its associated factors. Methods A multicenter, open trial prospective study was performed at three hospitals in Northern, Central, and Northeastern regions of Thailand. Thai healthy pregnant women attending antenatal clinics were recruited. Fecal samples of subjects at the third trimester of pregnancy were collected with sterilized techniques. The gut microbiome profiles and bacterial diversity were assessed using 16Ss RNA gene sequencing. Demographic data, dietary intake, and anthropometric data were recorded and analyzed. Results There were 86 healthy pregnant women. The dominant of gut microbiome profiles were Bacteroidetes and Firmicutes. Pregnant women in the Central region had significantly higher of Ruminococcaceae and Lachnospiraceae than those in other regions (p

Objectives Computerised physician order entry (CPOE) systems facilitate the review of medication orders by pharmacists. Reports have emerged that show conception flaws or the misuse of CPOE systems generate prescribing errors. We aimed to characterise pharmacist interventions (PIs) triggered by prescribing errors identified as system-related errors (PISREs) in French hospitals.Design This was a cross-sectional observational study based on PIs prospectively documented in the Act-IP observatory database from January 2014 to December 2018.Setting PISREs from 319 French computerised healthcare facilities were analysed.Participants Among the 319 French hospitals, 232 (72.7%) performed SRE interventions, involving 652 (51%) pharmacists.Results Among the 331 678 PIs recorded, 27 058 were qualified as due to SREs (8.2%). The main drug-related problems associated with PISREs were supratherapeutic (27.5%) and subtherapeutic dosage (17.2%), non-conformity with guidelines/contraindications (22.4%) and improper administration (17.9%). The PI prescriber acceptation rate was 78.9% for SREs vs 67.6% for other types of errors. The PISRE ratio was estimated relative to the total number of PIs. Concerning the certification status of CPOE systems, the PISRE ratio was 9.4% for non-certified systems vs 5.5% for certified systems (p

Abstract Animal food sources provide human beings with minerals considerably in adequate quantities. Fish is an indispensable reliable source of nutrients, as aquaculture is a sector that is fast growing and which provides 50% of the world’s fish production. However, fish production is hampered by the increasing costs of feeds due to the ever rising cost of fish meal, an integral component of fish feeds. Substituting fish meal with cheap, yet highly nutritious ingredients in fish feeds is therefore paramount. This study investigated the effects of substituting fish meal with adult cricket meal (ACM) and black soldier fly meal (BSFM) on minerals content of extruded fish feeds, where four levels of substitution (0, 25, 50 and 75%) were used. The effect of feed moisture content on minerals was also studied where 20 and 30% feed moisture levels were used. Leaching effects of the pellets were studied as well. The results showed a significant increase (P

Abstract Primary graft dysfunction (PGD) is a life-threatening clinical condition with a high mortality rate, presenting as left, right, or biventricular dysfunction within the initial 24 h following heart transplantation, in the absence of a discernible secondary cause. Given its intricate nature, definitive definition and diagnosis of PGD continues to pose a challenge. The pathophysiology of PGD encompasses numerous underlying mechanisms, some of which remain to be elucidated, including factors like myocardial damage, the release of proinflammatory mediators, and the occurrence of ischemia-reperfusion injury. The dynamic characteristics of both donors and recipients, coupled with the inclination towards marginal lists containing more risk factors, together contribute to the increased incidence of PGD. The augmentation of therapeutic strategies involving mechanical circulatory support accelerates myocardial recovery, thereby significantly contributing to survival. Nonetheless, a universally accepted treatment algorithm for the swift management of this clinical condition, which necessitates immediate intervention upon diagnosis, remains absent. This paper aims to review the existing literature and shed light on how diagnosis, pathophysiology, risk factors, treatment, and perioperative management affect the outcome of PGD.

Abstract We report the de novo design of small (

Abstract Spindle-shaped waves of oscillations emerge in EEG scalp recordings during human and rodent non-REM sleep. The association of these 10–16 Hz oscillations with events during prior wakefulness suggests a role in memory consolidation. Human and rodent depth electrodes in the brain record strong spindles throughout the cortex and hippocampus, with possible origins in the thalamus. However, the source and targets of the spindle oscillations from the hippocampus are unclear. Here, we employed an in vitro reconstruction of four subregions of the hippocampal formation with separate microfluidic tunnels for single axon communication between subregions assembled on top of a microelectrode array. We recorded spontaneous 400–1000 ms long spindle waves at 10–16 Hz in single axons passing between subregions as well as from individual neurons in those subregions. Spindles were nested within slow waves. The highest amplitudes and most frequent occurrence suggest origins in CA3 neurons that send feed-forward axons into CA1 and feedback axons into DG. Spindles had 50–70% slower conduction velocities than spikes and were not phase-locked to spikes suggesting that spindle mechanisms are independent of action potentials. Therefore, consolidation of declarative-cognitive memories in the hippocampus may be separate from the more easily accessible consolidation of memories related to thalamic motor function.

Abstract Background Adult patients surviving with congenital heart disease (ACHD) is growing. We examine the factors associated with heart transplant outcomes in this challenging population with complex anatomy requiring redo-surgeries. Methods We reviewed the United Network for Organ Sharing-Standard Transplant Analysis and Research database and analyzed 35,952 heart transplants from January 1st, 2000, to September 30th, 2018. We compared transplant characteristics for ischemic cardiomyopathy (ICM) (n = 14,236), nonischemic cardiomyopathy (NICM) (n = 20,676), and ACHD (n = 1040). Mean follow-up was 6.20 ± 4.84 years. Kaplan–Meier survival curves and Cox-proportional hazards analysis were used to analyze survival data. Results Multivariable analysis confirmed that ACHD was associated greater in-hospital death compared to ICM (HR = 0.54, P

Allergic bronchopulmonary aspergillosis (ABPA) is a hypersensitivity disease caused by Aspergillus fumigatus (Af), prevalent in persons with cystic fibrosis (CF) or asthma. In ABPA, Af proteases drive a T-helper cell-2 (Th2)-mediated allergic immune response leading to inflammation that contributes to permanent lung damage. Corticosteroids and antifungals are the mainstays of therapies for ABPA. However, their long-term use has negative sequelae. The treatment of patients with CF (pwCF) has been revolutionized by the efficacy of cystic fibrosis transmembrane conductance regulator (CFTR) modulator therapy. Pharmacological improvement in CFTR function with highly effective elexacaftor/tezacaftor/ivacaftor (ETI) provides unprecedented improvements in lung function and other clinical outcomes of pwCF. The mechanism behind the improvement in patient outcomes is a continued topic of investigation as our understanding of the role of CFTR function evolves. As ETI therapy gains traction in CF management, understanding its potential impact on ABPA, especially on the allergic immune response pathways and Af infection becomes increasingly crucial for optimizing patient outcomes. This literature review aims to examine the extent of these findings and expand our understanding of the already published research focusing on the intersection between ABPA therapeutic approaches in CF and the rapid impact of the evolving CFTR modulator landscape. While our literature search yielded limited reports specifically focusing on the role of CFTR modulator therapy on CF-ABPA, findings from epidemiologic and retrospective studies suggest the potential for CFTR modulator therapies to positively influence pulmonary outcomes by addressing the underlying pathophysiology of CF-ABPA, especially by decreasing inflammatory response and Af colonization. Thus, this review highlights the promising scope of CFTR modulator therapy in decreasing the overall prevalence and incidence of CF-ABPA.

Abstract Balling defect of the additively manufactured titanium lattice implants easily leads to muscle tissue rejection, which might cause failure of implantation. Electropolishing is widely used in surface polishing of complex components and has potential to deal with the balling defect. However, a clad layer could be formed on the surface of titanium alloy after electropolishing, which may affect the biocompatibility of the metal implants. To manufacture lattice structured β-type Ti-Ni-Ta-Zr (TNTZ) for bio-medical applications, it is necessary to investigate the impact of electropolishing on material biocompatibility. In this study, animal experiments were conducted to investigate the in vivo biocompatibility of the as-printed TNTZ alloy with or without electropolishing; and proteomics technology was used to elaborate the results. The following conclusions were drawn: (a) a 30% oxalic acid electropolishing treatment was effective in solving balling defects, and ~21 nm amorphous clad layer would be formed on the surface of the material after polishing; (b) the electropolished TNTZ suggested decreased cell cytotoxicity and improved blood biocompatibility as compared to as-printed TNTZ; (c) the amorphous clad layer could make a barrier to prevent Ta and Zr ions from penetrating into the muscle tissue, and could form a good tissue regeneration at the implantation site during 4 weeks, indicating that the electropolished TNTZ has the potential as implants; and (d) the cells attached to the electropolished TNTZ showed higher antioxidant capacity but less proliferation than attached to as-printed TNTZ. Graphical Abstract

The sub-regions of the hippocampal formation are essential for episodic learning and memory formation, yet the spike dynamics of each region contributing to this function are poorly understood, in part because of a lack of access to the inter-regional communicating axons. Here, we reconstructed hippocampal networks confined to four subcompartments in 2D cultures on a multi-electrode array that monitors individual communicating axons. In our novel device, somal, and axonal activity was measured simultaneously with the ability to ascertain the direction and speed of information transmission. Each sub-region and inter-regional axons had unique power-law spiking dynamics, indicating differences in computational functions, with abundant axonal feedback. After stimulation, spiking, and burst rates decreased in all sub-regions, spikes per burst generally decreased, intraburst spike rates increased, and burst duration decreased, which were specific for each sub-region. These changes in spiking dynamics post-stimulation were found to occupy a narrow range, consistent with the maintenance of the network at a critical state. Functional connections between the sub-region neurons and communicating axons in our device revealed homeostatic network routing strategies post-stimulation in which spontaneous feedback activity was selectively decreased and balanced by decreased feed-forward activity. Post-stimulation, the number of functional connections per array decreased, but the reliability of those connections increased. The networks maintained a balance in spiking and bursting dynamics in response to stimulation and sharpened network routing. These plastic characteristics of the network revealed the dynamic architecture of hippocampal computations in response to stimulation by selective routing on a spatiotemporal scale in single axons.

Abstract Background Non-schistosomiasis-associated squamous cell carcinoma of the urinary bladder is less common in the Western world. Limited information on its possible paraneoplastic syndromes exists. Leukocytosis tends to commonly be regarded by clinicians as an indication of sepsis, rather than a feature of paraneoplasia, potential surrogate marker for recurrence, and prognostic marker. Accompanying hypercalcemia may be missed entirely. Case presentation A 66-year-old Caucasian man presented with visible painless hematuria and symptomatic hypercalcemia. Investigations revealed a squamous cell carcinoma of the urinary bladder with marked leukocytosis. Hypercalcemia and leukocytosis resolved following radical cystectomy, recurred with nodal recurrence and regressed with radiotherapeutic control. Subsequently, serum leukocyte and calcium assays were included in his follow-up protocol. His survival was 20 months by the time of the report. Conclusion This report highlights hypercalcemia–leukocytosis syndrome as a paraneoplastic manifestation of non-schistosomiasis-associated squamous cell carcinoma to reemphasize the need for clinicians to assay for calcium in the presence of leukocytosis in such patients. Prompt identification and control of the paraneoplastic derangements, with treatment of the cancer recurrence it may connote, is advocated to provide a chance for better long-term outcomes in these patients.

Abstract Introduction Incident syphilis leads to changes in plasma HIV-1 RNA and CD4 + T-cell level in people with HIV (PWH) with viraemia. Its effect in PWH on suppressive antiretroviral therapy (ART) is less clear. Methods PWH on suppressive ART (plasma HIV-1 RNA

This study investigated the effect of different Bacillus spp. and Debaryomyces spp., which are screened from Melopsittacus undulates crop milk on growth performance, intestinal morphology, intestinal microflora and antioxidant abilities in broilers. By screening the Bacillus spp. and Debaryomyces spp. from parrot’s crop milk, the properties of these microbial were examined in vitro accordingly. In animal experiments, 480 1-day-old Ross 308 broilers were randomly divided into 6 treatments as control (corn-soybean meal), Bacillus velezensis with 5 × 106 cfu/kg feed (BV), Bacillus subtilis with 5 × 106 cfu/kg feed (BS), Debaryomyces hansenii with 5 × 106 cfu/kg feed (DH), B. velezensis + Saccharomyces cerevisiae with 5 × 106 cfu/kg feed (BV + SC), and B. velezensis + D. hansenii with 5 × 106 cfu/kg feed (BV + DH). The results showed that chickens in BV, BV + SC, and BV + DH groups showed significantly higher body weight and average weight gain than control group at 21 days of age. Biochemistry of triglyceride values in BV and BV + SC had significantly decreased than in control group. Intestinal lactic acid bacteria were significantly higher in BV and BS groups than in the control group in ileum. The villus height of jejunum in BV + SC and BV + DH was significantly higher than in the control group. Glutathione peroxidase activity was significantly higher in BV, BS, BV + SC groups than in the control group, but immune assays had no significant differences among the groups. Based on the results of animal growth performance, the number of lactic acids, intestinal morphology, antioxidant activity, and immune system, BV and BV + SC groups possess better feed additives for broiler chickens.HIGHLIGHTS Bacillus spp. and Debaryomyces spp. affect on growth performance, intestinal morphology, intestinal microflora and antioxidant abilities in broiler chickens. Broilers with feed additives of Bacillus velezensis, Debaryomyces hansenii, Saccharomyces cerevisiae have higher body weight and average weight gain B. velezensis and B. velezensis + Saccharomyces cerevisiae groups possess better feed additives for broiler chickens.

Abstract Introduction Ocular artifact has long been viewed as an impediment to the interpretation of electroencephalogram (EEG) signals in basic and applied research. Today, the use of blind source separation (BSS) methods, including independent component analysis (ICA) and second‐order blind identification (SOBI), is considered an essential step in improving the quality of neural signals. Recently, we introduced a method consisting of SOBI and a discriminant and similarity (DANS)‐based identification method, capable of identifying and extracting eye movement–related components. These recovered components can be localized within ocular structures with a high goodness of fit (>95%). This raised the possibility that such EEG‐derived SOBI components may be used to build predictive models for tracking gaze position. Methods As proof of this new concept, we designed an EEG‐based virtual eye‐tracker (EEG‐VET) for tracking eye movement from EEG alone. The EEG‐VET is composed of a SOBI algorithm for separating EEG signals into different components, a DANS algorithm for automatically identifying ocular components, and a linear model to transfer ocular components into gaze positions. Results The prototype of EEG‐VET achieved an accuracy of 0.920° and precision of 1.510° of a visual angle in the best participant, whereas an average accuracy of 1.008° ± 0.357° and a precision of 2.348° ± 0.580° of a visual angle across all participants (N = 18). Conclusion This work offers a novel approach that readily co‐registers eye movement and neural signals from a single‐EEG recording, thus increasing the ease of studying neural mechanisms underlying natural cognition in the context of free eye movement.

Right ventricular assist device (RVAD) weaning is often an important goal for durable left ventricular assist device support. This may be facilitated by mitral and tricuspid repair as well as by minimizing the trauma of RVAD decannulation by using Dacron grafts.

Although there is ample literature available on toxicity in games, as there is regarding trolling on social media, there are few to no cross-platform studies on toxicity and trolling. In other words, the extant literature focuses on one platform at a time instead of comparing and contrasting them. The present work aims to rectify this gap by analyzing interviews from a larger study of 22 self-proclaimed victims of in-game trolling to not only determine whether social media or gaming communities are considered more toxic but also to explore how definitions of the word ‘trolling’ change depending on the platform in question. We found that while definitions of in-game trolling behavior focused on behavioral styles of trolling (e.g., throwing one’s avatar into enemy fire to disadvantage one’s team, and blocking other players’ avatars’ movement), social media trolling is defined by more sinister actions such as misinformation spreading and ‘canceling’ other users. We also found that gaming is perceived as generally more toxic than social media, often due to company policies or lack thereof. Practical and theoretical implications for the study of toxicity in all online communities – gaming or social-media based – are discussed.

The frictional responses of graphene and boron nitride lubricants is studied from the perspective of the potential energy evolution. At a low normal load regime and high interface adhesion, friction can be effectively characterized by investigating the interfacial energy barrier formation process. By decomposing the energy evolution into strain and interfacial cohesive components, we find that the oscillation phase difference plays an essential role in the friction response and is controlled by the energy conversion between them. Analyses further reveal that the energy oscillations are excited by the vertical motion of the sliding asperity that induces periodic deformation and position changes in the lubrication systems. These new findings suggest the study of potential energy evolution is advantageous for understanding adhesive friction and infers the potential to leverage adhesion in 2D lubricant application through high conversion efficiency and out-of-phase oscillations between strain and cohesive energies.

BackgroundMetabolic brain imaging with 2-[18F]fluoro-2-deoxy-D-glucose positron emission tomography (FDG PET) is a supportive diagnostic and differential diagnostic tool for neurodegenerative dementias. In the clinic, scans are usually visually interpreted. However, computer-aided approaches can improve diagnostic accuracy. We aimed to build two machine learning classifiers, based on two sets of FDG PET-derived features, for differential diagnosis of common dementia syndromes.MethodsWe analyzed FDG PET scans from three dementia cohorts [63 dementia due to Alzheimer’s disease (AD), 79 dementia with Lewy bodies (DLB) and 23 frontotemporal dementia (FTD)], and 41 normal controls (NCs). Patients’ clinical diagnosis at follow-up (25 ± 20 months after scanning) or cerebrospinal fluid biomarkers for Alzheimer’s disease was considered a gold standard. FDG PET scans were first visually evaluated. Scans were pre-processed, and two sets of features extracted: (1) the expressions of previously identified metabolic brain patterns, and (2) the mean uptake value in 95 regions of interest (ROIs). Two multi-class support vector machine (SVM) classifiers were tested and their diagnostic performance assessed and compared to visual reading. Class-specific regional feature importance was assessed with Shapley Additive Explanations.ResultsPattern- and ROI-based classifier achieved higher overall accuracy than expert readers (78% and 80% respectively, vs. 71%). Both SVM classifiers performed similarly to one another and to expert readers in AD (F1 = 0.74, 0.78, and 0.78) and DLB (F1 = 0.81, 0.81, and 0.78). SVM classifiers outperformed expert readers in FTD (F1 = 0.87, 0.83, and 0.63), but not in NC (F1 = 0.71, 0.75, and 0.92). Visualization of the SVM model showed bilateral temporal cortices and cerebellum to be the most important features for AD; occipital cortices, hippocampi and parahippocampi, amygdala, and middle temporal lobes for DLB; bilateral frontal cortices, middle and anterior cingulum for FTD; and bilateral angular gyri, pons, and vermis for NC.ConclusionMulti-class SVM classifiers based on the expression of characteristic metabolic brain patterns or ROI glucose uptake, performed better than experts in the differential diagnosis of common dementias using FDG PET scans. Experts performed better in the recognition of normal scans and a combined approach may yield optimal results in the clinical setting.

This study will present a comprehensive review of the two-phase flow boiling heat transfer coefficient of hydrocarbons such as propane (R-290), butane (R-600), iso-butane (R-600a), and ethanol at various experimental conditions. Studying the multiphase flow heat transfer coefficient is crucial for many types of heat transfer equipment to achieve higher efficiency for more compact design and cost reduction. One reason we chose hydrocarbons as refrigerants in this study is that they are of an ozone depletion potential equal to zero (ODP = 0) and a deficient level of direct global warming potential (GWP = 3). Moreover, hydrocarbons’ thermodynamic and thermophysical characteristics qualify them to be a strong candidate for more heat transfer applications, initially, by constructing a database for the working fluids using multiple existing experimental work. The current data that this study have collected for the flow boiling spans a wide range of parameters, such as mass flux, heat flux, operating pressure, saturation temperature, etc. Furthermore, by comparing the experimental multiphase heat transfer coefficient database with the anticipated values of each correlation, the prediction performance of 26 correlations found in the literature was assessed. This study allows the best prediction method to be selected based on the minimum deviation of predicted results from the experimental database provided based on the mean absolute error (MAE) calculated from the assessed correlations. The conclusions of such a study can also be helpful for developing more accurate correlation methods for these fluids and improving the prediction of their flow boiling characteristics.

Women with advanced heart failure receive advanced surgical therapies such as durable left ventricular assist device (LVAD) implantation or heart transplantation at a rate much lower compared to males. Reasons for this discrepancy remain largely unknown. Much of what is understood reflects outcomes of those patients who ultimately receive device implant or heart transplantation. Females have been shown to have a higher mortality following LVAD implantation and experience higher rates of bleeding and clotting phenomena and right ventricular failure. Beyond outcomes, the literature is limited in the identification of pre-operative factors that drive lower than expected LVAD implant rates in this population. More focused research is needed to define the disparities in advance heart failure therapy delivery in women and other underserved populations.

Functional mitral regurgitation (MR) in the setting of heart failure results from progressive dilatation of the left ventricle (LV) and mitral annulus. This leads to leaflet tethering with posterior displacement. Contrary to common assumptions, MR often does not resolve with LVAD decompression of the LV alone. The negative impact of significant (moderate-severe) mitral regurgitation in the LVAD setting is becoming better recognized in terms of its harmful effect on right heart function, pulmonary vascular resistance and hospital readmissions. However, controversies remain regarding the threshold for intervention and management. At present, there are no consensus indications for the repair of significant mitral regurgitation at the time of LVAD implantation due to the conflicting data regarding potential adverse effects of MR on clinical outcomes. In this review, we summarize the current understanding of MR pathophysiology in patients supported with LVAD and potential future management strategies.

Here we reported a case, male, 33 years old, diagnosed with human immunodeficiency virus (HIV) infection 5 months ago, but he didn’t take antiretroviral drugs regularly. He was admitted to intensive care unit emergently due to hypoxemia, hypercapnia, and hypotension. CT showed severe lower trachea obstruction caused by soft tissue. After rapid bedside assessment, the patient was considered to need endotracheal operation, but he couldn‘t tolerate intubation and mechanical ventilation. Extracorporeal membrane oxygenation (ECMO) was used. Hemodynamics improved significantly along with rehydration and low-dose vasoactive drugs. Subsequently, the patient underwent rigid bronchoscopy, airway tumor resection and Y-type silicone stent implantation. Postoperatively protective endotracheal intubation and mechanical ventilation was followed. ECMO was weaned off after the operation, and endotracheal cannula was removed 6 h later. The pathological examination of excisional tissue showed lung squamous cell carcinoma. Finally, the patient was discharged safely and went to local hospital for further treatment. From this case, we conclude that ECMO could play a key role for those who need endotracheal surgery while cannot endure conventional intubation and mechanical ventilation.

The construction of C-C bonds via reductive coupling carbonyl compounds is a huge challenge in organic transformations. Here, the authors develop a highly efficient system for the photoreductive coupling of aldehydes and ketones to the corresponding 1,2-diols under mild conditions.

Collections of fungal samples from two dead leaf specimens from Italy were subjected to morphological examination and phylogenetic analyses. Two coelomycetous taxa belonging to two different genera in Xylariomycetidae, Sordariomycetes, namely Discosia and Sporocadus, were identified. The Discosia taxon is revealed as a new species and is herein introduced as Discosia ravennica sp. nov. while the Sporocadus taxon is identified as Sporocadus rosigena. Multi-locus phylogeny based on DNA sequence data of the large subunit (LSU) and internal transcribed spacer (ITS) of nuclear ribosomal genes, β-tubulin (β-tub) and RNA polymerase II second largest subunit (rpb2) showed that D. ravennica is related to D. neofraxinea but it forms an independent lineage that supports its new species status. The new taxon also differs from other Discosia species by its unilocular to bilocular, superficial and applanate conidiomata with basal stroma composed of cells of textura angularis, elongate-ampulliform conidiogenous cells and conidia smaller in size. Sporocadus rosigena is here reported as a new host record from Quercus ilex from Italy. Descriptions, illustrations and molecular data for both species are provided in this paper.

Lower olefins are mainly produced from fossil resources and the methanol-to-olefins process offers a new sustainable pathway. Here, the authors show a new zeolite containing tantalum and aluminium centres which shows simultaneously high propene selectivity, catalytic activity, and stability for the synthesis of propene.

Abstract To support point-of-care decision making by presenting outcomes of past treatment choices for cohorts of similar patients based on observational data from electronic health records (EHRs), a machine-learning precision cohort treatment option (PCTO) workflow consisting of (1) data extraction, (2) similarity model training, (3) precision cohort identification, and (4) treatment options analysis was developed. The similarity model is used to dynamically create a cohort of similar patients, to inform clinical decisions about an individual patient. The workflow was implemented using EHR data from a large health care provider for three different highly prevalent chronic diseases: hypertension (HTN), type 2 diabetes mellitus (T2DM), and hyperlipidemia (HL). A retrospective analysis demonstrated that treatment options with better outcomes were available for a majority of cases (75%, 74%, 85% for HTN, T2DM, HL, respectively). The models for HTN and T2DM were deployed in a pilot study with primary care physicians using it during clinic visits. A novel data-analytic workflow was developed to create patient-similarity models that dynamically generate personalized treatment insights at the point-of-care. By leveraging both knowledge-driven treatment guidelines and data-driven EHR data, physicians can incorporate real-world evidence in their medical decision-making process when considering treatment options for individual patients.

Scientists demystify stress changes within tens of days before a mainshock and often utilize its foreshocks as an indicator. Typically, foreshocks are detected near fault zones, which may be due to the distribution of seismometers. This study investigates changes in seismicity far from mainshocks by examining tens of thousands of M≥2 quakes that were monitored by dense seismic arrays for more than 10 years in Taiwan and Japan. The quakes occurred within epicentral distances ranging from 0 to 400 km during a period of 60 d before and after the mainshocks that are utilized to exhibit common behaviors of seismicity in the spatiotemporal domain. The superimposition results show that wide areas exhibit increased seismicity associated with mainshocks occurring more than several times to areas of the fault rupture. The seismicity increase initially concentrates in the fault zones and gradually expands outward to over 50 km away from the epicenters approximately 40 d before the mainshocks. The seismicity increases more rapidly around the fault zones approximately 20 d before the mainshocks. The stressed crust triggers ground vibrations at frequencies varying from ∼5×10-4 to ∼10-3 Hz (i.e., variable frequency) along with earthquake-related stress that migrates from exterior areas to approach the fault zones. The variable frequency is determined by the observation of continuous seismic waveforms through the superimposition processes and is further supported by the resonant frequency model. These results suggest that the variable frequency of ground vibrations is a function of areas with increased seismicity leading to earthquakes.