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IMPORTANCE: Lesbian, gay, bisexual, transgender, queer, and/or questioning (LGBTQ+) youth face worse mental health outcomes than non-LGBTQ+ peers. Family support may mitigate this, but sparse evidence demonstrates this in clinical settings. OBJECTIVES: To compare depression and suicide risk between LGBTQ+ and non-LGBTQ+ youth in primary care settings and to investigate whether family support mitigates these negative mental health outcomes. DESIGN, SETTING, AND PARTICIPANTS: This cross-sectional study uses data from well care visits completed by adolescents aged 13 to 19 years from February 2022 through May 2023, including the Patient Health Questionnaire–9 Modified for Teens (PHQ-9-M) and the Adolescent Health Questionnaire (AHQ; an electronic screener assessing identity, behaviors, and guardian support), at 32 urban or suburban care clinics in Pennsylvania and New Jersey. EXPOSURES: The primary exposure was self-reported LGBTQ+ status. Family support moderators included parental discussion of adolescent strengths and listening to feelings. Race and ethnicity (determined via parent or guardian report at visit check-in), sex, payer, language, age, and geography were covariates. MAIN OUTCOMES AND MEASURES: PHQ-9-M–derived mental health outcomes, including total score, recent suicidal ideation, and past suicide attempt. RESULTS: The sample included 60 626 adolescents; among them, 9936 (16.4%) were LGBTQ+, 15 387 (25.5%) were Black, and 30 296 (50.0%) were assigned female sex at birth. LGBTQ+ youth, compared with non-LGBTQ+ youth, had significantly higher median (IQR) PHQ-9-M scores (5 [2-9] vs 1 [0-3]; P < .001) and prevalence of suicidal ideation (1568 [15.8%] vs 1723 [3.4%]; P < .001). Fewer LGBTQ+ youth endorsed parental support than non-LGBTQ+ youth (discussion of strengths, 8535 [85.9%] vs 47 003 [92.7%]; P < .001; and listening to feelings, 7930 [79.8%] vs 47 177 [93.1%]; P < .001). In linear regression adjusted for demographic characteristics and parental discussion of strengths, LGBTQ+ status was associated with a higher PHQ-9-M score (mean difference, 3.3 points; 95% CI, 3.2-3.3 points). In logistic regression, LGBTQ+ youth had increased adjusted odds of suicidal ideation (adjusted odds ratio, 4.3; 95% CI, 4.0-4.7) and prior suicide attempt (adjusted odds ratio, 4.4; 95% CI, 4.0-4.7). Parental support significantly moderated the association of LGBTQ+ status with PHQ-9-M score and suicidal ideation, with greater protection against these outcomes for LGBTQ+ vs non-LGBTQ+ youth. CONCLUSIONS AND RELEVANCE: Compared with non-LGBTQ+ youth, LGBTQ+ youth at primary care visits had more depressive symptoms and higher odds of suicidal ideation and prior suicide attempt. Youth-reported parental support was protective against these outcomes, suggesting potential benefits of family support–focused interventions to mitigate mental health inequities for LGBTQ+ youth.

We use the concept of active antenna available power to derive a generalization of the Friis transmission formula for multiport antenna systems. With beamformer weights chosen, such that the array patterns are the same when transmitting and receiving, the active antenna available power at the receiving antenna divided by the input power at the transmitter is symmetric under link direction reversal in the near field as well as the far field. These results generalize the Friis transmission formula to beamformed multiport antenna systems in an arbitrary reciprocal propagation environment.

This article discusses strategies for improving relationships with difficult co-workers. The author shares a personal experience of realizing their own role in creating challenging relationships. The article explains that people may be difficult due to different needs and perspectives, and suggests reframing the concept of difficult to approach interactions with empathy and positive intent. The article also provides tips for working with different types of difficult people based on their individual characteristics. Overall, the article emphasizes the importance of understanding and addressing one's own role in difficult relationships. [Extracted from the article]

Extramedullary multiple myeloma (EMM) is an aggressive form of multiple myeloma (MM). This study represents the most comprehensive next-generation sequencing analysis of EMM tumors (N= 14) to date, uncovering key molecular features and describing the tumor microenvironment. We observed the co-occurrence of 1q21 gain/amplification and MAPK pathway mutations in 79% of EMM samples, suggesting that these are crucial mutational events in EMM development. We also demonstrated that patients with mutated KRASand 1q21 gain/amplification at the time of diagnosis have a significantly higher risk of EMM development (HR = 2.4, p= 0.011) using data from a large CoMMpass dataset. We identified downregulation of CXCR4 and enhanced cell proliferation, along with reduced expression of therapeutic targets (CD38, SLAMF7, GPRC5D, FCRH5), potentially explaining diminished efficacy of immunotherapy. Conversely, we identified significantly upregulated EZH2 and CD70 as potential future therapeutic options. For the first time, we report on the tumor microenvironment of EMM, revealing CD8+ T cells and NK cells as predominant immune effector cells using single-cell sequencing. Finally, this is the first longitudinal study in EMM revealing the molecular changes from the time of diagnosis to EMM relapse.

The design of functional supramolecular assemblies from individual molecular building blocks is a fundamental challenge in chemistry and material science. We report on the fabrication of “honeycomb” films by light-induced coassembly of diacetylene derivatives and carbon dots. Specifically, modulating noncovalent interactions between the carbon dots, macrocyclic diacetylene, and anthraquinone diacetylene facilitates formation of thin films exhibiting a long-range, uniform pore structure. We show that light irradiation at distinct wavelengths plays a key role in the assembly process and generation of unique macro-porous morphology, by both initiating interactions between the carbon dots and the anthraquinone moieties and giving rise to the topotactic polymerization of the polydiacetylene network. We further demonstrate utilization of the macro-porous film as a photocatalytic platform for water pollutant degradation and as potential supercapacitor electrodes, both applications taking advantage of the high surface area, hydrophobicity, and pore structure of the film.

Background: Relationships between stressful life events (SLEs) and health outcomes in people living with multiple sclerosis (plwMS), beyond relapse, are not well-established. We examined associations between SLEs and fatigue and symptoms of depression in plwMS. Methods: 948 participants were queried whether they had experienced any of the 16 SLEs (Holmes–Rahe Social Readjustment Rating Scale) in the preceding 12 months. SLEs were summated to estimate SLE number and SLE load (weighted for the degree of associated stress). Cross-sectional associations between SLE (number, load and individual) and fatigue, and depressive symptoms were examined using log-binomial or log-multinomial regression adjusted for age, sex, relapse symptoms, education, MS type at baseline, disability, fatigue, comorbidity, depression, and antidepressant/antifatigue medications, as appropriate. Sub-analyses restricted to SLEs with a negative emotional impact were performed. Results: Median SLE number and load were 2 (IQR 1–2) and 57 (IQR 28–97), respectively. SLE number and load were not associated with a higher prevalence of fatigue, or depressive symptoms, even when restricting analyses to SLEs with a perceived negative emotional impact. A new relationship or family member with a negative impact was associated with a threefold and 2.5-fold higher prevalence of depressive symptoms, respectively. Serious illness was associated with a 28% higher prevalence of depressive symptoms. Conclusion: Psychological support for SLEs, and/or intervention targeted to SLE appraisal, may be beneficial in mitigating the adverse effects of SLEs with a perceived negative emotional impact on depressive symptoms in plwMS. Potential associations between serious illness and increased prevalence of depressive symptoms may warrant further investigation.

Maternal history for sporadic Alzheimer’s disease (AD) predisposes the offspring to the disease later in life. However, the mechanisms behind this phenomenon are still unknown. Lifestyle and nutrition can directly modulate susceptibility to AD. Herein we investigated whether gestational high fat diet influences the offspring susceptibility to AD later in life. Triple transgenic dams were administered high fat diet or regular chow throughout 3 weeks gestation. Offspring were fed regular chow throughout their life and tested for spatial learning and memory, brain amyloidosis, tau pathology, and synaptic function. Gestational high fat diet attenuated memory decline, synaptic dysfunction, amyloid-β and tau neuropathology in the offspring by transcriptional regulation of BACE-1, CDK5, and tau gene expression via the upregulation of FOXP2 repressor. Gestational high fat diet protects offspring against the development of the AD phenotype. In utero dietary intervention could be implemented as preventative strategy against AD.

The presented article proposes a theory for the optimization of multiple-input-multiple-output antenna performance by assessing feeding coefficients. Antenna clusters with multiple feeding ports are utilized, which brings additional degrees of freedom and improves the performance. This work considers fixed shape and matching networks. The method is based on quadratic programming and maximizes total efficiency constrained by channel correlation and channel power distribution. The formulation provided in the article enables establishing trade-offs between all mentioned metrics. Evaluating the performance in this manner provides comprehensive information about the chosen geometry and port placement. Selected examples demonstrate how efficiency and channel correlation can be both in agreement but also in significant conflict. The effect of frequency dispersion on feeding is also investigated.

Performance limitations for implanted antennas, taking radiation efficiency as the metric, are presented. The performance limitations use a convex optimization procedure with the current density inside the implant acting as its degree of freedom. The knowledge of the limitations provides useful information in design procedures and physical insights. Ohmic losses in the antenna and surrounding tissue are considered and quantitatively compared. The interaction of all parts of the system is taken into account in a full-wave manner via the hybrid computation method. The optimization framework is thoroughly tested on a realistic implanted antenna design that is treated both experimentally and as a model in a commercial electromagnetic (EM) solver. Good agreement is reported. To demonstrate the feasibility of developed performance limitations, they are compared to the performance of a loop and a dipole antenna showing the importance of various loss mechanisms during the design process. The tradeoff between tissue loss and antenna ohmic loss indicates critical points at which the optimal solution drastically changes and the chosen topology for a specific design should be changed.

With the introduction of dynamic ECE-R95 and FMVSS 214 crash test requirements, there has been an increasing demand for systems enabling evaluation of performance of door and components of passive safety for side impacts without a need to perform full-scale crash tests. Full-scale crash tests result in substantive economic burden for vehicle development departments and prove to be time consuming. This review describes more than twenty side sled test systems designed for airbags, side door bars and door trim testing and the determination of their respective dynamic force-deflection characteristics. The simple sled test systems that use only one piston and do not allow door deformation are described here, as well as the sophisticated sled test systems that use multiple pistons and advanced simulation of door deformation in real time. In this review, the principle of each system is explained clearly and its advantages and disadvantages are evaluated.

Open-shell nanographenes exhibit unconventional π-magnetism arising from topological frustration or strong electron–electron interaction. However, conventional design approaches are typically limited to a single magnetic origin, which can restrict the number of correlated spins or the type of magnetic ordering in open-shell nanographenes. Here we present a design strategy that combines topological frustration and electron–electron interactions to fabricate a large fully fused ‘butterfly’-shaped tetraradical nanographene on Au(111). We employ bond-resolved scanning tunnelling microscopy and spin-excitation spectroscopy to resolve the molecular backbone and reveal the strongly correlated open-shell character, respectively. This nanographene contains four unpaired electrons with both ferromagnetic and anti-ferromagnetic interactions, harbouring a many-body singlet ground state and strong multi-spin entanglement, which is well described by many-body calculations. Furthermore, we study the magnetic properties and spin states in the nanographene using a nickelocene magnetic probe. The ability to imprint and characterize many-body strongly correlated spins in polyradical nanographenes paves the way for future advancements in quantum information technologies.

The upper bound on antenna gain is expressed as a sum of lossy characteristic modes, specifically, as a sum of characteristic far fields squared. The procedure combines the favorable properties of Harrington’s classical approach to maximum directivity and current-density-based approaches. The upper bound is valid for any antenna or array designed in a given design region for which optimal performance is determined. The decomposition into modes makes it possible to study the degrees of freedom of an obstacle, classify its radiation into normal or super-directive currents, and determine their compatibility with a given excitation. The bound considers an arbitrary shape of the design region and specific material distribution. The cost in $Q$ -factor and radiation efficiency is studied. The extra constraint of a self-resonance current is imposed for an electrically small antenna. The examples verify the developed theory, demonstrate the procedure’s utility, and provide helpful insight to antenna designers. The feasibility of the optimal gain is studied in detail on an example of endfire arrays using the aforementioned decomposition of optimal current density into lossy characteristic modes.

Characteristic modes of arbitrary 2-D periodic systems are analyzed using scattering parameter data. This approach bypasses the need for periodic integral equations and allows for characteristic modes to be computed from generic simulation or measurement data. Example calculations demonstrate the efficacy of the method through comparison against a periodic method of moments (MoM) formulation for a simple, single-layer conducting unit cell. The effect of vertical structure and electrical size on the number of modes is studied, and its discrete nature is verified with example calculations. A multiband polarization-selective surface and a beamsteering metasurface are presented as additional examples.

Classical gradient-based density topology optimization is adapted for method-of-moments numerical modeling to design a conductor-based system attaining the minimal antenna Q-factor evaluated via an energy stored operator. Standard topology optimization features are discussed, e.g., interpolation scheme and density and projection filtering. The performance of the proposed technique is demonstrated in a few examples in terms of the realized Q-factor values and necessary computational time to obtain a design. The optimized designs are compared to the fundamental bound and well-known empirical structures. The presented framework can provide a completely novel design, as presented in the second example.

A memetic framework for optimal inverse design is proposed by combining a local gradient-based procedure and a robust global scheme. The procedure is based on method-of-moment (MoM) matrices and does not demand full inversion of a system matrix. Fundamental bounds are evaluated for all optimized metrics in the same manner, providing natural stopping criteria and quality measures for realized devices. Compared to density-based topology optimization, the proposed routine does not require filtering or thresholding. Compared to commonly used heuristics, the technique is significantly faster, still preserving a high level of versatility and robustness. This is a two-part article in which the first part is devoted to the theoretical background and properties, and the second part applies the method to examples of varying complexity.

Optimal inverse design, including topology optimization and evaluation of fundamental bounds on performance, which was introduced in Part 1, is applied to various antenna design problems. A memetic scheme for topology optimization combines local and global techniques to accelerate convergence and maintain robustness. Method-of-moments (MoMs) matrices are used to evaluate objective functions and allow determination of fundamental bounds on performance. By applying the Shermann–Morrison–Woodbury identity, the repetitively performed structural update is inversion-free yet full-wave. The technique can easily be combined with additional features often required in practice, e.g., only a part of the structure is controllable, or evaluation of an objective function is required in a subdomain only. The memetic framework supports multifrequency and multiport optimization and offers many other advantages, such as an actual shape being known at every moment of the optimization. The performance of the method is assessed, including its convergence and computational cost.

The development of functional organic molecules requires structures of increasing size and complexity, which are typically obtained by the covalent coupling of smaller building blocks. Herein, with the aid of high-resolution scanning tunneling microscopy/spectroscopy and density functional theory, the coupling of a sterically demanded pentacene derivative on Au(111) into fused dimers connected by non-benzenoid rings was studied. The diradical character of the products was tuned according to the coupling section. In particular, the antiaromaticity of cyclobutadiene as the coupling motif and its position within the structure play a decisive role in shifting the natural orbital occupancies toward a stronger diradical electronic character. Understanding these structure–property relations is desirable not only for fundamental reasons but also for designing new complex and functional molecular structures.

•DNA POLθ–mediated DNA repair protects leukemia cells from the toxic effect of metabolically induced DNA damage.•DNA POLθ is a new therapeutic target to eradicate leukemia clones expressing oncogenic tyrosine kinases.

The synthesis of two-dimensionally extended polycyclic heteroatomic molecules keeps attracting considerable attention. In particular, frameworks bearing planar cyclooctatetraenes (COT) moieties can display intriguing properties, including antiaromaticity. Here, we present an on-surface chemistry route to square-type porphyrin tetramers with a central COT ring, coexisting with other oligomers. This approach employing temperature-induced dehydrogenative porphyrin homocoupling in an ultrahigh vacuum environment provides access to surface-supported, unsubstituted porphyrin tetramers that are not easily achievable by conventional synthesis means. Specifically, monomeric free-base (2H-P) and Zn-metalated (Zn-P) porphines (P) were employed to form square-type free-base and Zn-functionalized tetramers on Ag(100). An atomic-level characterization by bond-resolved atomic force microscopy and scanning tunneling microscopy and spectroscopy is provided, identifying the molecular structures. Complemented by density functional theory modeling, the electronic structure is elucidated, indeed revealing antiaromaticity induced by the COT moiety. The present study thus gives access, and insights, to a porphyrin oligomer, representing both a model system for directly fused porphyrins and a potential building block for conjugated, extended two-dimensional porphyrin sheets.

Emotion is defined (from Britannica) as a complex combination of experiences of consciousness, bodily sensation and behavior, reflecting personal significance of externally and/or internally triggered changes. As an indispensable part of human communication, emotions could be represented within the digital world as a means that could control human interaction with digital artifacts. When this is combined with gamification, a more engaging communication for the player could be established. In this article, we explore how multisensed emotions of players could be used as adaptation controllers within the emotion-adpting serious neurogames (SNGs). We first briefly describe the emotion sensing and recognition landscape, examining the emotion-source sensing and emotion inferring approaches. We then discuss the SNGs design framework and the way human-to-SNG communication is set. Additionally, we describe the way the adaptation of the SNG characteristics can be driven by the inferred emotions, towards the achievement of the desired SNG goals. In addition, we demonstrate the feasibility and design characteristics of multisensed emotion-adapting SNGs, by presenting a related application case, namely EmoSense, and evaluate its acceptance as a technological solution in the field of neurofeedback. Finally, we discuss challenges and opportunities in the field.

Optimal performance of antennas used in multiple-input multiple-output (MIMO) systems is addressed in this communication with optimality being expressed in terms of the power radiated, which is subject to realistic, yet unknown, excitation and fixed, however, arbitrarily complicated, matching. It is shown that if excitation is not specified, the optimality of an MIMO radiating system has to be understood differently as compared with the case of a specified excitation. Consequently, two important figures of merits—transducer and radiation efficiency figures—are adopted to measure the quality of the MIMO radiating systems. The communication is accompanied by examples illustrating the theoretical concepts.

Characteristic modes are formulated using the scattering dyadic, which maps incident plane waves to scattered far-fields generated by an object of arbitrary material composition. Numerical construction of the scattering dyadic using arbitrary full-wave electromagnetic solvers is demonstrated in examples involving a variety of dielectric and magnetic materials. Wrapper functions for computing characteristic modes in method-of-moments, finite-difference time domain, and finite-element solvers are provided as Supplementary Material.

An iterative algorithm is adopted to construct approximate representations of matrices describing the scattering properties of arbitrary objects. The method is based on the implicit evaluation of scattering responses from iteratively generated excitations. The method does not require explicit knowledge of any system matrices (e.g., stiffness or impedance matrices) and is well suited for use with matrix-free and iterative full-wave solvers, such as finite-difference time-domain method, finite-element method, and multilevel fast multipole algorithm. The proposed method allows for significant speed-up compared to the direct construction of a full transition matrix or scattering dyadic. The method is applied to the characteristic mode decomposition of arbitrarily shaped obstacles of arbitrary material distribution. Examples demonstrating the speed-up and complexity of the algorithm are studied with several commercial software packages.

Background:Patients with severe coronavirus disease 2019 (COVID-19) are at an increased risk of acute respiratory distress syndrome and mortality. This is due to the increased levels of pro-inflammatory cytokines that amplify downstream pathways that are controlled by immune regulators. Objective:This study aimed to investigate the association between cytokine genetic variants, cytokine serum levels/profiles, and disease severity in critically and noncritically ill COVID-19 patients. Methods:This cross-sectional study recruited 646 participants who tested positive for severe acute respiratory syndrome coronavirus 2 from six collection sites across the United Arab Emirates. Medical files were accessed to retrieve clinical data. Blood samples were collected from all participants. Patients were divided into two clinical groups, noncritical (n = 453) and critical (n = 193), according to World Health Organization classification guidelines for COVID-19 patients. Cytokine analyses were conducted on serum of a subset of the cohort, specifically on 426 participants (noncritical, 264; critical, 162). Candidate gene analyses of 33 cytokine-related genes (2,836 variants) were extracted from a genome-wide association study to identify genetic variants with pleiotropic effects on a specific cytokine and the severity of COVID-19 disease. Results:Age, body mass index (BMI), and pre-existing medical conditions were found to be significant risk factors that contribute to COVID-19 disease severity. After correcting for age, sex, and BMI, IP-10 (P< 0.001), IFN (P= 0.001), IL-6 (P< 0.001), and CXCL-16 (P< 0.001) serum levels were significantly higher among critical COVID-19 cases, when compared with noncritically ill patients. To investigate if the genetic variants involved in the serum cytokine levels are associated with COVID-19 severity, we studied several genes. Single nucleotide polymorphisms in IL6(rs1554606; odd ratio (OR)G= 0.67 [0.66, 0.68]; P= 0.017), IFNG(rs2069718; ORG= 0.63 [0.62, 0.64]; P= 0.001), MIP(rs799187; ORA= 1.69 [1.66, 1.72]; P= 0.034), and CXCL16(rs8071286; ORA= 1.42 [1.41, 1.44]; P= 0.018) were found to be associated with critically ill patients. Polymorphisms in the CXCL10, CCL2, IL1, CCL7, and TNFgenes were not associated with the COVID-19 critical phenotype. The genotypes of IL-6 (gene, IL6[7p15.3]) and CXCL-16 (gene, CXCL16[17p13.2]) were significantly associated with the serum levels of the respective cytokine in critical cases of COVID-19. Conclusion:Data obtained from measuring cytokine levels and genetic variant analyses suggest that IL-6 and CXCL-16 could potentially be used as potential biomarkers for monitoring disease progression of COVID-19 patients. The findings in this study suggest that specific cytokine gene variants correlate with serum levels of the specific cytokine. These genetic variants could be of assistance in the early identification of high-risk patients on admission to the clinic to improve the management of COVID-19 patients and other infectious diseases.