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The creation of new families of intermetallic or Zintl-phase compounds with high-spin orbit elements has attracted a considerable amount of interest due to the presence of unique electronic, magnetic, and topological phenomena in these materials. Here, we establish the synthesis and structural and electronic characterization of KMg4Bi3single crystals having a new structure type. KMg4Bi3crystallizes in space group Cmcmhaving unit cell parameters a= 4.7654(11) Å, b= 15.694(4) Å, and c= 13.4200(30) Å and features an edge-sharing MgBi4tetrahedral framework that forms cage-like one-dimensional channels around K+ions. Diffuse reflectance absorption measurements indicate that this material has a narrow band gap of 0.27 eV, which is in close agreement with the electronic structure calculations that predict it to be a trivial insulator. Electronic transport measurements from 80 to 380 K indicate this material behaves like a narrow band gap semiconductor doped to ∼1018holes/cm–3, with thermopowers of ∼100 μV/K and appreciable magnetoresistance. Electronic structure calculations indicate this material is close to a topological phase transition and becomes a topological insulator when the lattice is uniformly expanded by 3.5%. Overall, this unique structure type expands the landscape of potential quantum materials.

Purpose: Virtual reality (VR) allows for an immersive and interactive analysis of imaging data such as computed tomography (CT) and magnetic resonance imaging (MRI). The aim of this study is to assess the comprehensibility of VR anatomy and its value in assessing resectability of pancreatic ductal adenocarcinoma (PDAC). Methods: This study assesses exposure to VR anatomy and evaluates the potential role of VR in assessing resectability of PDAC. Firstly, volumetric abdominal CT and MRI data were displayed in an immersive VR environment. Volunteering physicians were asked to identify anatomical landmarks in VR. In the second stage, experienced clinicians were asked to identify vascular involvement in a total of 12 CT and MRI scans displaying PDAC (2 resectable, 2 borderline resectable, and 2 locally advanced tumours per modality). Results were compared to 2D standard PACS viewing. Results: In VR visualisation of CT and MRI, the abdominal anatomical landmarks were recognised by all participants except the pancreas (30/34) in VR CT and the splenic (31/34) and common hepatic artery (18/34) in VR MRI, respectively. In VR CT, resectable, borderline resectable, and locally advanced PDAC were correctly identified in 22/24, 20/24 and 19/24 scans, respectively. Whereas, in VR MRI, resectable, borderline resectable, and locally advanced PDAC were correctly identified in 19/24, 19/24 and 21/24 scans, respectively. Interobserver agreement as measured by Fleiss κ was 0.7 for CT and 0.4 for MRI, respectively (p< 0.001). Scans were significantly assessed more accurately in VR CT than standard 2D PACS CT, with a median of 5.5 (IQR 4.75–6) and a median of 3 (IQR 2–3) correctly assessed out of 6 scans (p< 0.001). Conclusion: VR enhanced visualisation of abdominal CT and MRI scan data provides intuitive handling and understanding of anatomy and might allow for more accurate staging of PDAC and could thus become a valuable adjunct in PDAC resectability assessment in the future.

Background: Anastomotic leakage (AL), a severe complication following colorectal surgery, arises from defects at the anastomosis site. This study evaluates the feasibility of predicting AL using machine learning (ML) algorithms based on preoperative data. Methods: We retrospectively analyzed data including 21 predictors from patients undergoing colorectal surgery with bowel anastomosis at four Swiss hospitals. Several ML algorithms were applied for binary classification into AL or non-AL groups, utilizing a five-fold cross-validation strategy with a 90% training and 10% validation split. Additionally, a holdout test set from an external hospital was employed to assess the models' robustness in external validation. Results: Among 1244 patients, 112 (9.0%) suffered from AL. The Random Forest model showed an AUC-ROC of 0.78 (SD: ± 0.01) on the internal test set, which significantly decreased to 0.60 (SD: ± 0.05) on the external holdout test set comprising 198 patients, including 7 (3.5%) with AL. Conversely, the Logistic Regression model demonstrated more consistent AUC-ROC values of 0.69 (SD: ± 0.01) on the internal set and 0.61 (SD: ± 0.05) on the external set. Accuracy measures for Random Forest were 0.82 (SD: ± 0.04) internally and 0.87 (SD: ± 0.08) externally, while Logistic Regression achieved accuracies of 0.81 (SD: ± 0.10) and 0.88 (SD: ± 0.15). F1 Scores for Random Forest moved from 0.58 (SD: ± 0.03) internally to 0.51 (SD: ± 0.03) externally, with Logistic Regression maintaining more stable scores of 0.53 (SD: ± 0.04) and 0.51 (SD: ± 0.02). Conclusion: In this pilot study, we evaluated ML-based prediction models for AL post-colorectal surgery and identified ten patient-related risk factors associated with AL. Highlighting the need for multicenter data, external validation, and larger sample sizes, our findings emphasize the potential of ML in enhancing surgical outcomes and inform future development of a web-based application for broader clinical use.

In this Pro-Con commentary article, we discuss use of continuous physiologic monitoring for clinical deterioration, specifically respiratory depression in the postoperative population. The Pro position advocates for 24/7 continuous surveillance monitoring of all patients starting in the postanesthesia care unit until discharge from the hospital. The strongest arguments for universal monitoring relate to inadequate assessment and algorithms for patient risk. We argue that the need for hospitalization in and of itself is a sufficient predictor of an individual’s risk for unexpected respiratory deterioration. In addition, general care units carry the added risk that even the most severe respiratory events will not be recognized in a timely fashion, largely due to higher patient to nurse staffing ratios and limited intermittent vital signs assessments (e.g., every 4 hours). Continuous monitoring configured properly using a “surveillance model” can adequately detect patients' respiratory deterioration while minimizing alarm fatigue and the costs of the surveillance systems. The Con position advocates for a mixed approach of time-limited continuous pulse oximetry monitoring for all patients receiving opioids, with additional remote pulse oximetry monitoring for patients identified as having a high risk of respiratory depression. Alarm fatigue, clinical resource limitations, and cost are the strongest arguments for selective monitoring, which is a more targeted approach. The proponents of the con position acknowledge that postoperative respiratory monitoring is certainly indicated for all patients, but not all patients need the same level of monitoring. The analysis and discussion of each point of view describes who, when, where, and how continuous monitoring should be implemented. Consideration of various system-level factors are addressed, including clinical resource availability, alarm design, system costs, patient and staff acceptance, risk-assessment algorithms, and respiratory event detection. Literature is reviewed, findings are described, and recommendations for design of monitoring systems and implementation of monitoring are described for the pro and con positions.

The COVID-19 pandemic significantly affected the world and work in particular, but its effects on the labor market were not evenly distributed. Seafarers, who are essential workers engaging in international maritime transport, encountered exacerbated challenges to labor conditions at sea during the pandemic. Notably, the inability to conduct crew changes violated their right to rest, increasing the risk of fatigue-related safety accidents at sea. Additionally, the precarious nature of maritime employment relationships delayed seafarers waiting to enlist on the vessels, creating extended financial hardship ashore. Socio-legal analysis revealed how the pandemic, related public health measures and precarious employment heightened the vulnerability of seafarers during the pandemic. Applying the Pressure, Disorganization and Regulatory Failure model and supported by qualitative data collected through a policy review, media coverage analysis and semi-structured interviews, we identified how seafarers’ health and safety rights were significantly compromised during the pandemic. Even though various initiatives were raised by international governmental and non-governmental organizations to address the “humanitarian crisis” at sea, maritime labor regulatory failures were not effectively addressed throughout the multiple waves of the pandemic.

The article titled "Butchering Pigs, Foraging Water and Fuel– The Future of Marine Logistics" explores the challenges and strategies of marine logistics, focusing on the experiences of the First Battalion, Twelfth Marine Regiment during the Spartan Fury 22.1 exercise. It emphasizes the importance of resource management, such as butchering pigs for food, foraging water, and fuel procurement. The article also discusses the need for innovative solutions to sustain operations in diverse environments. Additionally, it proposes the development of man-portable, autonomous, semi-submersible drones called Autonomous Tethered Logistics Apparatus (ATLA) as a cost-effective and low-signature logistics solution for a dispersed force in a contested environment. [Extracted from the article]

Der Beitrag nimmt Facebooks Targeting-Praktiken im Kontext der Erstürmung des US-amerikanischen Kapitols 2021 zum Anlass einer soziologischen Targeting-Analyse. Er argumentiert zunächst dafür, den Analysemodus umzustellen vom in der Sozialphilosophie üblichen Fokus auf Entscheidungen auf die Kategorie der Erfahrung. Daraufhin erfolgt eine pragmatistische Konzeption des Erfahrungsbegriffs, an die sich eine Klärung der Kriterien zur Bestimmung der gesellschaftlichen „Eingriffstiefe“ des Targeting anschließt. Hierzu wird die erweiterte Heuristik Luhmannscher Sinndimensionen (sachlich, sozial, zeitlich, räumlich) fruchtbar gemacht. Die Analyse des Targeting in allen Sinndimensionen kulminiert in der These, dass zeitgenössisches Deep Targetingdurch Orientierung am Aktualen und durch Steigerung der Eingriffstiefe in die Erfahrungsspielräume des Sozialen zu einer Kontingenz-einschränkenden Verengung von Erfahrung führt. Aus dieser These werden abschließend normative Konsequenzen gezogen.

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The International People's Tribunal (IPT) recently found the governments of past president Rodrigo Duterte, current president Ferdinand Marcos Jr., and the United States of America guilty of massive violations of international humanitarian law in the Philippines. The IPT, a quasi-judicial mechanism, heard testimony from 15 witnesses detailing human rights abuses, including extrajudicial killings, torture, enforced disappearances, and indiscriminate aerial bombing. The tribunal concluded that the Philippine government acted with impunity and disregard for international humanitarian law. The verdict has been delivered to those on trial and international bodies, calling for future actions by organizations such as the International Criminal Court. The United States' support for the Philippine military has enabled these abuses to persist. [Extracted from the article]

We review spectroscopic methods developed for the determination of magnetic fields in high-energy-density (HED) plasmas. In such plasmas, the common Zeeman-splitting magnetic-field diagnostics are often impeded by various broadening mechanisms of the atomic transitions. The methods described, encompassing atomic transitions in the visible and ultraviolet spectral regions, are applied to the study of imploding plasmas (in a Z-pinch configuration) with and without pre-embedded magnetic fields, relativistic-electron focusing diodes, and plasma-opening switches. The measurements of the magnetic field in side-on observations of cylindrical-plasma configurations that are local in the radial direction despite the light integration along the chordal lines of sight are discussed. The evolution of the magnetic-field distributions obtained, together with the measurements of the plasma temperature and density, allows for studying the plasma dynamics, resistivity, and pressure and energy balance. In particular, for the Z-pinch, an intriguing question on the current flow in the imploding plasma was raised due to the observation that the current during stagnation mainly flows at relatively large radii, outside the stagnation region. For the premagnetized plasma implosions, all three components of the magnetic field (azimuthal, axial, and radial) were measured, yielding the evolution of the current flow and the efficiency of the axial field compression, as well as the relation between the geometry of the field and the plasma rotation, found to develop in this configuration. The measurements in the relativistic electron diode are used to quantify the shielding of the magnetic field by the plasmas in the diode. Also described are the experimental and theoretical investigations of a nondiffusive fast penetration of magnetic field into a low-density plasma (in the plasma-opening-switch configuration).

Post-mortem CT can aid in injury identification and inform resuscitation algorithms in blunt agonal patients. Our data demonstrate a high rate of airway device misplacement and pneumothoraces which should mandate empiric confirmation of ETT position and chest decompression

Hintergrund: Der Beruf der Atmungstherapeuten (AT) hat verschiedene Aufgaben, u. a. Versorgung von Patienten, Diagnostik, Unterstützung der Therapie und Pflege, Schulung und Anleitung sowie Optimierung der Strukturen und Prozesse. Unklar ist, in welchem Umfang die verschiedenen Tätigkeitsfelder an deutschen Universitätskliniken umgesetzt werden und wie geschulte Mitarbeiter den Service bewerten. Ziel: Beschreibung der Tätigkeiten von AT an einem Universitätsklinikum sowie Evaluation der Mikroschulungen von Mitarbeitern. Methode: Die Daten wurden in einer prospektiven Beobachtungsstudie im Mixed-method-Design über 6 Monate gesammelt. Primäres Outcome war die Anzahl der AT-Tätigkeiten. Sekundäres Outcome war die Beurteilung von Mikroschulungen der AT, die von Mitarbeitern im Hinblick auf den Nutzen für den persönlichen Wissensgewinn, die praktische Anwendung und für Patienten auf Skalen von 1–10 (1 = sehr schlecht, 10 = sehr gut) bewertet wurden. Ergebnisse: Während des 6‑monatigen Studienzeitraums wurden von AT insgesamt 1674 Konsile angefordert und 2274 Tätigkeiten durchgeführt; die 3 häufigsten Tätigkeiten machten 45 % (n= 1037) aller Tätigkeiten aus und beinhalteten in 20,1 % (n= 461) Einstellung der nichtinvasiven Beatmung, in 13,1 % (n= 299) Sekretmanagement und in 12,2 % (n= 277) protokolliertes Weaning. Die Mikroschulungen durch AT wurden von 111 Mitarbeitern als sehr gut (Median 9,8, Interquartilsabstand 9–10) bewertet. Anteilig wurde 74 % der Arbeitszeit in direkter Versorgung und Schulung auf Station verbracht. Schlussfolgerungen: Das Tätigkeitsprofil von AT ist komplex, verantwortungsvoll und zum Großteil in der direkten Patientenversorgung verortet. Die Mikroschulungen durch AT im laufenden Betrieb können eine innovative Möglichkeit zur Kompetenzerweiterung der Mitarbeiter darstellen.

Acute myocardial injury is a common diagnosis in the emergency department and differential diagnoses are numerous. Cardiac magnetic resonance (CMR) strain sequences, such as fast strain ENCoded (fSENC), are early predictors of myocardial function loss. This study assessed the potential diagnostic and prognostic benefits of a layer-specific approach.

Injection site reactions are defined as skin reactions at the injection site to drugs administered subcutaneously. Pathophysiologically, these reactions are based on different immunological mechanisms. We report the case of a 49-year-old patient with type 1 diabetes mellitus (first diagnosis in 1994 at the age of 23 years). Continuous subcutaneous insulin infusion using an insulin pump has been used for many years. The patient presented to the department of dermatology with progressive symptoms in the area of the insulin injection sites on the lower abdomen, accompanied by pain, burning, erythema, tenderness, and the formation of subcutaneous nodules. Previous attempts to use different insulins and to change the injection sites did not improve his symptoms. Furthermore, the symptoms appeared within hours after the insulin pump was attached, so that the injection site has to be changed as soon as every 48 hours. No anaphylactic shock was reported at any time. Multiple histological specimens were obtained from an older lesion on the abdomen as well as from test sites after standard allergological tests (prick and intradermal tests) of various insulins. Histologically, these biopsies showed the image of an extensive deep-reaching small vessel vasculitis with the aspect of an urticarial vasculitis and confirmed the diagnosis of an injection-site reaction that can be characterized as a type III hypersensitivity reaction.

Obwohl Berufe im Sektor der Basisarbeit für unsere Gesellschaft von hoher Bedeutung sind, wurde eine gesundheitsförderliche Gestaltung dieser Arbeitsplätze bisher nicht so systematisch betrieben wie an Facharbeitsplätzen oder hochqualifizierten Arbeitsplätzen.

Axis-dependent conduction polarity (ADCP) is a unique electronic phenomena in which the charge polarity of carrier conduction can differ from p-type to n-type depending on the direction of travel through the crystal. Most materials that exhibit ADCP are metals, and very few semiconducting materials exhibit this effect. Here, we establish that PdSe2, a ∼0.5 eV band gap semiconductor that is air- and water-stable, exhibits ADCP, through the growth and characterization of the transport properties of crystals with extrinsic p- and n-type doping levels of Ir and Sb, respectively, in the 1016–1018cm−3range. Electron doped PdSe2exhibits p-type conduction in the cross-plane direction and n-type conduction along the in-plane directions above an onset temperature of 100–200 K that varies with doping level. Lightly p-doped samples show p-type thermopower in all directions at low temperatures, but above ∼360 K the in-plane thermopower turns negative. Density functional theory calculations indicate that the origin of ADCP arises from the complementary effective mass anisotropies in the valence and conduction bands in this material, which facilitate hole transport in the cross-plane direction, and electron transport along the in-plane directions. ADCP occurs at temperatures with sufficient thermal population of both carrier types to overcome the extrinsic doping levels to exploit the effective mass anisotropy. In total, the development of this stable semiconductor in which thermally or optically excited holes and electrons inherently migrate along different directions opens up numerous potential applications in a multitude of technologies.

Purpose:This study aimed to examine the feasibility of telepractice delivery of a treatment package including visual–acoustic biofeedback (VAB) and motor-based treatment for residual speech sound disorder affecting /ɹ/ in school-age children. The overall study used a single-case randomization design; however, this preliminary report will simply quantify changes in accuracy before and after completion of the treatment package. The present analysis did not differentiate between the relative contributions of biofeedback and motor-based treatments.Method:Seven children aged 9–14 years received speech therapy for /ɹ/ distortions via telepractice. The study design consisted of three phases: baseline (four sessions), treatment (20 sessions), and posttreatment (three sessions). Treatment included two sessions weekly for a duration of 10 weeks. The participants received one motor-based/nonbiofeedback session and one VAB session per week. The order of treatment within each week was randomly determined prior to the start of therapy. Overall progress was assessed using untrained listeners' ratings of word probes administered in the baseline and posttreatment phases.Results:Findings revealed that six of the seven participants showed a clinically significant response to the overall treatment package, although the magnitude of individual responses varied across speech contexts (consonantal and vocalic) and participants.Conclusions:The present results suggest that an intervention combining VAB and motor-based treatment for residual /ɹ/ errors can be effectively delivered via telepractice. Considerations for technology setup and treatment protocols are provided.

This work investigates the potential of large-scale thermal energy storage (TES) and hydrogen as seasonal storage technologies in achieving the energy autarky in renewable (RE) districts. The study focuses on the case of Austria, and considers two possible evolutions of the building stock thermal energy demand, a high-demand scenario (BAU) and a low demand scenario (BEST). A quasi-steady state model is implemented in MATLAB to calculate, on the basis of the energy demand for space heating and domestic hot water preparation, the size of required generation and storage technologies.

Monitoring systems for rolling contacts in machinery are widespread. There are multiple solutions in various applications like Health Usage Monitoring Systems (HUMS) for Helicopters and smart bearings from different manufacturers. The number of solutions and possibilities is rising. This paper outlines how the vibrational behavior depends on the measuring position outside and inside the gearbox. The effect of the sensor location is evaluated by examining different locations close to the main excitation of gearboxes—the loaded tooth contact—as well as positions on the gearbox housing. Based on the results, recommendations for an optimal sensor position for gear vibration monitoring are given by considering the efforts of sensor integration. The results can be used to select sensors with the lowest cost to support the widespread gear vibration monitoring.

Neurogenesis involves the precisely coordinated action of genetic programs controlling large-scale neuronal fate specification down to terminal events of neuronal differentiation. The Q neuroblasts in Caenorhabditis elegans, QL on the left and QR on the right, divide, differentiate, and migrate in a similar pattern to produce three neurons each. However, QL on the left migrates posteriorly, and QR on the right migrates anteriorly. The MAB-5/Hox transcription factor is necessary and sufficient for posterior Q lineage migration and is normally expressed only in the QL lineage. To define genes controlled by MAB-5in the Q cells, fluorescence-activated cell sorting was utilized to isolate populations of Q cells at a time in early L1 larvae when MAB-5first becomes active. Sorted Q cells from wild-type, mab-5loss-of-function (lof), and mab-5gain-of-function (gof) mutants were subject to RNA-seq and differential expression analysis. Genes enriched in Q cells included those involved in cell division, DNA replication, and DNA repair, consist with the neuroblast stem cell identity of the Q cells at this stage. Genes affected by mab-5included those involved in neurogenesis, neural development, and interaction with the extracellular matrix. cwn-1, which encodes a Wnt signaling molecule, showed a paired response to mab-5in the Q cells: cwn-1expression was reduced in mab-5(lof)and increased in mab-5(gof), suggesting that MAB-5is required for cwn-1expression in Q cells. MAB-5is required to prevent anterior migration of the Q lineage while it transcriptionally reprograms the Q lineage for posterior migration. Functional genetic analysis revealed that CWN-1is required downstream of MAB-5to inhibit anterior migration of the QL lineage, likely in parallel to EGL-20/Wnt in a noncanonical Wnt pathway. In sum, work here describes a Q cell transcriptome, and a set of genes regulated by MAB-5in the QL lineage. One of these genes, cwn-1, acts downstream of mab-5in QL migration, indicating that this gene set includes other genes utilized by MAB-5to facilitate posterior neuroblast migration.