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Purpose of reviewClonal hematopoiesis (CH) refers to the expansion of hematopoietic stem cell clones and their cellular progeny due to somatic mutations, mosaic chromosomal alterations (mCAs), or copy number variants which naturally accumulate with age. CH has been linked to increased risk of blood cancers, but CH has also been linked to adverse cardiovascular outcomes.Recent findingsA combination of clinical outcome studies and mouse models have offered strong evidence that CH mutations either correlate with or cause atherosclerosis, diabetes mellitus, chronic kidney disease, heart failure, pulmonary hypertension, aortic aneurysm, myocardial infarction, stroke, aortic stenosis, poor outcomes following transcatheter aortic valve replacement (TAVR) or orthotopic heart transplant, death or need of renal replacement therapy secondary to cardiogenic shock, death from cardiovascular causes at large, and enhance anthracycline cardiac toxicity. Mechanistically, some adverse outcomes are caused by macrophage secretion of IL-1β and IL-6, neutrophil invasion of injured myocardium, and T-cell skewing towards inflammatory phenotypes. CH mutations lead to harmful inflammation and arterial wall invasion by bone marrow-derived cells resulting in poor cardiovascular health and outcomes. Blockade of IL-1β or JAK2 signaling are potential avenues for preventing CH-caused cardiovascular morbidity and mortality.

Adequate sleep is crucial for elite athletes' recovery, performance readiness, and immune response. Establishing reference ranges for elite athletes enables appropriate contextualization for designing and targeting sleep interventions. Purpose: To establish sleep-quality reference ranges for Olympic and Paralympic cohorts using the Pittsburgh Sleep Quality Index (PSQI) and explore differences based on sex and sport types. Methods: Team USA athletes (men = 805, women = 798) completed the PSQI as part of a health-history questionnaire. Descriptive statistics were used to create reference ranges and linear models, and χ2 test of independence determined differences in PSQI global and component scores between sex, games, season, and participation. Results: Six hundred thirty-two (39.43%) athletes reported poor sleep (PSQIGlobal ≥ 5). Men displayed later bedtimes (P =.006), better global PSQI scores, shorter sleep latency, less sleep disturbance, and less use of sleep medication than women (all P <.001). Winter Games participants had later bedtime (P =.036) and sleep offset time (P =.028) compared with Summer Games athletes. Team-sport athletes woke earlier than individual-sport athletes (P <.001). Individual-sport athletes were more likely to have low (P =.005) and mild (P =.045) risk for reduced sleep duration than team-sport athletes. Conclusion: These data provide PSQI-specific reference ranges to identify groups at greatest risk for poor sleep, who may benefit most from targeted sleep interventions. [ABSTRACT FROM AUTHOR]

Purpose: Transmeridian travel is common for elite athletes participating in competitions and training. However, this travel can lead to circadian misalignment wherein the internal biological clock becomes desynchronized with the light–dark cycle of the new environment, resulting in performance decrement and potential negative health consequences. Existing literature extensively discusses recommendations for managing jet lag, predominantly emphasizing light-based interventions to synchronize the internal clock with the anticipated time at the destination. Nevertheless, visually impaired (VI) athletes may lack photoreceptiveness, diminishing or nullifying the effectiveness of this therapy. Consequently, this invited commentary explores alternative strategies for addressing jet lag in VI athletes. Conclusions: VI athletes with light perception but reduced visual acuity or visual fields may still benefit from light interventions in managing jet lag. However, VI athletes lacking a conscious perception of light should rely on gradual shifts in behavioral factors, such as meal timing and exercise, to facilitate the entrainment of circadian rhythms to the destination time. Furthermore, interventions like melatonin supplementation may prove useful during and after travel. In addition, it is recommended that athlete guides adopt phase-forward or phase-back approaches to synchronize with the athlete, aiding in jet-lag management and optimizing performance. [ABSTRACT FROM AUTHOR]

The physical demands of a single long-distance triathlon (LDT) are sufficient to cause robust physiological perturbations. In this unique case study, an ultraendurance athlete completed 100 LDTs in 100 days (100LDT). Purpose: This study aims to describe and analyze this single athlete's performance, physiological biomarkers, and sleep parameters throughout the 100LDT. Methods: An ultraendurance athlete completed an LDT (2.4-mile swim, 112-mile bike ride, and 26.2-mile marathon) each day for 100 consecutive days. Physical work, physiological biomarkers, and sleep parameters were recorded each night using a wrist-worn photoplethysmographic sensor. Clinical exercise tests were performed before and after the 100LDT. Time-series analysis assessed changes in biomarkers and sleep parameters across the 100LDT, and cross-correlations considered the associations between exercise performance and physiological metrics at varying time lags. Results: The swim and cycling performances varied across the 100LDT, while the run was relatively stable. Resting heart rate, heart-rate variability, oxygen saturation, sleep score, light sleep, sleep efficiency, and sleep duration were all best characterized by cubic models. Additional post hoc subanalyses suggest that the first half of the 100LDT most influenced these dynamics. Conclusions: The 100LDT resulted in nonlinear alterations to physiological metrics. This world record was a unique event but allows valuable insights into the limits of human endurance performance. [ABSTRACT FROM AUTHOR]

The neurocognitive health effects of repetitive head impacts have been examined in many sports. However, characterizations of head impacts for sliding-sport athletes are lacking. To describe head impact kinematics and injury epidemiology in elite athletes during the 2021–2022 Bobsleigh World Cup season. Cross-sectional study. On-track training and competitions during the Bobsleigh World Cup season. Twelve elite bobsleigh athletes (3 pilots [1 female], 9 push athletes [5 females]; age = 30 ± 5 years; female height and weight = 173 ± 8 cm and 75 ± 5 kg, respectively; male height and weight = 183 ± 5 cm and 101 ± 5 kg, respectively). Athletes wore an accelerometer-enabled mouthguard to quantify 6-degrees-of-freedom head impact kinematics. Isometric absolute and relative neck strength, number of head acceleration events (HAEs), workload (J), peak linear velocity (m·s−1), peak angular velocity (rad·s−1), peak linear acceleration (g), and peak angular acceleration (rad·s−2) were derived from mouthguard manufacturer algorithms. Linear mixed-effect models tested the effects of sex (male versus female), setting (training versus competition), and position (pilot versus push athlete) on the kinematic variables. A total of 1900 HAEs were recorded over 48 training and 53 competition days. No differences were found between the number of HAEs per run per athlete by sex (incidence rate ratio [IRR] = 0.82, P =.741), setting (IRR = 0.94, P =.325), or position (IRR = 1.64, P =.463). No sex differences were observed for workload (mean ± SD: males = 3.3 ± 2.2 J, females = 3.1 ± 1.9 J; P =.646), peak linear velocity (males = 1.1 ± 0.3 m·s−1, females = 1.1 ± 0.3 m·s−1; P =.706), peak angular velocity (males = 4.2 ± 2.1 rad·s−1, females = 4.7 ± 2.5 rad·s−1; P =.220), peak linear acceleration (male = 12.4 ± 3.9g, females = 11.9 ± 3.5g; P =.772), or peak angular acceleration (males = 610 ± 353 rad·s−2, females = 680 ± 423 rad·s−2; P =.547). Also, no effects of setting or position on any kinematic variables were seen. Male athletes had greater peak neck strength than female athletes for all neck movements, aside from right-side flexion (P =.085), but no sex differences were noted in relative neck strength. We provide a foundational understanding of the repetitive HAEs that occur in bobsleigh athletes. Future authors should determine the effects of repetitive head impacts on neurocognitive function and mental health. [ABSTRACT FROM AUTHOR]

As gallium oxide-based heterojunction devices gain prominence, low-resistance contacts to aluminum gallium oxide material are of increasing importance for high performance and access to modulation doped layers. Here, the activation of ion-implanted silicon donors is investigated as a function of donor density from 5 × 1018 cm−3 to 1 × 1020 cm−3, activation anneal duration from 6 s to 600 s, and activation temperature from 900°C to 1140°C. Importantly, ohmic behavior was achievable across a reasonably wide process window at moderate to high doping concentrations. Specific contact resistance of 1 × 10−3 Ω cm2 and sheet resistance of 2.8 kΩ/□ were achieved for a 60 nm-deep 1 × 1020 cm−3 box implant after activation at 1000°C for 6 s with standard Ti/Au contacts. Under these conditions, an activation efficiency of 7% was observed with Hall mobility of ~32 cm2/Vs. Furthermore, we demonstrate a Schottky diode formed of implanted material with a rectification ratio > 106 and further confirm the Hall carrier density results using capacitance–voltage profiling analysis. Finally, we show the significant impact of anneal duration and the potential for deleterious over-annealing which reduces the active carrier density, mobility, and resultant material conductivity. [ABSTRACT FROM AUTHOR]

Platinum oxide (PtOx) Schottky contacts on degenerately doped β-Ga2O3 substrates show an increased barrier height of 85% and 64% when compared to nickel and platinum Schottky contacts, respectively. At low reverse voltage bias, the reverse leakage current of the PtOx Schottky barrier diodes was approximately 5–6 orders of magnitude lower than the reference evaporated Ni and Pt Schottky contacts. PtOx Schottky contacts were deposited using reactive sputtering on highly doped (8 × 1018 cm−3) ( 2 ¯ 01 ) β-Ga2O3:Sn substrates grown by the edge-defined film-fed growth (EFG) method. All Schottky metals were capped with evaporated Au. Capacitance–voltage and temperature-dependent current–voltage measurements were performed in order to extract the barrier height of the PtOx Schottky contact. Analysis of the diode ideality factors reveal that the PtOx Schottky contacts on highly doped β-Ga2O3 do not follow the thermionic field emission model and are impacted by inhomogeneous barrier height distribution. This work highlights the significance of PtOx Schottky contacts for β-Ga2O3-based power devices as a means for reducing leakage current. This work also holds relevance for low-voltage applications, where Schottky contacts for degenerately doped semiconductors can enable new electronic device applications. [ABSTRACT FROM AUTHOR]

Several cardiovascular disease (CVD) risk factors (e.g., hypertension, poor glycemic control) can affect and be affected by autonomic nervous system (ANS) activity. Since excess adiposity can influence CVD development through its effect on hypertension and diabetes mellitus, it is important to determine how adiposity and altered ANS activity are related. The present study employed structural equation modeling to investigate the relation between adiposity and ANS activity both directly and indirectly through biological variables typically associated with glycemic impairment and cardiac stress in older adults. Utilizing the Atherosclerosis Risk in Communities (ARIC) dataset, 1,145 non-smoking adults (74±4.8 yrs, 62.8% female) free from known CVD, hypertension, and diabetes and not currently taking beta-blockers were evaluated for fasting blood glucose (FBG), insulin, and HbA1c concentrations, waist circumference (WC), blood pressure (BP), and markers of ANS activity. WC was recorded just above the iliac crest and was used to reflect central adiposity. Resting 2-minute electrocardiograph recordings, pulse wave velocity, and ankle-brachial index data were used to assess the root mean square of successive differences in RR intervals (RMSSD) and the pre-ejection period (PEP), markers of parasympathetic and sympathetic activity, respectively. FBG, insulin, and HbA1c inferred a latent variable termed glycemic impairment (GI), whereas heart rate and diastolic BP inferred a latent variable termed cardiac stress (CS). The structural equation model fit was acceptable [root mean square error of approximation = 0.050 (90% CI =.036,.066), comparative fit index =.970, Tucker Lewis Index = 0.929], with adiposity having both significant direct (β = 0.208, p = 0.018) and indirect (β = -.217, p =.041) effects on PEP through GI. Adiposity displayed no significant direct effect on RMSSD. CS displayed a significant pathway (β = -0.524, p = 0.035) on RMSSD, but the indirect effect of WC on RMSSD through CS did not reach statistical significance (β = -0.094, p = 0.137). These results suggest that adiposity's relation to ANS activity is multifaceted, as increased central adiposity had opposing direct and indirect effects on markers of sympathetic activity in this population of older adults. [ABSTRACT FROM AUTHOR]

The low thermal conductivity of β-Ga2O3 is a significant concern for maximizing the potential of this ultra-wide bandgap semiconductor as a power switching device technology. Here, we report on the use of nanocrystalline diamond (NCD) deposited via microwave plasma enhanced chemical vapor deposition (MP-CVD) as a top-side, device-level thermal management solution on a lateral β-Ga2O3 transistor. NCD was grown via MP-CVD on β-(AlxGa1−x)2O3/β-Ga2O3 heterostructures prior to the gate formation of the field-effect transistor. A reduced growth temperature of 400 °C and a SiNx barrier layer were used to protect the oxide semiconductors from etching in the MP-CVD H2 plasma environment. Raman spectroscopy showed a highly sp3-bonded NCD film was obtained at 400 °C, with grain size of about 50–100 nm imaged via atomic force microscopy. The incorporation of the NCD heat-spreading layer resulted in a β-(AlxGa1−x)2O3/β-Ga2O3 heterostructure field-effect transistor showing a decrease in the total thermal resistance at the gate by 42%. The fabrication process, including the NCD etch in the gate region, will need to be improved to minimize the impact of these processes on important device characteristics (i.e., drain current, threshold voltage, and leakage current). [ABSTRACT FROM AUTHOR]

This work demonstrates direct, rapid 2D thermal mapping measurement capabilities of the ultrawide bandgap semiconductor channel of lateral β-(AlxGa1−x)2O3/Ga2O3 transistors without sample contamination, long acquisition times, or sophisticated thermometry such as developing deep-ultra-violet compatible thermoreflectance systems. The temperature rise in the channel of a β-(Al0.21Ga0.79)2O3/Ga2O3 heterostructure field-effect transistor (HFET) was mapped using thermoreflectance imaging at 470 nm. First, the thermoreflectance response of the HFET channel was measured using a monochromator, revealing a maximum of the reflectance change around 470–480 nm. Thermoreflectance calibrations were then performed at 470 nm (peak of the reflectance change) and yielded an average thermoreflectance coefficient of 1.06 ± 0.07 × 10−4 K−1. Subsequent measurements of the device (power densities of 0.15–1.47 W/mm and gate-source voltage of 0 V) enabled extraction of a device-level thermal resistance of 51.1 mm·K/W in the channel at the drain-side of the gate. High-resolution, in situ scanning thermal microscopy measurements of the channel temperature rise show good agreement with and further support the thermoreflectance measurements. Finally, the thermal profile across the entire device length (metal electrodes and semiconductor channel) and width was simultaneously measured using thermoreflectance imaging at 470 nm, and the peak temperature rise was measured in the channel at the drain-side of the gate electrode. [ABSTRACT FROM AUTHOR]

The effect of heteroepitaxial β-(AlxGa1−x)2O3 film thickness and Al content on surface morphology was characterized to experimentally determine the critical thickness limitations of the (010) β-(AlxGa1−x)2O3/Ga2O3 heterostructure. High-resolution x-ray diffraction was used to assess the strain state of the films; reciprocal space mapping (RSM) revealed that even cracked films were still fully strained. In cracked films, diffuse scattering was observed in RSMs, indicating lattice tilting. Cracking of the films was investigated using atomic force microscopy (AFM), x-ray topography (XRT), bright-field scanning transmission electron microscopy (BF-STEM), and high-resolution transmission electron microscopy. Using both AFM and XRT, the [001] direction was observed to be the most prevalent crack direction; however, cracks were also observed in the [100] direction. In uncracked regions of the films, XRT revealed the alignment of threading dislocations along the [001] direction. Cross-sectional imaging of the crack geometry and propagation was performed using BF-STEM, and it was observed that the cracks in the [001] direction extended through the thickness of the β-(AlxGa1−x)2O3 film (∼205 nm) and a further ∼100–200 nm into the β-Ga2O3 substrate. Experimental data for critical film thickness showed good agreement with previous theoretical calculations based on the Griffith criterion for crack propagation. [ABSTRACT FROM AUTHOR]

The cortisol awakening response (CAR) is a distinct component of the circadian cortisol profile and has promise as a biomarker for the monitoring of athlete readiness and training status. Although some studies have suggested the CAR may be affected by the development of overtraining syndrome (OTS), this has yet to be systematically investigated. Purpose: To compare the CAR and diurnal cortisol slope between athletes diagnosed with OTS, healthy athletes, and sedentary controls. Methods: This study was a secondary analysis of data from the Endocrine and Metabolic Responses on Overtraining study. Male participants were recruited to either OTS, healthy athlete, or sedentary control groups. The participants produced saliva samples immediately after waking (S1), 30 minutes after waking (S2), at 16:00 hours, and at 23:00 hours. Salivary cortisol concentration was determined by an electrochemiluminescence assay. Mixed-effects models were used to assess the conditional effect of group (sedentary controls, OTS, and healthy athletes) on the change in cortisol over time. Separate models were fit for the awakening samples (S1 and S2) and for the diurnal slope (linear change across S1, 16:00 h, and 23:00 h). Results: The models demonstrated significant time-by-group interaction for OTS for the 2 cortisol concentrations collected during the awakening period (β = −9.33, P <.001), but not for the diurnal cortisol slope (β = 0.02, P =.80). Conclusions: These results suggest the CAR may be associated with OTS and should be considered within a panel of biomarkers. Further research is necessary to determine whether alterations in the CAR may precede the diagnosis of OTS. [ABSTRACT FROM AUTHOR]

Codoping of gallium nitride for improved acceptor ionization has long been theorized; however, reduction to practice proves difficult via growth. Herein, implementation of codoping via ion implantation and symmetric multicycle rapid thermal annealing utilizing magnesium codoped with silicon or oxygen is demonstrated. Results show enhanced photoluminescence with both donor species but with an order of magnitude greater increase with concurrent p‐type hall for codoping with oxygen. Furthermore, the addition of nitrogen to balance stoichiometry suppresses defect photoluminescence signals. The incorporation of the donor and nitrogen demonstrates defect reduction beyond magnesium, only implants despite the additional implant dose and resultant damage with coimplantation. The enhanced hole concentrations evident with oxygen incorporation reveal important considerations for device design given unintentional doping during growth and future incorporation of ion implantation capabilities. [ABSTRACT FROM AUTHOR]

Herein, the electrical and thermal performance of lateral AlGaN/GaN high electron mobility transistors (HEMTs) and metal‐insulator‐semiconductor field effect transistors (MISFETs) fabricated with 11 μm thick GaN buffer layers on 200 mm diameter Qromis Substrate Technology (QST) substrates are investigated. The QST substrate has a polycrystalline core engineered to be coefficient of thermal expansion (CTE)‐matched to GaN to minimize wafer bow and residual stress in the GaN film as a result of epitaxial growth. Raman spectroscopy is used to determine the biaxial residual stress in the GaN buffer of the as‐fabricated devices. Electrical characterization is demonstrated on the HEMTs including DC and pulsed output characteristics, DC transfer characteristics, Hall mobility, carrier concentration, sheet resistance, median transition frequency, and maximum stable gain. Finally, the thermal performance of the AlGaN/GaN MISFET is assessed via thermoreflectance thermal imaging at DC power densities up to 19 W mm−1. The thermal resistance of the MISFET, calculated using the peak temperature rises on the gate electrode for DC power densities <10 W mm−1, is measured to be 15.4 mm K W−1, which is comparable with state‐of‐the‐art GaN‐on‐Si lateral transistors. [ABSTRACT FROM AUTHOR]