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Anatomy is an essential component of clinical anesthesiology. The use of simulated patients and alternative materials, including embalmed human bodies, have become increasingly common during resident physician training due to the deemphasis on anatomical education during undergraduate medical training. In this report, the need for a more extensive review of relevant anatomy for the practice of anesthesiology was addressed by the design, evaluation, and dissemination of a human dissection course for procedural training of anesthesiology residents. The course utilized "freedom art" embalmed human bodies that allowed trainees to perform ultrasound-based regional and neuraxial techniques followed by detailed dissections of critical anatomy. One hundred and four residents participated in workshops and small group discussions and were evaluated using pre- and post-course assessments. A variety of clinical techniques were performed on the bodies, including regional blocks and neuraxial catheter placement. Insertion of peripheral/neuraxial catheters was successful, with dissections demonstrating the expected placement. Assessment scores improved following the course (pre-course mean 52.7%, standard deviation ([delta]) 13.1%; post-course mean 72.2%, [delta] 11.6%; t-test p < 0.0001) and feedback highlighted the usefulness and clinical relevance of course content. The ability to correlate ultrasound imaging with subsequent dissections of the "blocked" area and visualization of dye staining was extremely relevant for spatial understanding of the anatomy relevant for the clinical practice of these techniques. This manuscript demonstrates successful implementation of a comprehensive course for anesthesiology resident physicians to address gaps in undergraduate anatomical education and suggests that broader adoption of dissection courses may be beneficial for training anesthesiologists.

Abstract Introduction Even physicians who routinely work in complex, dynamic practices may be unprepared to optimally manage challenging critical events. High-fidelity simulation can realistically mimic critical clinically relevant events, however the reliability and validity of simulation-based assessment scores for practicing physicians has not been established. Methods Standardised complex simulation scenarios were developed and administered to board-certified, practicing anesthesiologists who volunteered to participate in an assessment study during formative maintenance of certification activities. A subset of the study population agreed to participate as the primary responder in a second scenario for this study. The physicians were assessed independently by trained raters on both teamwork/behavioural and technical performance measures. Analysis using Generalisability and Decision studies were completed for the two scenarios with two raters. Results The behavioural score was not more reliable than the technical score. With two raters > 20 scenarios would be required to achieve a reliability estimate of 0.7. Increasing the number of raters for a given scenario would have little effect on reliability. Conclusions The performance of practicing physicians on simulated critical events may be highly context-specific. Realistic simulation-based assessment for practicing physicians is resource-intensive and may be best-suited for individualized formative feedback. More importantly, aggregate data from a population of participants may have an even higher impact if used to identify skill or knowledge gaps to be addressed by training programs and inform continuing education improvements across the profession.

Abstract Adopting the Standard Halo Model (SHM) of an isotropic Maxwellian velocity distribution for dark matter (DM) particles in the Galaxy, the most stringent current constraints on their spin-dependent scattering cross-section with nucleons come from the IceCube neutrino observatory and the PICO-60 $$\hbox {C}_3\hbox {F}_8$$ C 3 F 8 superheated bubble chamber experiments. The former is sensitive to high energy neutrinos from the self-annihilation of DM particles captured in the Sun, while the latter looks for nuclear recoil events from DM scattering off nucleons. Although slower DM particles are more likely to be captured by the Sun, the faster ones are more likely to be detected by PICO. Recent N-body simulations suggest significant deviations from the SHM for the smooth halo component of the DM, while observations hint at a dominant fraction of the local DM being in substructures. We use the method of Ferrer et al. (JCAP 1509: 052, 2015) to exploit the complementarity between the two approaches and derive conservative constraints on DM-nucleon scattering. Our results constrain $$\sigma _{\mathrm{SD}} \lesssim 3 \times 10^{-39} \mathrm {cm}^2$$ σ SD ≲ 3 × 10 - 39 cm 2 ( $$6 \times 10^{-38} \mathrm {cm}^2$$ 6 × 10 - 38 cm 2 ) at $$\gtrsim 90\%$$ ≳ 90 % C.L. for a DM particle of mass 1 TeV annihilating into $$\tau ^+ \tau ^-$$ τ + τ - ( $$b\bar{b}$$ b b ¯ ) with a local density of $$\rho _{\mathrm{DM}} = 0.3~\mathrm {GeV/cm}^3$$ ρ DM = 0.3 GeV / cm 3 . The constraints scale inversely with $$\rho _{\mathrm{DM}}$$ ρ DM and are independent of the DM velocity distribution.

Abstract Background Indoor residual spraying (IRS), the coating of interior walls of houses with insecticides, is common in malaria-endemic areas. While important in malaria control, IRS potentially exposes residents to harmful insecticides. The World Health Organization recommends steps to minimize exposure; however, no programme has focused on educating populations. Methods A dramatic presentation and song were developed by study personnel and performed by lay performers in order to spread awareness of the importance of IRS and to minimize insecticide exposure. Performances were staged at 16 sprayed villages in the Vhembe District of Limpopo, South Africa, at which 592 attendees completed short questionnaires before and after the performance about behaviors that might limit insecticide exposure. Overall indices of the attendees’ change in knowledge of precautions to take prior to and after spraying to prevent insecticide exposure were analyzed using hierarchical mixed models to assess the effect of the performance on change in participants’ knowledge. Results Approximately half of attendees lived in homes that had been sprayed for malaria and 62% were female. Over 90% thought it better to allow IRS prior to the presentation, but knowledge of proper precautions to prevent exposure was low. The proportion answering correctly about proper distance from home during spraying increased from 49.4% pre-performance to 62.0% post-performance (RR = 1.26, 95% CI = 1.13, 1.41), and the proportion reporting correctly about home re-entry interval after spraying increased from 58.5 to 91.1% (RR = 1.54, 95% CI 1.35, 1.77). Attendees improved in their knowledge about precautions to take prior to and after spraying from mean of 57.9% correct to a mean of 69.7% (β = 12.1%, 95% CI 10.9, 13.4). Specifically, increased knowledge in closing cupboards, removing food and bedding from the home, covering immoveable items with plastic, and leading animals away from the home prior to spraying were observed, as was increased knowledge in sweeping the floors, proper disposal of dead insects, and discarding dirty washrags after spraying. Conclusions A dramatic presentation and song were able to increase the attendees’ knowledge of precautions to take prior to and after spraying in order to limit their insecticide exposure resulting from IRS. This approach to community education is promising and deserves additional study.

Household air pollution from the combustion of biomass and coal is estimated to cause approximately 780,000 premature deaths a year in India. The government has responded by promoting uptake of liquefied petroleum gas (LPG) by tens of millions of poor rural families. Many poor households with new LPG stoves, however, continue to partially use traditional smoky chulhas. Our primary objective was to evaluate three strategies to transition pregnant women in rural Maharashtra to exclusive use of LPG for cooking. We also measured reductions in kitchen concentrations of PM2.5 before and after our interventions. Our core intervention was a free stove, 2 free LPG cylinders (one on loan until delivery), and repeated health messaging. We measured stove usage of both the traditional and intervention stoves until delivery. In households that received the core intervention, an average of 66% days had no indoor cooking on a chulha. In an adjacent area, we evaluated a conditional cash transfer (CCT) based on usage of LPG in addition to the core intervention. Results were less successful, due to challenges implementing the CCT. Pregnant women in a third nearby area received the core intervention plus a maximum of one 14.2 kg cylinder per month of free fuel. In their homes, 90% of days had no indoor cooking on a chulha. On average, exclusive LPG use decreased kitchen concentrations of PM2.5 by approximately 85% (from 520 to 72 μg/m3). 85% of participating households agreed to pay the deposit on the 2nd cylinder. This high purchase rate suggests they valued how the second cylinder permitted continuous LPG supply. A program to increase access to second cylinders may, thus, be a straightforward way to encourage use of clean fuels in rural areas. Keywords: Clean fuels, Liquefied petroleum gas, Household energy, Energy transitions, Biomass, Cooking, Intervention

Introduction Health interventions often target pregnant women and their unborn children. Interventions in rural India targeting pregnant women, however, often do not cover the critical early windows of susceptibility during the first trimester and parts of the second trimester. This pilot seeks to determine if targeting newlyweds could protect entire pregnancies with a clean stove and fuel intervention.Methods We recruited 50 newlywed couples who use biomass as a cooking fuel into a clean cooking intervention that included a liquefied petroleum gas (LPG) stove, two gas cylinders, a table to place the stove on and health education. We first evaluated whether community health workers in this region could identify and recruit couples at marriage. We quantified how many additional days of pregnancy could be covered by an intervention if we recruited at marriage versus recruiting after detection of pregnancy.Results On average, we identified and visited newlywed couples within 40 (SD 21) days of marriage. Of the 50 couples recruited, 25 pregnancies and 18 deliveries were identified during this 1-year study. Due to challenges securing fuel from the LPG supply system, not all couples received their intervention prior to pregnancy. Regardless, couples recruited in the marriage arm had substantially more days with the intervention than couples recruited into a similar arm recruited at pregnancy (211 SD 46 vs 120 SD 45). At scale, a stove intervention targeting new marriages would cover about twice as many weeks of first pregnancies as an intervention recruiting after detection of pregnancy.Conclusions We were able to recruit in early marriage using existing community health workers. Households recruited early in marriage had more days with clean fuel coverage than those recruited at pregnancy. Our findings indicate that recruitment at marriage is feasible and warrants further exploration for stove and other interventions targeting pregnancy-related outcomes.

This data in brief article includes estimated time cooking based on temperature sensor data taken every 30 min from three stone fires and introduced fuel-efficient Envirofit stoves in approximately 168 households in rural Uganda. These households were part of an impact evaluation study spanning about six months to understand the effects of fuel-efficient cookstoves on fuel use and pollution. Daily particulate matter (pollution) and fuelwood use data are also included. This data in brief file only includes the weeks prior to, during, and after an in-person measurement team visited each home. The data is used to analyze whether households change cooking patterns when in-person measurement teams are present versus when only the temperature sensor is in the home.

BACKGROUND:Over half a million children die each year of diarrheal illness, although nearly all deaths could be prevented with oral rehydration salts (ORS). The literature on ORS documents both impressive health benefits and persistent underuse. At the same time, little is known about why ORS is underused and what can be done to increase use. We hypothesized that price and inconvenience are important barriers to ORS use and tested whether eliminating financial and access constraints increases ORS coverage. METHODS AND FINDINGS:In July of 2016, we recruited 118 community health workers (CHWs; representing 10,384 households) in Central and Eastern Uganda to participate in the study. Study villages were predominantly peri-urban, and most caretakers had no more than primary school education. In March of 2017, we randomized CHWs to one of four methods of ORS distribution: (1) free delivery of ORS prior to illness (free and convenient); (2) home sales of ORS prior to illness (convenient only); (3) free ORS upon retrieval using voucher (free only); and (4) status quo CHW distribution, where ORS is sold and not delivered (control). CHWs offered zinc supplements in addition to ORS in all treatment arms (free in groups 1 and 3 and for sale in group 2), following international treatment guidelines. We used household surveys to measure ORS (primary outcome) and ORS + zinc use 4 weeks after the interventions began (between April and May 2017). We assessed impact using an intention-to-treat (ITT) framework. During follow-up, we identified 2,363 child cases of diarrhea within 4 weeks of the survey (584 in free and convenient [25.6% of households], 527 in convenient only [26.1% of households], 648 in free only [26.8% of households], and 597 in control [28.5% of households]). The share of cases treated with ORS was 77% (448/584) in the free and convenient group, 64% (340/527) in the convenient only group, 74% (447/648) in the free only group, and 56% (335/597) in the control group. After adjusting for potential confounders, instructing CHWs to provide free and convenient distribution increased ORS coverage by 19 percentage points relative to the control group (95% CI 13-26; P < 0.001), 12 percentage points relative to convenient only (95% CI 6-18; P < 0.001), and 2 percentage points (not significant) relative to free only (95% CI -4 to 8; P = 0.38). Effect sizes were similar, but more pronounced, for the use of both ORS and zinc. Limitations include short follow-up period, self-reported outcomes, and limited generalizability. CONCLUSIONS:Most caretakers of children with diarrhea in low-income countries seek care in the private sector where they are required to pay for ORS. However, our results suggest that price is an important barrier to ORS use and that switching to free distribution by CHWs substantially increases ORS coverage. Switching to free distribution is low-cost, easily scalable, and could substantially reduce child mortality. Convenience was not important in this context. TRIAL REGISTRATION:Trial registry number AEARCTR-0001288.

From 2016 to 2019, the Indian Pradhan Mantri Ujjwala Yojana (PMUY) distributed over 80 million liquefied petroleum gas (LPG) stoves, making it the largest clean cooking program ever. Yet, evidence shows widespread continued use of the traditional chulha , negating the potential health benefits of LPG. Here we use semi-structured interviews with female and male adults to understand the drivers of LPG usage in Mulbagal, Karnataka, the site of a proto-PMUY program. We find that respondents perceive the main value of LPG to be saving time, rather than better health. We also find that norms of low female power in the household, in addition to costs, delay saving for and ordering LPG cylinder refills. Namely, female cooks controlled neither the money nor the mobile phone required to order a timely refill. These factors together contribute to the ‘refill gap’: the period of non-use between refilling cylinders, which may range from days to even months. Our work reveals how gender norms can amplify affordability challenges in low-income households.

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There is evidence that household point-of-use (POU) water treatment products can reduce the enormous burden of water-borne illness. Nevertheless, adoption among the global poor is very low, and little evidence exists on why.We gave 600 households in poor communities in Dhaka, Bangladesh randomly-ordered two-month free trials of four water treatment products: dilute liquid chlorine (sodium hypochlorite solution, marketed locally as Water Guard), sodium dichloroisocyanurate tablets (branded as Aquatabs), a combined flocculant-disinfectant powdered mixture (the PUR Purifier of Water), and a silver-coated ceramic siphon filter. Consumers also received education on the dangers of untreated drinking water. We measured which products consumers used with self-reports, observation (for the filter), and chlorine tests (for the other products). We also measured drinking water's contamination with E. coli (compared to 200 control households).Households reported highest usage of the filter, although no product had even 30% usage. E. coli concentrations in stored drinking water were generally lowest when households had Water Guard. Households that self-reported product usage had large reductions in E. coli concentrations with any product as compared to controls.Traditional arguments for the low adoption of POU products focus on affordability, consumers' lack of information about germs and the dangers of unsafe water, and specific products not meshing with a household's preferences. In this study we provided free trials, repeated informational messages explaining the dangers of untreated water, and a variety of product designs. The low usage of all products despite such efforts makes clear that important barriers exist beyond cost, information, and variation among these four product designs. Without a better understanding of the choices and aspirations of the target end-users, household-based water treatment is unlikely to reduce morbidity and mortality substantially in urban Bangladesh and similar populations.

Nucleotide sequences of the nuclear SSU rDNA and ITS1 are presented as a defined genetic marker for Porphyra tenera as a species. Exon nucleotide sequences were identical within all the P. tenera specimens. Intron nucleotide sequences varied between populations. The introns and ITS1 variations are presented as defined genetic markers to establish the Porphyra tenera strains. Wild-collected thalli identified by morphological systematics, from five populations of Porphyra tenera throughout Japan, were discriminated by comparing sequences of the various regions utilizing the results of this and previous studies. [ABSTRACT FROM AUTHOR]

Background: Fundoplication at the time of paraesophageal hernia (PEH) repair is thought to help prevent the development or persistence of postoperative gastroesophageal reflux (GERD) and might also prevent hernia recurrence. However, the published data is not strong enough to definitively recommend this approach. This study was designed to evaluate the effectiveness and complications of a fundoplication at the time of paraesophageal hernia repair., Methods: This was a retrospective cohort study of all patients who underwent a paraesophageal hernia repair at a single institution over a 14 year period from 2010 to 2023. Patients were divided into 2 cohorts, those who underwent fundoplication at the time of PEH repair and those who did not. Rates of PEH recurrence, rates of reoperation for a recurrent PEH, postoperative dysphagia rates, and postoperative GERD rates were then compared between the two cohorts., Results: There were 1,155 patients included in the study. There were 610 (53%) patients who underwent PEH repair with fundoplication and 545 (47%) who did not undergo a fundoplication. 113 (19%) of the patients who underwent fundoplication developed a hernia recurrence compared to 67 (12%) who had a PEH repair alone (p = 0.004). However, each cohort had similar rates of requiring reoperation (p = 0.4). Inclusion of a fundoplication did lead to higher rates of postoperative dysphagia > 30 days postoperatively, 12% vs 7% (p = 0.002), but did not lead to decreased rates of symptomatic GERD postoperatively, 7% with a fundoplication and 7% without (p = 0.93)., Conclusion: In this present study, fundoplication at the time of PEH repair did not prevent hernia recurrence, need for reoperation, or decrease postoperative GERD rates but does increase postoperative dysphagia. While there are definite indications for fundoplication at the time of PEH repair (i.e., type 1 hernia), these data do not support the routine use of fundoplication during PEH repair with a normal gastroesophageal flap valve intraoperatively., (© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Background: In patients with inflammatory bowel disease (IBD), multimorbidity with obesity and type 2 diabetes is common and increasing. Glucagon-like peptide 1 (GLP-1) receptor agonists are increasingly being prescribed for patients with IBD, yet their impact on patients with IBD is largely unknown. We aimed to assess the impact of GLP-1 receptor agonists on the course of IBD., Methods: We identified all IBD patients prescribed GLP-1 receptor agonists at a large academic healthcare network between 2009 and 2023. We analyzed demographics and IBD characteristics in the year pre- and post-GLP-1 receptor agonist prescription and matched them to non-IBD controls. Our primary outcome was IBD exacerbation in the year following GLP-1 receptor agonist initiation, measured as a composite of IBD-related hospitalization, corticosteroid prescription, medication escalation or changes, or IBD-related surgery. Secondary outcomes included change in metabolic risk factors., Results: Overall, 224 patients met inclusion criteria. At GLP-1 receptor agonist initiation, the median age was 54 years, 63% were female, 77% were White, and median BMI was 33.2 kg/m2. Compared to the 12-month period prior to GLP-1 receptor agonist initiation, in the 12 months post-GLP-1 receptor agonist initiation, there was no change in rates of IBD exacerbation, IBD-related hospitalization, steroids prescription, medication escalation or changes, or IBD-related surgery. There was a significant decrease in BMI in the year following GLP-1 receptor agonist initiation (median BMI 33.5 vs 31.6 kg/m2, P < .01), with rates of decrease comparable to non-IBD matched controls., Conclusions: In patients with IBD, GLP-1 receptor agonists are effective for weight loss and associated with few episodes of disease exacerbation., (© The Author(s) 2024. Published by Oxford University Press on behalf of Crohn’s & Colitis Foundation. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.)

Background: Although per oral endoscopic myotomy (POEM) has shown to be beneficial for the treatment of achalasia, it can be difficult to predict who will have a robust and long-lasting response. Historically, it has been shown that higher lower esophageal sphincter pressures have been associated with poorer responses to alternative endoscopic therapies such as Botox therapy and pneumatic dilation. This study was designed to evaluate if modern preoperative manometric data could similarly predict response to therapy after POEM., Methods: This was a retrospective study of 237 patients who underwent POEM at a single institution over a period of 13 years (2011-2023) and who had a high-resolution manometry performed preoperatively and an Eckardt symptom score performed both preoperative and postoperatively. The achalasia type and integrated relaxation pressures (IRP) were tested for potential correlation with the need for any further achalasia interventions postoperatively as well as the degree of Eckardt score reduction using a linear regression model., Results: The Achalasia type on preoperative manometry was not predictive for further interventions or degree of Eckardt score reduction (p = 0.76 and 0.43, respectively). A higher IRP was not predictive of the need for further interventions, however, it was predictive of a greater reduction in postoperative Eckardt scores (p = 0.03) as shown by the non-zero regression slope., Conclusion: In this study, achalasia type was not a predictive factor in the need for further interventions or the degree of symptom relief. Although IRP was not predictive of the need for further interventions, a higher IRP did predict better symptomatic relief postoperatively. This result is opposite that of other endoscopic treatment modalities (Botox and pneumatic dilation). Therefore, patients with higher IRP on preoperative high-resolution manometry would likely benefit from POEM which provides significant symptomatic relief postoperatively., (© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Background: It has been reported that higher surgeon experience leads to better patient outcomes. In this study, we look at surgeon experience and its association with postoperative outcomes and variation among the practice of surgeons performing paraesophageal hernia repairs (PEH)., Method: This was a retrospective study of 1155 patients who underwent PEH repair at a single institution (2010-2023). Surgeon experience was defined as the number of surgeries performed per surgeon and was split using the median surgeries (n = 100), with surgeons performing at or above the median categorized as high-experience and below the median as low-experience surgeons. A multivariable logistic regression model was used to test correlation between surgeon experience and variables, including demographics and intra- and post-operative outcomes., Results: High-experience surgeons performed more elective cases (93.4% vs 85.5%), but low-experience surgeons operated more on emergent (2.7% vs 0.9%), semi-elective (2.3% vs 1.4%), and urgent cases (9.5% vs 4.3%). Low-experience surgeons operated more on patients who were older (67.5 vs 63.2 years, p < 0.001) and had an increased risk of CVD (72.9% vs 61.5%, p < 0.001). Intraoperative OR time was considerably less for high-experience surgeons (115.8 vs 172.9 min, p < 0.001). Low-experience surgeons had increased risk of intra-operative complications (4.5% vs 1.8%, p = 0.021) and post-op pneumonia within 30 days (1.8% vs 0.3%). However, long-term outcomes such as hernia recurrence (OR: 1.10, CI: 0.78-1.54) and redo-operations for hiatal hernia (OR: 1.10, CI: 0.65-1.75) were similar for both groups., Conclusion: High-experience surgeons perform more complex revisional surgeries in less time with fewer complications. Low-experience surgeons operated more on patients with higher comorbidities but had significantly higher OR times. Long-term results of recurrence and redo-operations were comparable. These variations suggest that high-experience surgeons are more efficient while operating on more complex cases. These findings have pivotal implications to facilitate mentorship and education among less-experienced surgeons., (© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Understanding the sub-band gap luminescence in Ruddlesden-Popper 2D metal halide hybrid perovskites (2D HaPs) is essential for efficient charge injection and collection in optoelectronic devices. Still, its origins are still under debate with respect to the role of self-trapped excitons or radiative recombination via defect states. In this study, we characterized charge separation, recombination, and transport in single crystals, exfoliated layers, and polycrystalline thin films of butylammonium lead iodide (BA 2 PbI 4 ), one of the most prominent 2D HaPs. We combined complementary defect- and exciton-sensitive methods such as photoluminescence (PL) spectroscopy, modulated and time-resolved surface photovoltage (SPV) spectroscopy, constant final state photoelectron yield spectroscopy (CFSYS), and constant light-induced magneto transport (CLIMAT), to demonstrate striking differences between charge separation induced by dissociation of excitons and by excitation of mobile charge carriers from defect states. Our results suggest that the broad sub-band gap emission in BA 2 PbI 4 and other 2D HaPs is caused by radiative recombination via defect states (shallow as well as midgap states) rather than self-trapped excitons. Density functional theory (DFT) results show that common defects can readily occur and produce an energetic profile that agrees well with the experimental results. The DFT results suggest that the formation of iodine interstitials is the initial process leading to degradation, responsible for the emergence of midgap states, and that defect engineering will play a key role in enhancing the optoelectronic properties of 2D HaPs in the future.

Hip fractures are a severe health concern among older adults. While anthropometric factors have been shown to influence hip fracture risk, the low fidelity of common body composition metrics (e.g. body mass index) reduces our ability to infer underlying mechanisms. While simulation approaches can be used to explore how body composition influences impact dynamics, there is value in experimental data with human volunteers to support the advancement of computational modeling efforts. Accordingly, the goal of this study was to use a novel combination of subject-specific clinical imaging and laboratory-based impact paradigms to assess potential relationships between high-fidelity body composition and impact dynamics metrics (including load magnitude and distribution and pelvis deflection) during sideways falls on the hip in human volunteers. Nineteen females (<35 years) participated. Body composition was assessed via DXA and ultrasound. Participants underwent low-energy (but clinically relevant) sideways falls on the hip during which impact kinetics (total peak force, contract area, peak pressure) and pelvis deformation were measured. Pearson correlations assessed potential relationships between body composition and impact characteristics. Peak force was more strongly correlated with total mass (r = 0.712) and lean mass indices (r = 0.510-0.713) than fat mass indices (r = 0.401-0.592). Peak deflection was positively correlated with indices of adiposity (all r > 0.7), but not of lean mass. Contact area and peak pressure were positively and negatively associated, respectively, with indices of adiposity (all r > 0.49). Trochanteric soft tissue thickness predicted 59 % of the variance in both variables, and was the single strongest correlate with peak pressure. In five-of-eight comparisons, hip-local (vs. whole body) anthropometrics were more highly associated with impact dynamics. In summary, fall-related impact dynamics were strongly associated with body composition, providing support for subject-specific lateral pelvis load prediction models that incorporate soft tissue characteristics. Integrating soft and skeletal tissue properties may have important implications for improving the biomechanical effectiveness of engineering-based protective products., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Crown Copyright © 2024. Published by Elsevier Ltd. All rights reserved.)

The term defect tolerance (DT) is used often to rationalize the exceptional optoelectronic properties of halide perovskites (HaPs) and their devices. Even though DT lacked direct experimental evidence, it became a "fact" in the field. DT in semiconductors implies that structural defects do not translate to electrical and optical effects (e.g., due to charge trapping), associated with such defects. We present pioneering direct experimental evidence for DT in Pb-HaPs by comparing the structural quality of 2-dimensional (2D), 2D-3D, and 3D Pb-iodide HaP crystals with their optoelectronic characteristics using high-sensitivity methods. Importantly, we get information from the materials' bulk because we sample at least a few hundred nanometers, up to several micrometers, from the sample's surface, which allows for assessing intrinsic bulk (and not only surface-) properties of HaPs. The results point to DT in 3D, 2D-3D, and 2D Pb-HaPs. Overall, our data provide an experimental basis to rationalize DT in Pb-HaPs. These experiments and findings will help the search for and design of materials with real DT., Competing Interests: Competing interests statement:The authors declare no competing interest.

Solvated electrons are highly reductive chemical species whose chemical properties remain largely unknown. Diamond materials are proposed as a promising emitter of solvated electrons and visible light excitation would enable solar-driven CO 2 or N 2 reductions reactions in aqueous medium. But sub-bandgap excitation remains challenging. In this work, the role of surface states on diamond materials for charge separation and emission in both gaseous and aqueous environments from deep UV to visible light excitation is elucidated. Four different X-ray and UV-vis spectroscopy methods are applied to diamond materials with different surface termination, doping and crystallinity. Surface states are found to dominate sub-bandgap charge transfer. However, the surface charge separation is drastically reduced for boron-doped diamond due to a very high density of bulk defects. In a gaseous atmosphere, the oxidized diamond surface maintains a negative electron affinity, allowing charge emission, due to remaining hydrogenated and hydroxylated groups. In an aqueous electrolyte, a photocurrent for illumination down to 3.5 eV is observed for boron-doped nanostructured diamond, independent of the surface termination. This study opens new perspectives on photo-induced interfacial charge transfer processes from metal-free semiconductors such as diamonds., (© 2023 The Authors. Small Methods published by Wiley-VCH GmbH.)

Background: Although obesity is an established risk factor for adverse outcomes after paraesophageal hernia repair (PEHR), many obese patients nonetheless receive PEHR. The purpose of this study was to explore risk factors for adverse outcomes of PEHR among this high-risk cohort. We hypothesized that obese patients may have other risk factors for adverse outcomes following PEHR., Methods: A retrospective study of adult obese patients who underwent minimally invasive PEHR from 2017 to 2019 was performed. Patients were excluded for BMI < 30 or if they had concomitant bariatric surgery at time of PEHR. The primary outcome of interest was a composite adverse outcome (CAO) defined as having any of the four following outcomes after PEHR: persistent GERD > 30 d, persistent dysphagia > 30 d, recurrence, or reoperation. Chi-square and t-test analysis was used to compare demographic and clinical characteristics. Multivariable logistic regression analysis was used to evaluate independent predictors of CAO., Results: In total, 139 patients met inclusion criteria with a median follow-up of 19.7 months (IQR 8.8-81). Among them, 51/139 (36.7%) patients had a CAO: 31/139 (22.4%) had persistent GERD, 20/139 (14.4%) had persistent dysphagia, 24/139 (17.3%) had recurrence, and 6/139 (4.3%) required reoperation. On unadjusted analysis, patients with a CAO were more likely to have a history of prior abdominal surgery (86.3% vs 70.5%, p = 0.04) and were less likely to have undergone a preoperative CT scan (27.5% vs 45.5%, p = 0.04). On multivariable analysis, previous abdominal surgery was independently associated with an increased likelihood of CAO whereas age and preoperative CT scan had a decreased likelihood of CAO., Conclusions: Although there were adverse outcomes among obese patients, minimally invasive PEHR may be feasible in a subset of patients at specialized centers. These findings may help guide the appropriate selection of obese patients for PEHR., (© 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Improved stability and efficiency of two-terminal monolithic perovskite-silicon tandem solar cells will require reductions in recombination losses. By combining a triple-halide perovskite (1.68 electron volt bandgap) with a piperazinium iodide interfacial modification, we improved the band alignment, reduced nonradiative recombination losses, and enhanced charge extraction at the electron-selective contact. Solar cells showed open-circuit voltages of up to 1.28 volts in p-i-n single junctions and 2.00 volts in perovskite-silicon tandem solar cells. The tandem cells achieve certified power conversion efficiencies of up to 32.5%.

Halide perovskite-based photon upconverters utilize perovskite thin films to sensitize triplet exciton formation in a small-molecule layer, driving triplet-triplet annihilation upconversion. Despite having excellent carrier mobility, these systems suffer from inefficient triplet formation at the perovskite/annihilator interface. We studied triplet formation in formamidinium-methylammonium lead iodide/rubrene bilayers using photoluminescence and surface photovoltage methods. By studying systems constructed on glass as well as hole-selective substrates, comprising self-assembled layers of the carbazole derivative 2PACz ([2-(9H-carbazol-9-yl)ethyl]phosphonic acid) on indium-doped tin oxide, we saw how changes in the carrier dynamics induced by the hole-selective substrate perturbed triplet formation at the perovskite/rubrene interface. We propose that an internal electric field, caused by hole transfer at the perovskite/rubrene interface, strongly affects triplet exciton formation, accelerating exciton-forming electron-hole encounters at the interface but also limiting the hole density in rubrene at high excitation densities. Controlling this field is a promising path to improving triplet formation in perovskite/annihilator upconverters., Competing Interests: The authors declare no competing interests., (© 2023 The Author(s).)

A lead-free (K,Na)NbO 3 -based piezoelectric ceramic is textured along the (001) direction using the NaNbO 3 (NN) seeds. The composition 0.96(K 0.5 Na 0.5 )(Nb 0.965 Sb 0.035 )O 3 -0.01CaZrO 3 -0.03(Bi 0.5 K 0.5 )HfO 3 (KNN) is found to provide an excellent combination of electromechanical coefficients at room temperature. The textured composition with 5 wt % NN template (KNN-5NN) exhibits considerably improved electromechanical coefficients, d 33 ∼ 590 pC/N, k 31 ∼ 0.46, and d 31 ∼ 215 ×10 -12 C/N, at room temperature. A flexible piezoelectric energy harvester (F-PEH) is fabricated using the textured KNN-5NN ceramic and tested under cyclic force. F-PEH exhibits enhanced output voltage ( V oc ∼ 25 V), current ( I ∼ 0.4 μA), and power density ( P D ∼ 5.5 mW/m 2 ) ( R L of 10 MΩ) in the off-resonance frequency regime. In comparison to the random ceramic KNN-0NN-based F-PEH ( V oc ∼ 8 V and I ∼ 0.1 μA), the textured F-PEH significantly outperformed energy harvesting capability due to the large figure-of-merit value ( d 31 × g 31 ) ∼ 3354 ×10 -15 m 3 /J. This work provides a methodology for texturing lead-free materials and further implementing them in flexible energy harvesting devices and sensors.

Objectives: Pancreatic mass lesions are often solitary, although rarely synchronous pancreatic masses are encountered. No study has compared synchronous lesions with solitary lesions in the same population. The aim of the present study was to determine the prevalence, clinical, radiographic, and histologic findings of multiple pancreatic masses on consecutive patients undergoing endoscopic ultrasound (EUS) for pancreatic mass lesion., Methods: All patients undergoing EUS for pancreatic mass lesions with histologic sampling over a 5-year span were identified. Charts were abstracted for demographics, medical history, radiographic findings, EUS findings, and histology and were reviewed., Results: A total of 646 patients were identified, of which 27 patients (4.18%) had more than 1 pancreatic mass on EUS or cross-sectional imaging. The 2 groups were comparable with each other in terms of demographic factors and medical history. The 2 cohorts were comparable in location of the largest pancreas lesion and EUS characteristics. Patients with synchronous mass lesions were more likely to have metastatic lesions (P = 0.01). No other differences in histology were noted between the 2 groups., Conclusions: Patients with multiple pancreatic mass lesions were more likely to have metastatic lesions compared with patients with solitary lesions., Competing Interests: A.J.T. is a consultant for Lucid Diagnostics and Pentax Medical. All other authors declare no conflict of interest., (Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.)

I-V-VI 2 ternary chalcogenides are gaining attention as earth-abundant, nontoxic, and air-stable absorbers for photovoltaic applications. However, the semiconductors explored thus far have slowly-rising absorption onsets, and their charge-carrier transport is not well understood yet. Herein, we investigate cation-disordered NaBiS 2 nanocrystals, which have a steep absorption onset, with absorption coefficients reaching >10 5  cm -1 just above its pseudo-direct bandgap of 1.4 eV. Surprisingly, we also observe an ultrafast (picosecond-time scale) photoconductivity decay and long-lived charge-carrier population persisting for over one microsecond in NaBiS 2 nanocrystals. These unusual features arise because of the localised, non-bonding S p character of the upper valence band, which leads to a high density of electronic states at the band edges, ultrafast localisation of spatially-separated electrons and holes, as well as the slow decay of trapped holes. This work reveals the critical role of cation disorder in these systems on both absorption characteristics and charge-carrier kinetics., (© 2022. The Author(s).)

Background: Capsule endoscopy (CE) provides a novel approach to evaluate obscure gastrointestinal bleeding. Yet CE is not routinely utilized in the inpatient setting for a variety of reasons. We sought to identify factors that predict complete CE and diagnostically meaningful CE, as well as assess the impact of inpatient CE on further hospital management.1 na d2 METHODS: We conducted a retrospective review of patients undergoing inpatient CE at a tertiary referral, academic center over a 3 year period. We analyzed data on patient demographics, medical history, endoscopic procedures, hospital course, and results of CE. The primary outcome was complete CE and the secondary outcome was positive findings of pathology on CE., Results: 131 patients were included (56.5% were men 43.5% women, median age of 71.0 years). Overall, CE was complete in 77.1% of patients. Complete CE was not related to motility risk factors, gender, or administration modality. Patients with incomplete CE tended to be older, have lower BMI, and Caucasian, however results did not reach statistical significance (p = 0.06; p = 0.06; p = 0.08 respectively). Positive CE was noted in 73.3% of patients, with 35.1% of all patients having active bleeding. Positive CE was not associated with AVM risk factors or medication use. 28.0% of patients underwent subsequent hospital procedures, among which 67.6% identified the same pathology seen on CE., Conclusions: Contrary to previous studies, we found the majority of inpatient CEs were complete and positive for pathology. We found high rates of correlation between CE and subsequent procedures. The use of CE in the inpatient setting helps to guide the diagnosis and treatment of hospitalized patients with obscure gastrointestinal bleeding., (© 2022. The Author(s).)

COVID-19 was first recognized by the World Health Organization (WHO) in December 2019 and declared a global pandemic in March 2020. Although COVID-19 primarily results in pulmonary symptoms, it is becoming apparent that it can lead to multisystemic manifestations. Liver damage with elevated AST and ALT is seen in patients with COVID-19. Although the etiology of liver damage is still debated, biliary damage is rarely seen. This case demonstrates a potential complication of COVID-19 in a previously healthy patient. The patient contracted COVID-19 in March 2020 and endured a complicated course including intubation, multiple readmissions, and chronic abdominal pain. He is now awaiting a liver transplant. Our case portrays biliary damage as an additional possible complication of COVID-19 and the importance of imaging in its diagnosis., (Copyright © 2021 Elsevier Inc. All rights reserved.)

Using advanced near-UV photoemission spectroscopy (PES) in constant final state mode (CFSYS) with a very high dynamic range, we investigate the triple-cation lead halide perovskite Cs 0.05 (MA 0.17 FA 0.83 ) 0.95 Pb(I 0.83 Br 0.17 ) 3 and gain detailed insights into the density of occupied states (DOS) in the valence band and band gap. A valence band model is established which includes the parabolic valence band edge and an exponentially decaying band tail in a single equation. This allows us to precisely determine two valence band maxima (VBM) at different k -vectors in the angle-integrated spectra, where the highest one, resulting from the VBM at the R -point in the Brillouin zone, is found between -1.50 to -1.37 eV relative to the Fermi energy E F . We investigate quantitatively the formation of defect states in the band gap up to E F upon decomposition of the perovskites during sample transfer, storage, and measurements: during near-UV-based PES, the density of defect states saturates at a value that is around 4 orders of magnitude below the density of states at the valence band edge. However, even short air exposure, or 3 h of X-ray illumination, increased their density by almost a factor of six and ∼40, respectively. Upon prolonged storage in vacuum, the formation of a distinct defect peak is observed. Thus, near-UV CFSYS with modeling as shown here is demonstrated as a powerful tool to characterize the valence band and quantify defect states in lead halide perovskites.

Endoscopic ultrasound tissue acquisition, in the form of both fine needle aspiration (EUS-FNA) and fine needle biopsy (EUS-FNB), is utilized for pancreatic mass lesions, subepithelial lesions, and lymph node biopsy. Both procedures are safe and yield high diagnostic value. Despite its high diagnostic yield, EUS-FNA has potential limitations associated with cytological aspirations, including inability to determine histologic architecture, and a small quantitative sample for further immunohistochemical staining. EUS-FNB, with its larger core biopsy needle, was designed to overcome these potential limitations. However, it remains unclear which technique should be used and for which lesions. Comparative trials are plagued by heterogeneity at every stage of comparison; including variable needles used, and different definitions of endpoints, which therefore limit generalizability. Thus, we present a review of prospective trials, systematic reviews, and meta-analyses on studies examining EUS-FNA vs EUS-FNB. Prospective comparative trials of EUS-FNA vs EUS-FNB primarily focus on pancreatic mass lesions, and yield conflicting results in terms of demonstrating the superiority of one method. However, consistent among trials is the potential for diagnosis with fewer passes, and a larger quantity of sample achieved for next generation sequencing. With regard to subepithelial lesions and lymph node biopsy, fewer prospective trials exist, and larger prospective studies are necessary. Based on the available literature, we would recommend EUS-FNB for peri-hepatic lymph nodes., Competing Interests: Conflict-of-interest statement: Trindade AJ has received research funding from Ninepoint Medical. Trindade AJ is a consultant for Pentax Medical and Olympus America., (©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.)

Background: Sacroiliitis is an inflammatory arthritis of the sacroiliac joints and is associated with inflammatory bowel disease (IBD). Yet, sacroiliitis often goes undiagnosed in IBD, and the clinical association between IBD disease activity and sacroiliitis is not well established. Patients with Crohn's disease (CD) often receive magnetic resonance enterography (MRE) to assess disease activity, affording clinicians the opportunity to evaluate for the presence of sacroiliitis. We aimed to identify the prevalence and disease characteristics associated with sacroiliitis in CD patients undergoing MRE., Methods: All CD patients undergoing MRE for any indication between 2014 and 2018 at an IBD referral center were identified. The MREs were reviewed for the presence of sacroiliitis based on bone marrow edema (BME) and structural lesions. We analyzed demographics, IBD characteristics, clinical and endoscopic disease activity, and management between CD patients with and without sacroiliitis., Results: Two hundred fifty-eight patients with CD underwent MRE during the study period. Overall, 17% of patients had MR evidence of sacroiliitis, of whom 73% demonstrated bone marrow edema. Female gender, back pain, and later age of CD diagnosis were associated with sacroiliitis (P = 0.05, P < 0.001, P = 0.04, respectively). Disease location and CD therapy were not associated with sacroiliitis on MRE. Clinical, endoscopic, and radiographic disease activity were not associated with sacroiliitis on MRE., Conclusion: Sacroiliitis is a common comorbid condition in CD. With limited clinical clues and disease characteristics to suggest sacroiliitis, physicians may utilize MRE to identify sacroiliitis, especially in CD patients with back pain., (© 2020 Crohn’s & Colitis Foundation. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Through the optimization of the perovskite precursor composition and interfaces to selective contacts, we achieved a p-i-n-type perovskite solar cell (PSC) with a 22.3% power conversion efficiency (PCE). This is a new performance record for a PSC with an absorber bandgap of 1.63 eV. We demonstrate that the high device performance originates from a synergy between (1) an improved perovskite absorber quality when introducing formamidinium chloride (FACl) as an additive in the "triple cation" Cs 0.05 FA 0.79 MA 0.16 PbBr 0.51 I 2.49 (Cs-MAFA) perovskite precursor ink, (2) an increased open-circuit voltage, V OC , due to reduced recombination losses when using a lithium fluoride (LiF) interfacial buffer layer, and (3) high-quality hole-selective contacts with a self-assembled monolayer (SAM) of [2-(9 H -carbazol-9-yl)ethyl]phosphonic acid (2PACz) on ITO electrodes. While all devices exhibit a high performance after fabrication, as determined from current-density voltage, J - V , measurements, substantial differences in device performance become apparent when considering longer-term stability data. A reduced long-term stability of devices with the introduction of a LiF interlayer is compensated for by using FACl as an additive in the metal-halide perovskite thin-film deposition. Optimized devices maintained about 80% of the initial average PCE during maximum power point (MPP) tracking for >700 h. We scaled the optimized device architecture to larger areas and achieved fully laser patterned series-interconnected mini-modules with a PCE of 19.4% for a 2.2 cm 2 active area. A robust device architecture and reproducible deposition methods are fundamental for high performance and stable large-area single junction and tandem modules based on PSCs.

p-Type CuBi 2 O 4 is considered a promising metal oxide semiconductor for large-scale, economic solar water splitting due to the optimal band structure and low-cost fabrication. The main challenge in utilizing CuBi 2 O 4 as a photoelectrode for water splitting, is that it must be protected from photo-corrosion in aqueous solutions, an inherent problem for Cu-based metal oxide photoelectrodes. In this work, several buffer layers (CdS, BiVO 4 , and Ga 2 O 3 ) were tested between CuBi 2 O 4 and conformal TiO 2 as the protection layer. RuO x was used as the co-catalyst for hydrogen evolution. Factors that limit the photoelectrochemical performance of the CuBi 2 O 4 /TiO 2 /RuO x , CuBi 2 O 4 /CdS/TiO 2 /RuO x , CuBi 2 O 4 /BiVO 4 /TiO 2 /RuO x and CuBi 2 O 4 /Ga 2 O 3 /TiO 2 /RuO x heterojunction photoelectrodes were revealed by comparing photocurrents, band offsets, and directed charge transfer measured by modulated surface photovoltage spectroscopy. For CuBi 2 O 4 /Ga 2 O 3 /TiO 2 /RuO x photoelectrodes, barriers for charge transfer strongly limited the performance. In CuBi 2 O 4 /CdS/TiO 2 /RuO x , the absence of hole traps resulted in a relatively high photocurrent density and faradaic efficiency for hydrogen evolution despite the presence of pronounced deep defect states at the CuBi 2 O 4 /CdS interface. Hole trapping limited the performance moderately in CuBi 2 O 4 /BiVO 4 /TiO 2 /RuO x and strongly in CuBi 2 O 4 /TiO 2 /RuO x photoelectrodes. For the first time, our results show that hole trapping is a key factor that must be addressed to optimize the performance of CuBi 2 O 4 -based heterojunction photoelectrodes., Competing Interests: There are no conflicts to declare., (This journal is © The Royal Society of Chemistry.)

Recent advances in the management of Hodgkin lymphoma, due to new staging and response assessment systems as well as new therapies, have redefined the role of imaging for this disease. The purpose of this article is to provide radiologists with an update on the current role of imaging in Hodgkin lymphoma from diagnosis to assessment of treatment response, in view of the new staging and response assessment system and current treatment strategies., (Copyright © 2020 Elsevier Inc. All rights reserved.)

We assess a tandem photoelectrochemical cell consisting of a W:BiVO 4 photoanode top absorber and a CuBi 2 O 4 photocathode bottom absorber for overall solar water splitting. We show that the W:BiVO 4 photoanode oxidizes water and produces oxygen at potentials ≥0.7 V vs RHE when CoPi is added as a cocatalyst. However, the CuBi 2 O 4 photocathode does not produce a detectable amount of hydrogen from water reduction even when Pt or RuO x is added as a cocatalyst because the photocurrent primarily goes toward photocorrosion of CuBi 2 O 4 rather than proton reduction. Protecting the CuBi 2 O 4 photocathode with a CdS/TiO 2 heterojunction and adding RuO x as a cocatalyst prevents photocorrosion and allows for photoelectrochemical production of hydrogen at potentials ≤0.3 V vs RHE. A tandem photoelectrochemical cell composed of a W:BiVO 4 /CoPi photoanode and a CuBi 2 O 4 /CdS/TiO 2 /RuO x photocathode produces hydrogen which can be detected under illumination at an applied bias of ≥0.4 V. Since the valence band of BiVO 4 and conduction band of CuBi 2 O 4 are adequately positioned to oxidize water and reduce protons, we hypothesize that the applied bias is required to overcome the relatively low photovoltages of the photoelectrodes, that is, the relatively low quasi-Fermi level splitting within BiVO 4 and CuBi 2 O 4 . This work is the first experimental demonstration of hydrogen production from a BiVO 4 -CuBi 2 O 4 -based tandem cell and it provides important insights into the significance of photovoltage in tandem devices for overall water splitting, especially for cells containing CuBi 2 O 4 photocathodes.

A short lifetime is the main factor hindering the wider implementation of low-cost organic photovoltaics in large-area and outdoor applications. Ingress of oxygen and water vapour through non-ideal encapsulation layers is a known cause of degradation for polymer/fullerene based solar cells. To better understand the origin of this performance degradation, we study the effect of intentional exposure of the photo-active layer to simulated sunlight (AM1.5) in air both on the solar cell performance and on the molecular semiconductor materials. Cathode-free thin films of a blend of the electron donor polymer poly[2,3-bis-(3-octyloxyphenyl)quinoxaline-5,8-diyl-alt-thiophene-2,5-diyl] (TQ1) and the electron acceptor fullerene derivative [6,6]-phenyl-C 70 -butyric acid methyl ester (PC 70 BM) were exposed to simulated sunlight in air. Fourier-transform infrared spectra demonstrate the formation of carbonyl photo-oxidation products in the blend films, as well as in the pristine polymer and fullerene films. Solar cells prepared with photo-oxidized active layers show increasingly degraded electrical performance (lower short circuit current, open circuit voltage and fill factor) with increasing exposure time. The increased diode ideality factor indicates that trap-assisted recombination hinders device operation after exposure. The external quantum efficiency decreases drastically with increasing exposure time over the whole photon energy range, while the UV-vis absorption spectra of the blend films only show a mild photo-induced bleaching. This demonstrates that not only the photo-induced degradation of the solar cell performance is not predominantly caused by the loss in light absorption, but charge transport and collection are also hampered. This is explained by the fact that photo-oxidation of PC 70 BM causes bonds in its conjugated cage to break, as evidenced by the decreased π* intensity in C1s-NEXAFS spectra of PC 70 BM films. This degradation of unoccupied states of PC 70 BM will hinder the transport of photo-generated electrons to the electrode. Surface photovoltage spectroscopy gives direct evidence for gap states at the surface of a PC 70 BM film, formed after 2 hours of exposure and resulting in upward band bending at the PC 70 BM/air surface. These observations indicate that the photo-oxidation of PC 70 BM is likely to be the main cause of the performance degradation observed when the photoactive layer of a TQ1:PC 70 BM solar cell is intentionally exposed to light in air.

The role of vitamin D has long been discussed in many chronic diseases, and its significance in inflammatory bowel disease has recently gained attention. This article reviews vitamin D homeostasis, the involvement of vitamin D in the pathophysiology of inflammatory bowel disease, and vitamin D deficiency as a result of inflammatory bowel disease. In addition, this article explores the possibility of age, specifically in the elderly population, as a risk factor for developing vitamin D deficiency in patients with inflammatory bowel disease., Competing Interests: The authors are grateful to Dr Stuart Weinerman for his review of the article. The authors have no relevant conflicts of interest to disclose.

In-gap states in solar cell absorbers that are recombination centers determine the cell's photovoltaic performance. Using scanning tunneling spectroscopy (STS), temperature-dependent photoconductivity and steady-state photocarrier-grating measurements we probed, directly and indirectly, the energies of such states, both at the surface and in the bulk of two similar, but different halide perovskites, the single cation MAPbI 3 (here MAPI) and the mixed cation halide perovskite, FA 0.79 MA 0.16 Cs 0.05 Pb(I 0.83 Br 0.17 ) 3 (here MCHP). We found a correlation between the energy distribution of the in-gap states, as determined by STS measurements, and their manifestation in the photo-transport parameters of the MCHP absorbers. In particular, our results suggest that the in-gap recombination centers in the MCHP are shallower than those of MAPI. This can be one explanation for the better photovoltaic efficiency of the former.

Inorganic and organic lead halide perovskite materials attract great interest in the scientific community because of their potential for low-cost, high efficiency solar cells. In this report we add a new property of these materials, namely their photochemical activity in the visible light range. Both inorganic (CsPbBr3) and organic (CH3NH3PbBr3-MAPbBr3) perovskite thin films were demonstrated to promote photo-dissociation of adsorbed ethyl chloride (EC), employing 532 nm pulsed laser irradiation under ultra-high vacuum (UHV) conditions. From the post-irradiation temperature programmed desorption (TPD) analysis, the yield of photoproduct formation was found to be up to two orders of magnitude higher than for UV light-excited EC molecules on metallic and oxide surfaces. Photo-reactivity on top of the CsPbBr3 surface is almost an order of magnitude more efficient than on the CH3NH3PbBr3 surface, apparently due to the lower density of defect and surface states. A direct correlation was found between electron-induced luminescence and photoluminescence intensities and the photoreactivity cross-sections. We conclude that both the intense luminescence and the well-known photovoltaic properties associated with these halide perovskite materials are consistent with the efficiency of photo-reactivity in the visible range, reported here for the first time.

Purpose: Conflicting evidence exists regarding any association between diverticulosis and adenomatous polyps. We evaluated the prevalence of polyps and cancer in colonic regions containing diverticula., Methods: Six hundred consecutive colonoscopy reports from a single endoscopist were reviewed to determine prevalence and location of diverticulosis and polyps. Additionally, pathology reports of 88 colon cancer resection specimens were reviewed for the presence of diverticulosis, and compared with expected prevalence of diverticulosis in that colonic region based on the collected colonoscopy data., Results: Overall, rates of detected polyps were comparable between patients with and without diverticulosis. However, analyzing the data by colonic segment containing diverticulosis, the prevalence of adenomatous polyps was reduced in regions of diverticulosis compared to the same colonic segment unaffected by diverticulosis (7 vs. 17% for rectosigmoid (p = 0.005); 5 vs. 18% for descending (p < 0.0001); and 17 vs. 27% for ascending colon (p = 0.0495)). Among colon cancer resection specimens, the prevalence of diverticulosis was significantly reduced in the rectosigmoid and ascending colon, compared with expected rates of diverticulosis in those regions. (13 vs. 42% in rectosigmoid (p = 0.0006); 3 vs. 17% in ascending colon (p = 0.043))., Conclusion: Despite similar overall frequency of polyps in patients with and without diverticulosis, polyps were significantly less likely in the colonic segment affected by diverticulosis. Additionally, the frequency of diverticulosis in areas of cancer in the rectosigmoid and ascending colon was significantly lower than expected compared with the expected frequency of diverticulosis for those colonic regions. These observations suggest a true negative association between colonic neoplasia and diverticulosis.

New results are reported from the operation of the PICO-60 dark matter detector, a bubble chamber filled with 52 kg of C&#95;{3}F&#95;{8} located in the SNOLAB underground laboratory. As in previous PICO bubble chambers, PICO-60 C&#95;{3}F&#95;{8} exhibits excellent electron recoil and alpha decay rejection, and the observed multiple-scattering neutron rate indicates a single-scatter neutron background of less than one event per month. A blind analysis of an efficiency-corrected 1167-kg day exposure at a 3.3-keV thermodynamic threshold reveals no single-scattering nuclear recoil candidates, consistent with the predicted background. These results set the most stringent direct-detection constraint to date on the weakly interacting massive particle (WIMP)-proton spin-dependent cross section at 3.4×10^{-41}  cm^{2} for a 30-GeV c^{-2} WIMP, more than 1 order of magnitude improvement from previous PICO results.

Photovoltaic solar cells operate under steady-state conditions that are established during the charge carrier excitation and recombination. However, to date no model of the steady-state recombination scenario in halide perovskites has been proposed. In this Letter we present such a model that is based on a single type of recombination center, which is deduced from our measurements of the illumination intensity dependence of the photoconductivity and the ambipolar diffusion length in those materials. The relation between the present results and those from time-resolved measurements, such as photoluminescence that are commonly reported in the literature, is discussed.

We investigate the effect of high work function contacts in halide perovskite absorber-based photovoltaic devices. Photoemission spectroscopy measurements reveal that band bending is induced in the absorber by the deposition of the high work function molybdenum trioxide (MoO 3 ). We find that direct contact between MoO 3 and the perovskite leads to a chemical reaction, which diminishes device functionality. Introducing an ultrathin spiro-MeOTAD buffer layer prevents the reaction, yet the altered evolution of the energy levels in the methylammonium lead iodide (MAPbI 3 ) layer at the interface still negatively impacts device performance.

Direct comparison between perovskite-structured hybrid organic-inorganic methylammonium lead bromide (MAPbBr3) and all-inorganic cesium lead bromide (CsPbBr3), allows identifying possible fundamental differences in their structural, thermal and electronic characteristics. Both materials possess a similar direct optical band gap, but CsPbBr3 demonstrates a higher thermal stability than MAPbBr3. In order to compare device properties, we fabricated solar cells, with similarly synthesized MAPbBr3 or CsPbBr3, over mesoporous titania scaffolds. Both cell types demonstrated comparable photovoltaic performances under AM1.5 illumination, reaching power conversion efficiencies of ∼6% with a poly aryl amine-based derivative as hole transport material. Further analysis shows that Cs-based devices are as efficient as, and more stable than methylammonium-based ones, after aging (storing the cells for 2 weeks in a dry (relative humidity 15-20%) air atmosphere in the dark) for 2 weeks, under constant illumination (at maximum power), and under electron beam irradiation.

Halide perovskite-based solar cells still have limited reproducibility, stability, and incomplete understanding of how they work. We track electronic processes in [CH3NH3]PbI3(Cl) ("perovskite") films in vacuo, and in N2, air, and O2, using impedance spectroscopy (IS), contact potential difference, and surface photovoltage measurements, providing direct evidence for perovskite sensitivity to the ambient environment. Two major characteristics of the perovskite IS response change with ambient environment, viz. -1- appearance of negative capacitance in vacuo or post-vacuo N2 exposure, indicating for the first time an electrochemical process in the perovskite, and -2- orders of magnitude decrease in the film resistance upon transferring the film from O2-rich ambient atmosphere to vacuum. The same change in ambient conditions also results in a 0.5 V decrease in the material work function. We suggest that facile adsorption of oxygen onto the film dedopes it from n-type toward intrinsic. These effects influence any material characterization, i.e., results may be ambient-dependent due to changes in the material's electrical properties and electrochemical reactivity, which can also affect material stability.

High band gap, high open-circuit voltage solar cells with methylammonium lead tribromide (MAPbBr3) perovskite absorbers are of interest for spectral splitting and photoelectrochemical applications, because of their good performance and ease of processing. The physical origin of high performance in these and similar perovskite-based devices remains only partially understood. Using cross-sectional electron-beam-induced current (EBIC) measurements, we find an increase in carrier diffusion length in MAPbBr3(Cl)-based solar cells upon low intensity (a few percent of 1 sun intensity) blue laser illumination. Comparing dark and illuminated conditions, the minority carrier (electron) diffusion length increases about 3.5 times from Ln = 100 ± 50 nm to 360 ± 22 nm. The EBIC cross section profile indicates a p-n structure between the n-FTO/TiO2 and p-perovskite, rather than the p-i-n structure, reported for the iodide derivative. On the basis of the variation in space-charge region width with varying bias, measured by EBIC and capacitance-voltage measurements, we estimate the net-doping concentration in MAPbBr3(Cl) to be 3-6 × 10(17) cm(-3).

New data are reported from the operation of a 2 liter C3F8 bubble chamber in the SNOLAB underground laboratory, with a total exposure of 211.5 kg days at four different energy thresholds below 10 keV. These data show that C3F8 provides excellent electron-recoil and alpha rejection capabilities at very low thresholds. The chamber exhibits an electron-recoil sensitivity of <3.5×10(-10) and an alpha rejection factor of >98.2%. These data also include the first observation of a dependence of acoustic signal on alpha energy. Twelve single nuclear recoil event candidates were observed during the run. The candidate events exhibit timing characteristics that are not consistent with the hypothesis of a uniform time distribution, and no evidence for a dark matter signal is claimed. These data provide the most sensitive direct detection constraints on WIMP-proton spin-dependent scattering to date, with significant sensitivity at low WIMP masses for spin-independent WIMP-nucleon scattering.