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Transient reflectivity measurements are used to probe the strain waves induced by ultrashort laser pulses in bulk [100] germanium. The measurement signals are compared to purely analytical model functions based on the known material parameters for germanium. The modeling includes (i) a derivation of analytical solutions to the wave equation for strain waves coupled to the diffusion equation for heat and charge carriers and (ii) an expression for the impact on reflection coefficients that are caused by perturbations to the dielectric function but extended to cover a non-isotropic, uniaxial dielectric tensorial form. The model is held up against transient reflectivity measurements with an s- and a p-polarized probe and with a probe wavelength in the range of 502–710 nm. Excellent agreement is found when comparing the oscillatory shape of the measurement signals to the models. As for the magnitude of the oscillations, the models reproduce the overall trends of the experiment when using the previously published values for the elasto-optical tensor measured under static strain. [ABSTRACT FROM AUTHOR]

Growth of GeSn films directly on Si substrates is desirable for integrated photonics applications since the absence of an intervening buffer layer simplifies device fabrication. Here, we analyze the microstructure of two GeSn films grown directly on (001) Si by remote plasma-enhanced chemical vapor deposition (RPECVD): a 1000 nm thick film containing 3% Sn and a 600 nm thick, 10% Sn film. Both samples consist of an epitaxial layer with nano twins below a composite layer containing nanocrystalline and amorphous. The epilayer has uniform composition, while the nanocrystalline material has higher levels of Sn than the surrounding amorphous matrix. These two layers are separated by an interface with a distinct, hilly morphology. The transition between the two layers is facilitated by formation of densely populated (111)-coupled nano twins. The 10% Sn sample exhibits a significantly thinner epilayer than the one with 3% Sn. The in-plane lattice mismatch between GeSn and Si induces a quasi-periodic misfit dislocation network along the interface. Film growth initiates at the interface through formation of an atomic-scale interlayer with reduced Sn content, followed by the higher Sn content epitaxial layer. A corrugated surface containing a high density of twins with elevated levels of Sn at the peaks begins forming at a critical thickness. Subsequent epitaxial breakdown at the peaks produces a composite containing high levels of Sn nanocrystalline embedded in lower level of Sn amorphous. The observed microstructure and film evolution provide valuable insight into the growth mechanism that can be used to tune the RPECVD process for improved film quality. [ABSTRACT FROM AUTHOR]

Finite-temperature calculations are relevant for rationalizing material properties, yet they are computationally expensive because large system sizes or long simulation times are typically required. Circumventing the need for performing many explicit first-principles calculations, tight-binding and machine-learning models for the electronic structure emerged as promising alternatives, but transferability of such methods to elevated temperatures in a data-efficient way remains a great challenge. In this work, we suggest a tight-binding model for efficient and accurate calculations of temperature-dependent properties of semiconductors. Our approach utilizes physics-informed modeling of the electronic structure in the form of hybrid-orbital basis functions and numerically integrating atomic orbitals for the distance dependence of matrix elements. We show that these design choices lead to a tight-binding model with a minimal amount of parameters that are straightforwardly optimized using density functional theory or alternative electronic-structure methods. The temperature transferability of our model is tested by applying it to existing molecular-dynamics trajectories without explicitly fitting temperature-dependent data and comparison with density functional theory. We utilize it together with machine-learning molecular dynamics and hybrid density functional theory for the prototypical semiconductor gallium arsenide. We find that including the effects of thermal expansion on the onsite terms of the tight-binding model is important in order to accurately describe electronic properties at elevated temperatures in comparison with experiment. [ABSTRACT FROM AUTHOR]

We present a method by which the direct detection effect in superconducting hot-electron bolometer mixers can be analytically accounted for with sufficient practical accuracy. This is achieved by means of the advanced uniform, non-linear two-temperature model that considers the effective temperatures of electrons and phonons alongside established material parameters. We demonstrate the efficacy of this approach for the ex situ correction of the radiance of the emission line of atomic oxygen under conditions when the direct detection causes a 30% error in the line magnitude. The correction was applied to data collected by a balloon-borne heterodyne receiver operating in the upper atmosphere of Earth. The corrected line shape and magnitude are in reasonable agreement with the predictions of atmospheric radiation transfer models. [ABSTRACT FROM AUTHOR]

We present an algorithm to find first order saddle points on the potential energy surface (PES). The algorithm is formulated as a constrained optimization problem that involves two sets of atomic coordinates (images), a time-varying distance constraint and a constraint on the energy difference. Both images start in different valleys of the PES and are pulled toward each other by gradually reducing the distance. The search space is restricted to the pairs of configurations that share the same potential energy. By minimizing the energy while the distance shrinks, a minimum of the constrained search space is tracked. In simple cases, the two images are confined to their respective sides of the barrier until they finally converge near the saddle point. If one image accidentally crosses the barrier, the path is split at suitable locations and the algorithm is repeated recursively. The optimization is implemented as a combination of a quasi-Newton optimization and a linear constraint. The method was tested on a set of Lennard-Jones-38 cluster transitions and a set of 121 molecular reactions using density functional theory calculations. The efficiency in terms of energy and force evaluation is better than with competing methods as long as they do not switch to single-ended methods. The construction of a continuous search path with small steps and the ability to focus on arbitrary subsegments of the path provide an additional value in terms of robustness and flexibility. [ABSTRACT FROM AUTHOR]

This study investigates bilayers of 0.94(Na1/2Bi1/2)TiO3–0.06BaTiO3 (NBT–6BT) and 0.90(Na1/2Bi1/2)TiO3–0.06BaTiO3–0.04(K0.5Na0.5)NbO3 (NBT–6BT–4KNN) using digital image correlation, enabling the separate analysis of strain response in each layer. The bilayers were electrically connected without mechanical connection (polarization coupled) as well as mechanically and electrically connected (polarization and strain coupled) to determine the role of interlayer mechanical interactions. The large signal longitudinal and transverse piezoelectric coefficients, d 33 ∗ and d 31 ∗ , were characterized for both cases. In the polarization coupled composite, d 33 ∗ decreased linearly from 410 to 260 pm/V with increasing vol. % NBT–6BT. In contrast, in the polarization and strain coupled case, d 33 ∗ and d 31 ∗ were maximum at 50 vol. % NBT–6BT with values of 440 and −130 pm/V, respectively, highlighting the critical role of strain interactions in ceramic–ceramic composites. The stress-induced phase transformation through strain coupling significantly impacted the electromechanical response, with improved strain values observed in the NBT–6BT–4KNN layer. Furthermore, this study highlights the variability in the significance of strain coupling within bilayer systems as a function of the altering volume fraction of their constituent components. [ABSTRACT FROM AUTHOR]

Fluorescent emitters are quenched near the surfaces of metals via rapid energy transfer to the metal, via surface plasmons, waveguide modes, and absorption. Commonly, this quenching is reduced by introducing a polymeric or dielectric spacer but requires large distances, at least a fraction of the wavelength, between the metal and chromophore. Using the classical theory for a dipole above a metal/dielectric substrate, we investigate the fluorescent yield for emitters above a wide range of metals and spacers. For metals with low loss and low plasma frequencies, a high index spacer is shown to be advantageous for obtaining higher fluorescent yield in an "island of emission" at finely tuned spacer thickness just 20–30 nm from the metal surface. For such metal–dielectric combinations, fluorophores can be placed surprisingly close to the metal surface while remaining significantly emissive. [ABSTRACT FROM AUTHOR]

We extend some of the well-established self-interaction correction (SIC) schemes of density-functional theory—the Perdew–Zunger SIC and the average-density SIC—to the case of systems with noncollinear magnetism. Our proposed SIC schemes are tested on a set of molecules and metallic clusters in combination with the widely used local spin-density approximation. As expected from the collinear SIC, we show that the averaged-density SIC works well for improving ionization energies but fails to improve more subtle quantities like the dipole moments of polar molecules. We investigate the exchange-correlation magnetic field produced by our extension of the Perdew–Zunger SIC, showing that it is not aligned with the local total magnetization, thus producing an exchange-correlation torque. [ABSTRACT FROM AUTHOR]

Research into the psychology of coaching has been somewhat neglected in comparison to research on the psychological development of athletes. The purpose of this study was to examine the effects of a brief online rational-emotive-behavioral-therapy (REBT) program on coach irrational beliefs and well-being. Coaching staff from an elite international canoeing team (N = 4) took part in a three-session (30- to 40-min) REBT program. Participants completed measures of irrational beliefs and mental well-being at preintervention, postintervention, and follow-up (1 month) time points. Visual analyses and social validation revealed that the intervention reduced irrational beliefs and enhanced mental well-being in two participants. However, REBT was more effective for some coaches than others, and follow-up data indicated a return to base levels in some coaches. Limitations and recommendations for future research are discussed, alongside practitioner reflections. [ABSTRACT FROM AUTHOR]

Many-body dispersion (MBD) is a powerful framework to treat van der Waals (vdW) dispersion interactions in density-functional theory and related atomistic modeling methods. Several independent implementations of MBD with varying degree of functionality exist across a number of electronic structure codes, which both limits the current users of those codes and complicates dissemination of new variants of MBD. Here, we develop and document libMBD, a library implementation of MBD that is functionally complete, efficient, easy to integrate with any electronic structure code, and already integrated in FHI-aims, DFTB+, VASP, Q-Chem, CASTEP, and Quantum ESPRESSO. libMBD is written in modern Fortran with bindings to C and Python, uses MPI/ScaLAPACK for parallelization, and implements MBD for both finite and periodic systems, with analytical gradients with respect to all input parameters. The computational cost has asymptotic cubic scaling with system size, and evaluation of gradients only changes the prefactor of the scaling law, with libMBD exhibiting strong scaling up to 256 processor cores. Other MBD properties beyond energy and gradients can be calculated with libMBD, such as the charge-density polarization, first-order Coulomb correction, the dielectric function, or the order-by-order expansion of the energy in the dipole interaction. Calculations on supramolecular complexes with MBD-corrected electronic structure methods and a meta-review of previous applications of MBD demonstrate the broad applicability of the libMBD package to treat vdW interactions. [ABSTRACT FROM AUTHOR]

Many children around the globe suffer from spider phobia. Virtual reality exposure therapy is an effective phobia treatment, but so far predominantly tailored for adults. A gamified approach utilizing gaze interaction would allow for a more child-friendly and engaging experience, and provide the possibility to foster working mechanisms of exposure therapy. We developed an application in which children make spiders change in positively connoted ways (e.g., make them dance or shrink) if sufficient visual attention towards them is captured via eye tracking. Thereby, motivation for and positive affects during exposure towards spiders are aspired. In this pilot study on 21 children without (n = 11) and with fear of spiders (n = 10), we examined positive and negative affect during exposure to a virtual spider and to different gaze-related transformations of the spider within a quasi-experimental design. Within a one-group design, we additionally examined fear of spiders in spider fearful children before and one week after the intervention. We found that significantly more positive than negative affect was induced by the spiders' transformations in children without and with fear of spiders. Fear of spiders was furthermore significantly reduced in spider-fearful children, showing large effect sizes (d >.80). Findings indicate eligibility for future clinical use and evaluation in children with spider phobia. [ABSTRACT FROM AUTHOR]

This study aims to develop a Portuguese-language version of the Birth Satisfaction Scale-Revised (BSS-R) for clinical and research use in Portugal (PT-BSS-R). The factor structure, its invariance across depression levels, and the internal consistency of the PT-BSS-R were analysed. A sample of 1373 Portuguese-speaking postpartum women completed a sociodemographic and clinical form, the PT-BSS-R, and the Edinburgh Postnatal Depression Scale through an online survey tool. Four competing models were tested through confirmatory factor analyses and bifactor model-based psychometric indices were calculated. The internal consistency and the divergent/convergent validity are analysed. The psychometric properties of PT-BSS-R were found to be generally excellent. Both the original correlated three-factor model and the bifactor model exhibited a good fit to the data. Results from the bifactor model support the use of both the BSS-R total score and the subscale scores. Exemplary invariance findings were observed between groups stratified on the basis of depression screening. PT-BSS-R has demonstrated both divergent and convergent validity as well as internal consistency. PT-BSS-R is a psychometrically robust measure of birth satisfaction appropriate for clinical and research use in Portugal. [ABSTRACT FROM AUTHOR]

Here we report the efficient synthetic access to 13C/15N‐labelled pseudouridine phosphoramidites, which were incorporated into a binary H/ACA box guide RNA/product complex comprising 77 nucleotides (nts) in total and into a 75 nt E. coli tRNAGly. The stable isotope (SI) labelled pseudouridines were produced via a highly efficient chemo‐enzymatic synthesis. 13C/15N labelled uracils were produced via chemical synthesis and enzymatically converted to pseudouridine 5′‐monophosphate (ΨMP) by using YeiN, a Ψ‐5′‐monophosphate C‐glycosidase. Removal of the 5′‐phosphate group yielded the desired pseudouridine nucleoside (Ψ), which was transformed into a phosphoramidite building suitable for RNA solid phase synthesis. A Ψ ‐building block carrying both a 13C and a 15N label was incorporated into a product RNA and the complex formation with a 63 nt H/ACA box RNA could be observed via NMR. Furthermore, the SI labelled pseudouridine building block was used to determine imino proton bulk water exchange rates of a 75 nt E. coli tRNAGly CCmnm5U, identifying the TΨC‐loop 5‐methyluridine as a modifier of the exchange rates. The efficient synthetic access to SI‐labelled Ψ building blocks will allow the solution and solid‐state NMR spectroscopic studies of Ψ containing RNAs and will facilitate the mass spectrometric analysis of Ψ‐modified nucleic acids. [ABSTRACT FROM AUTHOR]

Some autoimmune diseases carry elevated risk for atherosclerotic cardiovascular disease (ASCVD), yet the underlying mechanism and the influence of traditional risk factors remain unclear. This study sought to determine whether autoimmune diseases independently correlate with coronary atherosclerosis and ASCVD risk and whether traditional cardiovascular risk factors modulate the risk. The study included 85,512 patients from the Western Denmark Heart Registry undergoing coronary computed tomography angiography. A diagnosis of 1 of 18 autoimmune diseases was assessed. Adjusted OR (aOR) for any plaque, any coronary artery calcification (CAC), CAC of >90th percentile, and obstructive coronary artery disease as well as adjusted HR (aHR) for ASCVD were calculated. During 5.3 years (Q1-Q3: 2.8-8.2 years) of follow-up, 3,832 ASCVD events occurred. A total of 4,064 patients had a diagnosis of autoimmune disease, which was associated with both presence of any plaque (aOR: 1.29; 95% CI: 1.20-1.40), any CAC (aOR: 1.28; 95% CI: 1.19-1.37), and severe CAC of >90th percentile (aOR: 1.53; 95% CI: 1.39-1.68), but not with having obstructive coronary artery disease (aOR: 1.04; 95% CI: 0.91-1.17). Patients with autoimmune diseases had a 46% higher risk (aHR: 1.46; 95% CI: 1.29-1.65) for ASCVD. Traditional cardiovascular risk factors were strongly associated with future ASCVD events, and a favorable cardiovascular risk factor profile in autoimmune patients was associated with ∼54% lower risk compared to patients with presence of risk factors (aHR: 0.46; 95% CI: 0.27-0.81). Autoimmune diseases were independently associated with higher burden of coronary atherosclerosis and higher risk for future ASCVD events, with risk accentuated by traditional cardiovascular risk factors. These findings suggest that autoimmune diseases increase risk through accelerated atherogenesis and that cardiovascular risk factor control is key for improving prognosis in patients with autoimmune diseases. [Display omitted] [ABSTRACT FROM AUTHOR]

Environmental pollution by plastics is a global issue of increasing concern. However, microplastic analysis in complex environmental matrices, such as soil samples, remains an analytical challenge. Destructive mass-based methods for microplastic analysis do not determine plastics' shape and size, which are essential parameters for reliable ecological risk assessment. By contrast, nondestructive particle-based methods produce such data but require elaborate, time-consuming sample preparation. Thus, time-efficient and reliable methods for microplastic analysis are needed. The present study explored the potential of frequency-domain fluorescence lifetime imaging microscopy (FD-FLIM) for rapidly and reliably identifying as well as differentiating plastics and natural materials from terrestrial environments. We investigated the fluorescence spectra of ten natural materials from terrestrial environments, tire wear particles, and eleven different transparent plastic granulates <5 mm to determine the optimal excitation wavelength for identification and differentiation via FD-FLIM under laboratory conditions. Our comparison of different excitation wavelengths showed that 445 nm excitation exhibited the highest fluorescence intensities. 445 nm excitation was also superior for identifying plastic types and distinguishing them from natural materials from terrestrial environments with a high probability using FD-FLIM. We could demonstrate that FD-FLIM analysis has the potential to contribute to a streamlined and time-efficient direct analysis of microplastic contamination. However, further investigations on size-, shape-, color-, and material-type detection limitations are necessary to evaluate if the direct identification of terrestrial environmental samples of relatively low complexity, such as a surface inspection soil, is possible. [ABSTRACT FROM AUTHOR]

Plant hormones are important in the control of physiological and developmental processes including seed germination, senescence, flowering, stomatal aperture, and ultimately the overall growth and yield of plants. Many currently available methods to quantify such growth regulators quickly and accurately require extensive sample purification using complex analytic techniques. Herein we used ultra-performance liquid chromatography-high-resolution mass spectrometry (UHPLC-HRMS) to create and validate the prediction of hormone concentrations made using attenuated total reflection Fourier-transform infrared (ATR-FTIR) spectral profiles of both freeze-dried ground leaf tissue and extracted xylem sap of Japanese knotweed (Reynoutria japonica) plants grown under different environmental conditions. In addition to these predictions made with partial least squares regression, further analysis of spectral data was performed using chemometric techniques, including principal component analysis, linear discriminant analysis, and support vector machines (SVM). Plants grown in different environments had sufficiently different biochemical profiles, including plant hormonal compounds, to allow successful differentiation by ATR-FTIR spectroscopy coupled with SVM. ATR-FTIR spectral biomarkers highlighted a range of biomolecules responsible for the differing spectral signatures between growth environments, such as triacylglycerol, proteins and amino acids, tannins, pectin, polysaccharides such as starch and cellulose, DNA and RNA. Using partial least squares regression, we show the potential for accurate prediction of plant hormone concentrations from ATR-FTIR spectral profiles, calibrated with hormonal data quantified by UHPLC-HRMS. The application of ATR-FTIR spectroscopy and chemometrics offers accurate prediction of hormone concentrations in plant samples, with advantages over existing approaches. [ABSTRACT FROM AUTHOR]

Blood clot formation, a crucial process in hemostasis and thrombosis, has garnered substantial attention for its implications in various medical conditions. Microscopic examination of blood clots provides vital insights into their composition and structure, aiding in the understanding of clot pathophysiology and the development of targeted therapeutic strategies. This study explores the use of topological data analysis (TDA) to assess plasma clot characteristics microscopically, focusing on the identification of the elements components, holes and Wasserstein distances. This approach should enable researchers to objectively classify fibrin networks based on their topologic architecture. We tested this mathematical characterization approach on plasma clots formed in static conditions from porcine and human citrated plasma samples, where the effect of dilution and direct thrombin inhibition was explored. Confocal microscopy images showing fluorescence labeled fibrin networks were analyzed. Both treatments resulted in visual differences in plasma clot architecture, which could be quantified using TDA. Significant differences between baseline and diluted samples, as well as blood anticoagulated with argatroban, were detected mathematically. Therefore, TDA could be indicative of clots with compromised stability, providing a valuable tool for thrombosis risk assessment. In conclusion, microscopic examination of plasma clots, coupled with Topological Data Analysis, offers a promising avenue for comprehensive characterization of clot microstructure. This method could contribute to a deeper understanding of clot pathophysiology and thereby refine our ability to assess clot characteristics. [ABSTRACT FROM AUTHOR]

Metals are essential for all living organisms, but the type of metal and its concentration determines its action. Even low concentrations of metals may have toxic effects on organisms and therefore exhibit antimicrobial activities. In this study, we investigate the evolutionary adaptation processes of Staphylococcus aureus to metals and common genes for metal tolerance. Laboratory and clinical isolates were treated with manganese, cobalt, zinc, or nickel metal salts to generate growth-adapted mutants. After growth in medium supplemented with zinc, whole-genome sequencing identified, among others, two genes, mgtE (SAUSA300_0910), a putative magnesium transporter and spoVG (SAUSA300_0475), a global transcriptional regulator, as hot spots for stress-induced single-nucleotide polymorphisms (SNPs). SNPs in mgtE were also detected in mutants treated with high levels of cobalt or nickel salts. To investigate the effect of these genes on metal tolerance, deletion mutants and complementation strains in an S. aureus USA300 LAC* laboratory strain were generated. Both, the mgtE and spoVG deletion strains were more tolerant to cobalt, manganese, and zinc. The mgtE mutant was also more tolerant to nickel exposure. Inductively coupled plasma mass spectrometry analysis demonstrated that the mgtE deletion mutant accumulated less intracellular zinc than the wild type, explaining increased tolerance. From these results, we conclude that mgtE gene inactivation increases zinc tolerance presumably due to reduced uptake of zinc. For the SpoVG mutant, no direct effect on the intracellular zinc concentration was detected, indicating toward different pathways to increase tolerance. Importantly, inactivation of these genes offers a growth advantage in environments containing certain metals, pointing toward a common tolerance mechanism. [ABSTRACT FROM AUTHOR]

Background: Standard-of-care nucleic acid amplification tests (routine NAATs) for Neisseria gonorrhoeae (GC) and Chlamydia trachomatis (CT) can take several days to result and therefore delay treatment. Rapid point-of-care GC/CT NAAT (rapid NAAT) could reduce the time to treatment and therefore onward transmission. This study evaluated the incremental cost per infectious day averted and overall cost of implementation associated with rapid compared with routine NAAT. Methods: Prospective sexually transmitted infection (STI) treatment data from men who have sex with men and transgender women in San Diego who received rapid NAAT between November 2018 and February 2021 were evaluated. Historical time from testing to treatment for routine NAAT was abstracted from the literature. Costs per test for rapid and routine NAAT were calculated using a micro-costing approach. The incremental cost per infectious day averted comparing rapid to routine NAAT and the costs of rapid GC/CT NAAT implementation in San Diego Public Health STI clinics were calculated. Results: Overall, 2333 individuals underwent rapid NAATwith a median time from sample collection to treatment of 2 days compared with 7 to 14 days for routine NAAT equating to a reduction of 5 to 12 days. The cost of rapid and routine GC/CT NAATwas $57.86 and $18.38 per test, respectively, with a cost-effectiveness of between $2.43 and $5.82 per infectious day averted. The incremental cost of rapid NAAT improved when at least 2000 tests were performed annually. Conclusions: Although rapid GC/CT NAAT is more expensive than routine testing, the reduction of infectious days between testing and treatment may reduce transmission and provide improved STI treatment services to patients. [ABSTRACT FROM AUTHOR]

Specialist and generalist insect herbivores evolved different strategies to process host‐plant metabolites. We explored frass composition in Laothoe populi (L.) caterpillars (Lepidoptera: Sphingidae), a specialist moth species that is closely associated with plants of the Salicaceae (Mirb.) family. We fed the caterpillars with leaves from three willow species (Salix caprea L., S. purpurea L. and S. viminalis L.), one willow hybrid (S. x rubens Schrank) and one poplar species (Populus tremula L.). Using untargeted metabolomics, we compared the chemical composition and variation among leaf and frass samples. We quantified the chemical variation using either a simple index based on the presence and concentration of metabolites (i.e., Bray‐Curtis) or an index that additionally accounts for chemical structural‐compositional similarity (CSCS) among metabolites. Due to the high degree of dietary specialisation, we expected low host‐specific variation in frass composition among the caterpillars. Based on literature, we further hypothesised that ingested salicinoids will be largely modified in the caterpillar gut while flavonoids will be often passively excreted. Finally, we compared chemical variation among the samples when quantified with Bray‐Curtis or CSCS metrics. As expected, we found relatively low host‐specific variation in the chemical composition of caterpillar frass. Our results further suggest that flavonoids were largely passively excreted by the caterpillars, while salicinoids were metabolised in the gut. Finally, we found that chemical composition measures based on Bray‐Curtis overestimated the differences in chemical composition between frass and leaves, suggesting that for these type of samples CSCS measures are better suited to reflect metabolic changes more realistically. [ABSTRACT FROM AUTHOR]

This document is a summary of an article from the journal Experimental & Clinical Endocrinology & Diabetes titled "Diagnosis, Therapy and Follow-Up of Diabetes Mellitus in Children and Adolescents." The article provides comprehensive information on the diagnosis, therapy, and follow-up of diabetes in this age group. It covers topics such as epidemiology, types of diabetes, risk factors, prevention, and early detection. The article emphasizes the importance of immediate insulin therapy after diagnosis and recommends specialized care for children with diabetes. It also discusses the psychosocial aspects of long-term care, the importance of a multi-professional team, and the treatment of acute and long-term complications. The document provides guidelines for the diagnosis and treatment of various types of diabetes in children and adolescents, including associated autoimmune diseases. It was prepared by the German Diabetes Society with input from experts in the field. [Extracted from the article]

Adult attention deficit hyperactivity disorder (ADHD) is often associated with personality pathology. However, only few studies have been conducted on the link between ADHD and pathological narcissism (PN), with or without a diagnosis of narcissistic personality disorder (NPD). In order to fill this gap, PN and NPD were assessed in 164 subjects suffering from ADHD, with several other measures including ADHD severity, quality of life, depression, anxiety, impulsivity, and emotion dysregulation (ED). We found that a significant proportion of ADHD patients suffered from NPD, and that both narcissistic grandiosity and vulnerability were associated with ADHD hyperactivity and impulsivity symptoms, but not with inattentive symptoms. These two dimensions seemed to be negatively associated with well-being and positively associated with most of the other studied psychiatric dimensions except ED, the latter being only associated with vulnerability, even after adjustment on borderline symptoms. Overall, despite important limitations that limit the generalizability of our findings to the overall ADHD population (notably linked to selection bias), we believe that this exploratory study sheds light on the potential clinical relevance of narcissistic pathology in adult ADHD patients. [ABSTRACT FROM AUTHOR]

Background: Listing tools have been developed to improve medications in older patients, including the Fit fOR The Aged (FORTA) list, a clinically validated, positive-negative list of medication appropriateness. Here, we aim to validate MyFORTA, an automated tool for individualized application of the FORTA list. Methods: 331 participants of a multi-center cohort study (AgeCoDe) for whom the FORTA score (sum of overtreatment and undertreatment errors) had been determined manually (gold standard [GS]) were reassessed using the automated MyFORTA (MF) tool. This tool determines the score from ATC and ICD codes combined with clinical parameters. Results: The FORTA scores were 9.01 ± 2.91 (mean ± SD, MF) versus 6.02 ± 2.52 (GS) (p < 0.00001). Removing undertreatment errors for calcium/vitamin D (controversial guidelines) and influenza/pneumococcal vaccinations (no robust information in the database), the difference decreased: 7.5 ± 2.7 (MF) versus 5.98 ± 2.55 (GS) (p < 0.00001). The remaining difference was driven by, for example, missing nitro spray in coronary heart disease/acute coronary syndrome as the related information was rarely found in the database, but notoriously detected by MF. Three hundred and forty errors from those 100 patients with the largest score deviation accounted for 68% of excess errors by MF. Conclusion: MF was more sensitive to detect medication errors than GS, all frequent errors only detected by MF were plausible, and almost no adaptations of the MF algorithm seem indicated. This automated tool to check medication appropriateness according to the FORTA list is now validated and represents the first clinically directed algorithm in this context. It should ease the application of FORTA and help to implement the proven beneficial effects of FORTA on clinical endpoints. [ABSTRACT FROM AUTHOR]

Background: There is a shortage of donor hearts in Switzerland, especially for pediatric recipients. However, the rate and reason for refusals of pediatric donor hearts offered in Switzerland has not been systematically analyzed. Methods: The national transplant database, Swiss Organ Allocation System, was searched for all hearts from Swiss and foreign donors younger than 16 years from 2015 to 2020. The numbers of accepted and refused hearts and early outcome were assessed, and the reasons for refusal were retrospectively analyzed. Results: A total of 136 organs were offered to the three Swiss pediatric heart centers and foreign donor procurement organizations. Of these, 26/136 (19%) organs were accepted and transplanted: 18 hearts were transplanted in Switzerland, and 13 of these were foreign. Reasons for refusal were (1) no compatible recipient due to blood group or weight mismatch, 89.4%; (2) medical, meaning organ too marginal for transplantation, 7.4%; (3) logistic, 1.4%; and (4) other, 1.8%. Five organs were refused in Switzerland by one center but later accepted and successfully transplanted by another center. Hearts from outside Switzerland were transplanted significantly less than Swiss hearts (n = 16/120 vs. 10/16, p <.001). Conclusion: The most common reason for refusing a pediatric donor heart is lack of compatibility with the recipient. Few hearts are refused for medical reasons. A more generous acceptance seems to be justified in selected patients. Switzerland receives a high number of foreign offers, but their rate of acceptance is lower than that of Swiss donations. [ABSTRACT FROM AUTHOR]

Breast cancer (BRCA) is a prevalent malignancy with the highest incidence among females. BRCA can be categorized into five intrinsic molecular subtypes (LumA, LumB, HER2, Basal, and Normal), each characterized by varying molecular and clinical features determined by the expression of intrinsic genes (PAM50). The Heat Shock Protein (HSP) family is composed of 95 genes evolutionary conservated, they have critical roles in proteostasis in both normal and cancerous processes. Many studies have linked HSP to the development and spread of cancer. They modulate the activity of multiple proteins expressed by oncogenes and anti-oncogenes through a range of interactions. In this study, we evaluate the mutational changes that HSP undergoes in BRCA mainly from the TCGA database. We observe that Copy Number Variations (CNV) are the more frequent events analyzed surpassing the occurrence of point mutations, indels, and translation start site mutations. The Basal subtype showcased the highest count of amplified CNV, including subtype-specific changes, whereas the Luminals tumors accumulated the greatest number of deletion CNV. Meanwhile, the HER2 subtype exhibited a comparatively lower frequency of CNV alterations when compared to the other subtypes. This study integrates CNV and expression data, finding associations between these two variables and the influence of CNV on the deregulation of HSP expression. To enhance the role of HSP as a risk predictor in BRCA, we succeeded in identifying CNV profiles as a prognostic marker. We included Artificial Intelligence to improve the clustering of patients, and we achieved a molecular CNV signature as a significant risk factor independent of known classic markers, including molecular subtypes PAM50. This research enhances the comprehension of HSP DNA alterations in BRCA and its relation with predicting the risk of affected individuals providing insights to develop guide personalized treatment strategies. [ABSTRACT FROM AUTHOR]

Bacterial zoonoses are diseases caused by bacterial pathogens that can be naturally transmitted between humans and vertebrate animals. They are important causes of non-malarial fevers in Kenya, yet their epidemiology remains unclear. We investigated brucellosis, Q-fever and leptospirosis in the venous blood of 216 malaria-negative febrile patients recruited in two health centres (98 from Ijara and 118 from Sangailu health centres) in Garissa County in north-eastern Kenya. We determined exposure to the three zoonoses using serological (Rose Bengal test for Brucella spp., ELISA for C. burnetti and microscopic agglutination test for Leptospira spp.) and real-time PCR testing and identified risk factors for exposure. We also used non-targeted metagenomic sequencing on nine selected patients to assess the presence of other possible bacterial causes of non-malarial fevers. Considerable PCR positivity was found for Brucella (19.4%, 95% confidence intervals [CI] 14.2–25.5) and Leptospira spp. (1.7%, 95% CI 0.4–4.9), and high endpoint titres were observed against leptospiral serovar Grippotyphosa from the serological testing. Patients aged 5–17 years old had 4.02 (95% CI 1.18–13.70, p-value = 0.03) and 2.42 (95% CI 1.09–5.34, p-value = 0.03) times higher odds of infection with Brucella spp. and Coxiella burnetii than those of ages 35–80. Additionally, patients who sourced water from dams/springs, and other sources (protected wells, boreholes, bottled water, and water pans) had 2.39 (95% CI 1.22–4.68, p-value = 0.01) and 2.24 (1.15–4.35, p-value = 0.02) times higher odds of exposure to C. burnetii than those who used unprotected wells. Streptococcus and Moraxella spp. were determined using metagenomic sequencing. Brucellosis, leptospirosis, Streptococcus and Moraxella infections are potentially important causes of non-malarial fevers in Garissa. This knowledge can guide routine diagnosis, thus helping lower the disease burden and ensure better health outcomes, especially in younger populations. [ABSTRACT FROM AUTHOR]

Adding ibrutinib to standard immunochemotherapy might improve outcomes and challenge autologous stem-cell transplantation (ASCT) in younger (aged 65 years or younger) mantle cell lymphoma patients. This trial aimed to investigate whether the addition of ibrutinib results in a superior clinical outcome compared with the pre-trial immunochemotherapy standard with ASCT or an ibrutinib-containing treatment without ASCT. We also investigated whether standard treatment with ASCT is superior to a treatment adding ibrutinib but without ASCT. The open-label, randomised, three-arm, parallel-group, superiority TRIANGLE trial was performed in 165 secondary or tertiary clinical centres in 13 European countries and Israel. Patients with previously untreated, stage II–IV mantle cell lymphoma, aged 18–65 years and suitable for ASCT were randomly assigned 1:1:1 to control group A or experimental groups A+I or I, stratified by study group and mantle cell lymphoma international prognostic index risk groups. Treatment in group A consisted of six alternating cycles of R-CHOP (intravenous rituximab 375 mg/m2 on day 0 or 1, intravenous cyclophosphamide 750 mg/m2 on day 1, intravenous doxorubicin 50 mg/m2 on day 1, intravenous vincristine 1·4 mg/m2 on day 1, and oral prednisone 100 mg on days 1–5) and R-DHAP (or R-DHAOx, intravenous rituximab 375 mg/m2 on day 0 or 1, intravenous or oral dexamethasone 40 mg on days 1–4, intravenous cytarabine 2 × 2 g/m2 for 3 h every 12 h on day 2, and intravenous cisplatin 100 mg/m2 over 24 h on day 1 or alternatively intravenous oxaliplatin 130 mg/m2 on day 1) followed by ASCT. In group A+I, ibrutinib (560 mg orally each day) was added on days 1–19 of R-CHOP cycles and as fixed-duration maintenance (560 mg orally each day for 2 years) after ASCT. In group I, ibrutinib was given the same way as in group A+I, but ASCT was omitted. Three pairwise one-sided log-rank tests for the primary outcome of failure-free survival were statistically monitored. The primary analysis was done by intention-to-treat. Adverse events were evaluated by treatment period among patients who started the respective treatment. This ongoing trial is registered with ClinicalTrials.gov , NCT02858258. Between July 29, 2016 and Dec 28, 2020, 870 patients (662 men, 208 women) were randomly assigned to group A (n=288), group A+I (n=292), and group I (n=290). After 31 months median follow-up, group A+I was superior to group A with 3-year failure-free survival of 88% (95% CI 84–92) versus 72% (67–79; hazard ratio 0·52 [one-sided 98·3% CI 0–0·86]; one-sided p=0·0008). Superiority of group A over group I was not shown with 3-year failure-free survival 72% (67–79) versus 86% (82–91; hazard ratio 1·77 [one-sided 98·3% CI 0–3·76]; one-sided p=0·9979). The comparison of group A+I versus group I is ongoing. There were no relevant differences in grade 3–5 adverse events during induction or ASCT between patients treated with R-CHOP/R-DHAP or ibrutinib combined with R-CHOP/R-DHAP. During maintenance or follow-up, substantially more grade 3–5 haematological adverse events and infections were reported after ASCT plus ibrutinib (group A+I; haematological: 114 [50%] of 231 patients; infections: 58 [25%] of 231; fatal infections: two [1%] of 231) compared with ibrutinib only (group I; haematological: 74 [28%] of 269; infections: 52 [19%] of 269; fatal infections: two [1%] of 269) or after ASCT (group A; haematological: 51 [21%] of 238; infections: 32 [13%] of 238; fatal infections: three [1%] of 238). Adding ibrutinib to first-line treatment resulted in superior efficacy in younger mantle cell lymphoma patients with increased toxicity when given after ASCT. Adding ibrutinib during induction and as maintenance should be part of first-line treatment of younger mantle cell lymphoma patients. Whether ASCT adds to an ibrutinib-containing regimen is not yet determined. Janssen and Leukemia & Lymphoma Society. [ABSTRACT FROM AUTHOR]

The literature argues that successive generations have become progressively more attached to the EU, due to having experienced increasing levels of integration during their impressionable adolescent years. This generational view of EU attachment assumes that after birth cohorts have outgrown their impressionable years, they do not become more attached to the EU, regardless of period-based changes. However, newer theories of European integration emphasise period-based influences that shape EU attachment across all age cohorts, rather than solely impacting adolescents during their formative years. We use an age period cohort model with repeated cross-sectional Eurobarometer data from 1991 to 2023, showing that all EU-citizens have on average become more attached to the EU over time, rather than later-born birth cohorts being more attached to the EU based on their generational membership. Contrary to what the literature assumes, this indicates that no ‘generations of Europeans’ exist, but that EU-attachment increases for all cohorts over time. Contrary to long-standing assumptions in the literature, this indicates that efforts to increase emotional attachment to the EU can proceed faster than generational change occurs. [ABSTRACT FROM AUTHOR]

Pattern recognition systems always misclassify anomalies, which can be dangerous for uninformed users. Therefore, anomalies must be filtered out from each classification. The main challenge for the anomaly filter design is the huge number of possible anomaly samples compared with the number of samples in the training set. Tailoring the filter for the given classifier is just the first step in this reduction. Paper tests the hypothesis that the filter trained in avoiding "near" anomalies will also refuse the "far" anomalies, and the anomaly detector is then just a classifier distinguishing between "far real" and "near anomaly" samples. As a "far real" samples generator was used, a Generative Adversarial Network (GAN) fake generator that transforms normally distributed random seeds into fakes similar to the training samples. The paper proves the assumption that seeds unused in fake training will generate anomalies. These seeds are distinguished according to their Chebyshev norms. While the fakes have seeds within the hypersphere with a given radius, the near anomalies have seeds within the sphere near cover. Experiments with various anomaly test sets have shown that GAN-based anomaly detectors create a reliable anti-anomaly shield using the abovementioned assumptions. The proposed anomaly detector is tailored to the given classifier, but its limitation is due to the need for the availability of the database on which the classifier was trained. [ABSTRACT FROM AUTHOR]

Patient-reported outcomes (PROs) offer a diverse array of potential applications within medical research and clinical practice. In comparative research, they can serve as tools for delineating the trajectories of health-related quality of life (HRQoL) across various cancer types. We undertook a secondary data analysis of a cohort of 1498 hospitalized cancer patients from 13 German cancer centers. We assessed the Physical and Mental Component Scores (PCS and MCS) of the 12-Item Short-Form Health Survey at baseline (t0), 6 (t1), and 12 months (t2), using multivariable generalized linear regression models. At baseline, the mean PCS and MCS values for all cancer patients were 37.1 and 44.3 points, respectively. We observed a significant improvement in PCS at t2 and in MCS at t1. The most substantial and significant improvements were noted among patients with gynecological cancers. We found a number of significant differences between cancer types at baseline, t1, and t2, with skin cancer patients performing best across all time points and lung cancer patients performing the worst. MCS trajectories showed less pronounced changes and differences between cancer types. Comparative analyses of HRQoL scores across different cancer types may serve as a valuable tool for enhancing health literacy, both among the general public and among cancer patients themselves. [ABSTRACT FROM AUTHOR]

The Mighei‐like carbonaceous (CM) chondrites have been altered to various extents by water–rock reactions on their parent asteroid(s). This aqueous processing has destroyed much of the primary mineralogy of these meteorites, and the degree of alteration is highly heterogeneous at both the macroscale and nanoscale. Many CM meteorites are also heavily brecciated juxtaposing clasts with different alteration histories. Here we present results from the fine‐grained team consortium study of the Winchcombe meteorite, a recent CM chondrite fall that is a breccia and contains eight discrete lithologies that span a range of petrologic subtypes (CM2.0–2.6) that are suspended in a cataclastic matrix. Coordinated multitechnique, multiscale analyses of this breccia reveal substantial heterogeneity in the extent of alteration, even in highly aqueously processed lithologies. Some lithologies exhibit the full range and can comprise nearly unaltered coarse‐grained primary components that are found directly alongside other coarse‐grained components that have experienced complete pseudomorphic replacement by secondary minerals. The preservation of the complete alteration sequence and pseudomorph textures showing tochilinite–cronstedtite intergrowths are replacing carbonates suggest that CMs may be initially more carbonate rich than previously thought. This heterogeneity in aqueous alteration extent is likely due to a combination of microscale variability in permeability and water/rock ratio generating local microenvironments as has been established previously. Nevertheless, some of the disequilibrium mineral assemblages observed, such as hydrous minerals juxtaposed with surviving phases that are typically more fluid susceptible, can only be reconciled by multiple generations of alteration, disruption, and reaccretion of the CM parent body at the grain scale. [ABSTRACT FROM AUTHOR]

Winchcombe is a CM chondrite that fell in England on February 28, 2021. Its rapid retrieval was well characterized. Within two polished sections of Winchcombe, terrestrial phases were observed. Calcite and calcium sulfates were found in a sample recovered from a field on March 6, 2021, and halite was observed on a sample months after its recovery from a driveway on March 2, 2021. These terrestrial phases were characterized by scanning electron microscopy, Raman spectroscopy, and transmission electron microscopy. Calcite veins crosscut the fusion crust and therefore postdate it. The calcite likely precipitated in the damp environment (sheep field) where the meteorite lay for six days prior to its retrieval. The sulfates occur on the edges of the sample and were identified as three minerals: gypsum, bassanite, and anhydrite. Given that the sulfates occur only on the sample's edges, including on top of the fusion crust, they formed after Winchcombe fell. Sulfate precipitation is attributed to the damp fall environment, likely resulted from sulfide‐derived H2S reacting with calcite within the meteorite. Halite occurs as euhedral crystals only on the surface of a polished section and exclusively in areas relatively enriched in sodium. It was likely produced by the interaction of the polished rock slice with the humid laboratory air over a period of months. The sulfates, fusion crust calcite, and halite all post‐date Winchcombe's entry into the Earth's atmosphere and showcase how rapidly meteorite falls can be terrestrially altered. [ABSTRACT FROM AUTHOR]

Background Dietary potassium (K+) has emerged as a modifiable factor for cardiovascular and kidney health in the general population, but its role in people with chronic kidney disease (CKD) is unclear. Here, we hypothesize that CKD increases the susceptibility to the negative effects of low and high K+ diets. Methods We compared the effects of low, normal and high KChloride (KCl) diets and a high KCitrate diet for 4 weeks in male rats with normal kidney function and in male rats with CKD using the 5/6th nephrectomy model (5/6Nx). Results Compared with rats with normal kidney function, 5/6Nx rats on the low KCl diet developed more severe extracellular and intracellular K+ depletion and more severe kidney injury, characterized by nephromegaly, infiltration of T cells and macrophages, decreased estimated glomerular filtration rate and increased albuminuria. The high KCl diet caused hyperkalemia, hyperaldosteronism, hyperchloremic metabolic acidosis and severe hypertension in 5/6Nx but not in sham rats. The high KCitrate diet caused hypochloremic metabolic alkalosis but attenuated hypertension despite higher abundance of the phosphorylated sodium chloride cotransporter (pNCC) and similar levels of plasma aldosterone and epithelial sodium channel abundance. All 5/6Nx groups had more collagen deposition than the sham groups and this effect was most pronounced in the high KCitrate group. Plasma aldosterone correlated strongly with kidney collagen deposition. Conclusions CKD increases the susceptibility to negative effects of low and high K+ diets in male rats, although the injury patterns are different. The low K+ diet caused inflammation, nephromegaly and kidney function decline, whereas the high K+ diet caused hypertension, hyperaldosteronism and kidney fibrosis. High KCitrate attenuated the hypertensive but not the pro-fibrotic effect of high KCl, which may be attributable to K+-induced aldosterone secretion. Our data suggest that especially in people with CKD it is important to identify the optimal threshold of dietary K+ intake. [ABSTRACT FROM AUTHOR]

Understanding how anthropogenic activities induce changes in the functional traits of arthropod communities is critical to assessing their ecological consequences. However, we largely lack comprehensive assessments of the long‐term impact of global‐change drivers on the trait composition of arthropod communities across a large number of species and sites. This knowledge gap critically hampers our ability to predict human‐driven impacts on communities and ecosystems.Here, we use a dataset of 1.73 million individuals from 877 species to study how four functionally important traits of carabid beetles and spiders (i.e. body size, duration of activity period, tolerance to drought, and dispersal capacity) have changed at the community level across ~40 years in different types of land use and as a consequence of land use changes (that is, urbanisation and loss of woody vegetation) at the landscape scale in Switzerland.The results show that the mean body size in carabid communities declined in all types of land use, with particularly stronger declines in croplands compared to forests. Furthermore, the length of the activity period and the tolerance to drought of spider communities decreased in most land use types. The average body size of carabid communities in landscapes with increased urbanisation in the last ~40 years tended to decrease. However, the length of the activity period, the tolerance to drought, and the dispersal capacity did not change significantly. Furthermore, urbanisation promoted increases in the average dispersal capacities of spider communities. Additionally, urbanisation favoured spider communities with larger body sizes and longer activity periods. The loss of woody areas at the landscape level was associated with trait shifts to carabid communities with larger body sizes, shorter activity periods, higher drought tolerances and strongly decreased dispersal capacities. Decreases in activity periods and dispersal capacities were also found in spider communities.Our study demonstrates that human‐induced changes in land use alter key functional traits of carabid and spider communities in the long term. The detected trait shifts in arthropod communities likely have important consequences for their functional roles in ecosystems. [ABSTRACT FROM AUTHOR]

Strain-related piezoelectric polarization is detrimental to the radiative recombination efficiency for InGaN-based long wavelength micro-LEDs. In this paper, partial strain relaxation of InGaN multiple quantum wells (MQWs) on the wafer scale has been demonstrated by adopting a partially relaxed InGaN superlattice (SL) as the pseudo-substrate. Such a pseudo-substrate was obtained through an electro-chemical etching method, in which a sub-surface InGaN/InGaN superlattice was etched via threading dislocations acting as etching channels. The degree of strain relaxation in MQWs was studied by x-ray reciprocal space mapping, which shows an increase of the in-plane lattice constant with the increase of etching voltage used in fabricating the pseudo-substrate. The reduced strain in the InGaN SL pseudo-substrate was demonstrated to be transferable to InGaN MQWs grown on top of it, and the engineering of the degree of strain relaxation via porosification was achieved. The highest relaxation degree of 44.7% was achieved in the sample with the porous InGaN SL template etched under the highest etching voltage. Morphological and structural properties of partially relaxed InGaN MQWs samples were investigated with the combination of atomic force and transmission electron microscopy. The increased porosity of the InGaN SL template and the newly formed small V-pits during QW growth are suggested as possible origins for the increased strain relaxation of InGaN MQWs. [ABSTRACT FROM AUTHOR]

Using adiabatic molecular dynamics coupled with the fluid dynamics equations, we model nucleation in an expanding beam of water vapor and argon on a microsecond scale. The size distribution of clusters, their temperature, and pickup cross sections in dependence on velocity are investigated and compared to the geometric cross sections and the experiment. The clusters are warmer than the expanding gas because of the time scale of relaxation processes. We also suggest that their translational and rotational kinetic energies are modified due to evaporative cooling. The pickup cross sections determined for the final clusters using molecules of the same kind increase with decreasing velocity, still obeying the (a + b N 1 / 3 ) 2 law. [ABSTRACT FROM AUTHOR]

Context: The influence of several psychological characteristics on the willingness of athletes to report concussion behaviors has not been well explored. Therefore, the purpose of this study was to understand how athletic identity and sport passion predicted participants' willingness to report symptoms above what was explained by athlete demographics, concussion knowledge, and perceived seriousness of concussions. Design: The study was cross-sectional. Methods: Three-hundred and twenty-two male and female high school and club sport athletes completed survey measures of concussion knowledge, athletic identity, harmonious and obsessive passion, and degree to which athletes indicated they would report concussions and concussion symptoms. Results: Athletes scored moderately high on their knowledge of symptoms and other concussion information (mean = 16.21; ± = 2.88) and above the midpoint on their attitudes and behaviors toward reporting concussion symptoms (mean = 3.64; ± = 0.70). There were no differences between gender, t(299) = −.78, P =.44, and previous concussion education, t(296) = 1.93, P =.06, related to concussion knowledge. Results of a hierarchical regression indicated that after entering athlete demographics, concussion knowledge, and perceived seriousness of concussions, of the 3 psychological variables in the final stage of the model, only obsessive passion was a significant predictor of athlete's attitudes to report a concussion. Conclusions: Perceived seriousness of concussion, perceived threat to long-term health, and obsessive passion were the strongest predictors of athlete's willingness to report concussions. Athletes who did not believe concussions posed a threat to their current or future health, and those that held an obsessive passion for sport were most at risk for not reporting concussions. Future research should continue to investigate the relationship between reporting behaviors and psychological factors. [ABSTRACT FROM AUTHOR]

Many state-of-the art machine learning (ML) interatomic potentials are based on a local or semi-local (message-passing) representation of chemical environments. They, therefore, lack a description of long-range electrostatic interactions and non-local charge transfer. In this context, there has been much interest in developing ML-based charge equilibration models, which allow the rigorous calculation of long-range electrostatic interactions and the energetic response of molecules and materials to external fields. The recently reported kQEq method achieves this by predicting local atomic electronegativities using Kernel ML. This paper describes the q-pac Python package, which implements several algorithmic and methodological advances to kQEq and provides an extendable framework for the development of ML charge equilibration models. [ABSTRACT FROM AUTHOR]

Clinical Scenario: Knee osteoarthritis (KOA) is a complex progressive synovial joint disease that results in impaired muscle function, including a considerable loss of maximal strength and power. Exercise therapies, such as sensorimotor or balance training and resistance training, are frequently used to improve muscle function, mobility, and quality of life, but their impact on maximal muscle strength in patients with KOA is not well understood. Focused Clinical Question: Does sensorimotor or balance training improve knee-extensor and knee-flexor maximal muscle strength compared with strength training or no intervention in patients with KOA? Summary of Key Findings: Results from 4 fair- to good-quality randomized controlled/clinical trials (level 1b) revealed inconsistent grade B evidence regarding the effect of sensorimotor or balance training to improve knee-extensor and knee-flexor maximal muscle strength in patients with KOA. Two studies, one good-quality study and one fair-quality study, showed significant strength improvements, and 2 good-quality studies demonstrated no significant strength enhancements. Clinical Bottom Line: Sensorimotor or balance training may be useful to improve maximal strength of quadriceps and hamstring muscle groups in patients with KOA; however, it seems that this depends on a training duration of at least 8 weeks and the use of unstable devices to induce destabilization of patients' balance, initiating neuromuscular adaptations. Strength of Recommendation: Due to inconsistent evidence (grade B), the true effect of sensorimotor or balance training to improve knee-extensor and knee-flexor maximal muscle strength in patients with KOA remains unclear and needs to be further investigated. [ABSTRACT FROM AUTHOR]