Evidence of striped electronic phases in a structurally modulated superlattice.

The electronic properties of crystals can be manipulated by superimposing spatially periodic electric, magnetic or structural modulations. Long-wavelength modulations incommensurate with the atomic lattice are particularly interesting1, exemplified by recent advances in two-dimensional (2D) moiré materials2,3. Bulk van der Waals (vdW) superlattices4-8 hosting 2D interfaces between minimally disordered layers represent scalable bulk analogues of artificial vdW heterostructures and present a complementary venue to explore incommensurately modulated 2D states. Here we report the bulk vdW superlattice SrTa2S5 realizing an incommensurate one-dimensional (1D) structural modulation of 2D transition metal dichalcogenide (TMD) H-TaS2 layers. High-quality electronic transport in the H-TaS2 layers, evidenced by quantum oscillations, is made anisotropic by the modulation and exhibits commensurability oscillations paralleling lithographically modulated 2D systems9-11. We also find unconventional, clean-limit superconductivity in SrTa2S5 with a pronounced suppression of interlayer relative to intralayer coherence. The in-plane magnetic field dependence of interlayer critical current, together with electron diffraction from the structural modulation, suggests superconductivity12-14 in SrTa2S5 is spatially modulated and mismatched between adjacent TMD layers. With phenomenology suggestive of pair-density wave superconductivity15-17, SrTa2S5 may present a pathway for microscopic evaluation of this unconventional order18-21. More broadly, SrTa2S5 establishes bulk vdW superlattices as versatile platforms to address long-standing predictions surrounding modulated electronic phases in the form of nanoscale vdW devices12,13 to macroscopic crystals22,23.

Obesity and abdominal hernia in ambulatory patients, 2018-2023.

PURPOSE: To determine the relationship between abdominal hernia and obesity. Although obesity is frequently cited as a risk factor for abdominal hernia, few studies have confirmed this association (Menzo et al. Surg Obes Relat Dis 14:1221-1232. 10.1016/j.soard.2018.07.005, 2018). METHODS: A cross-sectional study of primary care ambulatory patients aged older than 16 years treated at UCLA Health from 01/01/2018 to 06/06/2023. Abdominal hernia was identified by clinic encounter ICD-10 codes (K40-K46). RESULTS: There were 41,703 hernias identified among 1,362,440 patients (306.1 per10,000) with a mean age of 62.5 ± 16.1 years, and 57.6% were men. Nearly half (44.7%) of all abdominal hernias were diaphragmatic. There was an approximately equal distribution of the ventral (28.7%) and inguinal (24.3%) hernia. Each hernia type had a different relationship with obesity: The odds of having a ventral hernia increased with BMI in both sexes: BMI 25-29.9 kg/m2 odds ratio (OR) = 1.65, (CI 1.56-1.74); BMI 30-39.9 kg/m2 OR = 2.42 (CI 2.29-2.56), BMI 40-49.9 kg/m2 OR = 2.28 (CI 2.05-2.54) and BMI > = 50 kg/m2 OR = 2.54 (CI 2.03-3.17) all relative to normal BMI. In contrast, the odds of having an inguinal hernia decreased with obesity relative to normal weight [obesity (BMI 30-39.9 kg/m2): OR = 0.60 (CI 0.56-0.65)], morbid obesity (BMI 40-49.9 kg/m2): OR = 0.29 (CI 0.23-0.37). The OR for diaphragmatic hernia peaks with obesity in women and overweight status in men but was found to decrease with morbid obesity [OR = 1.18 (CI 1.07-1.30)]. There was no significant difference between men and women in the prevalence of femoral hernia (men: 0.7/per10,000, women: 0.9/per10,000, p = 0.19). CONCLUSIONS: The relationship between hernia and obesity is complex with some hernias decreasing in prevalence as obesity increases. Further research is needed to better understand this paradoxical relationship.

Leprosy in Britain: 50 years experience in Liverpool

BACKGROUND: Leprosy is a chronic infection that presents with varying dermal and neurological symptoms, and which can lead to extensive disability and morbidity, often with accompanying social stigma. AIM: To review the patients presenting to the Liverpool School of Tropical Medicine (LSTM) between 1946 and 2003, looking specifically at country of birth and of infection, details of clinical presentation, diagnosis, management and reactions. DESIGN: Retrospective record review. METHODS: We retrieved all available clinical records for patients seen between 1946 and 2003 (n = 50), consisting of letters, hospital and LSTM casenotes, and some radiographs and photographs. Any history of tuberculosis or diabetes was recorded. RESULTS: Most patients (64%) were born in the Indian subcontinent, and most were thought to have contracted the disease there (62%). Features at presentation included anaesthetic skin lesions in 19 (36%), hypopigmentation in 15 (30%), and peripheral nerve enlargement in 25 (50%). Diagnoses were made by a combination of clinical data and biopsy (60%), and slit skin smears were positive for acid-fast bacilli in 61% of multibacillary patients. Initial presentation was with a leprosy reaction in five cases (10%), and reactions were documented in 42% of all patients. Treatments were varied, progressing from traditional Eastern medicine to the WHO-approved multidrug therapy in use today, with prophylaxis for children and close contacts. DISCUSSION: Leprosy remains an important diagnosis to consider in patients with a history of work or travel in the tropics, and is a diagnosis with far-reaching medical, social and emotional consequences.