Proposal for All-Electrical Skyrmion Detection in van der Waals Tunnel Junctions.

A major challenge for magnetic skyrmions in atomically thin van der Waals (vdW) materials is reliable skyrmion detection. Here, based on rigorous first-principles calculations, we show that all-electrical skyrmion detection is feasible in two-dimensional vdW magnets via scanning tunneling microscopy (STM) and in planar tunnel junctions. We use the nonequilibrium Green's function method for quantum transport in planar junctions, including self-energy due to electrodes and working conditions, going beyond the standard Tersoff-Hamann approximation. We obtain a very large tunneling anisotropic magnetoresistance (TAMR) around the Fermi energy for a graphite/Fe3GeTe2/germanene/graphite vdW tunnel junction. For atomic-scale skyrmions, the noncollinear magnetoresistance (NCMR) reaches giant values. We trace the origin of the NCMR to spin mixing between spin-up and -down states of pz and dz2 character at the surface atoms. Both TAMR and NCMR are drastically enhanced in tunnel junctions with respect to STM geometry due to orbital symmetry matching at the interface.

Diboraperylene Diborinic Acid Self-Assembly on Ag(111)-Kagome Flat Band Localized States Imaged by Scanning Tunneling Microscopy and Spectroscopy.

Replacement of sp2-hybridized carbon in polycyclic aromatic hydrocarbons (PAHs) by boron affords electron-deficient π-scaffolds due to the vacant pz-orbital of three-coordinate boron with the potential for pronounced electronic interactions with electron-rich metal surfaces. Using a diboraperylene diborinic acid derivative as precursor and a controlled on-surface non-covalent synthesis approach, we report on a self-assembled chiral supramolecular kagome network on an Ag(111) surface stabilized by intermolecular hydrogen-bonding interactions at low temperature. Scanning tunneling microscopy (STM) and spectroscopy (STS) reveal a flat band at ca. 0.33 eV above the Fermi level which is localized at the molecule center, in good agreement with tight-binding model calculations of flat bands characteristic for kagome lattices.

Controlled Formation of Porous 2D Lattices from C3 -symmetric Ph6 -Me-Tribenzotriquinacene-OAc3.

The on-surface self-assembly of molecules to form holey nanographenes is a promising approach to control the properties of the resulting 2D lattice. Usually, planar molecules are utilized to prepare flat, structurally confined molecular layers, with only a few recent examples of warped precursors. However, control of the superstructures is limited thus far. Herein, we report the temperature-controlled self-assembly of a bowl-shaped, acetylated C3 -symmetric hexaphenyltribenzotriquinacene derivative on Cu(111). Combining scanning tunneling microscopy (STM) and density functional theory (DFT) confirms the formation of highly differing arrangements starting with π-stacked bowl-to-bowl dimers at low coverage at room temperature via chiral honeycomb structures, an intermediate trigonal superstructure, followed by a fully carbon-based, flattened hexagonal superstructure formed by on-surface deacetylation, which is proposed as a precursor for holey graphene networks with unique defect structures.

Investigating PSMA-PET/CT to resolve prostate MRI PIRADS4-5 and negative biopsy discordance.

BACKGROUND: To determine the utility of diagnostic 18F-DCPyL PSMA-PET/CT to aid management of men with highly suspicious multiparametric MRI prostate (PIRAD 4-5 lesions) and discrepant negative prostate biopsy. METHODS: A multicentre prospective consecutive case series was conducted (2018-2021), recruiting men with prior mpMRI prostate PIRADS 4-5 lesions and negative prostate biopsy. All men had 18F-DCPyL PSMA-PET/CT with subsequent management based on the concordance between MRI and PET: (1) Concordant lesions were biopsied using in-bore MRI targeting; (2) PSMA-PET/CT avidity without MRI correlate were biopsied using cognitive/software targeting with ultrasound guidance and (3) Patients with negative PET/CT were returned to standard of care follow-up. RESULTS: 29 patients were recruited with 48% (n = 14) having concordant MRI/PET abnormalities. MRI targeted biopsy found prostate cancer in six patients, with grade groups GG3 (n = 1), GG2 (n = 1), GG1 (n = 4) found. Of the 20 men who PSMA-PET/CT avidity and biopsy, analysis showed higher SUVmax (20.1 vs 6.8, p = 0.036) predicted prostate cancer. Of patients who had PSMA-PET avidity without MRI correlate, and those with no PSMA-PET avidity, only one patient was subsequently found to have prostate cancer (GG1). The study is limited by small size and short follow-up of 17 months (IQR 12.5-29.9). CONCLUSIONS: PSMA-PET/CT is useful in this group of men but requires further investigation. Avidity (higher SUVmax) that correlates to the mpMRI prostate lesion should be considered for targeted biopsy.

The frailty index based on laboratory test data as a tool to investigate the impact of frailty on health outcomes: a systematic review and meta-analysis.

The frailty index (FI) quantifies frailty as deficit accumulation. It has been adapted to employ laboratory test data (FI-Lab). Our objective was to systematically review and meta-analyse the FI-Lab's ability to predict mortality. Secondary objectives were to review the FI-Lab's association with adverse health outcomes and whether FI-Lab scores differed between the sexes. A systematic literature search was carried out using six online databases to identify studies that measured the FI-Lab in humans. Hazard ratios (HRs) were combined in a meta-analysis to create a pooled risk estimate for mortality. Of the 1,201 papers identified, spanning January 2010 until 11 July 2022, 38 were included. FI-Lab scores per 0.01 unit increase predicted mortality overall (HR = 1.04; 95% confidence interval (CI) = 1.03-1.05) and for studies with a mean age of 81+ years (HR = 1.04; 95% CI = 1.03-1.05). The quality of evidence for these meta-analyses are moderate and high, respectively. Further, higher FI-Lab scores were associated with more frequent adverse health outcomes. Sex differences in FI-Lab scores varied, with no consistent indication of a sex effect. The FI-Lab is associated with mortality and with a variety of adverse health outcomes. No consistent sex differences in FI-Lab scores were observed, with several studies in disagreement. Notably, these conclusions were most relevant to older (65+ years old) individuals; further evidence in younger people is needed in both clinical and population representative studies.

Strain-Driven Zero-Field Near-10 nm Skyrmions in Two-Dimensional van der Waals Heterostructures.

Magnetic skyrmions─localized chiral spin structures─show great promise for spintronic applications. The recent discovery of two-dimensional (2D) magnets opened new opportunities for topological spin structures in atomically thin van der Waals (vdW) materials. Despite recent progress in stabilizing metastable skyrmions in 2D magnets, their lifetime, essential for applications, has not been explored yet. Here, using first-principles calculations and atomistic spin simulations, we predict that compressive strain leads to stabilizing zero-field skyrmions with diameters close to 10 nm in a Fe3GeTe2/germanene vdW heterostructure. The origin of these unique skyrmions is attributed to the high tunability of Dzyaloshinskii-Moriya interaction and magnetocrystalline anisotropy energy by strain, which generally holds for Fe3GeTe2 heterostructures with buckled substrates. Furthermore, we calculate the energy barriers protecting skyrmions against annihilation and their lifetimes using transition-state theory. We show that nanoscale skyrmions in strained Fe3GeTe2/germanene can be stable for hours at temperatures up to 20 K.

Molecular Chains: Arranging and Programming Logic Gates.

One particularly fascinating vision for charge-operated devices is the controlled assembly of structures from single surface-deposited molecules. Here, we report on the assembly of linear clusters that consist of phthalocyanine (H2Pc) molecules on a Ag(111) surface. The molecules are imaged as well as manipulated with a low-temperature scanning tunneling microscope (STM). Upon deprotonation of every second H2Pc, the resulting HPc molecule exhibits an isomeric bistability which can be used as inputs in logic gates. Combining our STM measurements with density functional theory calculations we show that the HPc isomers exhibit a repulsive electrostatic interaction with adjacent H2Pc molecules which, due to the asymmetric charge distribution on HPc, results in a counterclockwise or clockwise molecule tilt of the latter, thereby defining the logic 0 and 1 of the output. It is shown that information can be relayed along molecule chains over distances equivalent to at least nine molecules.

Discovery of Magnetic Single- and Triple-q States in Mn/Re(0001).

We experimentally verify the existence of two model-type magnetic ground states that were previously predicted but so far unobserved. We find them in Mn monolayers on the Re(0001) surface using spin-polarized scanning tunneling microscopy. For fcc stacking of Mn the collinear row-wise antiferromagnetic state occurs, whereas for hcp Mn a three-dimensional spin structure appears, which is a superposition of three row-wise antiferromagnetic states known as the triple-q state. Density-functional theory calculations elucidate the subtle interplay of different magnetic interactions to form these spin structures and provide insight into the role played by relativistic effects.

Electrical Detection of Domain Walls and Skyrmions in Co Films Using Noncollinear Magnetoresistance.

A large noncollinear magnetoresistance (NCMR) is observed for Rh/Co atomic bilayers on Ir(111) using scanning tunneling microscopy and spectroscopy. The effect is 20% at the Fermi energy and large in a broad energy range. The NCMR can be used to electrically detect nanometer-scale domain walls and skyrmions directly in the tunnel current without the need for a differential measurement. The NCMR results from changes in the density of states of noncollinear spin textures with respect to the ferromagnetic state. Density functional theory calculations reveal that they originate from spin mixing between majority d_{xz} and minority p_{z} states.

Implications of the diagnostic criteria of idiopathic pulmonary fibrosis in clinical practice: Analysis from the Australian Idiopathic Pulmonary Fibrosis Registry.

BACKGROUND AND OBJECTIVE: Current guidelines for the diagnosis of idiopathic pulmonary fibrosis (IPF) provide specific criteria for diagnosis in the setting of multidisciplinary discussion (MDD). We evaluate the utility and reproducibility of these diagnostic guidelines, using clinical data from the Australian IPF Registry. METHODS: All patients enrolled in the registry undergo a diagnostic review whereby international IPF guidelines are applied via a registry MDD. We investigated the clinical applicability of these guidelines with regard to: (i) adherence to guidelines, (ii) Natural history of IPF diagnostic categories and (iii) Concordance for diagnostic features. RESULTS: A total of 417 participants (69% male, 70.6 ± 8.0 years) with a clinical diagnosis of IPF underwent MDD. The 23% of participants who did not meet IPF diagnostic criteria displayed identical disease behaviour to those with confirmed IPF. Honeycombing on radiology was associated with a worse prognosis and this translated into poorer prognosis in the 'definite' IPF group. While there was moderate agreement for IPF diagnostic categories, agreement for specific radiological features, other than honeycombing, was poor. CONCLUSION: In clinical practice, physicians do not always follow IPF diagnostic guidelines. We demonstrate a cohort of IPF patients who do not meet IPF diagnostic guideline criteria, based largely on their radiology and lack of lung biopsy, but who have outcomes identical to those with IPF.

Competition of Dzyaloshinskii-Moriya and Higher-Order Exchange Interactions in Rh/Fe Atomic Bilayers on Ir(111).

Using spin-polarized scanning tunneling microscopy and density functional theory we demonstrate the occurrence of a novel type of noncollinear spin structure in Rh/Fe atomic bilayers on Ir(111). We find that higher-order exchange interactions depend sensitively on the stacking sequence. For fcc-Rh/Fe/Ir(111), frustrated exchange interactions are dominant and lead to the formation of a spin spiral ground state with a period of about 1.5 nm. For hcp-Rh/Fe/Ir(111), higher-order exchange interactions favor an up-up-down-down (↑↑↓↓) state. However, the Dzyaloshinskii-Moriya interaction at the Fe/Ir interface leads to a small angle of about 4° between adjacent magnetic moments resulting in a canted ↑↑↓↓ ground state.

CT-Fluoroscopic Guidance for Performance of Targeted Transbronchial Cryobiopsy: A Preliminary Report.

BACKGROUND: Bronchoscopic transbronchial cryobiopsy is increasingly used for the histological assessment of diffuse parenchymal lung disease. Diagnostic performance may be improved by more accurate targeting of biopsy to radiologic abnormalities, and complication rates may be reduced by avoiding biopsy of pleura or larger vessels. OBJECTIVES: To report the preliminary experience of using CT-fluoroscopic guidance for accurate targeting of bronchoscopic transbronchial cryobiopsy. METHODS: Bronchoscopic cryobiopsy was performed in a hybrid CT theatre. 3D CT images were acquired following positioning of the cryoprobe in a distal airway segment. Where cryoprobe position was observed to be too close to the chest wall/diaphragm pleura, or not within the region of interest within the lung parenchyma, re-positioning of probe was undertaken and repeat 3D images were acquired to confirm positioning prior to cryobiopsy. RESULTS: CT-fluoroscopic transbronchial cryobiopsy was successfully performed in 4 patients: 3 patients with interstitial lung infiltrates, and one with an enlarging left upper lobe mass. Images were reviewed following each acquisition to accurately assess the probe position within the lung parenchyma, and relative to other thoracic structures. Intra-procedural imaging was of sufficient quality to allow the accurate positioning of the cryoprobe tip with respect to both the parenchymal region of interest and pleural surfaces. No complications were experienced, and all procedures yielded diagnostic specimens. CONCLUSIONS: Our preliminary experience confirms the feasibility of performing transbronchial cryobiopsy under CT-fluoroscopic guidance. Accurate targeting of transbronchial cryobiopsy may be achieved using CT-fluoroscopic guidance. Positioning of the probe tip, both with respect to parenchymal region of interest and to pleural surfaces, can be established with high accuracy.

Competing Forces during Contact Formation between a Tip and a Single Molecule.

Sn-phthalocyanine adsorbs on Ag(111) in a physisorbed or a chemisorbed configuration. Both structures are contacted with the tip of a combined scanning tunneling and atomic force microscope. The tunneling conductances of both configurations exhibit similar exponential variations with the tip-molecule distance. The short-range forces, however, display nontrivial distance dependencies. First-principles calculations reproduce the experimental results. Both attractive and repulsive interactions occur between the tip and different parts of the molecule due to a combination of bond formation and electrostatic interactions with the tip electric dipole. Consequently, deformations occur and the force varies in the resulting unexpected fashion.

Single electron charge sensitivity of liquid-gated carbon nanotube transistors.

Random telegraph signals corresponding to activated charge traps were observed with liquid-gated CNT FETs. The high signal-to-noise ratio that we observe demonstrates that single electron charge sensing is possible with CNT FETs in liquids at room temperature. We have characterized the gate-voltage dependence of the random telegraph signals and compared to theoretical predictions. The gate-voltage dependence clearly identifies the sign of the activated trapped charge.

Exercise Programming Modelling a Standard of Care Approach Improves Physical Health and Patient-Reported Outcomes in Individuals Living with Breast Cancer: A Pilot Study.

Controlled study designs widely report that exercise improves the health of individuals living with breast cancer. Still, many individuals living with breast cancer are not active enough to experience the benefits of exercise. The Activating Cancer Communities through an Exercise Strategy for Survivors study was developed to reach more individuals living with cancer. This report describes the effects of a 12-week individualized exercise program that models a standard-of-care approach on body composition, physical fitness, and patient-reported outcomes in individuals living with breast cancer. Individuals living with breast cancer were recruited for the study and completed an exercise program twice weekly overseen by a Clinical Exercise Physiologist. A total of 43 participants completed the exercise intervention, and 36 withdrew from the study. All participants had significantly improved aerobic fitness, waist circumference, hip circumference, lower body endurance, physical activity behaviour, health-related quality of life, emotional status, and fatigue levels after completing the program. Flexibility, balance, and sleep scores did not change. The results from the 12-week individualized exercise program largely align with the results from more controlled study designs. These results support future initiatives integrating exercise therapy into the standard of care for individuals living with breast cancer.

Impact of Different Artificial Intelligence User Interfaces on Lung Nodule and Mass Detection on Chest Radiographs.

Purpose: To explore the impact of different user interfaces (UIs) for artificial intelligence (AI) outputs on radiologist performance and user preference in detecting lung nodules and masses on chest radiographs. Materials and Methods: A retrospective paired-reader study with a 4-week washout period was used to evaluate three different AI UIs compared with no AI output. Ten radiologists (eight radiology attending physicians and two trainees) evaluated 140 chest radiographs (81 with histologically confirmed nodules and 59 confirmed as normal with CT), with either no AI or one of three UI outputs: (a) text-only, (b) combined AI confidence score and text, or (c) combined text, AI confidence score, and image overlay. Areas under the receiver operating characteristic curve were calculated to compare radiologist diagnostic performance with each UI with their diagnostic performance without AI. Radiologists reported their UI preference. Results: The area under the receiver operating characteristic curve improved when radiologists used the text-only output compared with no AI (0.87 vs 0.82; P < .001). There was no difference in performance for the combined text and AI confidence score output compared with no AI (0.77 vs 0.82; P = .46) and for the combined text, AI confidence score, and image overlay output compared with no AI (0.80 vs 0.82; P = .66). Eight of the 10 radiologists (80%) preferred the combined text, AI confidence score, and image overlay output over the other two interfaces. Conclusion: Text-only UI output significantly improved radiologist performance compared with no AI in the detection of lung nodules and masses on chest radiographs, but user preference did not correspond with user performance.Keywords: Artificial Intelligence, Chest Radiograph, Conventional Radiography, Lung Nodule, Mass Detection© RSNA, 2023.

Electrically tunable quantum anomalous Hall effect in graphene decorated by 5d transition-metal adatoms.

Based on first-principles calculations, we predict that 5d transition metals on graphene present a unique class of hybrid systems exhibiting topological transport effects that can be manipulated effectively by external electric fields. The origin of this phenomenon lies in the exceptional magnetic properties and the large spin-orbit interaction of the 5d metals leading to significant magnetic moments accompanied with colossal magnetocrystalline anisotropy energies. A strong magnetoelectric response is predicted that offers the possibility to switch the spontaneous magnetization direction by moderate electric fields, enabling an electrically tunable quantum anomalous Hall effect.

Information transfer by vector spin chirality in finite magnetic chains.

Vector spin chirality is one of the fundamental characteristics of complex magnets. For a one-dimensional spin-spiral state it can be interpreted as the handedness, or rotational sense of the spiral. Here, using spin-polarized scanning tunneling microscopy, we demonstrate the occurrence of an atomic-scale spin spiral in finite individual bi-atomic Fe chains on the (5×1)-Ir(001) surface. We show that the broken inversion symmetry at the surface promotes one direction of the vector spin chirality, leading to a unique rotational sense of the spiral in all chains. Correspondingly, changes in the spin direction of one chain end can be probed tens of nanometers away, suggesting a new way of transmitting information about the state of magnetic objects on the nanoscale.

Evaluating the diagnostic role of in-bore magnetic resonance imaging guided prostate biopsy: a single-centre study.

BACKGROUND: To evaluate the role of in-bore MRI-guided biopsy (IB-MRGB) in the diagnosis of clinically significant prostate cancer (csPCa). METHODS: In this tertiary single centre study, a total of 125 consecutive patients receiving IB-MRGB over a three-year period were evaluated, including 73 patients who had prior biopsies and 52 biopsy-naïve patients. We assessed cancer detection rate of patients according to the degree of suspicion based on mpMRI findings. Histopathological data were reviewed by experienced uropathologists. RESULTS: The mpMRI was suspicious for PCa (PI-RADS 4/5) in 77% (96/125) and equivocal (PI-RADS 3) in 23% (29/125). The detection rate for csPCa was 54.2% (52/96) and 20.7% (6/29) for suspicious lesions (PI-RADS 4/5) and equivocal lesions (PI-RADS 3), respectively. In subgroup analysis, patients with previous negative biopsy, overall positive biopsy rate and csPCa detection rate were 48.3% (19/35) and 34.5% (13/35), respectively. In patients on AS, 36/44 (81.8%) and 21/44 (47.8%) had PCa and csPCa respectively. In biopsy-naïve patients 34/52 (65.4%) and 27/52 (51.92%) had PCa and csPCa respectively. Of the patients on AS, 18/44 (41.6%) upgraded from ISUP 1 to ISUP 2 PCa, and 4/44 (9.1%) upgraded from ISUP 1 to ISUP 3 PCa on IB-MRGB. A total of 14 Clavien-Dindo≤2 complications occurred in 14 patients (11.2%) that were directly related to the biopsy. No Clavien-Dindo≥3 complications occurred. CONCLUSION: MRI-targeted biopsy is suitable for assessment of csPCa. Given the favourable complications profile, its use may be considered in both the initial biopsy and re-biopsy settings.

Nano-scale collinear multi-Q states driven by higher-order interactions.

Complex magnetic order arises due to the competition of different interactions between the magnetic moments. Recently, there has been an increased interest in such states not only to unravel the fundamental physics involved, but also with regards to applications exploiting their unique interplay with moving electrons. Whereas it is the Dzyaloshinskii-Moriya interaction (DMI) that has attracted much attention because of its nature to induce non-collinear magnetic order including magnetic-field stabilized skyrmions, it is the frustration of exchange interactions that can drive magnetic order down to the nano-scale. On top of that, interactions between multiple spins can stabilize two-dimensional magnetic textures as zero-field ground states, known as multi-Q states. Here, we introduce a two-dimensional itinerant magnet with various competing atomic-scale magnetic phases. Using spin-polarized scanning tunneling microscopy we observe several zero-field uniaxial or hexagonal nano-scale magnetic states. First-principles calculations together with an atomistic spin model reveal that these states are stabilized by the interplay of frustrated exchange and higher-order interactions while the DMI is weak. Unexpectedly, it is found that not only non-collinear magnetic states arise, but that higher-order interactions can also lead to collinear nano-scale multi-Q states.