Clinical Characteristics and Management of Children and Adolescents Hospitalized With Pyomyositis.

BACKGROUND: Pyomyositis, a bacterial muscle infection, is an important differential diagnosis in children and adolescents with musculoskeletal pain. In contrast to tropical regions, it is rarely recognized in temperate countries, but incidence is increasing and major studies are missing. METHODS: This retrospective multicenter study included patients <18 years of age hospitalized with pyomyositis in 11 Swiss children's hospitals between January 2010 and December 2022. Cases were identified by ICD-10 code (Myositis; M60-M60.9), and data was extracted from electronic hospital records. RESULTS: Of 331 patients identified, 102 fulfilled the case definition. Patient age at presentation ranged from 2 weeks to 17 years (median 8 years). The majority had no underlying illness and all presented with fever and localized pain. At the respective site of pyomyositis, 100 (98%) had impaired movement and 39 (38%) presented with local swelling. Pelvic (57%) and leg (28%) muscles were mostly affected. Blood or tissue cultures were obtained in 94 (92%) and 59 (57%) patients, respectively. Of those, 55 (58%) blood and 52 (88%) tissue cultures were positive, mainly for Staphylococcus aureus (35 and 19, respectively) and Streptococcus pyogene s (12 and 15, respectively). All patients received antibiotic treatment during hospitalization for a median of 10 days (interquartile range: 7-17), followed by outpatient treatment for a further median of 16 days (interquartile range: 11-22) in 95 (93%) patients. Fifty-nine (57%) patients required surgery. CONCLUSIONS: Pyomyositis is a challenging diagnosis that requires a high level of awareness. Blood and/or tissue cultures revealed S. aureus and S. pyogenes as the predominant causative agents.

Evaluation of Acoustophoretic and Dielectrophoretic Forces for Droplet Injection in Droplet-Based Microfluidic Devices.

Acoustophoretic forces have been successfully implemented into droplet-based microfluidic devices to manipulate droplets. These acoustophoretic forces in droplet microfluidic devices are typically generated as in acoustofluidic devices through transducer actuation of a piezoelectric substrate such as lithium niobate (LiNbO3), which is inherently accompanied by the emergence of electrical fields. Understanding acoustophoretic versus dielectrophoretic forces produced by electrodes and transducers within active microfluidic devices is important for the optimization of device performance during design iterations. In this case study, we design microfluidic devices with a droplet injection module and report an experimental strategy to deduce the respective contribution of the acoustophoretic versus dielectrophoretic forces for the observed droplet injection. Our PDMS-based devices comprise a standard oil-in-water droplet-generating module connected to a T-junction injection module featuring actuating electrodes. We use two different electrode geometries produced within the same PDMS slab as the droplet production/injection channels by filling low-melting-point metal alloy into channels that template the electrode geometries. When these electrodes are constructed on LiNbO3 as the substrate, they have a dual function as a piezoelectric transducer, which we call embedded liquid metal interdigitated transducers (elmIDTs). To decipher the contribution of acoustophoretic versus dielectrophoretic forces, we build the same devices on either piezoelectric LiNbO3 or nonpiezo active glass substrates with different combinations of physical device characteristics (i.e., elmIDT geometry and alignment) and operate in a range of phase spaces (i.e., frequency, voltage, and transducer polarity). We characterize devices using techniques such as laser Doppler vibrometry (LDV) and infrared imaging, along with evaluating droplet injection for our series of device designs, constructions, and operating parameters. Although we find that LiNbO3 device designs generate acoustic fields, we demonstrate that droplet injection occurs only due to dielectrophoretic forces. We deduce that droplet injection is caused by the coupled dielectrophoretic forces arising from the operation of elmIDTs rather than by acoustophoretic forces for this specific device design. We arrive at this conclusion because equivalent droplet injection occurs without the presence of an acoustic field using the same electrode designs on nonpiezo active glass substrate devices. This work establishes a methodology to pinpoint the major contributing force of droplet manipulation in droplet-based acoustomicrofluidics.

How do medical professionals make sense (or not) of AI? A social-media-based computational grounded theory study and an online survey.

To investigate opinions and attitudes of medical professionals towards adopting AI-enabled healthcare technologies in their daily business, we used a mixed-methods approach. Study 1 employed a qualitative computational grounded theory approach analyzing 181 Reddit threads in the several subreddits of r/medicine. By utilizing an unsupervised machine learning clustering method, we identified three key themes: (1) consequences of AI, (2) physician-AI relationship, and (3) a proposed way forward. In particular Reddit posts related to the first two themes indicated that the medical professionals' fear of being replaced by AI and skepticism toward AI played a major role in the argumentations. Moreover, the results suggest that this fear is driven by little or moderate knowledge about AI. Posts related to the third theme focused on factual discussions about how AI and medicine have to be designed to become broadly adopted in health care. Study 2 quantitatively examined the relationship between the fear of AI, knowledge about AI, and medical professionals' intention to use AI-enabled technologies in more detail. Results based on a sample of 223 medical professionals who participated in the online survey revealed that the intention to use AI technologies increases with increasing knowledge about AI and that this effect is moderated by the fear of being replaced by AI.

Probing the role of surface termination in the adsorption of azupyrene on copper.

The role of the inorganic substrate termination, within the organic-inorganic interface, has been well studied for systems that contain strong localised bonding. However, how varying the substrate termination affects coordination to delocalised electronic states, like that found in aromatic molecules, is an open question. Azupyrene, a non-alternant polycyclic aromatic hydrocarbon, is known to bind strongly to metal surfaces through its delocalised π orbitals, thus yielding an ideal probe into delocalised surface-adsorbate interactions. Normal incidence X-ray standing wave (NIXSW) measurements and density functional theory calculations are reported for the adsorption of azupyrene on the (111), (110) and (100) surface facets of copper to investigate the dependence of the adsorption structure on the substrate termination. Structural models based on hybrid density functional theory calculations with non-local many-body dispersion yield excellent agreement with the experimental NIXSW results. No statistically significant difference in the azupyrene adsorption height was observed between the (111) and (100) surfaces. On the Cu(110) surface, the molecule was found to adsorb 0.06 ± 0.04 Å closer to the substrate than on the other surface facets. The most energetically favoured adsorption site on each surface, as determined by DFT, is subtly different, but in each case involved a configuration where the aromatic rings were centred above a hollow site, consistent with previous reports for the adsorption of small aromatic molecules on metal surfaces.

What constitutes victims of toxicity - identifying drivers of toxic victimhood in multiplayer online battle arena games.

Introduction: Toxic behavior (i.e., toxicity) is a pervasive problem in online gaming communities such as League of Legends. This issue arises from factors such as frustrating and stressful in-game experiences and online disinhibition. Prior research on addressing toxicity has focused primarily on the perpetrators and how to mitigate their negative behavior and the consequences. The aim of this study was to approach toxicity from the perspective of the victims instead, and consequently, to investigate the factors that contribute to the experience of victimhood in multiplayer online battle arena games. Methods: A global sample of League of Legends and Defense of the Ancients 2 players (n=313) was collected to test hypotheses based on three theoretical approaches drawn from previous work, namely, the online disinhibition effect, social cognitive theory and theory of planned behavior. Participants were asked to complete a survey that included variables related to the three theoretical approaches. Results: The results of the study indicated that self-efficacy, and benign and toxic disinhibition, were the most relevant antecedents for the experience of being a victim of toxicity. Accordingly, the findings thus suggest that players with low self-efficacy and high online disinhibition may be more likely to experience victimhood in multiplayer online battle arena games. In general, insights based on our study demonstrate that individual characteristics partially explain why some players are more susceptible to toxic behavior than others. Discussion: The study's results have practical implications for game developers and policymakers, particularly in the areas of community management and player education. For example, game developers may consider incorporating self-efficacy training and disinhibition reduction programs into their games. Overall, this study contributes to the growing body of literature on toxicity in online gaming communities and invites further research into toxicity from the perspective of the victims.

Changes in drusen-associated autofluorescence over time observed by fluorescence lifetime imaging ophthalmoscopy in age-related macular degeneration.

PURPOSE: To observe fundus autofluorescence (FAF) lifetimes and peak emission wavelength (PEW) of drusen with respect to the pathology of the overlying RPE in the follow-up of AMD-patients. METHODS: Forty eyes of 38 patients (age: 75.1 ± 7.1 years) with intermediate AMD were included. FAF lifetimes and PEW were recorded by fluorescence lifetime imaging ophthalmoscopy (FLIO). Twenty-six eyes had a follow-up investigation between months 12 and 36, and 10 at months 37-72. AMD progression was retrieved from color fundus photography (CFP) and OCT. Drusen were classified with respect to changes in the overlying RPE into groups no, questionable or faint, and apparent hyperpigmentation based on CFP. RESULTS: Among the 210 hyperautofluorescent drusen found at baseline, those with hyperpigmentation had longer lifetimes and shorter PEW than those without. Drusen without hyperpigmentation had shorter lifetimes and PEW than neighboring RPE (all p < 0.001) at baseline, but drusen lifetimes increased, and PEW shortened further over follow-up. Eyes, showing AMD progression, had significantly longer FAF lifetimes at baseline than non-progressing eyes: 282 ± 102 ps versus 245 ± 98 ps, p < 0.001 and 365 ± 44 ps vs. 336 ± 48 ps, p = 0.025 for short and long wavelength FLIO channel, respectively. CONCLUSIONS: Depending on hyperpigmentation properties, drusen show lifetimes and PEW different from that of adjacent RPE which change over the natural history of AMD. This difference and change, however, might reflect progressive dysmorphia of the RPE rather than representing fluorescence of drusen material itself. Nevertheless, the observed FAF changes could make FLIO a useful tool for the early detection of AMD progression risk.

Fluorescence Lifetime and Spectral Characteristics of Subretinal Drusenoid Deposits and Their Predictive Value for Progression of Age-Related Macular Degeneration.

Purpose: To measure fundus autofluorescence (FAF) lifetimes and peak emission wavelengths (PEW) of subretinal drusenoid deposits (SDD) in age-related macular degeneration (AMD) and their development over time. Methods: Fluorescence lifetime imaging ophthalmoscopy (FLIO) was performed in 30 eyes with optical coherence tomography (OCT)-confirmed early or intermediate AMD and SDD. Contrasts of mean lifetimes in short- (SSC) and long-wavelength channels (LSC), PEW, and relative fluorescence intensity were determined as differences of the respective measures at individual SDD and their environment. Measurements were made at baseline and at follow-up intervals 1 (13-36 months) and 2 (37-72 months), respectively. Results: Of 423 SDD found at baseline, 259, 47, and 117 were hypoautofluorescent, isoautofluorescent, and hyperautofluorescent, respectively. FAF lifetimes of SDD were significantly longer than those of their environment by 14.5 ps (SSC, 95% confidence interval [CI], 13.3-15.7 ps) and 3.9 ps (LSC, 3.1-4.7 ps). PEW was shorter by 1.53 nm (1.07-1.98 nm, all contrasts P < 0.001) with higher contrasts for hyperfluorescent SDD. Over follow-up, SDD tended to hyperautofluorescence (relative intensities increased by 3.4% [95% CI, 2.9%-4.1%; P < 0.001] in follow-up 2). Hyperautofluorescence was associated with disruption of the ellipsoid zone on OCT. Disease progression to late-stage AMD was associated with higher lifetime contrast in SSC (15.9ps [14.2-17.6 ps] vs. 11.7 ps [9.9-13.5 ps], P < 0.001) at baseline. Conclusions: SDD show longer FAF lifetimes and shorter PEW than their environments. A high lifetime contrast of SDD in SSC might predict disease progression to late-stage AMD.

Impact of Thermophysical Properties of High-Alloy Tool Steels on Their Performance in Re-Purposing Applications.

Resource efficiency and circularity in the context of sustainability are rapidly gaining importance in the steel industry. One concept regarding circular economy is "repurposing". In the context of this work, worn-out machine circular knives are used to produce new chisels for woodturning. The chisels can be extracted parallel or perpendicular to the rolling direction of the primary production process, resulting in an associated carbide orientation of the repurposed tool. The rolling direction, and therefore carbide alignment, will influence the wear resistance and the thermophysical properties, whereby the thermal conductivity will determine the temperatures at the tip of the chisel. Therefore, the thermal conductivity was investigated with the dynamic measurement method, where the specific heat capacity, density and thermal diffusivity of the extracted chisels and industrial reference chisels were measured separately. Moreover, the electrical resistivity was measured in order to calculate the electronic thermal conductivity according to the Wiedemann-Franz-Lorenz law. It was shown that all of these parameters exhibited different degrees of variability with rising temperature. In a detailed analysis, the thermal diffusivity could be identified as an essential parameter of thermal conductivity. By taking two conventional chisels with different chemical compositions and heat treatments into account, it can be seen that the microstructure determines the thermophysical properties. Considering the carbide direction, the chisels that were extracted parallel to the rolling direction showed differing thermophysical properties. Therefore, the carbide orientation is shown to play a significant role regarding the heat dissipation at the cutting edge, because differences, especially in the electronic thermal conductivity in the parallel and perpendicular extracted chisels, can be measured. In addition to the wear resistance factor, the thermal conductivity factor now also supports the removal of the repurposed chisels parallel to the rolling direction.

Processing of a Martensitic Tool Steel by Wire-Arc Additive Manufacturing.

This work investigates the processability of hot-work tool steels by wire-arc additive manufacturing (DED-Arc) from metal-cored wires. The investigations were carried out with the hot-work tool steel X36CrMoWVTi10-3-2. It is shown that a crack-free processing from metal-cored wire is possible, resulting from a low martensite start (Ms) temperature, high amounts of retained austenite (RA) in combination with increased interpass temperatures during deposition. Overall mechanical properties are similar over the built-up height of 110 mm. High alloying leads to pronounced segregation during processing by DED-Arc, achieving a shift of the secondary hardness maximum towards higher temperatures and higher hardness in as-built + tempered condition in contrast to hardened + tempered condition, which appears to be beneficial for applications of DED-Arc processed material at elevated temperatures.

Correction: Thermally stable mesoporous tetragonal zirconia through surfactant-controlled synthesis and Si-stabilization.

[This corrects the article DOI: 10.1039/D2RA01459A.].

Validation of the Powder Metallurgical Processing of Duplex Stainless Steels through Hot Isostatic Pressing with Integrated Heat Treatment.

Duplex stainless steels exhibit an excellent combination of corrosion resistance and strength and are increasingly being manufactured through powder metallurgy (PM) to produce large, near-net-shaped components, such as those used for offshore applications. Hot isostatic pressing (HIP) is often used for PM production, in which pre-alloyed powders are compacted under high pressures and temperatures. Recent developments in HIP technology enable fast cooling as part of the process cycle, reaching cooling rates comparable to oil quenching or even faster. This enables the integrated solution annealing of duplex stainless steels directly after compaction. In contrast to the conventional HIP route, which requires another separate solution annealing step after compaction, the integrated heat treatment within the HIP process saves both energy and time. Due to this potential gain, HIP compaction at a high pressure of 170 MPa and 1150 °C with integrated solution annealing for the production of duplex stainless steels was investigated in this work. Firstly, the focus was to investigate the influence of pressure on the phase stability during the integrated solution annealing of the steel X2CrNiMoN22-5-3. Secondly, the steel X2CrNiMoCuWN25-7-4, which is highly susceptible to sigma phase embrittlement, was used to investigate whether the cooling rates used in the HIP are sufficient for preventing the formation of this brittle microstructural constituent. This work shows that the high pressure used during the solution heat treatment stabilizes the austenite. In addition, it was verified that the cooling rates during quenching stage in HIP are sufficient for preventing the formation of the sigma phase in the X2CrNiMoCuWN25-7-4 duplex stainless steel.

Lactate Thresholds and the Simulation of Human Energy Metabolism: Contributions by the Cologne Sports Medicine Group in the 1970s and 1980s.

Today, researchers, practitioners, and physicians measure the concentration of lactate during a graded exercise test to determine thresholds related to the maximal lactate steady state (maxLass) as a sensitive measure of endurance capacity. In the 1970s and 1980s, a group of Cologne-based researchers around Wildor Hollmann, Alois Mader, and Hermann Heck developed the methodology for systematic lactate testing and introduced a 4 mmol.L-1 lactate threshold. Later, they also developed the concept of the maxLass, and Mader designed a sophisticated mathematical model of human energy metabolism during exercise. Mader`s model simulates metabolic responses to exercise based on individual variables such as maximum oxygen uptake ( V ˙ O2max) and the maximal rate of lactate formation (νLa.max). Mader's model predicts that the νLa.max reduces the power at the anaerobic threshold and endurance performance but that a high νLa.max is required for events with high power outputs in elite athletes. Mader's model also assumed before the millennium that the rate of fat oxidation is explained by the difference between glycolytic pyruvate synthesis and the actual rate of pyruvate oxidation which is consistent with current opinion. Mader's model also simulated the V ˙ O2max slow component in the mid-1980s. Unfortunately, several landmark studies by the Cologne group were only published in German, and as a result, contributions by the Cologne group are under-appreciated in the English-speaking world. This narrative review aims to introduce key contributions of the Cologne group to human metabolism research especially for readers who do not speak German.

Topological Stone-Wales Defects Enhance Bonding and Electronic Coupling at the Graphene/Metal Interface.

Defects play a critical role for the functionality and performance of materials, but the understanding of the related effects is often lacking, because the typically low concentrations of defects make them difficult to study. A prominent case is the topological defects in two-dimensional materials such as graphene. The performance of graphene-based (opto-)electronic devices depends critically on the properties of the graphene/metal interfaces at the contacting electrodes. The question of how these interface properties depend on the ubiquitous topological defects in graphene is of high practical relevance, but could not be answered so far. Here, we focus on the prototypical Stone-Wales (S-W) topological defect and combine theoretical analysis with experimental investigations of molecular model systems. We show that the embedded defects undergo enhanced bonding and electron transfer with a copper surface, compared to regular graphene. These findings are experimentally corroborated using molecular models, where azupyrene mimics the S-W defect, while its isomer pyrene represents the ideal graphene structure. Experimental interaction energies, electronic-structure analysis, and adsorption distance differences confirm the defect-controlled bonding quantitatively. Our study reveals the important role of defects for the electronic coupling at graphene/metal interfaces and suggests that topological defect engineering can be used for performance control.

Thermally stable mesoporous tetragonal zirconia through surfactant-controlled synthesis and Si-stabilization.

Thermally stable, highly mesoporous Si-stabilized ZrO2 was prepared by sol-gel-synthesis. By utilizing the surfactant dodecylamine (DDA), large mesopores with a pore width of ∼9.4 nm are formed. Combined with an NH3-treatment on the hydrogel, a high specific surface area of up to 225 m2 g-1 and pore volume up to 0.46 cm3 g-1 are obtained after calcination at 973 K. The individual contributions of Si-addition, DDA surfactant and the NH3-treatment on the resulting pore system were studied by inductively coupled plasma with optical emission spectrometry (ICP-OES), X-ray diffraction (XRD), N2 sorption, and transmission electron microscopy (TEM). Electron tomography was applied to visualize and investigate the mesopore network in 3D space. While Si prevents the growth of ZrO2 crystallites and stabilizes the t-ZrO2 phase, DDA generates a homogeneous mesopore network within the zirconia. The NH3-treatment unblocks inaccessible pores, thereby increasing specific surface area and pore volume while retaining the pore width distribution.

Integration of Hot Isostatic Pressing and Heat Treatment for Advanced Modified γ-TiAl TNM Alloys.

The conventional processing route of TNM (Ti-Nb-Mo) alloys combines casting and Hot Isostatic Pressing (HIP) followed by forging and multiple heat treatments to establish optimum properties. This is a time-consuming and costly process. In this study we present an advanced alternative TNM alloy processing route combining HIP and heat treatments into a single process, which we refer to as IHT (integrated HIP heat treatment), applied to a modified TNM alloy with 1.5B. A Quintus HIP lab unit with a quenching module was used, achieving fast and controlled cooling, which differs from the slow cooling rates of conventional HIP units. A Ti-42.5Al-3.5Nb-1Mo-1.5B (at.%) was subjected to an integrated two HIP steps at 200 MPa, one at 1250 °C for 3 h and another at 1260 °C for 1 h, both under a protective Ar atmosphere and followed by cooling at 30 K/min down to room temperature. The results were compared against the Ti-43.5Al-3.5Nb-1Mo-0.8B (at.%) thermomechanically processed in a conventional way. Applying IHT processing to the 1.5B alloy does indeed achieve good creep strength, and the secondary creep rate of the IHT processed materials is similar to that of conventionally forged TNM alloys. Thus, the proposed advanced IHT processing route could manufacture more cost-effective TiAl components.

Influence of Electronic Non-Equilibrium on Energy Distribution and Dissipation in Aluminum Studied with an Extended Two-Temperature Model.

When an ultrashort laser pulse excites a metal surface, only a few of all the free electrons absorb a photon. The resulting non-equilibrium electron energy distribution thermalizes quickly to a hot Fermi distribution. The further energy dissipation is usually described in the framework of a two-temperature model, considering the phonons of the crystal lattice as a second subsystem. Here, we present an extension of the two-temperature model including the non-equilibrium electrons as a third subsystem. The model was proposed initially by E. Carpene and later improved by G.D. Tsibidis. We introduce further refinements, in particular, a temperature-dependent electron-electron thermalization time and an extended energy interval for the excitation function. We show results comparing the transient energy densities as well as the energy-transfer rates of the original equilibrium two-temperature description and the improved extended two-temperature model, respectively. Looking at the energy distribution of all electrons, we find good agreement in the non-equilibrium distribution of the extended two-temperature model with results from a kinetic description solving full Boltzmann collision integrals. The model provides a convenient tool to trace non-equilibrium electrons at small computational effort. As an example, we determine the dynamics of high-energy electrons observable in photo-electron spectroscopy. The comparison of the calculated spectral densities with experimental results demonstrates the necessity of considering electronic non-equilibrium distributions and electron-electron thermalization processes in time- and energy-resolved analyses.

Processability of a Hot Work Tool Steel Powder Mixture in Laser-Based Powder Bed Fusion.

Powder bed fusion of metals using a laser beam system (PBF-LB/M) of highly complex and filigree parts made of tool steels is becoming more important for many industrial applications and scientific investigations. To achieve high density and sufficient chemical homogeneity, pre-alloyed gas-atomized spherical powder feedstock is used. For high-performance materials such as tool steels, the number of commercially available starting powders is limited due to the susceptibility to crack formation in carbon-bearing steels. Furthermore, scientific alloy development in combination with gas-atomization is a cost-intensive process which requires high experimental effort. To overcome these drawbacks, this investigation describes the adaption of a hot work tool steel for crack-free PBF-LB/M-fabrication without any preheating as well as an alternative alloying strategy which implies the individual admixing of low-cost aspherical elemental powders and ferroalloy particles with gas-atomized pure iron powder. It is shown that the PBF-LB/M-fabrication of this powder mixture is technically feasible, even though the partly irregular-shaped powder particles reduce the flowability and the laser reflectance compared to a gas-atomized reference powder. Moreover, some high-melting alloying ingredients of the admixed powder remain unmolten within the microstructure. To analyze the laser energy input in detail, the second part of the investigation focuses on the characterization of the individual laser light reflectance of the admixed alloy, the gas-atomized reference powder and the individual alloying elements and ferroalloys.

Plasmodium sporozoite disintegration during skin passage limits malaria parasite transmission.

During transmission of malaria-causing parasites from mosquitoes to mammals, Plasmodium sporozoites migrate rapidly in the skin to search for a blood vessel. The high migratory speed and narrow passages taken by the parasites suggest considerable strain on the sporozoites to maintain their shape. Here, we show that the membrane-associated protein, concavin, is important for the maintenance of the Plasmodium sporozoite shape inside salivary glands of mosquitoes and during migration in the skin. Concavin-GFP localizes at the cytoplasmic periphery and concavin(-) sporozoites progressively round up upon entry of salivary glands. Rounded concavin(-) sporozoites fail to pass through the narrow salivary ducts and are rarely ejected by mosquitoes, while normally shaped concavin(-) sporozoites are transmitted. Strikingly, motile concavin(-) sporozoites disintegrate while migrating through the skin leading to parasite arrest or death and decreased transmission efficiency. Collectively, we suggest that concavin contributes to cell shape maintenance by riveting the plasma membrane to the subtending inner membrane complex. Interfering with cell shape maintenance pathways might hence provide a new strategy to prevent a malaria infection.

Evolution of Hierarchically Porous Nickel Alumina Catalysts Studied by X-Ray Ptychography.

The synthesis of hierarchically porous materials usually requires complex experimental procedures, often based around extensive trial and error approaches. One common synthesis strategy is the sol-gel method, although the relation between synthesis parameters, material structure and function has not been widely explored. Here, in situ 2D hard X-ray ptychography (XRP) and 3D ptychographic X-ray computed tomography (PXCT) are applied to monitor the development of hierarchical porosity in Ni/Al2 O3 and Al2 O3 catalysts with connected meso- and macropore networks. In situ XRP allows to follow textural changes of a dried gel Ni/Al2 O3 sample as a function of temperature during calcination, activation and CO2 methanation reaction. Complementary PXCT studies on dried gel particles of Ni/Al2 O3 and Al2 O3 provide quantitative information on pore structure, size distribution, and shape with 3D spatial resolution approaching 50 nm, while identical particles are imaged ex situ before and after calcination. The X-ray imaging results are correlated with N2 -sorption, Hg porosimetry and He pycnometry pore characterization. Hard X-ray nanotomography is highlighted to derive fine structural details including tortuosity, branching nodes, and closed pores, which are relevant in understanding transport phenomena during chemical reactions. XRP and PXCT are enabling technologies to understand complex synthesis pathways of porous materials.

Human Factors and Technological Characteristics Influencing the Interaction of Medical Professionals With Artificial Intelligence-Enabled Clinical Decision Support Systems: Literature Review.

BACKGROUND: The digitization and automation of diagnostics and treatments promise to alter the quality of health care and improve patient outcomes, whereas the undersupply of medical personnel, high workload on medical professionals, and medical case complexity increase. Clinical decision support systems (CDSSs) have been proven to help medical professionals in their everyday work through their ability to process vast amounts of patient information. However, comprehensive adoption is partially disrupted by specific technological and personal characteristics. With the rise of artificial intelligence (AI), CDSSs have become an adaptive technology with human-like capabilities and are able to learn and change their characteristics over time. However, research has not reflected on the characteristics and factors essential for effective collaboration between human actors and AI-enabled CDSSs. OBJECTIVE: Our study aims to summarize the factors influencing effective collaboration between medical professionals and AI-enabled CDSSs. These factors are essential for medical professionals, management, and technology designers to reflect on the adoption, implementation, and development of an AI-enabled CDSS. METHODS: We conducted a literature review including 3 different meta-databases, screening over 1000 articles and including 101 articles for full-text assessment. Of the 101 articles, 7 (6.9%) met our inclusion criteria and were analyzed for our synthesis. RESULTS: We identified the technological characteristics and human factors that appear to have an essential effect on the collaboration of medical professionals and AI-enabled CDSSs in accordance with our research objective, namely, training data quality, performance, explainability, adaptability, medical expertise, technological expertise, personality, cognitive biases, and trust. Comparing our results with those from research on non-AI CDSSs, some characteristics and factors retain their importance, whereas others gain or lose relevance owing to the uniqueness of human-AI interactions. However, only a few (1/7, 14%) studies have mentioned the theoretical foundations and patient outcomes related to AI-enabled CDSSs. CONCLUSIONS: Our study provides a comprehensive overview of the relevant characteristics and factors that influence the interaction and collaboration between medical professionals and AI-enabled CDSSs. Rather limited theoretical foundations currently hinder the possibility of creating adequate concepts and models to explain and predict the interrelations between these characteristics and factors. For an appropriate evaluation of the human-AI collaboration, patient outcomes and the role of patients in the decision-making process should be considered.