Usefulness of Clinical Frailty Scale for Comprehensive Geriatric Assessment of Older Heart Failure Patients.

Background: Comprehensive geriatric assessment (CGA) is a multidisciplinary diagnostic process to identify the physical, psychological, and social functions of patients with frailty. The Clinical Frailty Scale (CFS) might aid in effectively identifying older patients with heart failure (HF) and frailty who would then reap maximum benefits from the CGA. Methods and Results: A single-centre prospective cohort study that enrolled consecutive hospitalised patients (age ≥75 years) with HF was conducted. The Barthel index (BI), Mini Mental State Examination (MMSE), the Charlson comorbidity index (CCI), and the COntrolling NUTritional (CONUT) for CGA was used. Among 190 enrolled patients (mean age, 85.4 years; 47.9% male), all-cause mortality (primary endpoint) occurred in 45 patients and HF-related rehospitalization (secondary endpoint) in 59 patients within 1 year. The cumulative incidence of all-cause mortality was significantly higher in the high CFS group (low 6.3%, high 30.5%, P<0.001). However, the cumulative incidence of HF-related rehospitalization was not significantly different (low 26.3%, high 32.0%, P=0.304). The multivariable analysis revealed that the CFS group was independently associated with the risk of all-cause mortality. CFS showed a strong correlation with the BI and moderate correlation with the MMSE. Conclusions: The CFS was associated with all-cause mortality within 1 year and was correlated with frailty domains of CGA.

Extreme phonon anharmonicity underpins superionic diffusion and ultralow thermal conductivity in argyrodite Ag8SnSe6.

Ultralow thermal conductivity and fast ionic diffusion endow superionic materials with excellent performance both as thermoelectric converters and as solid-state electrolytes. Yet the correlation and interdependence between these two features remain unclear owing to a limited understanding of their complex atomic dynamics. Here we investigate ionic diffusion and lattice dynamics in argyrodite Ag8SnSe6 using synchrotron X-ray and neutron scattering techniques along with machine-learned molecular dynamics. We identify a critical interplay of the vibrational dynamics of mobile Ag and a host framework that controls the overdamping of low-energy Ag-dominated phonons into a quasi-elastic response, enabling superionicity. Concomitantly, the persistence of long-wavelength transverse acoustic phonons across the superionic transition challenges a proposed 'liquid-like thermal conduction' picture. Rather, a striking thermal broadening of low-energy phonons, starting even below 50 K, reveals extreme phonon anharmonicity and weak bonding as underlying features of the potential energy surface responsible for the ultralow thermal conductivity (<0.5 W m-1 K-1) and fast diffusion. Our results provide fundamental insights into the complex atomic dynamics in superionic materials for energy conversion and storage.

Anomalous behavior of liquid molecules near solid nanoparticles: Novel interpretation on thermal conductivity enhancement in nanofluids.

HYPOTHESIS: Recently, it has been reported that anomalous improvement in the thermal conductivity of nanofluid composed of base liquids and dispersed solid nanoparticles, compared to the theoretically predicted value calculated from the particle fraction. Generally, the thermal conductivity values of gases and liquids are dominated by the mean free path of the molecules during translational motion. Herein, we present solid evidence showing the possible contribution of the vibrational behavior of liquid molecules around nanoparticles to increasing these thermal conductivities. EXPERIMENTS: The behavior of liquid molecules in nanofluids containing SiO2 particles larger than 100 nm, which were dispersed in a 50 wt% aqueous solution of ethylene glycol, was investigated by means of small-angle neutron scattering, quasi-elastic neutron scattering, wide-angle X-ray scattering, and Raman spectroscopy. FINDINGS: The vibrational changes in the liquid molecules caused by the interactions between the nanoparticles and liquid molecules surrounding the nanoparticles contributed majorly to the increase in the thermal conductivity values of the SiO2 nanofluids. Because the vibration of liquid molecules is equivalent to phonon conduction in solids, the increase in thermal conductivity of the suspension due to the presence of nanoparticles was inferred to be derived from the limitation of the translational diffusion, which induces a solid-like behavior in the liquid.

Q-dependent collective relaxation dynamics of glass-forming liquid Ca0.4K0.6(NO3)1.4 investigated by wide-angle neutron spin-echo.

The relaxation behavior of glass formers exhibits spatial heterogeneity and dramatically changes upon cooling towards the glass transition. However, the underlying mechanisms of the dynamics at different microscopic length scales are not fully understood. Employing the recently developed wide-angle neutron spin-echo spectroscopy technique, we measured the Q-dependent coherent intermediate scattering function of a prototypical ionic glass former Ca0.4K0.6(NO3)1.4, in the highly viscous liquid state. In contrast to the structure modulated dynamics for Q < 2.4 Å-1, i.e., at and below the structure factor main peak, for Q > 2.4 Å-1, beyond the first minimum above the structure factor main peak, the stretching exponent exhibits no temperature dependence and concomitantly the relaxation time shows smaller deviations from Arrhenius behavior. This finding indicates a change in the dominant relaxation mechanisms around a characteristic length of 2π/(2.4 Å-1) ≈ 2.6 Å, below which the relaxation process exhibits a temperature independent distribution and more Arrhenius-like behavior.

Integrated backscatter-intravascular ultrasound and modification of plaque during excimer laser coronary angioplasty.

This study aims to test the hypothesis that the effect of excimer laser coronary angioplasty (ELCA) not only vaporizes thrombi and their underlying coronary plaque, it also changes their quality. We performed a series of cross-sectional analyses in 52 lesions in 51 patients before and after ELCA with integrated backscatter-intravascular ultrasound (IB-IVUS). The constituent parts of the plaque can be assessed by IB-IVUS (i.e., calcified, fibrous, lipid) according to integrated backscatter values. Minimum lumen diameter, lumen volume and vessel volume expanded after ELCA, while plaque volume did not significantly decrease. There was also a decrease of 'lipid' component (35.4-30.3%, P < 0.001) and an increase of IB-IVUS-derived 'fibrous' part (34.5-38.3%, P < 0.001). These results may help in understanding plaque change after ELCA. Excimer laser coronary angioplasty seems to contribute to the modification of coronary plaque composition in addition to debulking it.

Pulmonary Tumor Thrombotic Microangiopathy Caused by Recurrent Gastric Cancer 26 Years After Total Gastrectomy.

Pulmonary tumor thrombotic microangiopathy (PTTM) is a rare cancer-related complication that induces pulmonary hypertension (PH). PTTM can be caused by recurrent cancer, with 12 years being the longest reported interval from primary cancer to the development of PTTM. We herein report a 74-year-old woman who presented with dyspnea due to PH. The postmortem diagnosis was PTTM caused by recurrent gastric cancer 26 years after total gastrectomy. An autopsy revealed PTTM-specific histological characteristics. Our findings indicate that PTTM should be considered as a diagnosis for patients with a history of cancer who develop PH, even several decades after treatment.

Dimensional reduction by geometrical frustration in a cubic antiferromagnet composed of tetrahedral clusters.

Dimensionality is a critical factor in determining the properties of solids and is an apparent built-in character of the crystal structure. However, it can be an emergent and tunable property in geometrically frustrated spin systems. Here, we study the spin dynamics of the tetrahedral cluster antiferromagnet, pharmacosiderite, via muon spin resonance and neutron scattering. We find that the spin correlation exhibits a two-dimensional characteristic despite the isotropic connectivity of tetrahedral clusters made of spin 5/2 Fe3+ ions in the three-dimensional cubic crystal, which we ascribe to two-dimensionalisation by geometrical frustration based on spin wave calculations. Moreover, we suggest that even one-dimensionalisation occurs in the decoupled layers, generating low-energy and one-dimensional excitation modes, causing large spin fluctuation in the classical spin system. Pharmacosiderite facilitates studying the emergence of low-dimensionality and manipulating anisotropic responses arising from the dimensionality using an external magnetic field.

Spin glass behavior and magnetic boson peak in a structural glass of a magnetic ionic liquid.

Glassy magnetic behavior has been observed in a wide range of crystalline magnetic materials called spin glass. Here, we report spin glass behavior in a structural glass of a magnetic ionic liquid, C4mimFeCl4. Magnetization measurements demonstrate that an antiferromagnetic ordering occurs at TN = 2.3 K in the crystalline state, while a spin glass transition occurs at TSG = 0.4 K in the structural glass state. In addition, localized magnetic excitations were found in the spin glass state by inelastic neutron scattering, in contrast to spin-wave excitations in the ordered phase of the crystalline sample. The localized excitation was scaled by the Bose population factor below TSG and gradually disappeared above TSG. This feature is highly reminiscent of boson peaks commonly observed in structural glasses. We suggest the "magnetic" boson peak to be one of the inherent dynamics of a spin glass state.

Relevance of hydrogen bonded associates to the transport properties and nanoscale dynamics of liquid and supercooled 2-propanol.

2-Propanol was investigated, in both the liquid and supercooled states, as a model system to study how hydrogen bonds affect the structural relaxation and the dynamics of mesoscale structures, of approximately several Ångstroms, employing static and quasi-elastic neutron scattering and molecular dynamics simulation. Dynamic neutron scattering measurements were performed over an exchanged wave-vector range encompassing the pre-peak, indicative of the presence of H-bonding associates, and the main peak. The dynamics observed at the pre-peak is associated with the formation and disaggregation of the H-bonded associates and is measured to be at least one order of magnitude slower than the dynamics at the main peak, which is identified as the structural relaxation. The measurements indicate that the macroscopic shear viscosity has a similar temperature dependence as the dynamics of the H-bonded associates, which highlights the important role played by these structures, together with the structural relaxation, in defining the macroscopic rheological properties of the system. Importantly, the characteristic relaxation time at the pre-peak follows an Arrhenius temperature dependence whereas at the main peak it exhibits a non-Arrhenius behavior on approaching the supercooled state. The origin of this differing behavior is attributed to an increased structuring of the hydrophobic domains of 2-propanol accommodating a more and more encompassing H-bond network, and a consequent set in of dynamic cooperativity.

Freezable and Unfreezable Hydration Water: Distinct Contributions to Protein Dynamics Revealed by Neutron Scattering.

Hydration water plays a crucial role for activating the protein dynamics required for functional expression. Yet, the details are not understood about how hydration water couples with protein dynamics. A temperature hysteresis of the ice formation of hydration water is a key phenomenon to understand which type of hydration water, unfreezable or freezable hydration water, is crucial for the activation of protein dynamics. Using neutron scattering, we observed a temperature-hysteresis phenomenon in the diffraction peaks of the ice of freezable hydration water, whereas protein dynamics did not show any temperature hysteresis. These results show that the protein dynamics is not coupled with freezable hydration water dynamics, and unfreezable hydration water is essential for the activation of protein dynamics. Decoupling of the dynamics between unfreezable and freezable hydration water could be the cause of the distinct contributions of hydration water to protein dynamics.

Neutron Spin-Echo Studies of the Structural Relaxation of Network Liquid ZnCl2 at the Structure Factor Primary Peak and Prepeak.

Using neutron spin-echo spectroscopy, we studied the microscopic structural relaxation of a prototypical network ionic liquid ZnCl2 at the structure factor primary peak and prepeak. The results show that the relaxation at the primary peak is faster than the prepeak and that the activation energy is ∼33% higher. A stretched exponential relaxation is observed even at temperatures well-above the melting point Tm. Surprisingly, the stretching exponent shows a rapid increase upon cooling, especially at the primary peak, where it changes from a stretched exponential to a simple exponential on approaching the Tm. These results suggest that the appearance of glassy dynamics typical of the supercooled state even in the equilibrium liquid state of ZnCl2 as well as the difference of activation energy at the two investigated length scales are related to the formation of a network structure on cooling.

Gapless spin liquid in a square-kagome lattice antiferromagnet.

Observation of a quantum spin liquid (QSL) state is one of the most important goals in condensed-matter physics, as well as the development of new spintronic devices that support next-generation industries. The QSL in two dimensional quantum spin systems is expected to be due to geometrical magnetic frustration, and thus a kagome-based lattice is the most probable playground for QSL. Here, we report the first experimental results of the QSL state on a square-kagome quantum antiferromagnet, KCu6AlBiO4(SO4)5Cl. Comprehensive experimental studies via magnetic susceptibility, magnetisation, heat capacity, muon spin relaxation (µSR), and inelastic neutron scattering (INS) measurements reveal the formation of a gapless QSL at very low temperatures close to the ground state. The QSL behavior cannot be explained fully by a frustrated Heisenberg model with nearest-neighbor exchange interactions, providing a theoretical challenge to unveil the nature of the QSL state.

Ultralow thermal conductivity from transverse acoustic phonon suppression in distorted crystalline α-MgAgSb.

Low thermal conductivity is favorable for preserving the temperature gradient between the two ends of a thermoelectric material, in order to ensure continuous electron current generation. In high-performance thermoelectric materials, there are two main low thermal conductivity mechanisms: the phonon anharmonic in PbTe and SnSe, and phonon scattering resulting from the dynamic disorder in AgCrSe2 and CuCrSe2, which have been successfully revealed by inelastic neutron scattering. Using neutron scattering and ab initio calculations, we report here a mechanism of static local structure distortion combined with phonon-anharmonic-induced ultralow lattice thermal conductivity in α-MgAgSb. Since the transverse acoustic phonons are almost fully scattered by the compound's intrinsic distorted rocksalt sublattice, the heat is mainly transported by the longitudinal acoustic phonons. The ultralow thermal conductivity in α-MgAgSb is attributed to its atomic dynamics being altered by the structure distortion, which presents a possible microscopic route to enhance the performance of similar thermoelectric materials.

Mesenchymal stem cells cultured under hypoxic conditions had a greater therapeutic effect on mice with liver cirrhosis compared to those cultured under normal oxygen conditions.

BACKGROUND: Mesenchymal stem cells (MSCs) can be easily expanded. They can be acquired from medical waste such as adipose and umbilical cord tissues, are influenced by culturing conditions, and exert anti-inflammatory, antioxidant, anti-fibrotic, and angiogenic effects. We analyzed the multi-directional effects of MSCs cultured under hypoxic conditions and their underlying mechanisms in the treatment of liver cirrhosis in a mouse model. METHODS: Human bone marrow-derived MSCs cultured under hypoxic (5% O2; hypoMSCs) and normoxic (21% O2; norMSCs) conditions were compared by cap analysis of gene expression (CAGE) with or without serum from liver cirrhosis patients. The therapeutic effects of MSCs, including serum liver enzyme induction, fibrosis regression, and hepatic oxidative stress, were evaluated by injecting 1 × 106, 2 × 105, or 4 × 104 MSCs/mouse into the tail veins of mice with carbon tetrachloride (CCl4)-induced liver cirrhosis. Intravital imaging was performed with a two-photon excitation microscope to confirm the various MSC migration paths to the liver. RESULTS: CAGE analysis revealed that the RNA expression levels of prostaglandin E synthase (Ptges) and miR210 were significantly higher in hypoMSCs than in norMSCs. In vivo analysis revealed that both hypoMSCs and norMSCs reduced serum alanine aminotransferase, oxidative stress, and fibrosis compared to that in control mice in a dose-dependent manner. However, hypoMSCs had stronger therapeutic effects than norMSCs. We confirmed this observation by an in vitro study in which hypoMSCs changed macrophage polarity to an anti-inflammatory phenotype via prostaglandin E2 (PGE2) stimulation. In addition, miR210 reduced the rate of hepatocyte apoptosis. Intravital imaging after MSC administration showed that both cell types were primarily trapped in the lungs. Relatively a few hypoMSCs and norMSCs migrated to the liver. There were no significant differences in their distributions. CONCLUSION: The therapeutic effect of hypoMSCs was mediated by PGE2 and miR210 production and was greater than that of norMSCs. Therefore, MSCs can be manipulated to improve their therapeutic efficacy in the treatment of liver cirrhosis and could potentially serve in effective cell therapy. MSCs produce several factors with multidirectional effects and function as "conducting cells" in liver cirrhosis.

Localized Magnetic Excitations in the Fully Frustrated Dimerized Magnet Ba_{2}CoSi_{2}O_{6}Cl_{2}.

Magnetic excitations of the effective spin S=1/2 dimerized magnet Ba_{2}CoSi_{2}O_{6}Cl_{2} have been probed directly via inelastic neutron scattering experiments at temperatures down to 4 K. We observed five types of excitation at 4.8, 5.8, 6.6, 11.4, and 14.0 meV, which are all dispersionless within the resolution limits. The scattering intensities of the three low-lying excitations were found to exhibit different Q dependencies. Detailed analysis has demonstrated that Ba_{2}CoSi_{2}O_{6}Cl_{2} is a two-dimensional spin dimer system described only by a single dimer site, where the triplet excitations are localized owing to the almost perfect frustration of the interdimer exchange interactions and the undimerized spins, even in small concentration, make an essential contribution to the excitation spectrum.

Evidence for singular-phonon-induced nematic superconductivity in a topological superconductor candidate Sr0.1Bi2Se3.

Superconductivity mediated by phonons is typically conventional, exhibiting a momentum-independent s-wave pairing function, due to the isotropic interactions between electrons and phonons along different crystalline directions. Here, by performing inelastic neutron scattering measurements on a superconducting single crystal of Sr0.1Bi2Se3, a prime candidate for realizing topological superconductivity by doping the topological insulator Bi2Se3, we find that there exist highly anisotropic phonons, with the linewidths of the acoustic phonons increasing substantially at long wavelengths, but only for those along the [001] direction. This observation indicates a large and singular electron-phonon coupling at small momenta, which we propose to give rise to the exotic p-wave nematic superconducting pairing in the MxBi2Se3 (M = Cu, Sr, Nb) superconductor family. Therefore, we show these superconductors to be example systems where electron-phonon interaction can induce more exotic superconducting pairing than the s-wave, consistent with the topological superconductivity.

Triplon band splitting and topologically protected edge states in the dimerized antiferromagnet.

Search for topological materials has been actively promoted in the field of condensed matter physics for their potential application in energy-efficient information transmission and processing. Recent studies have revealed that topologically invariant states, such as edge states in topological insulators, can emerge not only in a fermionic electron system but also in a bosonic system, enabling nondissipative propagation of quasiparticles. Here we report the topologically nontrivial triplon bands measured by inelastic neutron scattering on the spin-1/2 two-dimensional dimerized antiferromagnet Ba2CuSi2O6Cl2. The excitation spectrum exhibits two triplon bands that are clearly separated by a band gap due to a small alternation in interdimer exchange interaction, consistent with a refined crystal structure. By analytically modeling the triplon dispersion, we show that Ba2CuSi2O6Cl2 is the first bosonic realization of the coupled Su-Schrieffer-Heeger model, where the presence of topologically protected edge states is prompted by a bipartite nature of the lattice.

Colossal barocaloric effects in plastic crystals.

Refrigeration is of vital importance for modern society-for example, for food storage and air conditioning-and 25 to 30 per cent of the world's electricity is consumed for refrigeration1. Current refrigeration technology mostly involves the conventional vapour compression cycle, but the materials used in this technology are of growing environmental concern because of their large global warming potential2. As a promising alternative, refrigeration technologies based on solid-state caloric effects have been attracting attention in recent decades3-5. However, their application is restricted by the limited performance of current caloric materials, owing to small isothermal entropy changes and large driving magnetic fields. Here we report colossal barocaloric effects (CBCEs) (barocaloric effects are cooling effects of pressure-induced phase transitions) in a class of disordered solids called plastic crystals. The obtained entropy changes in a representative plastic crystal, neopentylglycol, are about 389 joules per kilogram per kelvin near room temperature. Pressure-dependent neutron scattering measurements reveal that CBCEs in plastic crystals can be attributed to the combination of extensive molecular orientational disorder, giant compressibility and highly anharmonic lattice dynamics of these materials. Our study establishes the microscopic mechanism of CBCEs in plastic crystals and paves the way to next-generation solid-state refrigeration technologies.

Spin correlations of quantum spin liquid and quadrupole-ordered states of Tb2+x Ti2-x O7+y.

Spin correlations of the frustrated pyrochlore oxide Tb2+x Ti2-x O7+y have been investigated by using inelastic neutron scattering on single-crystalline samples (x = -0.007, 0.000, and 0.003), which have the putative quantum-spin-liquid (QSL) or electric-quadrupolar ground states. Spin correlations, which are notably observed in nominally elastic scattering, show short-range correlations around L points [ q = ( 1 2 , 1 2 , 1 2 ) ] , tiny antiferromagnetic Bragg scattering at L and Γ points, and pinch-point-type structures around Γ points. The short-range spin correlations were analyzed using a random-phase approximation (RPA) assuming the paramagnetic state and two-spin interactions among Ising spins. These analyses have shown that the RPA scattering intensity well reproduces the experimental data using temperature- and x-dependent coupling constants of up to tenth-neighbor site pairs. This suggests that no symmetry breaking occurs in the QSL sample and that a quantum treatment beyond the semiclassical RPA approach is required. Implications of the experimental data and the RPA analyses are discussed.

Structure of the magnetic excitations in the spin-1/2 triangular-lattice Heisenberg antiferromagnet Ba3CoSb2O9.

A spin-1/2 triangular-lattice Heisenberg antiferromagnet (TLHAF) is a prototypical frustrated quantum magnet, which exhibits remarkable quantum many-body effects that arise from the synergy between spin frustration and quantum fluctuation. The ground-state properties of a spin-1/2 TLHAF are theoretically well understood. However, the theoretical consensus regarding the magnetic excitations is limited. The experimental study of the magnetic excitations in spin-1/2 TLHAFs has also been limited. Here we show the structure of magnetic excitations in the spin-1/2 TLHAF Ba3CoSb2O9 investigated by inelastic neutron scattering. Significantly different from theoretical expectations, the excitation spectrum has a three-stage energy structure. The lowest-energy first stage is composed of dispersion branches of single-magnon excitations. The second and third stages are dispersive continua accompanied by a columnar continuum extending above 10 meV, which is six times larger than the exchange interaction J = 1.67 meV. Our results indicate the shortcomings of the current theoretical framework.Two-dimensional frustrated magnets are heavily studied because theories predict that quantum effects may lead to the emergence of fractionalized excitations. Ito et al. use inelastic neutron scattering to show that the excitation spectrum of Ba3CoSb2O9 disagrees with current theoretical expectations.