Posttransplant atrial fibrillation: Evidence of early posttransplant recipient-to-donor atrioatrial connections.

INTRODUCTION: Atrial fibrillation and atrial flutter originating from the donor s heart is a commonly reported complication post heart transplant. Atrial tachyarrhythmia originating from the recipient s heart, propagated through recipient-to-donor connections, is rare with only few cases reported in the literature; most reported cases from our review occur years post-transplant. CASE: A 47-year-old male presented with atrial tachycardia 6 months post heart transplant. Electrophysiologic study demonstrated atrial fibrillation originating from native heart and propagated through atrio-atrial connections to the donor heart. This arrhythmia was successfully terminated with radiofrequency ablation. CONCLUSION: Atrio-atrial connection between recipient and donor can form as early as a few months post heart transplant. Radiofrequency ablation appears to be an effective treatment for atrial fibrillation propagated through donor-to-recipient connections.

Biochemical and Molecular Characterization of Musa sp. Cultured in Temporary Immersion Bioreactor.

The genus Musa sp. contains commercially important fleshy fruit-producing plants, including plantains and bananas, with a strong potential for providing food security and sources of revenue to farmers. Concerns with the quality of vegetative tissues along with the possibility of the transmission of phytopathogens makes the availability of healthy plantlets limited for farmers. Micropropagation of plantains offers an alternative to producing large numbers of plantlets. However, conventional methods of micropropagation have high production costs and are labor-intensive. Recently, the temporary immersion bioreactor (TIB) has emerged as an alternative to conventional micropropagation (CM) methods. Our work utilized SEM microscopy (scanning electron microscope) and molecular and biochemical tools (qRT-PCR and ICP-OES) to characterize and compare the morphological properties, elemental composition, and photosynthetic gene expression of plantains cultured on TIB. Additionally, morphological features of growth and propagation rates were analyzed to compare outputs obtained from TIB and CM. Results showed higher growth and multiplication rates for plantlets cultivated in TIB. Gene expression analysis of selected photosynthetic genes demonstrated high transcript abundance of phosphoenolpyruvate carboxylase (PEPC) in plantain tissues obtained by TIB. Elemental composition analysis showed higher content of iron in plantains grown in TIB, suggesting a potential correlation with PEPC expression. These results demonstrate that micropropagation of Musa sp. via the liquid medium in TIB is an efficient and low-cost approach in comparison with solid media in CM.

High Thermal Conductivity of Submicrometer Aluminum Nitride Thin Films Sputter-Deposited at Low Temperature.

Aluminum nitride (AlN) is one of the few electrically insulating materials with excellent thermal conductivity, but high-quality films typically require exceedingly hot deposition temperatures (>1000 °C). For thermal management applications in dense or high-power integrated circuits, it is important to deposit heat spreaders at low temperatures (<500 °C), without affecting the underlying electronics. Here, we demonstrate 100 nm to 1.7 µm thick AlN films achieved by low-temperature (<100 °C) sputtering, correlating their thermal properties with their grain size and interfacial quality, which we analyze by X-ray diffraction, transmission X-ray microscopy, as well as Raman and Auger spectroscopy. Controlling the deposition conditions through the partial pressure of reactive N2, we achieve an ∼3× variation in thermal conductivity (∼36-104 W m-1 K-1) of ∼600 nm films, with the upper range representing one of the highest values for such film thicknesses at room temperature, especially at deposition temperatures below 100 °C. Defect densities are also estimated from the thermal conductivity measurements, providing insight into the thermal engineering of AlN that can be optimized for application-specific heat spreading or thermal confinement.

A review of the long-term use of proton pump inhibitors and risk of celiac disease in the context of HLA-DQ2 and HLA-DQ8 genetic predisposition.

Proton pump inhibitors (PPIs) are among the most prescribed and widely used medications; however, the long-term effects of these medications are only beginning to be investigated. Since the introduction of omeprazole in 1989, PPIs have become the first-choice treatment for esophagitis, peptic ulcer disease, Zoster-Ellison syndrome, dyspepsia, and the prevention of ulcers with non-steroidal anti-inflammatory drugs. Recent studies have specifically examined the rise in celiac disease (CD) in this context. This review explores how PPIs may impact the development of CD and highlights the need for additional research into the environmental and genetic factors that influence the development and progression of the disease. A literature search was performed using the keywords celiac disease, proton pump inhibitors, human leukocyte antigen (HLA)-DQ2, HLA-DQ8. The pathogenesis of CD is multifactorial, and human leukocyte antigens are one factor that may contribute to its development. Additionally, pharmaceuticals, such as PPIs, that cause gut dysbiosis have been linked to the inflammatory response present in CD. Recent studies have suggested that the rise in CD could be attributed to changes in the gut microbiome, highlighting the significant role that gut microbiota is proposed to play in CD pathogenesis. Although PPI therapy is helpful in reducing acid production in gastroesophageal disorders, additional information is needed to determine whether PPIs are still an appropriate treatment option with the possibility of developing CD in the future, particularly in the context of HLA-DQ2 and HLA-DQ8 predispositions. This review emphasizes the importance of personalized medicine for individuals with gastroesophageal disorders that require long-term use of PPIs.

Non-volatile electrically programmable integrated photonics with a 5-bit operation.

Scalable programmable photonic integrated circuits (PICs) can potentially transform the current state of classical and quantum optical information processing. However, traditional means of programming, including thermo-optic, free carrier dispersion, and Pockels effect result in either large device footprints or high static energy consumptions, significantly limiting their scalability. While chalcogenide-based non-volatile phase-change materials (PCMs) could mitigate these problems thanks to their strong index modulation and zero static power consumption, they often suffer from large absorptive loss, low cyclability, and lack of multilevel operation. Here, we report a wide-bandgap PCM antimony sulfide (Sb2S3)-clad silicon photonic platform simultaneously achieving low loss (<1.0 dB), high extinction ratio (>10 dB), high cyclability (>1600 switching events), and 5-bit operation. These Sb2S3-based devices are programmed via on-chip silicon PIN diode heaters within sub-ms timescale, with a programming energy density of [Formula: see text]. Remarkably, Sb2S3 is programmed into fine intermediate states by applying multiple identical pulses, providing controllable multilevel operations. Through dynamic pulse control, we achieve 5-bit (32 levels) operations, rendering 0.50 ± 0.16 dB per step. Using this multilevel behavior, we further trim random phase error in a balanced Mach-Zehnder interferometer.

PROTOCOL: Fear avoidance model psychological factors as predictors for persistent post-concussion clinical outcomes: An integrative review.

Background: Persisting symptoms after concussion (PSaC) include physical, cognitive, and psychological symptoms which contribute to rehabilitation challenges. Previous research has not thoroughly investigated the association between PSaC and pain-related psychological factors. Therefore, there is an opportunity to use current pain models, such as the Fear Avoidance Model (FAM), as a framework to explore these relationships. The goals of this integrative review are to (1) identify and describe range of evidence that explores relationships between psychological factors and clinical outcomes in patients with PSaC, and (2) develop a comprehensive understanding of FAM-specific psychological factors that have been identified as potential predictors of clinical outcomes in patients with PSaC. Methods: This review will be based on principles and stages of an integrative review which will allow for inclusion of diverse methodologies: (1) problem formulation, (2) literature search, (3) data evaluation, (4) data analysis, and (5) presentation. Methods for reporting this review will be informed by the 2020 PRISMA guidelines for systematic reviews. Discussion: The findings from this integrative review will inform healthcare professionals working in post-concussion rehabilitation settings regarding relationships between FAM psychological factors and PSaC-an area that until recently has not been thoroughly explored. Additionally, this review will inform the development of other reviews and clinical studies to further investigate relationships between FAM psychological factors and PSaC. Integrative Review Registration: OSF DOI 10.17605/OSF.IO/CNGPW.

An NLP-assisted Bayesian time-series analysis for prevalence of Twitter cyberbullying during the COVID-19 pandemic.

COVID-19 has brought about many changes in social dynamics. Stay-at-home orders and disruptions in school teaching can influence bullying behavior in-person and online, both of which leading to negative outcomes in victims. To study cyberbullying specifically, 1 million tweets containing keywords associated with abuse were collected from the beginning of 2019 to the end of 2021 with the Twitter API search endpoint. A natural language processing model pre-trained on a Twitter corpus generated probabilities for the tweets being offensive and hateful. To overcome limitations of sampling, data were also collected using the count endpoint. The fraction of tweets from a given daily sample marked as abusive is multiplied to the number reported by the count endpoint. Once these adjusted counts are assembled, a Bayesian autoregressive Poisson model allows one to study the mean trend and lag functions of the data and how they vary over time. The results reveal strong weekly and yearly seasonality in hateful speech but with slight differences across years that may be attributed to COVID-19.

Energy Efficient Neuro-Inspired Phase-Change Memory Based on Ge4 Sb6 Te7 as a Novel Epitaxial Nanocomposite.

Phase-change memory (PCM) is a promising candidate for neuro-inspired, data-intensive artificial intelligence applications, which relies on the physical attributes of PCM materials including gradual change of resistance states and multilevel operation with low resistance drift. However, achieving these attributes simultaneously remains a fundamental challenge for PCM materials such as Ge2 Sb2 Te5 , the most commonly used material. Here bi-directional gradual resistance changes with ≈10× resistance window using low energy pulses are demonstrated in nanoscale PCM devices based on Ge4 Sb6 Te7 , a new phase-change nanocomposite material . These devices show 13 resistance levels with low resistance drift for the first 8 levels, a resistance on/off ratio of ≈1000, and low variability. These attributes are enabled by the unique microstructural and electro-thermal properties of Ge4 Sb6 Te7 , a nanocomposite consisting of epitaxial SbTe nanoclusters within the Ge-Sb-Te matrix, and a higher crystallization but lower melting temperature than Ge2 Sb2 Te5 . These results advance the pathway toward energy-efficient analog computing using PCM.

Unveiling the Effect of Superlattice Interfaces and Intermixing on Phase Change Memory Performance.

Superlattice (SL) phase change materials have shown promise to reduce the switching current and resistance drift of phase change memory (PCM). However, the effects of internal SL interfaces and intermixing on PCM performance remain unexplored, although these are essential to understand and ensure reliable memory operation. Here, using nanometer-thin layers of Ge2Sb2Te5 and Sb2Te3 in SL-PCM, we uncover that both switching current density (Jreset) and resistance drift coefficient (v) decrease as the SL period thickness is reduced (i.e., higher interface density); however, interface intermixing within the SL increases both. The signatures of distinct versus intermixed interfaces also show up in transmission electron microscopy, X-ray diffraction, and thermal conductivity measurements of our SL films. Combining the lessons learned, we simultaneously achieve low Jreset ≈ 3-4 MA/cm2 and ultralow v ≈ 0.002 in mushroom-cell SL-PCM with ∼110 nm bottom contact diameter, thus advancing SL-PCM technology for high-density storage and neuromorphic applications.

Outcomes With sGC Therapy in Patients With HFpEF: A Meta-Analysis of Prior Trials.

Soluble guanylate cyclase (sGC) agents have been shown to have possible beneficial effects in heart failure treatment. Unfortunately, the role of sGC in HFpEF has not been shown to be efficacious based on recent trials. The CAPACITY HFpEF and VITALITY-HFpEF trials independently showed that sGC does not improve 6-minute walk test (6MWT) distance or the Kansas City Cardiomyopathy Questionnaire (KCCQ) physical limitation score (PLS). The objective of this study was to analyze current data on the 6MWT and KCCQ PLS score from trials that included patients with HFpEF treated with sGC. Using MEDLINE and Cochrane databases, meta-analysis and systematic review was performed looking at data in the CAPACITY HFpEF and VITALITY-HFpEF trials.  For safety analysis we evaluated serious adverse events between the CAPACITY HFpEF, VITALITY-HFpEF, SOCRATES-PRESERVED, and DILATE-1trials. A total of 2 trials were analyzed to assess 6MWT and KCCQ score. The total number of combined patients from both trials assessing 6MWT distance in sGC vs placebo therapy were 620 with 309 in the treatment group and 311 in the placebo group. The total number of combined patients from both trials assessing KCCQ score outcomes were 583 with 280 in the treatment group and 303 in the placebo group. A total of 4 trials were evaluated for safety analysis with a total of 987 patients with 529 in the treatment group and 458 in the placebo group. The analysis did not demonstrate significant difference in 6MWT (P = 0.97), KCCQ PLS (P = 0.83), or serious adverse events (P = 0.67).

Thermal Characterization of Metal-Oxide Interfaces Using Time-Domain Thermoreflectance with Nanograting Transducers.

Metal-oxide thermal boundary conductance (TBC) strongly influences the temperature rise in nanostructured systems, such as dense interconnects, when its value is comparable to the thermal conductance of the amorphous dielectric oxide. However, the thermal characterization of metal-amorphous oxide TBC is often hampered by the measurement insensitivity of techniques such as time-domain thermoreflectance (TDTR). Here, we use metal nanograting structures as opto-thermal transducers in TDTR to measure the TBC of metal-oxide interfaces. Combined with an ultrafast pump-probe laser measurement approach, the nanopatterned structures amplify the contribution of the thermal boundary resistance (TBR), the inverse of TBC, over the thermal resistance of the adjacent material, thereby enhancing measurement sensitivity. For demonstration purposes, we report the TBC between Al and SiO2 films. We then compare the impact of Al grating dimensions on the measured TBC values, sensitivities, and uncertainties. The grating periods L used in this study range from 150 to 300 nm, and the bridge widths w range from 72 to 205 nm. With the narrowest grating transducers (72 nm), the TBC of Al-SiO2 interfaces is measured to be 159-48+61 MW m-2 K-1, with the experimental sensitivity being 5× higher than that of a blanket Al film. This improvement is attributed to the reduced contribution of the SiO2 film thermal resistance to the temperature signal from TDTR response. The nanograting measurement approach described here is promising for the thermal characterization of a variety of nanostructured metal-amorphous passivation systems and interfaces common in semiconductor technology.

Clinical Characteristics and Outcomes in Immune Checkpoint Inhibitor Therapy-Associated Myocarditis.

Immune checkpoint inhibitor (ICI) therapy has played an important role in the treatment of several groups of cancers. Although a life prolonging treatment, many side effects have been shown with ICI therapy. This study looked at individual level clinical characteristics and outcomes with ICI therapy in patients who developed ICI-related myocarditis. A comprehensive review of the National Library of Medicine PubMed database was performed. Inclusion criteria were all studies that were composed of case reports and case series of individual patients undergoing ICI therapy that developed myocarditis. To appreciate individual patient level data, observational studies, clinical trials, systematic reviews, and meta-analyses were excluded. Our search yielded 333 results with 71 cases reviewed of ICI therapy-related myocarditis. The findings included an average age of 68 years, higher incidence in men, and pretreatment cardiac history of hypertension. Melanoma was the most prevalent malignancy with nivolumab being the most used ICI therapy. Heart failure was the most prevalent adverse event that was co-prevalent with myocarditis. Corticosteroid therapy alone was the most utilized therapy to treat ICI-related myocarditis. Mortality was seen in nearly half of the patient population. Our study reviewed the preexisting literature of prior reported myocarditis secondary to ICI therapy. Periodic surveillance should be performed by the cardio-oncologist and internist. Due to the expanding role of ICI therapy in treating a variety of cancer patients, appreciation of its impact on the development of myocarditis is needed.

Uncovering Thermal and Electrical Properties of Sb2Te3/GeTe Superlattice Films.

Superlattice-like phase change memory (SL-PCM) promises lower switching current than conventional PCM based on Ge2Sb2Te5 (GST); however, a fundamental understanding of SL-PCM requires detailed characterization of the interfaces within such an SL. Here we explore the electrical and thermal transport of SLs with deposited Sb2Te3 and GeTe alternating layers of various thicknesses. We find up to an approximately four-fold reduction of the effective cross-plane thermal conductivity of the SL stack (as-deposited polycrystalline) compared with polycrystalline GST (as-deposited amorphous and later annealed) due to the thermal interface resistances within the SL. Thermal measurements with varying periods of our SLs show a signature of phonon coherence with a transition from wave-like to particle-like phonon transport, further described by our modeling. Electrical resistivity measurements of such SLs reveal strong anisotropy (∼2000×) between the in-plane and cross-plane directions due to the weakly interacting van der Waals-like gaps. This work uncovers electrothermal transport in SLs based on Sb2Te3 and GeTe for the improved design of low-power PCM.

Thermal Interface Enhancement via Inclusion of an Adhesive Layer Using Plasma-Enhanced Atomic Layer Deposition.

Interfaces govern thermal transport in a variety of nanostructured systems such as FinFETs, interconnects, and vias. Thermal boundary resistances, however, critically depend on the choice of materials, nanomanufacturing processes and conditions, and the planarity of interfaces. In this work, we study the interfacial thermal transport between a nonreactive metal (Pt) and a dielectric by engineering two differing bonding characters: (i) the mechanical adhesion/van der Waals bonding offered by the physical vapor deposition (PVD) and (ii) the chemical bonding generated by plasma-enhanced atomic layer deposition (PEALD). We introduce 40-cycle (∼2 nm thick), nearly continuous PEALD Pt films between 98 nm PVD Pt and dielectric materials (8.0 nm TiO2/Si and 11.0 nm Al2O3/Si) treated with either O2 or O2 + H2 plasma to modulate their bonding strengths. By correlating the treatments through thermal transport measurements using time-domain thermoreflectance (TDTR), we find that the thermal boundary resistances are consistently reduced with the same increased treatment complexity that has been demonstrated in the literature to enhance mechanical adhesion. For samples on TiO2 (Al2O3), reductions in thermal resistance are at least 4% (10%) compared to those with no PEALD Pt at all, but could be as large as 34% (42%) given measurement uncertainties that could be improved with thinner nucleation layers. We suspect the O2 plasma generates stronger covalent bonds to the substrate, while the H2 plasma strips the PEALD Pt of contaminants such as carbon that gives rise to a less thermally resistive heat conduction pathway.

Protective Behavioral Strategies Mediate the Relationship between Overparenting and Alcohol-Related Consequences among College Students.

BACKGROUND: The negative consequences associated with alcohol misuse remain a concern on college campuses nationwide. Alcohol protective behavioral strategies are important factors in mitigating college students' experiences of alcohol-related negative consequences. Overparenting, or "helicopter parenting," is a form of over-involved parenting which has been associated with a range of substance use concerns in college students. The mechanism by which overparenting is associated with alcohol use and/or consequences is unclear; however, it may be partially explained by failure to engage in the use of protective behavioral strategies. Purpose/objectives: The current study explored the degree to which alcohol protective behavioral strategies mediated the relationship between overparenting and alcohol-related negative consequences when accounting for alcohol consumption and if these associations were invariant across race and gender. Methods: Participants were 625 traditional age college students who consumed alcohol within the 30 days prior to completing measures of alcohol consumption, overparenting, alcohol-related negative consequences, and alcohol protective behavioral strategies. Results: Alcohol protective behavioral strategies, specifically manner of drinking, partially mediated the relationship between overparenting and alcohol-related negative consequences when accounting for alcohol misuse. There were no differences noted across gender, but the models were found to be invariant across White and African American participants in relation to the protective value of alcohol protective behavioral strategies. Conclusion/Importance: Overparenting may relate to negative alcohol outcomes in part through less use of harm reduction strategies. More investigation into the value of alcohol protective behavioral strategies across race is needed.

Direct Quantification of Heat Generation Due to Inelastic Scattering of Electrons Using a Nanocalorimeter.

Transmission electron microscopy (TEM) is arguably the most important tool for atomic-scale material characterization. A significant portion of the energy of transmitted electrons is transferred to the material under study through inelastic scattering, causing inadvertent damage via ionization, radiolysis, and heating. In particular, heat generation complicates TEM observations as the local temperature can affect material properties. Here, the heat generation due to electron irradiation is quantified using both top-down and bottom-up approaches: direct temperature measurements using nanowatt calorimeters as well as the quantification of energy loss due to inelastic scattering events using electron energy loss spectroscopy. Combining both techniques, a microscopic model is developed for beam-induced heating and to identify the primary electron-to-heat conversion mechanism to be associated with valence electrons. Building on these results, the model provides guidelines to estimate temperature rise for general materials with reasonable accuracy. This study extends the ability to quantify thermal impact on materials down to the atomic scale.

Discovery of multivalley Fermi surface responsible for the high thermoelectric performance in Yb14MnSb11 and Yb14MgSb11.

The Zintl phases, Yb14 MSb11 (M = Mn, Mg, Al, Zn), are now some of the highest thermoelectric efficiency p-type materials with stability above 873 K. Yb14MnSb11 gained prominence as the first p-type thermoelectric material to double the efficiency of SiGe alloy, the heritage material in radioisotope thermoelectric generators used to power NASA's deep space exploration. This study investigates the solid solution of Yb14Mg1-x Al x Sb11 (0 ≤ x ≤ 1), which enables a full mapping of the metal-to-semiconductor transition. Using a combined theoretical and experimental approach, we show that a second, high valley degeneracy (N v = 8) band is responsible for the groundbreaking performance of Yb14 MSb11 This multiband understanding of the properties provides insight into other thermoelectric systems (La3-x Te4, SnTe, Ag9AlSe6, and Eu9CdSb9), and the model predicts that an increase in carrier concentration can lead to zT > 1.5 in Yb14 MSb11 systems.

Structural Insights on Microwave-Synthesized Antimony-Doped Germanium Nanocrystals.

Doped and alloyed germanium nanocrystals (Ge NCs) are potential candidates for a variety of applications such as photovoltaics and near IR detectors. Recently, bismuth (Bi) as an n-type group 15 element was shown to be successfully and kinetically doped into Ge NCs through a microwave-assisted solution-based synthesis, although Bi is thermodynamically insoluble in bulk crystalline Ge. To expand the composition manipulation of Ge NCs, another more common n-type group 15 element for semiconductors, antimony (Sb), is investigated. Oleylamine (OAm)- and OAm/trioctylphosphine (TOP)-capped Sb-doped Ge NCs have been synthesized by the microwave-assisted solution reaction of GeI2 with SbI3. Passivating the Ge surface with a binary ligand system of OAm/TOP results in formation of consistently larger NCs compared to OAm alone. The TOP coordination on the Ge surface is confirmed by 31P NMR and SEM-EDS. The lattice parameter of Ge NCs increases with increasing Sb concentration (0.00-2.0 mol %), consistent with incorporation of Sb. An increase in the NC diameter with higher content of SbI3 in the reaction is shown by TEM. XPS and EDS confirm the presence of Sb before and after removal of surface ligands with hydrazine and recapping the Ge NC surface with dodecanethiol (DDT). EXAFS analysis suggests that Sb resides within the NCs on highly distorted sites next to a Ge vacancy as well as on the crystallite surface. High Urbach energies obtained from photothermal deflection spectroscopy (PDS) of the films prepared from pristine Ge NC and Sb-doped Ge NCs indicate high levels of disorder, in agreement with EXAFS data. Electrical measurements on TiO2-NC electron- and hole-only devices show an increase in hole conduction, suggesting that the Sb-vacancy defects are behaving as a p-type dopant in the Ge NCs, consistent with the vacancy model derived from the EXAFS results.