High-Performance Thermomagnetic Gd-Si-Ge Alloys.

Exploring low-grade waste heat energy harvesting is crucial to address increasing environmental concerns. Thermomagnetic materials are magnetic phase change materials that enable energy harvesting from low-temperature gradients. To achieve a high thermomagnetic conversion efficiency, there are three main material requirements: (i) magnetic phase transition near room temperature, (ii) substantial change in magnetization with temperature, and (iii) high thermal conductivity. Here, we demonstrate a high-performance Gd5Si2.4Ge1.6 thermomagnetic alloy that meets these three requirements. The magnetic phase transition temperature was successfully shifted to 306 K by introducing Ge doping in Gd5Si4, and a sharper and more symmetric magnetization behavior with saturation magnetization of Mmax = 70 emu/g at a 2 T magnetic field was achieved in the ferromagnetic state. The addition of SeS2, as a low-temperature sintering aid, to the Gd-Si-Ge alloy improved the material's density and thermal conductivity by ∼45 and ∼275%, respectively. Our results confirm that the (Gd5Si2.4Ge1.6)0.9(SeS2)0.1 alloy is a suitable composite material for low-grade waste heat recovery in thermomagnetic applications.

Nintedanib for non-IPF progressive pulmonary fibrosis: 12-month outcome data from a real-world multicentre observational study.

Background: Nintedanib slows lung function decline for patients with non-idiopathic pulmonary fibrosis progressive pulmonary fibrosis (PPF) in clinical trials, but the real-world safety and efficacy are not known. Methods: In this retrospective cohort study, standardised data were collected from patients in whom nintedanib was initiated for PPF between 2019 and 2020 through an early-access programme across eight centres in the United Kingdom. Rate of lung function change in the 12 months pre- and post-nintedanib initiation was the primary analysis. Symptoms, drug safety, tolerability and stratification by interstitial lung disease subtype and computed tomography pattern were secondary analyses. Results: 126 patients were included; 67 (53%) females; mean±sd age 60±13 years. At initiation of nintedanib, mean forced vital capacity (FVC) was 1.87 L (58% predicted) and diffusing capacity of the lung for carbon monoxide (D LCO) was 32.7% predicted. 68% of patients were prescribed prednisolone (median dose 10 mg) and 69% were prescribed a steroid-sparing agent. In the 12 months after nintedanib initiation, lung function decline was significantly lower than in the preceding 12 months: FVC -88.8 mL versus -239.9 mL (p=0.004), and absolute decline in D LCO -2.1% versus -6.1% (p=0.004). Response to nintedanib was consistent in sensitivity and secondary analyses. 89 (71%) out of 126 patients reported side-effects, but 86 (80%) of the surviving 108 patients were still taking nintedanib at 12 months with patients reporting a reduced perception of symptom decline. There were no serious adverse events. Conclusion: In PPF, the real-world efficacy of nintedanib replicated that of clinical trials, significantly attenuating lung function decline. Despite the severity of disease, nintedanib was safe and well tolerated in this real-world multicentre study.

High-Performance Skutterudite/Half-Heusler Cascaded Thermoelectric Module Using the Transient Liquid Phase Sintering Joining Technique.

Thermoelectric (TE) materials have made rapid advancement in the past decade, paving the pathway toward the design of solid-state waste heat recovery systems. The next requirement in the design process is realization of full-scale multistage TE devices in the medium to high temperature range for enhanced power generation. Here, we report the design and manufacturing of full-scale skutterudite (SKD)/half-Heusler (hH) cascaded TE devices with 49-couple TE legs for each stage. The automated pick-and-place tool is employed for module fabrication providing overall high manufacturing process efficiency and repeatability. Optimized Ti/Ni/Au coating layers are developed for metallization as the diffusion barrier and electrode contact layers. The Cu-Sn transient liquid phase sintering technique is utilized for SKD and hH stages, which provides a high strength bonding and very low contact resistance. A remarkably high output power of 38.3 W with a device power density of 2.8 W·cm-2 at a temperature gradient of 513 °C is achieved. These results provide an avenue for widespread utilization of TE technology in waste heat recovery applications.

A persistent neutrophil-associated immune signature characterizes post-COVID-19 pulmonary sequelae.

Interstitial lung disease and associated fibrosis occur in a proportion of individuals who have recovered from severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection through unknown mechanisms. We studied individuals with severe coronavirus disease 2019 (COVID-19) after recovery from acute illness. Individuals with evidence of interstitial lung changes at 3 to 6 months after recovery had an up-regulated neutrophil-associated immune signature including increased chemokines, proteases, and markers of neutrophil extracellular traps that were detectable in the blood. Similar pathways were enriched in the upper airway with a concomitant increase in antiviral type I interferon signaling. Interaction analysis of the peripheral phosphoproteome identified enriched kinases critical for neutrophil inflammatory pathways. Evaluation of these individuals at 12 months after recovery indicated that a subset of the individuals had not yet achieved full normalization of radiological and functional changes. These data provide insight into mechanisms driving development of pulmonary sequelae during and after COVID-19 and provide a rational basis for development of targeted approaches to prevent long-term complications.

Chest pain in a young patient: an unusual complication of Epstein-Barr virus.

A 29-year-old man presented with sudden left-sided pleuritic chest pain on a background of sore throat during the preceding week. On examination he had tender cervical lymphadenopathy, he was tachycardic and had a 24 mm Hg blood pressure difference between the left and right arms. Bloods revealed deranged liver function tests and a lymphocytosis. His D-dimer was raised, hence he was treated for presumed pulmonary embolism before imaging was available. Monospot test was positive. He subsequently had both a CT pulmonary angiogram and a CT angiogram of the aorta to exclude pulmonary embolism and aortic dissection. The CT revealed splenomegaly with a large subdiaphragmatic haematoma secondary to splenic rupture. This had likely caused referred pain through diaphragmatic irritation. He was taken to theatre for urgent splenectomy. The unifying diagnosis was infectious mononucleosis complicated by spontaneous splenic rupture secondary to Epstein-Barr virus infection.

Primary tuberculosis of the thyroid gland: an unexpected cause of thyrotoxicosis.

We describe a 38-year-old Indian man who presented with a 2-week history of fever, night sweats and neck swelling who was found to be clinically thyrotoxic with a nodular goitre, tachycardia and high fever. Biochemical investigation revealed hyperthyroidism in association with deranged liver function tests and raised inflammatory markers. Ultrasound and CT scans of the neck revealed multinodular thyroid enlargement. He was considered most likely to have an acute infectious thyroiditis with a differential diagnosis of a toxic multinodular goitre and was started on carbimazole and antibiotics. He underwent fine needle aspiration of the thyroid which revealed necrotic cells and acid-fast bacilli, confirming a diagnosis of primary tuberculosis (TB) of the thyroid gland with no evidence of any other organ involvement on systemic imaging. He was started on TB therapy for 6 months and discharged with outpatient follow-up. Symptoms and biochemical markers subsequently resolved.

Cerebral vasculitis and encephalitis due to Epstein-Barr virus in a patient with newly diagnosed HIV infection.

Epstein-Barr virus (EBV) is a common infection which usually produces mild or no symptoms in immunocompetent individuals. In human immunodeficiency virus (HIV) associated immunosuppression it is most commonly associated with malignancy which usually occurs at very low CD4+ cell counts. We describe a newly diagnosed HIV-positive patient who presented with headaches and cerebellar signs. She was incorrectly diagnosed with cerebral tuberculosis (TB) infection based on the histology report from a cerebellar biopsy specimen. After extensive investigation including cerebrospinal fluid sampling and reanalysis of the brain biopsy specimens she was found to have EBV-associated cerebral vasculitis and encephalitis and was successfully treated with valganciclovir and steroids. Whilst there are a few reports of EBV-associated encephalitis, cerebral vasculitis secondary to EBV in the context of HIV infection has not previously been described in the literature.