Distinct Points Research Articles

Viral encephalitis and seizures cause rapid depletion of neuronal progenitor cells and alter neurogenesis in the adult mouse dentate gyrus

Infections impacting the central nervous system (CNS) constitute a substantial predisposing factor for the emergence of epileptic seizures. Given that epilepsy conventionally correlates with hippocampal sclerosis and neuronal degeneration, a potentially innovative avenue for therapeutic intervention involves fostering adult neurogenesis, a process primarily occurring within the subgranular zone of the dentate gyrus (DG) through the differentiation of neural stem cells (NSC). While experimental seizures induced by chemoconvulsants or electrical stimulation transiently enhance neurogenesis, the effects of encephalitis and the resultant virus-induced seizures remain inadequately understood. Thus, this study employed the Theiler's Murine Encephalomyelitis Virus (TMEV) model of virus-induced seizures in adult C57BL/6J mice to investigate the impact of infection-induced seizures on neurogenesis at three distinct time points [3, 7, and 14 days post-infection (dpi)]. Immunohistochemical analysis revealed a reduction in the overall number of proliferating cells post-infection. More notably, the specific cell types exhibiting proliferation diverged between TMEV and control (CTR) mice: (1) Neuronal progenitors (doublecortin, DCX+) were almost entirely absent at 3 dpi in the dorsal DG. They resumed proliferation at 14 dpi, but, did not recover to CTR levels, and displayed aberrant migration patterns. (2) The number of proliferating NSCs significantly decreased within the dorsal DG of TMEV mice at 14 dpi compared to CTR, while (3) a heightened population of proliferating astrocytes was observed. Most observed changes were not different between seizing and non-seizing infected mice. In summary, our findings demonstrate that viral infection rapidly depletes neuronal progenitor cells and causes aberrant migration of the remaining ones, potentially contributing to hyperexcitability. Additionally, the increased differentiation toward glial cell fates in infected mice emerges as a possible additional pro-epileptogenic mechanism.

Empowering lives: How deinstitutionalization and community living improve the quality of life of individuals with intellectual and developmental disabilities.

The number of people with intellectual and developmental disabilities (IDD) living in residential settings has not changed substantially in recent years in Spain. To change this situation the project "My House: A Life in the Community" aims to promote the transition of individuals with IDD and high support needs into community settings. This paper deepens the understanding of the underlying mechanisms responsible for the changes observed in the process of deinstitutionalization. A longitudinal study was designed to evaluate the quality of life of individuals with IDD (n = 90) across different environments at two distinct time points: when they were living in an institution and nine months after transitioning to a community-based setting. A comparison group (n = 72) consisting of individuals who remained institutionalized was included to carry out intergroup comparisons. T-tests were used to estimate mean differences both between and within groups. Longitudinal path models were used to investigate the processes underlying the relationships between variables. After transition, movers obtained significantly higher mean scores on all variables with large or very large effect sizes. However, simply moving to a different place was not the factor responsible for the observed improvements: positive changes in quality of life require the constant availability of opportunities to support decision making. deinstitutionalization will only lead to improvements in quality of life if it favors people's control over their lives. Community living should therefore be understood not as an autonomous life but as a chosen one.

The Role of Emotions, Power, and Politics in Setting Policy Agenda: A Theoretical Analysis of Policy Inaction in the Shipbreaking Industries in Bangladesh

Agenda-setting may not always be a rational process and depends mostly on the perception of the policy problem made by the policy entrepreneurs to the decision-makers where ‘non-decision’ or ‘policy-inaction’ is also a kind of decision to avoid certain issues. Taking the existing ship-breaking policy of Bangladesh as a case study, this study tries to theoretically analyze how the level of public emotions and exercise of political power impact policy-making in a policy domain that resulted in no policy change. The study applies mainly two theories of public policy: the threshold model of the policy process by Christopher Pepin-Neff and the theory of three faces of power by Lukes which relates public emotions and political power with policy formulations. The study argues that, according to these theories, the case study is an example of high emotion policy threshold (HEHP) issue where, despite the initiatives by some policy actors to open a new policy window and the demands of the advocacy coalition consisting of International Labour Organization (ILO) and non-government organizations (NGO), the government used covert power to establish the preference of employment generation, national GDP and GNP and exclude the demand of policy-redesign from policy-agenda. The objective of this study is not to establish a new proposition of policy discussion but rather to discuss policy inaction or agenda-setting in an existing problem from a new perspective, theoretically from two distinct points of view: emotions and political power.

Mechanically induced polyamorphism in a one-dimensional coordination polymer.

We created different amorphous structures of a coordination polymer by applying mechanical shear forces. One-dimensional Cu(Tf2N)2(bip)2 (1, Tf2N- = bis(trifluoromethanesulfonyl)imide, bip = 1,3-bis(1-imidazolyl)propane) melted at 245 °C and underwent a glass transition at -10 °C by a static cooling process. 1 formed another amorphous state with a distinct glass transition point of 70 °C under oscillatory shear stress. The difference of orientation in their structures was studied by X-ray absorption fine structure and small-angle X-ray scattering. The reversible transition between the two amorphous states was observed by dynamic mechanical analyses.

Dynamics of affect modulation in neurodevelopmental disorders (DynAMoND) – study design of a prospective cohort study

BackgroundAttention-deficit/hyperactivity disorder (ADHD) is a common neuro-developmental disorder that often persists into adulthood. Moreover, it is frequently accompanied by bipolar disorder (BD) as well as borderline personality disorder (BPD). It is unclear whether these disorders share underlying pathomechanisms, given that all three are characterized by alterations in affective states, either long or short-term. BD is characterized by infrequent but intense mood shifts, while ADHD and BPD involve more dynamic emotional fluctuations. It is yet to be determined whether these disorders represent distinct phenomena or different points on a spectrum of affective dysregulation.MethodsThis study seeks to distinguish the emotional dysregulation of BPD, ADHD, and BD by using digital phenotyping, a measurement burst electronic-diary method with different sampling rates, and accelerometry to measure participants’ activity. Our study will include 480 participants aged 14 to 50 (120 each from BPD, ADHD, BD, and healthy control groups) from five European sites. Participants’ smartphones will provide continuous data on their digital phenotypes, i.e., by indicators of physical activity and communication, for one year, along with daily evening ratings of mood and sleep. Moreover, five intensive measurement periods of five days each, called measurement bursts, will occur throughout the year, with electronic diaries asking participants to report on mood, self-esteem, impulsivity, life events, social interactions, and dysfunctional behaviors ten times a day. Moreover, participants will wear activity sensors during the five measurement bursts. Statistical analysis aims to identify whether affective dysregulation aspects share or differ across disorders. Specifically, data analysis aims to investigate the differences in parameters of affect fluctuation such as attractor strength and variability between disorders and to test the association of genetic risk factors for psychiatric disorders and resilience factors with critical parameters of affect modulation.DiscussionThe results of this study offer the potential to link patients’ external exposures with their affective state, reduce misdiagnosis, and determine the best timing for therapeutic interventions. Potential limitations of the study include insufficient recruitment of patients and drop-outs due to various protocol violations.Trial registrationStudy code: DRKS00028917, registered 27.07.2022, https://drks.de/search/de/trial/DRKS00028917.

An Accuracy Study of Contact and Non-Contact Clinical Thermometers at Songklanagarind Hospital, Thailand

Objective: This study aimed to assess and validate the accuracy of contact clinical thermometers (CCTs), clinical digital thermometers (CDTs), temperature probes, and non-contact clinical infrared thermometers (NCCITs), which are commonly used at Songklanagarind Hospital.Material and Methods: The Medical Equipment and Maintenance Centre (MEMC) at Songklanagarind Hospital collected a total of 187 clinical thermometers, from various departments. This collection comprised of 45 temperature probes, 112 CDTs, and 30 infrared thermometers. All these thermometers underwent calibration at three distinct temperature points, via comparison with the secondary reference temperature standard (Pt100, SIKA). To assess the accuracy of the collected thermometers, an evaluation of the associated error and uncertainty was conducted. The maximum permissible errors (MPEs) were precisely defined as: ±0.2 °C and ±0.3 °C for CCT and ±0.5 °C for NCCIT.Results: The results revealed that all temperature probes, which represent 100% of the sample, demonstrated an average acceptable accuracy; determined by the average of the percentage of acceptable accuracy across three temperature calibration points, within the Maximum Permissible Error (MPE) range of ±0.2 °C. However, only 14% of the CDTs showed an average acceptable accuracy within the MPE of ±0.2 °C. Meanwhile, 51% of the CDTs met the MPE of ±0.3 °C. Additionally, 90% of the NCCIT demonstrated superior acceptable accuracy compared to the MPE of ±0.5 °C.Conclusion: This research emphasizes the significance of assessing the reliability and accuracy of clinical thermometers through calibration techniques; especially during the ongoing COVID-19 pandemic, which demands large-scale illness screening.

Protocol for evaluating physiological and psychological acclimatization mechanisms in Tibetan plateau environment: a clinical study of doctors from Peking Union Medical College Hospital.

The transition from low to high altitude environments is associated with a multifaceted series of physiological and psychological alterations that manifest over time. These changes are intricately intertwined, with physiological acclimatization primarily mediated through the regulation of hypoxia-inducible factor (HIF), which orchestrates the expression of critical molecules and hormones. This process extends to encompass the epigenome, metabolism, and other regulatory mechanisms. In the realm of psychological acclimatization, chronic hypoxia and changes in atmospheric pressure at high altitudes may contribute to decreased levels of neurotransmitters, with potential implications for mental health, particularly in relation to sleep quality. Despite significant advancements in our understanding of plateau acclimatization mechanisms in recent years, there remain many uncertain factors that necessitate further research. This study is a single-center prospective observational study. It aims to utilize a series of physiological and medical instruments in conjunction with internationally recognized physiological and psychological questionnaires to monitor the dynamic shifts in the acclimatization ability of doctors from Peking Union Medical College Hospital. The monitoring will occur at seven distinct time points: pre-departure from Beijing, 1-7 days post-arrival at the Tibetan plateau during the acute phase of plateau hypoxic stress, and during the chronic phase of plateau hypoxic stress at 2 weeks, 3 months, 6 months, 12 months of residency in Tibet, and post-return to Beijing. Concurrently, a spectrum of omics analyses will be conducted, including comprehensive genomic, proteomic, and metabolomic assessments of blood leukocytes, fecal, and oral samples.

Impact of Spinal Manipulative Therapy on Brain Function and Pain Alleviation in Lumbar Disc Herniation: A Resting-State fMRI Study.

To elucidate how spinal manipulative therapy (SMT) exerts its analgesic effects through regulating brain function in lumbar disc herniation (LDH) patients by utilizing resting-state functional magnetic resonance imaging (rs-fMRI). From September 2021 to September 2023, we enrolled LDH patients (LDH group, n=31) and age- and sex-matched healthy controls (HCs, n=28). LDH group underwent rs-fMRI at 2 distinct time points (TPs): prior to the initiation of SMT (TP1) and subsequent to the completion of the SMT sessions (TP2). SMT was administered once every other day for 30 min per session, totally 14 treatment sessions over a span of 4 weeks. HCs did not receive SMT treatment and underwent only one fMRI scan. Additionally, participants in LDH group completed clinical questionnaires on pain using the Visual Analog Scale (VAS) and the Japanese Orthopedic Association (JOA) score, whereas HCs did not undergo clinical scale assessments. The effects on the brain were jointly characterized using the amplitude of low-frequency fluctuations (ALFF) and regional homogeneity (ReHo). Correlation analyses were conducted between specific brain regions and clinical scales. Following SMT treatment, pain symptoms in LDH patients were notably alleviated and accompanied by evident activation of effects in the brain. In comparison to TP1, TP2 exhibited the most significant increase in ALFF values for Temporal_Sup_R and the most notable decrease in ALFF values for Paracentral_Lobule_L (voxelwise P<0.005; clusters >30; FDR correction). Additionally, the most substantial enhancement in ReHo values was observed for the Cuneus_R, while the most prominent reduction was noted for the Olfactory_R (voxelwise P<0.005; clusters >30; FDR correction). Moreover, a comparative analysis revealed that, in contrast to HCs, LDH patients at TP1 exhibited the most significant increase in ALFF values for Temporal_Pole_Sup_L and the most notable decrease in ALFF values for Frontal_Mid_L (voxelwise P<0.005; clusters >30; FDR correction). Furthermore, the most significant enhancement in ReHo values was observed for Postcentral_L, while the most prominent reduction was identified for ParaHippocampal_L (voxelwise P<0.005; clusters >30; FDR correction). Notably, correlation analysis with clinical scales revealed a robust positive correlation between the Cuneus_R score and the rate of change in the VAS score (r=0.9333, P<0.0001). Long-term chronic lower back pain in patients with LDH manifests significant activation of the "AUN-DMN-S1-SAN" neural circuitry. The visual network, represented by the Cuneus_R, is highly likely to be a key brain network in which the analgesic efficacy of SMT becomes effective in treating LDH patients. (Trial registration No. NCT06277739).

Binding site maturation modulated by molecular density underlies Ndc80 binding to kinetochore receptor CENP-T

Macromolecular assembly depends on tightly regulated pairwise binding interactions that are selectively favored at assembly sites while being disfavored in the soluble phase. This selective control can arise due to molecular density-enhanced binding, as recently found for the kinetochore scaffold protein CENP-T. When clustered, CENP-T recruits markedly more Ndc80 complexes than its monomeric counterpart, but the underlying molecular basis remains elusive. Here, we use quantitative in vitro assays to reveal two distinct mechanisms driving this behavior. First, Ndc80 binding to CENP-T is a two-step process: initially, Ndc80 molecules rapidly associate and dissociate from disordered N-terminal binding sites on CENP-T. Over time, these sites undergo maturation, resulting in stronger Ndc80 retention. Second, we find that this maturation transition is regulated by a kinetic barrier that is sensitive to the molecular environment. In the soluble phase, binding site maturation is slow, but within CENP-T clusters, this process is markedly accelerated. Notably, the two Ndc80 binding sites in human CENP-T exhibit distinct maturation rates and environmental sensitivities, which correlate with their different amino acid content and predicted binding conformations. This clustering-induced maturation is evident in dividing human cells, suggesting a distinct regulatory entry point for controlling kinetochore assembly. We propose that the tunable acceleration of binding site maturation by molecular crowding may represent a general mechanism for promoting the formation of macromolecular structures.

JNR Skyrmions

The JNR ansatz provides a simple formula to obtain families of charge N self-dual SU(2) Yang-Mills instantons in four-dimensional Euclidean space, from the free data of N + 1 distinct points with associated positive weights. Here an analogous formula is presented for Skyrme fields in three-dimensional Euclidean space. These families of Skyrme fields include good approximations to a range of Skyrmions, with energies that are typically within a few percent of the numerically computed solutions.

Differences in Psychological Coping with Illness During the Treatment and Survivorship Phases in Adolescents According to Age and Sex.

Despite the importance of addressing different stages of cancer, there is a lack of data on how these stages relate to coping strategies. This study aims to analyze coping strategies among adolescents with cancer by comparing two distinct time points, the treatment phase and the post-treatment phase, with a particular focus on age and gender. A total of 201 cancer patients aged 12 to 17 years from Alicante, Valencia, and Madrid participated in the study. They completed a Demographic and Clinical Data Form questionnaire capturing age, gender, and illness phase, along with the ACS to assess coping strategies. During the treatment phase, strategies such as "worrying", "stress reduction", "ignoring the problem", and "self-blame" were used more frequently than during the follow-up phase, revealing notable changes in emotional management between the two stages. Gender differences were observed in the first three strategies. The coping strategies of adolescents with cancer vary significantly between the treatment and follow-up phases, with greater use of certain strategies during treatment and a decline in their use post-treatment. These findings highlight the evolving emotional demands of each stage and emphasize the need for targeted interventions that address the specific coping needs unique to each phase. Such targeted interventions in clinical settings could support emotional management by adapting strategies to the distinct challenges faced by adolescents during treatment and post-treatment phases.

Essential Analysis of New SEVIR Model: A Five Case Epidemic Model

In this work, we introduce a new SEVIR epidemic model to analyze the dynamics of infectious diseases by incorporating the key compartments such as susceptible, exposed, vaccinated, infected, and recovered populations. We add the vaccination compartment in the current model and calculate the consequences concerning the disease spreading; it is significantly relevant at the present day considering the general policies of worldwide vaccinations. For a stringent assessment of stability, it should involve derivation of a basic reproduction number, as this parameter characterizes whether an infection will be spread at all. Our results demonstrate that when we have R0 &lt; 1, the disease-free equilibrium is locally asymptotically stable, which implies that an infection will eventually die out. We also identify two distinguished disease-dependent equilibrium points for the first time, giving much deeper insight into long term behavior of the disease. Numerical simulations show the efficacy of vaccination toward reducing the newly infected individuals and suggest the model can predict stabilization for all compartments over time. The exposed and recovered population increases and stabilizes as the susceptible, infected, and vaccinated populations decline. In this regard, these are valuable insights into the progression of epidemics and put emphasis on vaccination programs. Our model provides a perspective on disease control by taking into account the interplay between vaccination and infection dynamics. It can be very useful for predicting future outbreaks and can guide public health policy. Future work will extend the model by adding quarantine measures to further hone our understanding of disease transmission.

Visual Analysis of Anomalous Behavior Patterns in Oil Wells Using Dimensionality Reduction with t-SNE Projection

Anomaly detection in production processes, especially in the oil industry, is of paramount importance due to the complexity and criticality of these systems. Producing oil wells are subject to a series of dynamic and interdependent variables, which can be monitored using sensors installed along the well. Precise analysis of these sensor records is essential for early identification of possible anomalies, as any deviation from the normal pattern can result in serious consequences, from operational failures to environmental and safety risks. Given the multidimensionality and variability of this data, the use of machine learning techniques becomes indispensable for analyzing and classifying the well's situation. However, even for computational software, anomaly identification remains a significant challenge, given the oscillatory behavior and scale disparity of the variables analyzed throughout the well's productive life. To mitigate these challenges, dimensional reduction techniques can be implemented, as they can bring some advantages, such as reducing computational cost, noise reduction, and improving classifier accuracy. A widely used tool for dimensional reduction, especially for visualization, is Distributed Stochastic Neighbor Embedding (t-SNE), which seeks to project high-dimensional data into a low-dimensional space preserving clusters, bringing similar data together by affinity through a t-distribution. For this approach, real records of pressure and temperature sensors from oil wells are used. These sensors are located at eight distinct points in the well, totaling eight dimensions that will be reduced to a two-dimensional plane. Therefore, this study aims to identify behavior patterns in multivariate data from producing oil wells visually using the t-SNE dimensionality reduction method. It is expected that through visualization, it will be possible to identify behavior patterns before and after the occurrence of anomalies and enable the development of appropriate artificial intelligence algorithms for this anomaly detection problem.

Continuous Operators from Spaces of Lipschitz Functions

We study the existence of continuous (linear) operators from the Banach spaces Lip0(M) of Lipschitz functions on infinite metric spaces M vanishing at a distinguished point and from their predual spaces F(M) onto certain Banach spaces, including C(K)-spaces and the spaces c0 and ℓ1. For pairs of spaces Lip0(M) and C(K) we prove that if they are endowed with topologies weaker than the norm topology, then usually no continuous (linear or not) surjection exists between those spaces. It is also showed that if a metric space M contains a bilipschitz copy of the unit sphere Sc0 of the space c0, then Lip0(M) admits a continuous operator onto ℓ1 and hence onto c0. Using this, we provide several conditions for a space M implying that Lip0(M) is not a Grothendieck space. Finally, we obtain a new characterization of the Schur property for Lipschitz-free spaces: a space F(M) has the Schur property if and only if for every complete discrete metric space N with cardinality d(M) the spaces F(M) and F(N) are weakly sequentially homeomorphic.

Optimizing Perforation Phasing through Nearest Neighbor Lookup and Delaunay Triangulation

Summary Sand production is a common occurrence in reservoirs with weak sandstone undergoing pressure depletion during hydrocarbon extraction. Among available techniques, the adoption of the cased, cemented, and perforated well completions (CCPs) stands out for its inherent safety measures and cost-effectiveness compared to alternative methods. This approach is anticipated to offer substantial potential for bolstering hydrocarbon yields when juxtaposed with the openhole completion methodology, positioning it as a preferable well completion strategy for such reservoirs. In the design of perforation arrangements, the determination of shots per linear foot (SPF, spf) is typically contingent upon the targeted hydrocarbon production capacity. Thus, fine-tuning the phase angle becomes imperative to forestall overlap within the damaged zones surrounding neighboring perforations, thereby mitigating the interaction between them—a pivotal consideration in the design optimization process. In light of the absence of constraints and the relative ease of implementing a single helical perforation pattern (SHPP) over other intricate designs, this research is centered on ascertaining the minimal separation between adjacent perforations, termed the minimum perforation-to-perforation spacing (PPSm), across various phase angles within this pattern. This objective is pursued through a swift exploration of nearest neighbors (NN) facilitated by a spatial-partitioning data structure, specifically a k-dimensional tree (KDTree), aimed at probing the optimal phase angles for customary values of SPF, predicated on a well diameter of 8½ in. Achieving a uniform distribution of the perforations has been realized through the application of mathematical and statistical principles, utilizing a parameter known as the equilateral likeness score (ELS). Employing the Delaunay triangulation, the arrangement of the perforations has been meticulously configured to minimize this score, thereby signifying the most even distribution of them. The optimal phase angles have been discerned from two distinct vantage points—maximizing the spacing between adjacent perforations and maximizing the feasible angle values for the phasing. A comparative analysis between the outcomes derived from the proposed theory and those from prior theories—including the isosceles obtuse triangle pattern (IOTP)—reveals the likelihood of notable disparities in the calculated optimal phase angles. Particularly within the realm of the two-wrapped-based methodologies, variations in the magnitude of these angles can be substantial, extending up to approximately 80° for certain shot densities. Notably, the optimal phase angles of 97° and 77° have been estimated for two prevalent shot densities of 6 spf and 12 spf, respectively, contrasting with the values of 99° and 143° previously obtained using IOTP. This substantial difference in phase angles observed for the shot density of 12 spf has been minimized to approximately 1° through refinement of the previous method, achieved by removing its constraint on the number of wraps.

Transcriptomic insights into the stress signaling and drought tolerance mechanisms in sea-island cotton (Gossypium barbadense)

Drought stress significantly impacts plant growth and agricultural productivity. Elucidating the molecular mechanisms underlying drought stress response and plant tolerance is crucial for developing resilient crops. In Gossypium barbadense (G. barbadense), the specific genetic responses to drought stress remain underexplored. To provide insights into the transcriptomic dynamics and tolerance mechanisms in G. barbadense, we screened a diverse panel of G. barbadense accessions to identify drought-tolerant genotypes and investigate drought-stress responses across root and shoot tissues at two distinct time points. Differentially expressed genes (DEGs) analysis revealed diverse drought-responsive genes across tissue types and treatment time points. Functional enrichment and predictive protein-protein interaction (PPI) network analyses elucidated intricate patterns of drought-stress signaling pathways and transcriptional regulatory mechanisms. These upregulated DEGs were enriched in functional categories such as hormone signal transduction, phosphatidylinositol signaling system, ubiquitin-mediated proteolysis, phenylpropanoid biosynthesis, glutathione metabolism, and carbon metabolism pathways. The PPI network analysis underscores the activation of key signaling genes such as plant U-box E3 ubiquitin ligases (PUBs), protein phosphatase 2 C (PP2Cs), and F-Box genes, as well as transcriptional factors (CBF/NFYA) and various effector genes. These networks revealed the activation of effector genes involved in phenylpropanoid biosynthesis (Thioredoxin like 2–1, 1-Cys), glutathione metabolism (Thioredoxin, GPX6), and carbohydrate/sugar metabolism (GBSSI, AMY1.1). Gene silencing experiments validated the regulatory roles predicted for PUBs and PP2Cs in stress signaling and NFYA transcriptional factor in modifying the plant morphology and physiology to enhance drought tolerance. This research provides critical insights into the genetic signatures of stress signaling and regulatory pathways associated with drought tolerance in G. barbadense. The identified candidate genes are valuable for targeted breeding efforts to enhance drought tolerance and crop yield.

Post 80% Cycling of Li-Ion Cells, an Update on a Seven Year Cycling Study of Diverse Lithium-Ion Battery Chemistries

Li-ion batteries are increasingly being used in various sectors, including consumer electronics, electric vehicles (EVs), and grid energy storage, as critical components in modern infrastructure. Convention for the EV market dictated that 80% of the initial capacity of the battery represented the end of life and is therefore commonly marked as the end point of battery aging studies. To exploit the potential applications of a given cell, an understanding of degradation trends beyond 80% capacity is needed and requires the collection of data at various standard use conditions.This work details a multi-year cycling study of commercial LiFePO4 (LFP), LiNixCoyAl1−x−yO2 (NCA), and LiNixMnyCo1−x−yO2 (NMC) 18650 cells, varying the discharge rate (C-rate), state of charge (SOC) ranges, and environment temperature. This work builds on a previously published analysis performed up to 80% capacity, now focusing on post 80% analysis[1]. The capacity degradation of each chemistry, under varying conditions, were compared. Cycling at varying discharge C-rates (0.5C, 1C, 2C, 3C), SOC ranges (0-100%, 20-80%, and 40-60%) and temperatures (15, 25, and 35 °C) affected each chemistry to different extents. Therefore, the relative importance of each parameter in cyclic aging is different for different chemistries.Overall, we find that each cell chemistry can conduct significant cycling post 80%, in some cases to a capacity retention of 40%, with minimal loss of round-trip efficiency (RTE). We find that SOC range is the most consistent factor in cell capacity fade rate for all chemistries considered. Temperature had varied impacts on capacity fade depending on cell chemistry, for example NCA cells show no clear trend before 80% capacity, but post 80%, increased temperatures caused an increase in the rate of capacity fade. C-rate of discharge has a more prominent impact on capacity as cells age. LFP cells are the only ones that showed a clear trend of the highest and lowest C-rates causing the most rapid fade before 80%. Post 80%, the NMC and NCA cells start to show a similar trend and the LFP trend becomes more pronounced.Most batteries do not display a distinct knee point, instead exhibiting a more linear degradation with gradual increase in slope. When they do experience knee points, there is no consistent trend across chemistries and conditions that appear to cause knees. Other metrics such as RTE, total discharged energy, and internal resistance (IR) are also being considered to identify trends. This study represents the broadest public report of post 80% capacity cycling across multiple chemistries and will be valuable in lifetime prediction modelling for efficient battery usage.

A review of consent policies in Dermatological Surgery in the United Kingdom and the impact of leaner pathways and teledermatology on consent.

Obtaining valid consent is an ethical and legal requirement in clinical practice, ensuring patients are adequately informed about their treatments. Recent updates in consent policies, including GMC guidance, the Patterson inquiry report, and key legal rulings like Montgomery, emphasise a shift towards patient-centred care and the importance of a comprehensive patient-clinician dialogue. Budget constraints and increasing NHS demand have led to the adoption of digital solutions and streamlined pathways, such as teledermatology and direct booking to surgery, potentially compromising the consent process. This review examines the current state of informed consent in UK dermatology, particularly in light of the Montgomery ruling, which requires clinicians to ensure patients are aware of all material risks and alternatives associated with their treatments. The two-stage consent process, involving consent at two distinct points, is advocated to allow patients adequate time for reflection and decision-making. However, challenges remain in pathways like one-stop clinics and direct booking for surgery, where limited face-to-face interaction and time constraints can undermine the quality of informed consent. To mitigate these issues, integrating multimedia tools and standardised procedure-specific consent forms can enhance patient comprehension and satisfaction. These tools ensure consistent and clear communication of risks, benefits, and alternatives, maintaining robust informed consent amidst evolving healthcare delivery models. Sustaining a thorough and individualised dialogue throughout the patient care journey is essential for upholding patient autonomy and shared decision-making in dermatological surgery.

Analysis of different populations accessing online overdose response training and harm reduction supplies (ADORES)

BackgroundAn online mail order naloxone and harm reduction supply program was created by an interdisciplinary team at the University of Rhode Island College of Pharmacy and hosted on the university website (UNIV). The program was subsequently funded by the Rhode Island Department of Health (DOH) and added to the DOH website. This study compares demographic characteristics of the two populations submitting requests through the program’s distinct access points, UNIV and DOH, to those of populations at-risk for overdose.MethodsThis is a retrospective comparative analysis using voluntarily provided information from mail order request forms submitted through two websites from June 2020 through October 2023. The primary objective was to compare demographic characteristics of requesters through the two access points to those of individuals at-risk for experiencing or responding to an overdose. Descriptive statistics were used to characterize the two distinct populations. Chi-square tests were performed to determine if statistically significant differences in population demographics existed between access points. Odds ratios were estimated using a simple logistic regression model to assess the relationship between access point and demographic characteristic to determine if either access point had a greater likelihood of reaching individuals with at-risk demographics.ResultsA total of 5,783 (UNIV = 1662; DOH = 4121) mail order request forms were included in the analysis. Participants who completed requests through UNIV were more likely to be 44 years old or younger and/or reside in rural areas. Participants who submitted requests through DOH were more likely to reside in non-rural and/or low-income areas, and/or identify as gender minorities. Additionally, UNIV respondents were more likely to be first-time naloxone requesters while DOH respondents were more likely to have obtained and used naloxone before.ConclusionsResults establish that different access points can reach different at-risk population subsets and support the use of multiple access points and advertising strategies to expand the reach of online mail order harm reduction programs.Study registrationThe study was retrospectively approved by the University of Rhode Island Institutional Review Board (IRB reference #2124391-2).

Making wrong site surgery a "never event" in spinal deformity surgery by use of a "landmark vertebra" to eliminate variability in identifying a target vertebral level.

Despite the introduction of "standardized counting" methods, errors in counting spinal levels and subsequent wrong-level surgery (WLS)remain critically important patient safety concerns. Previous work by our group has documented inconsistency in the identification of T12 despite the use of these systems including the Spinal Deformity Study Group (SDSG)conventions. To assist with consistent and repeatable identification of proposed preoperative surgical levels, the current study investigates a new strategy: utilization of a "landmark vertebra". It was hypothesized that individuals using a "landmark vertebra" strategy will achieve high concordance with target level identification between distinct time points as compared to conventional methods defining T12. Survey participants analyzed 99 pre-op radiographs, identifying and naming a "landmark vertebra" with concise descriptions like "last bilaterally ribbed vertebra." They then noted the proposed lowest instrumented vertebra's (LIV) distance relative to landmark (i.e., one below landmark). After a waiting period, participants used their written descriptions of the landmark and distance to LIV to reidentify these vertebrae. Cohen's Kappa (k) was used to measure intra-rater agreeability. The landmark strategy was compared to our previous work evaluating consistency in defining T12 based on the SDSG system. All raters showed perfect to near-perfect agreement when re-identifying the landmark and target vertebrae (k = 0.819-1.00; Table1A). Raters at all training levels had higher agreeability in naming the landmark vertebra and target when compared to raters at similar training levels defining T12 (k = 0.34-0.91; Table1B). This high agreement across training demonstrates the strategy's versatility and generalizability. Utilization of a landmark strategy proved to be highly effective in reducing intra-rater variability, with perfect to near-perfect agreement among all raters and consistently higher agreeability when compared to defining T12. Level II-prospective survey.