Variety Of Patterns Research Articles

BN SO48 - Antibiotic prescribing for elective inguinal hernia repairs

Abstract Background Inguinal hernia repairs are a common procedure with over one million operations performed annually in Europe and the US. The European Hernia Society do not recommend the routine use of antibiotics in low-risk patients due to no significant benefit. They advise the consideration of prophylaxis for patients with risk factors including recurrence, age > 70 years or immunosuppression. Many surgeons are using antibiotic prophylaxis in all patients. However, inappropriate antibiotic use contributes to increased antibiotic resistance and increased healthcare cost. Our trust guidelines recommend a single dose of Cefuroxime in all patients undergoing an inguinal hernia repair with mesh. Method The aim of the project was to determine the compliance with current trust guidelines regarding antibiotic use in elective inguinal hernia repair with mesh. We also aimed to report on antibiotic prescribing patterns. Patients undergoing an elective inguinal hernia repair with mesh over a six-month period were identified. Data was collected retrospectively from electronic patient records and included patient’s age, if they were classed as high risk (age over 70, recurrence of hernia, diabetic, steroid therapy), if antibiotics were prescribed, and if so, which antibiotics were utilised. Results Eighty-five patients were included in the final data analysis. The median age of patients included was 67 years of age, and 93% were male. 41 patients were identified as high risk, and most patients were ASA II. Our results reported that 48% of patients were prescribed prophylactic antibiotics at induction. However, only two patients were prescribed the correct antibiotic, as per trust guidelines. Most patients were prescribed Co-Amoxiclav (78%), with a range of other antibiotics being used, including Flucloxacillin, Clarithromycin and Metronidazole. We identified 37% of high-risk patients were not prescribed antibiotics. Conclusion Our trust guidelines were not reflective of best practice and did not consider individual patient or procedure risk factors. We identified varied antibiotic prescribing patterns with low compliance to trust guidelines. Utilising our findings, we have created new guidelines, which recommend that in low-risk patients, routine antibiotic prophylaxis is not required. However, in the presence of patient-related risk factors as mentioned above, then a single dose of Cefuroxime is recommended. The updated guidelines will ensure good antimicrobial stewardship and reduce unnecessary antibiotic prescriptions. In addition, they accurately reflect the current evidence base surrounding antibiotic prophylaxis.

Racially Informed Ethnic Heterogeneity in Asian American Intermarriage and Assimilation

Though racial integration of non-White minorities was initially considered unlikely, Asian Americans’ high rates of intermarriage with Whites suggest a new possibility. Recent research, however, reveals that Asian American intermarriage occurs in ethnically heterogeneous manners and further varies by spousal race and ethnicity. This study delves into the varied patterns of marital racial integration among Asian Americans, examining intermarriage data from the American Community Survey (ACS). In examining both interethnic and Asian-White interracial marriages, I find that Asian Americans continue to experience segmented assimilation in intermarriage, where their paths diverge by spousal race. Yet, ethnically heterogeneous understandings and experiences of one’s social position as “Asian” situate Asian Americans at varying distances from the mainstream White society, leading some Asian Americans to intermarry without having achieved acculturation or middle-class attributes. These findings challenge the presumed linear trajectory of minority incorporation, underscoring the pivotal role of race and racialization. This complexity further carries significant implications for broader American race relations

Prehistoric Italian foodways: Meta-analysis of stable isotope data from the Neolithic to the Iron Age

Italian Later Prehistory was characterised by profound changes that impacted everyday life in many aspects. Whether or not and how such changes were reflected in the subsistence practices of ancient populations is an ongoing question in the archaeological debate. This question has been investigated using stable carbon and nitrogen isotope analysis for several decades. Here, we present a 6000-year-long review of isotopic studies in the Italian Peninsula from the Neolithic to the Iron Age. We reconstruct chronological variations in food practices by observing δ13C and δ15N trends for 776 humans, 382 animals, and 432 C3 plants from 111 archaeological sites. During the Neolithic, when farming is first introduced, a homogenous signal characterised by terrestrial protein consumption is visible. The Copper Age, instead, shows a more varied pattern, possibly representative of a more diversified use of the landscape, characteristic of those millennia. The new cultural paradigm that invested Europe during the Bronze Age is also reflected in food practices in Italy, with the introduction of millets - signalled by high δ13C values in the Northern regions - possibly representing a pivotal shift. Not much data is available for the Iron Age, as only two sites from Northern Italy, showing a diffused consumption of C4 plants, and one site from Southern Italy, with a diet centred around C3 plants, are available for this period. The analysis of this extensive set of data suggests that the “Secondary Products Revolution” probably meant a shift in subsistence practices, with secondary sources substituting meat rather than integrating it.

High-performance near-substrate heat sink with Tesla-like rotor-wing microchannel for chiplet cooling application

Microchannel heat sink provides a viable solution for enhancing thermal management in high-power chiplets. However, in consideration of cooling efficiency, low pressure drop, cost-effectiveness and reliability, it’s challenging to create an effective heat sink for a million-watt chip. Inspired by Tesla structure, this study introduces a Tesla-like rotor-wing microchannel (TRWM) to boost cooling performance. Due to the features of main channels, branch channels, and micro-islands in TRWM design, fluid in microchannel is effectively mixed and stirred with varied flow patterns, high temperature gradients and significant velocity gradients, which enhances the cooling capacity through precise fluid dynamics adjustment. Three different TRWMs are designed and compared by simulations. And the simulated results show that TRWM of 135° model achieves a maximum heat flux of 1514 W cm−2 @0.1 cm2 under a 60 K temperature rise, improving cooling efficiency by 19.4 % over the traditional channel design with 1221 W cm−2 @0.1 cm2. And then, the TRWM is fabricated using Ultraviolet Lithgraphie Galvanoformung Abformung (UV-LIGA) and bonding processes. Ultimately, the fabricated 135° TRWM sample demonstrated a heat dissipation capacity of up to 1446 W cm-2 @0.1 cm2 with a temperature increase of 60 K, which corresponds well with the simulated results. Moreover, the discrepancy between the actual and simulated values is less than 6.3 % under the same conditions. This performance provides a practical design solution for chiplet cooling and highlights the potential of bioinspired microfluidics.

On-Body Cavity-Backed Slot Antenna With Pattern and Polarization Diversity for Medical Imaging

On-Body Cavity-Backed Slot Antenna With Pattern and Polarization Diversity for Medical Imaging

FGF8-mediated gene regulation affects regional identity in human cerebral organoids.

The morphogen FGF8 establishes graded positional cues imparting regional cellular responses via modulation of early target genes. The roles of FGF signaling and its effector genes remain poorly characterized in human experimental models mimicking early fetal telencephalic development. We used hiPSC-derived cerebral organoids as an in vitro platform to investigate the effect of FGF8 signaling on neural identity and differentiation. We found that FGF8 treatment increases cellular heterogeneity, leading to distinct telencephalic and mesencephalic-like domains that co-develop in multi-regional organoids. Within telencephalic domains, FGF8 affects the anteroposterior and dorsoventral identity of neural progenitors and the balance between GABAergic and glutamatergic neurons, thus impacting spontaneous neuronal network activity. Moreover, FGF8 efficiently modulates key regulators responsible for several human neurodevelopmental disorders. Overall, our results show that FGF8 signaling is directly involved in both regional patterning and cellular diversity in human cerebral organoids and in modulating genes associated with normal and pathological neural development.

Genome-wide analyses of Ariadne family genes reveal their involvement in abiotic stress responses in apple

E3 ligases are essential for ubiquitination and play a role in regulating various aspects of eukaryotic life. Ariadne (ARI) proteins, a subfamily of RBR (RING-between-RING) proteins, have been recognized as a new class of RING-finger E3 ligases. Recent research has shed light on their potential involvement in plants’ responses to abiotic stress. However, comprehensive studies on ARI genes in apple (Malus domestica) are still lacking. This study identified ten MdARI genes in the apple genome, and examined intraspecific and interspecific collinearity to explore the evolutionary relationships of ARI family members. Phylogenetic analyses classified MdARIs into two subfamilies (A and B), and by integrating gene structure, conserved motifs, and sequence comparison results, subfamily B was further divided into two subgroups (I and II). Tissue expression analyses revealed varied expression patterns of MdARI genes in different tissues, and subcellular localization showed that MdARI1-1, MdARI1-2, and MdARI9-1 were located in the nucleus, while the other seven MdARIs were distributed throughout the cell. Analyses of promoter cis-elements and expression patterns under cold, salt, and drought treatments indicated the involvement of MdARIs in abiotic stress responses. Several proteins crucial to the plant stress response were predicted to be potential MdARIs-interacting proteins based on the protein interaction network. Additionally, the interaction between UBC11 (E2) and MdARI7-2 was confirmed by a yeast two-hybrid (Y2H) experiment, suggesting that MdARI7-2 may function as an E3. These findings will greatly benefit future research on the role and mechanisms of ARI proteins in apple stress response.

CPW fed optically transparent ultrawideband fractal MIMO terahertz antenna with meshed ground plane

Abstract An optically transparent UWB antenna element and its two-element pattern diversity MIMO configurations are presented in this paper. Three iterations of the quarter elliptical coplanar waveguide ground plane, rectangular microstrip feedline, and octagonal annular rings make up the antenna element. By metal meshing the ground planes and loading the radiator with several octagonal slots, the optical transparency is improved. It has a maximal achieved gain of 6.78 dBi and operates with steady radiation characteristics over the frequency spectrum of 4.52–28.64 THz (145.48%). The dimensions of the antenna element are 18 × 20.5 μm2. A metallic stub is positioned between two identical antenna components that are positioned orthogonally to one another to create a two-element pattern diversity MIMO antenna arrangement. The MIMO antenna is 20.5 × 42.5 μm2 in total. Its impedance bandwidth is 23.72 THz for port 2 and 22.68 THz for port 1. Using a rectangular stub results in an intraport isolation of >19 dB. Between the two ports, the planes in the radiation patterns have switched places. The diversity performance characteristics, which are considerably below the permissible limitations, are as follows: ECC > 0.01, CCL < 0.3 b/s/Hz, DG ∼ 10, TARC < 0 dB, MEG ∼ −3 dB, and 1≤VSWR_MIMO≤2. Compared to previously published structures, the suggested antenna structures have the advantages of smaller dimensions, a larger bandwidth, and improved optical transparency.

Effects of urban areas on the diurnal cycle of temperature and precipitation in a global climate simulation

AbstractAnalyses of global climate model results for urban impacts on temperature and precipitation are rare. Previous analyses of the global Conformal Cubic Atmospheric Model simulation results for 1985–2010 have revealed urban effects on minimum and maximum temperatures. Using the same dataset to derive time‐zone‐corrected three‐hourly local time period (LTP) data, averaged diurnal cycles of temperature and precipitation were calculated for grid cells with greater than 10% urban fraction (urban grid cells) globally. Three latitudinal bands were assessed: northern extratropics (NET, 274 urban grid cells), southern extratropics (SET, 39 urban grid cells), and the Tropics (26 urban grid cells). The largest statistically significant urban influences on temperature are consistently found at night, in agreement with many previous studies on urban heat islands. Signs of urban cooling were found for a few hours, from 09:00 to 15:00 LTP, most often in summer. Influences of urban areas on precipitation varied, with small increases and decreases in all latitudinal bands and seasons. For NET, increases were generally found. In the Tropics, increases were found from 21:00 to 09:00 LTP for all seasons except DJF, with decreases for all seasons from 15:00 to 18:00 LTP. In SET, all seasons had increases for 21:00 to 00:00 LTP and decreases for 15:00 to 18:00 LTP. DJF had decreases for all LTPs except 21:00 to 00:00 LTP and SON had increases for all times except 15:00 to 18:00 LTP. Differences in rainfall in the region surrounding the urban areas were broadly similar to local changes in NET. For the Tropics and SET, regional decreases were found for DJF and JJA, with a more varied pattern for other months. Regional effects appeared to be more restricted to near‐urban areas in the Tropics than in NET. The results indicate some influence of nearby urban areas on regional temperature and precipitation.

Hypothalamic-pituitary-adrenal axis plasticity across life-history stages of a free-living subtropical finch, Amandava amandava amandava.

The alterations of phenotypic traits (morphology, endocrine physiology, and behavior) in response to predictable environmental cues across life-history stages in seasonally breeding birds enable successful culmination of reproduction. The present study elucidated the plasticity of the hypothalamic-pituitary-adrenal (HPA) axis in a subtropical free-living finch, Amandava amandava amandava, and suggests the crucial role of the baseline corticosterone (CORT) to coordinate energetic readiness across life-history stages. Birds were captured monthly from an area (25.1337° N 82.5644° E) in Uttar Pradesh, India, from June 2014 to May 2015. Only male birds were included in this study corresponding to different life-history stages (6/life-history stage; 2/month): pre-breeding (June-August), breeding (September-November), post-breeding (December-February), and quiescent phases (March-May). The pituitary expression of adrenocorticotropic hormone (ACTH), adrenal interrenal cell morphometry, and plasma level of the CORT showed varied patterns across life-history stages. The density and immunointensity of the ACTH-immunoreactive corticotropes and the interrenal cell number increased along with the significant plasma CORT elevation during the breeding cycle (both pre-breeding and breeding phases). CORT might facilitate the energy demand for the display of sexual behavior (nest-building, courtship), testicular recrudescence, and foraging of food for offspring during the breeding cycle. On the contrary, plasma CORT decrease in the post-breeding and quiescent phases might enable the bird to molt avoiding the protein catabolic effect of the hormone. Given the complexity involved in the study of baseline CORT in free-living birds, more studies are needed to better understand the crucial role of the HPA axis in the modulation of life-history stages in this and other subtropical avian species.

Simultaneous Integration of Pattern, Frequency and Polarization Diversities in Broadband Programmable Metasurface for Computational Imaging

Simultaneous Integration of Pattern, Frequency and Polarization Diversities in Broadband Programmable Metasurface for Computational Imaging

Circularly polarized twin port tunable silicon-graphene antenna with beam tilting characteristics for THz based 6G communication system

Abstract This communication explains the design and analyse of twin port silicon-graphene aerial. The intended aerial has three distinct features: (i) stimulation of ceramic through uneven cross slot produces the circularly polarised waves from 3.45 THz to 3.65 THz; (ii) a mirror arrangement of uneven cross shaped slot increases separation between ports by almost 25 dB; and (iii) suspension of partial reflecting surface over twin port antenna slants the radiation pattern by ±450. A sheet of graphene over silicon creates the tunablity in terms of working band and circularly polarized band by altering its chemical potential. The optimized result from HFSS is compared to the CST EM tool, and it is determined that the suggested aerial functions well in the 3.25-3.75 THz range with a peak gain of 3.5 dBi. By including pattern diversity characteristics, the suggested antenna's multi-port parameters are improved, and it becomes suitable for THz-built 6G wireless applications.

Barriers in translating existing nutrigenetics insights to precision nutrition for cardiometabolic health in ethnically diverse populations.

Cardiometabolic diseases pose a significant threat to global public health, with a substantial majority of cardiovascular disease mortality (more than three-quarters) occurring in low- and middle-income countries. There have been remarkable advances in recent years in identifying genetic variants that alter disease susceptibility by interacting with dietary factors. Despite the remarkable progress, several factors need to be considered before the translation of nutrigenetics insights to personalised and precision nutrition in ethnically diverse populations. Some of these factors include variations in genetic predispositions, cultural and lifestyle factors as well as socioeconomic factors. This review aims to explore the factors that need to be considered in bridging the gap between existing nutrigenetics insights and the implementation of personalised and precision nutrition across diverse ethnicities. Several factors might influence variations among individuals with regards to dietary exposures and metabolic responses and these include genetic diversity, cultural and lifestyle factors as well as socioeconomic factors. A multi-omics approach involving disciplines such as metabolomics, epigenetics and the gut microbiome might contribute to improved understanding of the underlying mechanisms of gene-diet interactions and the implementation of precision nutrition although more research is needed to confirm the practicality and effectiveness of this approach. Conducting gene-diet interaction studies in diverse populations is essential and studies utilising large sample sizes are required as this improves the power to detect interactions with minimal effect sizes. Future studies should focus on replicating initial findings to enhance reliability and promote comparison across studies. Once findings have been replicated in independent samples, dietary intervention studies will be required to further strengthen the evidence and facilitate their application in clinical practice. Nutrigenetics has a potential role to play in the prevention and management of cardiometabolic diseases. Conducting gene-diet interaction studies in diverse populations is essential giving the genetic diversity and variations in dietary patterns. Integrating data from disciplines such as metabolomics, epigenetics and the gut microbiome could help in early identification of individuals at risk of cardiometabolic diseases as well as the implementation of precise dietary interventions for preventing and managing cardiometabolic diseases.

Visualizing patterns of factors influencing school health promotion implementation

Abstract Background The school setting offers a special opportunity for health-promotion (HP) interventions, as children spend 1/3 of their daily time there. Yet, implementing HP remains challenging due to the complexity of schools and unique contextual factors influencing implementation. While common influencing factors have been described, the aim of this study is to explore how influencing factors co-occur within and vary across schools, forming potential patterns of barriers and facilitators. Methods As part of a school HP program involving 258 institutions across Germany, nine schools were selected using maximum heterogeneity sampling for in-depth interviews on influencing factors by employing the Consolidated Framework for Implementation Research (CFIR). The interviews were transcribed verbatim and analyzed deductively using the CFIR as category system. Identified influencing factors were quantified [-5; +5] whether being a major barrier (-5) or a major facilitator (+5). To visualize potential patterns, a matrix heat map (MHM) displaying all influencing factors across all schools was created. Preliminary results Influencing factors in almost all CFIR categories were identified and all schools reported factors as barriers, such as parental engagement or (in)sufficient time. From the MHM, patterns of influencing factors, co-occurring within and differing across schools, emerged. For instance, some schools found the physical environment to be a barrier, while others considered it a facilitator, often in conjunction with financing as another facilitator. Conclusions Qualitative analysis and visualization of results with a MHM served as a way to navigate the complexity of the school setting and to highlight patterns of factors influencing implementation. Understanding these patterns can enhance tailoring implementation strategies, thereby improve implementation of school HP interventions and, ultimately, foster child health outcomes. Key messages • Influencing factors for school HP implementation manifest in varied patterns of barriers and facilitators across schools, which has implications for tailoring implementation strategies. • Using qualitative analysis guided by the CFIR and a MHM for visualization can aid in navigating the complexity of schools.

Economic assessment of ecosystem services with a novel concept of elevation: An application of the discrete choice experiment method

AbstractThis research was conducted in the Hei River Basin of China to understand respondents' willingness to pay (WTP) for ecological services towards sustainable river system management. A discrete choice experiment is used to gauge respondents' preferences. In addition, elevation was introduced as a novel spatial attribute to account for heterogeneity. Primary data from 1680 respondents were collected across the Hei River Basin. The elevation of the river was categorized into five ad hoc elevation ranges to analyze the potential effects of elevation on environmental attributes. These samples were stratified as 1000–1600 m, 1601–2200 m, 2201–2800 m, 2801–3400 m, and 3401–4000 m. Pooled data results showed that the maximum WTP was for water quality, that is, 142.05 RMB, without considering the effect of elevation. However, when the interaction with elevation was included, the amount decreased to 133.52 RMB. Likewise, elevation‐based group estimates showed a varied pattern of spatial preference, with different preferences for each distinguishing attribute. Group A prioritized water quality (92.81 RMB) and the East Juyan area (4.12 RMB). In contrast, Group B preferred the guaranteed rate of irrigation of farmland (3.50 RMB) and reduced sandstorm frequency (17.90 RMB). Leisure and entertainment conditions had the lowest WTP across all groups (0.09–0.50 RMB). These findings highlight the importance of incorporating respondents' preferences in restoring and maintaining river systems. Additionally, it emphasized the need to consider respondents' socioeconomic characteristics when developing sustainable management policies.

Research on high-precision recognition model for multi-scene asphalt pavement distresses based on deep learning

Accurate detection of asphalt pavement distress is crucial for road maintenance and traffic safety. However, traditional convolutional neural networks usually struggle with this task due to the varied distress patterns and complex background in the images. To enhance the accuracy of asphalt pavement distress identification across various scenarios, this paper introduces an improved model named SMG-YOLOv8, based on the YOLOv8s framework. This model integrates the space-to-depth module and the multi-scale convolutional attention mechanism, while optimizing the backbone’s C2f structure with a more efficient G-GhostC2f structure. Experimental results demonstrate that SMG-YOLOv8 outperforms the YOLOv8s baseline model, achieving Pmacro and mAP50 scores of 81.1% and 79.4% respectively, marking an increase of 8.2% and 12.5% over the baseline. Furthermore, SMG-YOLOv8 exhibits clear advantages in identifying various types of pavement distresses, including longitudinal cracks, transverse cracks, mesh cracks, and potholes, when compared to YOLOv5n, YOLOv5s, YOLOv6s, YOLOv8n, and SSD models. This enhancement optimizes the network structure, reducing the number of parameters while maintaining excellent detection performance. In real-world scenarios, the SMG-YOLOv8 model, when applied to image data collected from projects, achieves a Pmacro of 80.5% and an Rmacro of 86.2%. This result demonstrates its excellent generalization capability and practicality. The model provides significant technical support for the intelligent detection of pavement distress.

Super Low Profile 5G mmWave Highly Isolated MIMO Antenna with 360∘ Pattern Diversity for Smart City IoT and Vehicular Communication

This study introduces a planar folded super low profile 5G mmWave monopole antenna for small IoT devices with superior efficiency and gain. Low-loss Rogers RT-5880 substrate material has been utilized to achieve higher efficiency, gain, and diversity performance in a relatively compact size. The unit element planar monopole antenna has been designed within 6.15×5.13×0.8mm3 with a partial ground. Four unit element antenna was orthogonally arranged on alternating sides of the substrate plane with narrow inter-component spacing in the multiple input multiple output (MIMO) system. The integration of the double negative (DNG) metamaterial array on the antenna led to a cumulative improvement in the overall performance of the antenna, which includes gain, efficiency, and isolation. The minimum isolation of the antenna increased by 11 dB with substrate-loaded metamaterial. The proposed MIMO antenna model with substrate-loaded metamaterial demonstrates 8 GHz instantaneous bandwidth (33.1 GHz - 41.1 GHz), 0.001 envelope correlation coefficient (ECC), diversity gain (DG) greater than 9.99 dB, channel capacity loss (CCL) less than 0.2bits/s/Hz, and a total active reflection coefficient (TARC) of 25 dB, which suggests that the diversity characteristics of the MIMO antenna system is impressive. Moreover, a densely packed 12-element antenna model has been introduced in this study with 360∘ pattern diversity, capable of receiving signals from any direction. Three 4-element MIMO systems have been arranged in an architecture to develop the 12-element MIMO system, and the size of the 12-element MIMO architecture is 15×15×15mm3. Despite having this compact size and dense packing, the 12-element MIMO antenna model shows similar diversity performance as the 4-element antenna model. Analog equivalent circuit models or resistor-inductor-capacitor (RLC) equivalent systems for the antenna models were created. A concept of a 128-element massive MIMO antenna has been presented to support the end devices, creating an application scenario of an IoT-interconnected smart city.

Anomaly detection for bridge health monitoring data based on multiple encoded images and convolutional neural network

In bridge health monitoring systems, abnormal monitoring data inevitably appear due to the complex operational conditions, and these anomalous data will seriously affect the accuracy and reliability of the results of bridge health assessment. Hence, it is vital to detect the abnormal data before further processing. However, the pattern diversity and sample scarcity usually make the accuracy of data anomaly detection unsatisfactory. A novel anomaly detection method for bridge health monitoring data based on encoded images and convolutional neural network (CNN) is proposed in this paper. First, the raw time series are encoded into images to highlight the intrinsic features in the anomaly data, and multiple encoding techniques are adopted to represent the data in different perspectives. Then, the CNN is utilized to establish the mapping between the encoded images and the anomaly patterns for achieving the data anomaly detection. At last, the proposed method is verified with the acceleration data measured from an actual large span cable-stayed bridge. It shows that the proposed method can significantly improve the performance of data anomaly detection while the results are hardly affected by the small sample sizes, and a detection accuracy of over 95% is achieved based on the multiple encoded images.

Translation of pathophysiological mechanisms of atrial fibrosis into new diagnostic and therapeutic approaches.

Atrial fibrosis is one of the main manifestations of atrial cardiomyopathy, an array of electrical, mechanical and structural alterations associated with atrial fibrillation (AF), stroke and heart failure. Atrial fibrosis can be both a cause and a consequence of AF and, once present, it accelerates the progression of AF. The pathophysiological mechanisms leading to atrial fibrosis are diverse and include stretch-induced activation of fibroblasts, systemic inflammatory processes, activation of coagulation factors and fibrofatty infiltrations. Importantly, atrial fibrosis can occur in different forms, such as reactive and replacement fibrosis. The diversity of atrial fibrosis mechanisms and patterns depends on sex, age and comorbidity profile, hampering the development of therapeutic strategies. In addition, the presence and severity of comorbidities often change over time, potentially causing temporal changes in the mechanisms underlying atrial fibrosis development. This Review summarizes the latest knowledge on the molecular and cellular mechanisms of atrial fibrosis, its association with comorbidities and the sex-related differences. We describe how the various patterns of atrial fibrosis translate into electrophysiological mechanisms that promote AF, and critically appraise the clinical applicability and limitations of diagnostic tools to quantify atrial fibrosis. Finally, we provide an overview of the newest therapeutic interventions under development and discuss relevant knowledge gaps related to the association between clinical manifestations and pathological mechanisms of atrial fibrosis and to the translation of this knowledge to a clinical setting.

Design and optimization of dielectric resonator based MIMO antenna with beam tilting at mm-wave for enhanced 5G communication using machine learning

In this paper, a dual-port ceramic-based multiple-input multiple-output (MIMO) antenna is designed for operation at mm-wave frequencies. The design incorporates a partially reflecting surface (PRS) positioned above the dual-port antenna to facilitate beam tilting. Additionally, various machine learning (ML) algorithms are utilized to optimize the unit cell length and the distance between the Dielectric Resonator Antenna (DRA) and the PRS, thereby achieving the desired beam tilting characteristics. The ceramic element is excited through an aperture, which generates the HEM11δ mode in the cylindrical dielectric resonator antenna (CDRA). The proposed antenna demonstrates excellent port isolation, exceeding 35 dB, and operates effectively within the 25.9–27.4 GHz frequency range. The PRS enables a broadside beam tilt of ±30 degrees, incorporating pattern diversity into the design. These characteristics make the proposed antenna an ideal candidate for mm-wave vehicle-to-vehicle and 5G communication systems.