Early Transition Research Articles

Impaired Cardiorespiratory Fitness of Elite Athletes after Asymptomatic or Mild SARS-CoV-2 Infection

Background and Objectives: The aim of the study was to evaluate the health status of professional athletes after recovering from COVID-19 and the impact that SARS-CoV-2 had on their overall cardiorespiratory fitness, which was done by conducting cardiopulmonary exercise testing (CPET). Materials and Methods: A total of twenty-seven professional basketball players (Euroleague Basketball and the ABA League) participated in the study. CPET was performed before (as part of their regular preparticipation exam, during the pre-season period), as well as after SARS-CoV-2 infection (after two weeks of home isolation, during the competitive part of the season). CPET was performed on a treadmill, while cardiovascular, respiratory, and metabolic functions were evaluated by using a breath-by-breath analysis technique (Quark CPET system manufactured by Cosmed, Rome, Italy). Results: Maximal oxygen consumption and aerobic efficiency were significantly reduced after SARS-CoV-2 infection (p = 0.000). An obvious decrease in oxygen pulse was observed during CPET after recovering from COVID-19 (p = 0.001), as was deterioration of ventilatory efficiency. Internal respiration was the most negatively affected. An early transition from aerobic to anaerobic mechanisms of creating energy for work and intensive metabolic fatigue were obvious after SARS-CoV-2 infection. Conclusions: Although it was believed that SARS-CoV-2 only affects the cardiopulmonary status of the elderly population and people with associated comorbidities, it is clear from this research that professional athletes can also be at certain risk. Even though no pathological cardiovascular and respiratory changes were found in athletes after COVID-19, results showed significantly decreased cardiorespiratory fitness, with an emphasis on internal respiration.

Increasing the Use of Enteral Antibiotics in Hospitalized Children With Uncomplicated Infections.

Route of administration is an important component of antimicrobial stewardship. Early transition from intravenous to enteral antibiotics in hospitalized children is associated with fewer catheter-related adverse events, as well as decreased costs and length of stay. Our aim was to increase the percentage of enteral antibiotic doses for hospital medicine patients with uncomplicated common bacterial infections (community-acquired pneumonia, skin and soft tissue infection, urinary tract infection, neck infection) from 50% to 80% in 6 months. We formed a multidisciplinary team to evaluate key drivers and design plan-do-study-act cycles. Interventions included provider education, structured discussion at existing team huddles, and pocket-sized printed information. Our primary measure was the percentage of antibiotic doses given enterally to patients receiving other enteral medications. Secondary measures included antibiotic cost, number of peripheral intravenous catheters, length of stay, and 7-day readmission. We used statistical process control charts to track our measures. Over a 6-month baseline period and 12 months of improvement work, we observed 3183 antibiotic doses (888 in the baseline period, 2295 doses during improvement work). We observed an increase in the percentage of antibiotic doses given enterally per week for eligible patients from 50% to 67%. We observed decreased antibiotic costs and fewer peripheral intravenous catheters per encounter after the interventions. There was no change in length of stay or readmissions. We observed increased enteral antibiotic doses for children hospitalized with common bacterial infections. Interventions targeting culture change and communication were associated with sustained improvement.

Complexity of many-body interactions in transition metals via machine-learned force fields from the TM23 data set

This work examines challenges associated with the accuracy of machine-learned force fields (MLFFs) for bulk solid and liquid phases of d-block elements. In exhaustive detail, we contrast the performance of force, energy, and stress predictions across the transition metals for two leading MLFF models: a kernel-based atomic cluster expansion method implemented using sparse Gaussian processes (FLARE), and an equivariant message-passing neural network (NequIP). Early transition metals present higher relative errors and are more difficult to learn relative to late platinum- and coinage-group elements, and this trend persists across model architectures. Trends in complexity of interatomic interactions for different metals are revealed via comparison of the performance of representations with different many-body order and angular resolution. Using arguments based on perturbation theory on the occupied and unoccupied d states near the Fermi level, we determine that the large, sharp d density of states both above and below the Fermi level in early transition metals leads to a more complex, harder-to-learn potential energy surface for these metals. Increasing the fictitious electronic temperature (smearing) modifies the angular sensitivity of forces and makes the early transition metal forces easier to learn. This work illustrates challenges in capturing intricate properties of metallic bonding with current leading MLFFs and provides a reference data set for transition metals, aimed at benchmarking the accuracy and improving the development of emerging machine-learned approximations.

Characteristics of turbulent core–annular flow with water-lubricated high viscosity oil in a horizontal pipe

Direct numerical simulations are performed to investigate the characteristics of a turbulent core–annular flow with water-lubricated high viscosity oil in a horizontal pipe. Six different superficial velocity ratios ( $\,j_w/j_o = 0.057\unicode{x2013}0.41$ ) are examined by changing the water superficial velocity $j_w$ for a fixed oil superficial velocity $j_o$ . The pressure drops in the pipe and the shapes of the phase interface agree well with those from previous experiments. The oil core flow is almost a plug flow, and the gaps between the phase interface and pipe wall are narrow and wide near the upper and lower surfaces of the pipe, respectively, due to the buoyancy. Within a narrow gap, water is confined mostly in a valley region of the wavy phase interface and hardly goes through its crest. On the other hand, water near the phase interface at a wide gap convects downstream almost at the core speed and the flow near the wall is similar to that of single-phase wall-bounded turbulent flow. The annular flow is characterized by three different regimes depending on the clearance Reynolds number ( $Re_c$ ) based on the core velocity and local gap size: laminar Couette flow driven by the core for $Re_c \le 600$ , transitional flow for $600 < Re_c < 2500$ and turbulent flow for $Re_c \ge 2500$ . The minimum pressure drop occurs at $j_w/j_o = 0.11$ in the early transition regime. For all $j_w/j_o$ considered, the negative lift force acting on the core comes from the pressure force which balances the buoyancy.

The WALLET Study: Financial Decision Making and Key Financial Behaviors Associated with Excess Spending

ABSTRACT Objectives The Wealth Accumulation and Losses in Later life Early Cognitive Transitions (WALLET) study data was used to examine correlates with excess spending in older adults who do and do not have early memory loss. Methods The WALLET study collected detailed financial information from participants’ primary checking account statements (n = 150). Information on participant sociodemographic, health, and disability status, memory functioning, financial decision-making, and financial literacy was also collected. Participants either had no memory problems or early memory loss. Bivariate and multiple regression analyses were conducted. Results The early memory loss group had significantly higher excess spending than those with no memory loss. Financial decision-making and higher-risk financial behaviors were also linked to higher excess spending. Early memory loss was no longer statistically significant after accounting for financial stressors and resources. Conclusions The multidimensional nature of financial capacity assessment has long been known. The WALLET study data is unique, however, in that it demonstrates the links between excess spending with decision-making, early memory loss, and a set of specific financial behaviors. Clinical Implications Real-world assessments of financial management and financial decision-making yield important information about how older adults are managing money and making key financial decisions. Checking account reviews can be used to determine excess spending.

Early retirement incentives and transition into informality

This paper explores the impact of a super early retirement incentive that allowed men to retire as early as 44 years old in Turkey in 1992. Relying on a Fuzzy Regression Discontinuity Design, I find that taking up the incentives significantly reduced the labor force participation of middle-aged men in Turkey. Analysis by education categories suggests that the incentives had an impact on both the skilled and unskilled labor force. I find that the policy-induced take-up of pension benefit receipt significantly increased the probability of moving into informal employment contracts. Findings suggest that the probability of informal wage employment increased for low-skilled individuals while the probability of informal self-employment probability increased for high-skilled individuals. Among low-skilled workers, the incentives seem to have relaxed credit constraints.

A Single-cell transcriptome atlas reveals the trajectory of early cell fate transition during callus induction in Arabidopsis

The acquisition of pluripotent callus from somatic cells plays an important role in plant development studies and the genetic improvement of crops. This developmental process incorporates a series of cell fate transitions and reprogramming. However, our knowledge of cell heterogeneity and of the mechanisms of cell fate transition during callus induction remains quite limited. Here, we performed a time series single-cell transcriptome experiment on Arabidopsis root explants that were induced in callus induction medium for 0 days, 1 day, and 4 days, and we constructed a detailed single-cell transcriptional atlas of the callus induction process. We identified the cell types responsible for initiating the early callus: lateral root primordia-initiating (LRPI)-like cells and quiescent center (QC)-like cells. LRPI-like cells are derived from xylem pole pericycle cells and are similar to lateral root primordia. We delineate the developmental trajectory of the dedifferentiation of LRPI-like cells into QC-like cells. QC-like cells are undifferentiated pluripotent acquired cells that appear in the early stages of callus formation and play a critical role in later callus development and organ regeneration. We further inferred the transcription factors that regulating QC-like cells and the gene expression signatures that are related to cell fate decisions. Overall, our cell-lineage transcriptome atlas for callus induction provides a distinct perspective on cell fate transition during callus formation, and significantly improves understanding of callus formation.

Gold nanoparticles-doped MXene heterostructure for ultrasensitive electrochemical detection of fumonisin B1 and ampicillin.

Early transition metal carbides (MXene) hybridized by precious metals open a door for innovative electrochemical biosensing device design. Herein, we present a facile one-pot synthesis of gold nanoparticles (AuNPs)-doped two-dimensional (2D) titanium carbide MXene nanoflakes (Ti3C2Tx/Au). Ti3C2Tx MXene exhibits high electrical conductivity and yields synergistic signal amplification in conjunction with AuNPs leading to excellent electrochemical performance. Thus Ti3C2Tx/Au hybrid nanostructure can be used as an electrode platform for the electrochemical analysis of various targets. We used screen-printed electrodes modified with the Ti3C2Tx/Au electrode and functionalized with different biorecognition elements to detect and quantify an antibiotic, ampicillin (AMP), and a mycotoxin, fumonisin B1 (FB1). The ultralow limits of detection of 2.284pM and 1.617pg.mL-1, which we achieved respectively for AMP and FB1 are far lower than their corresponding maximum residue limits of 2.8nM in milk and 2 to 4mgkg-1 in corn products for human consumption set by the United States Food and Drug Administration. Additionally, the linear range of detection and quantification of AMP and FB1 were, respectively, 10pM to 500nM and 10pgmL-1 to 1µgmL-1. The unique structure and excellent electrochemical performance of Ti3C2Tx/Au nanocomposite suggest that it is highly suitable for anchoring biorecognition entities such as antibodies and oligonucleotides for monitoring various deleterious contaminants in agri-food products.

Wasserstein-penalized Entropy closure: A use case for stochastic particle methods

We introduce a framework for generating samples of a distribution given a finite number of its moments, targeted at particle-based solutions of kinetic equations and rarefied gas flow simulations. Our model, referred to as the Wasserstein-Entropy distribution (WE), couples a physically-motivated Wasserstein penalty term to the traditional maximum-entropy distribution (MED) function, which serves to regularize the latter. The penalty term becomes negligible near the local equilibrium, reducing the proposed model to the MED, known to reproduce the hydrodynamic limit. However, in contrast to the standard MED, the proposed WE closure can cover the entire physically realizable moment space, including the so-called Junk line. We also propose an efficient Monte Carlo algorithm for generating samples of the unknown distribution which is expected to outperform traditional non-linear optimization approaches used to solve the MED problem. Numerical tests demonstrate that given moments up to the heat flux—that is, information equivalent to that contained in the Chapman-Enskog distribution—the proposed methodology provides a reliable closure in the collision-dominated and early transition regimes. Applications to greater rarefaction demand information from higher-order moments, which can be incorporated within the proposed closure.

Cohort profile: the Adverse Childhood Experiences cohort of the Malawi Longitudinal Study of Families and Health

PurposeThe Adverse Childhood Experiences (ACE) cohort of the Malawi Longitudinal Study of Families and Health (MLSFH-ACE) is a study of adolescents surveyed during 2017–2021. It provides an important opportunity to...

MANAGEMENT OF DIABETES INSIPIDUS AFTER SUBLABIAL TRANSSPHENOIDAL HYPOPHYSECTOMY SURGERY

Summary
 A 36-year-old female patient was diagnosed with diabetes insipidus after sublabial transsphenoid hypophysectomy (SLTH) surgery. The patient had pituitary adenoma. The patient undergoes 14 days of care in the ICU with titrated intravenous vasopressin dose(0,01-0,3unit/hour) and later subcutaneous dose(6-13unit/8 hours). Subcutaneous vasopressin started on day 3 while intravenous was tapering down; at the early transition from the intravenous vasopressin route to the subcutaneous vasopressin route on day 7, there is a sharp surge of urine production as well at plasma sodium level. The intravenous vasopressin started again, along with the elevated dose of subcutaneous vasopressin. The patient shows a response to therapy after a watchfully titrated dose.
  
 Background
 Diabetes insipidus is a combination of signs and symptoms generating a plentiful volume of urine and causing elevated serum osmolality. There are two types of diabetes insipidus: central diabetes insipidus and nephrogenic diabetes insipidus. Central neurogenic diabetes insipidus occurs when the production of the hormone Arginine Vasopressin (AVP) is low. In contrast, nephrogenic diabetes insipidus occurs when the kidneys cannot respond to high levels of the hormone AVP. Postsurgical central insipidus can be categorized into transient, permanent, and triphasic. Transient courses of diabetes insipidus following surgery represent most of the cases. Temporary diabetes insipidus is thought to be caused by temporary dysfunction of AVP-producing neurons as a result of direct surgical trauma or indirect after-surgical edema. The incidence of diabetes insipidus in patients who underwent pituitary surgery is 5%, and 4.6% of these patients will have only transient diabetes insipidus, and only 0.4% became permanent. 
 Transphenoidal surgery is considered a minimally invasive and effective procedure for pituitary adenomas. Diabetes Insipidus after this surgery is not an uncommon complication, even though the reported rate of postsurgical central diabetes insipidus varies widely from 1 to 67%. Postoperative temporary diabetes insipidus gradually resolves up to 6 months.
  
 Case Presentation
 A 36-year-old female patient presented chief complaints of headache and blurred vision, which gradually worsened one year ago. After undergoing several examinations, the patient was diagnosed with pituitary adenoma. The patient underwent a sublabial transsphenoidal hypophysectomy. The duration was three long hours and uneventful.
 On Day 0, the patient arrived at the intensive care unit (ICU) intubated, hemodynamically stable, and sedated. The patient is then monitored and weaned; a brain protection strategy and strict fluid balance urine collection and pain management are applied. On day 1, the patient was then extubated. The patient was examined for several parameters, such as electrolytes, kidney function, and blood glucose level. The patient began to significantly increase urine output (>5 milliliters/kilogram body weight/hour). Increased urine production is accompanied by a simultaneous decrease in urine-specific gravity (<1.005) and an increase in serum sodium level up to 151 mmol/liter. The patient was diagnosed with postsurgical diabetes insipidus. The patient started receiving intravenous vasopressin at a dose of 0.3 units/hour and titrated according to urine production until the target urine output was reached after the third day of care. After urine is reached, the dose of vasopressin slowly decreases, and the administration begins to transition to the subcutaneous route. On day 7 of treatment, when the intravenous vasopressin dose had been discontinued and the vasopressin dose at the 8u/h point, there was a significant urine production spike and an increase in the plasma sodium level to 156 mmol/liter. On the eighth day of treatment, the administration of vasopressin was again given intravenously and subcutaneously until a decrease in urine production towards the target was achieved. Finally, on days 11 to 14, vasopressin is administered only subcutaneously until the patient is discharged from the ICU. The patient was successfully discharged to the ward with a tapering-off subtotal dose.
  
  
 Discussion
 The patient developed polyuria within the initial hours of treatment. Polyuria is a hallmark sign of diabetes insipidus. The clinician should be aware of other polyuria causes, such as postoperative hypervolemia, hyperglycemia, and the use of diuresis drugs. This differential diagnosis must be excluded. In this case, the differential diagnosis was excluded through proper fluid balance calculations, monitoring serum electrolytes and glucose levels, and ensuring the absence of diuretic use. Confirmation of the postoperative central diabetes insipidus is made based on findings of high urine output (5 ml/kg BW/hour), urine specific gravity (<1.005), response to vasopressin, average blood glucose level, and absence of diuretic use.
 Diabetes Insipidus is the body's inability condition to concentrate urine due to defective production of the antidiuretic hormone (central diabetes insipidus) or nephrogenic diabetes insipidus (NDI), which corresponds to the insensitivity of the kidney to the antidiuretic effects of vasopressin. Diabetes insipidus (DI) is a syndrome characterized by polyuria (>30ml/kg/24H) of hypotonic urine, equivalent polydipsia, and hypernatremia. The patient shows elevated urine volume (108 cc/kg/24H) and blood sodium levels (144-151mmol/L). The primary therapy was the titrated vasopressin dose, in conjunction with electrolytes and fluid management. Vasopressin titration is based on patient clinical condition, urin output, fluid management, oral intake, and laboratory measures (natrium blood level and urin osmolarity).
 Transient Diabetes Insipidus must be closely monitored after neurosurgical operations, especially in regions adjacent to the pituitary DI. Transient Management with good monitoring is the key. The risk of morbidity comes from the risk of untreated dehydration, electrolyte imbalance
 Intravenous vasopressin provides a rapid effect with lower doses. At the same time, subcutaneous administration requires caution in critically ill patients because absorption is slow, resulting in a slow effect and the need for higher doses. The conversion of the administration route needs to consider the patient's pharmacology, route, and hemodynamics.
  
 References
 Leroy, C., Karrouz, W., Douillard, C., Do Cao, C., Cortet, C., Wémeau, J.-L., Vantyghem, M.-C., 2013. Diabetes insipidus. Ann. Endocrinol. 74, 496–507. https://doi.org/10.1016/j.ando.2013.10.002
 Priya, G., Kalra, S., Dasgupta, A., Grewal, E., 2021. Diabetes Insipidus: A Pragmatic Approach to Management. Cureus. https://doi.org/10.7759/cureus.12498
 Schreckinger, M., Szerlip, N., Mittal, S., 2013. Diabetes insipidus following resection of pituitary tumors. Clin. Neurol. Neurosurg. 115, 121–126. https://doi.org/10.1016/j.clineuro.2012.08.009
 Sharman, A., Low, J., 2008. Vasopressin and its role in critical care. Contin. Educ. Anaesth. Crit. Care Pain 8, 134–137. https://doi.org/10.1093/bjaceaccp/mkn021
  
  
  

Opportunities of MXenes in Heterogeneous Catalysis. V2C as Aerobic Oxidation Catalyst.

MXenes are 2D nanomaterials having alternating sheets of one atom-thick early transition metal layer and one atom-thick C or N layer. The external surface contains termination groups, whose nature depends on the etching agent used in the preparation procedure from the MAX phase. The present concept proposes that, due to their composition, the metal-surface termination groups make MXenes particularly suited as heterogeneous catalysts for some reactions. T Afterpresentingthe concept, we have selected V2C Mxene asexample to illustrate its catalytic activity showing how the catalytic performance varies when the surface groups are modified. As test reaction we selected the aerobic oxidation of indane to the corresponding indanol/indanone mixture using molecular oxygen as terminal oxidizing reagent. Two previously reported procedures to modify the surface groups, namely surface dehydroxylation by thermal treatment under diluted hydrogen flow and surface oxidation with ammonium monoperoxy sulfate to convert some surface groups into oxo groups were used, observing in both cases a decrease in the catalytic activity of V2C. Based on this, VIII/IV-OH are proposed as catalytic centers in this aerobic oxidation. Overall, the present concept shows the merits of MXenes in heterogeneous catalysis, based on their chemical composition and the surface functionality.

Experiences of Menopausal Transition Among Vietnamese Women: A Grounded Theory Analysis.

Background and Purpose: Complaints about menopause vary between cultures, and the experience of menopause changes significantly in women living in different countries. Limited evidence is available regarding the menopausal experience among Asian women. This study aims to explore the menopausal transition experiences of Vietnamese women. Methods: A qualitative inquiry was undertaken using the grounded theory approach. Semi-structured interviews were conducted and analyzed following constructivist grounded theory methods. Results: In the early transition, women's lives underwent many challenges. They had physical manifestations of menopause and difficulty in their sexual life. Later, women identified that their psychosocial impacts were affected, leading to emotional changes and changes in perceptions of others about the menopausal transition. The study also showed that each woman had their own beliefs and religion. Finally, after experiencing physical and mental changes, women found methods for discomfort relief. These methods included seeking information, applying strategies to manage menopausal challenges and consequences, and maintaining balance. Implications for Practice: The diverse perspectives on women's menopausal transition can help nurses and other health care professionals to provide culturally appropriate care for women.

Trans narratives on school experiences-This is how we feel.

The school environment remains unsafe for many trans people, where they are victims of discrimination, aggression, and bullying, resulting in socioemotional and physical harm to trans individuals. Intersectionality and minority stress are contributing factors in this already challenging education environment. In many cases, the voices of trans people are not heard or listened to at school; therefore, this study aims to listen to their school experiences in order to identify key areas for improvement. This study implemented a narrative research approach where six in-depth interviews were completed with trans participants from the Basque Country, Europe, and the United States of America that focused on five dimensions: being a trans, the role of school, lack of teacher education and training, segregation by gender, and socioemotional wellbeing. The transcriptions of these interviews were coded using Nvivo software in categorical systems in a deductive and inductive way. The results clearly showed that the binary society has a negative impact on trans people. In addition, the educational environment is still hostile for most of them, in which the lack of teacher training and gender identity content in the curriculum has a negative impact on trans people and their experiences at school. The findings support the idea that socially ingrained binarism is detrimental to all those who step outside the norm. It can also be said that the earlier the transition is made, the better the effect (clinical as well as socioemotional) on their personal lives. For this early transition to occur, it is necessary to have access to information from an early age.

Catalytic Eoconvergent C(sp3)−N Coupling to Access Chiral Amines: A Concept Review

AbstractNitrogen containing compounds like chiral amines have been widely used in synthetic medicines, biomass, and fine chemical products because of their particularly valuable motifs and exceedingly broad range of functionality. Enantioconvergent synthesis of chiral amines has high atomic economy and enantioselectivity with theoretically 100 % yield of enantioenriched products. In this concept article, we hope to provide a further understanding of chiral amines enantioconvergent synthesis methodology with an introduction of recent progresses in enantioconvergent amination reactions catalyzed by early transition metals and facilitate the development of enantioconvergent C(sp3)−N coupling for benign and efficient preparation of highly valuable chiral nitrogen‐containing units.

Cover crops and reduced tillage did not alter soil chemistry in first 3 years

AbstractCover crops have been promoted for increasing soil organic matter, which is critically low in many mid‐Southern US row crop production fields. This study was conducted to inform adaptive management in the early transition period of conservation adoption. Temporal change in soil chemistry was investigated with a split‐field experiment conducted over a 3‐year period in Mississippi corn (Zea mays L.)–soybean [Glycine max (L.) Merr.] rotational cropping systems that newly implemented winter cover crops and simultaneously reduced tillage. Relative to the untreated (i.e., winter fallow and multiple tillage passes) half of each study field, the chemical soil properties of the treated (i.e., winter cover crop and reduced tillage) half of each study field were not significantly different at the 0.05 significance level. This was true for soil organic matter, all macronutrients, pH, cation exchange capacity, base saturations, and micronutrients, with the exception of iron. Given these results, it is unlikely that growers adopting cover crops while reducing tillage will be able to accumulate significant soil organic matter in the early transition period.

Evaluation of Post-thrombolytic Events to Determine Appropriate ICU Monitoring Duration for Patients with Ischemic Stroke.

Standard treatment for eligible patients presenting with acute ischemic stroke (AIS) is thrombolysis with tissue plasminogen activators alteplase or tenecteplase. Current guidelines recommend monitoring patients in an intensive care unit (ICU) for 24h after thrombolytic therapy. However, recent studies have questioned the need for prolonged ICU monitoring. This retrospective cohort study aims to identify potential candidates for early transition to a lower level of care by assessing risk factors for neurological deterioration, symptomatic intracranial hemorrhage (sICH), or need for ICU intervention within 24h post-thrombolysis. This retrospective cohort study included adult patients 18years and older with AIS who received thrombolysis. Patients were excluded if they were transferred to another facility, if they were transitioned to comfort care or hospice care within 24h, or if they lacked imaging and National Institutes of Health Stroke Scale (NIHSS) score data. The primary end point was incidence of sICH between 0-12 and 12-24h. Secondary end points included the need for ICU intervention and rates of neurological deterioration. The analysis included 204 patients who received the full dose of alteplase. Among them, ten patients (4.9%) developed sICH, with the majority (n = 7) occurring within 12h post-thrombolysis. Sixty-two patients required ICU interventions within 12h compared with four patients after 12h. Twenty-four patients had neurological deterioration within 12h, and seven patients had neurological deterioration after 12h. Multivariable analysis identified mechanical thrombectomy and increased blood pressure at presentation as predictors of ICU need beyond 12h post-thrombolysis. Our study demonstrates that sICH, neurological deterioration, and need for ICU intervention rarely occur beyond 12h after thrombolytic administration. Patients presenting with blood pressures < 140/90mm Hg, NIHSS scores < 10, and not undergoing mechanical thrombectomy may be best candidates for early de-escalation. Larger prospective studies are needed to more fully evaluate the safety, feasibility, and financial impact of early transition out of the ICU.

Highly Efficient Iridium-Iron-Molybdenum Catalysts Condensed on Boron Nitride for Biomass-Derived Diols' Hydrogenolysis to Secondary Monoalcohols.

A trade-off of activity-selectivity exists in primary C-O hydrogenolysis of biomass-derived diols to secondary alcohols over bimetallic catalysts, especially the combination of noble metal and early transition metal in the metallic state and metal oxide state, respectively. Herein, the combination of high surface concentration of boron nitride (BN)-supported metals and the addition of Mo as third metal broke the trade-off. High yields (>50%) of secondary alcohols were obtained with robust productivity up to 25-fold based on Ir over Ir-Fe0.13-Mo0.08/BN (Ir = 20 wt %, Fe/Ir = 0.13, Mo/Ir = 0.08) than previously reported Ir-Fe catalysts. In contrast, simply increasing the loading amount of Ir-Fe catalysts or the addition of Mo species only enhanced the productivity by <2-4-fold. Various characterizations showed that large Ir loading enables the formation of condensed nanostructures (∼2 nm) on the BN support, which further alloy with Mo and Fe to form an face centred cubic (fcc)-type trimetallic alloy with surface enrichment of Fe. On the other hand, in Ir-Fe0.25-Mo0.08/BN with lower Ir (5 wt %) and lower Ir-based activity, the Mo species were rather bound on the support surface possibly as the MoBx state. These structures were formed by simple impregnation and reduction with H2 at the reaction temperature (453 K). The high activity of Ir-Fe0.13-Mo0.08/BN (20 wt % Ir) is derived from two aspects: (1) the formation of condensed nanostructures (∼2 nm) exposing more active sites and (2) alloying with Mo to modify the electronic state of Ir to enhance the H2 activation ability, as shown by the decreased Ea (82-84 → 67 kJ mol-1).

Multiple hot spot cooling with flow boiling of HFE-7000 in a multichannel pin fin heat sink

Electronics cooling applications require a high cooling performance due to increasing power consumption. Phase change heat transfer is a popular approach for offering high heat flux cooling. Controlling temperature distribution and mitigating boiling instabilities under high heat flux conditions present a significant challenge. While numerous studies investigated the effect of pin fins in a minichannel with single hotspots on boiling enhancement, few research studies are available for minichannels with multiple segmented hotspots. This study's primary objective is to dissipate high heat (1.4 kW) using flow boiling of a dielectric fluid, namely HFE-7000, which has lower thermophysical properties than water, to achieve a uniform temperature distribution, and to suppress boiling instabilities. The boiling performance of a pin fin multichannel heat sink with dimensions of 3 × 14 × 300 mm (H × W × L) subjected to 8 hotspots with uniform heating was investigated in this regard. Flow boiling experiments were performed over a wide range of input heat power from ∼0.1 to ∼1.4 kW with a coolant mass flux of 500 kg/m2 s in the three parallel minichannels having staggered elliptical pin fins with no tip clearance on each hotspot and distribution pins at the inlet. High-speed visualization was used to relate the heat transfer coefficient variations along the channel to flow patterns. The heat transfer performance and flow regimes at different locations were obtained and discussed. Thanks to the mixing effect of elliptical micro pin fins with optimum geometrical parameters along the heat sink, the presence of distribution pin fins at the inlet for suppressing boiling instabilities and early transition to stable annular flow, the temperature uniformity (∼2.3 °C, temperature difference between the inlet and outlet hotspots) could be achieved at the highest heat input. Heat transfer coefficient reduction upto 27 % was reported along the channel when comparing inlet (1st) and outlet (8th) hotspots.

Future changes in the wintertime ENSO-NAO teleconnection under greenhouse warming

El Niño-Southern Oscillation (ENSO) teleconnection to the Euro-Atlantic exhibits strong subseasonal variations, as the North Atlantic Oscillation (NAO) response systematically reverses its phase from early to late winter. Based on two sets of atmospheric model simulations in CMIP6 forced by historical and projected SST, we report a future disappearance of this teleconnection reversal, with the positive early winter ENSO-NAO correlation turning negative and the negative late winter correlation becoming stronger. We suggest that this negative NAO tendency is associated with the strengthening and eastward shift of the ENSO atmospheric teleconnection towards the Euro-Atlantic due to parallel changes in the ENSO tropical convection. While the early winter NAO phase transition is further facilitated by the mean state change in the North Atlantic jet meridional shear, which shifts the ENSO-driven Rossby wave-propagating direction, an intensified stratospheric pathway is demonstrated to play an additional role in strengthening the late winter NAO response.