High Cutoff Research Articles

Two-Stage Recruitment Design to Reduce Magnetic Resonance Imaging Screening Cost for a Theoretical Clinical Trial of White Matter Hyperintensity Progression.

White matter hyperintensities (WMH) and their progression are associated with risk of dementia and stroke, so are an important target for clinical trials. The cost of broad magnetic resonance imaging (MRI) screening to identify eligible individuals, however, limits the feasibility of designing clinical trials targeting WMH. A low-cost retinal or clinical screening measure before MRI could reduce recruitment costs versus an MRI-only screening design in a hypothetical clinical trial. Data from the Atherosclerosis Risk in Communities study with valid retinal and WMH measurements (N=1311) were used. To identify a population at greater likelihood of significant WMH on MRI and thus reduce the number of screening MRIs required, we evaluated 3 theoretical prescreening measures: (1) retinal, (2) clinical, (3) combined clinical-retinal. Given a target sample for clinical trials (N=646), we calculated screening sample sizes based on the proportion within the population having an elevated score for each prescreening measure (separately) multiplied by the proportion of significant WMH among those with that prescreening feature. Recruitment costs were calculated using estimated retinal and MRI cost estimates. Compared with the estimated cost of MRI-only screening (>$4.24 million, requiring MRI on 6526 participants), prescreening for a high clinical score resulted in total cost of $2.47 million, with an initial screening group of 52 778 participants, with MRI in 3801. A high clinical-retinal score cutoff resulted in costs of $2.9 million while requiring 13 572 participants, with 3801 completing MRI. A 2-stage design with low-cost prescreening measures is a promising approach, resulting in reduced theoretical recruitment costs compared with an MRI-only design.

A butterfly shape acceptor with rigid skeleton and unique assembly enables both efficient organic photovoltaics and high-speed organic photodetectors

Abstract It remains challenging to design efficient bifunctional semiconductor materials in organic photovoltaic and photodetector devices. Here, we report a butterfly-shaped molecule, named WD-6, which exhibits low energy disorder and small reorganization energy due to its enhanced molecular rigidity and unique assembly with strong intermolecular interaction. The binary photovoltaic device based on PM6:WD-6 achieved an efficiency of 18.41%. Notably, an efficiency of 19.42% was achieved for the ternary device based PM6:BTP-eC9:WD-6. Moreover, the photodetection device based on WD-6 demonstrated an ultrafast response speed (205 ns response time at λ of 820 nm) and a high cutoff frequency of -3 dB (2.45 MHz), surpassing the values of most commercial Si photodiodes. Based on these findings, we show-cased an application of the WD-6-based photodetection device in high-speed optical communication. These results offer valuable insights into the design of organic semiconductor materials capable of simultaneously exhibiting high photovoltaic and photo detective performance.

Waist circumference and waist-to-height ratio: Exploring the associations for high blood pressure risk in school-age adolescents

BackgroundChildhood and adolescent obesity present a global health concern, notably due to its association with adverse outcomes such as high blood pressure (HBP). Waist circumference (WC) and waist-to-height ratio (WHtR) are promising indicators for assessing HBP risk in school-age adolescents. However, their association with Stavnsbo-recommended WC cutoff points and high BP prevalence necessitates further investigation, holding potential implications for early intervention and prevention strategies. ObjectiveInvestigate the association between high blood pressure (HBP) and WC cutoff points advised by Stavnsbo, along with WHtR, in adolescents from privileged socioeconomic backgrounds in Brazil. MethodsThis cross-sectional study in 2022 involved 216 students aged 9 to 16 from a private school in Londrina, Paraná, Brazil. Data, collected through an internal project monitoring anthropometric and social indicators, included validated blood pressure assessments. Statistical analyses, employing t-tests, chi-square tests, and logistic regression, explored relationships between WC, WHtR, and blood pressure, adjusting for covariates. ResultsFemale participants had a lower prevalence of obesity (2.9% vs 5.3%) but a higher prevalence of overweight (27.5% vs 17.5%) compared to males. The overall excess weight prevalence was 26.4%, with females showing lower absolute risk scores for WC (25.5% vs 34.2%), WHtR (19.6% vs 23.7%), and HBP (21.5% vs. 40.3%). Significant associations were observed between HBP and WC (X2 = 9.759, P = 0.002) as well as WHtR (X2 = 6.335, P = 0.012) among males, with those in the “Risk” category exhibiting higher HBP prevalence. Overall, both WC and WHtR demonstrated significant associations with HBP (X2 = 12.428, P < 0.001, and X2 = 9.550, P = 0.002, respectively). Logistic regression indicated higher odds for HBP in males with risk values for WC (OR 3.876 [1.714–8.765 CI], P = 0.001) or WHtR (OR 3.684 [1.457–9.315 CI], P = 0.006). In the overall analysis, participants with risk values for WC had 3.2 (1.688–6.080 CI, P < 0.001) times higher odds, and for WHtR, 3.4 (1.679–6.934 CI, P = 0.001) times higher odds of HBP. ConclusionThis study highlights the associations between WC, WHtR, and HBP in adolescent schoolchildren. The results underscore the significance of gender-specific assessments and emphasize the potential of these anthropometric measures as valuable tools for identifying and managing HBP risk in adolescents. Further research and clinical applications are imperative to deepen understanding and address the health needs of this vulnerable population.

Is prostatic adenocarcinoma detectable by urine cytology-A multicenter retrospective review.

Urine cytology is robust for the diagnosis of urothelial lesions, but data on the detection rates of prostatic adenocarcinoma in urine cytology is limited. In this study, a multicenter review was performed to define the clinical role of urine cytology in diagnosis of prostatic adenocarcinoma. Cytologic diagnoses of lower tract urine cytology specimens with histology-proven prostatic adenocarcinoma from three institutions, from a period of over two decades, were reviewed. Clinicopathological parameters-tumor grade, stage, histologic features, and preanalytical factors-prostate-specific antigen (PSA) level and lesion size, were retrieved and compared with cytologic diagnoses. In total, 2115 urine cytology specimens from 1119 patients were retrieved. The atypia (or above/C3+) and suspicious (or above/C4+) rates were 19.48% and 3.36%. Bilobar and extracapsular involvement, lymphovascular invasion, Gleason score, and International Society of Urological Pathology grade were associated with a positive urine diagnosis (p < 0.05). The atypia (C3+) and suspicious (C4+) rates of urine cytology in patients with a PSA level of ≤4.0 ng/mL was paradoxically higher (p < 0.01), but PSA levels correlated positively with urine diagnosis at higher cutoffs (>10, >20, >50, >100 ng/mL). All these factors remained significant on multivariate analysis (p < 0.05), including a negative correlation with low-PSA (≤4.0 ng/mL, p = 0.001) and positive correlation with high-PSA (>20 ng/mL, p = 0.020). Lesion size and multifocality were not associated with urine cytology diagnosis (p > 0.05). Urine cytology showed low sensitivity in detection of prostatic adenocarcinoma. Detection rates were largely positively correlated with PSA levels but not for lesion size nor multifocality, limiting its clinical utility.

Application of a validated prognostic plasma protein biomarker test for renal decline in type 2 diabetes to type 1 diabetes: the Fremantle Diabetes Study Phase II

BackgroundThere are scant data relating to prognostic biomarkers for chronic kidney disease (CKD) complicating type 1 diabetes. The aim of this study was to assess the performance of the plasma protein biomarker-based PromarkerD test developed and validated for predicting renal decline in type 2 diabetes in the context of type 1 diabetes.MethodsThe baseline PromarkerD test score was determined in 91 community-based individuals (mean age 46.2 years, 56.5% males) with confirmed type 1 diabetes recruited to the longitudinal observational Fremantle Diabetes Study Phase II. The performance of the PromarkerD test in predicting the risk of incident CKD (estimated glomerular filtration rate (eGFR) < 60 mL/min/1.73m2 in people without CKD at baseline) or an eGFR decline of ≥ 30% over the next four years was determined. The score can range from 0 to 100%, and is categorized as representing low (< 10%), moderate (10% to < 20%) or high (≥ 20%) risk.ResultsThe area under the receiver operating characteristic curve was 0.93 (95% confidence interval 0.87–0.99) for the composite renal endpoint, indicating strong predictive accuracy. The positive and negative predictive values at moderate (10% to < 20%) and high (≥ 20%) risk PromarkerD cut-offs were 46.7–50.0% and ≥ 92.0%, respectively.ConclusionsThese preliminary data suggest that PromarkerD is at least as good a prognostic test for renal decline in type 1 as type 2 diabetes.

B-295 Sensitive and Rapid Homogeneous Immunoassay for the Detection of Zolpidem and its Major Metabolite in Urine

Abstract Background Zolpidem, a schedule IV controlled substance under the Controlled Substances Act, is commonly known as Ambien and Ambien CR, a prescription only treatment for insomnia. Zolpidem is one of the most common prescribed sleep aids in the U.S. due to its rapid sedative effects. The recommended duration of treatment is between two days and four weeks, as long-term use of zolpidem increases the risk of habit formation. Addiction to zolpidem can cause severe side effects, including memory loss, delusion, and in extreme cases, fatal overdose. From 2005-2010, Zolpidem-related emergency room visits doubled, underscoring the need for accurate testing as zolpidem testing plays an important role in cases of misuse, diversion, and forensics. The sole commercially available homogeneous immunoassay for the detection of zolpidem in urine has a relatively high cutoff at 20 ng/mL and poor cross-reactivity (0.02%) to major metabolite zolpidem 4-carboxylic acid. ARK Diagnostics has developed the ARK™ Zolpidem Assay to detect zolpidem at a cutoff concentration of 10 ng/mL with high cross-reactivity to its metabolite, Zolpidem phenyl 4-carboxylic acid and no cross-reactivity to zaleplon and zopiclone at concentrations below 100,000 ng/mL. Methods The ARK™ Zolpidem Assay is a liquid stable homogeneous enzyme immunoassay, consisting of two reagents, with a cutoff concentration of 10 ng/mL and semi-quantitative range up to 40 ng/mL. Preliminary performance characterization for this assay was evaluated on the Beckman Coulter AU680 Automated Clinical Chemistry Analyzer. Precision, analytical recovery, specificity, Histogram Overlap Analysis of ±50% controls and the cutoff, and method comparison with LC-MS/MS were evaluated. Results In semi-quantitative mode, total precision ranged from 2.6 to 3.1% CV. Spiked recovery of zolpidem ranged from 88.6% (2.5 ng/mL) to 96.8% (10 ng/mL). The major metabolite, zolpidem phenyl-4-carboxylic acid, showed an approximate equivalence to the 10 ng/mL zolpidem cutoff at 30 ng/mL (33.3% cross-reactivity). Histogram overlap analysis showed no overlap between cutoff and control levels. Method correlation with LC-MS/MS using authentic urine samples showed an excellent agreement with a specificity of 100% and sensitivity of 100% (15 positives and 100 negatives). Conclusions The ARK™ Zolpidem Assay measures zolpidem and its major metabolite zolpidem phenyl-4-carboxylic acid in human urine with acceptable performance. The assay is sensitive, rapid, and applicable to a wide range of clinical chemistry analyzers.

Utilization of a Postpartum Fasting Blood Glucose to Predict Impaired Glucose Tolerance in Patients with Gestational Diabetes Mellitus.

The Endocrine Society recommends a postpartum fasting blood glucose (FBG) be performed for patients with gestational diabetes mellitus (GDM) prior to hospital discharge to screen for ongoing hyperglycemia. There are limited data, however, on whether an FBG can screen for glucose intolerance and if it correlates with the gold standard 4- to 12-week 2-hour oral glucose tolerance test (OGTT). Our objective was to evaluate if FBG correlates with the gold standard 2-hour OGTT. This retrospective cohort study of patients with GDM who delivered >20 weeks' gestation at two urban centers from January 2017 to December 2020 included those who completed both a postpartum FBG prior to discharge and a 2-hour 75-g OGTT within 1 year of delivery. Abnormal 2-hour OGTT was defined as fasting value ≥100 mg/dL and/or 2-hour value ≥140 mg/dL. We evaluated test characteristics (e.g., sensitivity, specificity) of postpartum FBG cut-offs to predict an abnormal 2-hour OGTT result. A total of 235 patients met inclusion criteria, of which 63% were diet-controlled and 37% required medical management. FBG ranged from 64 to 134 mg/dL, with 6/235 (2.6%) with values ≥126 mg/dL. A total of 39/235 (16.6%) of patients had an abnormal 2-hour OGTT. Overall, area under the curve for FBG predicting abnormal 2-hour OGTT was 0.65. Traditionally considered high cut-offs (≥126 mg/dL) for predicting persistent impaired glucose intolerance demonstrated poor positive predictive value (PPV; <20%). In contrast, low cut-offs demonstrated excellent NPV (>90%). A postpartum FBG of 88 mg/dL was determined to be the optimal cut-off for FBG with NPV = 92.4% (Youden index = 0.34). In this dataset, if FBG ≥ 88 mg/dL was used to determine if 2-hour OGTT was required, almost half of GDM patients could avoid further glucose tolerance testing. While previously thought of as best utilized for its PPV, the FBG may be best used for its NPV. In our study, clinical application of an FBG < 88 mg/dL was highly correlative with a normal 2-hour OGTT. · Screening for postpartum glucose intolerance is essential for gestational diabetes.. · A promising initiative includes offering screening tests while in the hospital, including an FBG.. · Application of a postpartum FBG < 88 mg/dL is highly correlative with a normal 2-hour OGTT..

Study on the impact of cutoff voltage on structural and electrochemical stability of sodium-ion layered cathodes

NaNi1/3Fe1/3Mn1/3O2 is recognized for its relatively high theoretical specific capacity and operating voltage, rendering it a sodium-ion cathode material with significant commercial potential. A higher cutoff voltage typically enables more sodium ion deintercalation, thereby achieving higher capacity. However, this increased deintercalation can introduce challenges such as structural instability and side reactions with the electrolyte, leading to electrochemical performance degradation. This study focuses on the migration process of transition metal ions under conditions of high charging cutoff voltage and high sodium removal. At a voltage of 4.3 V, the migration of Ni ions facilitates more charge compensation but is accompanied by irreversible Ni migration, inducing an irreversible phase transition to the O’ phase. Conversely, at a cutoff voltage of 4.1 V, the P3 and O3 phases with high sodium removal demonstrate excellent cycling stability. The specific capacities before and after 150 cycles (at 0.5C) are 142.3 and 113.7 mAh/g, respectively, indicating a tolerable internal structural stress within these high sodium removal phases. This contrasts with the differentiated internal structural stresses generated by the P3, O3, and O’ phases during phase transitions at a cutoff voltage of 4.3 V. The research underscores the importance of regulating reversible crystal phases within the tolerance range of internal stress and avoiding irreversible crystal phases to enhance the cycling stability of cathode materials. These findings provide crucial insights for optimizing NNFMO cathode materials and hold significant implications for the design of high-performance, long-life sodium-ion batteries.

Reversible silicon anodes enabled by fluorinated inorganic-organic hybrid coating

Silicon anodes deliver batteries with energy densities much higher than those based on today’s dominant graphite anodes. However, they commonly exhibit huge volume variations and unfavorable interface stability, causing a gradually diminishing capacity on extended cycling. Most Si-based batteries consisting Si/C composites in industry can only use a very limited amount of Si (<30 % by weight). Exploiting molecular layer deposition (MLD) technique, a fluorine-rich flexible inorganic–organic hybrid alucone (AlFHQ) shell is controllably deposited onto Si electrodes. Employing ex situ XPS and AFM, the AlFHQ film presents reversible electrochemical evolutions in terms of composition and morphology. The interactions the between Li+ and −O−2,3,5,6-fluorobenzene functional groups help to construct a mechanically-chemically robust LiF-rich hybrid solid electrolyte interphase (SEI) on Si anode, delivering enhanced interfacial stability and integrity of electrode. An optimized coating thickness (≈5 nm) for interfacial stabilization and Li+ transport kinetics is demonstrated, namely, Si@AlFHQ-20. The reported fluorine-rich hybrid modification technique endows (a), stable cycling of Si anode (≈3.8 mAh cm−2) with an ultrahigh initial Coulombic efficiency (ICE) of 92.3 %; (b), enhanced rate capability of 1468 mAh/g at 2.0 A g−1 and good cycling performance; and (c), overall cell (Si@AlFHQ-20//LiCoO2@Al2O3) operational stability for more than 100 cycles under stringent cathode conditions (2.68 mAh cm−2, high cutoff voltage at 4.55 V).

Sb-anchoring single-crystal engineering enables ultra-high-Ni layered oxides with high-voltage tolerance and long-cycle stability

Ni-rich layered oxides are promising cathodes for Li-ion batteries, but the inherent structural defects result in severe surface/bulk degradation during long cycling, especially at high cutoff voltage. Herein we propose a Sb-anchoring single-crystalline engineering to enhance the microstructural and electrochemical stability of ultra-high-Ni layered oxides, where the surface-enriched Sb doping inhibits Li-Ni mixing, suppressing the undesired layered to mixed/rock-salt phase transformation; the bulk-doped Sb rivets into Ni sites, reinforcing the bulk phase stability; the single-crystal endows enhanced crack resistance and reduced surface area, preventing surface parasitic reactions and the subsequent proliferation of cathode electrolyte interfaces. In-situ XRD reveals an essential correlation between cycle stability and phase reversibility, whereas Sb doping into both surface and bulk structures showcases a continuous anchoring effect, largely enhancing the phase transformation reversibility. DFT calculations prove a high oxidation tolerance, as Ni2+ diffusion barrier is higher than the pure cathode. A representative Li(Ni0.9Co0.05Mn0.05)0.99Sb0.01O2 cathode exhibits a high-voltage up to 4.6V, and a Li(Ni0.9Co0.05Mn0.05)0.99Sb0.01O2//graphite full-cell demonstrates an ultra-high capacity retention of 93.4% after 1000 cycles at 1C in 3.0−4.2V. This simple and efficient cathode engineering will promote the promising application of Ni-rich layered oxides in high-energy Li-ion batteries.

Regulating interfacial reactions via quasi-solid polymer electrolyte to enable high-voltage lithium metal batteries

Sulfolane (SUL), known for its low cost, environmental friendliness, and high voltage tolerance, stands out as a promising polar solvent for lithium (Li) metal batteries with high energy density. However, its long-term stability with Li metal is compromised due to its inherently low reduction resistance. To address this issue, we introduce a novel electrolyte strategy, where the reactive SUL is encapsulated within a fluorinated polymer framework formed through in-situ thermal polymerization. The polymer network’s specific structure interacts with SUL, effectively mitigating its electrochemical degradation on the Li metal anode and the NCM811 cathode, thus enhancing electrode stability. This approach not only extends the Li+ plating/stripping reversibility for over 1,000 h at a current density of 0.3 mA cm−2, but also delivers outstanding performance in NCM811||Li batteries, achieving a capacity retention of 78.56 % after 1,000 cycles at 30 °C and 87.14 % after 100 cycles at 60 °C under a high cutoff voltage of 4.5 V.

Development and Characterization of an Advanced Voltage-Controllable Capacitor Based on AlInGaN/GaN-Si (111) Epitaxy

The AlInGaN/GaN heterojunction epitaxy material with high cutoff frequency and saturated power density has become a very popular candidate for millimeter wave applications in next-generation mobile communication. In this study, an advanced voltage-controllable capacitor based on the AlInGaN/GaN-Si (111) epitaxy was proposed by employing a bi-directional series MIS capacitor structure. The capacitor was fabricated by using a pad area of 40 μm × 40 μm, with a 1 μm distance between the positive and negative electrodes. The test results show that the capacitance is turned on with a saturation capacitance density and a maximum leakage current density of 0.30 fF/μm2 of 0.37 pA/μm2, respectively, for the control voltage from −6.5 V to 6 V. In particular, in the proposed design method, the saturation capacitance required for the practical application can be obtained by simply adjusting the capacitance area. The capacitor showcases characteristics of rapid turn-on and turn-off responses coupled with low loss, underscoring its promising prospects for deployment in RF switching applications.

Diagnostic accuracy of the Fibrosis-4 index for advanced liver fibrosis in nonalcoholic fatty liver disease with type 2 diabetes: A systematic review and meta-analysis.

The Fibrosis-4 index (FIB-4) is a noninvasive test widely used to rule out advanced liver fibrosis (AF) in patients with nonalcoholic fatty liver disease (NAFLD). However, its diagnostic accuracy in NAFLD patients with type 2 diabetes mellitus (T2DM) is controversial due to the high prevalence of AF in this population. Research focusing on the diagnostic accuracy of FIB-4 for liver fibrosis as validated by liver histology in NAFLD patients with T2DM was included, and 12 studies (n=5,624) were finally included in the meta-analysis. Sensitivity, specificity, hierarchical summary receiver operating characteristic (HSROC), positive predictive values (PPVs), and negative predictive values (NPVs) at low cutoffs (1.3-1.67) and high cutoffs (2.67-3.25) for ruling in and out AF were calculated. At low cutoffs, the meta-analysis revealed a sensitivity of 0.74, specificity of 0.62, and HSROC of 0.75. At high cutoffs, the analysis showed a sensitivity of 0.33, specificity of 0.92, and HSROC of 0.85, suggesting FIB-4 as useful for identifying or excluding AF. In subgroup analyses, high mean age and F3 prevalence were associated with lower sensitivity. The calculated NPV and PPV were 0.82 and 0.49 at low cutoffs, whereas the NPV was 0.28 and the PPV was 0.70 at high cutoffs. There were insufficient estimated NPVs <0.90 at a hypothesized prevalence of AF >30% at an FIB-4 cutoff range of 1.3-1.67. Collectively, FIB-4 has moderate diagnostic accuracy for identifying or excluding AF in NAFLD patients with T2DM, but more evidence must be accumulated due to the limited number of currently reported studies and their heterogeneity.

Phenotypic and genotypic characterization of antimicrobial resistance in Enterococcus species from dairy niches

The present work was carried out to investigate the prevalence of antimicrobial resistance (AMR) in dairy enterococci. Dairy samples comprising of raw milk and traditionally fermented milks were collected from local surrounding areas and a total of 140 enterococci strains were isolated from the dairy samples and further, 104 isolates were tested for antimicrobial susceptibility. The most prevalent resistance was observed against cephalosporins followed by fosfomycin, rifampicin, erythromycin etc. Multi-antibiotic resistance index of the tested isolates ranged from 0.09 to 0.36. Minimum inhibitory concentration testing showed very high cut-offs against erythromycin, tetracycline, cefepime and cefotaxime in certain isolates. Further, Extended Spectrum β-lactamase (ESBL) production tested by double disc synergy method confirmed 9 isolates as ESBL positive along with the presence of blaTEM gene in certain isolates. In addition, AMR genes against aminoglycoside, tetracyclines, macrolides, chloramphenicol along with multi-drug transporter gene (emeA) was also detected in many isolates. The resistant enterococci isolates also showed a high frequency of the presence of mobile genetic elements viz. Transposons (Tn-5397 and Tn-916/Tn-1545 family) and Integrons (intI1, intI3). Finally, virulence traits such as gelatinase and hemolysin production along with gelE and cylA genes was also detected in many of the resistant enterococci isolates. Although, the virulence traits could not be directly correlated with the AMR resistance of the isolates, the results from the study demonstrated the wide prevalence of AMR in dairy enterococci that could greatly contribute to the problem of antimicrobial resistance in the food chain.

Excited-State Forces with the Gaussian and Augmented Plane Wave Method for the Tamm-Dancoff Approximation of Time-Dependent Density Functional Theory.

Augmented plane wave methods enable an efficient description of atom-centered or localized features of the electronic density, circumventing high energy cutoffs and thus prohibitive computational costs of pure plane wave formulations. To complement existing implementations for ground-state properties and excitation energies, we present the extension of the Gaussian and augmented plane wave method to excited-state nuclear gradients within the Tamm-Dancoff approximation of time-dependent density functional theory and its implementation in the CP2K program package. Benchmarks for a test set of 35 small molecules demonstrate that maximum errors in the nuclear forces for excited states of singlet and triplet spin multiplicity are smaller than 0.1 eV/Å. The method is furthermore applied to the calculation of the zero-phonon line of defective hexagonal boron nitride. This spectral feature is reproduced with an error of 0.6 eV in comparison to GW-Bethe-Salpeter reference computations and 0.4 eV in comparison to experimental measurements. Accuracy assessments and applications thus demonstrate the potential use of the outlined developments for large-scale applications on excited-state properties of extended systems.

Negative Differential Resistance with Ultralow Peak-to-Valley Voltage Difference in Td-WTe2/2H-MoS2 Heterostructure.

Negative differential resistance (NDR) devices with a low peak-to-valley voltage difference (ΔV) exhibit a high cut off frequency and low power consumption efficiency, which is significant for fabricating high-performance oscillators. However, achieving an ultralow ΔV is challenging. In this work, we report the first construction of an NDR device utilizing a van der Waals heterostructure composed of semimetallic Td-WTe2 and semiconducting 2H-MoS2. Our findings reveal that the narrow energy region of the decreasing density of states (DOS) above the Fermi level of WTe2 acts as a narrow band gap, facilitating type-III band alignment with MoS2 and enabling band-to-band tunneling-based NDR transport. Notably, the NDR device exhibits an ultralow ΔV of approximately 0.01 V, which is at least an order of magnitude lower than previously reported values. This work not only introduces a new approach for NDR device fabrication but also provides new insights into the pivotal role of Td-WTe2 in NDR transport.

SP5.4 - Is Fecal Calprotectin a useful test?

Abstract Aim To identify whether there is a correlation between a positive Fecal Calprotectin level(FCP) and a diagnosis of Inflammatory Bowel Disease. Method Data was collected retrospectively from a database of all colonoscopies performed at a District General Hospital. Data was collected including patient demographics, FCP result, colonoscopy and histology report from the hospital electronic record system. Results A total of 450 patients underwent a colonoscopy for any reason with 250 male and 200 female. The average age was 63.5 years. Patients undergoing surveillance or interventional colonoscopies were excluded. 90 patients were referred for colonoscopy with a change in bowel habit and all these patients had a FCP. Out of these, 42 had a FCP greater than 99 ug/g. Only 4 had IBD confirmed on histology, 3 had non-specific bowel inflammation. Of the other 360 patients who underwent a colonoscopy for other indications, 33 had a FCP sent, with 6 being positive. Out of a total of 48 patients who had a positive FCP, 25 had a FCP result greater than 250 ug/g. however, only three of these patients had IBD confirmed on histology. Conclusion The results show no correlation between a positive FCP and a diagnosis of IBD even using a higher cut off at 250 ug/g. For most cases with altered bowel habits or rectal bleeding, a FCP should not be recommended as it will not change the need for a colonoscopy.

Nonlinear Viscoelastic Modeling of Finger Arteries: Toward Smartphone-Based Blood Pressure Monitoring via the Oscillometric Finger Pressing Method.

Oscillometric finger pressing is a smartphone-based blood pressure (BP) monitoring method. Finger photoplethysmography (PPG) oscillations and pressure are measured during a steady increase in finger pressure, and an algorithm computes systolic BP (SP) and diastolic BP (DP) from the measurements. The objective was to assess the impact of finger artery viscoelasticity on the BP computation. Nonlinear viscoelastic models relating transmural pressure (finger BP - applied pressure) to PPG oscillations during finger pressing were developed. The output of each model to a measured transmural pressure input was fitted to measured PPG oscillations from 15 participants. A parametric sensitivity analysis was performed via model simulations to elucidate the viscoelastic effect on the derivative-based BP computation algorithm. A Wiener viscoelastic model comprising a first-order transfer function followed by a static sigmoidal function fitted the measured PPG oscillations better than an elastic model containing only the static function (median (IQR) error of 30.5% (25.6%-34.0%) vs 50.9% (46.7%-53.7%); p<0.01). In Wiener model simulations, the derivative algorithm underestimated SP, especially with high pulse pressure and low transfer function cutoff frequency (i.e., greater viscoelasticity). The mean of the normalized PPG waveform at the maximum oscillation beat was found to correlate with the cutoff frequency (r = -0.8) and could thus possibly be used to compensate for viscoelasticity. Finger artery viscoelasticity negatively impacts oscillometric BP computation algorithms but can potentially be compensated for using available measurements. These findings may help in converting smartphones into truly cuffless BP monitors for improving hypertension awareness and control.

Efficacy of the Dapivirine Vaginal Ring Accounting for Imperfect Adherence.

Product adherence is critical to obtaining objective estimates of efficacy of pre-exposure prophylactic interventions against HIV-1 infection. With imperfect adherence, intention-to-treat analyses assess the collective effects of complete, sub-optimal and non-adherence, providing a biased and attenuated estimate of the averagecausal effect of an intervention. Using data from the MTN-020/ASPIRE phase III trial evaluating HIV-1 efficacy of the dapivirine vaginal ring, we conducted per-protocol, and adherence-adjusted causal inference analyses using principal stratification and marginal structural models. We constructed two adherence cut offs of ≥ 0.9mg (low cutoff) and > 4.0mg (high cutoff) that represent drug released from the ring over a 28-day period. The HIV-1 efficacy estimate (95% CI) was 30.8% (3.6%, 50.3%) (P = 0.03) from the per-protocol analysis, and 53.6% (16.5%, 74.3%) (P = 0.01) among the highest predicted adherers from principal stratification analyses using the low cutoff. Marginal structural models produced efficacy estimates (95% CIs)ranging from 48.8 (21.8, 66.4) (P = 0.0019) to 56.5% (32.8%, 71.9%) (P = 0.0002). Application of adherence-adjusted causal inference methods are useful in interpreting HIV-1 efficacy in secondary analyses of PrEP clinical trials.

Chemically Bonded Biphase Coating of Ni-Rich Layered Oxides with Enhanced High-Voltage Tolerance and Long-Cycle Stability.

Stabilizing the crystalline structure and surface chemistry of Ni-rich layered oxides is critical for enhancing their capacity output and cycle life at a high cutoff voltage. Herein, we adopted a simple one-step solid-state method by directly sintering the Ni0.9Co0.1(OH)2 precursor with LiOH and Ta2O5, to simultaneously achieve the bulk material synthesis of LiNi0.9Co0.1O2 and in situ construction of a rock-salt Ta-doped interphase and an amorphous LiTaO3 outer layer, forming a chemically bonded surface biphase coating on LiNi0.9Co0.1O2. Such a cathode architectural design has been demonstrated with superior advantages: (1) eliminating surface residual alkali, (2) strengthening the layered oxygen lattice, (3) suppressing bulk-phase transformation, and (4) facilitating Li-ion transport. The obtained cathode exhibits excellent electrochemical performance, including a high initial reversible capacity of 180.3 mAh g-1 at 1.0 C with 85.5% retention after 300 cycles (2.8-4.35 V) and a high initial reversible capacity of 182.5 mAh g-1 at 0.2 C with 87.6% retention after 100 cycles (2.8-4.5 V). Notably, this facile and scalable electrode engineering makes Ni-rich layered oxides promising for practical applications.