Low Pr Research Articles

The Relationship Between Intrinsic, Extrinsic Factors, and Socio Economic Status With the Level of Pneumonia Among Toddlers at Paal V Health Center, Jambi City

ABSTRACT Pneumonia is the most significant trigger of infections leading to death in children globally. Every year, an estimated 921,000 children under the age of 5 die due to pneumonia. This study aims to determine the relationship between intrinsic, extrinsic, and socioeconomic factors with the level of pneumonia in toddlers at the Paal V Community Health Center in Jambi City. This study uses an analytical quantitative research method, with a cross-sectional study design. The respondents in this study were 87 toddlers (aged 0-59 months). Data analysis was conducted using chi-square statistical analysis. The research results show the p-value of intrinsic factors, namely age PR 0.447 (p=0.339), gender PR 0.747 (p=0.668), Exclusive Breastfeeding PR 4.474 (p=0.000), low birth weight PR 2.364 (p=0.064), nutritional status PR 5.250 (p=0.000), history of Vitamin A supplementation PR = 3.897 (p=0.002), history of ARI PR 3.687 (p=0.003), history of asthma PR 5.647 (p=0.008), history of tuberculosis TB 2.514 (p=0.033). Extrinsic factors such as household crowding density PR 5.778 (p=0.000), smoking behavior indoors PR 0.763 (p=0.11). Socioeconomic factors such as mother's education PR 3.055 (p=0.025), mother's occupation PR 0.753 (p=0.036), and household income PR 2.703 (p=0.04). There is a relationship between Exclusive Breastfeeding, nutritional status, history of Vitamin A supplementation, history of ARI, history of asthma, history of Tuberculosis, household crowding density, mother's education, mother's occupation, and household income with the level of pneumonia in toddlers in Jambi City in 2023. Meanwhile, there is no relationship between age, gender, history of low birth weight, and indoor smoking behavior with the level of pneumonia in toddlers in Jambi City in 2023. Keywords: Pneumonia, Toddlers, Intrinsic, Extrinsic, Socioeconomic

Realizing excellent energy-storage performance under low electric fields in lead-free BiFeO3-BaTiO3-based ceramics with ultrahigh polarization difference

Amidst the swift progress of electronic devices, there's an escalating need for capacitors to attain heightened energy storage capabilities (> 5 J/cm3) under low electric fields(< 300 kV/cm), facilitating integration and downsizing. In this research, (0.67-x)BiFeO3–0.33BaTiO3-xLaAlO3 (x = 0–0.07) ceramics with ultrahigh polarization difference (ΔP = Pmax-Pr) were successfully synthesized via the traditional solid-phase method. Initially, the progressive substitution of LaAlO3 was found by XRD Rietveld refinement, PFM, and dielectric spectroscopy analysis to lead to a phase transition from the R3c phase to the Pm3m phase, obtaining ultra-small and highly electric field responsive PNRs, thus facilitating the relaxation behavior and achieving low Pr values. Moreover, the introduction of La3+ enables the 0.67BiFeO3–0.33BaTiO3 ceramics leading to an increased deviation of Bi ions from the centre, which maintains a relatively high Pmax to achieve an ultrahigh ΔP (~52.43 μC/cm2), resulting in excellent energy storage density (Wrec ~ 5.71 J/cm3) under relatively low electric fields (270 kV/cm), along with super temperature stabilities. This study offers an effective pathway to explore the high energy storage capabilities of dielectric capacitors under low fields.

Prandtl number effect on heat transfer and flow structures in Rayleigh–Bénard convection modulated by an oscillatory bottom plate

In this paper, we study the Prandtl number effect on Rayleigh–Bénard convection systems modulated by an oscillatory bottom plate. Direct numerical simulations are carried out in a Prandtl number range of 0.2≤Pr≤4.6 and a fixed Rayleigh number of Ra=108. The initial drop and subsequent rise evolutionary behaviour of the heat transfer efficiency, characterised by the Nusselt number at the bottom plate Nub, with respect to the characteristic oscillatory velocity Vosc is observed in the whole parameter space under consideration. If the oscillatory bottom plate does not induce boundary layer instabilities but thickens the boundary layer only, then one observes a heat transfer reduction, corresponding to a high Pr and a low Vosc. If periodic boundary layer instabilities are triggered, then both heat transfer reduction and enhancement are possible. The reduction is generally seen when Pr≤1.0. Under such circumstance, the velocity boundary layer is embedded in the thermal boundary layer, if the instability induced by a certain Vosc is not strong enough to compensate the heat resistance of the thermal boundary layer, one still observes a reduction in spite of the boundary layer instabilities. The enhancement is generally seen for a low Pr and/or a high Vosc, in which case violent boundary layer instabilities will be triggered, leading to a sufficient emission of hot plumes. Furthermore, the critical velocity V̄c, characterising the boundary layer instability, is found to be increasing with Pr as Vc̄∼Pr0.5; and the Reynolds number at the equilibrium state evolves in a similar way as Nub. In the end, modal analyses are performed based on standard and extended proper orthogonal decompositions. Energetic contribution of the modes and modal distributions confirm well the modulation of the oscillatory bottom plate and the induced boundary layer instabilities on the heat transfer and flow structures of the convection system.

Major pathologic response and long-term clinical benefit in hormone receptor-positive, human epidermal growth factor receptor 2-negative breast cancer after neoadjuvant chemotherapy

BackgroundThe majority of HR+/HER2-breast cancer patients can also achieve long-term survival despite not attaining pCR, indicating limited prognostic value of pCR in this population. This study aimed to identify novel pathologic end points for predicting long-term outcomes in HR+/HER2-breast cancer after neoadjuvant chemotherapy. MethodsWe analyzed HR+/HER2-breast cancer patients with stage II-III tumors who underwent curative surgery after neoadjuvant chemotherapy from three hospitals. Major pathologic response (MPR), defined as the presence of Miller-Payne grades 3–5 and positive lymph node ratio of ≤10 %, was used as a pathological evaluation indicator. We assessed the association between MPR and event-free survival (EFS) and performed Multivariable Cox regression to identify independent factors associated with EFS. ResultsFrom January 2010 to December 2020, 386 patients were included in the final analysis. 28 patients (7.3 %) achieved pCR and 118 patients (30.6 %) achieved MPR. The median duration of follow-up was 54.4 months,5-year EFS was 87 % in the MPR group vs. 68 % in the non-MPR group. Multivariate analysis showed that low PR expression, high clinical stage, lower Miller–Payne grades and Positive lymph node ratio were independent poor prognostic factors for EFS (all P values < 0.05). The prognostic effect of MPR remained in multivariable models (hazard ratio (HR), 0.45; 95 % confidence interval (CI), 0.26–0.76; P = 0.008), In non-pCR patients, those who achieved MPR exhibited a similar EFS compared with pCR patients (HR, 2.25; 95 % CI, 0.51–9.84; P = 0.28). ConclusionMPR may be a novel pathologic end point in HR+/HER2-breast cancer after neoadjuvant chemotherapy, holding greater applicability in the prognosis evaluation than pCR.

Double-Diffusive Natural Convection in L-Shaped Cavity by Lattice Boltzmann Method: Numerical Study

The double diffusive natural convection is studied numerically on an L-shaped cavity using lattice Boltzmann method (LBM). The top and right side of the cavity is insulated, the left and the bottom side of the cavity are maintained at high temperature, and remaining sides are considered as cold wall. This study is carried out using a two-dimensional nine-directional (D2Q9) lattice structure. Single relaxation time model is adopted to solve the LBM equations. The effects of different Rayleigh numbers (Ra = 103–105), aspect ratio (0.2–0.8), Prandtl number (Pr = 0.054, 0.7, 6.2, and 50), Lewis number (2), and buoyancy ratio (−2) on the temperature, concentration, and streamline contours are presented. For the selected range of operating parameters in this study, the heat and mass transfer are more pronounced for horizontal wall than vertical. At low Pr, the difference between horizontal wall to vertical wall average Nusselt number (Nu) is 11.2% and when Pr = 50, the same difference in average Nu is 37.5%. Similarly, the average Sherwood number between horizontal and vertical wall differences are 19.5% and 31.7%. For Ra = 105, the convection rate reduced by 46% and mass diffusion reduced by 52% between Pr = 0.054–50.

Unsteady wake and heat transfer characteristics of three tandem circular cylinders in forced and mixed convection flows

In natural convection (high Richardson number Ri), a high Prandtl number (Pr) leads to thinner thermal boundary layers, enlarging the thermal gradient and hence the enhancement of buoyancy effect. In forced convection (low Ri), a high Pr introduces thicker velocity boundary layers. In mixed convection scenarios, where both forced and natural convection are significant, the interaction between Pr and Ri determines the resultant flow pattern and heat transfer characteristic. Three tandem circular cylinders with an identical spacing ratio of 4.0 in both forced and mixed convection flows were numerically investigated by using finite element method. The computations were carried out in the range of Pr = 5–50 and Ri = 0–2 at a low Reynolds number of Re = 150. The results of the squared strain rate and the vorticity shed light on the enstrophy transfer process. Thermal plume structures in the far wake originate from the upper dispersed vortices due to the high superimposed buoyancy at low Pr, while they are suppressed at high Pr. The increase in Pr plays a role as the flow stabilization, while the growth of Ri plays the reverse role. The time-averaged velocity, pressure coefficient, and temperature become more asymmetrical at high Ri. The Nusselt number of the upstream cylinder is approximately equal to the empirical result without the consideration of thermal buoyancy. Due to the thermal buoyancy, the migration of shear layers along the cylinder surface leads to the frequency alteration and harmonic frequency in the drag, lift, and Nusselt coefficients.

Development and application of turbulent heat flux model for lead-bismuth eutectic based on deep learning

Existing turbulent heat flux (THF) closure models in Reynolds-averaged Navier–Stokes simulation of scalar transport are insufficient on accuracy for fluids with a low Prandtl number (Pr), such as lead–bismuth eutectic (LBE), especially under complex operating conditions like in heat exchangers of nuclear reactors. This paper aims to propose a THF model suitable for such conditions. Firstly, we established a high-fidelity database of forced convection flow past two tandem cylinders under a Reynolds number (Re) of 1 × 105 and various low Pr conditions by hybrid large eddy simulation and direct numerical simulation algorithm. Based on the database, a deep learning architecture was then built and trained to predict dimensionless THF. Finally, a posteriori test proved that the proposed THF model helps to improve the prediction performance for temperature fields and also performs well when extrapolated to cases of LBE past the tube bundles, especially under the case with large Peclet numbers.

Colorectal cancer screening with fecal immunochemical testing or primary colonoscopy: inequities in diagnostic yield.

Socioeconomic inequalities in the uptake of colorectal cancer screening are well documented, but the implications on inequities in health gain remain unclear. Sixty-year-olds were randomly recruited from the Swedish population between March 2014 and March 2020 and invited to undergo either 2 rounds of fecal immunochemical testing (FIT) 2 years apart (n = 60 137) or primary colonoscopy just once (n = 30 400). By linkage to Statistics Sweden's registries, we obtained socioeconomic data. In each defined socioeconomic group, we estimated the cumulative yield of advanced neoplasia in each screening arm (intention-to-screen analysis). In the biennial FIT arm, we predicted the probability of exceeding the yield in the primary colonoscopy arm by linear extrapolation of the cumulative yield to (hypothetical) additional rounds of FIT. In the lowest income group, the yield of advanced neoplasia was 1.63% (95% confidence interval [CI] = 1.35% to 1.93%) after 2 rounds of FIT vs 1.93% (95% CI = 1.49% to 2.40%) in the primary colonoscopy arm. Extrapolation to a third round of FIT implied a 86% probability of exceeding the yield in the primary colonoscopy arm. In the highest income group, we found a more pronounced yield gap between the 2 screening strategies-2.32% (95% CI = 2.15% to 2.49%) vs 3.71% (95% CI = 3.41% to 4.02%)- implying a low (2%) predicted probability of exceeding yield after a third round of FIT. Yield of advanced neoplasia from 2 rounds of FIT 2 years apart was poorer as compared with primary colonoscopy, but the difference was less in lower socioeconomic groups. ClinicalTrials.gov identifier NCT02078804.

Association between mitochondrial DNA genotype and sperm motility in humans

The relationship between genetic alterations in mitochondrial DNA (mtDNA) and progressive motility (PR) and rapid progressive motility (grade A) of ejaculated human spermatozoa remains unclear. In this study, we explored the association between human mtDNA genotype and sperm PR and grade A by analyzing mtDNA copy number, loci, haplogroup, rearrangement, deletions, and duplications and sperm motility parameters. Human sperm mtDNA copy number, loci and haplogroups were not associated with human sperm motility PR or A grade. However, the cumulative frequency of human sperm mtDNA rearrangements (including deletions and duplications) in participants with high PR and grade A ratio was higher than in participants with low PR and grade A ratio. Additional studies are needed to understand the relationship between mtDNA genotypes, including deletions and duplications, and human sperm motility.

Abstract PO4-21-01: Recurrent Desmoid Tumor and Ductal Carcinoma In Situ in an African-American Woman: A Case Report and Discussion on Disparities for These Two Cancer Subtypes

Abstract Introduction: Disparities in cancer care in patients from different races and ethnicities unfortunately do exist and are well described in literature. Hormonal-driven cancers, such as some soft-tissue tumors and DCIS, have been demonstrated to impact African-American women (AAW) disproportionately. These patients are at increased risk for not only development of these cancers, but also experience disparities in survival, treatment outcomes, and modalities of treatment. Clinical Case: A 47-year-old premenopausal AAW with past medical history of recurrent desmoid sarcoma of the abdomen and ductal carcinoma in-situ (DCIS) of the left breast presented to oncology clinic with recurrent abdominal mass. The patient was originally diagnosed with DCIS in the left breast in 2018 and subsequently underwent left breast mastectomy with TRAM reconstruction and fat graft later that year. In 2020, the patient noticed a left lower abdominal growth that quickly enlarged and became painful. She underwent imaging without biopsy and was taken to surgery in April 2021 with tumor removal and mesh placement. Pathology showed desmoid fibromatosis infiltrating skeletal muscle and involving the inked resection margin of the specimen. Conservative re-excision and additional therapy was recommended but not done at the time. In 2022, the patient had resection of the area again with pathology of the incisional scar showing skin and deep soft tissue foci suspicious for recurrent desmoid fibromatosis extending to the inked deep margin. No mesh was placed, and the wound closed almost completely. The patient was not aware of positive margins at the time. In January 2023, patient again notice a new bump that was bothersome. Initial CT and MRI without finding of defined mass, but with right rectus thickening and enlarged right external iliac lymph node. Core biopsy in June 2023 confirmed recurrent desmoid fibromatosis. In April 2023, annual screening with mammogram was performed with a finding of 2.9 cm cluster of heterogenous calcification in the right breast. Diagnostic mammogram and ultrasound performed. Core needle biopsy was subsequently performed in May with pathology consistent with high grade DCIS with low ER and PR positivity. Lymph node biopsy was negative, but clinically positive. She is currently undergoing further genetic testing with surgical workup for mastectomy. Discussion and Conclusion: AAW diagnosed with DCIS have higher all-cause and disease specific mortality in comparison to white women (WW) diagnosed with DCIS. AAW are also at increased risk of aggressive secondary breast cancers in both the ipsilateral and contralateral breast in comparison to other races. In regards to tumor biology, WW have been shown to have higher ER and PR positivity in both primary and primary breast cancers than AAW. In many of these large-scale studies higher mortality, recurrence, and metastasis in AAW have been identified regardless of treatment modality. Research into differences in treatment between AAW and WW has shown that AAW, in contrast to our patient case, are more likely to undergo endocrine and radiation therapy rather than mastectomy. Although there does not seem to be an increased risk of desmoid fibromatosis in AAW when compared to WW, other soft-tissue tumors and malignancies do show a predilection for AAW. Incidence of sarcoma in black patients is higher than white patients, and black patients also have poorer survival outcomes. This case provides an example of the intersectionality of two cancer subtypes that impact black patients disproportionately. More evidence is required to unearth the reasons why these two cancer subtypes which are driven by similar processes impact AAW to a greater degree. Citation Format: Vinita Akula, Jessica Jones. Recurrent Desmoid Tumor and Ductal Carcinoma In Situ in an African-American Woman: A Case Report and Discussion on Disparities for These Two Cancer Subtypes [abstract]. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr PO4-21-01.

Ultrasound deep learning radiomics and clinical machine learning models to predict low nuclear grade, ER, PR, and HER2 receptor status in pure ductal carcinoma in situ.

Low nuclear grade ductal carcinoma in situ (DCIS) patients can adopt proactive management strategies to avoid unnecessary surgical resection. Different personalized treatment modalities may be selected based on the expression status of molecular markers, which is also predictive of different outcomes and risks of recurrence. DCIS ultrasound findings are mostly non mass lesions, making it difficult to determine boundaries. Currently, studies have shown that models based on deep learning radiomics (DLR) have advantages in automatic recognition of tumor contours. Machine learning models based on clinical imaging features can explain the importance of imaging features. The available ultrasound data of 349 patients with pure DCIS confirmed by surgical pathology [54 low nuclear grade, 175 positive estrogen receptor (ER+), 163 positive progesterone receptor (PR+), and 81 positive human epidermal growth factor receptor 2 (HER2+)] were collected. Radiologists extracted ultrasonographic features of DCIS lesions based on the 5th Edition of Breast Imaging Reporting and Data System (BI-RADS). Patient age and BI-RADS characteristics were used to construct clinical machine learning (CML) models. The RadImageNet pretrained network was used for extracting radiomics features and as an input for DLR modeling. For training and validation datasets, 80% and 20% of the data, respectively, were used. Logistic regression (LR), support vector machine (SVM), random forest (RF), and eXtreme Gradient Boosting (XGBoost) algorithms were performed and compared for the final classification modeling. Each task used the area under the receiver operating characteristic curve (AUC) to evaluate the effectiveness of DLR and CML models. In the training dataset, low nuclear grade, ER+, PR+, and HER2+ DCIS lesions accounted for 19.20%, 65.12%, 61.21%, and 30.19%, respectively; the validation set, they consisted of 19.30%, 62.50%, 57.14%, and 30.91%, respectively. In the DLR models we developed, the best AUC values for identifying features were 0.633 for identifying low nuclear grade, completed by the XGBoost Classifier of ResNet50; 0.618 for identifying ER, completed by the RF Classifier of InceptionV3; 0.755 for identifying PR, completed by the XGBoost Classifier of InceptionV3; and 0.713 for identifying HER2, completed by the LR Classifier of ResNet50. The CML models had better performance than DLR in predicting low nuclear grade, ER+, PR+, and HER2+ DCIS lesions. The best AUC values by classification were as follows: for low nuclear grade by RF classification, AUC: 0.719; for ER+ by XGBoost classification, AUC: 0.761; for PR+ by XGBoost classification, AUC: 0.780; and for HER2+ by RF classification, AUC: 0.723. Based on small-scale datasets, our study showed that the DLR models developed using RadImageNet pretrained network and CML models may help predict low nuclear grade, ER+, PR+, and HER2+ DCIS lesions so that patients benefit from hierarchical and personalized treatment.

Optimized energy storage properties of Bi0.5Na0.5TiO3-based lead-free ceramics by composition regulation

To meet the demand for miniaturization and integration of electronic and electrical equipments, developing dielectric capacitors with excellent energy storage properties is of utmost importance. Bi0.5Na0.5TiO3-based ceramics have been investigated extensively for potential energy storage applications. However, its low breakdown strength Eb and high remnant polarization Pr limit the energy storage density and efficiency (η). Therefore, we explored a synergistic design strategy of domain control and grain size adjustment via La doping to successfully synthesize 0.8Bi0.5Na0.5TiO3-0.2NaNbO3-xLa2O3 (0.8BNT-0.2NN-xLa2O3) ceramics with superior energy storage properties to overcome above issues. It shows that the composition regulation by antiferroelectric NaNbO3 results in improved disrupted long rang order ferroelectric domain structure, effectively promoting the formation of polar nanoregions, subsequently weakening Pr and enhancing relaxation behavior. The introduction of antiferroelectric NaNbO3 effectively improves the η of the system. Moreover, the grain size is decreased and densification is enhanced after La tailoring, which is beneficial for the Eb and recyclable energy storage density (Wrec). Finally, a high Wrec of 4.40 ± 0.20 J/cm3 and η of 80.1 ± 2.1% at 450 kV/cm are obtained in 0.8BNT-0.2NN-0.07La2O3 ceramic. Besides, the sample demonstrates admirable temperature stability (25–175 °C) and frequency stability (10–100 Hz). Simultaneously, it displays stable discharge energy density, rapid discharge time of 0.36 μs, and good fatigue endurance (105 cycles). The results offer useful guidance for the design of novel ceramic capacitors with comprehensive energy storage performance.

Zircon U-Pb and Whole-Rock Geochemistry of the Aolunhua Mo-Associated Granitoid Intrusion, Inner Mongolia, NE China

The Aolunhua Mo deposit is a typical porphyry deposit, which is located in the middle southern section of the Da Hinggan Range metallogenic belt. Here, we report LA-ICP-MS zircon U-Pb age data from the Mo-associated granitoid, together with the element geochemistry of the zircons, discussing the source material of the ore-forming rock of the deposit. The zircon data constrain the crystallization age of the granite porphyry as 135.0 ± 1.0 Ma, correlating it with the widespread Yanshanian intermediate–felsic magmatic activity. The Th/U ratio of the zircon is greater than 0.1, with a significant positive Ce anomaly (Ce* = 1.72–188.71) and a negative Eu anomaly (Eu* = 0.05–0.57). The zircons show depleted LREE and enriched HREE patterns, as well as low La and Pr contents, suggesting crystallization from crust-derived magmas. Based on the geology of the ore deposit and the age data, in combination with the regional geodynamic evolution, we infer that the Aolunhua Mo deposit was formed near the peak stage of Sn poly-metallic metallogenesis in the Da Hinggan Range region at around 140 Ma, associated with a tectonic setting, characterized by the transition from compression to extension. Based on a comparison with the newly found Mo deposits along the banks of the Xilamulun River, we propose that the Tianshan–Linxi is an important Mo-metallogenic belt. It also suggests an increased likelihood for the occurrence of Mo along the north bank of the Xilamulun River.

Low-Field-Driven Superior Energy Storage Effect with Excellent Thermal Stability by Constructing Coexistent Glasses.

In this work, we found that the defreezing coexistent glassy ferroelectric states hold significant potential for achieving superior energy storage performance, especially under low fields, by using phase field simulations and experimental approaches. A remarkable room-temperature energy recoverable storage density Wr exceeding 2.7 J/cm3 with a high efficiency η surpassing 80% under a low electric field of 170 kV/cm was obtained in the x = 6-12% compositions of x[Bi(Mg2/3Nb1/3)O3]-(1-x)[0.94(Bi0.5Na0.5)TiO3-0.06BaTiO3-1%MnO2] (BNBT-BMN) ceramics due to the combination of low Pr and high Pm of the coexistent ferroelectric glasses. Intriguingly, the superior Wr and η of the coexistent state of glasses can also be maintained in a wide temperature range of 293-430 K, indicating the excellent thermal stability of the energy storage behavior. Importantly, the Wr and η of this glass coexistent composition increase upon heating from room temperature to 360 K due to the defreezing process, leading to maximum Wr ∼ 2.9 J/cm3 with high efficiency η ∼ 90% of x = 10% at 360 K. When considering both energy storage behavior and thermal stability under low fields (<250 kV/cm), the BNBT-BMN ceramics outperform nearly all lead-free counterparts available today. Consequently, our work not only expands the research scope of ferroic glasses but also establishes a new paradigm for developing superior lead-free dielectrics suitable for high-temperature energy storage devices.

Approximate Analytical Solution of the Influences of Magnetic Field and Chemical Reaction on Unsteady Convective Heat and Mass Transfer of Air, Water, and Electrolyte Fluids Subject to Newtonian Heating in a Porous Medium

This paper addresses the unsteady hydrodynamic convective heat and mass transfer of three fluids namely air, water, and electrolyte solution past an impulsively started vertical surface with Newtonian heating in a porous medium under the influences of magnetic field and chemical reaction. Suitable dimensionless parameters are used to transform the flow equations and the approximate analytic method employed to solve the flow problem. The results are illustrated graphically for the velocity, temperature, and concentration profiles. Though, low Prandtl numbers produce high-thermal boundary layer thickness, however, as a novelty, the presence of the magnetic field delayed the convection motion hence, the thermal boundary layer thickness is greater for water with high Pr = 7.0 as compared to air with low Pr = 0.71 and electrolyte solution with low Pr = 1.0. Practically, water with a high-Prandtl number can effectively absorb and release heat. This makes water useful in applications such as geothermal heat pumps and solar thermal collectors, industrial processes such as chemical reactions, distillation, and drying, and in oceanography in predicting the movement and behavior of ocean currents, which in turn can impact weather patterns and climate. Another major observation from the study is that the rate of cooling associated with air, water, or electrolyte impacts differently on the product being cooled.

Teclistamab Induces Rapid Responses in Patients with Relapsed/Refractory AL Amyloidosis

Introduction Systemic light chain (AL) amyloidosis is a rare disorder characterized by tissue deposition of amyloid fibrils derived from immunoglobulin free light chains. While daratumumab in combination with cyclophosphamide, bortezomib and dexamethasone (Dara-CyBorD) is the standard for upfront treatment of AL, management of relapsed/refractory (R/R) disease is often challenging, particularly in context of multiorgan dysfunction. Teclistamab was recently approved for treatment of R/R multiple myeloma (MM) and showed an overall response rate (ORR) of 63% (N Engl J Med 2022;387:495). Notable adverse effects (AEs) included cytokine release syndrome (CRS), neurologic, renal and hematologic toxicities, and infections. Efficacy of teclistamab in AL has not been previously reported. Here, we present a series of three patients who received treatment with teclistamab for R/R AL and MM. Methods In this retrospective study, we included all patients with R/R AL and MM who received teclistamab at two US academic centers between October 2022 and July 2023. We recorded all standard metrics, including serologic and biomarker data. Hematologic and organ responses were evaluated based on standard consensus criteria. Toxicity assessment was performed in accordance with the NCI CTCAE v5.0, except for CRS and neurotoxicity, which were graded according to the 2019 ASTCT criteria (BBMT 2019;25:625). Results We identified 3 patients; baseline characteristics are provided in Table 1 and treatment data in Table 2. Median age was 67 years (range, 54-70). All patients were male, and 2 had AL λ-type. At the time of teclistamab initiation, the median number of prior therapies was 7 (5-10), with all patients being refractory to a bortezomib, lenalidomide and daratumumab. Median iFLC was 228 mg/L (45.5-1272) with 10% median bone marrow (BM) plasmacytosis. In one patient with rapidly progressive multiple myeloma, BM FISH showed high-risk cytogenetic changes, including gain 1q, del 1p and del 17p. All patients were hospitalized for treatment initiation and received escalating doses of 0.06 mg/kg, 0.3 mg/kg and 1.5 mg/kg during the ramp-up phase. Subsequent treatment with target dose of 1.5 mg/kg was continued in the outpatient setting on a weekly basis. Monitoring for cytokine release syndrome (CRS) and neurologic toxicity was performed in accordance with institutional protocols. At a median follow-up of 49 days (44-58), 2 patients achieved hematologic responses (HR), with 1 complete hematologic response (CR) and 1 low dFLC PR. Both hematologic responses occurred promptly within 3 weeks of treatment initiation, were deep with iFLC &amp;lt;10 mg/L, and were ongoing at the last follow-up. One patient with rapid renal progression prior to teclistamab also enjoyed a renal response by day 42. The most common toxicity was hematologic, with 1 patient experiencing grade 4 lymphopenia, grade 2 thrombocytopenia and hypogammaglobulinemia. There were no infectious complications or instances of febrile neutropenia, CRS or neurologic AEs. All patients received routine prophylaxis against VZV and PJP, as well as prophylactic IVIg. One patient with heavily pre-treated, high-risk MM had an aggressive clinical relapse with widespread osseous involvement within 6 months of an autologous stem cell transplant (ASCT) and experienced progressive disease as best response to teclistamab, necessitating discontinuation after 29 days in favor of cytotoxic chemotherapy. Conclusion In this series of 3 patients with heavily pre-treated, R/R AL and MM, teclistamab showed an impressive hematologic response rate of 67%. These responses were deep and occurred rapidly within 3 weeks of treatment initiation. One patient also enjoyed a renal response, whereas cardiac responses were non-evaluable in 2 patients. While the most common treatment-related toxicity was hematologic in nature, infections or febrile neutropenia were not observed, likely due to the institution of aggressive prophylactic measures. Importantly, no new safety signals were identified in AL patients. To our knowledge, this is the first report providing preliminary evidence for efficacy of teclistamab in R/R AL, highlighting the need to investigate this strategy in clinical trials.

Quenching-driven advancements in functional properties of high-temperature lead-free Sc, Ga modified 0.67BiFeO3-0.33BaTiO3 relaxor ceramics

The processing method is one of the most important deciding factors in the fabrication of BiFeO3–BaTiO3 (BF-BT) based piezoceramics because of the Bi2O3 volatization. It significantly influences the functional properties, including the piezoelectric coefficients, dielectric properties, and microstructure. This study presents a significant advancement in the realm of high-temperature lead-free piezoelectric ceramics in terms of understanding effects of processing method on functional properties. In this light, a novel ceramic solid-solution, 0.67{Bi(Fe0.97Ga0.03)1-xScxO3}-0.33(BaTiO3) with x ≤ 0.07, incorporating Scandium (Sc) and Gallium (Ga) modifications, was meticulously designed and synthesized. Impact of two distinct sintering methods, namely air quenching (AQ) and closed sintering (CS) on the structure and properties of the developed materials are investigated. X-ray diffraction (XRD) and Fourier-transform infrared (FTIR) analysis verified the formation of pure perovskite phases with successful incorporation of Sc and Ga into the 0.67BF-0.33BT lattice. The FTIR analysis revealed a sharp absorptive band in the 590-604 cm−1 range, corresponding to the signature of stretching and bending vibrations of (Ti/Fe)O6 octahedra. Rietveld structure refinement confirmed the coexistence of pseudocubic (Pm-3m) and rhombohedral (R3c) phases in AQ samples, with predominantly pseudocubic phase, while CS samples closely approximated the pseudocubic phase. The microstructure of the samples exhibits small average grain size distribution (<2 μm). Temperature-dependent dielectric measurements show strong frequency dispersion in the dielectric permittivity with broadened transition peaks. The ferroelectric studies reveal low Pr and Ec values. These observations suggest a ferroelectric relaxor-like behavior of the developed materials. Moreover, the permittivity peaks maxima (Tm) temperature corresponding to CS samples for 0.04<x < 0.07 is less than 390 °C at 10 Hz while it is above 400 °C for AQ samples. The results of our study reveal that AQ samples exhibit superior electrical and ferroelectric properties as compared to the CS samples. The AQ samples demonstrate improvements in Tm (>400 °C), d33(∼35 pC/N), Pr (∼4–11 μC/cm2), PS (∼8–21 μC/cm2), Ec (∼13–25 kV/cm) with reduced dielectric loss, and a better dielectric constant over a wide temperature range.

Hemodynamic significance of intracranial atherosclerotic disease and ipsilateral imaging markers of cerebral small vessel disease.

Cerebral small vessel disease (CSVD) commonly exists in patients with symptomatic intracranial atherosclerotic disease (sICAD). We aimed to investigate the associations of hemodynamic features of sICAD lesions with imaging markers and overall burden of CSVD. Patients with anterior-circulation sICAD (50%-99% stenosis) were analyzed in this cross-sectional study. Hemodynamic features of a sICAD lesion were quantified by translesional pressure ratio (PR = Pressurepost-stenotic/Pressurepre-stenotic) and wall shear stress ratio (WSSR = WSSstenotic-throat/WSSpre-stenotic) via CT angiography-based computational fluid dynamics modeling. PR ⩽median was defined as low ("abnormal") PR, and WSSR ⩾ fourth quartile as high ("abnormal") WSSR. For primary analyses, white matter hyperintensities (WMHs), lacunes, and cortical microinfarcts (CMIs) were assessed in MRI and summed up as overall CSVD burden, respectively in ipsilateral and contralateral hemispheres to sICAD. Enlarged perivascular spaces (EPVSs) and cerebral microbleeds (CMBs) were assessed for secondary analyses. Among 112 sICAD patients, there were more severe WMHs, more lacunes and CMIs, and more severe overall CSVD burden ipsilaterally than contralaterally (all p < 0.05). Abnormal PR and WSSR (vs normal PR and WSSR) was significantly associated with moderate-to-severe WMHs (adjusted odds ratio = 10.12, p = 0.018), CMI presence (5.25, p = 0.003), and moderate-to-severe CSVD burden (12.55; p = 0.033), ipsilaterally, respectively independent of contralateral WMHs, CMI(s), and CSVD burden. EPVSs and CMBs were comparable between the two hemispheres, with no association found with the hemodynamic metrics. There are more severe WMHs and CMI(s) in the hemisphere ipsilateral than contralateral to sICAD. The hemodynamic significance of sICAD lesions was independently associated with severities of WMHs and CMI(s) ipsilaterally.

AgNbO3-Based Multilayer Capacitors: Heterovalent-Ion-Substitution Engineering Achieves High Energy Storage Performances.

The demand for miniaturization and integration in next-generation advanced high-/pulsed-power devices has resulted in a strong desire for dielectric capacitors with high energy storage capabilities. However, practical applications of dielectric capacitors have been hindered by the challenge of poor energy-storage density (Urec) and efficiency (η) caused by large remanent polarization (Pr) and low breakdown strength (BDS). Herein, we take a method of heterovalent ion substitution engineering in combination with the multilayer capacitor (MLCC) technology and thus achieve a large maximum polarization (Pmax), zero Pr, and high BDS in the AgNbO3 (AN) system simultaneously and obtain excellent Urec and η. The substitution of Sm3+ for Ag+ in SmxAN+Mn MLCCs at x ≥ 0.01 decreases the M1-M2 phase transition temperature, and the antiferroelectric (AFE) M2 phase appears at room temperature, which is beneficial to achieving a low Pr value. Due to the low Pr value and high BDS ∼ 1300 kV·cm-1, an excellent Urec ∼9.8 J·cm-3 and PD,max ∼ 34.8 MW·cm-3 were achieved in SmxAN+Mn MLCCs at x = 0.03. The work suggests a paradigm that can enhance the energy storage capabilities of AFE MLCCs to meet the demanding requirements of advanced energy storage applications.

Effect of Bi(Zn1/2Nb2/5)O3 addition on phase transition and energy storage properties of BaTiO3 ceramics

Bi(Zn1/2Nb2/5)O3-modified BaTiO3 ceramics were designed with formula (1‒x)BaTiO3‒xBi(Zn1/2Nb2/5)O3 (0 ≤ x ≤ 0.15) and fabricated using conventional solid-state route. With increasing Bi(Zn1/2Nb2/5)O3 concentration, grain volume increased and phase structure was transformed from tetragonal to pseudo-cubic. Dielectric properties changed from temperature-dependent to temperature-insensitive and curves were flattened. Additionally, higher pseudo-cubic phase content induced slim P-E loop and low Pr. Therefore, 0.94BaTiO3‒0.06Bi(Zn1/2Nb2/5)O3 ceramic achieved energy storage density of 1.85 J/cm3 and high energy efficiency of 91.2% under electric field of 230 kV/cm. This energy storage density was 5 times higher than that of pure BT ceramic. Meanwhile, energy storage properties of this ceramic exhibited excellent thermal stability in the range of 30–120 °C and good frequency stability over 10–100 Hz. This work provides promising alternative option in energy storage materials.