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Lived experience of depression in women living with Human Immunodeficiency Virus in Gondar City health facilities, Northwest, Ethiopia: A phenomenological study
Background Many women living with HIV (WLHIV) in worldwide experience mental health conditions, particularly depression, which can negatively affect their overall wellbeing. Their lived experiences play a crucial WLHIV has been explored in various global context, there is limited research focusing on the specific women’s lived experience of depression in Ethiopia. Understanding these experience is essential to inform the development of culturally appropriate and targeted mental health interventions and support system. Method A qualitative phenomenological design was employed to explore women’s lived experience of depression in Ethiopia. Criterion-based sampling was used, and recruitment continued until data saturation was achieved. Data were collected through in-depth face to face interviews with 16 participants attending health facilities. An inductive approach was used for analysis, with code derived from the data using Ritchie and Spencer’s analytical framework. Subsequently, Interpretive Phenomenological Analysis was applied to identify key themes and subthemes. Data analysis was supported by MAXQDA (version 22) software. Results This study identified key themes on women’s lived experience of depression, including symptoms, meaning, perceived causes, perpetuating and relieving factors, treatment perceptions, coping strategies, and challenges. Depression affected emotional, physical and social well-being, and was shaped by factors such as HIV status, stigma, financial hardship, and lack of support. Women used diverse coping strategies, including spiritual practices, social support, and daily routines. Some preferred spiritual healing over professional care. Depression also negatively affected memory, motivation, self-care, and ART adherence, contributing to isolation, unemployment, and decline health. Conclusion Depression among WLHIV shaped by intersecting social, economic, and health related challenge. Addressing this requires the Ministry of Health to implement integrated, culturally sensitive mental health interventions and strengthen mental health awareness, combining psychosocial support, spiritual care, and improved access to professional services.
Load identification method for pepper harvesting drum based on dynamic chaotic characteristics of vibration-torque coupling
To improve the accuracy, robustness, and interpretability of load-state identification for pepper harvesting drums under complex field disturbances, this study proposes a load identification method based on the chaotic dynamics of vibration-torque coupling. Vibration signals reflect the structural dynamic response of the drum, whereas torque signals reflect load variations caused by crop-drum interaction. By modeling their nonlinear coupling, the proposed method captures load-sensitive dynamic evolution that is more discriminative than single-signal or conventional statistical features. This study aims to obtain reliable real-time drum load-state information to support adaptive adjustment of harvesting parameters, improve operational stability, and reduce fruit damage. A six-dimensional nonlinear coupled dynamical system was constructed by integrating Lorenz and Rössler models, explicitly representing drum load evolution through the cross-coupled nonlinear behavior of vibration and torque. A hybrid framework combining genetic algorithms and Gauss-Newton iteration was used for parameter identification, and the maximum Lyapunov exponent was extracted to quantify trajectory divergence under different load conditions, establishing a chaos-based and physically interpretable load characterization scheme. Based on Central Composite Design (CCD) experiments, the optimal operating parameters were determined as a drum rotational speed of 150 r/min and a forward speed of 0.42 m/s. Under these conditions, the picking rate reached 99.05%, the fruit damage rate was 2.35%, and the average load identification accuracy reached 90.47%. The AUC values for no-load, light-load, normal-load, and overload states were 0.992, 0.981, 1.000, and 0.947, respectively. Comparative experiments verified that the proposed method outperformed conventional load identification methods, and its successful implementation on embedded hardware demonstrated its applicability for on-machine real-time load identification. Overall, this method provides a robust and physically interpretable solution for pepper harvesting drum load identification and supports the optimization of pepper harvester operation.
Research on the equilibrium strategy of data value co-creation in water conservancy engineering projects based on differential game theory
Water conservancy engineering projects are characterized by long construction cycles, multiple participants, and dispersed data, resulting in low efficiency in data resource utilization. Therefore, data value co-creation is needed to enhance the value of data elements. This study develops a three-party dynamic differential game model of data value co-creation involving the contractor, designer, and owner. Both centralized and decentralized decision-making scenarios are considered, and a government subsidy mechanism is introduced to analyze multi-party collaborative decision-making behavior and its influencing factors. The results show that: (1) Under the centralized decision-making scenario, both the data value level and the total returns from data value co-creation are higher than those under the decentralized decision-making scenario. Centralized decision-making is more conducive to maximizing data value. (2) Government subsidies can increase the level of effort and returns of participating subjects, thereby incentivizing these subjects to engage in data value co-creation. (3) The cost coefficient of data value co-creation for participating parties has an inhibitory effect on their willingness to engage in data value co-creation. In contrast, an increase in the utility coefficient can significantly enhance their willingness. The research findings can provide theoretical support for data value co-creation practices in water conservancy projects and for the formulation of related policies.
Automated spermatogenic staging in periodic acid-Schiff-stained testes of Sprague–Dawley rats using a deep learning model for normal and atrophied tissues
The spermatogenic stage serves as a vital criterion for assessing normal spermatogenesis and is central to evaluating reproductive toxicity. Current manual methods for evaluating the spermatogenic stage are time-intensive, require expert knowledge, and are less effective at detecting subtle changes or comparing stage frequencies across samples. To overcome these limitations, this study introduces a method that leverages object detection models and Region-based Convolutional Neural Networks to enable efficient and accurate evaluation of spermatogenic stages. A total of 16 periodic acid-Schiff-stained testicular tissue whole-slide images (WSIs) obtained from 16 Sprague–Dawley rats were used in this study. A total of 14 stages were identified, and the approach was further applied to atrophied testicular samples as a real-world example. A total of 10 WSIs (nine normal and one atrophied testes) were used for model training, validation, and testing. Six additional WSIs (three normal and three atrophied testes) were used for model inference. For the test set, the model achieved a mean average precision of 0.869 and a mean average recall of 0.977 for detecting spermatogenic stages and atrophy. For the inference set, agreement with pathologist assessments exceeded 91%, providing objective benchmarks for stage evaluation and facilitating the comparison of stage frequencies across multiple samples. The model enabled the quantitative assessment of atrophied tissues by analyzing the proportional changes in atrophied seminiferous tubules relative to normal tubules. This automated approach has the potential to reduce the workload of pathologists by enabling rapid, reproducible assessment of toxicological changes during spermatogenesis. As a proof-of-concept, the integration of deep learning demonstrated the feasibility of improving the efficiency and objectivity of pathological evaluations in reproductive toxicity studies.
Effects of mindfulness-based stress reduction on perioperative outcomes in patients with advanced hepatocellular carcinoma undergoing transarterial chemoembolization
Objective To evaluate the effects of mindfulness-based stress reduction (MBSR) combined with standard perioperative care on perioperative outcomes in patients with advanced hepatocellular carcinoma (HCC) undergoing transarterial chemoembolization (TACE). Methods This retrospective study enrolled patients with advanced HCC who underwent TACE and received either standard perioperative care alone or standard care combined with an MBSR intervention. Post-embolization syndrome (PES) was assessed 72 hours after TACE. Postoperative pain was evaluated using the numerical rating scale (NRS), while anxiety and depression were assessed using the Hospital Anxiety and Depression Scale (HADS). Self-care efficacy was measured using the Strategies Used by People to Promote Health (SUPPH) scale. Univariate and multivariable logistic regression analyses were performed to explore factors associated with PES. Results Compared with standard care, the MBSR intervention was associated with significantly lower postoperative NRS pain scores at all assessed time points, reduced use and escalation of analgesic medications, and lower anxiety and depression scores (all P < 0.05). Patients in the mindfulness group also demonstrated significantly higher SUPPH scores, indicating better self-care efficacy ( P < 0.001). In addition, the incidence of PES and postoperative length of hospital stay were significantly lower in the mindfulness group. Logistic regression analysis showed that the mindfulness intervention was independently associated with a reduced risk of PES (OR = 0.55, 95% CI 0.31–0.96). Conclusion Mindfulness-based stress reduction combined with standard perioperative care was associated with improved pain control, psychological well-being, self-care efficacy, and reduced perioperative complications in patients with advanced HCC undergoing TACE. This intervention may serve as a feasible supportive approach in perioperative clinical practice.
Characterization of genomic diversity in bacteriophages infecting Rhodococcus
Bacteriophages are ubiquitous and highly genetically diverse biological entities. Here we describe the isolation and bioinformatic characterization of 56 phages isolated on two Rhodococcus spp. They include both lytic and temperate phages and are grouped with previously described Rhodococcus phages into six clusters and 16 singletons based on genome similarity. Their genome sizes range from 43.9 kbp to 142 kbp and they have a G + C content ranging from 41.2% to 68.4%. Some of the Rhodococcus phages are more closely related to phages isolated on non- Rhodococcus Actinobacteria hosts than they are to phages isolated from the same host genus, demonstrating complex evolutionary histories. This study further expands the growing field of Actinobacteriophage genomics.
GC–MS based tentative identification of γ-sitosterol from Brassica nigra seeds and evaluation of its anticancer potential: An integrated in vitro and in silico study
Cervical cancer remains a significant global health burden, particularly in developing countries where limited access to effective therapies contributes to high morbidity and mortality. Natural products derived from medicinal plants have emerged as promising sources of novel anticancer agents; however, identifying active compounds and elucidating their molecular mechanisms remain challenging. This study investigates the anticancer potential of Brassica nigra seed extract, with particular emphasis on γ-sitosterol as a bioactive compound relevant to cervical cancer therapy. Isopropanol extracts of B. nigra seeds were analyzed using GC–MS for phytochemical profiling. Cytotoxicity was assessed via MTT assay on HeLa (cervical cancer) and Vero (normal) cell lines, followed by a brine shrimp lethality bioassay. Anti-inflammatory activity was evaluated using protein denaturation and membrane stabilization assays, and thrombolytic activity was examined through a clot lysis assay. An integrated in silico approach was employed to evaluate γ-sitosterol, including oral drug-likeness prediction, target screening, protein–protein interaction network analysis, BRCA expression profiling, molecular docking, and 100 ns molecular dynamics simulations to explore its interaction with neuropilins and other cancer-related targets. The extract demonstrated dose-dependent cytotoxicity against HeLa cells (CC₅₀ = 0.36 mg/mL), while showing lower toxicity in Vero cells (CC₅₀ = 1.26 mg/mL), yielding a Selectivity Index of approximately 3.5, indicative of selective anticancer activity. Significant inhibition of protein denaturation (IC₅₀ = 74.8 µg/mL) suggested notable anti-inflammatory potential. GC–MS identified γ-sitosterol as a major constituent (17.33% peak area). Computational analyses revealed stable binding interactions of γ-sitosterol with key targets including TP53, AKT, and BRCA1, supporting its potential role as a multi-target modulator of apoptosis, survival signaling, and genomic stability pathways. Overall, B. nigra seed extract, enriched with γ-sitosterol, exhibits promising cytotoxic and anti-inflammatory activities. Further isolation, mechanistic validation, and in vivo studies are warranted to confirm its therapeutic potential in cervical cancer management.
Terahertz-driven nonlinear phononics induces transient ferromagnetism in antiferromagnetic MnF2
Ultrafast optical manipulation of magnetism provides a promising pathway for next-generation spintronic technologies. Here, we theoretically demonstrate that terahertz-driven nonlinear phononics can induce transient ferromagnetic polarization in antiferromagnetic MnF2. Using first-principles calculations and nonlinear lattice-dynamics modeling, we show that the simultaneous excitation of two degenerate Eu infrared-active phonons drives a rectified displacement of the intrinsic B2g Raman mode through trilinear phonon coupling. The resulting lattice distortion modifies magnetic exchange interactions and produces a finite magnetization in an otherwise collinear antiferromagnetic state. Furthermore, a tailored two-pulse terahertz excitation scheme with distinct pulse widths and controlled delay enhances the rectified Raman displacement and the induced magnetization. Magnetization-dynamics simulations reveal picosecond-scale oscillations and a sizable light-induced magnetic moment approaching 1 μB per unit cell under strong excitation. These results establish a phonon-mediated pathway for ultrafast optical manipulation of antiferromagnetic order and suggest a strategy for controlling magnetism in antiferromagnetic materials using engineered terahertz fields.
Epidemiology of invasive pneumococcal disease in Southwest Sweden during the first eleven years after the introduction of general childhood pneumococcal vaccination
Background Invasive pneumococcal disease (IPD) still causes significant morbidity and mortality. In this study, we describe incidence, risk factors, manifestations, and outcome of IPD in Southwest Sweden during the first eleven years after the introduction of conjugate pneumococcal vaccines in the childhood vaccination program in 2009. Methods Clinical data from 2,288 consecutive episodes of IPD in Region Västra Götaland, Sweden during 2009–2019 were retrospectively collected from medical records. Incidence rates were calculated using population data from the same period. The results were compared to data from three previous studies from the same geographical area with a total follow-up of 56 years. Results The incidence of all IPD episodes in 2009–2019 was 12.8/100,000/year. A very high IPD incidence was seen in patients with multiple myeloma (1,497/100,000) and chronic lymphocytic leukemia (505/100,000). Meningitis occurred in 26% of the IPD episodes in children <2 years compared to 4.3% in the age group ≥65 years (12/46 versus 60/1,403; p < 0.001). The opposite was found for pneumonia, which accounted for 22% of the IPD episodes in children <2 years compared to 77% among the elderly (10/46 vs. 1,085/1,403; p < 0.001). In 604 IPD episodes (26.4%), one or more complications were observed, most commonly parapneumonic effusion and empyema. When data were compared with the previous study period, the IPD incidence in children <2 years declined from 22.5 in 1996–2008 to 10.7 per 100,000 in 2009–2019, while only a modest reduction was observed in adults ≥65 years (from 45.0/100,000 to 41.2/100,000). The overall case fatality rate (CFR) increased from 9.9% in 1996–2008 to 12.9% in 2009–2019, which could be explained by increased patient age and underlying comorbidity. Conclusions A substantial decrease in IPD incidence was seen in infants and young children but not in the elderly during the first eleven years after the introduction of the general childhood pneumococcal vaccination program. Patients with hematological malignancies remain a high-risk group of IPD.
Significant reduction of thermal conductivity in monolayer MoSe2 through fractional-layer engineering
Controlling phonon-mediated heat transport in two-dimensional (2D) materials through intrinsic and disorder-free mechanisms remains a fundamental challenge. Here, we demonstrate that fractional-layer engineering provides a general route to intrinsically suppress thermal conductivity in 2D materials. Using first-principles calculations combined with the Boltzmann transport equation, thermal conductivity of monolayer MoSe2 and fractional-layer MoSe was investigated. Specifically, fractional-layer reconstruction leads to an almost twofold reduction in thermal conductivity. Phonon analysis shows that thermal conductivity suppression is dominated by strongly enhanced four-phonon scattering of acoustic phonons, with splitting processes playing the leading role. Additionally, fractional-layer engineering drives a sign reversal and a pronounced enhancement of the Grüneisen parameter for the out-of-plane acoustic mode, indicating strengthened phonon anharmonicity. Our results identify fractional-layer engineering as a broadly applicable strategy for intrinsic phonon and thermal-transport regulation in 2D materials.
Effectiveness of the Responding to Experienced and Anticipated Discrimination (READ) training on reducing stigma for medical students in Tunisia
Doctors have been identified as having a crucial role in responding to anticipated and experienced stigma of People with Mental Illness (PWMI). This paper aims to evaluate the effectiveness of the READ (Responding to Experienced and Anticipated Discrimination), an anti-stigma training for medical students, by measuring changes in their knowledge, attitudes, and skills, in responding to patients anticipated and experienced discrimination. The Mental Health Knowledge Schedule (MAKS), the Mental Illness Clinicians’ Attitudes version 2 (MICA2), and an OSCE (Observed Structured Clinical Examination) were used to determine participants’ knowledge, attitudes, and behaviours towards PWMI before and immediately after the training. There was evidence of difference in MICA2 mean total scores in the intervention group were compared to the control group after adjusting for age, gender and MICA baseline mean total scores (MD: −7.88; p < 0.001; 95% CI: −10.23 to −3.96). Moreover, the intervention group was 4.45 times more likely to be scored “pass” in the OSCE compared to the control group (p = 0.046, 95% CI: 1.03 to 19.26) after adjusting for age, gender and OSCE baseline scores. The positive changes in students’ attitudes and skills after the READ training should encourage further research on the causal pathways of this positive relationship.
Surface modulation of two-dimensional perovskite for spatially selective p-type doping in van der Waals stacked MoS2 toward high-performance homojunction photodetector
Homogeneous p–n junctions in two-dimensional transition metal dichalcogenides (e.g., MoS2) demonstrate significant potential in high-performance optoelectronic devices. However, achieving stable and controllable p-type doping in MoS2 remains challenging, hindering the construction of high-quality p–n homojunctions. Traditional doping methods such as chemical adsorption or gate voltage modulation often suffer from issues like poor stability or complex fabrication processes. This study revealed that oxygen plasma treatment effectively modulated the surface morphology and potential of two-dimensional perovskite (2DPVK) nanosheets grown by a floating solution growth method. Furthermore, by establishing a van der Waals interface between processed 2DPVK and MoS2, successful reconfiguration of carrier polarity in MoS2 was achieved. This enabled the fabrication of lateral MoS2 homogeneous p–n junctions by spatially selective treatment of 2DPVK. The homojunction device exhibited pronounced rectification characteristics and maintained a low dark current. Under laser illumination, the photocurrent increased by four orders of magnitude relative to the dark current, and the open-circuit voltage reached 0.6 V. Photocurrent mapping further revealed the dominant role of the built-in electric field in carrier separation. In the self-driven (zero bias) mode, the device demonstrates a high responsivity of 0.33 A W−1. This study successfully achieved selective p-type doping of MoS2 through interface-engineered van der Waals stacking, which provides innovative insights for controllable design in high-efficiency optoelectronic devices based on two-dimensional materials.
Electrophysiological asymmetry in vincristine-exposed children with acute lymphoblastic leukemia: Evidence from bilateral nerve conduction studies
Vincristine-induced peripheral neuropathy (VIPN) is a frequent complication of therapy for acute lymphoblastic leukemia (ALL) in children. Beyond acute toxicity, VIPN may affect motor development, balance, and quality of life in survivors. Although often assumed to be symmetric, the extent of electrophysiological asymmetry has not been systematically evaluated. This study aimed to quantify side-to-side differences in vincristine-exposed children using bilateral nerve conduction studies (NCS). Forty-seven bilateral NCS assessments were performed in 47 children with ALL (32 post-treatment survivors and 15 on active therapy). Distal latencies, amplitudes, and conduction velocities were compared between sides using intraclass correlation coefficients (ICC), Cohen’s kappa, and McNemar’s test at three hierarchical levels: individual parameters, nerve-level classifications, and limb-level neuropathy. Motor nerve parameters, particularly compound muscle action potential amplitude and conduction velocity, showed only fair to moderate inter-side agreement (ICC range 0.28–0.64), with the lowest concordance observed in the peroneal and ulnar nerves. In contrast, sensory latencies demonstrated excellent symmetry (ICC > 0.90). Whole-nerve classifications for motor nerves revealed fair to moderate agreement (kappa 0.38–0.49), while NCS-defined polyneuropathy classification showed substantial agreement (kappa = 0.66). Furthermore, marked amplitude asymmetry (side-to-side ratio < 0.5) was observed in 40.4% of peroneal nerves. These results suggest that electrophysiological asymmetry is a frequent feature of pediatric VIPN and may have clinical relevance. Recognition of asymmetry does not fully align with the traditional view of VIPN as a symmetric neuropathy and supports consideration of bilateral NCS in clinical and research settings. Improved awareness of asymmetry may help improve diagnostic accuracy and inform the development of future assessment criteria. Because asymmetry could contribute to postural imbalance, gait deviations, and reduced functional capacity, its detection may be relevant for rehabilitation planning and for guiding future studies on long-term motor outcomes in this pediatric population.
Three-dimensional characterization of laser-induced stress in a bulk GaN substrate using stimulated Raman scattering microscopy
The three-dimensional (3D) stress distribution in a bulk GaN substrate with laser-induced indentations for laser slicing was characterized using stimulated Raman scattering (SRS) microscopy. Local shifts in the Raman peak corresponding to the E2H mode were detected around the indentations, indicating the induction of local stress. The spatial distribution of internal stress was successfully visualized, revealing a clear in-plane anisotropy with compressive and tensile stresses along the a- and m-axes, respectively, as well as its extension in the depth direction. SRS microscopy enables the 3D visualization of residual stress in bulk GaN substrates, facilitating the optimization of fabrication processes.
Seasonal dynamics in sheep fecal microbiome and soil bacterial communities under grazing management
The gut microbiome plays a key role in animal health, productivity, and environmental sustainability. As it represents a valuable proxy for animal welfare, its investigation has become increasingly important in livestock studies. With the growing focus on promoting sustainable livestock, supporting rural areas at risk of abandonment is receiving particular attention. Indeed, sheep grazing offers a promising strategy for improving sustainability, biodiversity, and land management. This study focuses on the interconnected dynamics between the sheep gut and soil microbiomes, assessing how seasonal changes and grazing activity shape microbial diversity and community structure across the animal–soil interface. Fecal and soil samples were collected throughout 2024 in a commercial farm in Tuscany, Italy: 215 fecal and 46 soil samples (23 pasture and 23 meadow – i.e., not grazed) were stored. Alpha and Beta diversity were assessed using the Kruskal-Wallis test and PERMANOVA, respectively, and the differential abundance analysis was also performed. The relative abundance analysis at the family and genus level revealed an increase in the number of taxa from winter to autumn in both fecal and soil samples. When the Chao1 index was considered, alpha diversity was higher in fecal samples, followed by soils. Principal Coordinate Analysis revealed distinct clustering between animal and soil microbiota, with slightly reduced differentiation in Summer. In fecal samples, the five most abundant bacterial families were Ruminococcaceae , Spirochaetaceae , Porphyromonadaceae , Lachnospiraceae , and Rikenellaceae , whose abundance varied seasonally. Ruminococcaceae, Lachnospiraceae, and Rikenellaceae decreased in Summer, while Spirochaetaceae and Porphyromonadaceae increased. The increased abundance of these families during Summer may reflect heat stress in animals. Differential abundance analysis also suggested potential microbial transfer from animals to soil: Peptostreptococcaceae and Erysipelotrichaceae were enriched in grazed soils across multiple seasons. Repeated cross-sectional studies like this are essential for understanding microbiome dynamics and animal–soil interactions in grazing systems.
Recombination mechanisms in CIGS solar cells: Insights from temperature-dependent electrical measurements
Temperature, a key environmental factor affecting photovoltaic devices, strongly influences the electrical performance of CIGS solar cells. This study examines cells with 30 and 60 nm CdS buffer layers using temperature-dependent current–voltage and capacitance–voltage (C–V) measurements. While both structures show similar efficiency temperature coefficients, the underlying recombination mechanisms differ: thin-buffer cells are dominated by interface-related processes, whereas standard-buffer cells exhibit more bulk-controlled behavior. C–V profiling indicates that thermally activated changes in carrier concentration shift with buffer thickness, occurring near the heterojunction in thin-buffer cells and deeper in the absorber for thicker layers. These spatial differences are consistent with thermally activated (VSe−VCu) defect transformations. Overall, temperature-dependent electrical characterization provides insight into dominant recombination pathways and reveals how buffer thickness influences the location and impact of thermally activated defect states in CIGS heterostructures.
Charlson comorbidity health analytics: A population management strategy to identify risk of hospitalizations, repeated hospitalizations, and resultant high cost
Background Building on prior development work, the objective of this study of health care utilization of all Weill Cornell Medicine health insurance beneficiaries over a six-year period was to demonstrate the validity of the Charlson Comorbidity Health Analytics (CCHA), a summed weighted measure of 38 chronic conditions in adults and children, that prospectively predict longitudinal risk of hospital admissions, repeated admissions and resultant high cost in populations. The objective of the Charlson Comorbidity Health Analytics (CCHA) is to provide a new foundational framework for population management strategies by identifying the highest risk patients who can then be the focus for interventions designed to reduce unplanned hospitalizations and resultant high costs. Methods All 27,190 Weill Cornell Medicine beneficiaries in the years 2016–2021, that is, employees and their dependents, including spouses/partners and their children, were linked across the years in a de-identified way, and CCHA was calculated from claims data. In addition to basic demographics, data included all outpatient and inpatient claims, including payments for each service over each year, excluding pharmacy. While two pharmaceuticals are part of the CCHA (anticoagulants and anti-psychotics), no data about pharmaceuticals was available for this analysis. First, CCHA from each year 2016–2021 was evaluated cross-sectionally as a predictor of that year’s hospitalizations and costs. Second, the CCHA from 2016 beneficiaries who were followed for five years were used to predict longitudinal risk of hospitalizations, repeated hospitalizations, and costs in each of the next five years. Then the CCHA was compared to the CMS Chronic Conditions Warehouse 30 (CCW30) measure. Finally, the CCHA from any given year (2016–2021) was analyzed for its predictive ability over the remaining one to five years of follow-up to predict hospitalizations, repeated hospitalizations, and costs. Results Of the total 27,190 beneficiaries over the six years, 55.8% were employees (66.2% women with an average age of 40.9 years), and 25.7% children (average age of 6.1 years). The Charlson Comorbidity Health Analytics (CCHA) score from an index year longitudinally predicts the risk of hospitalizations--including repeated hospitalizations--which drive healthcare costsover six years (p < .01), providing the foundation for interventions in the highest risk patients. Moreover, the 2016 CCHA was a more significant predictor of readmission in 2017–2021 than a 2016 admission. In addition, comorbidity from any index year can be used to predict subsequent admissions and costs; therefore, it works in dynamic populations, like employers and unions that have changes in beneficiaries over time. Conclusions and Relevance The Charlson Comorbidity Health Analytics is a method for prospectively identifying the small percent of patients who are at high longitudinal risk for unplanned hospitalizations and high costs. Intervention efforts can then be focused on high-comorbidity patients at high risk [1], with the goal of preventing health deterioration leading to health crises. Comorbidity Health Analytics provides a new foundational framework for population management strategies and specifically for interventions designed to reduce unplanned hospitalizations and thereby reduce costs.
Temperature-accelerated lifetime testing and failure analysis of GaAs and InGaAs laser power converters
Laser power converters (LPCs) are key components in laser wireless power transmission systems. In this work, accelerated lifetime tests were conducted on GaAs single-junction and InGaAs single-junction LPCs by elevating the device temperature to 160, 175, and 190 °C to induce accelerated aging. Dark current injections of 8.06 and 8.62 A were applied to GaAs and InGaAs LPCs, respectively, corresponding to simulated photocurrent under laser power densities of 14.65 and 12.78 W/cm2. The failure distributions were fitted using the Arrhenius model, yielding activation energies of 1.11 eV for GaAs single-junction LPCs and 1.15 eV for InGaAs single-junction LPCs. The estimated lifetimes of both devices under an operating temperature of 85 °C are approximately 64 years. Post-aging characterization reveals that device degradation is mainly caused by an increase in series resistance, which leads to a reduction in fill factor and maximum power point. The increase in series resistance is attributed to the degradation of grid electrodes. In addition, the formation of surface cracks is likely associated with the curvature of the LPC exceeding its strain limit.
Cell–cell junction gene signatures as subtype-specific prognostic biomarkers in breast cancer
Cell–cell junctions (CCJs) are essential for maintaining epithelial integrity, and adhesion-related molecules have long been implicated in breast cancer progression. However, the subtype-specific prognostic significance of CCJ-related gene expression patterns within individual intrinsic breast cancer subtypes has not been systematically characterized. We analyzed 179 genes annotated to the Gene Ontology term “cell–cell junction organization” (GO:0045216) across intrinsic breast cancer subtypes using the METABRIC and The Cancer Genome Atlas (TCGA) datasets. Subtype-specific prognostic CCJ genes were identified using multivariate Cox proportional hazards models for disease-specific survival and integrated into CCJ gene expression signatures. The prognostic performance was validated in an independent cohort (SCAN-B). Elevated CCJ signature scores were associated with poorer survival across subtypes, with particularly strong effects in Luminal B (LumB) and Basal-like (Basal) tumors. Person-year analyses indicated that high CCJ scores predicted an increased incidence of early recurrence (0–5 years) in these aggressive subtypes. Pathway enrichment analyses revealed that high-score tumors exhibited upregulation of extracellular matrix organization and matrisome-related pathways. Single-cell RNA sequencing further demonstrated that LumB CCJ genes (e.g., PARD6B , CDH3 ) were predominantly expressed in tumor epithelial cells, whereas the Basal CCJ signature reflected contributions from epithelial (e.g., MARVELD2 ) and endothelial (e.g., RAMP2 ) cells. Collectively, CCJ signatures stratify prognosis and capture subtype-specific cellular and microenvironmental features in breast cancer.
MgB2 thermal kinetic inductance detector
Thermal Kinetic Inductance Detectors (TKIDs) inherently combine the phonon-limited noise performance of traditional bolometers with the array scalability and responsivity of superconducting kinetic inductance detectors. Using a superconducting resonator as the thermally sensitive element provides high responsivity and a tunable dynamic range, with phonon noise set by the cryogenic operating temperature of the free-standing membrane. In this work, MgB2-based TKIDs are demonstrated operating from below 1 K up to 20 K with characterized noise-equivalent power using integrated on-membrane heaters. A comprehensive characterization of electrical, thermal, and noise properties is presented. The internal quality factor of the prototype devices is measured to be Qi&gt;2×104 at 4.2 K, with a bolometer time constant of τ&lt;0.7 ms below 5.6 K. The intrinsic detector noise is NEPmeasured&lt;10−14 W/Hz for T&lt;8 K, demonstrating phonon noise-limited performance from 4 to 8 K.