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Spontaneous ordering in ultra-large anion size-mismatched BaZr (S1−xOx)3
Chalcogenide perovskite semiconductors, with their excellent optical absorption, chemical stability, and lack of toxicity, have emerged as a promising alternative to traditional halide perovskites. Through first-principles density functional theory, we show that despite the large lattice mismatch between the prototypical BaZrS3 and BaZrO3 chalcogenide perovskites, BaZr(S1−xOx)3 can form low-energy ordered lattices that significantly reduce strain. The bandgap dependence of the resulting ordered compound on x is found to exhibit double Vegard's law behavior, having two distinct linear regions, associated with an underlying distorted or undistorted perovskite structures.
Small-area spatio-temporal analysis of cancer risk to support effective and equitable cancer prevention
Cancer is rapidly increasing worldwide and urgent global action towards cancer control is required. Consistent with global trends, Canada is expected to experience a near doubling in new cases and cancer deaths between 2020–2040; population growth and ageing being the primary drivers. The projected increased cancer incidence and its associated costs is expected to further exacerbate socioeconomic inequities. Focused actions to prevent cancer, to detect it earlier when more treatable, and, to lower the risk of recurrence, must be prioritized. Almost half of all cancers are preventable, caused by risk factors that are potentially avoidable and modifiable. Integrating cancer prevention with care-based models is necessary and represents the most cost-effective and sustainable approach to control cancer. To be effective, prevention efforts must consider the cancers impacting local populations and understand how community and individual factors interact within the spatial and temporal contexts in which people live. This study is part of the Nova Scotia Community Cancer Matrix project which profiles the cancers impacting communities over time; measuring associations between cancer and socioeconomic status (SES); and determining how the joint spatial distribution of cancers can be used to address inequities, identify priority populations and strengthen prevention efforts. Using Bayesian inference to model spatio-temporal variations in 58,206 cases diagnosed in 301 communities between 2001–2017, across 10 preventable cancer types, we report significant disparities in cancer risk across communities based on sex and community SES. The work highlights the utility of small-area mapping to identify at-risk communities and understand how community-SES impacts risk. It also uncovers significant inequities rooted in the differential distribution of material and social capacity, operating beyond the control of individuals. The approach is implementable to other regions to inform and strengthen prevention efforts aiming at reducing the burden of cancer or that of other diseases.
Field-dependent anisotropic microwave responses in van der Waals ferromagnet Fe4GeTe2
The exploration of two-dimensional van der Waals (2D-vdW) ferromagnets with high Curie temperature (TC) is crucial for the development of high-performance, non-volatile, and low-power spintronic devices. 2D-vdW Fe4GeTe2 (F4GT) is considered a promising candidate material due to its nearly room-temperature TC, strong magnetization, high conductivity, and variable magnetic anisotropy. In this study, we investigate the multiple magnetic couplings in F4GT single crystals using electron spin resonance (ESR) technique. ESR lines associated with the change from perpendicular magnetic anisotropy to easy plane anisotropy are observed, indicating strong anisotropic responses to the microwaves. As the temperature increases, the resonance lines for H∥ab shift toward higher fields, while those for H∥c move toward lower fields. These opposite behaviors are attributed to the competition between the inner magnetic field and the demagnetization effect. In addition, the angle-dependent ESR spectra of F4GT single crystal exhibit a [3 cos2(π2−φ)−1]2-like behavior, which indicates a characteristic of 2D magnetic coupling attributed to the dominant effects of q→ 0 mode. These findings provide significant insights into the complex spin couplings in F4GT and pave the way for its potential applications in microwave-based spintronic devices.
Combining CD3/GD2 bispecific T cell engager with human Vγ9Vδ2 T cells facilitates neuroblastoma cell targeting and killing in vitro
Cancer immunotherapy, particularly T cell–based therapies, is considered to have strong potential for treating various types of cancer. A promising approach that has emerged is the use of γδ T cell-based strategies for cancer treatment. Neuroblastoma (NB), a solid tumor frequently found in childhood, is one of the more intriguing targets for immunotherapy. In this study, we report an alternative immunotherapy method for treating neuroblastoma by combining bispecific antibody with human Vγ9Vδ2 T cells. Initially, we screened for human scFv against CD3 epsilon using phage panning technology. Human scFv CD3 clone 18 demonstrated the highest ability to bind CD3 epsilon in an indirect ELISA assay. Consequently, we selected human scFv CD3 clone 18 to create a bispecific T cell engager antibody targeting both CD3 and disialoganglioside (GD2), called CD3/GD2 BiTE. This bispecific antibody was composed of human scFv CD3 clone 18 (VH-VL) and mouse scFv GD2 (VL-VH), linked by a flexible peptide linker. The interleukin-2 signal sequence and polyhistidine tag were added at the N- and C-termini for protein secretion and purification, respectively. CD3/GD2 BiTE was transiently produced in a mammalian cell expression system, which provided both high yield and quality. The CD3/GD2 BiTE folded naturally into a compact monomeric structure. Cell-based binding activity assays demonstrated that CD3/GD2 BiTE specifically binds to its target antigens on CD3-positive Jurkat cells and GD2-positive SH-SY5Y cells, but did not react with CD3-negative Raji cells and GD2-negative SK-N-SH cells. In subsequent in vitro experiments, the cytotoxicity of CD3/GD2 BiTE combined with human Vγ9Vδ2 T cells against neuroblastoma cells was evaluated. Human Vγ9Vδ2 T cells were primed with CD3/GD2 BiTE to improve the binding specificity and avidity against neuroblastoma cell lines before adding into SH-SY5Y cells. At concentrations of 180 and 360 nM, the CD3/GD2 BiTE significantly enhanced the killing ability of human Vγ9Vδ2 T cells against SH-SY5Y cells at an E:T ratio of 1:1. Moreover, CD3/GD BiTE armed with human Vγ9Vδ2 T cells enabled the killing of neuroblastoma cells using five- to ten-times fewer effector cells. The combination of CD3/GD2 BiTE and human Vγ9Vδ2 T cells also exhibited cytotoxic activity against a three-dimensional tumor spheroid model of SH-SY5Y GFP at an E:T ratio of 1:1. Consequently, CD3/GD2 BiTE enhances tumor-targeting and cytotoxic abilities of human Vγ9Vδ2 T cells against neuroblastoma cells in both two-dimensional and three-dimensional cell cultures. These results suggest that the combination of CD3/GD2 BiTE and human Vγ9Vδ2 T cells could represent an alternative immunotherapy strategy for treating neuroblastoma patients in the future.
Defect enhancement of Er emission in single crystal Er2O3
We report observations of crystal defect induced modifications in the laser-excited Er3+ photoluminescence spectra of single-crystal Er2O3 thin films. These include marked enhancement of transition intensities known to be weak or nonexistent in as-grown samples. In this Letter, we examine the temperature and defect density dependence of the measurements and suggest photophysical processes that may account for these unexpected results.
Hepatic transcriptome profiling unveils candidate genes in cattle with liver abscesses under the influence of beef genetics in dairy cattle
Liver abscesses are a significant concern in cattle feeding, linked to visceral condemnation and carcass trimming; however, the molecular mechanism of development and progression of liver abscesses is unknown. This study aimed to evaluate the hepatic transcriptomic profile, immunohistochemistry, and IGF-I circulation in beef × dairy (Angus × Holstein) steers with and without liver abscesses. Samples were collected from twelve steers (final body weight of 719 ± 5.8 kg) originating from the same feedlot and were selected based on liver scores at harvest. The animals were divided into abscessed (n = 6) and healthy livers (n = 6). Blood samples were used to measure circulating insulin-like growth factor I (IGF-I) levels using an ELISA kit. Liver samples were divided into two portions; one portion was used for immunohistochemistry (IHC) to identify IGF-I receptor (IGF-IR) abundance, while the second portion was used for RNA extraction, library preparation, and sequencing (Illumina NovaSeq 6000 platform). Differentially expressed genes (DEGs) were identified with the DESeq2 R package, using an adjusted p-value ≤ 0.05 and fold change > 1.5. Sera IGF-I was not affected by liver condition; however, IGF-IR abundance was up-regulated in abscessed livers. A total of 568 DEGs were identified, with 372 up-regulated and 196 down-regulated in abscessed livers. Notably, the most highly up-regulated genes were FGF23, NXPH4, and CYP7A1, while EPHA6, CD70, and INHBA showed the most significant downregulation. Protein-protein interaction (PPI) network analysis identified THBS1 and COL1A2 as significant hub genes. The DEGs showed enrichment in biological processes related to angiogenesis, cell migration, adhesion, and extracellular matrix organization. Pathway analysis indicated activation in signaling pathways, including hepatic fibrosis, interleukin, and IGF-I signaling. These findings reveal candidate genes and pathways linked to inflammatory responses and tissue remodeling, offering valuable evidence that enhances our understanding of the progression of liver abscesses in cattle.
Nonlinear transport in carbon quantum dot electronic devices: Experiment and theory
Carbon quantum dots (CQDs) are a promising material for electronic applications due to their easy fabrication and interesting semiconductor properties. Further, CQDs exhibit quantum confinement and charging effects, which may lead not only to improved performances but also to devices with novel functionalities. Here, we investigate the electronic transport of CQDs embedded on epoxy polymer. Our samples are coupled to interdigitated electrodes with individually addressable microelectrodes. Remarkably, the current–voltage characteristics show strongly nonlinear regimes at room temperature, ranging from Schottky diode to Coulomb blockade and even negative differential conductance (NDC) behavior. We propose a master equation theoretical framework which allows us to compute current curves that agree well with the observations. This model emphasizes the importance of interacting dots and electron traps in generating a cohesive picture that encompasses all transport regimes. Overall, our results suggest that CQDs constitute a versatile materials platform for 3D integrated electronic purposes.
Prediction of testosterone deficiency using different screening indexes in adult American men: An NHANES cross-sectional study
Background Testosterone levels are closely associated with visceral obesity, insulin resistance, and lipid metabolism. The objective of this study was to investigate the associations among eight indicators related to visceral obesity, insulin resistance, lipid metabolism, and testosterone levels. Methods The data were obtained from a cross-sectional survey based on National Health and Nutrition Examination Survey (NHANES) 2013–2016. Logistic and linear regression were employed to assess the associations between these inicators and testosterone levels. Simultaneously, the receiver operating characteristic (ROC) curve was utilized to evaluate their predictive capacity for testosterone deficiency (TD). Results Data from a collective of 1514 individuals selected from NHANES were analyzed. After adjusting all potential confounders, a tight association was identified between these eight indexes and TD. The ROC curve analysis showed that the triglyceride-glucose waist-to-height ratio (TyG-WHtR)is the best predictor of testosterone deficiency (AUC: 0.7760, 95%CI: 0.7460–0.8060), with a cut-off value of 5.375. Further analyses indicated that participants with higher TyG-WHtR index exhibitrd a lower total testosterone level(β: −79.36,95%CI: −105.90, −52.82). Additionally, males in TyG-WHtR index tertile 3 had a higher risk of TD (OR: 6.61, 95%CI: 2.90,15.07), and lower total testosterone levels (β: −121.9, 95%CI: −186.82, −56.98). All the results remained stable in the subgroup analyses stratified by diabetes and hypertension. Conclusions We found that these indexses are tightly associated with testosterone levels in U.S. adult men. Moreover, the TyG-WHtR index demonstrates the most effective predictive performance in the population. However, more well-designed studies are still needed to validate their association.
Enhanced electrocaloric effect in lead-free relaxor ferroelectrics via point defect engineering
The electrocaloric effect enables solid-state refrigeration technology with high energy efficiency and zero global warming potential. Normal displacive ferroelectric materials exhibit the highest electrocaloric effect just above their Curie point. The freezing temperature (Tf) of a relaxor ferroelectric material functions as a Curie point in displacive ferroelectrics, suggesting that the highest electrocaloric effect for a relaxor ferroelectric material is near its Tf. However, relaxor ferroelectrics often exhibit significant hysteresis around Tf, making them unsuitable for electrocaloric applications. In this work, we show that the highest electrocaloric effect in lead-free Bi0.5Na0.5TiO3-SrTiO3-based relaxor ferroelectric ceramics occurs at temperatures a few degrees above the temperature with their maximum permittivity (Tm) and is far above their Tf. Moreover, the A-site vacancy design can be used to effectively increase the electrocaloric effect and broaden the working temperature range, which is due to the increase in field-induced polarization and strong relaxation achieved via point defect engineering. This Letter reveals the appropriate temperature window for the high electrocaloric effect in relaxor ferroelectrics and shows that the A-site vacancy design can further enhance electrocaloric properties and extend the working temperature range for electrocaloric applications.
Risk factors associated with adverse outcomes after cervical conization in patients with cervical adenocarcinoma in situ
Background Identifying high-risk groups for adverse outcomes after conization is crucial for developing targeted treatment plans for patients with cervical adenocarcinoma in situ (ACIS). This study aimed to analyze the clinical characteristics of patients with ACIS and identify risk factors associated with adverse outcomes. Methods Patients diagnosed with ACIS through colposcopic biopsy at the Affiliated Hospital of Qingdao University and Qilu Hospital between January 2012 and December 2022 were selected. After meeting the inclusion and exclusion criteria, we collected their clinical data. Chi-square (χ2) tests and logistic regression models were employed to determine independent risk factors. Results A total of 379 patients with ACIS were included in this analysis. About 26.1% of these patients tested positive on preoperative endocervical curettage (ECC), while 79.4% had a single lesion. Among the 334 patients who underwent cervical conization, 17.1% had positive surgical margins. Additionally, residual lesions were present in 53.6% of cases, and pathological upgrading occurred in 7.8% of patients. Multivariate analysis indicated that age (p < 0.001), preoperative histopathological results from ECC (p = 0.033), and the number of ACIS lesions (p < 0.001) were associated with positive surgical margins. Number of births (p = 0.011), preoperative histopathological results from ECC (p = 0.030), and surgical margin statuses at cervical conization (p < 0.001) were independent risk factors for residual lesions. Preoperative histopathological result of ECC (p = 0.035) was confirmed as a predictor of postoperative pathological upgrading. Conclusions Older, multiparous patients with ACIS and abnormal preoperative ECC results require deeper diagnostic excision. Patients with positive conization margins necessitate further treatment, particularly when accompanied by abnormal ECC results. For women who wish to preserve their fertility, a repeat conization may be appropriate; however, in older and multiparous women, a hysterectomy would be recommended.
Microscopic-scale defect analysis on <b>β</b>-Ga2O3 through microscopy
β-Ga2O3 is a wide bandgap semiconductor with potential for surpassing current-generation high-power device performance and cost-effectiveness, due to its unique properties and availability of large high-quality substrates. However, β-Ga2O3 power electronics are still relatively immature, and commercial realization of reliable high-power devices will require intimate knowledge of performance-limiting extended defects. While several defects have been characterized in bulk substrates, less attention has been given to defects in homoepitaxially grown β-Ga2O3, despite its importance in producing high quality active layers for power devices. In this work, we characterize the bulk electronic properties and extended structural defects in (010) β-Ga2O3 homoepitaxially grown via hydride vapor phase epitaxy (HVPE) using photoemission, transmission electron microscopy (TEM), and complementary spectroscopy and microscopy techniques. We observe two types of linear, surface defects aligned along the [001] crystal axis. One defect consists of a micrometer-sized particle and a tail of protruding material, while the other is a groove in the surface. The large particle is a Ga-rich phase that is likely present early in the HVPE growth that disrupts the surface, while the groove defect appears purely structural in nature. Defect etching and TEM analysis reveal that the linear defects are associated with different dislocation structures, which can explain the different local conductivity measured at each. Our results emphasize that proper surface processing of the bulk substrate is still necessary for obtaining higher quality epitaxial growth for large area power devices.
The hepatic transcriptome is differentially regulated by a standardized meal in healthy individuals compared to patients with fatty liver disease
The human liver is dynamic organ with minute to hourly adaptions in response to feeding. Patients with non-alcoholic fatty liver disease (NAFLD) and cirrhosis have altered transcriptomic features compared to controls but how and if food intake affects such is unknown in humans. Our aim was to investigate the hepatic transcriptome at both fasting and postprandial states in patients with NAFLD, cirrhosis, and healthy controls and secondly to develop a browsable resource enabling easy and unrestricted access to such data. We hypothesized that hepatic transcriptome differed between groups, and this was also regulated by food intake. We obtained liver tissue by transjugular liver biopsies from patients with NAFLD (n = 9, mean age 49 (16 SD) y, BMI 35 (5) kg/m2), cirrhosis (n = 9, age 61 (11) y, BMI 32 (5) kg/m2) and healthy controls (n = 10, age 25 (3) y, BMI 23 (3) kg/m2). The hepatic transcriptome was sequenced using NGS and evaluated in bioinformatic analyses to assess differentially expressed genes (DEG) and gene ontology biological processes (GOBP). We identified 553 DEG between healthy controls and patients with NAFLD, 5527 DEG between healthy controls and patients with cirrhosis, and 3898 DEG in NAFLD compared with cirrhosis. A hitherto uncharacterized gene (MET proto-oncogene) was differentially expressed in human NAFLD and cirrhosis. The hepatic transcriptome changed significantly during a standardized meal and these changes were blunted in patients with NAFLD and cirrhosis. GOBP analyses revealed an increase in pro-inflammatory and pro-fibrotic genes in NAFLD and cirrhosis, as well as a decrease in genes related to metabolism. Data were made browsable using two web-based apps. The hepatic transcriptome is differentially regulated by a standardized meal in healthy individuals compared to patients with fatty liver disease.
High-linearity on-chip GaN-on-Si temperature sensors based on an E-mode-compatible process
In this work, we present GaN-on-Si on-chip temperature (T) sensors and ICs based on field-effect rectifiers (FERs) using an e-mode-compatible process. The single-FER T sensor presents a high sensitivity of 3.57 mV/K and a high linearity with R2 values up to 0.997, with a positive temperature coefficient (PTC). This is improved from the existing devices with negative temperature coefficients, thanks to the combined PTCs of the turn-on voltage (VON) and resistance (RON) of the device. The performance is further enhanced by ICs cascading FERs, showing a proportional enhancement of sensitivity vs the number of cascaded FERs (NFER) and leading to a sensitivity as high as 11.76 mV/°C. This scheme also leads to a significant enhancement in linearity, up to 0.999 and beyond 0.998 in a wide range of the input current (IIN). In addition to the wide use of GaN FERs, the proposed approach yields a high-performance and low-cost T-sensing solution for power GaN devices to enable better system performance and reliability.
The CLASS (Cerebral visual impairment Learning and Awareness for School Staff) Pilot Study: An evaluation of the awareness of CVI amongst teachers and comparative evaluation of two different educational resources on understanding
Cerebral visual impairment (CVI) is the leading cause of visual impairment in children in high income countries. Despite its prevalence, awareness of CVI among educators remains low, meaning that many affected children may not receive the support they need in school. While previous research has highlighted the challenges faced by children with CVI, few studies have systematically assessed teacher awareness and the effectiveness of targeted educational interventions in improving classroom practices. This study addresses this gap by evaluating: (1) teacher awareness of CVI, (2) existing classroom practices that may impact children with CVI, (3) the effectiveness of two CVI educational media formats (video and text) in increasing understanding, and (4) the changes teachers would be willing to implement following exposure to these resources. By comparing the impact of these two formats, this study provides insights into how best to deliver CVI training for teachers in a way that is both accessible and effective. A total of 111 teachers from primary, secondary, and special schools across the UK participated in a survey incorporating either a three-minute video simulation or a 1.5-minute text-based resource about CVI. Before exposure, 72% of participants had not heard of CVI, with awareness particularly low among mainstream teachers (98% of primary and 80% of secondary teachers were unaware). Teachers also reported inconsistent use of CVI-supportive practices, such as reducing classroom clutter and simplifying smart screen content. Both media formats significantly increased teachers’ willingness to implement changes (p < 0.0001). The text format showed a slightly greater increase in average Likert scores, and the Wilcoxon signed-rank test revealed a larger statistical effect for text (z = -12.91) compared to video (z = -8.90). However, the video format was also highly effective, producing a similarly strong impact, with both formats achieving an identical median increase of 1.0. These results suggest that while text may have led to slightly larger shifts in rank-based scores, the video format remained a powerful and engaging tool for increasing teachers’ willingness to implement CVI-supportive strategies. The findings suggest that small, manageable adaptations, such as reducing visual distractions and maintaining consistency in classroom layouts, are practical for teachers and may have a meaningful impact on children with CVI. This study highlights the potential of bite-size learning resources in raising awareness and encouraging evidence-based teaching adaptations. By providing concise, accessible materials, teachers can be equipped with strategies to support children with CVI while minimising additional workload demands. Future efforts should focus on scaling these resources to reach a wider audience, including families and caregivers, to foster a more inclusive understanding and response to CVI.
Enhanced flexoelectric response of BaHf<i>x</i>Ti1−<i>x</i>O3 ceramics through polymorph phase boundary in spontaneously polarized surface
Ferroelectric ceramics typically exhibit ultrahigh flexoelectric coefficients that far exceed theoretical values due to various extrinsic factors. It has been demonstrated that the high values are mostly contributed by the surface piezoelectric response of spontaneously polarized surface layers, and their proportion even exceeds 99%. Herein, we introduced polymorph phase boundary (PPB) into the polarized surface layers of BaHf0.01Ti0.99O3 ceramics in order to enhance the surface piezoelectric response. Ultimately, an ultrahigh effective flexoelectric coefficient (μρ) of ∼ 550 μC/m was obtained in the BaHf0.01Ti0.99O3 ceramics at room temperature, the maximum μρ reaching 910 μC/m at the Curie temperature (TC), which is more than that of other BaHfxTi1−xO3 ceramics. The large surface piezoelectric response of BaHf0.01Ti0.99O3 ceramics can persist up to TC, which should be attributed to the biaxial stress clamping PPB in the polarized surface layers, allowing the high μρ to be maintained close to the TC. Our study not only provides a strategy to enhance the flexoelectric coefficients in ferroelectric ceramics but also aids in a deeper understanding of the significant contribution of the polarized surface layers to the flexoelectric coefficients.
Measuring Child Labor: The Who’s, the Where’s, the When’s, and the Why’s
Measuring child labor accurately is a major challenge: parents’ and children’s reports tend to differ dramatically, and there is typically no way to verify whose reports are truthful (if any). To overcome this challenge, this paper uses novel data from a cocoa certifier in Côte d’Ivoire that draws on satellite imagery to minimize under-reporting. Concretely, aerial photos allow them to select remote and hard-to-reach communities—where parents typically have not been sensitized by government or NGOs, averting social desirability biases—and to visit these communities while cocoa is being harvested—precisely when children in employment are very visible, making it easier for enumerators to impute it if parents still fail to report it. We compare their figures with those obtained from business-as-usual surveys with parents and children in these regions, and find that (1) reporting inconsistencies between parents and their children in fact decrease with household remoteness; (2) adults dramatically under-report child labor relative to the certifier data, by a factor of at least 60%; and (3) in turn, children self-reports are statistically identical to the latter. Taking advantage of an experiment that randomly assigned a text-message campaign to discourage child labor, we further show that parents’ reports not only underestimate its prevalence, but can even lead to the wrong conclusions about the effects of policy interventions.
Low-temperature microwave annealing stabilizes the morphotropic phase boundary in HfO2/ZrO2 superlattice heterostructures
This study presents a method for achieving stable morphotropic phase boundary characteristics in superlattice HfO2/ZrO2 (SL-HZO)-based metal-ferroelectric-metal (MFM) capacitors using low-temperature microwave annealing (MWA) technology. Compared to conventional rapid thermal annealing, MWA-treated SL-HZO-based MFM capacitors exhibit excellent dielectric properties (κ = 51) at reduced processing temperatures. These devices also demonstrate improved reliability, including lower leakage current, higher breakdown strength, and an operational lifetime exceeding 10 years at voltages up to 2.54 V. This approach mitigates thermal budget limitations in back-end-of-line processes while enhancing device performance, offering a promising solution for advanced integrated circuit applications.
The joint effect of weight-adjusted waist index and physical activity on all-cause mortality in Chinese elderly patients with multimorbidity: A study based on the CLHLS from 2011 to 2018
Background The relationship between physical activity changes, weight-adjusted waist circumference index (WWI), and mortality risk among older Chinese adults with multimorbidity remains unclear. This study aimed to examine whether changes in physical activity and WWI modify the mortality risk by analyzing data from the Chinese Longitudinal Healthy Longevity Survey (CLHLS). Method Our study was based on the 2011 ~ 2018 wave of the CLHLS, involving a study of 2,626 older adults with multimorbidity. Cox proportional hazards models were employed to estimate hazard ratios (HRs) and 95% confidence intervals (95% CIs) and a stratified analysis was conducted to assess the combined impact of WWI and physical exercise on all-cause mortality in patients with multimorbidity. Result Patients with multimorbidity who engaged in regular physical activity exhibited a 41% reduction in all-cause mortality compared to those who had never been physically active (HR:0.59, 95% CI:0.49, 0.70). All-cause mortality was increased by 13% in patients with high WWI and multimorbidity compared to those with low WWI (HR:1.13, 95% CI:1.01, 1.27). Furthermore, WWI-stratified analyses revealed that varying physical activity profiles had a more pronounced protective or detrimental impact on all-cause mortality among multimorbidity patients in the high WWI group compared to the low WWI group. Conclusion This study demonstrates that both initiating and maintaining physical activity significantly reduce mortality risk in multimorbid older adults, even those with higher WWI. Our findings support integrating structured exercise interventions and routine WWI monitoring into clinical care to improve survival outcomes in this population.
Subthreshold swing behavior in amorphous indium-gallium-zinc-oxide transistors from room to cryogenic temperatures
While cryogenic-temperature subthreshold swing (SS) in crystalline semiconductors has been widely studied, a careful study on the temperature-dependent SS in amorphous oxide semiconductors remains lacking. In this paper, a comprehensive analysis of the SS in thin-film transistors with an amorphous indium-gallium-zinc-oxide (IGZO) channel at temperatures from 300 K down to 4 K is presented. Main observations include the following: (1) at room temperature (300 K), the devices exhibit a SS of 61 mV/dec and a low interface trap density of &lt;1011 cm−2. (2) A SS saturation around 40 mV/dec is observed between 200 and 100 K. It is well explained by the electron transport via band tail states with exponential decay (Wt) of 17 meV. (3) At deep cryogenic temperatures, the SS increases significantly, exceeding 200 mV/dec at 4 K. Such high SS values are actually limited by the measurement current range, confirmed by Id − Vg simulations based on the variable range hopping model. This work not only elucidates the SS behavior in amorphous IGZO devices but also provides a deep understanding of the physical mechanisms of electron transport in amorphous semiconductors.
Empowering safety managers to champion the implementation of smoking cessation services in the construction industry: Protocol for a sequential multiple assignment randomized trial
US construction workers (CWs) have the highest cigarette smoking rate among all occupations (27.2% vs. 15%), yet the lowest coverage of workplace smoking cessation services (14% vs. 29%). This study aims to empower safety managers to implement smoking cessation services in the construction industry. Using participatory research methods, this study aims to: 1) Develop multilevel strategies (MLIs) to implement adaptive smoking cessation programs delivered by the safety manager on construction sites, and 2) conduct a cluster-randomized, hybrid type 1 effectiveness-implementation, 2-phase sequential multiple assignment randomized trial (SMART) to test the programs (ClinicalTrials.gov: NCT06098144). The MLIs include: 1) creating the outer setting (research investigators, stakeholders) and inner setting facilitation (companies’ advisory committee, study champion), 2) conducting observational field assessments of workflows, 3) training safety managers to deliver the intervention, and 4) conducting implementation process evaluations. In SMART, 32 construction sites within 8 companies with 608 CWs will be enrolled. In Phase 1, sites will be randomized to A1 (referral to Tobacco Quitline -TQL) or B1 (referral to TQL + nicotine replacement treatment (NRT) + 1 group behavioral counseling session). In Phase 2, responders who quit smoking at 3 months continue with the assessment only, while non-responders will be re-randomized to C (4 counseling sessions + NRT; A1 + C, B1 + C) or an extra dose of Phase 1 treatment (A2, B2). Participants will receive 4 follow-up assessments at 3, 6, 9, and 12 months. Primary outcomes are the effectiveness (12-month biomarker-confirmed prolonged abstinence) and cost-effectiveness (cost/quit, cost/quality-adjusted life-year) of A1 + A2 vs. B1 + B2 and A1 + C vs. B1 + C. The secondary outcome is the feasibility of the program’s implementation. We hypothesize that B1 + B2 will outperform A1 + A2, and B1 + C will outperform A1 + C. This project will generate novel scientific evidence on the effectiveness, cost-effectiveness, and implementation feasibility of smoking cessation programs in the construction industry.