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We use low-dose cryogenic transmission electron microscopy (cryo-TEM) to investigate the atomic-scale structure of antiperovskite Na2NH2BH4 crystals by preserving the room-temperature cubic phase and carefully monitoring the electron dose. Via quantitative analysis of electron beam damage using selected area electron diffraction, we find cryogenic imaging provides 6-fold improvement in beam stability for this solid electrolyte. Cryo-TEM images obtained from flat crystals revealed the presence of a new, long-range-ordered supercell with a cubic phase. The supercell exhibits doubled unit cell dimensions of 9.4 Å × 9.4 Å as compared to the cubic lattice structure revealed by X-ray crystallography of 4.7 Å × 4.7 Å. The comparison between the experimental image and simulated potential map indicates the origin of the supercell is a vacancy ordering of sodium atoms. This work demonstrates the potential of using cryo-TEM imaging to study the atomic-scale structure of air- and electron-beam-sensitive antiperovskite-type solid electrolytes.

BACKGROUND: The effect of transdermal glyceryl trinitrate (GTN, a nitrovasodilator) on clinical outcome when administered before hospital admission in suspected stroke patients is unclear. Here, we assess the safety and efficacy of GTN in the prespecified subgroup of patients who had an ischaemic stroke within the Rapid Intervention with Glyceryl trinitrate in Hypertensive stroke Trial-2 (RIGHT-2). METHODS: RIGHT-2 was an ambulance-based multicentre sham-controlled blinded-endpoint study with patients randomised within 4 hours of onset. The primary outcome was a shift in scores on the modified Rankin scale (mRS) at day 90. Secondary outcomes included death; a global analysis (Wei-Lachin test) containing Barthel Index, EuroQol-5D, mRS, telephone interview for cognitive status-modified and Zung depression scale; and neuroimaging-determined brain frailty markers. Data were reported as n (%), mean (SD), median [IQR], adjusted common OR (acOR), mean difference or Mann-Whitney difference (MWD) with 95% CI. RESULTS: 597 of 1149 (52%) patients had a final diagnosis of ischaemic stroke; age 75 (12) years, premorbid mRS>2 107 (18%), Glasgow Coma Scale 14 (2) and time from onset to randomisation 67 [45, 108] min. Neuroimaging brain frailty was common: median score 2 [2, 3] (range 0-3). At day 90, GTN did not influence the primary outcome (acOR for increased disability 1.15, 95% CI 0.85 to 1.54), death or global analysis (MWD 0.00, 95% CI -0.10 to 0.09). In subgroup analyses, there were non-significant interactions suggesting GTN may be associated with more death and dependency in participants randomised within 1 hour of symptom onset and in those with more severe stroke. CONCLUSIONS: In patients who had an ischaemic stroke, ultra-acute administration of transdermal GTN in the ambulance did not improve clinical outcomes in a population with more clinical and radiological frailty than seen in previous in-hospital trials.

We developed a high-content image-based screen that utilizes the pro-inflammatory stimulus lipopolysaccharide (LPS) and murine macrophages (RAW264.7) with the goal of enabling the identification of novel anti-inflammatory lead compounds. We screened 2,259 bioactive compounds with annotated mechanisms of action (MOA) to identify compounds that block the LPS-induced phenotype in macrophages. We utilized a set of seven fluorescence microscopy probes to generate images that were used to train and optimize a deep neural network classifier to distinguish between unstimulated and LPS-stimulated macrophages. The top hits from the deep learning classifier were validated using a linear classifier trained on individual cells and subsequently investigated in a multiplexed cytokine secretion assay. All 12 hits significantly modulated the expression of at least one cytokine upon LPS stimulation. Seven of these were allosteric inhibitors of the mitogen-activated protein kinase kinase (MEK1/2) and showed similar effects on cytokine expression. This deep learning morphological assay identified compounds that modulate the innate immune response to LPS and may aid in identifying new anti-inflammatory drug leads.

Underlying various routes to peer influence on risky choices is the assumption that individuals have beliefs around their peer's preferences which are incorporated in their choices. However, much is unknown about the accuracy of these beliefs and how they weigh in individuals' considerations. We tested these implicit assumptions by actually collecting real-life peers' preference to contrast with people's prediction, and quantifying what changes when individuals were asked to take the peer's perspective as the decision-maker instead of themselves. Since perspective taking develops through late adolescence, adolescence makes an especially dynamic window for observation. With a sample of typically developing friend dyads (N=128, 12.0-22.8 years), we collected fully mutual data on decision preferences in an economic risky decision making task with safe (certain) and risky (more variable outcomes) options that vary in their expected values. Upon establishing individuals' baseline risk preferences and their prediction of their peers' risk preferences, they took their own and their peers' perspective in choices where their unchosen option was assigned to the peer. We modified an economic expected utility model to include a new parameter representing the adjudication between one's own and friend's outcome, and analyzed age-related changes with Generalized Additive Models. We found although peer's risk preferences were overestimated in decisions on average, participants aged 16-22 years weighed friend outcome more and earned less when taking their friend's perspective compared to their own, indicating this is a heightened period for prosocial considerations.

Abstract As wireless communication systems increasingly require compact and efficient antennas, conventional antenna design methods are proving difficult to meet the rigorous demands of modern applications. For this purpose, this study introduces a methodology which uses pixelated Inverted-F Antenna (IFA) inspired designs optimised through genetic algorithms to enhance performance in constrained spatial environments. As pixels the antenna features the exemplary use of Einstein Hat-shaped tiles, enabling the antenna to efficiently utilize space. A with the proposed method optimised antenna is compared to traditional IFA designs and shows improved properties like enhanced antenna gain and efficiency as well as smaller reflection coefficient offering a promising solution for future compact antenna systems in the Internet of Things and beyond. Finally, a prototype was manufactured and the scattering parameters and antenna gain were measured within an anechoic chamber.

Abstract Miniaturization of medical tools promises to revolutionize surgery by reducing tissue trauma and accelerating recovery. Magnetic untethered devices, with their ability to access hard-to-reach areas without physical connections, emerge as potential candidates for such miniaturization. Despite the benefits, these miniature devices face challenges regarding force and torque outputs, restricting their ability to perform tasks requiring mechanical interactions such as tissue penetration and manipulation. To overcome magnetic actuation system-based force and torque limitations, this study proposes Variable Outer Radius Individually Addressable Coil Stacks (VORIACS), a novel magnetic actuation system optimized for high force output generation to magnetic devices within its workspace. The VORIACS marks significant improvements and breakthroughs in magnetic actuation within decimeter-scale workspace. The VORIACS is comprised of 12 coils that are optimized for 2D magnetic field generation under maximized power consumption of up to 12 kW. We implement six two-channel motor controllers, powered by six separate power supplies. Each of the twelve coils in the system is operated on its own motor-controller channel. This arrangement allows the system to exceed the magnetic forces and torques possible for single-coil versions of the same geometry. This study elaborates on optimizing, manufacturing, integrating, and demonstrating this system. Comparative analysis reveals that while a suboptimal, single-coil version of this system generates 0.31 N force (710 mT/m magnetic gradient magnitude), the VORIACS produces 1.673 N force (3834 mT/m magnetic gradient magnitude) on the same magnetic object placed 5 cm away from the coils. Moreover, the strong penetration force generated by VORIACS enables needle penetration to a mock gel that has the rigidity of liver tissue. In addition, we demonstrate the advantage of stacked coils with variable radii for magnetic field manipulability while maintaining the optimized force delivery property of the system, which improves control and could facilitate multi-tool manipulation. By enabling a fivefold increase in magnetic pulling force compared to its single-coil counterpart, VORICAS raises the potential penetration capabilities of untethered magnetic robotics in surgical procedures.

Abstract Background Antidepressants have a pivotal role in the treatment of many psychiatric disorders, but there are concerns about long-term use and adverse effects. The objectives of this study were (1) to examine time trends in antidepressant use, (2) to estimate the prevalence of long-term and potential high-risk antidepressant use, and (3) to examine patient characteristics associated with potential deprescribing indications (PDIs) (i.e., simultaneous long-term and potential high-risk antidepressant use). Methods Repeated population-based cross-sectional study for all 609,299 people aged ≥ 18 years resident in the Tayside or Fife regions of Scotland. The prevalence of antidepressant use was examined on June 30th (index date) of each year from 2012 to 2019, while the prevalence of long-term and potential high-risk use as well as PDIs was assessed and compared on the same dates in 2012 and 2019. Binary logistic regression modeling was used to examine patient characteristics associated with PDIs. Results Antidepressant use increased by 27% from 12.0 to 15.3% among adult residents between 2012 and 2019. While the proportion of antidepressants users dispensed ≥ 1 antidepressant for > 2 years increased from 54.3 to 61.9% between 2012 and 2019, the proportion of antidepressant users triggering ≥ 1 indicator of potential high-risk use decreased slightly from 37.9 to 34.7%. In 2019, potential high-risk use most commonly related to indicators targeting fall risk (16.0%), cardiovascular risks (14.1%), insomnia (10.6%), and risk of orthostatic hypotension (8.6%). More than 1 in 4 (25.8%) antidepressant users had PDIs. The main risk factors associated with PDIs included increasing age (65–79, adjusted OR 14.12; 95% CI, 13.15–15.17), increasing number of drugs taken concomitantly (≥ 15 drugs, adjusted OR 7.37; 95% CI, 6.71–8.10), use of tricyclic antidepressants (≥ 50 mg) (adjusted OR 5.49; 95% CI, 5.02–6.01), and concomitant use of ≥ 2 antidepressants (adjusted OR 5.52; 95% CI, 5.20–5.85). Conclusions Long-term and potential high-risk use of antidepressants is widespread, and potential deprescribing indications (PDIs) are increasing, suggesting the need for a critical review of their ongoing use by clinicians. If deemed necessary, future deprescribing interventions may use the criteria applied here for identification of patients with PDIs and for evaluating intervention effectiveness.

Fieldwork is an important component of data collection in environmental sciences and other related disciplines. Sensitive to the ways in which field based environmental sciences (FBES) research is often unsafe and lacks inclusivity, we explore findings from a mixed methods study that identified barriers to inclusion and overlooked risks to safety for FBES researchers. We found that gender and gender identity presented a direct risk for discrimination, harassment, and violence in the field (63.8% of cis females and 100% of nonbinary/genderqueer respondents). Sexuality, race, and ethnicity also posed a risk to FBES researchers with 88.3% of respondents stating that marginalised groups are underrepresented in FBES. Over half of our respondents stated class and socio-economic background to be a barrier to their participation in FBES research due to job precarity and lack of funding. These risks and barriers experienced by researchers can lead to a lack of novelty in environmental science. As such, we argue that we need to increase diversity whilst reducing risks in FBES and cultivate a more prosperous, safe, and empowered research culture.

In the UK, Latin is often seen as an elitist subject taught largely at fee-paying schools. Over the past generation, however, great strides have been made in opening up the subject to students from all backgrounds. A major hindrance to widening access to Latin at university level is that the language can often prove challenging for students. Data collected for this article reveal that only 77% of Latin students on beginners' modules in UK universities achieved a pass. Or in other words, nearly a quarter of students embarking on the study of Latin either fail or withdraw from their module. This article seeks to investigate the problems of retention and progression in support of the battle to make the study of Latin sustainable and accessible in higher education. By analysing survey responses from 29 UK universities offering beginners' Latin modules, it explores the impact of factors such as module weighting and duration, contact hours, class sizes, textbooks and assessment methods. In so doing, it breaks new ground in its rigorous statistical analysis of a significant set of quantitative data in an effort to improve our understanding of successful ancient language teaching, tackle real-world issues of retention, and promote student success.

Traditionally, imposter syndrome is defined as feelings of inferiority regardless of one's accomplishments and experiences. Imposter syndrome is often viewed as an experience that racially minoritized populations in higher education "must" encounter. But these traditional understandings frame imposter syndrome as a personal flaw rather than a product of structural oppression. Consequently, these limited and deficit focused ideas of imposter syndrome urge scholars and practitioners to disrupt normative conceptualizations of imposter syndrome by examining the phenomenon from a structural lens and to expand the literature on the experiences of Latinx college students at PWIs. As such, the purpose of this phenomenological study was to illuminate Latinx students' strategies to cope with imposter syndrome within the hostile and unwelcoming environments of predominantly white institutions. Three major themes emerged from the data: (a) code-switching, (b) consejo de las personas más cercanas, and (c) strategic consciousness: committing to survive the toxicity of imposter syndrome at PWIs; these findings highlight three major ways that Latinx students cope with feelings of imposter syndrome. Implications for future research and practice are outlined to further explore how institutions of higher education can dismantle structures, systems, policies, and procedures that perpetuate imposter phenomenon.

Objective: Surgery for recurrent aortic arch obstruction is highly challenging and publications are rare. The aim of this retrospective, single-center study was to evaluate mortality, complications, and reintervention rate after an anatomic repair. Methods: Between 1999 and 2022, in total 946 operations on the aortic arch were performed at the Children's Heart Center Linz. In 39 cases, the indication was a recurrent or residual aortic arch obstruction or coarctation in a patient aged 18 years or younger. This is our study cohort. The aorta was reconstructed by a direct anastomosis/autograft in 20 patients, patch in 17 patients, and interposition graft in 2 adolescents. In 32 procedures, cardiopulmonary bypass with whole body perfusion was employed, in 4, antegrade cerebral perfusion was employed, in 2, a left heart bypass was employed, and in 1 no cardiopulmonary bypass was used. Results: Median (Q1, Q3) age at operation was 253 days (100, 2198 days), weight 7.5 kg (4.5, 17.8 kg). Median cardiopulmonary bypass time was 177 minutes (115, 219 minutes), crossclamp time 73 minutes (49, 102 minutes). Three infants died during the hospital stay: 1 with Williams syndrome, 1 with hypoplastic left heart syndrome, and 1 with heterotaxia. There was no death due to an arch complication. The main complications were 1 neurologic injury after postoperative resuscitation (Williams syndrome) and 1 permanent recurrent laryngeal nerve paralysis. During the follow-up period of median 8.1 years (2.6, 12 years) 1 re-reintervention on the aortic arch was necessary. Conclusions: Sophisticated reoperations on the aortic arch could be performed safely. In children, the growth potential of all segments of the aorta could be sustainably preserved by avoiding interposition or extra-anatomic bypass grafts.

BACKGROUND: Humeral avulsion of the glenohumeral ligament (HAGL) lesions are an uncommon cause of anterior glenohumeral instability and may occur in isolation or combination with other pathologies. As HAGL lesions are difficult to detect via magnetic resonance imaging (MRI) and arthroscopy, they can remain unrecognized and result in continued glenohumeral instability. PURPOSE: To compare patients with anterior shoulder instability from a large multicenter cohort with and without a diagnosis of a HAGL lesion and identify preoperative physical examination findings, patient-reported outcomes, imaging findings, and surgical management trends associated with HAGL lesions. STUDY DESIGN: Cross-sectional study; Level of evidence, 3. METHODS: Patients with anterior glenohumeral instability who underwent surgical management between 2012 and 2020 at 11 orthopaedic centers were enrolled. Patients with HAGL lesions identified intraoperatively were compared with patients without HAGL lesions. Preoperative characteristics, physical examinations, imaging findings, intraoperative findings, and surgical procedures were collected. The Student t test, Kruskal-Wallis H test, Fisher exact test, and chi-square test were used to compare groups. RESULTS: A total of 21 HAGL lesions were identified in 915 (2.3%) patients; approximately one-third (28.6%) of all lesions were visualized intraoperatively but not identified on preoperative MRI. Baseline characteristics did not differ between study cohorts. Compared with non-HAGL patients, HAGL patients were less likely to have a Hill-Sachs lesion (54.7% vs 28.6%; P = .03) or an anterior labral tear (87.2% vs 66.7%; P = .01) on preoperative MRI and demonstrated increased external rotation when their affected arm was positioned at 90° of abduction (85° vs 90°; P = .03). Additionally, HAGL lesions were independently associated with an increased risk of undergoing an open stabilization surgery (odds ratio, 74.6 [95% CI, 25.2-221.1]; P < .001). CONCLUSION: Approximately one-third of HAGL lesions were missed on preoperative MRI. HAGL patients were less likely to exhibit preoperative imaging findings associated with anterior shoulder instability, such as Hill-Sachs lesions or anterior labral pathology. These patients underwent open procedures more frequently than patients without HAGL lesions.

This paper presents the numerical study for heat generation and electro-osmotic effects of Carreau model of a fluid in an unsteady channel. This prepared model has many useful applications in microfluidic biological and mechanical research. Modified Darcy’s law, viscous dissolution and ciliated walls are also presented. Non-Newtonian fluids play a key role in biological fluids which include the motion of foods within digestive zone, blood circulation, including small bowls and migration of urine. The main findings for the research is to analyze the flow rate change and check the behavior of velocity and temperature by using different parameters. The modeled equations of Carreau fluid flow are depressed into a simple form by employing the long wavelength approximation and small Reynolds number, then the resulting equations are calculated numerically by using MATHEMATICA. Impact of physical factors are graphically figured for velocity, temperature field and streamline distribution. The results show that velocity modifies by applying different values of flow rate and Darcy’s number. Temperature profile increases for advanced values of Prandtl number, Eckert number and heat source parameter. For heat source parameter (γ=0.5, 0.6 and 0.7) and Eckert number (Ec=1.0, 1.5 and 2.0) the temperature profile expands at the region (y