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Understanding how diffuse mild traumatic brain injuries can provoke common and persistent post-concussive symptoms (PCS), such as impaired sleep, is crucial to prevent and treat chronic disability and neurodegeneration. We mapped the spatially-resolved single cell landscape of diffuse mTBI pathology in a mouse model of blast exposure; identifying brainstem injuries predictive of later PCS. Repeated mTBI was necessary to establish chronic microglial activation and phagocytosis of myelin in the pontine reticular formation; where IL33 release by oligodendrocytes predicted microgliopathy. In postmortem brainstem tissues from patients with traumatic brain injury, chronic microglial activation and myelin phagocytosis was evident up to 20 years after diffuse mTBI caused by blast. In living patients with chronic blast mTBI, myelin injury in pontine projections mediated sleep disturbance and other PCS, with a dose dependent effect of mTBI number on sleep disturbance severity. These results support a mechanism for diffuse mTBIs to cause delayed persistent PCS.

Charge traps in the semiconductor bulk (bulk charge traps) make it difficult to predict the electric field within wide-bandgap semiconductors. The issue is the daunting number of bulk charge-trap candidates which means the treatment of bulk charge traps is generally qualitative or uses generalized models that do not consider the trap's particular electronic structure. The electric field within a wide-bandgap semiconductor is nonetheless a crucial quantity in determining the operation of semiconductor devices and the performance of solid-state single-photon emitters embedded within the semiconductor devices. In this work we accurately compute the average electric field measured at the location of N$V^-$ charged defects for the substitutional N (N$_\text{C}$) concentration of $n_{\text{N}_\text{C}} \approx 1.41\times10^{18}$ cm$^{-3}$ for the commonly used oxygen-terminated diamond (see [D. A. Broadway $et$ $al$., Nature Electronics 1, 502 (2018)]). We achieve this result by evaluating the leading-order contribution to the electric field far away from the surface, which comes from the N$_\text{C}$ defects that induce the ionization of the N$V^-$. Our results use density-functional theory (DFT) and the principle of band bending. Our work has the potential to aid both in the prediction of the functioning of semiconductor devices and in the prediction and correction of the spectral diffusion that often plagues the optical frequencies of solid-state single-photon emitters upon repeated photoexcitation measurements. Our results for the timescales involved in thermally driven charge transfer also have the potential to aid in investigations of charge dynamics.

We exploit fluctuational electrodynamics to present trace expressions for the torque experienced by arbitrary objects in a passive, non-absorbing, rotationally invariant background environment. Specializing to a single object, this formalism, together with recently developed techniques for calculating bounds via Lagrange duality, is then used to derive limits on the maximum Casimir torque that a single object with an isotropic electric susceptibility can experience when out of equilibrium with its surrounding environment. The maximum torque achievable at any wavelength is shown to scale in proportion to body volumes in both subwavelength (quasistatics) and macroscopic (ray optics) settings, and come within an order of magnitude of achievable torques on topology optimized bodies. Finally, we discuss how to extend the formalism to multiple bodies, deriving expressions for the torque experienced by two subwavelength particles in proximity to one another.

Objective: In the US, Hispanic persons have a higher rate of Type 2 diabetes (T2D) than the national average, as well as experience more diabetes-related complications than non-Hispanic whites (NHWs) . This increased prevalence can be attributed to social and biological factors, like access to care and increased predisposition to pre-diabetic conditions. Currently, limited evidence exists for the effectiveness of randomized controlled trials (RCTs) at improving A1C levels in this population with T2D. Methods: A systematic search focused on T2D interventions published from 1985 to 20was conducted using PubMed, Scopus, PsycInfo, and CINAHL. Search terms were structured around five broad concepts: diabetes, study design, language, race/ethnicity, and disparities. We focused on non-pharmacologic interventions, and included RCTs with ≥18.5% Hispanic persons, utilizing the 2020 US Census as standard. A random effects meta-analysis was performed to calculate the pooled effect size to provide summary estimates. Results: Of the 111,289 articles reviewed, 28 trials met inclusion criteria. Participants were 90% Hispanic and 70% female with a mean age of 55.8 years. Most interventions used cultural tailoring, lifestyle and behavioral changes, or telehealth support and included bilingual nurses, Spanish educational materials, or community health workers. Compared to control, these interventions were associated with a 0.19% (95% confidence interval: -0.39% to 0.01%; p Conclusion: This meta-analysis examined non-pharmacologic interventions in Hispanic persons with T2D and found that they reduced A1c to a small degree. This finding is important for future T2D interventions tailoring to this population, as well as future health policy. Future analyses will examine which type of interventions (i.e. individual, community, societal, or multi-level) are most successful at reducing A1c among Hispanic persons. Disclosure S.Uranga: None. L.Bianco: None. A.Deckard: None. W.Wan: n/a. J.Alexander: None. E.M.Staab: None. A.W.Rodriguez: None. R.Shetty: None. N.Laiteerapong: None.

Background: The prevalence of Type 2 diabetes (T2D) is high among non-Hispanic Black persons. This population also has a high rate of poorly controlled T2D and a high burden of T2D related complications. To address this, various interventions have been studied to improve glycemic control. We performed a meta-analysis of published interventions on Black persons with T2D and their effects on HbA1c outcomes. Methods: An electronic search of literature in PubMed, Scopus, CINAHL, PsycINFO, and Medline was conducted from 1985 to 20for studies evaluating T2D interventions among predominantly minority populations. This analysis was limited to non-pharmacologic randomized controlled trials (RCTs) and studies that had an average ≥12.5% of total participants identifying as Black, utilizing the 2020 US Census as standard. Interventions were aimed at improving outcomes including blood pressure, weight, and lipids. For this analysis, we focused on the outcome HbA1c and its differences between experimental and control groups. A random effects meta-analysis was performed to calculate the pooled effect size of the various outcomes. Results: For this analysis, 35 RCTs were included (n=6467) . The participants were 61% Black and 65% female with a mean age of 56 years. Interventions included interdisciplinary T2D management, telehealth-based support, lifestyle focused programs, and peer support programs. There was a statistically significant reduction in HbA1c in the experimental group when compared to the control group (-0.17, 95% CI -0.28 to -0.06, p Conclusion: This meta-analysis found non-pharmacologic interventions were effective in reducing HbA1c among Black persons to a small degree. Future research is needed to estimate the effects of the level of intervention (i.e. individual, community, societal, or multi-level) in reducing HbA1c among this population to inform future public health programming and policy. Disclosure F.Osman: None. C.Jiang: None. A.Deckard: None. W.Wan: n/a. J.Alexander: None. E.M.Staab: None. A.W.Rodriguez: None. R.Shetty: None. N.Laiteerapong: None.

Objective: Asian persons have an increased risk of type 2 diabetes (T2D) compared to non-Hispanic white persons, with approximately two in five individuals being diagnosed. The prevalence of T2D among this population has grown in recent years as Asian persons are the fastest growing racial/ethnic group in the US. We conducted a meta-analysis of US randomized controlled trials (RCTs) to evaluate the effectiveness of T2D interventions at improving systolic blood pressure (SBP) , diastolic blood pressure (DBP) , and HbA1c among this population. Methods: An electronic search of literature in PubMed, Scopus, CINAHL, PsycINFO, and Medline was conducted from 1985 to 2019 for studies evaluating T2D interventions among predominantly minority populations. This analysis was limited to RCTs with an average >6% of total participants identifying as Asian, utilizing the 2020 US Census as standard. Interventions focusing on the efficacy of a drug, device, diet, surgery, or procedure were excluded. A random effects meta-analysis was performed to calculate the pooled effect size of the various outcomes. Results: Of the articles reviewed, 9 met inclusion criteria. All 9 included HbA1c and 5 included SBP/DBP. Participants were 62.8% Asian and 40.3% female with a mean age of 53.4 years. Interventions included diabetes education programs, utilization of community health workers, bilingual counseling, and cognitive therapy. There was a 0.36% decrease in HbA1c in the experimental group when compared to the control group (95% CI -0.48 to -0.25, p=0.80, I2=0%) . Compared to control, these interventions had minimal effects on SBP (-0.08, 95% CI -0.22 to 0.07, p=0.73, I2=0%) and DBP (0.01, 95% CI -0.22 to 0.25, p=0.23, I2=29%) . Conclusion: This meta-analysis found that RCTs for T2D in Asian persons modestly lowered HbA1c, with minimal impact on SBP/DBP. Future analysis should include observational studies to evaluate a larger sample and investigate their impact on other markers of health, as well as characterize these effects by level of intervention to inform health policy. Disclosure J. Xiao: None. J. Yu: None. A. Deckard: None. W. Wan: n/a. E. M. Staab: None. A. W. Rodriguez: None. R. Shetty: None. N. Laiteerapong: None.

Objective: Communities of racial/ethnic minority groups experience a higher prevalence of type 2 diabetes (T2DM) with higher rates of diabetes-related complications compared to non-Hispanic Whites. Interventions that utilize community health workers (CHW) are often successful at improving glycemic control. This analysis aimed to examine the effectiveness of CHW interventions on glycemic control in people of racial/ethnic minority groups with T2DM. Methods: A search of electronic databases (PubMed, Scopus, CINAHL, PsycInfo) to identify articles published between 1985 and 20was conducted using broad search terms for diabetes, race/ethnicity, and disparities. To further refine articles to those focusing on CHW-based randomized controlled trials, abstracts were searched for “community workers” and “promotores.” A random effects model was used to calculate the effect of CHW interventions on hemoglobin A1c (HbA1c) with future plans to analyze effects on other cardiovascular risk factors such as body mass index, blood pressure, and cholesterol. Results: A total of 22 RCTs were identified, involving 4996 adults (26% Black, 50% Hispanic, 11% Asian, and 11% Pacific Islander) . CHW interventions among people of racial/ethnic minority groups was associated with a 0.44% (95% confidence interval: -0.56% to -0.31%; p Conclusion: CHW interventions are an effective means to lower HbA1c among people of racial/ethnic minority groups with T2DM. This finding is important for future healthcare policies, which should work to emphasize culturally sensitive interventions for patients with T2DM while maintaining cost effectiveness through CHWs. Future research should examine the effectiveness of CHWs for diabetes prevention. Disclosure R.Shetty: None. A.Deckard: None. W.Wan: n/a. A.Nathan: None. E.M.Staab: None. A.W.Rodriguez: None. A.Gandhi: None. A.A.Baig: None. N.Laiteerapong: None.

The objective of this study was to identify sources and linkages among methicillin-resistant Staphylococcus aureus infections using whole-genome sequencing (WGS).A total of 56 samples were obtained from all patients with a confirmed MRSA infection over 6 months at University of Florida-Health Jacksonville. Samples were cultured and sequenced; data was analyzed on an automated cloud-based platform. Genetic Clusters were defined as40 single nucleotide polymorphisms. Temporal Clusters were defined as ≥5 MRSA cases over 3 days.We found 7 Genetic Clusters comprising 15 samples. Four Genetic Clusters contained patients with non-overlapping stays (3-10 weeks apart), 3 of which contained patients who shared the same Unit. We also found 5 Temporal Clusters comprising 23 samples, although none of the samples were genetically related.Results showed that temporal clustering may be a poor indicator of genetic linkage. Shared epidemiological characteristics between patients in Genetic Clusters may point toward previously unidentified hospital sources. Repeated observation of related strains is also consistent with ongoing MRSA transmission within the surrounding high-risk community.WGS is a valuable tool for hospital infection prevention and control.

The Rakai Community Cohort Study in south central Uganda has surveyed people aged 15–49 since 1994. Antiretroviral therapy (ART) was introduced in 2004. HIV p24 and gp41 subtype distribution and viral diversity were studied from blood samples collected at three surveys in 1994–1995, 2002–2003, and 2008–2009, which were compared with a new survey round from 2011 to 2012. These included 1364 HIV+ individuals. For both p24 and gp41 domains, the genetic diversity within subtypes A and D was significantly increasing in the pre-ART era and decreased between the last two survey rounds in the ART era (p

Plasmonic structures are promising to enhance and control nonlinear optical processes as the subwavelength-scale elements not only increase the local electric field intensities, but also result in ...

The process of thermalization in many-body systems is driven by complex interactions among sub-systems and with the surrounding environment. Here we lay the theoretical foundations for the active control of local thermal states in arbitrary non-reciprocal systems close to their equilibrium state. In particular we describe how to (i) force some part of the system to evolve according to a prescribed law during the relaxation process (i.e. thermal targeting probem), (ii) insulate some elements from the rest of the system or (iii) synchronize their evolution during the relaxation process. We also derive the general conditions a system must fulfill in order that some parts relax toward a minimal temperature with a minimum energetic cost or relax toward a prescribed temperature with a minimum time. Finally, we consider several representative examples in the context of systems exchanging heat radiatively.

Waste heat is a free and abundant energy source, with 15% of global total energy use existing as waste heat above 600 K. For 600–900 K temperature range, near-field thermophotovoltaics (NFTPVs) are theorized to be the most effective technology to recycle waste heat into electrical power. However, to date, experimental efficiencies have not exceeded 1.5%. In this work, we optimize the efficiency of three modeled InAs/InAsSbP-based room-temperature NFTPV devices positioned 0.1 μm from a 750 K p-doped Si radiator. We couple a one-dimensional fluctuational electrodynamics model for the near field optics to a two-dimensional drift-diffusion model, which we validated by reproducing measured dark current–voltage curves of two previously published InAs and InAsSbP devices. The optimized devices show four to six times higher above-bandgap energy transfer compared to the blackbody radiative limit, yielding enhanced power density, while simultaneously lowering parasitic sub-bandgap energy transfer by factors of 0.68–0.85. Substituting InAs front- and back-surface field layers with InAsSbP show 1.5- and 1.4-times higher efficiency and power output, respectively, from lowered parasitic diffusion currents. Of our three optimized designs, the best performing device has a double heterostructure with an n–i–p doping order from front to back. For radiator-thermophotovoltaic gaps of 0.01–10 μm and radiators within 600–900 K, this device has a maximum efficiency of 14.2% and a maximum power output of 1.55 W/cm2, both at 900 K. Within 600–900 K, the efficiency is always higher with near- vs far-field illumination; we calculate up to 3.7- and 107-times higher efficiency and power output, respectively, using near-field heat transfer.

Enormous potential lies in waste-heat recycling for the world’s industrial sector. Portable solid-state modules are a universal low-maintenance method to recycle this waste-heat. One such technology, near-field thermophotovoltaics (NFTPV), relies on a heat source in extreme proximity (

Objective:To determine the prevalence of low scores for two neuropsychological tests with five total scores that evaluate learning and memory functions.Method:N = 5402 healthy adults from 11 countries in Latin America and the commonwealth of Puerto Rico were administered the Rey–Osterrieth Complex Figure (ROCF) and the Hopkins Verbal Learning Test (HVLT-R). Two-thirds of the participants were women, and the average age was 53.5 ± 20.0 years. Z-scores were calculated for ROCF Copy and Memory scores and HVLT-R Total Recall, Delayed Recall, and Recognition scores, adjusting for age, age2, sex, education, and interaction variables if significant for the given country. Each Z-score was converted to a percentile for each of the five subtest scores. Each participant was categorized based on his/her number of low scoring tests in specific percentile cutoff groups (25th, 16th, 10th, 5th, and 2nd).Results:Between 57.3% (El Salvador) and 64.6% (Bolivia) of the sample scored below the 25th percentile on at least one of the five scores. Between 27.1% (El Salvador) and 33.9% (Puerto Rico) scored below the 10th percentile on at least one of the five subtests. Between 5.9% (Chile, El Salvador, Peru) and 10.3% (Argentina) scored below the 2nd percentile on at least one of the five scores.Conclusions:Results are consistent with other studies that found that low scores are common when multiple neuropsychological outcomes are evaluated in healthy individuals. Clinicians should consider the higher probability of low scores when evaluating learning and memory using various sets of scores to reduce false-positive diagnoses of cognitive deficits.

Direct proton-knockout reactions of ^{55}Sc at ∼220 MeV/nucleon were studied at the RIKEN Radioactive Isotope Beam Factory. Populated states of ^{54}Ca were investigated through γ-ray and invariant-mass spectroscopy. Level energies were calculated from the nuclear shell model employing a phenomenological internucleon interaction. Theoretical cross sections to states were calculated from distorted-wave impulse approximation estimates multiplied by the shell model spectroscopic factors, which describe the wave function overlap of the ^{55}Sc ground state with states in ^{54}Ca. Despite the calculations showing a significant amplitude of excited neutron configurations in the ground-state of ^{55}Sc, valence proton removals populated predominantly the ground state of ^{54}Ca. This counterintuitive result is attributed to pairing effects leading to a dominance of the ground-state spectroscopic factor. Owing to the ubiquity of the pairing interaction, this argument should be generally applicable to direct knockout reactions from odd-even to even-even nuclei.

Many-body physics aims to understand emergent properties of systems made of many interacting objects. This article reviews recent progress on the topic of radiative heat transfer in many-body systems consisting of thermal emitters interacting in the near-field regime. Near-field radiative heat transfer is a rapidly emerging field of research in which the cooperative behavior of emitters gives rise to peculiar effects which can be exploited to control heat flow at the nanoscale. Using an extension of the standard Polder and van Hove stochastic formalism to deal with thermally generated fields in $N$-body systems, along with their mutual interactions through multiple scattering, a generalized Landauer-like theory is derived to describe heat exchange mediated by thermal photons in arbitrary reciprocal and non-reciprocal multi-terminal systems. In this review, we use this formalism to address both transport and dynamics in these systems from a unified perspective. Our discussion covers: (i) the description of non-additivity of heat flux and its related effects, including fundamental limits as well as the role of nanostructuring and material choice, (ii) the study of equilibrium states and multistable states, (iii) the relaxation dynamics (thermalization) toward local and global equilibria, (iv) the analysis of heat transport regimes in ordered and disordered systems comprised of a large number of objects, density and range of interactions, and (v) the description of thermomagnetic effects in magneto-optical systems and heat transport mechanisms in non-Hermitian many-body systems. We conclude this review by listing outstanding challenges and promising future research directions., 54 pages, 45 figures

Severe SARS-CoV-2, the virus responsible for the 2020 Coronavirus pandemic, commonly manifests with fever, myalgia, anosmia, generalized malaise, and shortness of breath, among other viral like symptomatology. The neurological manifestations of COVID-19 have been infrequently described;still, there is evidence of the neurological sequelae the virus can develop. Critically ill patients are somewhat predisposed to develop neuromuscular complications, including critical illness myopathy (CIM). This case report describes a case of a post-COVID-19 Polyneuro-myopathy. A 86 year-old male patient with a past medical history significant for arterial hypertension, dyslipidemia, chronic kidney disease stage III, congestive heart failure, atrial fibrillation, and prostate carcinoma. Patient traveled to Dominican Republic and days after returning to Puerto Rico started to develop non bloody diarrhea followed by generalized malaise, weakness, muscle aches, tachycardia, tachypnea, and shortness of breath. Upon examination patient was found with an irregularly irregular rhythm;consistent with a diagnosis of atrial fibrillation with fast ventricular response. Chest CT scan was done and there was evidence of patchy ground-glass opacities suspicious of pneumonia. COVID-19 PCR test came back negative but considering being high risk for SARS-COVID infection, he was admitted to COVID-ICU. Days after admission patient developed an unknown neurological deterioration with hypercapnia associated. A complete neurological workup was done;including head CT, electroencephalogram, electromyogram, and lumbar puncture;all with normal results. Patient continued to clinically deteriorate, requiring endotracheal intubation to protect the airway. COVID-19 PCR test was repeated and came back positive. After completion of 10 days of Remdesivir and Dexamethasone, patient was clinically better but despite multiple attempts to extubate the patient, he failed CPAP trials and required tracheostomy. No clear neurological etiology was identified;post COVID-19 Polyneuromyopathy was our diagnosis of exclusion. There is increasing evidence of the neurological sequalae SARS-CoV-2/COVID-19 could develop;but ICU-acquired weakness/critically induce polyneuropathy are two conditions expected in this patient population. We need to be aware about the possibility of these neurological complications in order to properly prevent, diagnose and treat. Well-designed rehabilitation programs are much in need after this pandemic.