Structural vulnerabilities and PrEP awareness among Boston heterosexuals and people who inject drugs at risk for HIV: findings from 2018 to 2019 cycles from the Boston, MA site of the NHBS

Little is known about biopsychosocial factors relating to pre-exposure prophylaxis (PrEP) awareness among people with either heterosexual or injection drug use HIV risk behaviors. Participants engaged in vaginal/anal sex with a person of the opposite sex (N = 515) or were people who injected drugs (PWID; N = 451) in the past 12 months from 2018-2019 in Boston, MA. We examined associations between PrEP awareness and: homelessness; perceived HIV-related stigma; country of birth; bacterial STDs, chlamydia, and/or gonorrhea in the past 12 months, lifetime hepatitis C virus (HCV) infection, sexual orientation, and poverty. More PWID (36.8%) were aware of PrEP than people with heterosexual HIV risk (28%; p = .001). Among people with heterosexual risk, homelessness (aOR = 1.99, p = .003), and among PWID: homelessness (aOR = 2.11, p = .032); bacterial STD (aOR = 2.96, p = .012); chlamydia (aOR = 6.14, p = .008); and HCV (aOR = 2.40, p < .001) were associated with increased likelihood of PrEP awareness. In the combined sample: homelessness (aOR = 2.25, p < .001); HCV (aOR = 2.18, p < .001); identifying as homosexual (aOR = 3.71, p = .036); and bisexual (aOR = 1.55, p = .016) were each associated with PrEP awareness. Although having an STD, HCV, identifying as homosexual or bisexual, and experiencing homelessness were associated with increased PrEP awareness, most participants were unaware of PrEP. Efforts to increase PrEP awareness could engage PWID and heterosexual HIV risk behavior.

Long-term survival in patients with brain-only metastatic non-small cell lung cancer undergoing upfront intracranial stereotactic radiosurgery and definitive treatment to the thoracic primary site

BACKGROUND AND PURPOSE

To evaluate modern clinical outcomes for patients with brain-only metastatic non-small cell lung cancer (NSCLC) treated with intracranial stereotactic radiosurgery (SRS) with or without definitive treatment of the primary site.

MATERIALS AND METHODS

Patients with synchronously diagnosed NSCLC and brain-only metastatic disease treated with intracranial SRS at a single institution were retrospectively identified. Patients were stratified based on whether they did (A) or did not (B) receive definitive primary site treatment. Patient characteristics and clinical outcomes were compared.

RESULTS

From 2008 to 2022, 103 patients were identified, 53 of whom received definitive primary site treatment. Median follow-up was 2.1 y (A) and 0.8 y (B) (p < 0.001). 28 (53 %) patients in Group A received immune checkpoint inhibitor (ICI) therapy versus 19 (38 %) in Group B (p = 0.13) and there were no other statistically significant baseline or treatment characteristic differences between the groups. 5-year local-PFS was 34.5 % (A) versus 0 % (B) (p < 0.001). 5-year regional-PFS was 33.0 % (A) versus 0 % (B) (p < 0.001). 5-year distant body-PFS was 34.0 % (A) versus 0 % (B) (p < 0.001). 5-year CNS-PFS was 14.7 % (A) versus 0 % (B) (p = 0.12). 5-year OS was 40.2 % (A) versus 0 % (B) (p = 0.001). 5-year CSS was 67.6 % (A) versus 0 % (B) (p = 0.002). On multivariable analysis, lack of definitive treatment to the primary site (HR = 2.40), AJCC T3-4 disease (HR = 2.73), and lack of ICI therapy (HR = 2.86) were significant predictors of death.

CONCLUSION

Definitive treatment to the thoracic primary site in patients with brain-only metastatic NSCLC after intracranial radiosurgery was associated with slower progression of disease and improved survival.

An individual patient data meta-analysis of wound care in patients with toxic epidermal necrolysis

Toxic epidermal necrolysis (TEN) involves extensive mucocutaneous loss, and care is supportive. The approach to wound care includes surgical debridement or using dressings while leaving the epidermis intact. Robust evidence for either approach is lacking. We compared surgical debridement to the use of dressings while leaving the epidermis in situ (referred to hereon as dressings) in adult patients with TEN. The primary outcome assessed was mortality. The secondary outcome was time to re-epithelialisation. The impact of medications was evaluated. An individual patient data (IPD) systematic review and meta-analysis was undertaken. A random effects meta-analysis and survival analysis for IPD data examined mortality, re-epithelisation time and the effect of systemic medications. The quality of evidence was rated per the Grading of Recommendations Assessment, Development and Evaluation (GRADE). PROSPERO: CRD42021266611 Fifty-four studies involving 227 patients were included in the systematic review and meta-analysis, with a GRADE from very low to moderate. There was no difference in survival in patients who had surgical debridement or dressings (univariate: p = 0.91, multivariate: p = 0.31). Patients who received dressings re-epithelialised faster than patients who underwent debridement (multivariate HR: 1.96 [1.09-3.51], p = 0.023). Intravenous immunoglobulin (univariate HR: 0.21 [0.09-0.45], p < 0.001; multivariate HR: 0.22 [0.09-0.53], p < 0.001) and cyclosporin significantly reduced mortality (univariate HR: 0.09 [0.01-0.96], p = 0.046; multivariate HR: 0.06 [0.01-0.73], p = 0.028) irrespective of the wound care. This study supports the expert consensus of the dermatology hospitalists, that wound care in patients with TEN should be supportive with the epidermis left intact and supported with dressings, which leads to faster re-epithelialisation.

Dopant Engineering of Hafnia-Based Ferroelectrics for Long Data Retention and High Thermal Stability

Hafnia-based ferroelectrics have gained much attention because they can be used in highly scaled, advanced complementary metal-oxide semiconductor (CMOS) memory devices. However, thermal stability should be considered when integrating hafnia-based ferroelectric transistors in advanced CMOS devices, as they can be exposed to high-temperature processes. This work proposed that doping of Al in hafnia-based ferroelectric material can lead to high thermal stability. A ferroelectric capacitor based on Al-doped hafnia, which can be used for one-transistor-one-capacitor applications, exhibits stable operation even after annealing at 900 °C. Moreover, it demonstrates that the ferroelectric transistors based on Al-doped hafnia for one-transistor applications, such as ferroelectric NAND, retain their memory states for 10 years at 100 °C. This study presents a practical method to achieve thermally stable ferroelectric memories capable of enduring high-temperature processes and operation conditions.

Demonstration of the threshold-switching memory devices using EMIm(AlCl3)Cl and ZnO for neuromorphic applications

The threshold-switching behaviors of the synapses lead to energy-efficient operation in the neural computing system. Here, we demonstrated the threshold-switching memory devices by inserting the ZnO layer into the ionic synaptic devices. The EMIm(AlCl3)Cl is utilized as the electrolyte because its conductance can be tuned by the charge states of the Al-based ions. The redox reactions of the Al ions in the electrolyte can lead to the analog resistive switching characteristics, such as excitatory postsynaptic current, paired-pulse facilitation, potentiation, and depression. By inserting the ZnO layer into the EMIm(AlCl3)-based ionic synaptic devices, the threshold switching behaviors are demonstrated. Using the resistivity difference between ZnO and EMIm(AlCl3)Cl, the analog resistive switching behaviors are tunned as the threshold-switching behaviors. The threshold-switching behaviors are achieved by applying the spike stimuli to the device. Demonstration of the threshold-switching behaviors of the ionic synaptic devices has a possibility to achieve high energy-efficiency for the ion-based artificial synapses.

Proton Re-Irradiation with Concurrent Hyperthermia in Patients with Recurrent Breast Cancer

PURPOSE/OBJECTIVE(S)

The aim of this study is to evaluate the safety and effectiveness of proton re-irradiation with concurrent hyperthermia in the treatment of recurrent breast cancer.

MATERIALS/METHODS

We retrospectively identified patients previously treated with photon whole breast or chest wall irradiation for a primary breast cancer at our institution, who subsequently developed a histologically-confirmed locoregional recurrence or new ipsilateral primary breast cancer and underwent proton chest wall re-irradiation with concurrent hyperthermia as part of definitive treatment. Acute toxicity was evaluated once weekly while on-treatment and at 2 weeks and 3 months post-treatment. Toxicities were graded according to CTCAE v4.0.

RESULTS

Fifteen patients received proton re-irradiation with concurrent superficial hyperthermia at our institution from August 2018 to December 2022. Median interval between radiation treatment courses was 7.7 years (range 1-30 years). Four patients (26%) had gross, unresected disease at the time of re-treatment. The median initial radiation dose, re-irradiation dose, and cumulative EQD2 was 60.4 Gy (50.6-61.2 Gy), 60 Gy (RBE) (45-66 Gy (RBE)), and 120 Gy (RBE) (103-126 Gy (RBE)), respectively. Patients received a median of 9 (3-14) concurrent hyperthermia treatments delivered twice weekly, and 13 patients (87%) received seven or more hyperthermia treatments. Median toxicity follow-up was 9 months (0-36 months). Acute grade 3 toxicities included two patients (13%) with grade 3 dermatitis, both of which resolved with conservative management within 3 months of treatment completion. Chronic grade 2 or higher toxicities included two grade 2 hyperpigmentation, one grade 3 induration, one grade 2 telangiectasia, and one grade 2 rib fracture. There were no grade 4-5 acute or late toxicities. There was one in-field local recurrence and one regional recurrence outside of the re-irradiation field. Both patients had gross, unresected disease at the time of re-irradiation. Two patients (13%) developed distant disease.

CONCLUSION

Proton re-irradiation with concurrent hyperthermia is feasible and well-tolerated in the re-treatment of breast cancer. Further studies are warranted to determine long-term toxicity and oncologic outcomes.

Monitoring environmental microbiomes: Alignment of microbiology and computational biology competencies within a culturally integrated curriculum and research framework

We have developed a flexible undergraduate curriculum that leverages the place-based research of environmental microbiomes to increase the number of Indigenous researchers in microbiology, data science and scientific computing. Monitoring Environmental Microbiomes (MEM) provides a curriculum and research framework designed to integrate an Indigenous approach when conducting authentic scientific research and to build interest and confidence at the undergraduate level. MEM has been successfully implemented as a short summer workshop to introduce computing practices in microbiome analysis. Based on self-assessed student knowledge of topics and skills, increased scientific confidence and interest in genomics careers were observed. We propose MEM be incorporated in a scalable course-based research experience for undergraduate institutions, including tribal colleges and universities, community colleges and other minority serving institutions. This coupled curricular and research framework explicitly considers cultural perspectives, access and equity to train a diverse future workforce that is more informed to engage in microbiome research and to translate microbiome science to benefit community and environmental health.

Microbiologically influenced corrosion-more than just microorganisms

Microbiologically influenced corrosion (MIC) is a phenomenon of increasing concern that affects various materials and sectors of society. MIC describes the effects, often negative, that a material can experience due to the presence of microorganisms. Unfortunately, although several research groups and industrial actors worldwide have already addressed MIC, discussions are fragmented, while information sharing and willingness to reach out to other disciplines are limited. A truly interdisciplinary approach, which would be logical for this material/biology/chemistry-related challenge, is rarely taken. In this review, we highlight critical non-biological aspects of MIC that can sometimes be overlooked by microbiologists working on MIC but are highly relevant for an overall understanding of this phenomenon. Here, we identify gaps, methods, and approaches to help solve MIC-related challenges, with an emphasis on the MIC of metals. We also discuss the application of existing tools and approaches for managing MIC and propose ideas to promote an improved understanding of MIC. Furthermore, we highlight areas where the insights and expertise of microbiologists are needed to help progress this field.

Recent Advances and Future Prospects for Memristive Materials, Devices, and Systems

Memristive technology has been rapidly emerging as a potential alternative to traditional CMOS technology, which is facing fundamental limitations in its development. Since oxide-based resistive switches were demonstrated as memristors in 2008, memristive devices have garnered significant attention due to their biomimetic memory properties, which promise to significantly improve power consumption in computing applications. Here, we provide a comprehensive overview of recent advances in memristive technology, including memristive devices, theory, algorithms, architectures, and systems. In addition, we discuss research directions for various applications of memristive technology including hardware accelerators for artificial intelligence, in-sensor computing, and probabilistic computing. Finally, we provide a forward-looking perspective on the future of memristive technology, outlining the challenges and opportunities for further research and innovation in this field. By providing an up-to-date overview of the state-of-the-art in memristive technology, this review aims to inform and inspire further research in this field.

Ferroelectric Transistors for Memory and Neuromorphic Device Applications

Ferroelectric materials have been intensively investigated for high-performance nonvolatile memory devices in the past decades, owing to their nonvolatile polarization characteristics. Ferroelectric memory devices are expected to exhibit lower power consumption and higher speed than conventional memory devices. However, non-complementary metal-oxide-semiconductor (CMOS) compatibility and degradation due to fatigue of traditional perovskite-based ferroelectric materials have hindered the development of high-density and high-performance ferroelectric memories in the past. The recently developed hafnia-based ferroelectric materials have attracted immense attention in the development of advanced semiconductor devices. Because hafnia is typically used in CMOS processes, it can be directly incorporated into current semiconductor technologies. Additionally, hafnia-based ferroelectrics show high scalability and large coercive fields that are advantageous for high-density memory devices. This review summarizes the recent developments in ferroelectric devices, especially ferroelectric transistors, for next-generation memory and neuromorphic applications. First, the types of ferroelectric memories and their operation mechanisms are reviewed. Then, issues limiting the realization of high-performance ferroelectric transistors and possible solutions are discussed. The experimental demonstration of ferroelectric transistor arrays, including 3D ferroelectric NAND and its operation characteristics, are also reviewed. Finally, challenges and strategies toward the development of next-generation memory and neuromorphic applications based on ferroelectric transistors are outlined.

Defect Engineering of Hafnia-Based Ferroelectric Materials for High-Endurance Memory Applications

Zirconium-doped hafnium oxide (HfZrO_x) is one of the promising ferroelectric materials for next-generation memory applications. To realize high-performance HfZrO_x for next-generation memory applications, the formation of defects in HfZrO_x, including oxygen vacancies and interstitials, needs to be optimized, as it can affect the polarization and endurance characteristics of HfZrO_x. In this study, we investigated the effects of ozone exposure time during the atomic layer deposition (ALD) process on the polarization and endurance characteristics of 16-nm-thick HfZrO_x. HfZrO_x films showed different polarization and endurance characteristics depending on the ozone exposure time. HfZrO_x deposited using the ozone exposure time of 1 s showed small polarization and large defect concentration. The increase of the ozone exposure time to 2.5 s could reduce the defect concentration and improve the polarization characteristics of HfZrO_x. When the ozone exposure time further increased to 4 s, a reduction of polarization was observed in HfZrO_x due to the formation of oxygen interstitials and non-ferroelectric monoclinic phases. HfZrO_x, with an ozone exposure time of 2.5 s, exhibited the most stable endurance characteristics because of the low initial defect concentration in HfZrO_x, which was confirmed by the leakage current analysis. This study shows that the ozone exposure time of ALD needs to be controlled to optimize the formation of defects in HfZrO_x films for the improvement of polarization and endurance characteristics.

Healthcare workers' acceptance of and adherence to latent tuberculosis treatment

BACKGROUND

Healthcare workers (HCWs) with latent tuberculosis infection (LTBI) have a high risk of active tuberculosis and need systematic LTBI screening and treatment. However, acceptance and adherence rates of LTBI treatment are low.

AIMS

To examine the specific reasons for the loss at each LTBI treatment-cascade stage: acceptance, continuation and completion of LTBI treatment in HCWs.

METHODS

This retrospective descriptive study was conducted among 61 HCWs with an interferon-gamma release assay-confirmed LTBI diagnosis who were prescribed LTBI treatment at a tertiary hospital in the Republic of Korea. Data were analysed using Pearson's chi-square, Fisher's exact, independent t-test and Mann-Whitney U-test. A word cloud analysis was used to describe the perceived meaning of LTBI in HCWs.

RESULTS

HCWs who refused or discontinued LTBI treatment perceived LTBI as 'not a big deal', whereas HCWs who completed LTBI treatment had a high-risk perception of the LTBI prognosis, such as 'frightened about adverse prognosis'. Determinants of non-adherence to the recommended LTBI treatment included a busy work schedule, side effects of anti-tuberculosis agents and the inconvenience of regularly taking anti-tuberculosis agents.

CONCLUSIONS

To ensure LTBI treatment adherence in HCWs, effective interventions that are customized to each stage of the LTBI treatment should be developed, with due consideration of the stage-specific perceived facilitators and barriers in the LTBI treatment cascade.

Inorganic Perovskite Quantum Dot-Mediated Photonic Multimodal Synapse

Artificial synapse is the basic unit of a neuromorphic computing system. However, there is a need to explore suitable synaptic devices for the emulation of synaptic dynamics. This study demonstrates a photonic multimodal synaptic device by implementing a perovskite quantum dot charge-trapping layer in the organic poly(3-hexylthiophene-2,5-diyl) (P3HT) channel transistor. The proposed device presents favorable band alignment that facilitates spatial separation of photogenerated charge carriers. The band alignment serves as the basis of optically induced charge trapping, which enables nonvolatile memory characteristics in the device. Furthermore, high photoresponse and excellent synaptic characteristics, such as short-term plasticity, long-term plasticity, excitatory postsynaptic current, and paired-pulse facilitation, are obtained through gate voltage regulation. Photosynaptic characteristics obtained from the device showed a multiwavelength response and a large dynamic range (∼10³) that is suitable for realizing a highly accurate artificial neural network. Moreover, the device showed nearly linear synaptic weight update characteristics with incremental depression electric gate pulse. The simulation based on the experimental data showed excellent pattern recognition accuracy (∼85%) after 120 epochs. The results of this study demonstrate the feasibility of the device as an optical synapse in the next-generation neuromorphic system.

Preoperative Chemoradiotherapy With Capecitabine With or Without Temozolomide in Patients With Locally Advanced Rectal Cancer: A Prospective, Randomised Phase II Study Stratified by O6-Methylguanine DNA Methyltransferase Status: KCSG-CO17-02

AIMS

To evaluate the clinical efficacy of adding temozolomide (TMZ) to preoperative capecitabine (CAP)-based chemoradiotherapy in patients with locally advanced rectal cancer (LARC) and validate O⁶-methylguanine DNA methyltransferase (MGMT) methylation status as a predictive marker for TMZ combined regimens.

MATERIALS AND METHODS

LARC patients with clinical stage II (cT3-4N0) or III (cT_anyN+) disease were enrolled. They were stratified into unmethylated MGMT (uMGMT) and methylated MGMT (mMGMT) groups by methylation-specific polymerase chain reaction before randomisation and were then randomly assigned (1:1) to one of four treatment arms: uMGMT/CAP (arm A), uMGMT/TMZ + CAP (arm B), mMGMT/CAP (arm C) and mMGMT/TMZ + CAP (arm D). The primary end point was the pathological complete response (pCR) rate.

RESULTS

Between November 2017 and July 2020, 64 patients were randomised. Slow accrual caused early study termination. After excluding four ineligible patients, 60 were included in the full analysis set. The pCR rate was 15.0% (9/60), 0%, 14.3%, 18.8% and 26.7% for the entire cohort, arms A, B, C and D, respectively (P = 0.0498 between arms A and D). The pCR rate was 9.7% in the CAP group (arms A + C), 20.7% in the TMZ + CAP group (arms B + D), 6.9% in the uMGMT group (arms A + B) and 22.6% in the mMGMT group (arms C + D). Grade 1-2 nausea or vomiting was significantly more frequent in the TMZ + CAP treatment groups (arms B + D) than in the CAP treatment groups (arms A + C, P < 0.001) with no difference in grade 3 adverse events. There were no grade 4 or 5 adverse events.

CONCLUSION

The addition of TMZ to CAP-based chemoradiotherapy tended to improve pCR rates, particularly in those with mMGMT LARC. MGMT status may warrant further investigation as a predictive biomarker for chemotherapeutic agents and radiotherapy.

A safety and pharmacodynamic study of the highly selective aldosterone synthase inhibitor PB6440 in the cynomolgus monkey

Background

Aldosterone is an important mediator of hypertension, particularly resistant hypertension, heart failure, and chronic kidney disease. PB6440 is a potent inhibitor of aldosterone synthase (CYP11B2) with high selectivity over the closely related enzyme CYP11B1. In previous studies in cynomolgus monkeys, PB6440 exhibited excellent oral bioavailability and a marked suppression of aldosterone synthesis at doses as low as 1 mg/kg/day. Importantly, no effect was observed on cortisol production nor significant changes noted in plasma concentrations of the steroid precursors 11-deoxycortisol or deoxycorticosterone (DOC), which are dependent on CYP11B1 activity. The purpose of the current study was to assess the safety and pharmacodynamics of higher doses of PB6440 in the cynomolgus monkey in order to determine a therapeutic index prior to initiation of studies in humans.

Methods

Male and female cynomolgus monkeys (2/sex/dose group) were administered 0, 10, 30 or 100 mg/kg PB6440 once-daily for 14 days by oral gavage. Assessment of safety was based on mortality, clinical observations, body weights, and clinical and anatomic pathology. Blood samples were also collected for pharmacodynamic analysis, including aldosterone, cortisol, 11-deoxycortisol, DOC, and ACTH.

Results

PB6440 was well tolerated at all doses. There were no deaths and no reports of clinical observations at any dose level. Mild decreases in body weight were observed in PB6440-treated animals, which were likely due to the diuretic effects of the compound. PB6440 caused an increase in adrenal weights which was associated with hypertrophy of the adrenal zona fasciculata, a finding which has previously been observed with other aldosterone synthase inhibitors. PB6440 led to marked declines in basal aldosterone levels of −97%, −97% and −98% from baseline at 10, 30 and 100 mg/kg/day, respectively, at 24-hours following the final dose. Despite these clear declines in circulating aldosterone levels, no meaningful changes in cortisol, 11-deoxycortisol, DOC, or ACTH levels were observed, supporting lack of CYP11B1 inhibition. PB6440 led to expected decreases in plasma sodium (up to 7 nmol/L at the high dose). No effect on plasma potassium levels were observed at any dose level.

Conclusions

PB6440 was well tolerated in the cynomolgus monkey at doses that are much higher than needed for potent aldosterone suppression based on previous studies. At the highest dose level tested (100 mg/kg), which led to a 98% reduction in basal aldosterone levels, no evidence of significant CYP11B1 inhibition was observed. The absence of an increase in plasma potassium in the presence of a plasma sodium decline merits further study. Thus, PB6440 is a highly selective novel aldosterone synthase inhibitor for the potential treatment of hypertension, heart failure, and chronic kidney disease in humans.

Funding Acknowledgement

Type of funding sources: Public Institution(s). Main funding source(s): PhaseBio Pharmaceuticals Inc.

Emulating the Signal Transmission in a Neural System Using Polymer Membranes

Neurons are vital components of the brain. When stimulated by neurotransmitters at the dendrites, neurons deliver signals as changes in the membrane potential by ion movement. The signal transmission of a nervous system exhibits a high energy efficiency. These characteristics of neurons are being exploited to develop efficient neuromorphic computing systems. In this study, we develop chemical synapses for neuromorphic devices and emulate the signaling processes in a nervous system using a polymer membrane, in which the ionic permeability can be controlled. The polymer membrane comprises poly(diallyl-dimethylammonium chloride) and poly(3-sulfopropyl acrylate potassium salt), which have positive and negative charges, respectively. The ionic permeability of the polymer membrane is controlled by the injection of a neurotransmitter solution. This device emulates the signal transmission behavior of biological neurons depending on the concentration of the injected neurotransmitter solution. The proposed artificial neuronal signaling device can facilitate the development of bio-realistic neuromorphic devices.

Evaluation of the MolecuTech® REBA MTB-XMDR kit for detection of pre-extensively drug-resistant TB

BACKGROUND: Rapid diagnosis of drug-resistant TB is critical for early initiation of effective therapy. YD Diagnostics in South Korea recently developed the MolecuTech^® REBA MTB-XMDR test to rapidly detect multidrug-resistant TB (MDR-TB), pre-extensively drug-resistant TB (pre-XDR-TB) and resistance to second-line injectable drugs (SLIDs) simultaneously using a fully automated test platform. This study aimed to evaluate the MolecuTech^® test for the detection of MDR- and pre-XDR-TB, as well as SLID resistance.METHODS: A total of 151 clinical Mycobacterium tuberculosis isolates from South Korea were tested using the MolecuTech test, and the results were analysed by comparing these with phenotypic drug susceptibility testing (pDST) and sequencing.RESULTS: Compared to pDST, the MolecuTech test showed a sensitivity and specificity of respectively 97.7% and 100.0% for rifampicin (RIF), 82.4% and 100.0% for isoniazid (INH), 97.5% and 97.2% for fluoroquinolones (FQs), and 94.0% and 98.8% for SLIDs. Concordances with the sequencing results of each resistance determinant were 99.3% for RIF, 96.7% for INH, 98.7% for FQs and 99.3% for SLIDs.CONCLUSION: The MolecuTech test is an efficient and reliable rapid molecular diagnostic tool for the simultaneous screening of MDR- and pre-XDR-TB.

Metal Halide Perovskite-Based Memristors for Emerging Memory Applications

There is an increased demand for next-generation memory devices with high density and fast operation speed to replace conventional memory devices. Memristors are promising candidates for next-generation memory devices because of their scalability, stable data retention, low power consumption, and fast operation. Among the various types of memristors, halide perovskites exhibit potential as emerging materials for memristors by using hysteresis based on the movement of defects or ions in halide perovskites. However, research on the implementation of perovskite materials as memristors is in its early stages; some challenges and problems must be solved to enable the practical application of halide perovskites for next-generation memory devices. From this perspective, we highlight the recent progress in memristors that use halide perovskites. Moreover, we introduce a strategy to enhance the performance and analyze the operation mechanism of memory devices that use halide perovskites. Finally, we summarize the challenges in the development of device technology to use halide perovskites in next-generation memory devices.

Isolated posterior inferior cerebellar artery dissection with ischaemic stroke: evaluating the radiological features and diagnostic feasibility of high-resolution vessel wall imaging

AIM

To evaluate the radiological features of isolated posterior inferior cerebellar artery dissection (PICAD) and the feasibility of using high-resolution vessel-wall imaging (HR-VWI) for diagnosing PICAD.

MATERIALS AND METHODS

Three hundred and nine patients with arterial dissection involving the posterior cerebral circulation, who underwent HR-VWI between March 2012 and July 2019 were reviewed retrospectively. Among them, 44 patients (14.2%) were diagnosed with isolated PICAD in consensus among a neuroradiologist, a neurointerventionist, and a neurologist. Two neuroradiologists reviewed the vessel wall images independently for evidence of dissection (dissection flap, outer diameter enlargement on T2-weighted imaging [WI], mural haematoma). Diagnostic confidence was also scored on a five-point scale. Intra- and interobserver agreement for diagnosing PICAD and detecting evidence of dissection were evaluated.

RESULTS

Dissection flaps were seen on T2WI in all cases (100%) and on contrast-enhanced T1WI in 34 patients (79.1%). Outer diameter enlargement of the steno-occlusive lesions on angiography was detected in most cases (97.7%). A mural haematoma was detected on three-dimensional (3D) contrast-enhanced motion-sensitised driven-equilibrium T1WI in 97.1% of the cases. The mean diagnostic confidence score derived by two neuroradiologists was 4.72. The two reviewers showed substantial to almost perfect agreement (weighted kappa coefficient: 0.62-0.97).

CONCLUSION

Use of HR-VWI as a diagnostic tool for PICAD is feasible, and a dissection flap with outer wall enlargement on HR-T2WI allows confident dissection diagnosis. The present data suggest that PICAD might be considered as a stroke aetiology in patients with unexplained ischaemic stroke in the PICA territory, and that PICA evaluation with HR-VWI is both necessary and feasible.

Trends in body mass index changes among Korean adolescents between 2005-2020, including the COVID-19 pandemic period: a national representative survey of one million adolescents

OBJECTIVE

The impact of the coronavirus disease 2019 (COVID-19) pandemic on weight gain in children and adolescents remains unknown. We aimed to identify an estimated 15-year trend in mean body mass index (BMI) changes and prevalence of obesity and overweight among Korean adolescents from 2005 to 2020, including the period of the COVID-19 pandemic.

PATIENTS AND METHODS

We analyzed data taken from a nationwide survey (Korea Youth Risk Behavior Survey), between 2005 and 2020. Representative samples of one million Korean adolescents aged 13-18 years (n=1,057,885) were examined. The 15-year trends in mean BMI and proportion of obesity or overweight, and the changes due to the COVID-19 pandemic were analyzed.

RESULTS

The data of 1,057,885 Korean adolescents were analyzed (mean age: 14.98 years; females, 48.4%). The estimated weighted mean BMI was 20.5 kg/m2 [95% confidence interval (CI), 20.4-20.5] from 2005 to 2008 and 21.5 kg/m2 (95% CI, 21.4-21.6) in 2020 (during the COVID-19 pandemic). Although the 15-year trend of mean BMI gradually increased, the change in mean BMI before and during the pandemic significantly lessened (βdiff, -0.027; 95% CI, -0.028 to -0.026). The 15-year (2005-2020) trend changes in the prevalence of obesity and overweight were similar (obesity prevalence from 2005-2008, 3.2%; 95% CI, 3.1-3.3 vs. obesity prevalence in 2020, 8.6%; 95% CI, 8.2-9.0; βdiff, -0.309; 95% CI, -0.330 to -0.288).

CONCLUSIONS

The 15-year trend of overall mean BMI and obesity and overweight prevalence demonstrated a significant increase; however, its slope decreased during the pandemic. These landmark results suggest the need for the development of precise strategies to prevent pediatric obesity and overweight during the COVID-19 pandemic.

CMOS-compatible compute-in-memory accelerators based on integrated ferroelectric synaptic arrays for convolution neural networks

Convolutional neural networks (CNNs) have gained much attention because they can provide superior complex image recognition through convolution operations. Convolution processes require repeated multiplication and accumulation operations, which are difficult tasks for conventional computing systems. Compute-in-memory (CIM) that uses parallel data processing is an ideal device structure for convolution operations. CIM based on two-terminal synaptic devices with a crossbar structure has been developed, but unwanted leakage current paths and the high-power consumption remain as the challenges. Here, we demonstrate integrated ferroelectric thin-film transistor (FeTFT) synaptic arrays that can provide efficient parallel programming and data processing for CNNs by the selective and accurate control of polarization in the ferroelectric layer. In addition, three-terminal FeTFTs can act as both nonvolatile memory and access device, which tackle issues from two-terminal devices. An integrated FeTFT synaptic array with parallel programming capabilities can perform convolution operations to extract image features with a high-recognition accuracy.

High-precision measurement of the W boson mass with the CDF II detector

The mass of the W boson, a mediator of the weak force between elementary particles, is tightly constrained by the symmetries of the standard model of particle physics. The Higgs boson was the last missing component of the model. After observation of the Higgs boson, a measurement of the W boson mass provides a stringent test of the model. We measure the W boson mass, M_W, using data corresponding to 8.8 inverse femtobarns of integrated luminosity collected in proton-antiproton collisions at a 1.96 tera-electron volt center-of-mass energy with the CDF II detector at the Fermilab Tevatron collider. A sample of approximately 4 million W boson candidates is used to obtain [Formula: see text], the precision of which exceeds that of all previous measurements combined (stat, statistical uncertainty; syst, systematic uncertainty; MeV, mega-electron volts; c, speed of light in a vacuum). This measurement is in significant tension with the standard model expectation.

SOX9+ enthesis cells are associated with spinal ankylosis in ankylosing spondylitis

OBJECTIVE

Although cartilage degeneration and invasion of the subchondral bone plate in entheseal lesion has been considered to consequently lead bony ankylosis in ankylosing spondylitis (AS), no evident mechanisms are known.

DESIGN

To identify histopathological and physiological changes in enthesitis-related ankylosis in AS, we performed molecular characterization of transcription factors and surface markers, and transcriptome analysis with human tissues. Entheseal tissue containing subchondral bone was obtained from the facet joints of 9 patients with AS and 10 disease controls, and assessed by using differential staining techniques. Enthesis cells were isolated, characterized, stimulated with TNF and/or IL-17A, and analysed by cell-based experimental tools.

RESULTS

We found diffusely distributed granular tissue and cartilage in the subchondral bone in AS. Co-expression of SOX9, a specific transcription factor in cartilage, and matrix metalloproteinase 13 (MMP13) was found in the granular tissues within the subchondral bone from AS patients. Intriguingly, SOX9 expression was significantly higher in AS enthesis cells than controls and correlated with TNFR1 and IL-17RA expressions, which is important for high reactivity to TNF and IL-17A cytokines. Co-stimulation by TNF and IL-17A resulted in accelerated mineralization/calcification features, and increased OCN expression in AS enthesis cells. Furthermore, SOX9 overexpression in enthesis leads to promoting mineralization feature by TNF and IL-17A stimuli. Finally, OCN expression is elevated in the destructive enthesis of advanced AS.

CONCLUSION

These findings provide insight into the links between inflammation and the mineralization of entheseal tissue as the initiation of spinal ankylosis, emphasizing the importance of SOX9⁺ enthesis cells.

Local Application of Mineral-Coated Microparticles Loaded With VEGF and BMP-2 Induces the Healing of Murine Atrophic Non-Unions

Deficient angiogenesis and disturbed osteogenesis are key factors for the development of nonunions. Mineral-coated microparticles (MCM) represent a sophisticated carrier system for the delivery of vascular endothelial growth factor (VEGF) and bone morphogenetic protein (BMP)-2. In this study, we investigated whether a combination of VEGF- and BMP-2-loaded MCM (MCM + VB) with a ratio of 1:2 improves bone repair in non-unions. For this purpose, we applied MCM + VB or unloaded MCM in a murine non-union model and studied the process of bone healing by means of radiological, biomechanical, histomorphometric, immunohistochemical and Western blot techniques after 14 and 70 days. MCM-free non-unions served as controls. Bone defects treated with MCM + VB exhibited osseous bridging, an improved biomechanical stiffness, an increased bone volume within the callus including ongoing mineralization, increased vascularization, and a histologically larger total periosteal callus area consisting predominantly of osseous tissue when compared to defects of the other groups. Western blot analyses on day 14 revealed a higher expression of osteoprotegerin (OPG) and vice versa reduced expression of receptor activator of NF-κB ligand (RANKL) in bone defects treated with MCM + VB. On day 70, these defects exhibited an increased expression of erythropoietin (EPO), EPO-receptor and BMP-4. These findings indicate that the use of MCM for spatiotemporal controlled delivery of VEGF and BMP-2 shows great potential to improve bone healing in atrophic non-unions by promoting angiogenesis and osteogenesis as well as reducing early osteoclast activity.

Controlling the Grain Size of Dion-Jacobson-Phase Two-Dimensional Layered Perovskite for Memory Application

Organic-inorganic halide perovskites (OIHPs) have emerged as an active layer for resistive switching memory (RSM). Among various OIHPs, two-dimensional OIHPs are advantageous in RSMs because of their stability. This stability can be further improved using two-dimensional Dion-Jacobson OIHPs. Moreover, OIHP-based RSMs operated by the formation of halide-ion filaments are affected by grain boundaries because they can act as a shortcut for ion migration. Therefore, it is essential to control the grains in OIHPs for reliable memory operation. Here, we present RSMs using Dion-Jacobson OIHP with controlled grain sizes. The grain sizes of the OIHP are effectively controlled by adjusting the ratio of the N,N-dimethylformamide and dimethyl sulfoxide. The controlled grain sizes can modulate the paths for halide ion migration, which enables the change of the on/off ratio in RSM. In addition, cross-point array structure is essential for high-density memory applications. However, in the cross-point array structure, unwanted current flow through unselected memory cells can happen due to sneak-current paths, so it is necessary to suppress leakage current from neighboring cells by adopting selector devices. We demonstrate the application of selector devices to OIHP-based RSMs to prevent sneak current paths. These results provide the potential of OIHP for use in high-density memory applications.