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Inorganic sodium solid-state electrolytes: progress, existing issues, and solutions towards high-performance all solid-state batteries
No full textNa-ion batteries (NIBs) have gained attention as a cost-effective option for large-scale energy storage, offering electrochemical properties similar to lithium-ion batteries (LIBs). To improve safety and energy density, solid-state electrolytes (SSEs) are being incorporated into NIBs, paving the way for high-performance all-solid-state sodium-ion batteries (ASSNIBs). This review summarises recent progress in Na-based SSEs, categorised into oxides, sulfides, and halides, with particular emphasis on their crystal structures, ion conduction mechanisms, and electrochemical performance. We then critically examine the key challenges facing ASSNIBs, including low ionic conductivity, unstable electrode/electrolyte interfaces, and the reliance on rare or costly materials. To gain deeper insights into these issues, we highlight advanced characterisation and modelling techniques, including cryogenic electron microscopy, in-situ/operando characterisation, and machine learning approaches—all of which contribute to understanding Na-ion transport mechanisms and interfacial dynamics more comprehensively, and comparing with conventional electrochemical tests, structural characterisation and modelling methods. Building on these insights, we explore promising strategies such as microstructural design, mixed-ion approaches, and interface engineering to overcome the current limitations in Na SSEs. Finally, we offer perspectives on future research directions to support the rational design and optimisation of Na SSEs, ultimately advancing the development of next-generation ASSNIBs. The advanced characterisation and machine learning methodologies emphasised herein will also prove valuable for broader applications in electrochemical energy storage systems
Developing and validating the CE-MACE model to predict one-year major adverse cardiovascular events post COPD exacerbation using routine healthcare data
No full textBackground
Patients with chronic obstructive pulmonary disease (COPD) are at an elevated risk of cardiovascular events, particularly following acute exacerbations. Existing prediction models underestimate their risk. We developed and validated the CE-MACE model to predict one-year major adverse cardiovascular event (MACE) risk following a COPD exacerbation.
Methods
Using electronic health records from the UK Clinical Practice Research Datalink (CPRD) Aurum database, we included patients aged ≥40-years-old with moderate or severe COPD exacerbations. The outcome was fatal or non-fatal MACE (acute coronary syndrome, arrhythmia, heart failure, or ischemic stroke). Cause-specific hazard models were used to estimate the coefficient of predictors. Model performance was assessed by Nagelkerke’s R², Harrell’s C statistic, calibration-in-the-large, calibration slope, and decision curve analysis. Internal-external cross validation was used to evaluate model performance across nine geographic regions. A risk score was derived from the original coefficients.
Results
A total of 338,981 patients were included. The overall one-year cumulative incidence rate of MACE following COPD exacerbation was 5.04% (4.96–5.12%). Six predictors were retained: age, exacerbation severity, MACE history, mMRC dyspnoea scale, hypertension, and diabetes. In internal-external cross validation, the pooled estimation for Nagelkerke’s R² was 3.120% (2.945–3.295%), Harrell’s C statistic was 0.752 (0.746–0.759). Calibration-in-the-large was -0.006 (-0.008–-0.004) and calibration slope equal to 0.999 (0.977–1.020). The model suggested clinical utility with higher net benefit than default strategies across the risk thresholds range from 2% to 18%. Model- driven risk stratification demonstrated significantly different cumulative incidence rates among these risk categories. Sensitivity analysis revealed that the CE-MACE model is generalisable to those patients with any history of COPD exacerbation.
Conclusion
The CE-MACE highlights the burden of cardiovascular multimorbidity in patients with COPD. The model could help precisely identify those at high risk in clinical practice and promote integrated multidisciplinary healthcare for these patients
Spatial and temporal risk mapping of human and porcine Taenia solium infections in Malawi: a systematic review and geostatistical approach
No full textBackground
Taenia solium, colloquially called the pork tapeworm, is a zoonotic parasite with a human definitive host and a porcine intermediate host. Humans can become an aberrant intermediate host due to accidental ingestion of parasite eggs from the environment or through autoinfection, resulting in human cysticercosis (HCC), neurocysticercosis (NCC) if the central nervous system is infected. Pigs become infected with the larval stage, porcine cysticercosis (PCC), through the ingestion of parasite eggs shed by humans through defecation. Malawi has been classified as endemic for T. solium by the WHO based on the presence of key risk factors; however, the subnational distribution is not known. To ensure the appropriate resources are mobilized to support targeted future T. solium control measures in Malawi, there is a need to understand the variation in T. solium endemicity status across the country.
Methods
The current study uses a systematic literature review (SLR) using a pre-registered protocol; (PROSPERO CRD42023411044) to collate all available evidence on T. solium in Malawi. A geospatial risk mapping approach was conducted based on data from Malawi demographic
health surveys (MDHS), and pig density data from the Food and Agriculture Organization (FAO) database to create geospatial risk maps of endemic subnational areas for 2000, 2004, 2010, and 2016. To create a single composite risk factor map for the four years from the MDHS, each parameter was plotted as a binary variable with the high or low risk categories and overlaid into a single composite risk factor classification. Additional data from hospital records on NCC and meat inspection records across several Agricultural Development Divisions (ADDs) were also collected
Enhancing anti-CTLA-4 antibody delivery to the brain using focused ultrasound and microbubbles
No full textIntroduction
Gliomas, particularly glioblastomas, are characterised by their poor prognosis and low patient survival rate. Cytotoxic T lymphocyte-associated antigen-4 antibodies, a type of immune checkpoint inhibitors, have shown promise as an effective treatment strategy against the most aggressive tumour cells within the microenvironment of gliomas. However, their delivery to the brain is hindered by the impermeable blood-brain barrier, which is leaky in a heterogenous way, leading to uneven drug distribution across the tumours. Focused ultrasound, combined with intravenously administered microbubbles, is a technique that can non-invasively, safely, and reversibly increase the permeability of the blood-brain barrier in a targeted area, promoting the delivery of therapeutics, such as immune checkpoint inhibitors, to inaccessible tumour areas, to prevent tumour relapse.
Methods
We applied two different types of focused ultrasound sequences (long pulses vs rapid short-pulses) with microbubbles to the left hippocampus of wild-type female C57BL/6 mice before administering a fluorescently labelled cytotoxic T lymphocyte-associated antigen-4 antibody.
Results
We determined that the targeted brain region had a significant (p < 0.0001) increase in antibody delivery following ultrasound treatment with both pulse sequences. A more uniform delivery was achieved when treating with rapid short-pulse sequences, where bursts of short 5 µs pulses of focused ultrasound were emitted at a fast repetition frequency (1.25 kHz). We observed a significant increase in anti-tumour immune cells in long-pulse treated brains.
Conclusion
These results provide a proof-of-principle for how focused ultrasound with microbubbles can promote homogenous anti-tumour drug delivery and modulate the immune microenvironment
Lung capacity is a determinant of cardiovascular disease and myocardial infarction
No full textIntroduction: There is growing evidence suggesting that lung capacity is associated with risk of cardiometabolic disease. However, most studies rely on spirometric measures of lung capacity and self-reported cardiometabolic disease. We aimed to investigate the association of total lung capacity (TLC) with cardiometabolic disease defined using ICD-10 codes.
Methods: Data from adult patients referred to Cambridge University Hospitals between 2016 and 2024 were used if spirometry, single breath gas transfer, and body plethysmography were performed in the same session. GLI reference equations were used to generate z-scores for lung function measures. ICD-10 codes for cardiovascular disease, hypertension, and diabetes were extracted from medical records. We used multi-level (mixed-effects) Cox regression analysis to investigate the association between lung function measurements and incident cardiometabolic disease.
Results: 5628 patients were included, 51% were female, with a median age of 62 (IQR 50-70) years. 60% reported a smoking history. Mean follow-up time was 5.7 (SD 2.3) years, during which time 5% received a cardiovascular disease code, 7% a hypertension code, and 3% a diabetes code. A 1-unit increment in TLC z-score was associated with a 12% lower risk of cardiovascular disease (HR: 0.88, 95%CI 0.80-0.97) later in life. The same was seen for FVC (HR: 0.88, 95%CI 0.77-0.99) but not FEV1/FVC or DLCO. A larger TLC was also associated with lower risk of myocardial infarction. We found no association of lung function measures with incident hypertension or diabetes.
Conclusion: Lung capacity is a determinant for cardiovascular disease and myocardial infarction, with larger lungs being protective. TLC and FVC should be considered by clinicians along with other factors, when evaluating a person’s risk of cardiovascular disease
Equity, accessibility, and public health implications of digital platforms delivering real-time air quality information: a systematic technology review
No full textAir pollution is the leading contributor to global disease burden, accounting for over 8 million deaths in 2024 (Landrigan, 2017; Health Effects Institute, 2024). The increasing availability of internet connected technologies (ICTs), including mobile phones, sensors and computers promises to expand the reach of health protective information at orders of magnitude greater than has yet to be observed (Klasnja and Pratt, 2012; Sun et al, 2024). Mounting evidence from digital health studies, including those implementing randomised control trials (RCTs), demonstrates that the delivery of information about air quality conditions, or ‘AQ information’, coupled with practical behavioural advice can lower exposures and improve health outcomes at the population level, with examples ranging from reduced asthma attacks to less emergency room visits associated with adverse respiratory and cardiovascular incidents (Neidell and Kinney, 2012; Janke, 2014, Rappold et al, 2014, D’Antoni et al, 2017)
Modelling UK air quality implications of decarbonisation using hydrogen
No full textMany air pollutants are directly or indirectly caused by energy production and consumption. There is concern that decarbonising economies by replacing fossil fuel with hydrogen combustion could lead to higher pollutant emissions than by an electrification strategy. This study examines the implications of adopting hydrogen. Future UK energy scenarios, with varying levels of hydrogen, have been produced using the UK TIMES energy systems model, and a link established to the air pollution model UKIAM (UK Integrated Assessment Model). Using this interface, air pollutant emissions from the energy sector have been derived and superimposed on non-energy contributions to map concentrations and estimate the resulting exposure to PM2.5 and NO2 pollution in the UK and associated health benefits. All net zero scenarios achieve a substantial improvement in air quality, with a maximum of 0.3 μg m−3 contribution to PM2.5 population-weighted mean concentrations from hydrogen production and use. This depends on the hydrogen technologies used: as a worst case, hydrogen could eliminate 50% of the economic benefits resulting from improved air quality under net zero measures.
This disbenefit arises despite emission factors for hydrogen production and use meeting potential regulatory limits for NOx. However technological improvements could possibly reduce emissions very substantially. Attention should turn to understand where hydrogen is used to displace other future or existing energy sources. Other sources of PM2.5 emissions could be potentially more important for influencing PM2.5 concentrations, such as road transport non-exhaust emissions and biomass combustion and should be considered carefully in future energy scenarios
On the stability of CMOS ICs with plasma-enhanced silicone encapsulation for active implantable neurotechnology: 4.3 years of accelerated life testing
No full textThe long-term stability of polymer-encapsulated CMOS integrated circuits (ICs) is essential for mm-size active implantable medical devices (AIMDs), where hermetic packaging is impractical. Validating robust, biocompatible, implantable IC encapsulation is a prerequisite for chip-scale polymeric bioelectronic implants. This study presents the first long-term validation of a design strategy combining medical-grade silicone, plasma surface treatment for adhesion, and foundry-manufactured CMOS ICs. These ICs feature a perforated shield layer (top metal layer) and a double-layer wall-of-vias to reduce moisture ingress and mechanical delamination. Test structures with silicon oxide/nitride passivation were encapsulated using implant-compatible processes and immersed in saline under accelerated ageing conditions (47 °C, 67 °C, and 87 °C) for up to 4.3 years, under DC and biphasic biases.
Throughout the study, electrochemical impedance spectroscopy (EIS) showed no insulation failures. Minor visual corrosion was confined to wire bonds and solder pads, with no correlation to electrical degradation. These results demonstrate the robustness to biofluid exposure of modern IC passivation when combined with well-adhered silicone encapsulation. To our knowledge, this is the longest and most comprehensive accelerated ageing study of its kind, and the first to establish a scalable, industry-compatible encapsulation method for implanted ICs. Our findings provide critical evidence supporting the integration of CMOS ICs into next-generation bioelectronic implants
Childbirth experience and its relationship with postpartum depression and anxiety: a cross-sectional study from Gaza
No full textGuts, grit and God? Spiritual capital and entrepreneurial resilience in a turbulent environment
No full textopen access articleEntrepreneurs operating in turbulent environments face significant uncertainty, resource constraints, and institutional instability, requiring innovative coping mechanisms. While resilience research has traditionally focused on tangible and network-based resources, the role of spiritual capital as a critical, yet largely unexplored, resource for entrepreneurial action remains insufficiently understood. This study addresses this gap by investigating how spiritual capital functions as a distinct yet complementary intangible resource alongside social capital in shaping entrepreneurial resilience. Using a cross-sectional survey of 622 entrepreneurs in Lagos, Nigeria, a setting marked by economic and political volatility, the study employs Structural Equation Modelling (SEM) to assess the direct and mediating effects of spiritual capital on resilience. The findings indicate that spiritual capital significantly enhances entrepreneurial resilience, particularly in fostering psychological stability, perseverance, and adaptive capacity. Moreover, the study reveals that while bonding social capital strengthens resilience through emotional and resource-based support, its effect is mediated by spiritual capital, which provides deeper existential motivation. Bridging social capital also plays a role but is less significant when spiritual capital is present, suggesting that in environments where external networks are weak or inaccessible, spiritual capital acts as a stabilising force. The study contributes to the resource-based view (RBV) by demonstrating that resilience is shaped not only by firm-level resources but also by deeply embedded, internally cultivated assets. Practically, the findings highlight the importance of integrating spirituality and psychological resilience mechanisms into entrepreneurship support programs, particularly in volatile institutional contexts