Search Results (542)

Phase-change memory (PCM) is a promising candidate for in-memory computation and neuromorphic computing due to its high endurance, low cycle-to-cycle variability, and low read noise. However, among other factors, its performance strongly depends on the post-lithography fabrication steps. This study examines the impact of reactive ion etching (RIE) on PCM device performance by evaluating different etching gas mixtures, CHF${}_3$:O${}_2$, H${}_2$:Ar, and Ar, and determining their impact on key device characteristics, particularly initial resistance and cycling stability. The present study demonstrates that a two-step etching approach in which the capping layer is first removed using H${}_2$:Ar and the underlying GST layer is subsequently etched using physical Ar sputtering ensures stable and reliable PCM operation. In contrast, chemically reactive gases negatively impact the initial resistance, cycling stability, and device lifetime, likely due to alterations in the material composition. For the cycling stability evaluation, an advanced measurement algorithm utilizing the aixMATRIX setup by aixACCT Systems is employed. This algorithm enables automated testing, dynamically adjusting biasing parameters based on cell responses, ensuring a stable ON/OFF ratio and high-throughput characterization. Full article

Polyethylene terephthalate (PET) films were modified by direct fluorination using fluorine gas at room temperature and 660 torr for reaction times ranging from 10 min to 5 h. Some of the fluorinated samples were dried at 70 °C for 7 days. FT-IR and XPS analyses confirmed the successful incorporation of fluorine into the PET structure, with the formation of -CHF- and -CF₂- groups. The degree of fluorination increased with the reaction time, but excessive reaction led to the formation and loss of CF₄. Drying further decreased the fluorine content due to the continued CF₄ formation. XRD revealed that fluorination increased the crystallinity of PET owing to increased polarity, whereas drying decreased the crystallinity owing to increased crosslinking. The DSC results showed an increase in the glass transition temperature (T_g) after fluorination and drying, which was attributed to increased polarity and crosslinking, respectively. The surface hydrophilicity of PET increased significantly with fluorination time, and the water contact angle decreased to as low as 3.35°. This was due to the introduction of polar fluorine atoms and the development of a rough and porous surface morphology, as observed by AFM. Interestingly, drying of the fluorinated samples led to an increase in the water contact angle, with a maximum of 85.95°, owing to increased crosslinking and particle formation on the surface. This study demonstrates a simple and effective method for controlling the hydrophilicity and hydrophobicity of PET surfaces via direct fluorination and drying. Full article

Electromagnetic Railguns Face Severe Ablation and Melting Risks Due to Extremely High Transient Thermal Loads During High-Speed Launching, Directly Impacting Launch Reliability and Service Life. To address this thermal management challenge, this study proposes and validates the effectiveness of spray cooling technology. Leveraging its high heat transfer coefficient, exceptional critical heat flux (CHF) carrying capacity, and strong transient cooling characteristics, it is particularly suitable for the unsteady thermal control during the initial launch phase. An experimental platform was established, and a three-dimensional numerical model was developed to systematically analyze the dynamic influence mechanisms of nozzle inlet pressure, flow rate, spray angle, and spray distance on cooling performance. Experimental results indicate that the system achieves maximum critical heat flux (CHF) and rail temperature drop at an inlet pressure of 0.5 MPa and a spray angle of 0°. Numerical simulations further reveal that a 45° spray cone angle simultaneously achieves the maximum temperature drop and optimal wall temperature uniformity. Key parameter sensitivity analysis demonstrates that while increasing spray distance leads to larger droplet diameters, the minimal droplet velocity decay combined with a significant increase in overall momentum markedly enhances convective heat transfer efficiency. Concurrently, increasing spray distance effectively improves rail surface temperature uniformity by optimizing the spatial distribution of droplet size and velocity. Full article

Chronic obstructive pulmonary disease (COPD) and chronic heart failure (CHF) are pathologies that impact mortality and morbidity worldwide. These chronic diseases have multiple causes, and they share some common clinical symptoms, such as diaphragm dysfunction (DD) and cognitive decline (CD), which, in turn, increase the mortality and morbidity rates in patients with COPD and CHF. One of the causes of CD is impaired glymphatic system function, with an accumulation of proteins and metabolites in the central nervous system. The glymphatic system is a structure that has not yet been widely considered by researchers and clinicians. Three key factors stimulate the ongoing physiological function of the glymphatic system: autonomic balance, heart rate, and, most importantly, the diaphragm. All these factors are altered in patients with COPD and CHF. This article reviews the relationship between the importance of the diaphragm, the glymphatic system, and CD, focusing on inspiratory rehabilitation training (IMT). Based on the data reported in this narrative review, we can strongly speculate that a consistent regimen of IMT in patients can improve cognitive status, reducing the cascade of symptoms that follow the diagnosis of CD. Further research is needed to understand whether targeting the glymphatic system with IMT is an effective option for helping patients delay the onset of CD. Full article

(1) Chronic heart failure (CHF) is a typical component of the polymorbid profile of an elderly patient. The aim of this systematic review was to search for data from pharmacokinetic (PK) studies of any drugs in patients with CHF to systematize information on changes in PK parameters depending on the physicochemical properties (PCPs) of the drug and route of its administration. (2) A systematic review of PK studies in patients with CHF was performed using Elibrary.ru, United States National Library of Medicine (PubMed), China National Knowledge Infrastructure (CNKI), and Directory of Open Access Journals (DOAJ). The final number of included articles was 106. A descriptive and correlation analysis of PK data and PCPs of drugs included in the study was carried out. Inclusion criteria: PK study, available PK parameters, demographic data, and diagnosed CHF. Risk of bias was assessed using ROBINS-I. (3) Evaluation of correlations between PCPs of drugs and their PK revealed a link between (i) plasma protein binding (PPB) and volume of distribution for lipophilic drugs; (ii) PCPs, half-life, and clearance for drugs with high PPB; and (iii) PPB and clearance for hydrophilic and amphiphilic drugs. (4) Hypoalbuminemia associated with CHF may lead to an increased volume of distribution of lipophilic drugs; lipophilic drugs used in CHF patients may be associated with prolongation of the half-life period and reduction in clearance; highly protein-bound drugs may manifest with reduced clearance. PK characteristics identified in this review should guide modifications to dosing regimens in CHF patients receiving medications from different groups. Full article

Objective: This study aimed to evaluate the association between the triglyceride–glucose index (TGI) and the risk of cardiovascular disease in patients with type 2 diabetes mellitus. Methods: This study included 1348 type 2 diabetic patients who attended the endocrinology clinic at Jordan University Hospital between March 2023 and September 2023. Medical records were reviewed to identify patients with documented cardiovascular disease, and the triglyceride–glucose index (TGI) was calculated for each patient. Results: Our results showed that the TGI was higher among patients who developed any major adverse cardiovascular event (MACE), coronary artery disease (CAD), congestive heart failure (CHF), and/or myocardial infarction (MI) compared to those who did not (p < 0.001 for all comparisons). Significantly higher TGI values in males were associated with higher odds of a MACE, stroke, and CHF; higher TGI values in females were associated with higher odds of a MACE, CAD, and MI. Higher TGI values in patients younger than 60 were associated with higher odds of a MACE, CAD, CHF, and MI, while in patients older than 60, higher TGI values were associated with higher odds of CAD and MI. The TGI value that was the most predictive of a MACE in our population was >9.36, >9.39 for CAD, and >9.40 and >9.39 for CHF and MI, respectively. Conclusion: The TGI was shown to be associated with a significantly higher risk of a MACE, CAD, CHF, and MI in the whole population, along with stroke in males only. The TGI was more strongly associated with MACEs in patients younger than 60 years compared to older patients. In conclusion, the TGI was associated with cardiovascular outcomes in this diabetic cohort; however, its discriminative ability was modest (AUC 0.55–0.64). This indicates that the TGI alone is insufficient as a predictive tool and should be interpreted alongside established risk factors. Prospective studies are needed to clarify its incremental value in risk prediction. Full article

Background/Objectives: Malnutrition is common among patients with advanced chronic illnesses receiving palliative care, yet comparative data between diagnostic groups are limited. This study aimed to evaluate and compare the nutritional status of patients with end-stage chronic heart failure (CHF) and chronic respiratory disease (CRD), and to assess the clinical utility of the Controlling Nutritional Status (CONUT) score in this setting. Methods: We conducted a retrospective analysis of 80 patients (41 with CHF, 39 with CRD) enrolled in a palliative care program (mean age 77.8 ± 6.8 years, 65% male). Nutritional status was assessed using BMI (Body Mass Index), CONUT score, and routine biochemical markers. Functional and clinical variables, including the Palliative Performance Scale (PPS), were also collected. Results: Moderate-to-severe malnutrition (CONUT ≥ 5) was significantly more prevalent in patients with CHF patients (44%) than CRD patients (10%, p = 0.002). CHF patients exhibited lower BMI, cholesterol, lymphocyte counts, and prealbumin levels. Despite more frequent nutritional follow-up and protein supplementation in the CHF group, these interventions were not associated with improved nutritional classification. The CONUT score correlated more strongly with functional impairment (PPS) than with disease type alone. Conclusions: Patients with CHF receiving palliative care demonstrate higher rates of malnutrition than those with CRD. The CONUT score, derived from standard blood test, may be pragmatic screening tool for identifying nutritional vulnerability and guiding interventions. While it does not predict survival, it may help detect functional decline earlier and support care strategies aimed at maintaining quality of life in end-stage disease. Full article

Background: Patients with symptomatic abdominal tissue excess following massive weight loss (MWL) often experience skin affections associated with hygiene challenges, functional impairments, and psychological distress, all of which significantly impact their quality of life (QoL). Abdominoplasty effectively addresses these issues when conservative treatments prove ineffective. However, health insurance companies (HICs) in Switzerland frequently deny reimbursement. This study aimed to evaluate HIC’s reimbursement policies for abdominoplasty, quantifying time delays and additional costs generated by reconsideration due to initial rejections while assessing postoperative QoL of patients. Methods: A retrospective cohort study was conducted including patients undergoing abdominoplasty for symptomatic abdominal tissue excess after MWL between July 2019 and December 2023. Eligibility required HIC approval, informed consent, and legal age. Primary outcomes measured the number of reimbursement requests needed per patient, duration until approval, and additional diagnostic and therapeutic interventions following rejection. Secondary outcomes focused on additional consequent costs, differences in baseline characteristics and symptomatology, as well as QoL improvements using a non-validated, study-specific questionnaire. Results: Of 52 patients included, 33 received cost approval after a single request, whereas 19 required multiple submissions. The mean duration until approval was 15 weeks, with a 26-week delay for the multiple-request group, generating additional costs of CHF 715 per patient. Moreover, abdominoplasty significantly improved QoL in all patients, with no differences between groups. Conclusions: Initial reimbursement denials caused treatment delays, prolonged symptomatology, and increased healthcare costs, despite clear surgical indications. However, future studies involving larger cohorts are needed to support these findings. Full article

Background: Effective volume management can significantly improve patients’ health outcomes, but the current situation of volume management in older patients with chronic heart failure (CHF) and multimorbidity is not optimistic. This study aimed to explore the facilitators and barriers of self-volume management in patients and to provide a basis for the development of self-volume management strategies. Methods: A descriptive qualitative research method was used. Semi-structured interviews were conducted with older patients with CHF and multimorbidity between January and April 2025 in two tertiary hospitals in Shanghai, China. Data were analyzed using content analysis. Results: Eight facilitators emerged, including the hospital–community collaboration mechanism, Medicare and long-term care insurance coverage, diverse social support, the doctor–patient trust relationship, results-oriented incentives, digital health management, high self-efficacy, and strong motivation for health. Nine barriers were identified; these were insufficient adaptability of self-volume management programs, limited access to community resources, lack of standardized self-volume management tools, inadequate multidisciplinary team communication, one-way doctor–patient communication, lack of knowledge of self-volume management, physical limitations, management negligence caused by work constraints, and behavioral habits’ consolidation. Conclusions: Self-volume management was affected by various factors. The study suggests strengthening health insurance coverage to reduce financial burden, taking advantage of family support and providing digital health management tools. In addition, healthcare providers should provide patient-centered care, enhance multidisciplinary collaboration, and address individual barriers with precise intervention strategies. Full article

Reliable prognostic indicators for congestive heart failure (CHF) secondary to myxomatous mitral valve disease (MMVD) in dogs are limited. The hemoglobin, albumin, lymphocyte, and platelet (HALP) score, a prognostic marker in humans, has not been evaluated in veterinary medicine. This study aimed to assess the HALP score’s utility for predicting short-term mortality in dogs with CHF due to MMVD. This retrospective study included 54 small-breed dogs. The HALP score was calculated as: hemoglobin (g/L) × albumin (g/L) × lymphocytes (/L)/platelets (/L). Six-, nine-month, and one-year mortality were assessed. The HALP score was significantly higher in survivor groups. Receiver operating characteristic (ROC) analysis showed good predictive accuracy for six- and nine-month mortality (area under the curve > 0.7). A cut-off of 11.13 for six-month mortality yielded 44.44% sensitivity and 94.44% specificity. Kaplan–Meier analysis confirmed that a higher HALP score was associated with significantly longer survival. The HALP score appears to be a valuable, novel prognostic indicator for short-term mortality in dogs with CHF due to MMVD. Full article

(1) Background. Although treatment with enhanced external counterpulsation (EECP) in patients with ischemic chronic heart failure (CHF) is pathophysiologically justified, its long-term vascular effects remain insufficiently defined. We aimed to study the vascular effects of long-term complex treatment (36 months) including EECP in patients with ischemic CHF, and to examine the relationship between these effects and clinical outcomes. (2) Methods. A total amount of 120 patients with ischemic CHF were randomized to receive one course of EECP per year (35 h; Group 1), two courses of EECP per year (70 h; Group 2), or one course of placebo-counterpulsation per year (35 h; Group 0;). For a period of 36 months, all patients underwent annual assessments including transthoracic echocardiography, nailfold videocapillaroscopy, finger photoplethysmography, applanation tonometry, exercise tolerance testing, and clinical outcome monitoring. (3) Results. Compared to the placebo group, long-term EECP treatment in patients with ischemic CHF, was accompanied by a significantly greater increase in exercise tolerance (∆23.5–45.0% vs. 7.0%; p < 0.001) and improvements in left ventricular ejection fraction (∆9.9–19.6% vs. 5.6%; p < 0.001) and myocardial stress (decrease in NT-proBNP level ∆−80.4–−82.4% vs. −75.8%; p < 0.001), as well as both functional and structural vascular parameters (p < 0.001). The effect size depended on the annual number of EECP courses. The highest event-free survival was found in Group 2. At 36 months, improvement of vascular parameters emerged as stronger predictors of reduced cardiovascular event risk compared to the 12-month. (4) Conclusions. Long-term EECP treatment of patients with ischemic CHF improves both functional and structural vascular parameters, with an increasing role of their improvement in reducing the risk of cardiovascular events after 36 months. Full article

The critical heat flux (CHF) of minichannel heat sinks is crucial, as it helps prevent thermal safety incidents and equipment failure. However, the underlying mechanisms of CHF in minichannels remain poorly understood, and existing CHF prediction models require further refinement. This study systematically investigates the characteristics and influencing factors of critical heat flux (CHF) in rectangular minichannels through combined experimental and theoretical approaches. Experiments were conducted using microchannels with hydraulic diameters ranging from 0.5 to 2.0 mm, with ethanol employed as the working fluid. Key parameters-including mass flux, channel geometry, system pressure, and inlet subcooling-were analyzed to assess their influence on CHF. Results indicate that CHF increases with mass flux; however, the increase rate diminishes under higher mass flux. Larger channel dimensions significantly enhance CHF by delaying liquid film dryout. System pressure further improves CHF by reducing bubble detachment frequency and promoting flow stability. Increased inlet subcooling enhances CHF by delaying the onset of nucleate boiling and improving convective heat transfer. Four classical CHF prediction models were evaluated, revealing significant overprediction-up to 148.69% mean absolute error (MAE)-particularly for channels with hydraulic diameters below 1.0 mm. An ANN deep learning model was developed, achieving a reduced MAE of 8.93%, with 93% of predictions falling within ±15% error. This study offers valuable insights and a robust predictive model for optimizing microchannel heat sink performance in high heat flux applications. Full article

Background and Objectives: The optimal effluent dose of continuous haemofiltration (CHF) when coupled to veno-venous extracorporeal membrane oxygenation (ECMO) for septic shock is unknown. We examined our 44-patient ECMO registry, contrasting a smaller high-dose subgroup (HDHF ≥ 45 mL kg⁻¹ h⁻¹; n = 13) with a larger standard-dose subgroup (SDHF 25–35 mL kg⁻¹ h⁻¹; n = 31). The primary endpoint was 72 h change in SOFA score (ΔSOFA). Materials and Methods: All adults cannulated for ECMO (January 2018–January 2025) and started on CHF within 2 h were eligible. Variables were abstracted at baseline, 24 h and 72 h. Continuous data were analysed by Student’s t or Mann–Whitney tests, categorical data by χ²/Fisher; and paired changes by Wilcoxon. Two-sided p < 0.05 signified significance. Results: Baseline characteristics were comparable (age 49.1 ± 15.2 vs. 50.4 ± 14.9 y; APACHE II 28.4 ± 5.3 vs. 27.5 ± 5.9). Median effluent reached 48.1 mL kg⁻¹ h⁻¹ (IQR 46.6–49.7) in HDHF and 29.7 mL kg⁻¹ h⁻¹ (27.5–31.9) in SDHF (p < 0.001). IL-6 fell by 1 061 ± 487 pg mL⁻¹ with HDHF versus 637 ± 425 pg mL⁻¹ with SDHF (p = 0.003). Mean arterial pressure rose 19.2 ± 8.1 vs. 12.7 ± 8.3 mmHg (p = 0.03), and norepinephrine declined 0.46 ± 0.22 vs. 0.30 ± 0.19 µg kg⁻¹ min⁻¹ (p = 0.04). ΔSOFA at 72 h was –4.4 ± 2.1 with HDHF and –2.6 ± 2.3 with SDHF (p = 0.01). Twenty-eight-day mortality was 38.5% (5/13) versus 45.2% (14/31), p = 0.64. Effluent dose correlated with ΔIL-6 (ρ = 0.53, p < 0.001) and ΔSOFA (ρ = 0.45, p = 0.003). Conclusions: In this ECMO cohort, high-dose haemofiltration, although applied in only 13 patients, appeared to achieve greater cytokine clearance, faster haemodynamic recovery and deeper early organ-failure improvement than standard dosing, without excess bleeding. Survival advantage was not demonstrable, underscoring the need for prospective randomised confirmation of the dose–response signal. Full article

Improving the pool boiling heat transfer by changing the properties of the heating surface has been experimentally studied by many researchers. In this paper, two novel microstructured surfaces with open channels were simulated and investigated. The two microstructured surfaces had different cavity positions and different groove widths of open channels. At the same time, a pool boiling experiment on the plain-heated surface was carried out to verify the reliability and accuracy of the CFD model. The results showed the relationship between the heat flux and wall superheat. Moreover, the bubble dynamic behaviors of different surfaces were obtained. It was found that both microstructured surfaces could enhance the pool boiling heat transfer coefficient (HTC) and critical heat flux (CHF). Enlarging the length of the groove gap can not only increase the heat transfer area, but also increase the bubble nucleation rate. However, constantly increasing the groove width will cause the horizontal coalescence of bubbles on the heating surface at low heat flux. When the negative effect of bubble coalescence is higher than the enhancement effect, the boiling heat transfer capacity of the heating surface will decrease unless the heat flux is high enough to delay bubble coalescence. Full article

This study investigates the dynamic impact of population aging on consumption preferences in China, a critical area given consumption’s role in global economic growth and the country’s accelerating demographic shifts. Utilizing pooled panel data from the 2015, 2017, and 2019 China Household Finance Survey (CHFS) and employing the Target Group Index (TGI) to quantify preferences, we construct a micro-econometric model incorporating quadratic age terms and various control variables. Our findings reveal a robust U-shaped relationship between age and consumption preferences for both subsistence and developmental consumption, indicating a decline in preference during middle age followed by a resurgence in later life. We further identify significant heterogeneity: gender moderates this relationship, with elderly women showing a greater preference for subsistence consumption and different inflection points for developmental consumption. Higher income intensifies the age-preference link for subsistence goods, while middle-aged individuals exhibit stronger developmental preferences. Moreover, an increased number of properties intensifies age’s impact on consumption preferences across both categories. Regional analyses also show diverse patterns, though all seven cultural regions consistently exhibit a U-shaped trend. Contrary to conventional views of low consumption among the elderly, our results suggest that population aging may positively influence overall consumption, offering crucial empirical insights for policy formulation in aging societies. Full article