Tech

Telemedicine Reduces Cancellations and No-Shows for Rheumatology Care During COVID in Large Ohio Health System

ATLANTA -- New research presented at ACR Convergence, the American College of Rheumatology's annual meeting, shows that expanded use of telemedicine during the COVID-19 pandemic improved cancellation rates, no-shows and completed medical visits for rheumatology ambulatory clinics in one large Ohio health system (ABSTRACT #1584).

Telemedicine is the practice of medicine at a physical distance using various forms of communication technology. While the doctor, nurse or other healthcare professional works at one site, the patient receives care at another site. Telemedicine may be practiced using webcams, smartphones, secure video messaging platforms or other technology. All modalities used are HIPPA compliant.

When COVID-19 surged worldwide in early 2020, many rheumatology clinics and practices cut back on their in-patient care services to reduce the risk of infection spread among their vulnerable patients, many of whom take immune-suppressing drugs that put them at higher risk for serious infections. Some patients remain wary of going into the clinic for routine care due to COVID, and lack of transportation and other issues had been a nagging barrier to rheumatology care in the past.

Researchers wanted to know if telemedicine could bridge gaps in access to rheumatology care, allowing medical visits with physical distancing and eliminating the need for a time-consuming or costly trip to the clinic. In a new retrospective study, researchers at MetroHealth Medical Center in Cleveland, Ohio compared data on completed clinic visits, no-shows and cancellation rates between their in-person and telemedicine appointments for rheumatology clinics in 2020.

"In the setting of a novel infection with unclear infectious characteristics, patients and hospital systems across the country moved to postpone procedures and cancel face-to-face visits due to the potential risk," says the study's co-author, Reem Alkilany, MD, a rheumatology fellow at MetroHealth. "Many rheumatology patients are already at an increased risk for infection due to immunosuppressive medications and immune system dysfunction related to their diseases. While in-person visits may place patients at risk for contracting the virus, delaying care can increase the risk for disease flares and the potential need for hospitalization. Telemedicine offered a way for rheumatology patients and providers to connect with one another in place of delayed care or even absence of care."

The researchers pulled retrospective data from their electronic health record system for rheumatology outpatient appointments between Jan. 3 and May 31, 2020. Appointments were placed in three categories: canceled, no-show or completed. They divided all the data into two 10-week periods: a pre-COVID phase from Jan. 3 to March 15, and a COVID phase from March16 to May 31. During the pre-COVID phase, there were only in-person clinic visits, while in the COVID phase, the clinic offered telemedicine or in-person visits to their patients.

Telemedicine appointment cancellations were nearly zero in the COVID phase, or one out of 825 telemedicine appointments scheduled, compared to the pre-COVID phase, when 527 out of 1677 appointments, all in person, were cancelled. No-shows also trended downward when telemedicine became an option for care. In the COVID phase of the study, the clinics had 191 no-shows, including 121 in-person and 70 telemedicine. In the pre-COVID phase, when only in-person care was offered, there were 220 no-shows. During the COVID period, MetroHealth Medical Center also had slight increases in visit completions with telemedicine as an option for rheumatology care: 1,038 completed visits, including 754 telemedicine and 284 in-person visits out of 1675 scheduled visits, compared to only 930 completed visits out of 1677 scheduled, all in person, in the phase of the study before COVID.

Based on these findings, MetroHealth's Division of Rheumatology aims for 40% of future follow-up visits to be performed through telemedicine, says Dr. Alkilany. "We see that there are some rheumatology concerns that are more cognitive, or less reliant on procedural intervention or physical exam, that are suited for patient-provider visits via telemedicine, such as titrating gout medication to reach a particular uric acid level," she says. "Visits that require diagnostic or therapeutic procedures, such as joint injection or ultrasound, will always require in-person visits and a physical exam. Although in-person visits cannot always be replaced by phone or video visits, we believe that telemedicine's potential to increase the accessibility and convenience of healthcare makes it an essential component to the future of medicine."

ATLANTA -- A new study reveals that Black patients with rheumatoid arthritis (RA) were less likely to be prescribed a biologic treatment and more likely to use glucocorticoids, which carry a risk of serious long-term side effects. This study highlights ongoing racial disparities in the care of patients with rheumatic disease. Details of the study was shared at ACR Convergence, the ACR's annual meeting (RA is the most common type of autoimmune arthritis. It is caused when the immune system (the body's defense system) is not working properly. RA may cause pain and swelling in the joints as well as affect multiple organ systems such as the lung and eye. RA is treated with disease modifying anti rheumatic drugs, including biologics, to help stop joint pain and swelling, and also prevent joint damage. "

Racial disparities in access to care and effective treatment regimens are poorly understood in the RA population, but past research shows that non-white RA patients have a lower frequency of biologic use versus white patients, even when accounting for comparable disease activity and access to treatment. This new study looked at racial disparities in RA treatment and emergency department use in patients with RA at a single, tertiary academic center in Pennsylvania.

"With the explosion of effective therapies for rheumatoid arthritis, it is particularly important to make sure that we are treating patients in the best way possible," says the study's co-author, Michael George, MD, MSCE, Assistant Professor of Medicine at the Hospital of the University of Pennsylvania. "Variability in practice, and disparities in treatment, suggest that there is room for significant improvement. We hope that this study will add to the existing literature about disparities in rheumatoid arthritis care-understanding why they exist and finding ways to address them are key to improving the health of patients with RA."

The study used electronic health record data from 1,831 patients with RA from 2010 to 2018. Patients had at least two RA diagnoses from a rheumatology outpatient encounter and at least one prescription of a disease-modifying antirheumatic drug (DMARD) during the follow-up period, or from their first to their last clinic visit. The researchers also measured patient demographic information, medication use and comorbidities at the baseline visit and at any point during the follow-up period.

The researchers then compared the differences in patient characteristics and visits between Black and white patients. Of the 1,831 patients in the study, 82% were female, 35% were Black, 54% were white and the mean age was 55. The average follow-up period for all patients was 6.97 years. Black patients were more likely to be older, have a higher body-mass index (BMI), were former or current smokers and had higher rates of cardiovascular disease and diabetes.

The researchers found racial disparities in how RA was treated with prednisone and conventional synthetic DMARD treatments used significantly more often in Black patients than whites: 79.3% of Black patients used prednisone compared to 69.1% of whites, and 96.7% of Black patients used a conventional DMARD compared to 93.5% of whites.

Additionally, white patients in the study were significantly more likely to use a biologic, a more advanced, expensive, and effective treatment for controlling RA disease activity and preventing joint damage. According to the data, 74% of whites and 67% of Blacks were prescribed a biologic drug. Black patients also had significantly more visits to the hospital emergency department (ED) over the eight-year period.

"This project supports prior work showing reduced use of biologics and a greater use of prednisone in patients who were Black - which could potentially mean worse outcomes or increased steroid side effects in this group," says Dr. George. "A key next step that many are working on is understanding the key drivers of these disparities - understanding why they exist (e.g., access to medications, insurance, patient-provider communication, health beliefs, etc.) is important so we know how to address these disparities."

ATLANTA -- New research presented at ACR Convergence, the American College of Rheumatology's annual meeting, shows that an artificial intelligence-based analysis model, called an artificial neural network, enables accurate detection of definite radiographic sacroiliitis in people with axial spondyloarthritis, an advance that could be useful for both diagnosis in the clinic and classification of patients for inclusion in clinical trials (ABSTRACT #2018).

Axial spondyloarthritis (AxSpA) is a type of spondyloarthritis. This inflammatory form of arthritis usually attacks the spine and pelvis. The main symptom in most patients is low back pain. Many people with axial spondyloarthritis progress to having some degree of spinal fusion, known as ankylosing spondylitis. AxSpA affects both males and females, usually developing before age 30.

If doctors suspect AxSpA, they typically recommend conventional radiography, or X-rays, of the sacroiliac joints. Magnetic resonance imaging (MRI) is also used to assess patients with suspected AxSpA. Researchers select patients for enrollment in clinical trials using classification criteria for their disease. Patients are classified as having either radiographic or non-radiographic AxSpA based on definite signs of the disease on their imaging seen by readers. However, the reliability of radiographic sacroiliitis assessment is known to be poor. Expert readers - as opposed to evaluation by local rheumatologists or radiologists - usually produce more reliable results, but they are not available in many locations.

One proposed solution to this problem is determining if an artificial intelligence (AI)based model can be used to analyze radiographs for improved accuracy of these readings making them comparable to the top experts. This study set out to develop and validate an artificial neural network model that uses AI technology to detect definite radiographic sacroiliitis as a manifestation of AxSpA.

"Conventional X-ray of sacroiliac joints is still the first and sometimes the only available imaging procedure to diagnose AxSpA in many parts of the world," says study co-author Professor Denis Poddubnyy, Head of the Division of Rheumatology at Charité Universitätsmedizin Berlin in Germany. "Accurate assessment of radiographic sacroiliitis is relevant for making the correct diagnosis. In the presence of definite radiographic sacroiliitis in a patient with symptoms suggestive of spondyloarthritis, no other imaging procedures are normally needed, and treatment can be started right away. The presence or absence of radiographic sacroiliitis is also relevant for the inclusion in many clinical trials in spondyloarthritis. We see a big discrepancy between the local and central assessment of sacroiliitis reaching sometimes half of the cases."

For the study, the researchers used conventional radiographs of sacroiliac joints from two independent cohorts of patients with AxSpA, including 1,669 radiographs used to train and validate the neural network, and 100 radiographs used as a test dataset. All the radiographs went through reading by both humans and the artificial neural network. Readers used the modified New York criteria to determine either the presence or absence of definite radiographic sacroiliitis. The researchers then analyzed whether the human readers or artificial neural network agreed.

The artificial neural network achieved excellent performance in accurately recognizing definite radiographic sacroiliitis in these patients, with high ratings of sensitivity and specificity, the study's findings showed. This artificial intelligence-driven model could enable accurate detection of sacroiliitis, making it relevant for both diagnosis of patients in the clinic and classification of AxSpA when selecting patients for clinical trials.

"I do think that the developed might be helpful in both clinical practice (as a decision-supportive tool) and research (classification of the included patients)," says Dr. Poddubnyy. "However, this is only the first step. The next big challenge is to develop an artificial intelligence-based tool for the assessment of MRI of sacroiliac joints. This would be especially relevant for the diagnosis and differential diagnosis of AxSpA at the early stage."

Scientists have detected preexisting antibody-driven immunity against SARS-CoV-2 in a small proportion of individuals who were uninfected at the time of sampling. Sixteen out of 302 adults (5.3%) harbored IgG antibodies that were likely generated during previous seasonal "common cold" coronavirus infections, and which cross-reacted with subunit S2 of the SARS-CoV-2 spike protein complex. Notably, the presence of these cross-reactive IgG antibodies was much more prevalent in an additional cohort of SARS-CoV-2-uninfected children and adolescents (aged 1 to 16 years): at least 21 of these 48 subjects (43.8%) had detectable levels of SARS-CoV-2 S-reactive IgG antibodies. Together, these findings may help explain higher COVID-19 susceptibility in older people and provide insight into whether pre-established immunity to seasonal coronaviruses offers protection against SARS-CoV-2. Though previous studies suggest cross-reactive immunity is neither sterilizing nor long-lasting, the presence of cross-reactivity can reduce viral transmission and ameliorate symptoms and is, therefore, an important area of study. Using a technique based on flow cytometry, Kevin Ng and colleagues found that the SARS-CoV-2-reactive antibodies from uninfected individuals were predominantly of the IgG class--rather than IgM or IgA antibodies--that targeted the viral S2 protein, responsible for cell entry and thought to more similarly structured across different coronaviruses than subunit S1. (By comparison, individuals previously infected with SARS-CoV-2 retained higher numbers of IgA, IgG, and IgM antibodies, which could target both S1 and S2 subunits.) In cell culture experiments, sera from both older and younger uninfected individuals with cross-reactive antibodies showed the ability to neutralize SARS-CoV-2 and SARS-CoV-2 S pseudotypes, whereas sera from uninfected patients lacking cross-reactive antibodies exhibited no such neutralizing activity. Further exploring potential targets on S2 that are conserved across multiple coronaviruses may hold the promise of a universal coronavirus vaccine, the authors say.

Philadelphia, November 6, 2020 - Mindfulness training and engaging in classroom-based games can influence self-regulation and food liking when introduced during the preschool years according to a new study in the Journal of Nutrition Education and Behavior, published by Elsevier.

"For this study, we were interested in developing and evaluating a brief five-week intervention that incorporated best practices for supporting two important indicators for children's development: self-regulation and food liking, particularly liking fruits and vegetables," said Sara A. Schmitt, PhD, Department of Human Development and Family Studies, Purdue University, West Lafayette, IN, USA. "As part of the intervention we were focused on mindfulness activities and classroom-based games, and all the activities had embedded exposure to fruits and vegetables. We also included sensory learning techniques like tastings throughout many of the sessions."

After developing the intervention, researchers from Purdue University, Central Michigan University, and Yale University assessed 39 children from two Head Start centers serving children from low-income families. Children from one center received the intervention while children in a second center did not. All children were assessed on self-regulation skills and liking of fruits and vegetables pre- and postintervention.

"What we found was that children who participated in the intervention experienced significant gains in their behavioral regulation and in their liking of fruits and vegetables from pre- to postintervention. Children in the comparison group who did not receive the intervention did not achieve similar gains in those skills. What this tells us is that there is promise in this intervention in terms of improving our targeted outcomes," commented Dr. Schmitt.

The Internet of Things (IoT) allowing smart phones, home appliances, drones and self-driving vehicles to exchange digital information in real time requires a powerful security solution, as it can have a direct impact on user safety and assets. A solution for IoT security that has been is a physical unclonable function (PUF) that can supplement software-based key security vulnerable to various attack or physical attack.

Hardware-based PUF semiconductor chips, for example, each have a unique physical code, similar to the human iris and fingerprints. Because the variations in the microstructure derived from manufacturing process act as a key value, the security keys generated via PUFs are random and unique, making it impossible to duplicate. However, there were limitations in that the hardware structure had to be changed in order to increase the number of combinations of keys to enhance cryptographic characteristics.

Under these circumstances, a team led by Jung-Ah Lim and Hyunsu Ju from the Korea Institute of Science and Technology (KIST) Center for Opto-Electronic Materials and Devices announced that they have successfully developed an encryption device that can greatly strengthen the cryptographic characteristics of PUFs selectively detecting circular polarization, without modify the hardware structure, through collaboration with a team headed by Suk-Kyun Ahn, Professor of Polymer Science and Engineering at Pusan National University.

Light, which behaves as both a particle and a wave, can travel in a straight line, while rotating in the form of a spiral, as circularly polarized light.

The core technology applied to the encryption device developed by the KIST and PNU research team is a phototransistor that can detect the circular polarization of light rotating in a clockwise or counterclockwise direction.

The main strategy used in the newly developed photoresistor is a combination of cholesteric liquid crystal and low bandgap π-conjugated polymer with excellent near-infrared light absorption and charge transport properties. The cholesteric liquid crystal film has a strong tendency to selectively reflect near-infrared circularly polarized light, as the amount of light reaching the device is controlled according to the rotational direction of the light. In the study, the device exhibited excellent dissymmetry factor for photocurrent with high sensitivity in detecting circularly polarized light.

The research team succeeded in fabricating a PUF device that could serve as a fundamental solution against hacking, wiretapping, etc. by increasing the number of combinations in generating encryption keys using a simple solution process, without changing the physical size of the array.

Dr. Jung-Ah Lim from KIST said, "This study presents measures to implement a new encryption device amidst the need to develop a highly secure cryptographic technology with the advent of the era of IoT.

Dr. Suk-Kyun Ahn from PNU said, "The technology to discriminate the rotational direction of circularly polaized light based on a simple fabrication process is expected to have a strong potential in not only next-generation encryption devices but also dvarious chiroptical optoelectronic applications."

Tracking emissions of anthropogenic greenhouse gases by atmospheric observations is a major challenge for policymaking, such as the Paris Agreement. Huge atmospheric observation networks comprised of a variety of platforms including satellites have been developed to monitor regional/country-scale changes in the anthropogenic greenhouse gas emissions. The outbreak of the new coronavirus (COVID-19) has been affecting the global socio-economic activity, leading to a significant reduction in fossil-fuel-derived CO2 (FFCO2) emissions and other anthropogenic air pollutants in the world. This situation gave us a unique opportunity to assess our ability to quantify the changes in the regional FFCO2 emissions using atmospheric observations. However, there are few reports of observational evidence for CO2 emission reduction due to the COVID-19 lockdown, although a large number of publications have reported reductions in short-lived air pollutants from various parts of the world.

In Scientific Reports by Nature Publishing, researchers from the National Institute for Environmental Studies (NIES), Japan, and the Japan Agency for Marine-Earth Science and Technology (JAMSTEC) analyzed atmospheric CO2 and CH4 concentrations observed at Hateruma Island, Japan, which is located in the continental margin of East Asia, and detected signals related to the FFCO2 reduction in China caused by the restrictions associated with the COVID-19 outbreak in January-March 2020.

We estimated that the FFCO2 emissions decreased by about 20% during January-February 2020 as a result of the measures to prevent the spread of COVID-19 within China and to the outside world. While a significant reduction of the atmospheric pollutants has been reported, papers on the atmospheric signals of the FFCO2 reduction are yet to be found in the published literature. "The size of the atmospheric reservoir of CO2 is quite large and the atmospheric CO2 has a relatively long lifetime. These characteristics make the change in the atmospheric CO2 concentrations caused by the COVID-19 influence quite small", stated Prabir K. Patra, co-author of the study and researcher at JAMSTEC.

To detect such faint signals in the CO2 variations, the research team of NIES and JAMSTEC focused on the relative variation of the atmospheric CO2 and CH4 observed at Hateruma Island for the past 20 years at daily time intervals. "The atmospheric observation at Hateruma Island is often influenced by the continental emissions during winter due to the airflow pattern caused by the East Asian monsoon. We know that the temporal variations in the atmospheric CO2 and CH4 concentrations show considerable similarity, and the temporal change in the ratio of CO2 to CH4 variations trace very well the temporal change in fossil-fuel emissions in China for the years before 2020", said Yasunori Tohjima, lead author of the study and researcher at NIES. "Thus the variation ratio of CO2 to CH4 was expected to detect the signal reflecting the change in the continental CO2 emissions related to COVID-19 restrictions."

The research team found that the monthly average ratio of the atmospheric CO2 to CH4 variations in January, February, and March tracked the yearly increase in FFCO2 emissions from China during 1997-2019. However, the ratios showed significant decreases in February and March 2020, which coincided with the lockdown period in China. "The relationship between the variation ratio and the FFCO2 emissions from China should be evaluated by using an atmospheric transport model and a set of CO2 and CH4 flux maps", said Yosuke Niwa, co-author of the study and researcher at NIES. "We used multiple simulations of atmospheric CO2 and CH4 at Hateruma Island for various emission reduction scenarios of fossil-fuel CO2 by using NICAM-TM." The study thus concluded that China's FFCO2 emissions decreased by about 30% in February and about 20% in March 2020. "Our approach presented in this study has the potential to detect signals from the emission reduction from any specific region in near-real-time using continuous and high-precision measurements of CO2 and CH4", mentioned Prabir K. Patra.

Scientists at Linköping University, Sweden, working with the perovskite family of materials have taken a step forwards and developed an optoelectronic magnetic double perovskite. The discovery opens the possibility to couple spintronics with optoelectronics for rapid and energy-efficient information storage.

Perovskites form a family of materials with many interesting properties: they are cheap to manufacture, have excellent light-emitting properties and can be tailored for different applications. Researchers have until now concentrated on developing variants for solar cells, light-emitting diodes and rapid optical communication. Perovskites can consist of many different organic and inorganic substances, but they are defined by their special cubic crystal structure. One type of perovskite that contains halogens and lead has recently been shown to have interesting magnetic properties, opening the possibility of using it in spintronics.

Spintronics is the field of technology in which information is stored about the direction of rotation of a particle (its spin), not only its charge (plus or minus). Spintronics is thought to have huge potential for the next generation of information technology, since information can be transmitted at higher speeds and with low energy consumption. It turned out, however, that the magnetic properties of halide perovskites have until now been associated only with lead-containing perovskites, which has limited the development of the material for both health and environmental reasons.

The scientists at Linköping University have now, together with a large group of colleagues in Sweden, the Czech Republic, Japan, Australia, China and the US, and led by Professor Feng Gao of LiU, managed to create non-hazardous perovskite alloy, and produce a magnetic double perovskite.

They show in an article in Science Advances that magnetic iron ions, Fe3+, are incorporated into a previously known double perovskite with interesting optoelectronic properties and consisting of caesium, silver, bismuth and bromine, Cs2AgBiBr6.

The researchers have shown in experiments that the new material has a magnetic response at temperatures below 30 K (-243.15 °C).

"These are preliminary experiments from an exploratory investigation, and we are not completely sure of the origin of the magnetic response. Our results, however, suggest that it is probably due to a weak ferromagnetic or anti-ferromagnetic response. If so, we have a whole class of new materials for future information technology. But more research is needed, not least to obtain the magnetic properties at higher temperatures", says Feng Gao.

"Perovskites are exciting materials, and they have a huge potential for use in future products that need the cheap and rapid transfer of information", he says.

Researchers at the University of Colorado Boulder are developing a wearable electronic device that's "really wearable"--a stretchy and fully-recyclable circuit board that's inspired by, and sticks onto, human skin.

The team, led by Jianliang Xiao and Wei Zhang, describes its new "electronic skin" in a paper published today in the journal Science Advances. The device can heal itself, much like real skin. It also reliably performs a range of sensory tasks, from measuring the body temperature of users to tracking their daily step counts.

And it's reconfigurable, meaning that the device can be shaped to fit anywhere on your body.

"If you want to wear this like a watch, you can put it around your wrist," said Xiao, an associate professor in the Paul M. Rady Department of Mechanical Engineering at CU Boulder. "If you want to wear this like a necklace, you can put it on your neck."

He and his colleagues are hoping that their creation will help to reimagine what wearable devices are capable of. The group said that, one day, such high-tech skin could allow people to collect accurate data about their bodies--all while cutting down on the world's surging quantities of electronic waste.

"Smart watches are functionally nice, but they're always a big chunk of metal on a band," said Zhang, a professor in the Department of Chemistry. "If we want a truly wearable device, ideally it will be a thin film that can comfortably fit onto your body."

Stretching out

Those thin, comfortable films have long been a staple of science fiction. Picture skin peeling off the face of Arnold Schwarzenegger in the Terminator film franchise. "Our research is kind of going in that direction, but we still have a long way to go," Zhang said.

His team's goals, however, are both robot and human. The researchers previously described their design for electronic skin in 2018. But their latest version of the technology makes a lot of improvements on the concept--for a start, it's far more elastic, not to mention functional.

To manufacture their bouncy product, Xiao and his colleagues use screen printing to create a network of liquid metal wires. They then sandwich those circuits in between two thin films made out of a highly flexible and self-healing material called polyimine.

The resulting device is a little thicker than a Band-Aid and can be applied to skin with heat. It can also stretch by 60% in any direction without disrupting the electronics inside, the team reports.

"It's really stretchy, which enables a lot of possibilities that weren't an option before," Xiao said.

The team's electronic skin can do a lot of the same things that popular wearable fitness devices like Fitbits do: reliably measuring body temporary, heart rate, movement patterns and more.

Less waste

Arnold may want to take note: The team's artificial epidermis is also remarkably resilient.

If you slice a patch of electronic skin, Zhang said, all you have to do is pinch the broken areas together. Within a few minutes, the bonds that hold together the polyimine material will begin to reform. Within 13 minutes, the damage will be almost entirely undetectable.

"Those bonds help to form a network across the cut. They then begin to grow together," Zhang said. "It's similar to skin healing, but we're talking about covalent chemical bonds here."

Xiao added that the project also represents a new approach to manufacturing electronics--one that could be much better for the planet. By 2021, estimates suggest that humans will have produced over 55 million tons of discarded smart phones, laptops and other electronics.

His team's stretchy devices, however, are designed to skip the landfills. If you dunk one of these patches into a recycling solution, the polyimine will depolymerize, or separate into its component molecules, while the electronic components sink to the bottom. Both the electronics and the stretchy material can then be reused.

"Our solution to electronic waste is to start with how we make the device, not from the end point, or when it's already been thrown away," Xiao said. "We want a device that is easy to recycle."

The team's electronic skin is a long way away from being able to compete with the real thing. For now, these devices still need to be hooked up to an external source of power to work. But, Xiao said, his group's research hints that cyborg skin could soon be the fashion fad of the future.

"We haven't realized all of these complex functions yet," he said. "But we are marching toward that device function."

In 1973, physicist and later Nobel laureate Philip W. Anderson proposed a bizarre state of matter: the quantum spin liquid (QSL). Unlike the everyday liquids we know, the QSL actually has to do with magnetism - and magnetism has to do with spin.

Disordered electron spin produces QSLs

What makes a magnet? It was a long-lasting mystery, but today we finally know that magnetism arises from a peculiar property of sub-atomic particles, like electrons. That property is called "spin", and the best - yet grossly insufficient - way to think of it is like a child's spinning-top toy.

What is important for magnetism is that spin turns every one of a material's billions of electrons into a tiny magnet with its own magnetic "direction" (think north and south pole of a magnet). But the electron spins aren't isolated; they interact with each other in different ways until they stabilize to form various magnetic states, thereby granting the material they belong to magnetic properties.

In a conventional magnet, the interacting spins stabilize, and the magnetic directions of each electron align. This results in a stable formation.

But in what is known as a "frustrated" magnet, the electron spins can't stabilize in the same direction. Instead, they constantly fluctuate like a liquid - hence the name "quantum spin liquid."

Quantum Spin Liquids in future technologies

What is exciting about QSLs is that they can be used in a number of applications. Because they come in different varieties with different properties, QSLs can be used in quantum computing, telecommunications, superconductors, spintronics (a variation of electronics that uses electron spin instead of current), and a host of other quantum-based technologies.

But before exploiting them, we first have to gain a solid understanding of QSL states. To do this, scientists have to find ways to produce QSLs on demand - a task that has proven difficult so far, with only a few materials on offer as QSL candidates.

A complex material might solve a complex problem

Publishing in PNAS, scientists led by Péter Szirmai and Bálint Náfrádi at László Forró's lab at EPFL's School of Basic Sciences have successfully produced and studied a QSL in a highly original material known as EDT-BCO. The system was designed and synthesized by the group of Patrick Batail at Université d'Angers (CNRS).

The structure of EDT-BCO is what makes it possible to create a QSL. The electron spins in the EDT-BCO form triangularly organized dimers, each of which has a spin-1/2 magnetic moment which means that the electron must fully rotate twice to return to its initial configuration. The layers of spin-1/2 dimers are separated by a sublattice of carboxylate anions centred by a chiral bicyclooctane. The anions are called "rotors" because they have conformational and rotational degrees of freedom.

The unique rotor component in a magnetic system makes the material special amongst QSL candidates, representing a new material family. "The subtle disorder provoked by the rotor components introduces a new handle upon the spin system," says Szirmai.

The scientists and their collaborators employed an arsenal of methods to explore the EDT-BCO as a QSL material candidate: density functional theory calculations, high-frequency electron spin resonance measurements (a trademark of Forró's lab), nuclear magnetic resonance, and muon spin spectroscopy. All of these techniques explore the magnetic properties of EDT-BCO from different angles.

All the techniques confirmed the absence of long-range magnetic order and the emergence of a QSL. In short, EDT-BCO officially joins the limited ranks of QSL materials and takes us a step further into the next generation of technologies. As Bálint Náfrádi puts it: "Beyond the superb demonstration of the QSL state, our work is highly relevant, because it provides a tool to obtain additional QSL materials via custom-designed functional rotor molecules."

First the background: Microbiologists traditionally determine which organisms they are dealing with using the small subunit ribosomal RNA or in short SSU rRNA gene. This marker gene allows to identify almost any living creature, be it a bacterium or an animal, and thus assign it to its place in the tree of life. Once the position in the tree of life is known, specific DNA probes can be designed to make the organisms visible in an approach called FISH (fluorescence in situ hybridization). FISH has many applications, for example to sort cells, or to microscopically record their morphology or spatial position. This approach - which leads from DNA to gene to tree and probe to image - is called the "full-cycle rRNA approach". To make the SSU rRNA measurable, it is usually amplified with polymerase chain reaction (PCR). Today, however, PCR is increasingly being replaced by so-called metagenomics, which record the entirety of all genes in a habitat. Rapid methodological advances now allow the fast and efficient production of large amounts of such metagenomic data. The analysis is performed using significantly shorter DNA sequence segments - much shorter than the SSU gene - which are then laboriously assembled and placed into so-called metagenomically assembled genomes (MAGs). The short gene snippets do not provide complete SSU rRNA, and even in many assemblies and MAGs we do not find this important marker gene. This makes it hard to molecularly identify organisms in metagenomes, to compare them to existing databases or even to visualize them specifically with FISH.

phyloFlash provides remedy

Researchers at the Max Planck Institute for Marine Microbiology in Bremen now present a method that closes this gap and makes it possible to reconstruct and analyze SSU rRNA from raw metagenome data. "This software called phyloFlash, which is freely available through GitHub, combines the full-cycle rRNA approach for identification and visualization of non-cultivated microorganisms with metagenomic analysis; both techniques are well established at the Max Planck Institute for Marine Microbiology in Bremen," explains Harald Gruber-Vodicka, who chiefly developed the method. "phyloFlash comprises all necessary steps, from the preparation of the necessary genome database (in this case SILVA), data extraction and taxonomic classification, through assembly, to the linking of SSU rRNA sequences and MAGs". In addition, the software is very user-friendly and both installation and application are largely automated.

Especially suitable for simple communities

Gruber-Vodicka and his colleague Brandon Seah - who are shared first authors of the publication now presenting phyloFlash in the journal mSystems - come from symbiosis research. The communities they are dealing with in this field of research are comparatively simple: Usually a host organism lives together with one or a handful of microbial symbionts. Such communities are particularly well suited for analysis with phyloFlash. "For example, we do a lot of research on the deep-sea mussel Bathymodiolus, which is home to several bacterial subtenants," says Gruber-Vodicka. "With the help of this well-studied community, we were able to test whether and how reliably phyloFlash works". And indeed, the new software reliably identified both the mussel and its various symbionts. Niko Leisch, also a symbiosis researcher at the Max Planck Institute for Marine Microbiology, tested phyloFlash on small marine roundworms. Analyses of various such nematodes showed that some of the species of these inconspicuous worms might be associated with symbionts. "These exciting glimpses underline the great potential of our simple and fast method", Gruber-Vodicka points out.

OpenSource and all-purpose

phyloFlash is an OpenSource software. Extensive documentation and a very active community ensure its continuous testing and further development. "phyloFlash is certainly not only interesting for microbiologists," emphasizes Gruber-Vodicka. "Already now, numerous scientists from diverse fields of research make use of our software. The simple installation was certainly helpful in this respect, as it lowers the threshold for use". This easy access and interactive character is also particularly important to Brandon Seah, who now works at the Max Planck Institute for Developmental Biology: "The most satisfying thing for me about this project is to see other people using our software to drive their own research forward," says Seah. " From the beginning, we've added features and developed the software in response to user feedback. These users are not just colleagues down the hall, but also people from the other side of the world who have given it a try and gotten in touch with us online. It underlines how open-source is more productive and beneficial both for software development and for science."

The software phyloFlash at GitHub: https://github.com/HRGV/phyloFlash

phyloFlash manual available at https://hrgv.github.io/phyloFlash/

Astrophysicists consider that around 40% of the ordinary matter that makes up stars, planets and galaxies remains undetected, concealed in the form of a hot gas in the complexe cosmic web. Today, scientists at the Institut d'Astrophysique Spatiale (CNRS/Université Paris-Saclay) may have detected, for the first time, this hidden matter through an innovative statistical analysis of 20-year-old data. Their findings are published on November 6, 2020 in Astronomy & Astrophysics.

Galaxies are distributed throughout the Universe in the form of a complex network of nodes connected by filaments, which are in turn separated by voids. This is known as the cosmic web. The filaments are thought to contain almost all of the ordinary (so-called baryonic) matter of the Universe in the form of a diffuse, hot gas. However, the signal emitted by this diffuse gas is so weak that in reality 40 to 50% of the baryons[1] goes undetected.

These are the missing baryons, hidden in the filamentary structure of the cosmic web, that Nabila Aghanim, a researcher at the Institut d'Astrophysique Spatiale (CNRS/Université Paris-Saclay) and Hideki Tanimura, a post-doctoral researcher, together with their colleagues, are attempting to detect. In a new study, funded by the ERC ByoPiC project, they present a statistical analysis that reveals, for the first time, the X-ray emission from the hot baryons in filaments. This detection is based on the stacked X-ray signal, in the ROSAT[2] survey data, from approximately 15 000 large-scale cosmic filaments identified in the SDSS[3] galaxy survey. The team made use of the spatial correlation between the position of the filaments and the associated X-ray emission to provide evidence of the presence of hot gas in the cosmic web, and for the first time measure its temperature.

These findings confirm earlier analyses by the same research team, based on indirect detection of hot gas in the cosmic web through its effect on the cosmic microwave background[4]. This paves the way for more detailed studies, using better quality data, to test the evolution of gas in the filamentary structure of the cosmic web.

Researchers have found a way to produce nylon fibres that are smart enough to produce electricity from simple body movement, paving the way for smart clothes that will monitor our health through miniaturised sensors and charge our devices without any external power source.

This discovery - a collaboration between the University of Bath, the Max Planck Institute for Polymer Research in Germany and the University of Coimbra in Portugal - is based on breakthrough work on solution-processed piezoelectric nylons led by Professor Kamal Asadi from the Department of Physics at Bath and his former PhD student Saleem Anwar.

Piezoelectricity describes the phenomenon where mechanical energy is transformed into electric energy. To put it simply, when you tap on or distort a piezoelectric material, it generates a charge. Add a circuit and the charge can be taken away, stored in a capacitor for instance and then put to use - for example, to power your mobile phone.

While wearing piezoelectric clothing, such as a shirt, even a simple movement like swinging your arms would cause sufficient distortions in the shirt's fibres to generate electricity.

Professor Asadi said: "There's growing demand for smart, electronic textiles, but finding cheap and readily available fibres of electronic materials that are suitable for modern-day garments is a challenge for the textile industry.

"Piezoelectric materials make good candidates for energy harvesting from mechanical vibrations, such as body motion, but most of these materials are ceramic and contain lead, which is toxic and makes their integration in wearable electronics or clothes challenging."

Scientists have been aware of the piezoelectric properties of nylon since the 1980s, and the fact that this material is lead-free and non-toxic has made it particularly appealing. However, the silky, man-made fabric often associated with cheap T-shirts and women's stockings is "a very difficult material to handle", according to Professor Asadi.

"The challenge is to prepare nylon fibres that retain their piezoelectric properties," he said.

In its raw polymer form, nylon is a white powder that can be blended with other materials (natural or man-made) and then moulded into myriad products, from clothes and toothbrush bristles to food packaging and car parts. It's when nylon is reduced to a particular crystal form that it becomes piezoelectric. The established method for creating these nylon crystals is to melt, rapidly cool and then stretch the nylon. However this process results in thick slabs (known as 'films') that are piezoelectric but not suited to clothing. The nylon would need to be stretched to a thread to be of woven into garments, or to a thin film to be used in wearable electronics.

The challenge of producing thin piezoelectric nylon films was thought to be insurmountable, and initial enthusiasm for creating piezoelectric nylon garments turned to apathy, resulting in research in this area virtually grinding to a halt in the 1990s.

On a whim, Professor Asadi and Mr Anwar - a textile engineering- took a completely new approach to producing piezoelectric nylon thin films. They dissolved the nylon powder in an acid solvent rather than by melting it. However, they found that the finished film contained solvent molecules that were locked inside the materials, thereby preventing formation of the piezoelectric phase.

"We needed to find a way to remove the acid to make the nylon useable," said Professor Asadi, who started this research at the Max Planck Institute for Polymer Research in Germany before moving to Bath in September.

By chance, the pair discovered that by mixing the acid solution with the acetone (a chemical best known as a paint thinner or nail varnish remover), they were able to dissolve the nylon and then extract the acid efficiently, leaving the nylon film in a piezoelectric phase.

"The acetone bonds very strongly to the acid molecules, so when the acetone is evaporated from nylon solution, it takes the acid with it. What you're left with is nylon in its piezoelectric crystalline phase. The next step is to turn nylon into yarns and then integrate it into fabrics."

Developing piezoelectric fibres is a major step towards being able to produce electronic textiles with clear applications in the field of wearable electronics. The goal is to integrate electronic elements, such as sensors, in a fabric, and to generate power while we're on the move. Most likely, the electricity harvested from the fibres of piezoelectric clothing would be stored in a battery nestled in a pocket. This battery would then connect to a device either via a cable or wirelessly.

"In years to come, we could be using our T-shirts to power a device such as our mobile phone as we walk in the woods, or for monitoring our health," said Professor Asadi.

Germanium telluride (GeTe) is known as a ferrolectric Rashba semiconductor with a number of interesting properties. The crystals consist of nanodomains, whose ferrolectric polarization can be switched by external electric fields. Because of the so-called Rashba effect, this ferroelectricity can also be used to switch electron spins within each domain. Germanium telluride is therefore an interesting material for spintronic devices, which allow data processing with significantly less energy input.

Now a team from HZB and the Lomonosov Moscow State University, which has established a Helmholtz-RSF Joint Research Group, has provided comprehensive insights into this material at the nanoscale. The group is headed by physical chemist Dr. Lada Yashina (Lomonosov State University) and HZB physicist Dr. Jaime Sánchez-Barriga. "We have examined the material using a variety of state-of-the-art methods to not only determine its atomic structure, but also the internal correlation between its atomic and electronic structure at the nanoscale," says Lada Yashina, who produced the high-quality crystalline samples in her laboratory.

Their microscopy investigations showed that the crystals possess two distinct types of boundaries surrounding ferroelectric nanodomains with sizes between 10 to 100 nanometres. At BESSY II, the team was able to observe two surface terminations with opposite ferroelectric polarization, and to analyse how these terminations correspond to nanodomains with either Ge or Te atoms at the topmost surface layer.

"At BESSY II, we were able to precisely analyze the intrincate relationship between the spin polarization in the bulk or at the surface and the opposite configurations of the ferroelectric polarization", explains Jaime Sánchez-Barriga. The scientists also determined how the spin texture switches by ferroelectric polarization within individual nanodomains. "Our results are important for potential applications of ferroelectric Rashba semiconductors in non-volatile spintronic devices with extended memory and computing capabilities at the nanoscale," emphasizes Sánchez-Barriga.

Scientists at the National Center for Tumor Diseases Dresden (NCT/UCC) and Dresden University Medicine, together with an international team of researchers, were able to demonstrate that certain white blood cells, so-called neutrophil granulocytes, can potentially - after completing a special training programme - be utilised for the treatment of tumours. In order to stimulate the training of this part of the innate immune system, the scientists used beta-glucan, a long-chain sugar molecule that occurs as a natural fibre mainly in the cell walls of fungi, oats or barley. The immune training already became effective at the level of blood formation in the bone marrow, in the precursor cells of the neutrophil granulocytes. Based on this newly described mechanism, it is possible that novel cancer immunotherapies which improve treatment for cancer patients will be developed in the future. The scientists published their results in the renowned specialist journal Cell.

The National Center for Tumor Diseases Dresden (NCT/UCC) is a joint institution of the German Cancer Research Center (DKFZ), the University Hospital Carl Gustav Carus Dresden, Carl Gustav Carus Faculty of Medicine at TU Dresden and the Helmholtz- Zentrum Dresden-Rossendorf (HZDR).

Tumour cells can evade the immune system in a variety of ways and in this manner nullify its protective effect. Immunotherapies aim at preventing these evasive manoeuvers and at redirecting the natural defence mechanisms in the patient's body against the cancer cells.

Modern immunotherapies rely on the specialists of our defence system, such as T cells, dendritic cells or certain antibodies. As part of the specific immune system, these are able to recognise suitable structures on tumour or immune cells and initiate or execute a precisely tailored defence reaction. For the first time, scientists at the National Center for Tumor Diseases Dresden (NCT/UCC) and University Medicine Dresden were now able to demonstrate that even the non-specific immune response of our body can - through special training - be weaponised against tumours. "Based on the mechanism described, new forms of cancer immunotherapy are conceivable which could improve the chances for treatment for certain patients in the future," says Prof. Triantafyllos Chavakis, Director of the Institute of Clinical Chemistry and Laboratory Medicine (IKL) of the University Hospital Carl Gustav Carus Dresden.

Training of neutrophil granulocytes inhibits tumour growth

At the centre of the described mechanism are special immune cells, so-called neutrophil granulocytes - or neutrophils for short. These form the most common subgroup of the white blood cells and are part of the innate, non-specific immune defence. In contrast to the specific part of our immune system - which first analyses foreign structures in the body in detail and then, with a time lag, activates tailor-made defence mechanisms - the non-specific part of the body's own defence acts as a rapid response force: if pathogens enter the body or cells degenerate, it reacts very quickly and mostly stereotypically.

However, certain stimuli can also influence - or even train - the non-specific immune response. Training causes certain actors of the rapid response force to exhibit altered properties and perform their tasks better and over a longer period of time than before: the impact of the rapid response force increases. The researchers have now been able to demonstrate for the first time that this effect, which is already known to occur in infections, can also be used against tumours.

The neutrophil granulocytes play an important role in this process. In certain tumours, they accumulate in the environment of the tumour or migrate into it. These "tumour-associated neutrophils" - located directly at the tumour - can inhibit tumour growth, but some also have tumour-promoting properties. It is assumed that the tumour itself releases substances that turn the neutrophils into drivers of tumour growth. In experimental models, the scientists were able to partially reverse this process, which is detrimental to healing, by specially training the non-specific immune response. In order to stimulate the immune system, they used the long- chain sugar molecule (polysaccharide) beta-glucan. This is a natural fibre found mainly in the cell walls of fungi, oats or barley. Administrating beta-glucan caused the proportion of neutrophils with tumour-inhibiting properties to increase significantly and tumour growth to decrease.

Change in blood formation ensures long-term effect

Of particular importance in this context was proving that the reprogramming of neutrophil granulocytes already begins in the bone marrow. Here, from stem cells, various precursor cells develop and it is from these that the different blood cells emerge. The administration of beta-glucan altered the gene activity of the myeloid precursor cells. The neutrophils later also develop from these. "This causes the properties of the short-lived neutrophils to change in the longer term, towards activity directed against the tumour. This is because the precursor cells form neutrophils with tumour-inhibiting properties over a longer period of time," explains joint first author Lydia Kalafati from IKL and NCT/UCC.

As the next step, it would be conceivable to utilise the principle of neutrophil training in combination with already approved immunotherapies in cancer patients. "In doing so, we also want to investigate in which types of tumours the method works particularly well, in order to then use it in a very targeted manner in future," says Prof. Martin Bornhäuser, member of the Managing Directorate of the NCT/UCC and Director of the Department of Medicine I of the University Hospital Dresden.