Title: AHA News: After Three Strokes, He 'Overheard' the Grim Prognosis and Fought Back
Category: Health News
Created: 8/20/2021 12:00:00 AM
Last Editorial Review: 8/23/2021 12:00:00 AM

Extract

We read with great interest the correspondence by T. Bitter and co-workers in the European Respiratory Review, about our recently published review entitled "Central sleep apnoea: not just one phenotype" [1]. We first want to express our gratefulness to the authors for their support and appreciation of our work, particularly regarding the urgent need for an increasingly differentiated view of central sleep apnoea (CSA) in the context of precision medicine.

Background:

Screening rates for Human Immunodeficiency Virus (HIV) remain low despite guidelines by both the CDC and USPSTF recommending that all adolescents and adults be screened at least once. The aim of this quality improvement study was to increase HIV screening among eligible patients.

Methods:

This quality improvement study assessed the impact of interventions to increase HIV screening in an outpatient population at a large urban safety-net hospital. Outcomes were compared from the preintervention (December 2020 to November 2021) to postintervention years (December 2021 to November 2022). Stepwise electronic alerts to prompt HIV screening paired with provider financial incentives were implemented. The proportion of eligible individuals screened for HIV were compared after intervention implementation.

Results:

Average monthly HIV screening increased from 506 ± 97 to 2484 ± 663 between the pre- and postintervention periods, correlating to a 5.1-fold increase in screening (7.8% to 39.8%, P < .01). Increases were seen across all ages, and those aged 55 to 64 and 65+ had the highest relative increase in screening at 7.5 and 9.3-fold, respectively (P < .01). Screening rates increased for Hispanics (7.9% preintervention vs 43.6% postintervention, P < .01). In the pre- and postintervention periods, 41 patients with new HIV diagnoses were identified (13 preintervention and 28 postintervention) and 85.4% were linked to care within 30 days.

Conclusions:

Stepwise interventions targeted at primary care clinicians are an effective way to increase HIV screening rates, particularly in older demographics. Earlier HIV diagnosis coupled with linkage to care is an important strategy in ending the HIV epidemic.

BACKGROUND:Pulmonary function tests (PFTs) have historically used race-specific prediction equations. The recent American Thoracic Society guidelines recommend the use of a race-neutral approach in prediction equations. There are limited studies centering the opinions of practicing pulmonologists on the use of race in spirometry. Provider opinion will impact adoption of the new guideline. The aim of this study was to ascertain the beliefs of academic pulmonary and critical care providers regarding the use of race as a variable in spirometry prediction equations.METHODS:We report data from 151 open-ended responses from a voluntary, nationwide survey (distributed by the Association of Pulmonary Critical Care Medicine Program Directors) of academic pulmonary and critical care providers regarding the use of race in PFT prediction equations. Responses were coded using inductive and deductive methods, and a thematic content analysis was conducted.RESULTS:There was a balanced distribution of opinions among respondents supporting, opposing, or being unsure about the incorporation of race in spirometry prediction equations. Responses demonstrated a wide array of understanding related to the concept and definition of race and its relationship to physiology.CONCLUSIONS:There was no consensus among providers regarding the use of race in spirometry prediction equations. Concepts of race having biologic implications persist among pulmonary providers and will likely affect the uptake of the Global Lung Function Initiative per the American Thoracic Society guidelines.

For clean-room technologies such as isolators and restricted access barrier systems (RABS), decontamination using hydrogen peroxide (H₂O₂) is increasingly attractive to fulfill regulatory requirements. Several approaches are currently used, ranging from manual wipe disinfection to vapor phase hydrogen peroxide (VPHP) or automated nebulization sanitization. Although the residual airborne H₂O₂ concentration can be easily monitored, detection of trace H₂O₂ residues in filled products is rather challenging. To simulate the filling process in a specific clean room, technical runs with water for injection (WfI) are popular. Thus, the ability to detect traces of H₂O₂ in water is an important prerequisite to ensure a safe and reliable use of H₂O₂ for isolator or clean room decontamination. The objective of this study was to provide a validated quantitative, fluorometric Amplex UltraRed assay, which satisfies the analytical target profile of quantifying H₂O₂ in WfI at low nanomolar to low micromolar concentrations (ppb range) with high accuracy and high precision. The Amplex UltraRed technology provides a solid basis for this purpose; however, no commercial assay kit that fulfills these requirements is available. Therefore, a customized Amplex UltraRed assay was developed, optimized, and validated. This approach resulted in an assay that is capable of quantifying H₂O₂ in WfI selectively, sensitively, accurately, precisely, and robustly. This assay is used in process development and qualification approaches using WfI in H₂O₂-decontaminated clean rooms and isolators.

G protein–coupled receptors (GPCRs) couple to heterotrimeric G proteins, comprised of α and β subunits, to convert extracellular signals into activation of intracellular signaling pathways. Canonically, GPCR-mediated activation results in the exchange of GDP for GTP on G protein α subunits (Gα) and the dissociation of Gα-GTP and G protein β subunits (Gβ), both of which can regulate a variety of signaling pathways. Hydrolysis of bound GTP by Gα returns the protein to Gα-GDP and allows reassociation with Gβ to reform the inactive heterotrimer. Naturally occurring mutations in Gα have been found at conserved glutamine and arginine amino acids that disrupt the canonical G protein cycle by inhibiting GTP hydrolysis, rendering these mutants constitutively active. Interestingly, these dysregulated Gα mutants are found in many different cancers due to their ability to sustain aberrant signaling without a need for activation by GPCRs. This review will highlight an increased recognition of the prevalence of such constitutively activating Gα mutations in cancers and the signaling pathways activated. In addition, we will discuss new knowledge regarding how these constitutively active Gα are regulated, how different mutations are biochemically distinct, and how mutationally activated Gα are unique compared with GPCR-activated Gα. Lastly, we will discuss recent progress in developing inhibitors directly targeting constitutively active Gα mutants.

SIGNIFICANCE STATEMENT

Constitutively activating mutations in G protein α subunits (Gα) widely occur in and contribute to the development of many human cancers. To develop ways to inhibit dysregulated, oncogenic signaling by these mutant Gα, it is crucial to better understand mechanisms that lead to constitutive Gα activation and unique mechanisms that regulate mutationally activated Gα in cells. The prevalence of activating mutations in Gα in various cancers makes Gα proteins compelling targets for the development of therapeutics.

ABSTRACTDespite global consensus on the importance of male involvement in family planning, disparities persist in low- and middle-income countries, where women continue to bear the responsibility for these initiatives. The Philippines, with a high fertility rate and unmet family planning needs, exemplifies this challenge. We present the experiences and lessons learned from implementing the no-scalpel vasectomy (NSV) program in Davao City, showcasing its potential for increasing male engagement in family planning decisions. Launched in 2008, the program aimed to address gender disparity by promoting NSV as a safe and effective contraceptive alternative to female-centric methods. Through the use of culturally sensitive information campaigns and couple-focused counseling, the program challenged traditional notions of masculinity and encouraged shared decision-making. Strong local government commitment and public-private partnerships played key roles in driving the program’s success. Results showed an average annual increase of 80% in NSV clients over the past 3 years compared to before the COVID-19 pandemic, underscoring its effectiveness. The program presents a compelling intervention model for similar initiatives, highlighting how overcoming cultural barriers, infrastructure limitations, and budgetary constraints through policy advocacy, strategic partnerships, and tailored approaches can significantly boost male involvement in family planning and improve reproductive health outcomes within communities.

ABSTRACTIntroduction: Nigeria has the highest number of children who have not received any vaccines in Africa. The training-of-trainers (TOT) model used to train program managers (PMs) and health care workers (HCWs) is ineffective for adult learning and limits immunization programs’ success. We incorporated adult learning principles (ALPs) in designing and delivering TOT for immunization PMs and HCWs to use data to engage communities for tailored immunization strategies.Methods: Our study was implemented in 3 local government areas (LGAs) of the Federal Capital Territory, Nigeria. A training curriculum was developed, integrating ALPs and technical and operational content based on best practices in delivering immunization training and the training needs assessment findings. State PMs (n=10), LGA PMs (n=30), and HCWs (n=42) were trained on the human-centered design for tailoring immunization programs (HCD-TIP) approaches using ALPs. We used interviews and surveys with purposively and conveniently sampled PMs and HCWs, respectively, and observations to assess participants’ satisfaction, knowledge and competence, behavior changes, and results. The interviews were analyzed thematically, and surveys were statistically.Results: There was a high level of satisfaction with the training among LGA PMs (100%), state PMs (91%), and HCWs (85%), with significant knowledge and competence improvements post-training (P<.001). The trained participants conducted 2 HCD sessions with 24 undervaccinated communities and co-designed 24 prototype solutions for testing. Results showed increased coverage of the pentavalent vaccine first dose (54%) and third dose (188%) across 12 participating communities. Improved community colaboration, communication skills, and data-driven approaches were the most cited behavior changes in practice.Conclusion: The application of ALPs in training, use of HCD-TIP approaches and tools, and supportive supervision enhanced PMs’ and HCWs’ capacity for tailored interventions. Countries should consider adopting a holistic approach that focuses on using these approaches in immunization programs to strengthen the health system for equitable vaccine coverage.

Neuroendocrine tumor (NET) metastases to the heart are found in 1%–4% of NET patients and have been reported primarily in the form of individual cases. We investigated the prevalence, clinical characteristics, imaging features, and outcomes of NET patients with cardiac metastases on ⁶⁸Ga-DOTATATE PET/CT. Methods: ⁶⁸Ga-DOTATATE PET/CT of 490 consecutive patients from a single institution were retrospectively reviewed for sites of metastases. The cumulative cardiovascular event rate and overall survival of patients with cardiac NET metastases (CNMs) were compared with those of a control group of metastatic NET patients without cardiac metastases. In patients with CNMs, the cardiac SUV_max with and without normalization to the myocardial background uptake was compared with a separate cohort of 11 patients with active cardiac sarcoidosis who underwent ⁶⁸Ga-DOTATATE PET/CT for research purposes. Results: In total, 270 patients with metastatic NETs were identified, 9 (3.3%) of whom had CNMs. All 9 patients had grade 1–2 gastroenteropancreatic NETs, most commonly from the small intestine (7 patients). The control group consisted of 140 patients with metastatic grade 1–2 gastroenteropancreatic NETs. On Kaplan–Meier analysis, there was no significant difference in the risk of cardiovascular adverse events (P = 0.91 on log-rank test) or mortality (P = 0.83) between the metastatic NET patients with and without cardiac metastases. The degree of cardiac DOTATATE uptake was significantly higher in CNMs than in patients with cardiac sarcoidosis without overlap, in terms of both cardiac SUV_max (P = 0.027) and SUV_max–to–myocardial background ratio (P = 0.021). Conclusion: Routine ⁶⁸Ga-DOTATATE PET/CT can be used to identify CNMs in 3% of patients with metastatic NETs. CNMs do not confer added cardiovascular or mortality risk. A distinguishing feature of CNMs is their high degree of DOTATATE uptake compared with focal myocardial inflammation.

The phase 3 VISION trial demonstrated that [¹⁷⁷Lu]Lu-PSMA-617 prolonged progression-free survival and overall survival (OS) in prostate-specific membrane antigen [PSMA]–positive metastatic castration-resistant prostate cancer (mCRPC) patients who progressed on taxane-based chemotherapy and androgen receptor–signaling inhibitors (ARSIs). The U.S. expanded-access program (EAP; NCT04825652) was opened to provide access to [¹⁷⁷Lu]Lu-PSMA-617 for eligible patients until regulatory approval was obtained. This study aimed to evaluate the efficacy and safety profile of [¹⁷⁷Lu]Lu-PSMA-617 within the EAP and compare the results with those from the VISION trial. Methods: Patients enrolled in the EAP at 4 institutions in the United States with available toxicity and outcome data were included. Outcome measures included OS, a prostate-specific antigen (PSA) response rate (RR) of at least 50%, and incidences of toxicity according to Common Terminology Criteria for Adverse Events version 5.0. Differences in baseline characteristics, outcome data, and toxicity between the EAP and VISION were evaluated using t testing of proportions and survival analyses. Results: In total, 117 patients with mCRPC who received [¹⁷⁷Lu]Lu-PSMA-617 within the EAP between May 2021 and March 2022 were eligible and included in this analysis. Patients enrolled in the EAP were more heavily pretreated with ARSI (≥2 ARSI regimens: 70% vs. 46%; P < 0.001) and had worse performance status at baseline (Eastern Cooperative Oncology Group score ≥ 2: 19% vs. 7%; P < 0.001) than VISION patients. EAP and VISION patients had similar levels of grade 3 or higher anemia (18% vs. 13%; P = 0.15), thrombocytopenia (13% vs. 8%; P = 0.13), and neutropenia (3% vs. 3%; P = 0.85) and similar PSA RRs (42% vs. 46%; P = 0.50) and OS (median: 15.1 vs. 15.3 mo; P > 0.05). Conclusion: Patients with PSMA-positive mCRPC who received [¹⁷⁷Lu]Lu-PSMA-617 within the EAP were later in their disease trajectory than VISION patients. Patients enrolled in the EAP achieved similar PSA RRs and OS and had a safety profile similar to that of the VISION trial patients.

Intrapatient intermetastatic heterogeneity (IIH) has been demonstrated in metastatic castration-resistant prostate cancer (mCRPC) patients and is of the utmost importance for radiopharmaceutical therapy (RPT) eligibility. This study was designed to determine the prevalence of IIH and RPT eligibility in mCRPC patients through a triple-tracer PET imaging strategy. Methods: This was a multisite prospective observational study in which mCRPC patients underwent both ¹⁸F-FDG and ⁶⁸Ga-prostate-specific membrane antigen (PSMA)–617 PET/CT scans. A third scan with ⁶⁸Ga-DOTATATE, a potential biomarker of neuroendocrine differentiation, was performed if an ¹⁸F-FDG–positive/⁶⁸Ga-PSMA–negative lesion was found. Per-tracer lesion positivity was defined as having an uptake at least 50% above that of the liver. IIH prevalence was defined as the percentage of participants having at least 2 lesions with discordant features on multitracer PET. Results: IIH was observed in 81 patients (82.7%), and at least 1 ¹⁸F-FDG–positive/⁶⁸Ga-PSMA–negative lesion was found in 45 patients (45.9%). Of the 37 participants who also underwent ⁶⁸Ga-DOTATATE PET/CT, 6 (16.2%) had at least 1 ⁶⁸Ga-DOTATATE–positive lesion. In total, 12 different combinations of lesion imaging phenotypes were observed. On the basis of our prespecified criteria, 52 (53.1%) participants were determined to be eligible for PSMA RPT, but none for DOTATATE RPT. Patients with IIH had a significantly shorter median overall survival than patients without IIH (9.5 mo vs. not reached; log-rank P = 0.03; hazard ratio, 2.7; 95% CI, 1.1–6.8). Conclusion: Most mCRPC patients showed IIH, which was associated with shorter overall survival. On the basis of a triple-tracer PET approach, multiple phenotypic combinations were found. Correlation of these imaging phenotypes with genomics and treatment response will be relevant for precision medicine.

Understanding the differences between prognostic and predictive indices is imperative for medical research advances. We have developed a new prognostic measure that will identify the strengths, limitations, and potential applications in clinical practice.

BACKGROUND AND PURPOSE:

Vertebrobasilar artery stent placement (VBS) is potentially effective in preventing recurrent posterior circulation strokes; however, the incidences of in-stent restenosis and stented-territory ischemic events based on the location of stent placement have rarely been investigated. We aimed to investigate the characteristics and prognosis of VBS between intracranial and extracranial.

MATERIALS AND METHODS:

This study was single-center retrospective cohort study, and we obtained medical records of patients who underwent VBS. We compared clinical and periprocedural factors between extracranial and intracranial VBS. The primary outcomes included the incidence of in-stent restenosis (>50% reduction in lumen diameter) and stented-territory ischemic events. We compared the incidence of in-stent restenosis and stented-territory ischemic events by using Kaplan-Meier curves.

RESULTS:

Of the 105 patients, 41 (39.0%) underwent extracranial VBS, and 64 (61.0%) underwent intracranial VBS. During the follow-up, the incidences of in-stent restenosis and stented-territory ischemic events were 15.2% and 22.9%, respectively. The procedure time was longer (47.7 ± 19.5 minutes versus 74.5 ± 35.2 minutes, P < .001), and the rate of residual stenosis (≥30%) just after VBS was higher (2 [4.9%] versus 24 [37.5%], P < .001) in intracranial VBS than in extracranial VBS. Also, the incidences of in-stent restenosis were significantly higher in intracranial VBS than in extracranial VBS (4.9% versus 21.9%, P = .037). On the other hand, the incidences of stented-territory ischemic events (7.3% versus 32.8%, P < .001) were significantly higher in intracranial VBS than in extracranial VBS. The main mechanisms of stroke were artery-to-artery embolism (2 [66.7%]) in extracranial VBS, and artery-to-artery embolism (9 [42.9%]) and branch atheromatous disease (8 [38.1%]) in intracranial VBS. The Kaplan-Meier curve demonstrated a higher incidence of in-stent restenosis and stented-territory ischemic events in intracranial VBS than in extracranial VBS (P = .008 and P = .002, respectively).

CONCLUSIONS:

During the follow-up, the incidence of in-stent restenosis and stented-territory ischemic events was higher in patients with intracranial VBS than in those with extracranial VBS. The higher rates of postprocedural residual stenosis might have contributed to the increased risk of in-stent restenosis. Furthermore, prolonged procedure time and additional stroke mechanism, including branch atheromatous disease, might be associated with a higher risk of stented-territory ischemic events in intracranial VBS.

Diffuse large B-cell lymphoma (DLBCL) is a heterogenous group of lymphoid malignancies. Based on gene expression profiling, it has been subdivided into germinal center (GC)-derived and activated B-cell (ABC) types. Advances in molecular methodologies have further refined the subclassification of DLBCL, based on recurrent genetic abnormalities. Here, we describe a distinct case of DLBCL that presented in leukemic form. DNA sequencing targeting 275 genes revealed pathogenically relevant mutations of CD79B, MyD88, TP53, TBL1XR1, and PIM1 genes, indicating that this lymphoma would be best classified as MCD/C5 DLBCL, an ABC subtype. Despite an initial good clinical response to BTK inhibitor ibrutinib, anti-CD20 antibody rituxan, alkylating agent bendamustine, and hematopoietic stem-cell transplant, the lymphoma relapsed, accompanied by morphologic and molecular evidence of disease progression. Specifically, the recurrent tumor developed loss of TP53 heterozygosity (LOH) and additional chromosomal changes central to ABC DLBCL pathogenesis, such as PRDM1 loss. Acquired resistance to ibrutinib and rituxan was indicated by the emergence of BTK and FOXO1 mutations, respectively, as well as apparent activation of alternative cell-activation pathways, through copy-number alterations (CNAs), detected by high-resolution chromosomal microarrays. In vitro, studies of relapsed lymphoma cells confirmed resistance to standard BTK inhibitors but sensitivity to vecabrutinib, a noncovalent inhibitor active against both wild-type as well as mutated BTK. In summary, we provide in-depth molecular characterization of a de novo leukemic DLBCL and discuss mechanisms that may have contributed to the lymphoma establishment, progression, and development of drug resistance.

Mammalian astrocytes have regional roles within the brain parenchyma. Indeed, the notion that astrocytes are molecularly heterogeneous could help explain how the central nervous system (CNS) retains embryonic positional information through development into specialized regions into adulthood. A growing body of evidence supports the concept of morphological and molecular differences between astrocytes in different brain regions, which might relate to their derivation from regionally patterned radial glia and/or local neuron inductive cues. Here, we review evidence for regionally encoded functions of astrocytes to provide an integrated concept on lineage origins and heterogeneity to understand regional brain organization, as well as emerging technologies to identify and further investigate novel roles for astrocytes.

Josh is having an Ys-y time. Anna Marie ranks all the slime families. Robert gets notified every time google kills a product. And Chris tells everyone to blink on cue.

The post RPG Cast – Episode 572: “Partly Cloudy Souls With a Chance of Roguelike” appeared first on RPGamer.

CNN anchor Anderson Cooper was flabbergasted Wednesday by a surrogate’s defense of Donald Trump, calling his explanation for the former president’s bombastic statements literal “bulls---.”

On AC360, former California Lieutenant Gov. Abel Maldonado, a Republican, said that Trump’s recent comments calling for the military to “handle” Democrats were simply his way of expressing his inner New Yorker. “He’s a fighter,” Maldonado added.

The conversation began when Cooper brought up Trump’s former chairman of the Joint Chiefs of Staff, Mark Milley, who, alongside other military leaders, have begun to warn of the dangers of re-electing the former president. Milley has called Trump a “fascist to his core.”

Read more at The Daily Beast.

Stationeers and Icarus developers RocketWerkz are making a spiritual successor to beloved space sim Kerbal Space Program, which is currently titled "Kitten Space Agency" in a flagrant display of adherence to wholesome internet trends. It's based on an actual Kerbal Space Program 2 pitch the studio threw at Take-Two subsidiary Private Division back in the day. RocketWerkz CEO and original DayZ creator Dean Hall has hired several former KSP and KSP2 developers to work on the game, and is describing it on social media as a "KSP killer".

Read more

The developers who remade Half-Life as Black Mesa are working on a new roguelite co-op shooter. It will feature no physicists celebrating Bring Your Shotgun To Work Day, but instead let up to four players tactically breach oil rigs and airports occupied by corporate-sponsored mercenaries. In Rogue Point the richest CEO on earth has croaked it, causing various megacorps to compete in a violent bum rush for control of that wealth. Which is where your team of renegade shooterists come in. They don't want to win this contest, they just want everyone else to lose.

Read more

The James Webb Space Telescope has spotted six strange worlds the size of planets that formed like stars – and the smallest may be building its own miniature solar system

The failure of Boeing's Starliner capsule has left two astronauts stuck in space for months – but also proved how private spaceflight can go right

Computer code dating back to the 1960s is still vital to banks, airlines and governments, but programmers familiar with the language are in short supply. Now AI models are being trained to fill the skills gap

A lithium-ion battery made from three droplets of hydrogel is the smallest soft battery of its kind – and it could be used in biocompatible and biodegradable implants

Express Sport writers have decided who should replace Gary Lineker

Oakland's mayor and district attorney were both sent packing in a recall vote. Leaders in other Democratic-run cities should take notice.

ROGER FEDERER has explained why he gets injured less than rivals Rafael Nadal and Novak Djokovic..

A pilot program aimed at training women and non-binary persons for careers in cybersecurity will soon start recruiting its third group of students. The program, offered to students in computer science and related courses in seven Canadian post-secondary institutions, should start looking for candidates next month for the fall academic year, said Vivian Lee, team […]

The post Pilot cybersecurity training program for women to recruit third cohort first appeared on ITBusiness.ca.

The identification of a new hominin group called Denisovans was one of the most exciting discoveries in human evolution in the last decade.

The post Several Denisovan Populations Introgressed into Modern Humans Multiple Times: Study appeared first on Sci.News: Breaking Science News.

They fight invaders, clear debris and tend neural connections, but sometimes microglia go rogue. Preventing this malfunction may offer new treatments for brain conditions including Alzheimer's

How well do we look after people who are seriously sick? Astonishingly, research is scant – which makes Neil Vickers and Derek Bolton's ambitious new book, Being Ill, very welcome

The European Commission has revealed the progress of potential European Union countries in areas including food safety. As part of the Enlargement Package, the EU Commission has assessed how prepared Albania, Bosnia and Herzegovina, Kosovo, Montenegro, North Macedonia, Serbia, Georgia, Moldova, Ukraine, and Turkey are as they work towards EU... Continue Reading

Kraft Heinz has announced it is removing its Lunchables meal kits from the National School Lunch Program. With eight $1 billion+ brands, Kraft Heinz is North America’s third-largest food and beverage company and the fifth-largest in the world. The National School Lunch Program (NSLP) is America’s second-largest food and nutrition... Continue Reading

Imagine pulling up to a refueling station and filling your vehicle’s tank with liquid hydrogen, as safe and convenient to handle as gasoline or diesel, without the need for high-pressure tanks or cryogenic storage. This vision of a sustainable future could become a reality if a Calgary, Canada–based company, Ayrton Energy, can scale up its innovative method of hydrogen storage and distribution. Ayrton’s technology could make hydrogen a viable, one-to-one replacement for fossil fuels in existing infrastructure like pipelines, fuel tankers, rail cars, and trucks.

The company’s approach is to use liquid organic hydrogen carriers (LOHCs) to make it easier to transport and store hydrogen. The method chemically bonds hydrogen to carrier molecules, which absorb hydrogen molecules and make them more stable—kind of like hydrogenating cooking oil to produce margarine.

A researcher pours a sample of Ayrton’s LOHC fluid into a vial.Ayrton Energy

The approach would allow liquid hydrogen to be transported and stored in ambient conditions, rather than in the high-pressure, cryogenic tanks (to hold it at temperatures below -252 ºC) currently required for keeping hydrogen in liquid form. It would also be a big improvement on gaseous hydrogen, which is highly volatile and difficult to keep contained.

Founded in 2021, Ayrton is one of several companies across the globe developing LOHCs, including Japan’s Chiyoda and Mitsubishi, Germany’s Covalion, and China’s Hynertech. But toxicity, energy density, and input energy issues have limited LOHCs as contenders for making liquid hydrogen feasible. Ayrton says its formulation eliminates these trade-offs.

Safe, Efficient Hydrogen Fuel for Vehicles

Conventional LOHC technologies used by most of the aforementioned companies rely on substances such as toluene, which forms methylcyclohexane when hydrogenated. These carriers pose safety risks due to their flammability and volatility. Hydrogenious LOHC Technologies in Erlanger, Germany and other hydrogen fuel companies have shifted toward dibenzyltoluene, a more stable carrier that holds more hydrogen per unit volume than methylcyclohexane, though it requires higher temperatures (and thus more energy) to bind and release the hydrogen. Dibenzyltoluene hydrogenation occurs at between 3 and 10 megapascals (30 and 100 bar) and 200–300 ºC, compared with 10 MPa (100 bar), and just under 200 ºC for methylcyclohexane.

Ayrton’s proprietary oil-based hydrogen carrier not only captures and releases hydrogen with less input energy than is required for other LOHCs, but also stores more hydrogen than methylcyclohexane can—55 kilograms per cubic meter compared with methylcyclohexane’s 50 kg/m³. Dibenzyltoluene holds more hydrogen per unit volume (up to 65 kg/m³), but Ayrton’s approach to infusing the carrier with hydrogen atoms promises to cost less. Hydrogenation or dehydrogenation with Ayrton’s carrier fluid occurs at 0.1 megapascal (1 bar) and about 100 ºC, says founder and CEO Natasha Kostenuk. And as with the other LOHCs, after hydrogenation it can be transported and stored at ambient temperatures and pressures.

Judges described [Ayrton's approach] as a critical technology for the deployment of hydrogen at large scale.” —Katie Richardson, National Renewable Energy Lab

Ayrton’s LOHC fluid is as safe to handle as margarine, but it’s still a chemical, says Kostenuk. “I wouldn’t drink it. If you did, you wouldn’t feel very good. But it’s not lethal,” she says.

Kostenuk and fellow Ayrton cofounder Brandy Kinkead (who serves as the company’s chief technical officer) were originally trying to bring hydrogen generators to market to fill gaps in the electrical grid. “We were looking for fuel cells and hydrogen storage. Fuel cells were easy to find, but we couldn’t find a hydrogen storage method or medium that would be safe and easy to transport to fuel our vision of what we were trying to do with hydrogen generators,” Kostenuk says. During the search, they came across LOHC technology but weren’t satisfied with the trade-offs demanded by existing liquid hydrogen carriers. “We had the idea that we could do it better,” she says. The duo pivoted, adjusting their focus from hydrogen generators to hydrogen storage solutions.

“Everybody gets excited about hydrogen production and hydrogen end use, but they forget that you have to store and manage the hydrogen,” Kostenuk says. Incompatibility with current storage and distribution has been a barrier to adoption, she says. “We’re really excited about being able to reuse existing infrastructure that’s in place all over the world.” Ayrton’s hydrogenated liquid has fuel-cell-grade (99.999 percent) hydrogen purity, so there’s no advantage in using pure liquid hydrogen with its need for subzero temperatures, according to the company.

The main challenge the company faces is the set of issues that come along with any technology scaling up from pilot-stage production to commercial manufacturing, says Kostenuk. “A crucial part of that is aligning ourselves with the right manufacturing partners along the way,” she notes.

Asked about how Ayrton is dealing with some other challenges common to LOHCs, Kostenuk says Ayrton has managed to sidestep them. “We stayed away from materials that are expensive and hard to procure, which will help us avoid any supply chain issues,” she says. By performing the reactions at such low temperatures, Ayrton can get its carrier fluid to withstand 1,000 hydrogenation-dehydrogenation cycles before it no longer holds enough hydrogen to be useful. Conventional LOHCs are limited to a couple of hundred cycles before the high temperatures required for bonding and releasing the hydrogen breaks down the fluid and diminishes its storage capacity, Kostenuk says.

Breakthrough in Hydrogen Storage Technology

In acknowledgement of what Ayrton’s nontoxic, oil-based carrier fluid could mean for the energy and transportation sectors, the U.S. National Renewable Energy Lab (NREL) at its annual Industry Growth Forum in May named Ayrton an “outstanding early-stage venture.” A selection committee of more than 180 climate tech and cleantech investors and industry experts chose Ayrton from a pool of more than 200 initial applicants, says Katie Richardson, group manager of NREL’s Innovation and Entrepreneurship Center, which organized the forum. The committee based its decision on the company’s innovation, market positioning, business model, team, next steps for funding, technology, capital use, and quality of pitch presentation. “Judges described Ayrton’s approach as a critical technology for the deployment of hydrogen at large scale,” Richardson says.

As a next step toward enabling hydrogen to push gasoline and diesel aside, “we’re talking with hydrogen producers who are right now offering their customers cryogenic and compressed hydrogen,” says Kostenuk. “If they offered LOHC, it would enable them to deliver across longer distances, in larger volumes, in a multimodal way.” The company is also talking to some industrial site owners who could use the hydrogenated LOHC for buffer storage to hold onto some of the energy they’re getting from clean, intermittent sources like solar and wind. Another natural fit, she says, is energy service providers that are looking for a reliable method of seasonal storage beyond what batteries can offer. The goal is to eventually scale up enough to become the go-to alternative (or perhaps the standard) fuel for cars, trucks, trains, and ships.

RoboCop: Rogue City revives ‘80s action and satire in an immersive FPS that redefines Alex Murphy’s journey with gritty realism and tactical combat

Following developer TRAGsoft bringing monster collecting game Coromon to mobile after it debuted on PC and Switch, we are getting …

Continue reading "Roguelite ‘Coromon: Rogue Planet’ in Development for Release on iOS, Android, Switch, and Steam in 2025"

While most fans have been looking forward to Warhammer 40,000: Space Marine 2 or basically a sequel to Warhammer 40,000: …

Continue reading "Warhammer 40,000: Space Marine 2 Steam Deck Review (in Progress) – GOTY Contender, but Play It Elsewhere for Now"

Team17, the developer of the Worms and publisher of Dredge, Blasphemous and more, is working on Rogue Point, a new rogue-lite tactical FPS game. The studio has enlisted the help of Crowbar Collective, the team behind Black Mesa, the fan-made and Valve-approved Half-Life remake that needs no further introduction. Rogue Point is currently in development and slated to enter early access soon.

Rogue Point is set in a dystopian future where a single CEO had controlled everything. After his death, competing companies work to carve up his empire. To achieve this, they hire mercenaries using the MERX app, and it’s as simple as getting food using Uber Eats. Currently, only Rogue Point, a team of vigilantes, is fighting back against this dystopian state of affairs.

Team17/Crowbar Collective

The game pits teams of four against computer-controlled enemies of different classes, each offering unique challenges. Players must strategize and play with the right loadouts or risk losing. There’s plenty of gear to acquire, too, with some weapons only available in the mission field.

Maps are procedurally generated to ensure no two playthroughs are the same. Unlocked equipment may also be used in future runs. Besides the standard campaign missions where “high-octane tactical combat meets strategic planning,” there’s an endgame mission with maxed-out difficulty, promising a challenge for those craving it.

The developers have a rather extensive wishlist of features they hope to add to the game down the road. Those include new weapons (who doesn’t like new gear?), improved AI and new maps. There are currently four maps announced, but the procedural generation should make things less repetitive.

Rogue Point isn’t in early access yet, but you can wishlist it on Steam. The game is set to come out in 2025, but the developers have yet to announce a final release date.

This article originally appeared on Engadget at https://www.engadget.com/gaming/pc/rogue-point-is-a-tactical-shooter-from-the-teams-behind-worms-and-black-mesa-142959920.html?src=rss

The Indian Council of Medical Research (ICMR) has issued a call for proposals for its Centre for Advanced Research (CAR) initiative under the Extramural Research Programme, inviting experienced research teams to

The National Accreditation Board for Testing and Calibration Laboratories (NABL), under the Quality Council of India (QCI), has announced a collaborative effort with Man─Made Textile Research Association (MANTRA) in Surat to deliver a specialized technical training programme on medical textiles testing.

Reality has again failed to support the spin surrounding the 340B Drug Pricing Program.

For 2023, discounted purchases under the 340B program reached a record $66.3 billion—an astounding $12.6 billion (+23.4%) higher than its 2022 counterpart. The gross-to-net difference between list prices and discounted 340B purchases also grew, to $57.8 billion (+$5.5 billion). 340B purchases are now almost 40% larger than Medicaid’s prescription drug purchases.

Hospitals again accounted for 87% of 340B purchases for 2023. Purchases at every 340B covered entity type grew, despite drug prices that grew more slowly than overall inflation.

Lobbyists claim that manufacturers’ 340B contract pharmacy changes are “stripping billions of dollars from the healthcare safety net.” But every year, the data tell a very different story. Only in the U.S. healthcare system can billions more in payments and spreads be considered a cut.

Read on for full details and our analysis, along with fresh details of troubling behavior by the Health Resources and Services Administration (HRSA).
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Today’s guest post comes from Chris Dowd, Senior VP of Market Development at ConnectiveRx.

Chris examines three key trends that will affect patient support programs: the Inflation Reduction Act (IRA), legal/regulatory battles over copay adjustment programs, and uncertainties following a national election. He then outlines three actions that should guide manufacturers' preparation.

To learn more, register for ConnectiveRx’s free webinar on December 11: The Perfect Storm? Patient Support Programming in 2025 and Beyond.

Read on for Chris’s insights.
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The ACRO D&I Site Resource Grants Program aims to help sites acquire the resources and skills that will get them selected for studies and improve the reach of clinical research into underrepresented communities.

The post ACRO Announces Diversity and Inclusion Site Resource Grants Program first appeared on ACRO.

ACRO is pleased to announce the launch of the ACRO Diversity and Inclusion Site Resource Grants Program! The ACRO D&I Site Resource Grants Program aims to help sites acquire the resources and skills that will get them selected for studies and improve the reach of clinical research into underrepresented communities. “We are excited to invite […]

The post ACRO Announces Diversity and Inclusion Site Resource Grants Program first appeared on ACRO.

ACRO’s Good Clinical Podcast is back with bonus episode! Host Sophia McLeod sat down with Tafoya Hubbard and Kristen Surdam to discuss ACRO’s new D&I Site Resource Grants Program.

The post Bonus Episode: Fast Facts on the ACRO D&I Grants Program first appeared on ACRO.

Looking back over the last 40 years at FDA (as I have), there are three characteristics that create a more progressive environment at the agency: continuity of leadership, presidential support, and increased funding. For FDA in 2013 (as the saying goes): 2 out of 3 ain’t bad. In particular, medical innovation seems poised to flourish in an FDA environment where there is continuity of policy and leadership, instead of a new team learning the ropes. I explore this and other themes in the latest issue of Pharmaphorum.com. You can read my thoughts at: http://www.pharmaphorum.com/2013/01/29/fda-post-election-continuity-and-progress-likely-to-mark-2013/.

Consultations on the reclassification of two progestogen-only contraceptive pills from prescription-only to pharmacy medicines have been launched.