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Objective: To investigate the sleep quality and related factors among clinical nurses in Macau. Method: 332 clinical nurses selected by convenient samplings were investigated by Pittsburgh Sleep Quality Index (PSQI) Questionnaire. Results: 46.4% of the clinical nurses had PSQI score over seven, which indicated the poor sleep quality. The PSQI scores showed the main sleep problems among clinical nurses were day time dysfunction, sleep latency and subjective sleep quality. The nurses whose education level was diploma level or below, and who were under the pressure of studying Bachelor or non-Bachelor courses had poor sleep quality. Conclusion: The proportion of clinical nurses who had poor sleep quality was high. Therefore, hospital administrators should make efforts to help staff keep balance between studying and working so as to improve the sleep quality of clinical nurses. [ABSTRACT FROM AUTHOR]

Introduction: Acute kidney injury develops frequently after nephrectomy, causing increased hospital duration of stay and mortality. Both propofol and volatile anaesthetic agents are thought to have renoprotective effects. We investigated whether the type of maintenance anaesthetic (propofol or desflurane) affected the incidence of acute kidney injury after nephrectomy., Methods: This single-centre, randomised controlled trial enrolled adult patients with renal cell carcinoma undergoing nephrectomy. In patients allocated to the propofol group, anaesthesia was induced and maintained using a target-controlled infusion of propofol. In patients allocated to the desflurane group, anaesthesia was induced with a bolus of thiopental and maintained with desflurane. Both groups received a target-controlled infusion of remifentanil during surgery. The primary outcome was the incidence of acute kidney injury within 7 postoperative days based on the serum creatinine component of the Kidney Disease: Improving Global Outcomes criteria., Results: We analysed 317 patients (median (IQR [range]) age 62 (52-70 [26-85] y); 221 (70%) men). Postoperative AKI developed in 79 (25%) patients: 43 (27%) in the propofol group and 36 (23%) in the desflurane group (absolute risk difference (95%CI) 4.6 (-4.9-14.0%), p = 0.347). The severity of kidney injury was stage 1 in 76 patients, stage 2 in two patients and stage 3 in one patient., Discussion: The type of anaesthetic maintenance drug (propofol vs. desflurane) did not affect the incidence of acute kidney injury after nephrectomy. Future research might be better directed towards investigating other potentially modifiable risk factors for postoperative acute kidney injury in this patient population., (© 2024 Association of Anaesthetists.)

Obsessive-compulsive disorder (OCD), a disabling and notoriously treatment-resistant neuropsychiatric disorder, affects 2-3% of the general population and is characterized by recurring, intrusive thoughts (obsessions) and repetitive, ritualistic behaviors (compulsions). Although long associated with dysfunction within the cortico-striato-thalamic-cortical circuits, the thalamic role in OCD pathogenesis remains highly understudied in the literature. Here, we identified a rat thalamic nucleus - the reuniens (NRe) - that mediates persistent, compulsive self-grooming behavior. Optogenetic activation of this nucleus triggers immediate, excessive grooming with strong irresistibility, increases anxiety, and induces negative affective valence. A thalamic-hypothalamic pathway linking NRe to the dorsal premammillary nucleus (PMd) was discovered to mediate excessive self-grooming behavior and render it a defensive coping response to stress, mirroring the compulsions faced by OCD patients. Given the close resemblance between this self-grooming behavior and the clinical manifestations of OCD, the results from this study highlight the role of NRe in mediating OCD-like compulsive behaviors. This can be attributed to NRe's position at the nexus of an extensive frontal-striatal-thalamic network regulating cognition, emotion, and stress-related behaviors, suggesting NRe as a potential novel target for intervention., Competing Interests: Competing interests: The authors declare no competing interests. Ethics approval and consent to participate: This study involved only animal research. All methods in this study were performed in accordance with the relevant guidelines and regulations. Approval for all experiments and procedures has been obtained from the Animal Experimentation Ethics Committee of the Chinese University of Hong Kong (AEEC ref: 22-028-HMF)., (© 2025. The Author(s).)

Background/aims: Self-expandable metallic stents (SEMSs) are widely used as palliative or bridge to surgery treatments in patients with malignant colorectal obstruction (MCO). Stent occlusion is more common with uncovered stents, but stent migration is more common with covered stents. Our purpose was to compare the efficacy and safety of a newly designed covered SEMS with an uncovered proximal flared end (CSEMS-UPF) with that of the conventional uncovered SEMS (UCSEMS) in the treatment of MCO., Methods: This prospective randomized trial was conducted at a tertiary-care academic hospital. We enrolled 87 patients with stage 4 cancer and MCO: colorectal cancer in 60 patients and extracolonic cancer in 27 patients. Insertion of UCSEMS was randomly assigned to 43 patients, and 44 patients received the CSEMS-UPF. The primary outcome was the duration of stent patency after successful placement. The secondary outcomes were the number of patients with technical and clinical success and early and late complications from the stent insertion., Results: The median patency of the stent did not differ between the UCSEMS and CSEMS-UPF groups (484 [231-737] days vs. 216 [66-366] days, P= 0.242). The technical and clinical success rates did not differ significantly between the groups, either (100.0% vs. 93.2%, respectively, P= 0.241; 100.0% vs. 92.7%, respectively, P= 0.112), nor did the early (n = 2 [4.7%] vs. n = 4 [9.8%], P> 0.999) or late (n = 12 [27.9%] vs. n = 15 [36.6%], P> 0.999) stent complication rates differ between the groups., Conclusions: The UCSEMS and newly developed CSEMS-UPF are similarly effective treatments for MCO, with no differences in the stent migration or occlusion rates (Clinical trial registration number: NCT02640781).

Background: This trial assessed the feasibility of titrating evening dosing of anti-hypertensive medications based on nighttime home blood pressure measurement (HBPM) readings in primary care for hypertensive (HT) patients., Methods: 78 patients with nocturnal HT and stage I daytime HT were randomly assigned in a 1:1 ratio to either nighttime HBPM measurements (intervention group) or daytime HBPM measurements (control group). Nighttime blood pressure (BP) was measured 3x per night for at least two nights over 1 week using an automatic and validated HBPM device. The intervention group and control group aimed to achieve systolic BP <120 mmHg on nocturnal HBPM and systolic BP <135 mmHg on daytime HBPM respectively. All patients were seen every four weeks and followed the same drug titration algorithm., Results: The trial achieved a recruitment rate of 6.5 persons per month and a retention rate of 96.1%. In the intervention group, patients provided ≥6 (considered adequate) and ≥9 nighttime HBPM readings for 77.5% and 63.8% of their follow-ups, respectively. At 6-month, both groups had similar nighttime, 24-hour, and daytime BP on ambulatory BP monitoring, as well as similar numbers of non-dippers and healthcare utilisation. Most patients reported that they learned more from their HBPM nighttime readings and found the intervention well-tolerated., Conclusion: Adjusting evening dosage of anti-HT medications based on nighttime HBPM is a potential and feasible treatment approach for patients with nocturnal HT in primary care. This approach is well-accepted by patients and results in at least non-inferior BP control. Although titrating medications according to nighttime HBPM readings may improve nighttime BP, the small sample size limited statistical significance and the single-centre design restricted generalizability. Additionally, a few patients exhibited fair adherence to nighttime HBPM. Further randomised controlled trials are required to confirm that targeting nocturnal BP should be the primary treatment goal for HT., Competing Interests: No potential conflict of interest was reported by the author(s)., (© 2025 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.)

Introduction: A drug-specific chromogenic assay is not immediately available, so it hampers the treatment of patients who present in a clinical emergency. In this pilot study, we aimed to create a formula to predict a plasma edoxaban level based on the international normalized ratio (INR) and heparin-calibrated anti-Xa activity and derive a novel workflow for routine laboratory diagnosis. Method: Forty-two patients prescribed edoxaban were recruited and randomized to a testing or validation cohort. Plasma levels from the testing cohort were used to create a prediction formula that was then validated in a validation cohort and real-world clinical requests. Results: The INR-derived formula had high sensitivity (95.8-100%) to predict the plasma edoxaban level > 50 ng/mL and >100 ng/mL but with low specificity. However, the specificity of predicting the plasma edoxaban level of ≥100 ng/mL was 100% by using an INR ≥ 1.5 as cut-off. Heparin-calibrated anti-Xa-derived formula had a high sensitivity (90.9-100%) and specificity (93.8-100%) in real clinical situations. A two-tier approach of combining INR-derived and heparin-calibrated anti-Xa-derived formulae can overcome the low specificity and utilize the advantages of wide availability and a short turnaround time of the INR-derived formula. Conclusions: Both INR-derived and heparin-calibrated anti-Xa-derived formulae can be applied to calculate the plasma edoxaban level. A two-tier workflow of combining these two formulae greatly helps streamline the treatment of patients prescribed edoxaban who present in a clinical emergency. Adoption of this framework is feasible for routine diagnostic laboratories.

Acute kidney injury (AKI) is associated with high morbidity and mortality rates, primarily due to the lack of effective therapeutic options for kidney repair. To restore the biological function of injured kidney, there is a need to protect renal tubular epithelial cells (RTECs) and regulate M1 macrophages, responsible for progress of AKI. Herein, based on metabolic glycoengineering-mediated click chemistry, we prepare the engineered extracellular vesicles (pSEVs), derived from PEGylated hyaluronic acid (HA)-modified mesenchymal stem cells. Owing to their cell-protective and anti-inflammatory properties, pSEVs effectively prevent the apoptosis of RTECs and inhibit the polarization of macrophages into an inflammatory phenotype in vitro. When systemically administered into the cisplatin-induced AKI animal model, pSEVs selectively accumulate in injured kidneys via HA-mediated binding to CD44 and toll-like receptor4 which are over-expressed on RTECs and M1 macrophages, respectively. This targeted delivery efficiently alleviates AKI-related symptoms, as evidenced by delayed kidney weight reduction, and decreased levels of creatinine, blood urea nitrogen, and neutrophil gelatinase-associated lipocalin. Overall, pSEVs show potent anti-inflammatory effects and specific targeting to injured kidneys, presenting a considerable potential as the therapeutics for AKI., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2025 Elsevier Ltd. All rights reserved.)

Objectives: Balloon eustachian tuboplasty (BET) is an emerging treatment for dilatory eustachian tube (ET) dysfunction. However, its efficacy in patients with both chronic suppurative otitis media (COM) and ET dysfunction remains unclear. The objective of the trial was to assess the efficacy and safety of BET versus medical management (MM) alone in adult patients with COM and chronic dilatory ET dysfunction, which was defined by a failed Valsalva maneuver., Methods: In this prospective, multicenter, randomized controlled trial, a total of 116 participants (121 ears) treated between January 2021 and June 2023 were randomly assigned (1:1) to receive either BET with MM or MM alone (fluticasone furoate nasal steroid spray). The short-term primary outcome was the normalization of the Valsalva maneuver at the 8-week follow-up. Secondary outcomes were improved Eustachian Tube Dysfunction Questionnaire- 7 (ETDQ-7) scores and decreased air-bone gap (ABG) analyzed at 8 weeks. Adverse events were monitored in both groups during the follow-up period., Results: Among the 116 participants (121 ears), 60 participants (62 ears) received BET and 56 participants (59 ears) received MM alone. Demographics, baseline characteristics, ETDQ-7 scores, bone conduction thresholds, and ABG did not differ significantly between the groups. In the BET group, 46.8% (29/62, ears) achieved a successful Valsalva maneuver compared with 15.3% (9/59, ears) in the MM-only group (p<0.001). BET group (-6.2±9.4) showed greater subjective symptom improvement than the MM-only group (-2.6±8.6) regarding ETDQ-7 scores (p=0.028). ABG decreased more in the BET group (-5.8±11.4 dB) compared with the MM-only group (-1.2±10.5 dB) (p=0.023). No serious procedure-related or device-related adverse events occurred in either group during the 8-week follow-up., Conclusion: Our trial suggests that BET, combined with MM, demonstrated superiority over MM alone, along with its safety, in treating dilatory ET dysfunction in patients with COM.

UDP-GlcNAc serves as a building block for glycosaminoglycan (GAG) chains in cartilage proteoglycans and simultaneously acts as a substrate for O-GlcNAcylation. Here, we show that transporters for UDP-GlcNAc to the endoplasmic reticulum (ER) and Golgi are significantly downregulated in osteoarthritic cartilage, leading to increased cytosolic UDP-GlcNAc and O-GlcNAcylation in chondrocytes. Mechanistically, upregulated O-GlcNAcylation governs the senescence-associated secretory phenotype (SASP) by stabilizing GATA4 via O-GlcNAcylation at S406, which compromises its degradation by p62-mediated selective autophagy. Elevated O-GlcNAcylation in the superficial layer of osteoarthritic cartilage coincides with increased GATA4 levels. The topical deletion of Gata4 in this cartilage layer ameliorates post-traumatic osteoarthritis (OA) in mice while inhibiting O-GlcNAc transferase mitigates OA by decreasing GATA4 levels. Excessive glucosamine-induced O-GlcNAcylation stabilizes GATA4 in chondrocytes and exacerbates post-traumatic OA in mice. Our findings elucidate the role of UDP-GlcNAc compartmentalization in regulating secretory pathways associated with chronic joint inflammation, providing a senostatic strategy for the treatment of OA., Competing Interests: Competing interests: The authors declare the following competing interests: Y.-J.K. and J.-H.K. are co-founders of Liflex Science. D.K., J.L., C.K., and J.-H.K. are the inventors of a patent application based on this study (South Korea patent pending, No. 10-2024-0155038). The other authors declare no competing interests., (© 2025. The Author(s).)

Background: Obstructive sleep apnea (OSA) is common after stroke. Still, routine screening of OSA with polysomnography (PSG) is often unfeasible in clinical practice, primarily because of how limited resources are and the physical condition of patients. In this study, we used several artificial intelligence techniques to predict moderate-to-severe OSA and identify its features in patients with acute ischemic stroke., Methods: A total of 146 patients with acute ischemic stroke underwent PSG screening for OSA. Their baseline demographic characteristics, including age, sex, body mass index (BMI), Epworth Sleepiness Scale (ESS) score, and stroke risk factors, were recorded. Logistic regression analysis was conducted to identify significant features associated with moderate-to-severe OSA in patients with stroke. These significant features were used with six machine learning and ensemble learning algorithms, namely decision tree, support vector machine, random forest, extreme gradient boosting (XGBoost), adaptive boosting (AdaBoost), and gradient boosting, to compare the performance of several predictive models., Results: Multivariate logistic regression analysis revealed that age, sex, BMI, neck circumference, and ESS score were significantly associated with the presence of moderate-to-severe OSA. According to the machine learning and ensemble learning results, the XGBoost model achieved the highest performance, with an area under the receiver operating characteristic curve of 0.89 and an accuracy and F1 score of 0.80., Conclusion: This study identified key factors contributing to moderate-to-severe OSA in patients with ischemic stroke. The XGBoost model exhibited high predictive performance, indicating it has potential as a supporting tool for decision-making in health-care settings., Competing Interests: Declaration of competing interest The authors declare no financial and non-financial competing interests., (Copyright © 2024. Published by Elsevier Inc.)

Kawasaki disease (KD) is a severe acute febrile illness and systemic vasculitis that causes coronary artery aneurysms in young children. Platelet hyperreactivity and an aberrant immune response are key indicators of KD; however, the mechanism by which hyperactive platelets contribute to inflammation and vasculopathy in KD remains unclear. A cytokine-mediated positive feedback loop between KD platelets and monocytes is identified. KD platelet-monocyte aggregates (MPAs) are mediated by an initial interaction of P-selectin (cluster of differentiation 62P, CD62p) and its glycoprotein ligand 1 (PSGL-1). This is followed by a coordinated interaction of platelet glycoprotein (GP)Ibα with monocyte CD11b. Monocyte-activated platelets initiate transforming growth factor (TGF)β1 release, which results in nuclear localization of nuclear factor kappaB in monocytes, therefore, driving the phenotypic conversion of classical monocytes (CD14 + CD16 - ) into proinflammatory monocytes (CD14 + CD16 + ). The platelet-activated monocytes release interleukin-1 and tissue necrotic factor-α, which promote further platelet activation. KD-induced inflammation and vasculopathy are prevented by inhibiting the components of this positive feedback loop. Notably, mice deficient in platelet TGFβ1 show less MPA and CD14 + CD16 +  monocytes, along with reduced inflammation and vasculopathy. These findings reveal that platelet-monocyte interactive proteins (CD62p/PSGL-1 and (GP)Ibα/CD11b) and cytokine mediators (platelet TGFβ1) are potential biomarkers and therapeutic targets for KD vasculopathy., (© 2024 The Author(s). Advanced Science published by Wiley‐VCH GmbH.)

Gasoline exhaust particles (GEP) are risk factors for cardiovascular disease. Activating transcription factor 3 (ATF3) is a transcription factor known to form a heterodimer with AP-1 transcription factors for its target gene expression. However, the involvement of ATF3 in GEP-induced gene expression in human umbilical vein endothelial cells (HUVECs) has not been investigated. In this study, we found that GEP, at IC 50 value of 59 μg/ml, induced the expression of ATF3, which led to the expression of matrix metalloproteinase 1 (MMP1) in HUVECs. GEP induce an interaction between c-Jun and ATF3, and c-Jun depletion attenuates GEP-induced MMP1 expression. Depletion of NADPH oxidase 4 (Nox4) suppressed GEP-induced reactive oxygen species (ROS) generation and the subsequent upregulation of ATF3 and MMP1, suggesting that Nox4-derived ROS play a role as upstream regulators of GEP-induced ATF3 expression and MMP1 upregulation. Furthermore, Nox4 depletion attenuated the interaction between ATF3 and c-Jun and their binding to the AP-1 binding site of the MMP1 promoter. Taken together, these findings demonstrate that GEP induce the expression of MMP1 by generating Nox4-dependent ROS, which subsequently increase ATF3 expression and its interaction with c-Jun. This leads to their binding to the promoter region of MMP1 and its transcription. These findings suggest that Nox4-derived ROS and ATF3 are critical for GEP-induced MMP1 expression., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2025 Elsevier B.V. All rights reserved.)

Background: The efficacy of extracorporeal shockwave therapy (ESWT) for treating shoulder calcific tendinitis can be influenced by various prognostic factors. This study aimed to identify prognostic factors associated with the failure of ESWT for symptom relief and to evaluate the predictive capability of the eXtreme Gradient Boosting (XGBoost) algorithm of artificial intelligence techniques in this context., Methods: This retrospective study enrolled patients with persistent shoulder pain attributed to calcific tendinitis who underwent ESWT after failed conservative treatment between January 1998 and December 2022. Age, sex, duration of symptoms, calcification classification and size, pre-ESWT visual analog scale (VAS), and pre-ESWT Constant-Murley score (CMS) served as potential input attributes. The post-ESWT VAS score and CMS score were the output attributes. The XGBoost model was utilized to predict treatment outcomes based on these factors. The dataset was balanced using the synthetic minority oversampling technique (SMOTE), and the model's performance was assessed using 10-fold cross-validation. Spearman's rank correlation coefficient analysis was adopted to explore the relationships between significant continuous input attributes and post-ESWT VAS and CMS scores., Results: A total of 296 patients with calcific tendinitis were enrolled and completed the one-year follow-up. The findings revealed that a prolonged symptom duration (>10 months), severe pain (pre-ESWT VAS > 5), and higher pre-ESWT CMS (>55) were significant prognostic factors for the failure of ESWT for symptom relief. Using these factors as inputs, the XGBoost model demonstrated high accuracy, precision, recall, F1 score. By reducing the input attributes to age, calcification size, pre-ESWT CMS, and symptom duration, the model maintained a high prediction rate, suggesting that these factors are sufficient for effective prediction., Discussion/conclusions: The present study identified significant prognostic factors for associated with the failure of ESWT in the treatment of shoulder calcific tendinitis. By utilizing artificial intelligence techniques, particularly the XGBoost algorithm, we demonstrated an effective ability to predict the VAS and the CMS outcomes following ESWT. By employing the trained XGBoost model, clinicians can offer accurate predictions regarding the outcome of ESWT in this clinical scenario, aiding in treatment decision-making and optimizing patient care., (Copyright © 2025. Published by Elsevier Inc.)

Importance: Perioperative bleeding is common in general surgery. The POISE-3 (Perioperative Ischemic Evaluation-3) trial demonstrated efficacy of prophylactic tranexamic acid (TXA) compared with placebo in preventing major bleeding without increasing vascular outcomes in noncardiac surgery., Objective: To determine the safety and efficacy of prophylactic TXA, specifically in general surgery., Design, Setting, and Participants: Subgroup analyses were conducted that compared randomized treatment with TXA vs placebo according to whether patients underwent general surgery or nongeneral surgery in the POISE-3 blinded, international, multicenter randomized clinical trial. Participants were 45 years or older, were undergoing noncardiac surgery, had increased cardiovascular risk, and were expected to require at least an overnight hospital admission after surgery. Among 26 581 eligible patients identified, 17 046 were excluded, resulting in 9535 patients randomized to the POISE-3 trial. Participants were enrolled from June 2018 through July 2021. The data were analyzed during December 2023., Intervention: Prophylactic, 1-g bolus of intravenous TXA or placebo at the start and end of surgery., Main Outcomes and Measures: The primary efficacy outcome was a composite of life-threatening bleeding, major bleeding, or bleeding into a critical organ. The primary safety outcome was a composite of myocardial injury after noncardiac surgery, nonhemorrhagic stroke, peripheral arterial thrombosis, or symptomatic proximal venous thromboembolism at 30 days. Cox proportional hazards models were conducted, incorporating tests of interaction., Results: Among 9535 POISE-3 participants, 3260 underwent a general surgery procedure. Mean age was 68.6 (SD, 9.6) years, 1740 were male (53.4%), and 1520 were female (46.6%). Among general surgery patients, 8.0% and 10.5% in the TXA and placebo groups, respectively, had the primary efficacy outcome (hazard ratio [HR], 0.74; 95% CI, 0.59-0.93; P = .01) and 11.9% and 12.5% in the TXA and placebo groups, respectively, had the primary safety outcome (HR, 0.95; 95% CI, 0.78-1.16; P = .63). There was no significant interaction by type of surgery (general surgery vs nongeneral surgery) on the primary efficacy (P for interaction = .81) and safety (P for interaction = .37) outcomes. Across subtypes of general surgery, TXA decreased the composite bleeding outcome in hepatopancreaticobiliary surgery (HR, 0.55; 95% CI, 0.34-0.91 [n = 332]) and colorectal surgery (HR, 0.67; 95% CI, 0.45-0.98 [n = 940]). There was no significant interaction across subtypes of general surgery (P for interaction = .68)., Conclusions and Relevance: In this study, TXA significantly reduced the risk of perioperative bleeding without increasing cardiovascular risk in patients undergoing general surgery procedures., Trial Registration: ClinicalTrials.gov Identifier: NCT03505723.

Approximately 30 % of global agricultural land is used to produce food that is ultimately lost or wasted, making it imperative to explore strategies for mitigating this waste. This study explored the potential of chitosan (CS) derivatives as edible coatings to extend food shelf life. Although soluble CS derivatives such as glycol CS are suitable coatings, their antimicrobial properties often diminish with increased solubility. To address this issue, gallic acid (GA), a polyphenol, was conjugated with CS using 1-ethyl-3-(3-dimethylaminopropyl)carbodiimide/N-hydroxysuccinimide (EDC/NHS) chemistry to create edible coating solutions. The resulting CS-GA films exhibited remarkable solubility, mechanical strength, UV-blocking properties, and superior antioxidant and antimicrobial properties. Furthermore, these films exhibited a high affinity for hydrophobic fruit surfaces while also facilitating easy washing, making them an alternative for consumers who are averse to film-coated products. The CS-GA-coated fruits exhibited minimal surface spoilage, decreased mass loss, and increased firmness. Therefore, these CS-GA conjugate coatings hold significant potential as eco-friendly, edible, and washable food packaging coatings., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Colloidal quantum-dot light-emitting diodes (QD-LEDs) have been significantly improved in terms of device performance and lifetime by employing zinc oxide (ZnO) as an electron transport layer (ETL). Although atomic layer deposition (ALD) allows fabrication of uniform, high-quality ZnO films with minimal defects, the high conductivity of ZnO has hindered its straightforward application as an ETL in QD-LEDs. Herein, we propose fabrication of Al-doped ZnMgO (Al:ZnMgO) ETLs for QD-LEDs through a supercycle ALD, with alternating depositions of various metal oxides. The supercycle ALD allows for extensive control of compositions, which is not possible in typical hydrolysis-based approaches. ZnMgO alloys produced by ALD adjust the band gap to match the QDs and suppress the electron injection. However, Mg compositions of >10% lead to a reduction in electron conductivity, limiting the charge balance in the QDs. The Al doping provides Al 3+ ions, oxygen vacancies, and zinc interstitials to compensate for the reduced conductivity of ZnMgO. Composition tuning based on the supercycle ALD enables to realize the ETLs offering optimal electron injection capability without compromising the electrical conductivity. QD-LEDs with the Al:ZnMgO ETLs exhibit a peak external quantum efficiency of 15.7% and peak luminance of 167,000 cd m -2 , on par with typical devices using ZnMgO nanocrystal-based ETLs.

Background: Lymph node metastasis (LNM) prediction for each LN station is required for tailored surgery for patient safety or improving quality of life in gastric cancer. This retrospective review was performed to develop a prediction program for calculating the probability of LNM according to LN stations in patients with gastric cancer., Method: Among patients who underwent gastrectomy for primary gastric cancer between 2003 and 2017 at Seoul National University Hospital, 4660 patients up to 2013 were used as the development set, and 2564 patients after 2013 were used as the validation set. Not only the center of tumor but also all locations of stomach by tumor were included in the analysis. A multiple logistic regression analysis was used to develop an LNM prediction program for each LN station in development set. The program was validated using C-statistics and a calibration plot of the validation set., Results: Multivariate analysis identified tumor depth, gross type, and involved locations as covariates associated with LNM. However, the significant factors differed slightly according to the LN station. The prediction equations were developed for each LN station. In the validation set, the prediction equation exhibited good discriminant C-statistics of over 0.8 for all stations. The calibration plot of the prediction equation predicted the LNM rate, which corresponded closely to the actual rate., Conclusions: A program was developed to predict LNM at LN stations. Predictive power was confirmed via internal validation. Predicting the LN metastatic rate for each LN station could help in planning more customized surgery., Competing Interests: Declaration of competing interest None declared. (for all authors)., (Copyright © 2025. Published by Elsevier Ltd.)

Aims: Intra-articular (IA) injection therapy, particularly IA hyaluronic acid (HA), is a common treatment for knee osteoarthritis, but it does have limitations. The injection of IA polynucleotide (PN) has emerged as an alternative, potentially offering superior clinical outcomes. This study investigates current practice patterns and the perceived effectiveness of PN among clinicians for treating knee osteoarthritis in the Republic of Korea. Methods: Based on a survey conducted among clinicians who use PN in clinical practice, we explored the current practices and assessed the perceived effectiveness of IA PN in treating knee osteoarthritis. Results: A total of 265 clinicians who used IA PN for knee osteoarthritis participated in the survey. Most clinicians (73.3%) used PN therapy for the treatment of chronic pain, with varying administration frequencies. In addition, 25.8% of clinicians used PN for the treatment of acute flare-ups. In cases of knee effusion, 55.5% of clinicians removed the effusion prior to administering PN. Clinicians rated PN as more effective than HA for both chronic pain and acute flare-ups, with higher scores for cushioning, anti-inflammatory effects, and delaying joint degeneration. The clinicians stated that patients expressed a higher satisfaction with IA PN compared with IA HA, noting improvement in joint smoothness, noise reduction, pain relief, and a reduction in heat sensation and swelling. Conclusions: The results of the present study highlight the extensive use and perceived benefits among clinicians of IA PN for knee osteoarthritis in the Republic of Korea. Further research is warranted to explore the effectiveness of PN in acute flare-ups and to validate these findings in broader populations.

Neurodegenerative diseases (NDs) demonstrate a complex interaction with the immune system, challenging the traditional view of the brain as an "immune-privileged" organ. Microglia were once considered the sole guardians of the brain's immune response. However, recent research has revealed the critical role of peripheral immune cells located in key brain regions like the meninges, choroid plexus, and perivascular spaces. These previously overlooked cells are now recognized as contributors to the development and progression of NDs. This newfound understanding opens doors for pioneering therapeutic strategies. By targeting these peripheral immune cells, we may be able to modulate the brain's immune environment, offering an alternative approach to treat NDs and circumvent the challenges posed by the blood-brain barrier. This comprehensive review will scrutinize the latest findings on the complex interactions between these peripheral immune cells and NDs. It will also critically assess the prospects of targeting these cells as a ground-breaking therapeutic avenue for these debilitating disorders., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Inc. All rights reserved.)

To overcome genotoxicity, cells have evolved powerful and effective mechanisms to detect and respond to DNA lesions. RecQ Like Helicase-4 (RECQL4) plays a vital role in DNA damage responses. RECQL4 is recruited to DNA double-strand break (DSB) sites in a poly(ADP-ribosyl)ation (PARylation)-dependent manner, but the mechanism and significance of this process remain unclear. Here, we showed that the domain of RECQL4 recruited to DSBs in a PARylation-dependent manner directly interacts with poly(ADP-ribose) (PAR) and contains a PAR-binding motif (PBM). By replacing this PBM with a PBM of hnRNPA2 or its mutated form, we demonstrated that the PBM in RECQL4 is required for PARylation-dependent recruitment and the roles of RECQL4 in the DSB response. These results suggest that the direct interaction of RECQL4 with PAR is critical for proper cellular response to DSBs and provide insights to understand PARylation-dependent control of the DSB response and cancer therapeutics using PARylation inhibitors., (© 2024 The Author(s). FEBS Open Bio published by John Wiley & Sons Ltd on behalf of Federation of European Biochemical Societies.)

This randomized controlled trial examined the effectiveness of an online autism training intervention in reducing stigma toward autistic individuals. Participants were 208 Korean undergraduate students who were blinded to group allocation, with 106 assigned to the autism training and 102 assigned to a control intervention. All participants completed an online Qualtrics survey that included a pre-test survey (perceived similarity to different minority groups), the training, and a post-test survey (perceived similarity, stigma toward autistic people, knowledge about autism, confidence in their knowledge, and open-responses question asking for descriptions of autism). We conducted independent sample t tests and a mixed-effects model to examine group-level differences, and a reliable change index (RCI) analysis to examine individual changes in the perceived similarity score. The responses to the open-ended questions were analyzed using qualitative content analysis. Results revealed that the experimental group reported reduced stigma toward autistic individuals, increased perceived similarity with autistic individuals, and increased confidence in their autism knowledge and demonstrated increased knowledge about autism compared to the control group. At the individual level, the RCI analysis indicated that the training was effective for a notable subset of participants (25%). At post-test, the experimental group recognized the strengths of autistic people and described autistic individuals as "people like us," while many in the control group mentioned misconceptions about autism. Future research should employ more robust intervention designs and tailor materials for diverse target populations, including administrators, to foster systemic destigmatization., Competing Interests: Declarations. Conflict of interest: All authors declare no conflicts of interest., (© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

In recent years, active packaging technology for extending food shelf life and intelligent packaging technology for monitoring food freshness have become essential for ensuring food safety. Among sensing technologies, pH-sensitive sensors have notable advantages, including simplicity, compactness, and affordability, making them ideal for monitoring food freshness. This study proposes an intelligent food indicator based on a composite nanofiber membrane fabricated by electrospinning. The membrane, composed of poly(vinyl alcohol) (PVA), tannic acid (TA), and the natural pH-sensitive dye curcumin (CUR), was heat-treated to enhance its moisture stability for food packaging. Furthermore, the incorporation of TA and CUR into PVA provides additional benefits such as UV-blocking, antioxidant, and antimicrobial properties, effectively delaying food spoilage. The CUR-incorporated nanofibrous membrane exhibited faster detection of shrimp spoilage via colorimetric changes under increasingly alkaline conditions than film samples. Moreover, compared to film-based samples, the composite nanofiber membrane exhibited faster color change responsiveness owing to its porous and high surface area structure, thus serving as an efficient and intelligent indicator., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024. Published by Elsevier Ltd.)

Bronchial exfoliative cytology is classified as non-abrasive (washing, aspiration and bronchoalveolar lavage) and abrasive (brushing). Brush abrasion dislodges epithelial cells but can induce bleeding and cytomorphologic artifacts. In this study, the largest cohort to date of bronchial cytology specimens were referenced against bronchial biopsy as the reference standard. Findings in the study will be useful for selecting biopsy modality and reducing necessary procedural risks. All consecutive bronchial cytology and bronchial biopsy from 1995 to 2022 were retrieved. The diagnoses were reviewed and categorized into five-tiered diagnostic categories to compare diagnostic agreement and concordance. Review of 14,148 specimens yielded 3963 non-abrasive, 2378 abrasive cytology specimens matched to biopsy, with 4355 matches between non-abrasive and abrasive cytology specimens. Agreement between non-abrasive and abrasive cytology was moderate (κ = 0.580), and similar when referenced against biopsy (κ = 0.456 (non-abrasive), κ = 0.498 (abrasive)). Abrasive bronchial cytology showed a higher percentage of malignant diagnosis (20.95 % vs. 12.63 %, p < 0.001) and over-diagnosis rate (36.40 % vs. 29.79 %, p < 0.001), but higher sensitivity (0.747 vs. 0.572, p = 0.002). For subgroup analysis of transbronchial biopsies, matched abrasive cytology showed higher discordant rates (p < 0.05) and lower accuracy (0.907 vs. 0.873, p = 0.020). With the added bleeding risk associated with brushing, abrasive techniques may only be preferable in cases with clinical or bronchoscopic suspicion of malignancy, in particular endobronchial mucosal lesions. For routine bronchoscopy, non-abrasive bronchial cytology appears to be adequate., Competing Interests: Declaration of competing interest The authors declare that there is no conflict of interest regarding the publication of this paper., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Background: Thoracic epidural analgesia (TEA), once the standard for pain management in major abdominal operations, is associated with postoperative complications, making preperitoneal continuous wound infiltration (CWI) a promising alternative. This study aimed to compare the effectiveness of CWI and TEA in managing postoperative pain after open pancreatoduodenectomy., Methods: In a single-centre, randomized, open-label non-inferiority trial, adult patients undergoing elective open pancreatoduodenectomy were assigned to either CWI or TEA for pain management. The primary outcomes were mean pain scores at rest on the first 3 postoperative days (PODs), using an 11-point numeric rating scale, with a non-inferiority margin of 1 point or less. Secondary outcomes included pain scores at rest and during coughing on PODs 1, 2, and 3; total opioid consumption; incidence of postoperative complications; quality of postoperative recovery; and duration of hospital stay., Results: Among the 134 patients analysed (CWI 70, TEA 64), CWI was non-inferior to TEA in terms of mean pain scores at rest (mean difference -0.13, 95% c.i. -0.72 to 0.47). Additionally, CWI demonstrated superior pain relief at rest and higher-quality recovery scores on POD 3. Compared with CWI, TEA was associated with significantly decreased total opioid consumption and shortened time to the first passage of flatus, but a higher incidence of postoperative hypotension. No other outcome measures showed significant differences between the two groups., Conclusion: CWI was non-inferior to TEA during the early postoperative period, and has emerged as a favourable alternative to TEA, offering better pain relief and enhanced recovery on POD 3. Registration number: NCT04375826 (http://www.clinicaltrials.gov)., (© The Author(s) 2024. Published by Oxford University Press on behalf of BJS Foundation Ltd. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.)

Chylothorax contains an abundant amount of immunoglobulins and white blood cells, leading to the belief that superimposed pleural infection is unlikely. We report two cases of biochemically confirmed chylothorax due to cirrhosis, complicated by superimposed pleural infection following repeated pleural interventions. These findings highlight the potential for superimposed infection in chylothorax and challenge the belief in the bacteriostatic effect of chyle. Clinical vigilance is essential to consider this possibility if features of infection arise during the management of chylothorax., Competing Interests: None declared., (© 2024 The Author(s). Respirology Case Reports published by John Wiley & Sons Australia, Ltd on behalf of The Asian Pacific Society of Respirology.)

The rapid development of electric vehicles necessitates high-energy density Li-ion batteries for extended range. Silicon is a promising alternative to graphite anodes due to its high capacity; however, its substantial volume expansion during cycling leads to continuous growth of the solid electrolyte interphase and significant capacity fading. This study addresses these issues by designing a porous Si structure combined with a double carbon-species coating layer, induced by low interfacial energy in a scalable process. Carbon and graphene are located on Si surfaces, forming a close interface that maintains electrical contact, suppresses lithium consumption, and enhances charge transfer properties. The composite anode with a double carbon-species coating on Si demonstrates rapid stabilization with increasing coulombic efficiency, achieving a specific capacity of 1,814 mAh g -1 at 0.2 C and a high-rate capability of 1,356 mAh g -1 at 10 C. Additionally, in a full-cell configuration with LiFePO 4 , it recorded a specific capacity of 161 mAh g -1 at 0.2 C. These results show the potential of porous Si with a carbon-graphene coating for stable, high-capacity operation in Li-ion batteries, offering new insights into high-performance electrochemical systems. Moreover, the double carbon-species coating derived from a scalable surface chemistry-based process presents a realistic alternative for industrial applications., (© 2024 Wiley-VCH GmbH.)

Non-symbolic stimuli representing numerosities are invariably associated with continuous magnitudes, complicating the interpretation of experimental studies on numerosity perception. Although various algorithms for experimental numerosity generation have been proposed, they do not consider the quantifiable distribution of values of continuous magnitudes and the degree of numerosity-magnitudes association. Consequently, they cannot thoroughly exclude the possibility of magnitudes integration or strategy switch between different magnitudes in numerical stimulus perception. Here, we introduce a protocol for numerosity generation, animal training, and behavior outcomes analysis that takes the aforementioned issues into consideration. This protocol has been applied to rodents and is applicable to other animals in numerosity studies. © 2024 Wiley Periodicals LLC. Basic Protocol 1: Algorithm for generating non-symbolic numerical stimuli Alternate Protocol: General algorithm for generating non-symbolic numerical stimuli Basic Protocol 2: Numerical training and testing for rodents., (© 2024 Wiley Periodicals LLC.)

Background: In this study, we aimed to compare the in-hospital mortality of patients with cancer who experienced acute abdominal complications that required emergent surgery in open (treatment decisions made by the primary attending physician of the patient's admission department) versus closed (treatment decisions made by intensive care unit [ICU] intensivists) ICUs., Methods: This retrospective, single-center study enrolled patients with cancer admitted to the ICU before or after emergency surgery between November 2020 and September 2023. Univariate and logistic regression analyses were conducted to explore the associations between patient characteristics in the open and closed ICUs and in-hospital mortality., Results: Among the 100 patients (open ICU, 49; closed ICU, 51), 23 died during hospitalization. The closed ICU group had higher Acute Physiology and Chronic Health Evaluation (APACHE) II scores, vasopressor use, mechanical ventilation, and preoperative lactate levels and a shorter duration from diagnosis to ICU admission, surgery, and antibiotic administration than the open ICU group. Univariate analysis linked in-hospital mortality and APACHE II score, postoperative lactate levels, continuous renal replacement therapy (CRRT), and mechanical ventilation. Multivariate analysis revealed that in-hospital mortality rate increased with CRRT use and was lower in the closed ICU., Conclusions: Compared to an open ICU, a closed ICU was an independent factor in reducing in-hospital mortality through prompt and appropriate treatment.

Acute mountain sickness (AMS) is initiated in response to a hypoxic and hypobaric environment at a high altitude. The precise prevalence of AMS in Jade Mountain climbers remained largely unknown, particularly data obtained from real medical consultations. An overnight stay at the Pai-Yun Lodge (3402 m) is usually required before an ascent of the Jade Mountain. Since 2004, a Pai-Yun Clinic has been established in the Pai-Yun Lodge. The Pai-Yun Clinic provided regular and emergency medical service every weekend. We conducted a retrospective study by using medical records from the Pai-Yun Clinic between 2018 and 2019. A total of 1021 patients were enrolled, with 56.2 % males. Different age groups were 3.2 %, 54.5 %, 37.9 %, and 4.4 % in <20, 20-39, 40-59, and ≥60 years, respectively. There were 582 (57.0 %) patients diagnosed to have AMS (230 [39.5 %] were mild type and 352 [60.5 %] were severe type). The factors associated with AMS development included young age, absence of climbing history (>3000 m) within the last 3 months, first climbing (>3000 m) experience, taking preventive medication, low oxygen saturation, and a high Lake Louise AMS score (LLAMSS). The factors associated with AMS severity included absence of taking preventive medication, low oxygen saturation, and a high LLAMSS. Approximately 15 % of Jade Mountain climbers needed medical service, of which 60 % had AMS. 60 % of patients with AMS must require oxygen supply or medication prescription. Oxygen saturation measure and LLAMSS evaluation are reasonable tools to predict the occurrence and severity of AMS on Jade Mountain., Competing Interests: Declaration of competing interest The authors have no conflicts of interest relevant to this article., (Copyright © 2024 Formosan Medical Association. Published by Elsevier B.V. All rights reserved.)

Colloidal quantum dot (QD)-based light-emitting diodes (QD-LEDs) have reached the pinnacle of quantum efficiency and are now being actively developed for next-generation displays and brighter light sources. Previous research has suggested utilizing inorganic hole-transport layers (HTLs) to explore brighter and more stable QD-LEDs. However, the performance metrics of such QD-LEDs with inorganic HTLs generally lag behind those of organic-inorganic hybrid QD-LEDs employing organic HTLs. In this study, colloidal NiMgO nanocrystals (NCs) with spatially controlled Mg are introduced as HTLs for realizing efficient and stable all-inorganic QD-LEDs. During the co-condensation of Ni and Mg precursors to produce valence band-lowered NiMgO NCs, incorporating ≈2% Mg into the NiO lattice creates additional Ni vacancies (V Ni ) within and on the NCs, influencing the hole concentration and mobility of the NiMgO NC films. Passivating the V Ni exposed on the surface with magnesium hydroxide allows for tuning the electrical properties of the NiMgO NCs relative to those of an electron transport layer, allowing for a balanced charge supply and suppressed negative charging of the QDs. Optimized all-inorganic QD-LEDs employing NiMgO NCs achieved a peak external quantum efficiency of 16.4%, peak luminance of 269 455 cd m⁻ 2 , and a half-life of 462 690 h at 100 nit., (© 2024 Wiley‐VCH GmbH.)

Background/objective: It is difficult to predict perinatal brain injury, and performing brain magnetic resonance imaging (MRI) based on suspected injury remains a clinical challenge. Therefore, we aimed to develop a reliable method for predicting perinatal brain injury using a machine learning model with early birth data., Methods: Neonates admitted to our institution from January 2017 to June 2024 with a gestational age of ≥36 weeks, a birth weight of ≥1800 g, admission within 6 h of birth, and who underwent brain MRI to confirm perinatal brain injury were included. Various machine learning models, including gradient boosting, were trained using early birth data to predict perinatal brain injury. Synthetic minority over-sampling and adaptive synthetic sampling (ADASYN) were applied to address class imbalance. Model performance was evaluated using accuracy, F1 score, and ROC curves. Feature importance scores and Shapley additive explanations (SHAP) values were also calculated., Results: Among 179 neonates, 39 had perinatal brain injury. There were significant differences between the injury and non-injury groups in mode of delivery, Apgar scores, capillary pH, lactate dehydrogenase (LDH) levels, and whether therapeutic hypothermia was performed. The gradient boosting model with the ADASYN method achieved the best performance. In terms of feature importance scores, the 1 min Apgar score was the most influential predictor. Additionally, SHAP analysis showed that LDH levels had the highest SHAP values., Conclusion: the gradient boosting model with ADASYN oversampling effectively predicts perinatal brain injury, potentially improving early detection for predicting long-term outcomes, reducing unnecessary MRI scans, and lowering healthcare costs.

Background: There are few studies that have examined clinical and radiological outcomes at 5 years after isolated medial patellofemoral ligament (MPFL) reconstruction. To date, midterm outcomes after isolated double-bundle (DB) MPFL reconstruction are not well known., Hypothesis: Isolated DB MPFL reconstruction using a patellar suture anchor technique would lead to improved functional scores and radiological findings, and these improvements would remain stable over the 5-year postoperative period., Study Design: Case series; Level of evidence, 4., Methods: Isolated MPFL reconstruction was performed in patients with recurrent patellar instability between March 2013 and February 2017. Clinical and functional evaluations were performed via an interview using the Kujala, Lysholm, and Tegner scores preoperatively and at 6, 12, 24, and 60 months postoperatively. Radiographs were taken preoperatively, immediately postoperatively, and at 24 and 60 months after surgery. Radiographic assessments included measuring the modified Insall-Salvati ratio, congruence angle, and lateral patellofemoral angle., Results: A total of 31 patients (31 knees) underwent isolated MPFL reconstruction; 4 patients did not complete 5-year follow-up, and thus, 27 patients (27 knees) were enrolled in the study. The mean age at the time of surgery was 22.0 ± 6.4 years (range, 14-32 years). All clinical and functional scores significantly improved in the first 2 years ( P < .001), with the mean Kujala, Lysholm, and Tegner scores improving from 52.7 to 90.7, 49.6 to 92.7, and 2.9 to 5.1, respectively. There was no significant difference in scores between 2- and 5-year follow-up. All radiographic parameters significantly improved between preoperatively and immediately postoperatively ( P < .001), with mean values for the modified Insall-Salvati ratio, congruence angle, and lateral patellofemoral angle improving from 1.7° to 1.6°, 5.7° to -6.6°, and 3.0° to 5.9°, respectively. No significant differences were observed in radiographic measurements between the postoperative time points. No patients experienced a patellar redislocation or fracture., Conclusion: The prospective analysis of isolated DB MPFL reconstruction at 5-year follow-up showed that clinical and radiological outcomes significantly improved postoperatively and were maintained to 5 years. These midterm results suggest that isolated DB MPFL reconstruction is an effective treatment option for patients with patellar instability., Competing Interests: The authors have declared that there are no conflicts of interest in the authorship and publication of this contribution. AOSSM checks author disclosures against the Open Payments Database (OPD). AOSSM has not conducted an independent investigation on the OPD and disclaims any liability or responsibility relating thereto., (© The Author(s) 2024.)

Sucrose is a desirable component of processed soybean foods and animal feed, and thus, its content is used as an important characteristic for assessing the quality of soybean seeds. However, few studies have focused on the quantitative trait loci (QTLs) associated with sucrose regulation in soybean seeds. This study aims to measure the sucrose content of 1014 soybean accessions and identify genes related to high sucrose levels using QTL analysis. Colorimetric analysis based on the enzymatic reaction of invertase (INV) and glucose oxidase (GOD) was employed to test the germplasms. A total of six high-sucrose genetic resources (IT186230, IT195321, IT263138, IT263276, IT263286, and IT276521) and two low-sucrose genetic resources (IT025668 and IT274054) were identified. Two F 2:3 populations, IT186230 × IT025668 and Ilmi × IT186230, were then established from these germplasms. QTL analysis identified four QTLs ( qSUC6.1 , qSUC11.1 , qSUC15.1 , and qSUC17.1 ), explaining 7.3-27.6% of the phenotypic variation in the sugar content. Twenty candidate genes were found at the four QTLs. Notably, Glyma.17G152300 , located in the qSUC17.1 QTL region, exhibited a 17-fold higher gene expression in the high-sucrose germplasm IT186230 compared to the control germplasm Ilmi, confirming its role as a major gene regulating the sucrose content in soybean. These results may assist in marker-assisted selection for breeding programs that aim to develop soybean lines with a higher sucrose content.

The development of efficient charge transport layers is crucial for realizing high-performance and stable quantum dot light-emitting diodes (QD-LEDs). The use of a ZnO/ZnMgO bilayer as an electron transporting layer (ETL) has garnered considerable attention. This configuration leverages the high electron mobility of ZnO and the favorable surface state of ZnMgO. Furthermore, the versatility of this configuration extends to its wide range of thickness tunability, rendering it suitable for the construction of thick devices for top-emitting structures with microcavities. However, despite the promising attributes of this bilayer configuration, the impact of the ZnO/ZnMgO bilayer ETL interface on QD-LEDs performance remains largely unexplored. Thus, this study investigated the effect of ultraviolet ozone (UVO) treatment on the stabilization of the ZnO/ZnMgO interface. UVO treatment was found to significantly enhance luminance uniformity across the QD-LEDs emission area while improving operational stability by over 4-fold. Comprehensive analyses employing X-ray photoelectron spectroscopy and Fourier-transform infrared spectroscopy confirmed that UVO treatment significantly reduced the defect states of the hydroxyl groups and removed the insulating native ethanolamine ligands, thereby facilitating improved and uniform electron transport. Moreover, the effectiveness of UVO treatment in enhancing electron transport was supported by impedance analyses. Therefore, this paper presents an effective approach for enhancing the interface of a highly potent ZnO/ZnMgO bilayer ETL, which can ultimately improve the luminance uniformity and stability of QD-LEDs.

Background: To investigate association of prenatal risk factors and neonatal outcomes of preterm infants with pulmonary hypertension (PH)., Methods: A prospective cohort study of very-low-birth-weight infants born at 22-29 weeks' gestation who received PH-specific treatment during hospitalization. Infants were classified using a two-step cluster analysis based on gestational age (GA), small-for-gestational-age (SGA), exposure to antenatal corticosteroids (ACS), histologic chorioamnionitis (HCA), and oligohydramnios., Results: Among 910 infants, six clusters were identified: cluster A (HCA, n = 240), cluster B (oligohydramnios, n = 79), cluster C (SGA, n = 74), cluster D (no-ACS, n = 109), cluster E (no dominant parameter, n = 287), and cluster F (HCA and oligohydroamnios, n = 121). Cluster A was used as a reference group for comparisons among clusters. Compared to cluster A, cluster C (aHR: 1.63 [95% CI: 1.17-2.26]) had higher risk of overall in-hospital mortality. Clusters B (aHR: 1.52 [95% CI: 1.09-2.11]), D (aHR: 1.71 [95% CI: 1.28-2.30]), and F (aHR: 1.51 [95% CI: 1.12-2.03]) had higher risks of receiving PH-specific treatment within the first week of birth compared to cluster A., Conclusion: These findings may provide a better understanding of prenatal risk factors contributing to the development of PH., Impact: Pulmonary hypertension (PH), presenting as hypoxic respiratory failure, has complex etiologies in preterm infants. Although multifactorial risks for the development of PH in preterm infants are known, few studies have classified infants with similar etiologies for PH. Each cluster has distinct patterns of prenatal condition and neonatal outcome., (© 2024. The Author(s), under exclusive licence to the International Pediatric Research Foundation, Inc.)

The auditory brainstem response (ABR) is a noninvasive test that measures neural activity in response to auditory stimuli. Racial differences in head shape have provided strong evidence for specific normative data and accurate device calibration. International standards emphasize the need for standardized procedures and references. This study aimed to outline the standard procedure and related normative ABR values. Standard procedures were performed according to International Electrotechnical Commission (IEC) standards. Five studies from two countries were included to compare the normative values of the ABR. The dataset from the National Standard Reference Data Center (NSRDC) was used as reference. Normative values were described in terms of stimuli, latency, and amplitude. For click stimuli, the latency of the ABR showed different patterns across populations, such as those from Korea and the USA. Although the latencies reported by the NSRDC and for Koreans were relatively short, those reported for USA populations were longer. Using clicks, it was shown that the USA population had the largest ABR amplitude compared to those reported for the other two datasets. For Wave V latency using tone bursts, a similar pattern was identified with click stimuli. Frequency-specific trends were also observed. Although there is a lack of ABR datasets, the information and insights of the present study could be utilized as standard guidelines in research on ABR.

This study employed a self-developed nanofluid/ultrasonic atomization minimal quantity lubrication system. The use of ultrasonic cavitation can effectively improve the accumulation of nanofluids via van der Waals force bonding and enhance their efficiency. This system is a high-speed milling manufacturing innovation in lubrication technology. Two types of nanoparticles (multiwalled carbon nanotubes and MoS 2 nanoparticles) were used to facilitate the mixing of nanofluids and their lubrication in the high-speed milling of 7075-T6 aluminum alloy. The surface roughness of each group of experimental results was used as the characteristic index. The surface roughness obtained from the optimization of the experimental results was 0.51 μm, while the worst group, which was based on the original orthogonal table, had a surface roughness of 1.05 μm, demonstrating an improvement of 51.43% in the quality characteristics. Results of comparative experiments demonstrated that using a nanofluid mixed with multiwalled carbon nanotubes and MoS 2 nanoparticles exerted better effects on surface roughness, tool wear, and workpiece burrs than using only nanofluids with single nanoparticles. This finding can be attributed to the mixed nanofluid, which simultaneously possesses the good grinding capability of MoS 2 and the excellent heat transfer property of multiwalled carbon nanotubes., Competing Interests: Declaration of conflicting interestsThe authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Gauze or bandages are commonly used to effectively control bleeding during trauma and surgery. However, conventional treatment methods can sometimes lead to secondary damages. In recent years, there has been increased interest in developing adhesive hemostatic hydrogels as a safer alternative for achieving hemostasis. Methylcellulose (MC) is a well-known thermo-sensitive polymer with excellent biocompatibility that is capable of forming a hydrogel through physical crosslinking owing to its inherent thermo-reversible properties. However, the poor mechanical properties of the MC hydrogel comprising a single crosslinked network (SN) limit its application as a hemostatic material. To address this issue, we incorporated a chitosan-gallol (CS-GA) conjugate, which has the ability to form chemical crosslinks through self-crosslinking reactions under specific pH conditions, into the MC hydrogel to reinforce the MC hydrogel network. The resulting MC/CS-GA hydrogel with a dual-crosslinked network (DN), involving both physical and chemical crosslinks, exhibited synergistic effects of the two types of crosslinks. Thus, compared with those of the SN hydrogel, the composite DN hydrogel exhibited significantly enhanced mechanical strength and tissue adhesive properties. Moreover, the DN hydrogel presented excellent biological activity in vitro. Additionally, in rat hepatic hemorrhage models, the DN hydrogel exhibited high hemostatic efficiency, showcasing its multifunctional capabilities., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier B.V. All rights reserved.)

The redox regulation, maintaining a balance between oxidation and reduction in living cells, is vital for cellular homeostasis, intricate signaling networks, and appropriate responses to physiological and environmental cues. Here, a novel redox sensor, based on DNA-encapsulated silver nanoclusters (DNA/AgNCs) and well-defined chemical fluorophores, effectively illustrating cellular redox states in live cells is introduced. Among various i-motif DNAs, the photophysical property of poly-cytosines (C 20 )-encapsulated AgNCs that sense reactive oxygen species (ROS) is adopted. However, the sensitivity of C 20 /AgNCs is insufficient for evaluating ROS levels in live cells. To overcome this drawback, the ROS sensing mechanism of C 20 /AgNCs through gel electrophoresis, mass spectrometry, and small-angle X-ray scattering is primarily defined. Then, by tethering fluorescein amidite (FAM) and Cyanine 5 (Cy5) dyes to each end of the C 20 /AgNCs sensor, an Energy Transfer (ET) between AgNCs and FAM is achieved, resulting in intensified green fluorescence upon ROS detection. Taken together, the FAM-C 20 /AgNCs-Cy5 redox sensor enables dynamic visualization of intracellular redox states, yielding insights into oxidative stress-related processes in live cells., (© 2024 The Author(s). Small published by Wiley‐VCH GmbH.)

Background and Objectives : Stroke patients often experience changes in their pelvic tilt, trunk impairments and decreased gait and balance. While various therapeutic interventions have been attempted to improve these symptoms, there is a need for interventions that are easy to apply and reduce the physical labor of physical and occupational therapists. We aimed to investigate the immediate effects of two different methods of trunk elastic taping on the pelvic inclination, trunk impairment, balance, and gait in chronic stroke patients. Materials and Methods : We performed a single-blind randomized controlled trial involving 45 patients with chronic stroke. Participants were randomly assigned to one of three groups: forward rotation with posterior pelvic tilt taping (FRPPT, n = 14), backward rotation with posterior pelvic tilt taping (BRPPT, n = 14), or placebo taping (PT = 14). This study was conducted from December 2023 to January 2024. All the measurements were performed twice: before the intervention and immediately after the intervention. The pelvic inclination was assessed using the anterior pelvic tilt angle. The trunk impairment scale (TIS) was used to measure the trunk impairment. The balance and gait were evaluated using a force plate and walkway system. Results : The pelvic inclination was significantly different in the FRPPT and BRPPT groups compared to the PT group ( p < 0.05, p < 0.001). The TIS and gait were significantly increased in the FRPPT group compared to the PT group ( p < 0.05). The balance significantly improved in the FRPPT and BRPPT within groups ( p < 0.05). Conclusions : Two different methods of posterior pelvic tilt taping improved the anterior pelvic tilt in chronic hemiplegic stroke patients compared with PT, and the FRPPT method also improved the trunk impairment and gait. Therefore, posterior pelvic tilt taping can be used as an intervention with immediate effect.

Marine organisms have complex life histories. For broadcast spawners, successful continuation of the population requires their small gametes to make contact in the water column for sufficiently long periods for fertilization to occur. Anthropogenic climate change has been shown to impact fertilization success in various marine invertebrates, including sea urchins, which are key grazers in their habitats. Gamete performance of both sexes declined when exposed to elevated temperatures and/or pCO2 levels. Examples of reduced performance included slower sperm swimming speed and thinning egg jelly coat. However, such responses to climate change stress were not uniform between individuals. Such variations could serve as the basis for selection. Fertilization kinetics have long been modeled as a particle collision process. Here, we present a modified fertilization kinetics model that incorporates individual variations in performance in a more environmentally relevant regime, and which the performance of groups with different traits can be separately tracked in a mixture. Numerical simulations highlight that fertilization outcomes are influenced by changes in gamete traits as they age in sea water and the presence of competition groups (multiple dams or sires). These results highlight the importance of considering multiple individuals and at multiple time points during in vivo assays. We also applied our model to show that interspecific variation in climate stress vulnerabilities elevates the risk of hybridization. By making a numerical model open-source, we aim to help us better understand the fate of organisms in the face of climate change by enabling the community to consider the mean and variance of the response to capture adaptive potential., (© The Author(s) 2024. Published by Oxford University Press on behalf of the Society for Integrative and Comparative Biology.)

Graphitic carbon exhibits distinctive characteristics that can be modulated by varying the number of carbon layers. Here, we developed a method to control the growth of graphitic carbon layers through pyrolysis of zeolitic imidazolate frameworks (ZIFs). The key is to pyrolyze hollow-structured ZIF-8 containing Co ions to simultaneously obtain an amorphous carbon source for graphitic carbons and Co metal nanoparticles for catalyzing graphitization of amorphous carbons. Owing to sparsely distributed Co ions within ZIF-8, Co nanoparticles are formed, which leads to localized graphitization. The graphitic carbon obtained contained two to five layers, unlike carbonized ZIF-67. The few-layered graphitic carbon was subjected to KOH activation and employed as a support for atomic-sized Co(OH) 2 owing to the short routes for Co nanoparticle egress and OH - ion movement. Our strategy does not involve any highly corrosive process for catalyst leaching and can even be used to produce atomic-sized Co(OH) 2 with few-layered graphitic carbons., Competing Interests: The authors declare no competing financial interest., (This journal is © The Royal Society of Chemistry.)

Introduction: Maintaining adequate preload during kidney transplantation (KT) is important for graft function. We evaluated whether a high or low normal target for a dynamic preload index of stroke volume variation (SVV) would impact graft function during living donor KT., Methods: We compared haemodynamic management algorithms using two different targets of SVV: SVV6% group (n = 30) versus SVV12% group (n = 30). Crystalloids were administered to achieve SVV less than the assigned target. Neutrophil gelatinase-associated lipocalin (NGAL) level at the end of surgery was compared. We also compared the incidence of delayed graft function (DGF), daily serum creatinine level and glomerular filtration rate (GFR) until 2 weeks postoperatively., Results: The total amount of crystalloids administered was significantly different between the SVV6% and SVV12% groups (median [interquartile range] 2,250 [1,700-3,600] vs. 1,350 [1,050-1,900], P < 0.001). There was no significant difference in NGAL level at the end of the operation between the SVV6% and SVV12% groups (395 [234-560] vs. 518 [346-654], P = 0.115). The incidence of DGF was not significantly different, and there was no significant difference in the postoperative serum creatinine levels or GFR between the groups., Conclusions: Our randomised trial demonstrated that an SVV target of either 6% or 12% could be adequate as a preload management target for postoperative graft function during living donor KT. However, given the low incidence of DGF in living donor KT and type II error, our study should be interpreted carefully and further studies for deceased donor KT are required., (Copyright © 2024 Copyright: © 2024 Singapore Medical Journal.)

Facet joint septic arthritis is a rare; yet, severe spinal infection often misdiagnosed due to its non-specific clinical presentation and radiological mimickers. This case series illustrates various clinical presentations, imaging features, and outcomes of patients with facet joint septic arthritis. We demonstrate different disease stages to aid clinicians and radiologists in recognizing this condition. Key diagnostic pitfalls are also discussed to enhance diagnostic accuracy in clinical practice., Competing Interests: There are no conflicts of interest., (© 2024 Published by Scientific Scholar on behalf of Journal of Clinical Imaging Science.)