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Introduction: Most providers have routinely performed universal lumbar puncture (LP) on well-appearing, febrile infants 22 to 28 days old. In 2021, the American Academy of Pediatrics recommended clinicians should perform an LP in this age group if inflammatory markers are abnormal. This quality improvement project aimed to decrease LP rates in febrile infants 22 to 28 days old in the emergency department (ED) within 1 year, regardless of race/ethnicity, from a baseline of 87%., Methods: We used our institution's quality improvement framework to perform multiple Plan-Do-Study-Act cycles. A multidisciplinary team reviewed the febrile infant literature, local epidemiology, and identified key drivers. We provided departmental education, updated our clinical pathway, and used clinical decision support. We analyzed baseline (January 2017-March 2022) and intervention data (April 2022-March 2024) and tracked data using statistical process control charts. Our primary outcome measure was rates of LP in the ED for this cohort. Process measures included rates of infants with procalcitonin results. ED length of stay, rates of first LP attempt after hospitalization, and missed bacterial meningitis were balancing measures., Results: The baseline LP rate of 87% decreased to 44% during the intervention period, resulting in a downward centerline shift. There were no significant differences when LP rates were analyzed by race/ethnicity. There was an upward centerline shift in the process measure of infants with procalcitonin results. There was no observed special cause variation in our balancing measures., Conclusion: Quality improvement efforts, including education, clinical pathway updates, and clinical decision support, safely reduced rates of LPs in febrile infants 22 to 28 days old., (Copyright © 2024 the Author(s). Published by Wolters Kluwer Health, Inc.)

This is a revision of the previous American Academy of Pediatrics policy statement titled "Patient Safety in the Emergency Care Setting" and is the first joint policy statement by the American Academy of Pediatrics, the American College of Emergency Physicians, and the Emergency Nurses Association to address pediatric patient safety in the emergency care setting. Caring for children in the emergency setting can be prone to medical errors because of a number of environmental and human factors. The emergency department has frequent workflow interruptions, multiple care transitions, and barriers to effective communication. In addition, the high volume of patients, high decision density under time pressure, diagnostic uncertainty, and limited knowledge of patients' history and preexisting conditions make the safe care of critically ill and injured patients even more challenging. It is critical that all emergency departments, including general emergency departments who care for the majority of ill and injured children, understand the unique safety issues related to children. Furthermore, it is imperative that all emergency departments practice patient safety principles, support a culture of safety, and adopt best practices to improve safety for all children seeking emergency care. This policy statement outlines the recommendations necessary for emergency departments to minimize pediatric medical errors and to provide safe care for children of all ages., (Copyright © 2022 Emergency Nurses Association. Published by Elsevier Inc. All rights reserved.)

This is a revision of the previous American Academy of Pediatrics policy statement titled "Patient Safety in the Emergency Care Setting," and is the first joint policy statement by the American Academy of Pediatrics, the American College of Emergency Physicians, and the Emergency Nurses Association to address pediatric patient safety in the emergency care setting. Caring for children in the emergency setting can be prone to medical errors because of a number of environmental and human factors. The emergency department (ED) has frequent workflow interruptions, multiple care transitions, and barriers to effective communication. In addition, the high volume of patients, high-decision density under time pressure, diagnostic uncertainty, and limited knowledge of patients' history and preexisting conditions make the safe care of critically ill and injured patients even more challenging. It is critical that all EDs, including general EDs who care for the majority of ill and injured children, understand the unique safety issues related to children. Furthermore, it is imperative that all EDs practice patient safety principles, support a culture of safety, and adopt best practices to improve safety for all children seeking emergency care. This policy statement outlines the recommendations necessary for EDs to minimize pediatric medical errors and to provide safe care for children of all ages., (Copyright © 2022 by the American Academy of Pediatrics.)

Patient safety is the foundation of high-quality health care and remains a critical priority for all clinicians caring for children. There are numerous aspects of pediatric care that increase the risk of patient harm, including but not limited to risk from medication errors attributable to weight-dependent dosing and need for appropriate equipment and training. Of note, the majority of children who are ill and injured are brought to community hospital emergency departments. It is, therefore, imperative that all emergency departments practice patient safety principles, support a culture of safety, and adopt best practices to improve safety for all children seeking emergency care. This technical report outlined the challenges and resources necessary to minimize pediatric medical errors and to provide safe medical care for children of all ages in emergency care settings., (Copyright © 2022 by the American Academy of Pediatrics.)

Individual carbon nanotubes (CNT) and graphene have unique mechanical and electrical properties; however, the properties of their macroscopic assemblies have not met expectations because of limited physical dimensions, the limited degree of dispersion of the components, and various structural defects. Here, a state-of-the-art assembly for a novel type of hybrid fiber possessing the properties required for a wide variety of multifunctional applications is presented. A simple and effective multidimensional nanostructure of CNT and graphene oxide (GO) assembled by solution processing improves the interfacial utilization of the components. Flexible GOs are effectively intercalated between nanotubes along the shape of CNTs, which reduces voids, enhances orientation, and maximizes the contact between elements. The microstructure is finely controlled by the elements content ratio and dimensions, and an optimal balance improves the mechanical properties. The hybrid fibers simultaneously exhibit exceptional strength (6.05 GPa), modulus (422 GPa), toughness (76.8 J g -1 ), electrical conductivity (8.43 MS m -1 ), and knot strength efficiency (92%). Furthermore, surface and electrochemical properties are significantly improved by tuning the GO content, further expanding the scope of applications. These hybrid fibers are expected to offer a strategy for overcoming the limitations of existing fibers in meeting the requirements for applications in the fiber industry., (© 2022 The Authors. Advanced Science published by Wiley-VCH GmbH.)

Theoretical considerations suggest that the strength of carbon nanotube (CNT) fibers be exceptional; however, their mechanical performance values are much lower than the theoretical values. To achieve macroscopic fibers with ultrahigh performance, we developed a method to form multidimensional nanostructures by coalescence of individual nanotubes. The highly aligned wet-spun fibers of single- or double-walled nanotube bundles were graphitized to induce nanotube collapse and multi-inner walled structures. These advanced nanostructures formed a network of interconnected, close-packed graphitic domains. Their near-perfect alignment and high longitudinal crystallinity that increased the shear strength between CNTs while retaining notable flexibility. The resulting fibers have an exceptional combination of high tensile strength (6.57 GPa), modulus (629 GPa), thermal conductivity (482 W/m·K), and electrical conductivity (2.2 MS/m), thereby overcoming the limits associated with conventional synthetic fibers.

Background and Objectives: Inappropriate vancomycin use is common in children's hospitals. We report a quality improvement (QI) intervention to reduce vancomycin use in our tertiary care PICU., Methods: We retrospectively quantified the prevalence of infections caused by organisms requiring vancomycin therapy, including methicillin-resistant Staphylococcus aureus (MRSA), among patients with suspected bacterial infections. Guided by these data, we performed 3 QI interventions over a 3-year period, including (1) stakeholder education, (2) generation of a consensus-based guideline for empiric vancomycin use, and (3) implementation of this guideline through clinical decision support. Vancomycin use in days of therapy (DOT) per 1000 patient days was measured by using statistical process control charts. Balancing measures included frequency of bacteremia due to an organism requiring vancomycin not covered with empiric therapy, 30-day mortality, and cardiovascular, respiratory, and renal organ dysfunction., Results: Among 1276 episodes of suspected bacterial infection, a total of 19 cases of bacteremia (1.5%) due to organisms requiring vancomycin therapy were identified, including 6 MRSA bacteremias (0.5%). During the 3-year QI project, overall vancomycin DOT per 1000 patient days in the PICU decreased from a baseline mean of 182 DOT per 1000 patient days to 109 DOT per 1000 patient days (a 40% reduction). All balancing measures were unchanged, and all cases of MRSA bacteremia were treated empirically with vancomycin., Conclusion: Our interventions reduced overall vancomycin use in the PICU without evidence of harm. Provider education and consensus building surrounding indications for empiric vancomycin use were key strategies., Competing Interests: CONFLICT OF INTEREST DISCLOSURES: The authors have indicated they have no potential conflicts of interest to disclose., (Copyright © 2022 by the American Academy of Pediatrics.)

The sulfur on the sulfur-assisted reduced graphene oxide (SrGO) surface provides the origin of poly(phenylene sulfide) PPS-grafting via S N Ar mechanism. In-situ polymerization from sulfur on SrGO afforded surface modification of SrGO, resulting in enhanced dispersibility in PPS. The tensile strength, electrical and thermal conductivities, and flame retardancy of PPS-coated SrGO were efficiently enhanced using highly concentrated SrGO and masterbatch (MB) for industrial purposes. Three-dimensional X-ray microtomography scanning revealed that diluting MB in the PPS resin afforded finely distributed SrGO across the PPS resin, compared to the aggregated state of graphene oxide. For the samples after dilution, the thermal conductivity and flame retardancy of PPS/SrGO are preserved and typically enhanced by up to 20%. The proposed PPS/SrGO MB shows potential application as an additive for reinforced PPS due to the ease of addition during the extrusion process.

Objectives: The main objectives of this study were to determine the effect of concurrent malnutrition on disease condition and the primary outcome of mortality in children younger than 5 years hospitalized after presenting to a rural emergency department (ED) in Uganda and to identify a high-risk patient population who may benefit from acute ED intervention., Methods: A retrospective, observational study was performed to examine the effect of any form of malnutrition on the primary disease conditions of lower-respiratory tract infection (LRTI), malaria, and diarrheal illness. This study was conducted via review of a quality assurance database between January 2010 and July 2014., Results: Of 3428 hospitalized children, the mean age (SD) was 19.8 months (13.9 months) and 56% were boys. Children diagnosed with malaria, an LRTI, or diarrheal illness all had a higher rate of mortality with concurrent malnutrition versus those without malnutrition (malaria, 6.2% [3.6-8.8%] vs 2.8% [2.0-3.7%]; P < 0.01; LRTI, 8.7% [5.0-12.4%] vs. 3.7% [2.6-4.9%], P < 0.01; and diarrheal illness, 10.9% [1.9-19.9%] vs 1.7% [0.1-3.4%], P < 0.01). In children with an LRTI or malaria with concurrent malnutrition, they were statistically significantly less likely to have abnormal temperature and heart rate during the ED encounter than those without concurrent malnutrition., Conclusions: Based on these results, children with malnutrition and concurrent diseases with known high morbidity may not present with abnormal vital signs. This may have clinical relevance in patient management to the acute care provider in identifying and triaging children with malnutrition and acute disease conditions., Competing Interests: Disclosure: The authors declare no conflict of interest., (Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.)

In this study, the effect of interfacial interaction between solvent and sheets on the exfoliation of sulfur-doped reduced graphene oxide (SrGO) sheets was studied, using molecular dynamics simulations. Four organic solvents of toluene, tetrahydrofuran, N-methyl-2-pyrrolidone, and sulfolane, were used in this simulation. An insertion simulation considering the size effect of insertion molecules was used to determine the insertion efficiency of the solvent molecules. The insertion efficiency of toluene was the best among the four solvents due to the influence of the effective thickness of the solvent. An exfoliation simulation considering electrostatic interaction was conducted to evaluate the exfoliation efficiency of the SrGO sheets. Unlike the insertion efficiency case, the sulfolane was found to have the best exfoliation efficiency among the four solvents, due to the strong electrostatic repulsion and weak attractive energy between the SrGO sheets. The exfoliation efficiency of the SrGO sheets was improved by increasing the sulfur content and the ratio of the thiol type to the total number of sulfur-doped groups. These results reveal that decreasing the attractive energy and increasing the electrostatic repulsion between the solvent and SrGO sheets are a useful way to improve the exfoliation efficiency of SrGO sheets.

With the increase in practical interest in flexible thermoelectric (TE) generators, the demand for high-performance alternatives to brittle TE materials is growing. Herein, we have demonstrated wet-spun CNT fibers with high TE performance by systematically controlling the longitudinal carrier mobility without a significant change in the carrier concentration. The carrier mobility optimized by CNT alignment increases the electrical conductivity without decreasing the thermopower, thus improving the power factor. On further adjusting the charge carriers via mild annealing, the CNT fibers exhibit a high power factor of 432 μW m-1 K-2. Based on the excellent TE performance and shape advantages for modular design of the CNT fiber, the all-carbon based flexible TE generator without an additional metal electrode has been fabricated. The flexible TE generator based on 40 pairs of p- and n-type CNT fibers shows the maximum power density of 15.4 and 259 μW g-1 at temperature differences (ΔT) of 5 and 20 K, respectively, currently one of the highest values reported for TE generators based on flexible materials. The strategy proposed here can improve the performance of flexible TE fibers by optimizing the carrier mobility without a change in the carrier concentration, and shows great potential for flexible TE generators.

Pediatric emergency medicine quality work continues to focus on the National Academies of Sciences, Engineering, and Medicine's 6 domains of quality, with a need for specific emphasis on equity and patient centeredness. Adopting the principles of high-reliability organizations, pediatric emergency departments should become increasing transparent with benchmarking and collaboration across institutions in order to develop an infrastructure for quality and safety to improve the care of pediatric patients in the emergency department., (Copyright © 2018 Elsevier Inc. All rights reserved.)

A therapeutic reduced graphene oxide (RGO) is synthesized by using fucoidan (Fu) as the reducing and surface functionalizing agent. The synthesized Fu-RGO exhibits promising characteristics for therapeutic applications such as high dispersity in aqueous media, biocompatibility, selective cytotoxicity to cancer cells, high loading capacity of the anticancer drug, and photothermal conversion effect. Therefore, Fu-GO is successfully harnessed as a combinatorial cancer treatment platform through bio-functional (Fu), chemo (doxorubicin (Dox)) and photothermal (RGO with near-infrared irradiation) modalities.

In this study, the influences of the carboxyl functionalization of intercalators on exfoliation of graphite oxide were analyzed using molecular dynamics (MD) simulations. Molecular models of four-layered graphene oxide (GO) sheets, four different solvents (ethanol, dimethylformamide, tetrahydrofuran, and N-methyl-2-pyrrolidone), and four different intercalators (anthracene, 2-anthracenecarboxylic acid, 2,3-anthracenedicarboxylic acid, and 2,6-anthracenedicarboxylic acid) were used in the MD simulations. A separation simulation of GO sheets was performed to determine the point at which the GO sheets begin to exfoliate. An insertion simulation was used to obtain the minimum kinetic energy required for exfoliation and to calculate GO-solvent and GO-intercalator interaction energies. As the simulation result, GO-solvent and GO-intercalator interactions affected the minimum kinetic energy required for exfoliation. Having more carboxyl functional groups on the anthracene improved both the GO-intercalator interaction and the efficiency of the intercalators during exfoliation. These results reveal that increasing the interaction energy between the GO sheets and the insertion molecules is an efficient way to improve the performance of the solvents and the intercalators for the exfoliation of GO sheets.

To meet the demand for next-generation flexible optoelectronic devices, it is crucial to accurately establish the chemical structure-property relationships of new optical polymer films from a theoretical point of view, prior to production. In the current study, computer-aided simulations of newly designed poly(ester imide)s (PEsIs) with various side groups (⁻H, ⁻CH₃, and ⁻CF₃) and substituted positions were employed to study substituent-derived steric effects on their optical and thermal properties. From calculations of the dihedral angle distribution of the model compounds, it was found that the torsion angle of the C⁻N imide bonds was effectively constrained by the judicious introduction of di-, tetra-, and hexa-substituted aromatic diamines with ⁻CF₃ groups. A high degree of fluorination of the PEsI repeating units resulted in weaker intra- and intermolecular conjugations. Their behavior was consistent with the molecular orbital energies obtained using density functional theory (DFT). In addition, various potential energy components of the PEsIs were investigated, and their role in glass-transition behavior was studied. The van der Waals energy ( E vdW ) played a crucial role in the segmental chain motion, which had an abrupt change near glass-transition temperature ( T g ). The more effective steric effect caused by ⁻CF₃ substituents at the 3-position of the 4-aminophenyl group significantly improved the chain rigidity, and showed high thermal stability ( T g > 731 K) when compared with the ⁻CH₃ substituent at the same position, by highly distorting (89.7°) the conformation of the main chain.

We herein report a facile, cost-competitive, and scalable method for producing viscoelastic conductors via one-pot melt-blending using polymers and supramolecular gels composed of carbon nanotubes (CNTs), diphenylamine (DP), and benzophenone (BP). When mixed, a non-volatile eutectic liquid (EL) produced by simply blending DP with BP (1:1 molar ratio) enabled not only the gelation of CNTs (EL-CNTs) but also the dissolution of a number of commodity polymers. To make use of these advantages, viscoelastic conductors were produced via one-pot melt-blending the EL and CNTs with a model thermoplastic elastomer, poly(styrene-b-butadiene-b-styrene) (SBS, styrene 30 wt %). The resulting composites displayed an excellent electromechanical sensory along with re-mendable properties. This simple method using cost-competitive EL components is expected to provide an alternative to the use of expensive ionic liquids as well as to facilitate the fabrication of novel composites for various purposes., (© 2017 Wiley-VCH Verlag GmbH & Co. KGaA, Weinheim.)

The coordination chemistry of plant polyphenols and metal ions can be used for coating various substrates and for creating modular superstructures. We herein explored this chemistry for the controlled release of guests from mesoporous silica nanoparticles (MSNs). The selective adsorption of tannic acids (TAs) on MSN silica walls opens the MSN mesoporous channels without disturbing mass transport. The channel may be closed by the coordination of TA with Cu II ions. Upon exposure to light, photolysis of Trojan horse guests (photoacid generators, PAGs) leads to acid generation, which enables the release of payloads by decomposing the outer coordination shell consisting of TA and Cu II . We also fabricated a modular assembly of MSNs on glass substrates. The photoresponsive release characteristics of the resulting film are similar to those of the individual MSNs. This method is a fast and facile strategy for producing photoresponsive nanocontainers by non-covalent engineering of MSN surfaces that should be suitable for various applications in materials science., (© 2017 Wiley-VCH Verlag GmbH & Co. KGaA, Weinheim.)

Background/objective: Sasang constitutional medicine is a component of traditional Korean medicine that classifies individuals into four Sasang constitutional types (SCTs) by their physical and psychological traits. Each SCT is known to show different susceptibilities to disorders. This systematic review investigated the effect of SCT as a risk factor for various disorders., Methods: A systematic literature survey was conducted by searching seven databases for all articles on the prevalence rates of disorders according to SCT and sex., Results: From 14,272 relevant articles, 15 studies (13 disorders) were ultimately identified to verify different prevalence rates by SCT. Of the 13 disorders, 6 (prehypertension, general obesity, abdominal obesity, metabolic syndrome, diabetes mellitus, and irritable bowel syndrome [IBS]) had a significantly different prevalence by SCT. Metabolic syndrome and its associated disorders showed the highest prevalence in Taeumin-type individuals, whereas IBS was most prevalent in Soeumin-type individuals. In general, these findings were consistent with the results obtained in an analysis of male and female participants., Conclusions: This study revealed that susceptibility to disorders was affected by SCT to some extent. Further studies are needed to determine the concrete features of SCT-related susceptibility, which may be helpful in preventive medicine with Sasang constitutional practice.

Fever in the pediatric population is a common chief complaint presenting to the emergency department and may be one of the first indications of a life-threatening infection, especially in patients with neutropenia. Given that pediatric patients with febrile neutropenia frequently present to emergency departments for emergent care, it is critical for emergency medicine physicians and pediatricians and family physicians working in the emergency department to know the key aspects of the clinical approach to these patients. This review of the clinical evaluation and treatment of the pediatric patient presenting with fever and confirmed or suspected neutropenia will provide health care providers with the necessary tools to effectively care for this patient population.

In this study, we develop a new methodology for transmission electron microscopy (TEM) analysis that enables us to directly investigate the interface between carbon nanotube (CNT) arrays and the catalyst and support layers for CNT forest growth without any damage induced by a post-growth TEM sample preparation. Using this methodology, we perform in situ and ex situ TEM investigations on the evolution of the morphology of the catalyst particles and observe the catalyst particles to climb up through CNT arrays during CNT forest growth. We speculate that the lifted catalysts significantly affect the growth and growth termination of CNT forests along with Ostwald ripening and sub-surface diffusion. Thus, we propose a modified growth termination model which better explains various phenomena related to the growth and growth termination of CNT forests.

Atomically-thin molecular layers of aryl-functionalized graphene oxides (GOs) were used to modify the surface characteristics of source-drain electrodes to improve the performances of organic field-effect transistor (OFET) devices. The GOs were functionalized with various aryl diazonium salts, including 4-nitroaniline, 4-fluoroaniline, or 4-methoxyaniline, to produce several types of GOs with different surface functional groups (NO2-Ph-GO, F-Ph-GO, or CH3O-Ph-GO, respectively). The deposition of aryl-functionalized GOs or their reduced derivatives onto metal electrode surfaces dramatically enhanced the electrical performances of both p-type and n-type OFETs relative to the performances of OFETs prepared without the GO modification layer. Among the functionalized rGOs, CH3O-Ph-rGO yielded the highest hole mobility of 0.55 cm(2) V(-1) s(-1) and electron mobility of 0.17 cm(2) V(-1) s(-1) in p-type and n-type FETs, respectively. Two governing factors: (1) the work function of the modified electrodes and (2) the crystalline microstructures of the benchmark semiconductors grown on the modified electrode surface were systematically investigated to reveal the origin of the performance improvements. Our simple, inexpensive, and scalable electrode modification technique provides a significant step toward optimizing the device performance by engineering the semiconductor-electrode interfaces in OFETs.

A rapid and efficient multiresidue method that involves using improved QuEChERS method and liquid chromatography-electrospray tandem mass spectrometry (LC-ESI-MS/MS) was developed to measure trace levels of sulfonamides in fish tissue. This proposed method was proven to be a powerful, highly sensitive, and environmentally friendly analytical tool that requires minimal sample preparation. The typical MS/MS fragmentation patterns of the [M+H](+) were 156 m/z, 108 m/z, and 92 m/z. Separation was performed on HC-C18 columns with a gradient elution by using methanol -5mM ammonium acetate containing formic acid (pH 3.5). This method was validated and exhibited favorable performance as well as acceptable accuracy (80.2-93.5%), precision (3.82-8.71%), sensitivity (limits of detection (LODs) 0.43-1.22 μg kg(-1), limits of quantification (LOQs) 1.27-3.71 μg kg(-1); decision limit (CCα) 1.49-10.9 μg kg(-1), detection capability (CCβ) 1.71-11.4 μg kg(-1)), and an acceptable matrix effect (-18.2-18.4%). This methodology has been successfully applied in analyzing various fish tissue from local markets., (Copyright © 2014 Elsevier Ltd. All rights reserved.)

New halogen/nitrogen dual-doped graphenes (X/N-G) with thermally tunable doping levels are synthesized via the thermal reduction of graphite oxide (GO) with stepwise-pyrolyzed ionic liquids. The doping process of halogen and nitrogen into the graphene lattice proceeds via substitutional or covalent bonding through the physisorption or chemisorption of in situ pyrolyzed dopant precursors. The doping process is performed by heating to 300-400 °C of ionic liquid, and the chemically assisted reduction of GO is facilitated by ionic iodine, resulting in I/N-G materials possessing about three and two orders of magnitude higher conductivity (∼22,200 S m(-1)) and charge carrier density (∼10(21) cm(-3)), compared to those of thermally reduced GO. The thermally tunable doping levels of halogen in X/N-G significantly increase the conductivity of doped graphene to ∼27,800 S m(-1).

Nitrogen doping in carbon nanotube (CNT) fibers using pyrolyzed ionic liquid induced interfacial hydrogen bonding between individual CNTs, enhancing mechanical properties and electrical conductivity simultaneously. In particular, the nitrogen doped CNT fiber using the ionic liquid BMI-I exhibited about 104%, 714%, and 38% increased tensile strength (0.65 N/tex), elastic modulus (83 N/tex), and electrical conductivity (1350 S cm(-1)), respectively, compared to pristine CNT fiber.

Background: It was reported that 64% of tic disorder patients used complementary and alternative medicine. This review aims to evaluate the efficacy of herbal medicines in treating tic disorders., Methods: We searched eight databases including MEDLINE and CINAHL from their respective inceptions up to September 2013. The search terms were related to the concept of "herbal medicine" AND "tic disorder OR Tourette's syndrome". We included randomised controlled trials (RCTs) of any type of herbal medicines. We assessed the methodological quality of the trials according to the Cochrane risk of bias criteria., Results: Sixty one studies were identified, and four RCTs met the inclusion criteria. Two types of herbal medicines, Qufeng Zhidong Recipe (QZR) decoction and Ningdong (ND) granules, were used in the included RCTs. All four RCTs had a high risk of bias. Two RCTs tested the effects of QZR on the Yale Global Tic Severity Scale (YGTSS) score and response rate compared with conventional medicine. The meta-analysis showed significant effects of QZR on the YGTSS score with high statistical heterogeneity (n = 142; weighted mean difference: -18.34; 95% confidence interval (CI): -23.07 to -13.60; I2 = 97%) and the response rate (n = 142; risk ratio: 1.69; 95% CI: 1.39 to 2.06; I2 = 0%). One RCT compared ND granules with placebo and showed significant effects on the YGTSS score and response rate. The other RCT show significant effects of ND granules plus conventional medicine on the response rate compared with conventional medicine only., Conclusion: This systematic review provided first piece of limited meta-analytic evidence for the effectiveness of herbal medicines in improving the symptoms of tic disorders.

A carbon nanotube yarn core graphitic shell hybrid fiber was fabricated via facile heat treatment of epoxy-based negative photoresist (SU-8) on carbon nanotube yarn. The effective encapsulation of carbon nanotube yarn in carbon fiber and a glassy carbon outer shell determines their physical properties. The higher electrical conductivity (than carbon fiber) of the carbon nanotube yarn overcomes the drawbacks of carbon fiber/glassy carbon, and the better properties (than carbon nanotubes) of the carbon fiber/glassy carbon make up for the lower thermal and mechanical properties of the carbon nanotube yarn via synergistic hybridization without any chemical doping and additional processes.

Chemical post-treatment of the carbon nanotube fiber (CNTF) was carried out via intramolecular cross-dehydrogenative coupling (ICDC) with FeCl3 at room temperature. The Raman intensity ratio of the G band to the D band (IG/ID ratio) of CNT fiber increased from 2.3 to 4.6 after ICDC reaction. From the XPS measurements, the AC═C/AC-C ratio of the CNT fiber increased from 3.6 to 4.8. It is of keen interest that both the electrical conductivity and tensile strength of CNT yarn improved to 3.5 × 10(3) S/cm and 420 MPa, which is 180 and 200% higher than that of neat CNT yarn.

A chemical defect healing of reduced graphene oxide (RGO) was carried out via intramolecular cross-dehydrogenative coupling (ICDC) with FeCl3 at room temperature. The Raman intensity ratio of the G-band to the D-band, the IG/ID ratio, of the RGO was increased from 0.77 to 1.64 after the ICDC reaction. From XPS measurements, the AC=C/AC-C ratio, where the peak intensities from the C=C and C-C bonds are abbreviated as AC=C and AC-C, of the RGO was increased from 2.88 to 3.79. These results demonstrate that the relative amount of sp(2)-hybridized carbon atoms is increased by the ICDC reaction. It is of great interest that after the ICDC reaction the electrical conductivity of the RGO was improved to 71 S cm(-1), which is 14 times higher than that of as-prepared RGO (5 S cm(-1)).

Highly conductive reduced graphene oxide (GO) polymer nanocomposites are synthesized by a well-organized in situ thermochemical synthesis technique. The surface functionalization of GO was carried out with aryl diazonium salt including 4-iodoaniline to form phenyl functionalized GO (I-Ph-GO). The thermochemically developed reduced GO (R-I-Ph-GO) has five times higher electrical conductivity (42,000 S/m) than typical reduced GO (R-GO). We also demonstrate a R-I-Ph-GO/polyimide (PI) composites having more than 10(4) times higher conductivity (~1 S/m) compared to a R-GO/PI composites. The electrical resistances of PI composites with R-I-Ph-GO were dramatically dropped under ~3% tensile strain. The R-I-Ph-GO/PI composites with electrically sensitive response caused by mechanical strain are expected to have broad implications for nanoelectromechanical systems., (© 2012 American Chemical Society)

Water-dispersible graphene was prepared by reacting graphite oxide and 6-amino-4-hydroxy-2-naphthalenesulfonic acid (ANS). X-ray diffraction study showed that the basal reflection (002) peak of graphite oxide was absent in the ANS-functionalized graphene (ANS-G), indicating crystal layer delamination. Ultraviolet-visible spectral data were recorded to assess the solubility of the ANS-G in water. Fourier transform infrared spectral analysis suggested the attachment of ANS molecules to the surface of graphene. Raman and x-ray photoelectron spectroscopy revealed that oxygen functionality in the graphite oxide had been removed during reduction. Atomic force microscopy found that the thickness of ANS-G in water was about 1.8 nm, much higher than that of single layer graphene. Thermal stability measurements also indicated successful removal of oxygen functionality from the graphite oxide and the attachment of thermally unstable ANS to the graphene surfaces. The electrical conductivity of ANS-G, determined by a four-point probe, was 145 S m(-1) at room temperature.

Fingerprinting analysis of fresh ginseng according to root age was performed using 1H-NMR spectroscopy and multivariate analysis techniques. Various peaks were detected in the aliphatic (0-3 ppm), sugar (3-6 ppm), and aromatic (6-9 ppm) regions of the 1H-NMR spectra of the water extracts of fresh ginseng root. The use of principal components (PCs) analysis (PCA) for metabolomic profiling allowed the large 1H-NMR data set obtained for various metabolites to be reduced to PC1, PC2, and PC3. Two dimensional score plots showed clear separations with these three components at different roots ages, and explained 89.6% of the total variance. Canonical discriminant analysis identified the ginseng roots at various ages from the NMR results with over 89.9% discrimination accuracy. These results indicate that the combination of 1H-NMR and PCA provides a very promising tool for the authentication and quality control of fresh ginseng roots at different ages.

Abnormal expression and signaling of ErbB receptors has been implicated in multiple epithelial malignancies, including pancreatic cancer. Erlotinib, an epidermal growth factor receptor tyrosine kinase inhibitor (EGFR-TKI), has been recently approved for pancreatic cancer treatment, but there are no reliable predictors of patient response. Expression of additional ErbB receptors seems to influence tumor response to EGFR-targeted therapy. We analyzed the influence of ErbB3 expression on pancreatic cancer cell response to erlotinib treatment. Proliferation assays of five human pancreatic cancer cell lines were performed following treatment with erlotinib. Expression and phosphorylation profiles of ErbB receptors and downstream adaptor protein (Akt, ERK1/2, STAT3, mTOR) were evaluated following stimulation with EGF or neuregulin-beta. The formation of EGFR homodimers and EGFR-ErbB3 heterodimers, necessary to enable ErbB3 downstream signaling, was demonstrated by chemical cross-linking assays. The effects of RNA inhibition of ErbB3 on sensitivity to erlotinib treatment were evaluated in AsPC-1 pancreatic cancer cells. Erlotinib inhibited Akt phosphorylation and proliferation of all the ErbB3-expressing cell lines but did not affect mTOR activation. Cross-linking studies confirmed the presence of EGFR-ErbB3 heterodimers in pancreatic cancer cells. Only the ErbB3-deficient MIA PaCa-2 cells displayed persistent Akt activation and ongoing proliferation in spite of erlotinib treatment. siRNA-mediated inhibition of ErbB3 expression in AsPC-1 cells resulted in acquired resistance to erlotinib treatment. Pancreatic cancer cells which lack ErbB3 do not display activation of the ErbB3-PI3K-Akt cascade induced by EGFR/ErbB3 heterodimers and become less critically dependent on EGFR signaling and therefore resistant to erlotinib. Pancreatic cancer expression of ErbB3 may be useful for EGFR-targeted therapy patient selection.