The controlled growth of vertical van der Waals (vdW) heterostructures based on two-dimensional (2D) single crystals is crucial for the energy band modulation of 2D materials and related device ...applications. In this study, we investigated the epitaxial intercalation method to directly grow large-area hexagonal boron nitride (hBN)/graphene stacked vdW heterostructures on commercial copper foils. The method consists of three steps: growth of the top hBN template, hydrogen termination of the hBN edge, and intercalation growth of graphene between the hBN and a copper catalyst. In the intercalation step, compared with the conventional use of methane, a precursor with a lower hydrogen content, such as acetylene, is beneficial in maintaining the integrity of the hBN template. The ratio of hydrogen to acetylene determines the crystallization and quality of the intercalated graphene and hBN/graphene heterostructures. With our epitaxial intercalation method, we extend the bottom-up fabrication of large-scale high-quality vdW heterostructures.
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IJS, KILJ, NUK, PNG, UL, UM
The ability to control the crystal orientation of 2D van der Waals (vdW) layered materials grown on large‐scale substrates is crucial for tailoring their electrical properties, as well as for ...integration of functional 2D devices. In general, multiple orientations, i.e., two or four orientations, appear through the crystal rotational symmetry matching between the material and its substrate. Here, it is reported that hexagonal boron nitride (h‐BN), an ideal electric barrier in the family of 2D materials, has a single orientation on inclined Cu (1 0 1) surfaces, where the Cu planes are tilted from the (1 0 1) facet around specific in‐plane axes. Density functional theory (DFT) calculation indicates that this is a manifestation of only one favored h‐BN orientation with the minimum vdW energy on the inclined Cu (1 0 1) surface. Moreover, thanks to the high interfacial strength with the underlying Cu, the single‐orientation h‐BN is free of thermal wrinkles, and exhibits a spatially homogeneous morphology and tunnel conductance. The findings point to a feasible approach to direct growth of single‐orientation, wrinkle‐free h‐BN thin film for high‐performance 2D electrical devices, and will be of benefit for controllable synthesis of other vdW materials.
The catalyst surface selection rule of hexagonal boron nitride (h‐BN) growth by chemical vapor deposition is demonstrated. The catalyst‐terrace symmetry breaking by surface steps is proposed to be the key for single‐orientation growth of h‐BN on a series of inclined Cu (1 0 1) facets. The single‐orientation h‐BN is free of wrinkles and exhibits excellent homogeneity of dielectric performance.
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BFBNIB, FZAB, GIS, IJS, KILJ, NLZOH, NUK, OILJ, SBCE, SBMB, UL, UM, UPUK
Abstract
An array of embedded graphene ribbons, whose edges connect to a buffer layer, can be grown on 4H-SiC(0001). The intensity of the Raman
D
peak of the armchair edge of the ribbon shows the ...same polarization dependence as that of the non-connected armchair edge of graphene. Considering the Raman scattering process of the
D
peak at the armchair edge, this polarization dependence indicates that electrons and holes in the embedded graphene by incident photons are scattered back at the boundary of the embedded graphene ribbon and buffer layer. These results show that polarized Raman scattering spectroscopy is useful for investigating the edge structure of embedded graphene.
12133 Background: Hepatitis, as an immune-related adverse event (irAE), occurs in 2%-10% of patients treated with immune checkpoint inhibitors (ICIs). Although guidelines recommend the use of ...mycophenolate mofetil (MMF) for steroid-refractory and steroid-resistant ir-hepatitis, there has been no evidence on the efficacy of MMF. Methods: We retrospectively reviewed consecutive patients with solid tumors who developed grade 2 or higher ir-hepatitis requiring systemic steroids after ICIs (nivolumab, pembrolizumab, atezolizumab, avelumab, durvalumab and ipilimumab) between January 2015 and August 2023. The changes in aspartate aminotransferase (AST), alanine aminotransferase (ALT), and total bilirubin level, according to the CTCAE version 5.0, were used to assess ir-hepatitis. ALT improvement was calculated as the ratio of the change in ALT values from onset to day 7, normalized by the ALT values at onset. Results: Among 4405 patients treated with ICI during the study period, 130 patients (3%) developed grade 2 or higher ir-hepatitis requiring systemic steroids. The median age was 62 (range: 19-85) years-old, and 122 patients (94%) had an ECOG performance status (PS) 0/1. These patients included 67 (52%) with melanoma, 35 (27%) with lung cancer, 7 (5%) with esophageal cancer, and 21 (16%) with other cancers. Among 123 evaluable patients, 46 patients (46/123, 37%) received MMF including 20 patients experiencing steroid-refractory and 26 steroid-resistant. The median duration from the start of systemic steroids to MMF was 11 days (range: 0-113 days). Improvement of hepatitis to grade 1 with MMF was observed in 40 patients (40/46, 87%) with a median time of 18 (range: 3-176) days. Of the patients evaluated for the impact of the timing of MMF on the improvement of ir-hepatitis (n=38), ALT improvement at day 7 after ir-hepatitis onset in patients who initiated MMF within 3 days of ir-hepatitis onset (early combination group, n=8) was significantly higher compared with the patients who initiated MMF after 3 days of ir-hepatitis onset (late combination group, n=30) (72.3% vs. 41.7%, p=0.02). Additionally, among patients evaluable for systemic steroid dosage (n=45), the total systemic steroid dosage in patients in the early combination group (n=8) was significantly less than in the late combination group (n=37) (median: 2120mg vs 4005 mg, p=0.02). Conclusions: MMF was effective for both steroid-refractory and steroid -resistant ir-hepatitis. Early combination with MMF in addition to systemic steroids can lead to a more rapid improvement of ir-hepatitis compared to late combination with MMF consequently reducing the total systemic steroid dosage. Table: see text
Background
Serum adiponectin circulates in three multimeric isoforms: high-molecular-weight (HMW), middle-molecular-weight (MMW), and low-molecular-weight (LMW) isoforms. Potential change in the ...circulating adiponectin levels in patients with nephrotic syndrome (NS) remain unknown. This study aimed to assess the levels of total adiponectin and the distribution of its isoforms in pediatric patients with NS.
Methods
We sequentially measured total adiponectin and each adiponectin isoform levels at the onset of NS, initial remission, and during the remission period of the disease in 31 NS patients. We also calculated the ratios of HMW (%HMW), MMW (%MMW), and LMW (%LMW) to total adiponectin incuding 51 control subjects.
Results
The median of total serum adiponectin levels in patients were 36.7, 36.7, and 20.2 μg/mL at the onset, at initial remission, and during the remission period of NS, respectively. These values were significantly higher than those in control subjects. The median values of %HMW, %MMW, and %LMW values were 56.9/27.0/14.1 at the onset, 62.0/21.8/13.4 at the initial remission, and 58.1/21.7/17.5 at during the remission period of NS, respectively. Compared with control subjects, %HMW at initial remission and %MMW at the onset were high, and the %LMW values at the onset and at initial remission were low.
Conclusions
In patients with NS, total serum adiponectin levels increase at the onset of the disease, and the ratio of adiponectin isoforms changes during the course of the disease. Further studies are needed to delineate the mechanisms between proteinuria and adiponectin isoforms change.
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EMUNI, FIS, FZAB, GEOZS, GIS, IJS, IMTLJ, KILJ, KISLJ, MFDPS, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, SBMB, SBNM, UKNU, UL, UM, UPUK, VKSCE, ZAGLJ
We reconstructed a segmental bone defect in a finger associated with a dorsal skin defect using a bone graft covered with a free medial femoral condyle periosteal flap and a skin graft in two ...patients. The vascularised periosteal flap (VPF) improved the survival of the bone graft and allowed the take of the skin graft. The use of a VPF can be considered in patients with crush injury of the digits with segmental loss of bone and dorsal skin
Level of Evidence: Level V (Therapeutic)
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DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, UILJ, UKNU, UL, UM, UPUK
We aimed to introduce a surgical option for crushing–penetrating injuries around the metacarpophalangeal (MP) joint of the middle finger with extensor reconstruction of the interphalangeal (IP) ...joints. We also assessed the outcomes of patients using this surgical protocol. First, MP joint reconstruction was performed early (mean, 1.2 weeks after injury) using free autogenous cartilage or bone graft. We next performed a tendon transfer using a modified Brand method (M. Brand) at the same setting of extensor tendon tenolysis (mean, 4.7 months after injury) in order to extend the IP joints as a bonus for mutilating injuries of the hand. The mean arc of motion of each MP and IP joint increased after the M. Brand procedure. In one patient, worsening of palmar subluxation at the base of the proximal phalanx at the MP joint was observed. We found that tendon transfer by M. Brand achieves additional reconstruction for patients who have an IP joint extension lag after a crushing–penetrating injury around the MP joint. On the basis of these encouraging findings in this small series of cases, we recommend the M. Brand procedure after the MP joint stabilizes, as an optional bonus for mutilating injured hand.
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EMUNI, FIS, FZAB, GEOZS, GIS, IJS, IMTLJ, KILJ, KISLJ, MFDPS, NUK, OBVAL, OILJ, PNG, SAZU, SBCE, SBJE, SBMB, SBNM, UKNU, UL, UM, UPUK, VKSCE, ZAGLJ
Abstract
We report a rare case of entrapment of the median nerve following a closed fracture of the proximal one-fourth of the radius in an adolescent in failure of back hand spring. We proposed that ...the forearm pronation and the wrist extension in, “the Back Handspring position” made the median nerve close to the radius at one-fourth proximal radius, played an important role in this complication.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, MFDPS, NUK, OILJ, PNG, SAZU, SBCE, SBJE, SBMB, SBNM, UL, UM, UPUK, VKSCE, ZAGLJ
Abstract Although carbapenem is the recommended for urinary tract infection (UTI) caused by extended-spectrum beta-lactamase (ESBL)-producing organisms, non-carbapenems have been reported to be ...effective for adult patients with UTI caused by ESBL-producing organisms. The purpose of this study was to evaluate the efficacy of non-carbapenems for pediatric patients with UTI due to ESBL-producing Escherichia coli ( E. coli ) based on the microbiologic and clinical outcomes. Fifteen children, who were treated for first febrile UTI caused by ESBL-producing E. coli were enrolled in this study. Antimicrobial susceptibilities and ESBL production were determined according to the Clinical and Laboratory Standards Institute guidelines. To detect CTX-M genes, polymerase chain reaction was performed with specific primers for blaCTX-M detection. Of the 15 enrolled patients, 10 (66.7%) were boys and 5 (33.3%) were girls, with a median age of four months. VUR was detected in six patients (40%). For detection of blaCTX-M by PCR, CTX-M-3, CTX-M-8, CTX-M-14, and CTX-M-15 were detected in five, one, eight, and one patient, respectively. Overall, 14 of the 15 isolates (93.3%) were susceptible for fosfomycin (FOM), and all isolates were susceptible for cefmetazole (CMZ), flomoxef (FMOX), and imipenem/cilastatin (IPM/CS). Of the 15 patients, 12 (80%) clinically improved without the use of carbapenems. In conclusion, even if isolates of ESBL-producing E. coli are multidrug resistant based on MIC assessment, clinical susceptibility to non-carbapenems, such as CMZ, FMOX, and FOM, is possible. Accordingly, carbapenems may not be required all the time for treatment of pediatric UTI in clinical practice.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UL, UM, UPCLJ, UPUK, ZRSKP
Salmonella osteomyelitis of the radius in a healthy individual is very rare. We present such a case involving the distal radius of a healthy 23-year-old man without underlying disease or possible ...episode. He had right wrist pain for approximately 3 years, and osteolytic lesion was seen in the right distal radius. He underwent surgical treatment, and salmonella was isolated from pus in the lesion. Postoperative antibiotics successfully treated his infection. He had no sign of recurrence, but the point of entry for infection remains unknown. J. Med. Invest. 62: 97-99, February, 2015
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