The relationship between structure and performance in alkaline Zn batteries is undeniable, where anode utilization, dendrite formation, shape change, and passivation issues are all addressable ...through anode morphology. While tailoring 3D hosts can improve the electrode performance, these practices are inherently limited by scaffolds that increase the mass or volume. Herein, a direct write strategy for producing template‐free metallic 3D Zn electrode architectures is discussed. Concentrated inks are customized to build designs with low electrical resistivity (5 × 10−4 Ω cm), submillimeter sizes (200 μm filaments), and high mechanical stability (Young's modulus of 0.1–0.5 GPa at relative densities of 0.28–0.46). A printed Zn lattice anode versus NiOOH cathode with an alkaline polymer gel electrolyte is then demonstrated. This Zn||NiOOH cell operates for over 650 cycles at high rates of 25 mA cm−2 with an average areal capacity of 11.89 mAh cm−2, a cumulative capacity of 7.8 Ah cm−2, and a volumetric capacity of 23.78 mAh cm−3. A thicker Zn anode achieves an ultrahigh areal capacity of 85.45 mAh cm−2 and a volumetric capacity of 81.45 mAh cm−3 without significant microstructural changes after 50 cycles.
Zn colloidal inks are customized for direct writing of 3D Zn architectures with excellent physiochemical and mechanical properties. 3D Zn lattices are used to assemble quasisolid‐state Zn||NiOOH alkaline batteries, showing high areal capacity at high rates. Their long life cycles also enable the highest cumulative capacity compared to others, indicating excellent potential of printed Zn anodes for practical use.
Patients with lower-extremity peripheral artery disease (PAD) have greater functional impairment, faster functional decline, increased rates of mobility loss, and poorer quality of life than people ...without PAD. Supervised exercise therapy (SET) improves walking ability, overall functional status, and health-related quality of life in patients with symptomatic PAD. In 2017, the Centers for Medicare & Medicaid Services released a National Coverage Determination (CAG-00449N) for SET programs for patients with symptomatic PAD. This advisory provides a practical guide for delivering SET programs to patients with PAD according to Centers for Medicare & Medicaid Services criteria. It summarizes the Centers for Medicare & Medicaid Services process and requirements for referral and coverage of SET and provides guidance on how to implement SET for patients with PAD, including the SET protocol, options for outcome measurement, and transition to home-based exercise. This advisory is based on the guidelines established by the Centers for Medicare & Medicaid Services for Medicare beneficiaries in the United States and is intended to assist clinicians and administrators who are implementing SET programs for patients with PAD.
Zusammenfassung
Hintergrund
Neben der Qualität einer Leitlinie ist ihre Implementierung in den Behandlungsalltag von Bedeutung. Ziel dieser Untersuchung war die Erfassung des Implementierungsgrades ...der interdisziplinären S3-Leitlinie zur Diagnostik und Therapie des Prostatakarzinoms.
Material und Methoden
Ein Fragebogen mit Fragen zur Implementierung der S3-Leitlinie wurde an 119 niedergelassene und 37 in Kliniken tätige Urologen versandt. Vergleiche wurden mit dem χ
2
-Test durchgeführt.
Ergebnisse
Die Rücklaufquote lag bei 63 %. 93 % der antwortenden Urologen gaben an, die Leitlinie im täglichen Alltag zu nutzen. 95 % sahen die starken Empfehlungen der Leitlinie (Formulierung „soll“) als Therapiestandard an. In der Klinik tätige Urologen empfehlen die Leitlinie seltener ihren Patienten als Informationsquelle (30 vs. 58 %, p = 0,0283), jedoch häufiger anderen Ärzten (95 vs. 72 %, p = 0,0294), als Urologen in der Praxis.
Schlussfolgerung
Die interdisziplinäre S3-Leitlinie zur Diagnostik und Therapie des Prostatakarzinoms wird von einer überwiegenden Mehrheit der Urologen in der täglichen Arbeit genutzt. Die starken Empfehlungen der Leitlinie (Formulierung „soll“) werden als Therapiestandard angesehen. Optimierungsmöglichkeiten bestehen in einer kompakteren Darstellung und einer Propagierung der Leitlinie über das urologische Fachgebiet hinaus.
Caffeine is the most consumed psychoactive substance worldwide. Previous studies suggested higher caffeine consumption in subjects with schizophrenia spectrum disorders (SSD) as well as associations ...with symptoms, medication and medication side-effects.
In a large and well-characterized sample of SSD subjects we explored the association between caffeine consumption and clinical (psychosis related, severity, general health) as well as pharmacological (antipsychotic treatment, sedation potential) variables.
Eight hundred four subjects with data on their caffeine (coffee and tea) consumption successively recruited were included in this study.
After controlling for potential confounders (demographic variables, smoking) only the negative dimension of psychosis was associated with the amount of caffeine ingested. Less severe negative symptoms were associated with higher caffeine consumption. The effect size of this association was small (partial correlation coefficient = −0.12) but significant.
•Higher caffeine consumption was associated with lower negative symptoms.•This association was still significant after adjustment for multiple confounders.•A more sedative treatment was associated with higher caffeine consumption.•Taking into account smoking the association with treatment was no more significant.•Caffeine consumption was not associated with anxiety or quality of sleep.
Plant-based diets (PBD) may offer various health benefits and contribute to a sustainable way of life, but, if not planned correctly, may also confer risks, e.g., by focusing on plant foods with low ...nutrient density, such as foods primarily consisting of refined carbohydrates. A plant-based diet index (PDI) differentiating between a healthful, unhealthful, and overall PBD, offers a promising approach to standardize and compare studies and integrate results. In this review we (1) summarize current evidence on the PDI and disease risk of relevance to public health, (2) discuss the methodology of the PDI and how it can be sensibly applied in further studies and (3) indicate areas with a lack of knowledge, such as vulnerable populations. In summary, our amalgamation shows, that adherence to a healthier plant-based diet is associated with an 8–68% lower risk for metabolic risk factors, diabetes, and cardiovascular disease, while adherence to an unhealthier plant-based diet is associated with a 10–63% higher risk. Although differences in calculation methods and underlying diet patterns between populations should be accounted for, the PDI can be a useful tool to assess adherence to different plant-based diet patterns and their association with health outcomes in cohort studies across cultures.
Secondary prevention of cardiovascular disease (CVD), the leading cause of morbidity and mortality, is critical to improving health outcomes and quality of life in our aging population. As mobile ...health (mHealth) technology gains universal leverage and popularity, it is becoming more user-friendly for older adults and an adjunct to manage CVD risk and improve overall cardiovascular health. With the rapid advances in mHealth technology and increasing technological engagement of older adults, a comprehensive understanding of the current literature and knowledge of gaps and barriers surrounding the impact of mHealth on secondary CVD prevention is essential. After a systematic review of the literature, 26 studies that used mHealth for secondary CVD prevention focusing on lifestyle behavior change and medication adherence in cohorts with a mean age of ≥60 years were identified. Improvements in health behaviors and medication adherence were observed, particularly when there was a short message service (ie, texting) component involved. Although mobile technologies are becoming more mainstream and are starting to blend more seamlessly with standard health care, there are still distinct barriers that limit implementation particularly in older adults, including affordability, usability, privacy, and security issues. Furthermore, studies on the type of mHealth that is the most effective for older adults with longer study duration are essential as the field continues to grow. As our population ages, identifying and implementing effective, widely accepted, cost-effective, and time-efficient mHealth interventions to improve CVD health in a vulnerable demographic group should be a top health priority.
OBJECTIVESTo investigate the prevalence of and factors associated with chronic insomnia and obstructive sleep apnea (CIOSA) comorbidity in obstructive sleep apnea (OSA) patients. METHODSBetween March ...2014 and March 2015, we conducted a prospective, cross-sectional study of 238 adults diagnosed with OSA according to polysomnography and International Classification of Sleep Disorders-Third Edition criteria. RESULTSThe prevalence of CIOSA was 29%. There was a trend towards older age in the CIOSA group. Sex was not associated with CIOSA. Sleep-maintenance and sleep-onset insomnia predominated in the sample. Beck's depression and anxiety inventory scores were higher in the CIOSA group. Both depression and anxiety symptoms were associated with CIOSA. The arousal and apnea-hypopnea indices were lower in the CIOSA group. CIOSA was also associated with age ≥ 60 years and current tobacco use. Severe OSA and alcohol use were negatively associated with CIOSA. CONCLUSIONSChronic insomnia is prevalent among OSA patients. Our study highlights the need for detailed evaluation of patients with sleep breathing disorders to diagnose other important sleep and mood disorders (such as depression and anxiety), given their frequent association.
Although supervised exercise therapy (SET) is effective in improving walking distance among adults with symptomatic peripheral artery disease (PAD), some research suggests that individuals with ...comorbid PAD and type 2 diabetes mellitus (T2DM) may experience a blunted response to SET. It is unknown whether free-living sedentary time changes during SET, and if increases in sedentary time could, in part, explain poor response to SET. The purposes of this pilot study were to (1) determine if older adults with PAD (with and without T2DM) engaging in SET change their sedentary behavior and (2) examine the relationship between changes in sedentary behavior and SET outcomes. We hypothesized that decreased sedentary time during SET would be associated with greater improvements in six-minute walk test (6MWT) total distance and other key SET outcomes.
Participants (n = 44) initiating a 12-week SET program completed the 6MWT, Short Physical Performance Battery, Walking Impairment Questionnaire, and accelerometer-assessed sedentary behavior at SET initiation, 6 weeks, and 12 weeks.
Participants' mean age was 72.3 (7.1) years, mean ankle-brachial index was 0.71 (0.25), and 47.7% were female. On average, sedentary time did not change after SET, although there was substantial variability (-40% to +38% change in minutes of sedentary time/day). Participants with T2DM experienced greater improvements in claudication onset distance than participants without T2DM (mean = 35 m, P = 0.044, 95% confidence interval = 1.6 to 115.4 m). Neither changes in sedentary time from baseline to 6 weeks (P = 0.419) nor T2DM (P = 0.154) predicted changes in 6MWT total distance from baseline to 12 weeks.
As SET availability increases, further examination of factors that may influence SET outcomes will help maximize benefits of this proven therapy.
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