As numbers of maintenance hemodialysis patients are growing, debilitating conditions of muscle wasting and atrophy are becoming some of the greatest concerns in end-stage renal disease patients. ...Exercise training has various potential benefits in terms of prevention of a sustained decline in functional status. This study aimed to evaluate the physical, psychological, laboratory, and dialysis-related effects of intradialytic exercise.
We enrolled 22 patients from a hemodialysis center for a 6-month non-randomized prospective trial. Combination of aerobic exercise with bicycle ergometer and anaerobic exercise with elastic bands was conducted during hemodialysis. Data including physical fitness test results, dialysis-related measurements, and biochemical laboratory results were collected at baseline, 3, and 6 months. Depression and quality of life were assessed using Beck Depression Inventory and Short Form-36 health survey.
After exercise completion, there were significant improvements in back muscle power, forward and backward trunk flexibility, vertical jump, elbow flexion, sit to stand test, and 6-minute walk test (p < 0.05). No significant changes were observed in dry weight, blood pressure, Kt/V, and biochemical variables, except for intradialytic hypotension (p < 0.05). For depression, Beck Depression Inventory showed statistically significant enhancement (p < 0.05). Scores of Short Form-36 health survey did not show significant increase in each domain, except for bodily pain (p < 0.05).
Combined aerobic and anaerobic exercise training during dialysis was found to be effective on physical health status, intradialytic hypotension, and depression in terms of mental health. Therefore, the findings of the current study may provide an appropriate guidance for encouraging exercise by nephrologists.
Optimal pain management after insertion of a central venous catheter in children remains unclear.
This study aimed to evaluate the effects of a selective supraclavicular nerve block on postoperative ...analgesia in pediatric patients undergoing hickman catheter or chemoport insertion.
Fifty patients aged 3-18 years scheduled for elective Hickman or chemoport insertion were randomized into two groups of 25 each: one group received an ultrasound-guided selective supraclavicular nerve block with 0.1 mL/kg of 0.5% ropivacaine (SSCNB group), and the other group did not receive a nerve block (control group). The primary outcome was the postoperative Wong-Baker Faces Pain Rating Scale score measured between 10 and 30 min after surgery. Secondary outcomes included pain scores at 1, 3, and 24 h after the surgery, block-related complications, length of stay in the postanesthesia care unit, postoperative analgesic consumption, and time to first analgesic use 24 h after surgery.
The worst pain score within 30 min in the recovery room was significantly lower in the SSCNB group compared to the control group (6 5-7 vs. 3 2-4; median difference, -3; 95% CI, -4 to -1; p < .001). Pain scores at 1, 3, and 24 h after surgery were also significantly lower in the SSCNB group. The need for both opioid and non-opioid analgesics in the postoperative period was significantly lower in the SSCNB group (36.0% vs. 0%; p = .002 and 44.0% vs. 16.0%; mean difference, -28%; 95% CI, -56 to 0.19; p = .033, respectively), while other secondary outcomes were not significantly different between the two groups.
Ultrasound-guided SSCNB is an effective method for managing postoperative pain in children undergoing Hickman catheter or chemoport insertion, reducing the need for analgesics within 24 h after surgery.
The nuclear factor-erythroid 2 p45-related factor 2 (NRF2, also called
) and its cytoplasmic repressor, Kelch-like ECH-associated protein 1 (KEAP1), are major regulators of redox homeostasis ...controlling a multiple of genes for detoxification and cytoprotective enzymes. The NRF2/KEAP1 pathway is a fundamental signaling cascade responsible for the resistance of metabolic, oxidative stress, inflammation, and anticancer effects. Interestingly, a recent accumulation of evidence has indicated that NRF2 exhibits an aberrant activation in cancer. Evidence has shown that the NRF2/KEAP1 signaling pathway is associated with the proliferation of cancer cells and tumerigenesis through metabolic reprogramming. In this review, we provide an overview of the regulatory molecular mechanism of the NRF2/KEAP1 pathway against metabolic reprogramming in cancer, suggesting that the regulation of NRF2/KEAP1 axis might approach as a novel therapeutic strategy for cancers.
The fabrication of ultrathin silicon wafers at low cost is crucial for advancing silicon electronics toward stretchability and flexibility. However, conventional fabrication techniques are ...inefficient because they sacrifice a large amount of substrate material. Thus, advanced silicon electronics that have been realized in laboratories cannot move forward to commercialization. Here, a fully bottom‐up technique for producing a self‐releasing ultrathin silicon wafer without sacrificing any of the substrate is presented. The key to this approach is a self‐organized nanogap on the substrate fabricated by plasma‐assisted epitaxial growth (plasma‐epi) and subsequent hydrogen annealing. The wafer thickness can be independently controlled during the bulk growth after the formation of plasma‐epi seed layer. In addition, semiconductor devices are realized using the ultrathin silicon wafer. Given the high scalability of plasma‐epi and its compatibility with conventional semiconductor process, the proposed bottom‐up wafer fabrication process will open a new route to developing advanced silicon electronics.
A fully bottom‐up technique for fabricating a self‐releasing ultrathin silicon wafer without sacrificing any of the substrate is presented, whereas conventional technologies waste large amounts of such material. A plasma‐assisted epitaxially grown silicon seed layer with a self‐organized nanogap is a key for the realization of the fully bottom‐up process. The results represent a technological breakthrough in advanced silicon microelectronics and photovoltaics.
A molecular Solomon link was synthesized in high yield through the template‐free, coordination‐driven self‐assembly of a carbazole‐functionalized donor and a tetracene‐based dinuclear ruthenium(II) ...acceptor. The doubly interlocked topology was realized by a strategically chosen ligand which was capable of participating in multiple CH⋅⋅⋅π and π–π interactions, as evidenced from single‐crystal X‐ray analysis and computational studies. This method is the first example of a two‐component self‐assembly of a molecular Solomon link using a directional bonding approach. The donor alone was not responsible for the construction of the Solomon link, and was confirmed by its noncatenane self‐assemblies obtained with other similar ruthenium(II) acceptors.
Link up: A molecular Solomon link has been prepared by using the title reaction. This template‐free approach favors the doubly interlocked 2catenane because of multiple π–π and CH⋅⋅⋅π interactions, as evidenced by X‐ray crystal structure and computational analysis.
Parkinson's disease (PD) is neurodegenerative movement disorder characterized by degeneration of midbrain‐type dopamine (mDA) neurons in the substantia nigra (SN). The RNA‐binding protein Lin28 plays ...a role in neuronal stem cell development and neuronal differentiation. In this study, we reveal that Lin28 conditional knockout (cKO) mice show degeneration of mDA neurons in the SN, as well as PD‐related behavioral deficits. We identify a loss‐of‐function variant of LIN28A (R192G substitution) in two early‐onset PD patients. Using an isogenic human embryonic stem cell (hESC)/human induced pluripotent stem cell (hiPSC)‐based disease model, we find that the Lin28 R192G variant leads to developmental defects and PD‐related phenotypes in mDA neuronal cells that can be rescued by expression of wild‐type Lin28A. Cell transplantation experiments in PD model rats show that correction of the LIN28A variant in the donor patient (pt)‐hiPSCs leads to improved behavioral phenotypes. Our data link LIN28A to PD pathogenesis and suggest future personalized medicine targeting this variant in patients.
Synopsis
Developmental aspects are recently emphasized as an etiology of Parkinson's disease (PD). Lin28 is a RNA‐binding protein identified to have roles in the developing brain. Here, we show PD‐associated disease phenotypes are developed in Lin28 conditional knockout mice and in an in vitro human disease model for a loss‐of‐function variant of LIN28A (arginine to glycine at aa 192, R192G) detected from two young age‐onset PD patients.
Pathologic findings for Parkinson's disease (PD) are manifested in Lin28 conditional knockout (cKO) mice (Lin28a/b flox/flox, Nestin‐Cre).
A loss‐of‐function variant of LIN28A (arginine to glycine at aa 192, R192G) are detected from two young age‐onset PD patients.
PD‐related pathologic phenotypes are present in midbrain‐type dopamine (mDA) neurons differentiated from the hESCs and the patient‐derived hiPSCs carrying LIN28A (R192G).
Behavioral recovery of rats with PD after cell transplantation requires correction of the LIN28A variant in the donor patient (pt)‐hiPSCs.
The RNA‐binding protein Lin28 regulates midbrain dopaminergic neuron development and its loss of function is associated with Parkinson's disease in mice and human patients.
Conventional semi‐transparent perovskite solar cells (ST‐PSCs) generally exhibit inferior performance and stability relative to opaque PSCs. However, a comprehensive understanding of the origins of ...inferior performance and stability of ST‐PSCs and a practical solution to these challenges are both lacking. Here, it is shown for the first time that lithium ions from a lithium bis(trifluoromethanesulfonyl)imide (LiTFSI)‐doped 2,2′,7,7′‐tetrakisN,N‐di(4‐methoxyphenyl)amino−9,9′‐spirobifluorene (Spiro‐MeOTAD) hole‐transport layer (HTL) can diffuse into the molybdenum trioxide buffer layer at their interface, yielding ST‐PSCs with lower efficiency and accelerated degradation. It is also demonstrated that this undesired Li‐ion diffusion can be avoided by HTL surface modification with stable lithium oxides. Using this approach, the constructed ST‐PSC exhibits a new record power conversion efficiency (PCE) of 22.02% (21.68% certified) and a fill factor of >80%, with >99% shelf‐stability after 400 h and >99% operational stability for 240 h, which clears away this longstanding limitation of the performance and stability of ST‐PSCs. This strategy is also applied to fabricate four‐ and two‐terminal perovskite/silicon tandem solar cells with bifacial equivalent efficiencies of 31.5% and 26.34%, respectively, at 20% albedo.
A new internal degradation mechanism in semi‐transparent perovskite solar cells (Indium tin oxide/tin oxide/perovskite/Spiro‐MeOTAD/molybdenum trioxide (MoO3)/transparent conducting oxide) is unraveled. When the hole‐transport layer's surface is enriched with lithium bis(trifluoromethanesulfonyl)imide (LiTFSI), Li+ diffused into MoO3 layer and results in continuous degradation of the device. Conversion of LiTFSI into stable lithium oxides improves both efficiency and stability of the device due to the effective mitigation of Li+ diffusion.
Background
Perioperative central venous catheters are required but may be associated with various complications.
Aims
The purpose of our study was to assess the incidence and perioperative risk ...factors for catheter‐related internal jugular vein thrombosis in pediatric surgical patients.
Methods
This prospective observational study included children under 6 years of age who were scheduled to undergo central venous catheterization of the right internal jugular vein under general anesthesia. A central venous catheter was inserted under real‐time ultrasound guidance. An investigator examined for thrombosis using ultrasonography at predetermined time points. The primary aim was the incidence of catheter‐related thrombosis from insertion until the 5th day postoperatively or the removal of the central venous catheter. The secondary aim was the determination of the risk factors for thrombosis.
Results
Eighty patients completed the study. Internal jugular vein thrombi were found in 31 patients (38.8%, 95% CI 28.0–49.4). On multiple logistic regression analyses, the number of insertion attempts was the only influencing factor for catheter‐related thrombosis (p < .001). More than two insertion attempts increased the risk of thrombosis (odds ratio 5.6; 95% CI 1.7 – 18.7, p = .004). Anesthesia time (p = .017; mean difference 166.4 min; 95% CI 55.7–277.1), intraoperative red blood cell transfusion (p = .001; median difference 21.1 ml kg−1; 95% CI 6.6–34.4), and intensive care unit stay (p = .001; median difference 100.0 h; 95% CI 48–311) differed between patients with transient thrombosis and those with thrombosis lasting for more than 3 days.
Conclusion
Internal jugular vein thrombosis was frequently detected by ultrasound following central venous catheterization in pediatric surgical patients. Multiple insertion attempts may be associated with the incidence of thrombosis. The clinical relevance of thrombi detected via ultrasound surveillance has not been determined.
Background
A high proportion of pediatric patients with brain tumors (BTs) are known to experience a decline in neurocognitive function after treatment. We prospectively examined neuropsychological ...functioning of patients with BTs of varying tumor types at different time points before, during, and after proton beam therapy.
Materials and methods
A total of 98 patients with posterior fossa tumors (PFTs; n = 33), germ cell tumors (GCTs; n = 52), and other supratentorial tumors (STTs; n = 13) underwent baseline neuropsychological assessments and 57 patients underwent follow‐up assessments.
Results
All groups displayed significantly lower performance intelligence quotient (PIQ) and processing speed (PS) scores than the normative means at baseline. The PFT group exhibited significantly lower scores for full‐scale IQ, PIQ, PS, attention, and executive function. The GCT group displayed full‐scale IQ scores within the normal range, but a significantly high proportion had memory deficits. In the STT group, all functions except for the PIQ and PS were intact. Longitudinal evaluations demonstrated stable global IQ scores over time in all groups. In the PFT group, verbal comprehension, attention, and PS improved over time. However, in the GCT group, verbal IQ scores declined significantly and psychological problems worsened over time, which were correlated with poorer neurocognitive function at 3–5 years after treatment. In the STT group, no significant changes were observed.
Conclusion
Because patients with BTs exhibit various types of neurocognitive deficit before radiotherapy, early cognitive treatment tailored to the tumor type maybe beneficial. Interventions for psychological problems and memory function may be necessary, especially for patients with GCT.
This study presents an effective method for recovering unbroken solar cells from photovoltaic (PV) modules. The combustion process is effective at removing ethylene vinyl acetate (EVA) in PV modules. ...However, the solar cell tends to break during the combustion process. We verify that the breakage mechanisms of the solar cell in the module are related to the thermal changes of EVA during the heat treatment process, that is, generated gases form bubbles behind the glass, and the thermal deformation of the rear EVA applies stress to the solar cell. This study investigates the simple pretreatments of glass cracking and EVA patterning to prevent the breakage behavior. An unbroken solar cell was successfully recovered from the module after complete EVA removal using the combustion process. The recovered solar cell was immersed in a mixed acid solution of HNO3 and HF to reclaim the crystalline silicon wafer, which subsequently underwent the solar cell manufacturing process. The PV performances of the solar cells based on the reclaimed wafer and a commercial wafer were evaluated and compared. The PV performance of the solar cell manufactured from the reclaimed wafer was measured at 18.5%, whereas that from the commercial wafer‐based solar cell was measured at 18.7%. Consequently, the considered pretreatment processes yielded solar cells acceptable for use in the PV industry.
The proposed process is capable of recovering unbroken solar cells by applying simple pretreatments on both sides of the PV module that are effective at removing the stress factors during the solar cell recovery process. The unbroken solar cell recovered from the module was immersed in a mixed acid solution to reclaim the crystalline silicon wafer, and a solar cell was remanufactured. The PV performance of the solar cell was evaluated to have a high efficiency of 18.5%.
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