Self-healable soft conductors, which can withstand certain degrees of deformation and can recover from damage spontaneously, are essential for wearable applications. In this work, a soft hydrogel ...based self-healing triboelectric nanogenerator (HS-TENG), which is highly deformable, and both mechanically and electrically self-healable, has been successfully fabricated from a poly(vinyl alcohol)/agarose hydrogel. The incorporation of photothermally active polydopamine particles and multiwalled carbon nanotubes (MWCNTs) allows the HS-TENG to be physically self-healed in ∼1 min upon exposure to near-infrared (NIR) light. At the same time, the chemical self-healing of the HS-TENG can be triggered by water spraying at 25 °C when introducing water-active dynamic borate bonds into the hydrogel. The applicability of the HS-TENG as a soft energy device to harvest human motion energies has been demonstrated. By tapping the HS-TENG with various deformations, the rectified electricity can charge commercial LEDs with sustainable energy. Working in single-electrode mode, the electrical outputs of the HS-TENG in terms of short-circuit transferred charge (
Q
sc
), open circuit voltage (
V
oc
) and short-circuit current (
I
sc
) reach ∼32 nC, ∼95 V and ∼1.5 μA, respectively, and remain stable even with 200% strain since the MWCNTs disperse evenly in the matrix and play the role of conductive fillers in the HS-TENG.
A soft hydrogel based self-healing triboelectric nanogenerator (HS-TENG) is highly deformable, and both mechanically and electrically self-healable upon exposure to water spraying and near-infrared (NIR) light.
Coronavirus disease 2019 (COVID-19), caused by a novel betacoronavirus severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), was first described in a cluster of patients presenting with ...pneumonia symptoms in Wuhan, China, in December of 2019. Over the past few months, COVID-19 has developed into a worldwide pandemic, with over 400,000 documented cases globally as of March 24, 2020. The SARS-CoV-2 virus is most likely of zoonotic origin, but has been shown to have effective human-to-human transmission. COVID-19 results in mild symptoms in the majority of infected patients, but can cause severe lung injury, cardiac injury, and death. Given the novel nature of COVID-19, no established treatment beyond supportive care exists currently, but extensive public-health measures to reduce person-to-person transmission of COVID-19 have been implemented globally to curb the spread of disease, reduce the burden on healthcare systems, and protect vulnerable populations, including the elderly and those with underlying medical comorbidities. Since this is an emerging infectious disease, there is, as of yet, limited data on the effects of this infection on patients with cardiovascular disease, particularly so for those with congenital heart disease. We summarize herewith the early experience with COVID-19 and consider the potential applicability to and implications for patients with cardiovascular disease in general and congenital heart disease in particular.
•The global COVID-19 pandemic is caused by a novel coronavirus, SARS-CoV-2.•COVID-19 results in respiratory illness, but some patients can have cardiac injury.•Patients with underlying cardiac disease have worse outcomes with COVID-19.•ACHD patients may be at increased risk of worse outcomes with COVID-19.•No treatment exists currently, the focus is on supportive care and prevention.
Nanoarchitectonics, as a technology to arrange nano-sized structural units such as molecules in a desired configuration, requires nano-organization, which usually relies on intermolecular ...interactions. This review briefly introduces the development of using enzymatic reactions to control intermolecular interactions for generating artificial nanoarchitectures in a cellular environment. We begin the discussion with the early examples and uniqueness of enzymatically controlled self-assembly. Then, we describe examples of generating intracellular nanostructures and their relevant applications. Subsequently, we discuss cases of forming nanostructures on the cell surface via enzymatic reactions. Following that, we highlight the use of enzymatic reactions for creating intercellular nanostructures. Finally, we provide a summary and outlook on the promises and future direction of this strategy. Our aim is to give an updated introduction to the use of enzymatic reaction in regulating intermolecular interactions, a phenomenon ubiquitous in biology but relatively less explored by chemists and materials scientists. Our goal is to stimulate new developments in this simple and versatile approach for addressing societal needs.
Here we report the synthesis and effect on the cell viability of pyrrole-conjugated phosphopeptides. Encouraged by the selective inhibition of cancer cells by a naphthyl-capped phosphopeptide (Nap-ff
...y,
), we conjugated the heteroaromatic dipyrrole or tripyrrole motif at the N-terminal of short peptides containing phosphotyrosine or phosphoserine and examined the bioactivity of the resulting phosphopeptides (
-
). Although most of the phosphopeptides exhibit comparable activities with that of
against HeLa cells at 200 μM, they, differing from
, are largely compatible with HeLa cells at 400 μM. Enzymatic dephosphorylation of
-
, at 400 μM is unable to induce a dramatic morphological transition of the peptide assemblies observed in the case of
. These results suggest that a heteroaromatic motif at the N-terminal of peptides likely disfavors the formation of extensive nanofibers or morphological changes during enzymatic self-assembly, thus provide useful insights for the development of phosphopeptides as substrates of phosphatases for controlling cell fate.
COVID-19 and Fontan physiology have each been associated with an elevated risk of venous thromboembolism (VTE), however little is known about the risks and potential consequences of having both.
A ...51 year old male with tricuspid atresia status post Fontan and extracardiac Glenn shunt, atrial flutter, and sinus sick syndrome presented with phlegmasia cerulea dolens (PCD) of the left lower extremity in spite of supratherapeutic INR in the context of symptomatic COVID-10 pneumonia. He was treated with single session, catheter directed mechanical thrombectomy that was well-tolerated.
This report of acute PCD despite therapeutic anticoagulation with a Vitamin K antagonist, managed with emergent mechanical thrombectomy, calls to attention the importance of altered flow dynamics in COVID positive patients with Fontan circulation that may compound these independent risk factors for developing deep venous thrombosis with the potential for even higher morbidity.
Background Public health emergencies may significantly impact emergency medical services responses to cardiovascular emergencies. We compared emergency medical services responses to out-of-hospital ...cardiac arrest (OHCA) and ST-segment‒elevation myocardial infarction (STEMI) during the 2020 COVID-19 pandemic to 2018 to 2019 and evaluated the impact of California's March 19, 2020 stay-at-home order. Methods and Results We conducted a population-based cross-sectional study using Los Angeles County emergency medical services registry data for adult patients with paramedic provider impression (PI) of OHCA or STEMI from February through May in 2018 to 2020. After March 19, 2020, weekly counts for PI-OHCA were higher (173 versus 135; incidence rate ratios, 1.28; 95% CI, 1.19‒1.37;
<0.001) while PI-STEMI were lower (57 versus 65; incidence rate ratios, 0.87; 95% CI, 0.78‒0.97;
=0.02) compared with 2018 and 2019. After adjusting for seasonal variation in PI-OHCA and decreased PI-STEMI, the increase in PI-OHCA observed after March 19, 2020 remained significant (
=0.02). The proportion of PI-OHCA who received defibrillation (16% versus 23%; risk difference RD, -6.91%; 95% CI, -9.55% to -4.26%;
<0.001) and had return of spontaneous circulation (17% versus 29%; RD, -11.98%; 95% CI, -14.76% to -9.18%;
<0.001) were lower after March 19 in 2020 compared with 2018 and 2019. There was also a significant increase in dead on arrival emergency medical services responses in 2020 compared with 2018 and 2019, starting around the time of the stay-at-home order (
<0.001). Conclusions Paramedics in Los Angeles County, CA responded to increased PI-OHCA and decreased PI-STEMI following the stay-at-home order. The increased PI-OHCA was not fully explained by the reduction in PI-STEMI. Field defibrillation and return of spontaneous circulation were lower. It is critical that public health messaging stress that emergency care should not be delayed.
The aims of this study were to determine the percentage of females who after initiating the human papillomavirus (HPV) vaccine series, both completed it and completed it on-time, as well as to ...examine factors associated with series completion and on-time completion. Using data from the North Carolina Immunization Registry, of 138,823 females analyzed, 55% completed the series, and 28% completed it on-time. Over 83% of those who initiated the vaccine series in 2006 completed it by the final study date, as compared to 32% of those who initiated the vaccine in 2009. On-time dosing rates, however, are declining, and have been hovering at 25% for the last two years of the study. Factors such as African-American race and public funding were significantly associated with lower rates of on-time dosing as well as series completion when compared to White race and private funding, respectively. Among girls and young women who initiate the HPV vaccination series, overall completion rates are low, but if given enough time most of those who begin the series will complete it. Our results suggest that strategies to improve the timely completion of the HPV vaccination series may be needed.
Patients undergoing invasive cardiac catheterization (ICC) can experience anxiety and pain. A common practice in the United States is to administer benzodiazepines and opioids for conscious sedation ...to relieve these symptoms. Music may reduce anxiety and pain perception. We sought to evaluate the role of music in lieu of pharmacotherapy for conscious sedation during elective ICC. A retrospective data analysis was performed on patients who underwent ICC and received music therapy ± intravenous sedation/analgesics based on patient's preference compared with control patients who were offered and received intravenous sedation/analgesics based on patient's preference. A total of 161 patients were analyzed, 49 in the music arm, and 112 in the control arm. Baseline characteristics were similar in the 2 groups except that the rate of drug addiction, back pain, post-traumatic stress disorder, and hearing loss were higher in the control group when compared with the music arm. 42 (86%) of the patients in the music group and 29 (26%) of the control group received no sedation or analgesia in the periprocedural period. The average dose of midazolam (0.7 mg vs 0.1 mg, p <0.0001) and fentanyl (39.5 mcg vs 3 mcg, p <0.0001) was higher in the control than the music arm, respectively. 42 (86%) of patients receiving music therapy believed music was helpful in reducing their stress/anxiety levels. In conclusion, music may serve as adjunctive/alternative intervention to pharmacotherapy in relieving anxiety and stress for patients undergoing elective ICC.
Advance care planning is essential for patient-centered care at the end of life, yet little is known about the end-of-life experience for adults with congenital heart disease.
In order to ...characterize the end-of-life experience for this population, a retrospective case series was performed including 86 patients followed at a single referral center, of whom 61 (71%) died at the study institution. Cyanotic heart disease was common (n = 33, (39%)). Median age at death was 41 years (range 20–89). The majority had living parents and 19 (35%) identified a parent as their medical proxy. Hospitalizations and office visits both tended to increase in frequency during the last year of life, but 44% of patients experienced no decline in NYHA functional class during that time. The most common causes of death were circulatory failure (36%) and arrhythmia (22%). Invasive procedures were common in the last year of life. 59 (69%) deaths occurred in an intensive care unit and 34 (40%) occurred after operation or transcatheter intervention. The provision of advance care planning was infrequent.
These data provide a framework for providers to use when counseling their patients about end-of-life issues. They also reinforce the need for early advance care planning for adults with congenital heart disease, especially for those with complex anatomy and those undergoing surgery or transcatheter intervention.
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