Abstract
Owing to unique fundamental physics and device applications, twisted moiré physics in two-dimensional (2D) van der Waals (vdW) layered magnetic materials has recently received particular ...attention. We investigate magnetic vdW Fe
3
GeTe
2
(FGT)/CrGeTe
3
(CGT) moiré heterobilayers with twist angles of 11° and 30° from first-principles. We show that the moiré heterobilayer is a ferromagnetic metal with an
n
-type CGT layer due to the dominant spin-majority electron transfer from the FGT layer to the CGT layer, regardless of various stacked structures. The spin-majority hybridized bands between Cr and Fe bands crossing the Fermi level are found regardless of stacking. The band alignment of the CGT layer depends on the effective potential difference at the interface. We show that an external electric field perpendicular to the in-plane direction modulates the interface dipole and band edges. Our study reveals a deeper understanding of the effects of stacking, spin alignment, spin transfer, and electrostatic gating on the 2D vdW magnetic metal/semiconductor heterostructure interface.
Nonalcoholic steatohepatitis (NASH) is considered as a progressive form of nonalcoholic fatty liver disease (NAFLD). To distinguish NASH from nonalcoholic fatty liver (NAFL), we evaluated the ...diagnostic value of circulating miRNAs. Small RNA sequencing was performed on 12 NAFL patients and 12 NASH patients, and the miRNA expression was compared. After selecting miRNAs for the diagnosis of NASH, we analyzed the diagnostic accuracy of each miRNA and the combination of miRNAs. External validation was performed using quantitative reverse transcription PCR. Among the 2,588 miRNAs, 26 miRNAs significantly increased in the NASH group than in the NAFL group. Among the 26 elevated miRNAs in the NASH group, 8 miRNAs were selected, and in silico analysis was performed. Only four miRNAs (miR-21-5p, miR-151a-3p, miR-192-5p, and miR-4449) showed significant area under the receiver operating characteristic curve (AUC) values for NASH diagnosis. The combination of the four miRNAs showed satisfactory diagnostic accuracy for NASH (AUC 0.875; 95% CI 0.676-0.973). External validation revealed similar diagnostic accuracy for NASH (AUC 0.874; 95% CI 0.724-0.960). NASH represents significantly distinct miRNA expression profile compared with NAFL. The combination of serum circulating miRNAs can be used as a novel biomarker for the NASH diagnosis in NAFLD.
Non-alcoholic fatty liver disease (NAFLD) is a dominant cause of chronic liver disease, but the exact mechanism of progression from simple steatosis to nonalcoholic steatohepatitis (NASH) remains ...unknown. Here, we investigated the role of exosomes in NAFLD progression. Exosomes were isolated from a human hepatoma cell line treated with palmitic acid (PA) and their miRNA profiles examined by microarray. The human hepatic stellate cell (HSC) line (LX-2) was then treated with exosome isolated from hepatocytes. Compared with controls, PA-treated hepatocytes displayed significantly increased CD36 and exosome production. The microarray analysis showed there to be distinctive miRNA expression patterns between exosomes from vehicle- and PA-treated hepatocytes. When LX-2 cells were cultured with exosomes from PA-treated hepatocytes, the expression of genes related to the development of fibrosis were significantly amplified compared to those treated with exosomes from vehicle-treated hepatocytes. In conclusion, PA treatment enhanced the production of exosomes in these hepatocytes and changed their exosomal miRNA profile. Moreover, exosomes derived from PA-treated hepatocytes caused an increase in the expression levels of fibrotic genes in HSCs. Therefore, exosomes may have important roles in the crosstalk between hepatocytes and HSCs in the progression from simple steatosis to NASH.
Virtual simulation-based education for healthcare professionals has emerged as a strategy for dealing with infectious disease disasters, particularly when training at clinical sites is restricted due ...to the risk of infection and a lack of personal protective equipment. This research evaluated a virtual simulation-based education program intended to increase nurses' perceived competence in providing psychological support to patients affected by infectious disease disasters.
The efficacy of the program was evaluated via a randomized controlled trial. We recruited 104 nurses for participation in the study and allocated them randomly and evenly to an experimental group and a control group. The experimental group was given a web address through which they could access the program, whereas the control group was provided with a web address that directed them to text-based education materials. Data were then collected through an online survey of competence in addressing disaster mental health, after which the data were analyzed using the Statistical Package for the Social Sciences(version 23.0).
The analysis showed that the experimental group's disaster mental health competence (F = 5.149, p =.026), problem solving process (t = 3.024, p =.003), self-leadership (t = 2.063, p =.042), learning self-efficacy (t = 3.450, p =.001), and transfer motivation (t = 2.095, p =.039) significantly statistically differed from those of the control group.
A virtual nursing simulation-based education program for psychological support can overcome limitations of time and space. The program would also be an effective learning resource during infectious disease outbreaks.
This Korean clinical trial was retrospectively registered (21/11/2023) in the Clinical Research Information Service ( https://cris.nih.go.kr ) with trial registration number KCT0008965.
Background:
The-Optimal-Lymph-Flow (TOLF) intervention aims to promote lymph flow through therapeutic lymphatic exercises to relieve lymphatic pain, swelling, lymphedema symptoms, and to decrease ...lymph fluid levels among breast cancer survivors. To enhance the efficacy of the TOLF intervention, an innovative, intelligent, Kinect-enhanced lymphatic exercise intervention (Kinect-TOLF) was developed to teach patients to perform the lymphatic exercises correctly.
Objectives:
This feasibility trial aimed to determine the feasibility, usability, and effects of the Kinect-TOLF on lymphatic pain, swelling, lymphedema symptoms, and lymph fluid levels.
Methods:
A single-arm feasibility trial with a pre- and post-test design was employed to recruit 30 breast cancer survivors with persistent lymphatic pain or swelling. Patients received a single training session to learn how to perform the lymphatic exercises using the Kinect-TOLF program. Descriptive statistics, Wilcoxon signed-rank tests, t-test, Spearman’s rank correlation coefficients, linear regressions, and Cohen’s d were performed for data analysis. Qualitative data were assessed for common themes.
Results:
The Kinect-TOLF was effective in training patients to perform the lymphatic exercises correctly with high user satisfaction. Significant reductions were found in scores of lymphatic pain (MedΔ = −1.00, CI = −1.5, −0.1, P = .004), arm/hand swelling (MedΔ = −1.00, CI = −1.5, −0.5, P = .004), total swelling (MedΔ = −1.5, CI = −2.0, −1.0, P = .003), number of lymphedema symptoms (MΔ = −3.8, CI = −5.5, −2.1, P < .001), and lymphedema symptom severity (MΔ = −5.3, CI = −9.5, −1.1, P = .016). A significant reduction in lymph fluid levels was found in mean L-Dex scores (MΔ = −2.68, CI = −4.67, −0.69, P = .010). Greater decrease in mean L-Dex scores were found in patients with abnormal lymph fluid levels (L-Dex ≥ 7.1) (MΔ = −5.19, CI = −1.75, −8.63, P = .008). Patients’ qualitative feedback supported the results of the study.
Conclusions:
The Kinect-TOLF is safe, feasible, and effective in reducing lymphatic pain, swelling, lymphedema symptoms, and in decreasing lymph fluid levels. Future research should focus on a randomized clinical trial to confirm the unique or synergistic efficacy of the Kinect-TOLF in comparison with current lymphedema treatment and other forms of exercises or movement therapy. This study was registered in ClinicalTrials.gov with US ClinicalTrials.gov Identifier: NCT03999177.
Recently, to improve the performance of an integrated metal-oxide-semiconductor (MOS) device, an attempt has been made in the industry to replace the amorphous oxide with a crystalline oxide. ...However, various characteristics caused by the difference between amorphous and crystalline oxide in the MOS structure have not been systematically investigated. Therefore, we demonstrate the difference in atomic interface structures, electronic structures, and tunneling properties concerning varied oxide phases in a representative system, Si/SiO2/Si structures, with sub-3 nm-thick silica from first-principles. We investigate two oxide phases of amorphous (a-) and crystalline (c-) SiO2 with and without H passivation at the interface. Si/a-SiO2 exhibits a smooth interface layer, whereas Si/c-SiO2 exhibits an abrupt interface layer, resulting in the thicker interface layer of Si/a-SiO2 than Si/c-SiO2. Thus for a given total silica thickness, the adequate tunneling-blocking thickness, where all the Si atoms form four Si–O bonds, is thinner in a-SiO2 than c-SiO2, originating more tunneling current through a-SiO2 than c-SiO2. However, the effects of dangling bonds at Si/c-SiO2 rather than Si/a-SiO2 on tunneling currents are crucial, particularly in valence bands. Furthermore, when the dangling bonds are excluded by H atoms at Si/c-SiO2, the tunneling current dramatically reduces, whereas the H-passivation effect on the tunneling blocking at Si/a-SiO2 is insignificant. Our study contributes systematic knowledge regarding oxide phases and interfaces to promote for high performance of MOS devices.
Background:
Fatigue and lymphatic pain are the most common and debilitating long-term adverse effects of breast cancer treatment. Fatigue and pain independently have negative effects on quality of ...life, physical functions, and cancer recurrence-free survival. The interactions between fatigue and pain may aggravate their negative effects.
Objectives:
Examine the effects of co-occurring fatigue and lymphatic pain on activities of daily living (ADLs), emotional distress, and overall health of breast cancer patients.
Methods:
A cross-sectional and observational design was used to enroll 354 breast cancer patients. Valid and reliable instruments were used to assess fatigue, lymphatic pain, ADLs, emotional distress, and overall health. Descriptive statistics and multivariable regression models were used for data analysis.
Results:
After controlling for demographic and clinical factors, patients with co-occurring fatigue and lymphatic pain had higher odds of having impaired ADLs (OR = 24.43, CI = 5.44-109.67, P < .001) and emotional distress (OR = 26.52, CI = 9.64-72.90, P < .001) compared to patients with only fatigue and only lymphatic pain. Patients with co-occurring fatigue and lymphatic pain had 179% increase in impaired ADL scores (B = 8.06, CI = 5.54-10.59) and 211% increase in emotional distress scores (B = 9.17, CI = 5.52-12.83) compared to those without co-occurring fatigue and lymphatic pain. Patients with co-occurring fatigue and lymphatic pain had a 34% decrease (B = −26.29, CI = −31.90 to −20.69) and patients with only fatigue had a 33% decrease in overall health scores (B = −25.74, 95% CI = −34.14 to −17.33), indicating poor overall health.
Conclusions:
Fatigue and lymphatic pain affected 66.4% of breast cancer patients. Findings from this study suggest that co-occurring fatigue and lymphatic pain have negative effects on breast cancer patients’ ADLs, emotional distress, and overall health. The synergistic interactions between fatigue and lymphatic pain incrementally aggravated their negative effects on ADLs and emotional distress. Findings of the study highlight the need to evaluate the underlying mechanisms for co-occurring fatigue and lymphatic pain and develop interventions that target both fatigue and lymphatic pain to improve breast cancer patients’ the quality of life.
The number of people living with dementia continues to grow, increasing the demands on unpaid caregivers of people living with dementia. Caregiving can be emotionally and mentally distressing. In ...response, numerous interventions have been developed and tested to improve mental health in caregivers of people living with dementia. However, the effects of self-guided interventions on mental health in this population have remained understudied.
We systematically examined the effects of self-guided interventions on stress, burden, and mental health of unpaid caregivers of people living with dementia.
A systematic review method following PRISMA guideline was used. PubMed, CINAHL, PsycINFO, Scopus, and Embase databases were searched using relevant search terms for the study aims from September to November 2022. The search was limited to peer-reviewed articles written in English. This review included articles that examined 1) unpaid caregivers of people living with dementia; 2) a self-guided, self-directed, or self-facilitated intervention; and 3) intervention to improve psychological or mental health as an outcome of interest. The exclusion criteria were: 1) secondary data analysis research based on an intervention study, 2) systematic reviews or meta-analyses, or 3) articles that evaluated only the acceptability or feasibility of a program. The collected data were synthesized using descriptive analysis with tabular summaries. The quality of each paper included was assessed by using JBI Quality Assessment tools.
A total of 16 articles and 1,182 unpaid caregivers of people living with dementia were included in this review. Stress, burden, depressive symptoms, anxiety, quality of life, self-efficacy, positive aspects of caregiving, social support, and personal relationship were measured in at least three articles. Depressive symptoms and burden were the most frequently measured outcomes. Stress was generally reduced after the interventions. However, the results of burden and mental health from each intervention were mixed and inconsistent. Interestingly, interventions that lasted less than 3 months were more likely to have better efficacy.
Although the results of self-guided interventions are mixed, this is a potentially useful tool in improving emotional well-being for unpaid caregivers of people living with dementia due to low time burden, ease-to-access, and affordability. Future direction in intervention development should include identifying the optimal length and components of self-guided interventions and collaboration with clinicians for wider distribution to unpaid caregivers of people living with dementia.
This review was not registered at the PROSPERO, and a review protocol was not prepared.
Owing to unique fundamental physics and device applications, twisted moiré physics in two-dimensional (2D) van der Waals (vdW) layered magnetic materials has recently received particular attention. ...We investigate magnetic vdW Fe
GeTe
(FGT)/CrGeTe
(CGT) moiré heterobilayers with twist angles of 11° and 30° from first-principles. We show that the moiré heterobilayer is a ferromagnetic metal with an n-type CGT layer due to the dominant spin-majority electron transfer from the FGT layer to the CGT layer, regardless of various stacked structures. The spin-majority hybridized bands between Cr and Fe bands crossing the Fermi level are found regardless of stacking. The band alignment of the CGT layer depends on the effective potential difference at the interface. We show that an external electric field perpendicular to the in-plane direction modulates the interface dipole and band edges. Our study reveals a deeper understanding of the effects of stacking, spin alignment, spin transfer, and electrostatic gating on the 2D vdW magnetic metal/semiconductor heterostructure interface.
Display omitted
•Atomic rearrangements at metal/oxide/semiconductor interfaces affect band alignment.•Interface dipoles by atomic rearrangements determine slanted oxide-band alignment.•Interface ...dipoles by work-function changes and effective charge densities are important.•Interface dipoles by charge-density differences are negligible for band alignment.
We study the effects of interface atomic rearrangement on the band alignments of Ge/a-Al2O3/Au structures as a prototype for metal-amorphous oxide–semiconductor systems with a nanometer-thick oxide from first principles. The significant atomic rearrangement at Ge/a-Al2O3 and a-Al2O3/Au interface regions results in a slanted band alignment in the oxide region, which cannot be described by the numerical Schottky–Mott model. The band alignment is explained by considering the interface dipoles due to the interface-work-function change and the interface effective charge density, which were previously dismissed as unimportant. On the other hand, the effect of the interface dipole on the band alignment originating from the interface-charge-density difference is found to be negligible.
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