The effect of electrolyte additive 1,2-dichloroethane (DCE) on the electrochemical stability of aluminum-graphite battery using acetamide-AlCl3 electrolyte is investigated comparatively. Original ...dendritic and dead aluminum are observed in Al-Al cells at a high operation rate. Original dendritic and dead aluminum are observed in the anode and separator of Al-Al cells at a high operation rate. DCE is a preferred electrolyte additive to reduce the polarization of the acetamide-AlCl3 electrolyte. Furthermore, DCE can effectively suppress the dendrites on the Al anode in Al|acetamide-AlCl3|Al cells. Besides, it has a positive effect on improving the discharge specific capacity and cycle stability of aluminum-graphite batteries with a high coulombic efficiency over 300 cycles. This result indicates that organic additive is suitable to improve the electrochemical performance of aluminum-graphite batteries.
Insomnia is a common disease, and the application of various types of sleeping pills for cognitive impairment is controversial, especially as different doses can lead to different effects. Therefore, ...it is necessary to evaluate the cognitive impairment caused by different sleeping pills to provide a theoretical basis for guiding clinicians in the selection of medication regimens.
To evaluate whether various different doses (low, medium and high) of anti-insomnia drugs, such as the dual-orexin receptor antagonist (DORA), zopiclone, eszopiclone and zolpidem, induce cognitive impairment.
The PubMed, Embase, Scopus, Cochrane Library, and Google Scholar databases were searched from inception to September 20th, 2022 for keywords in randomized controlled trials (RCTs) to evaluate the therapeutic effects of DORA, eszopiclone, zopiclone and zolpidem on sleep and cognitive function. The primary outcomes were indicators related to cognitive characteristics, including scores on the Digit Symbol Substitution Test (DSST) and daytime alertness. The secondary outcomes were the indicators associated with sleep and adverse events. Continuous variables were expressed as the standard mean difference (SMD). Data were obtained through GetData 2.26 and analyzed by Stata v.15.0.
A total of 8702 subjects were included in 29 studies. Eszopiclone
significantly increased the daytime alertness score (SMD = 3.00, 95 % CI: 1.86 to 4.13) compared with the placebo, and eszopiclone
significantly increased the daytime alertness score (SMD = 4.21, 95 % CI: 1.65 to 6.77; SMD = 3.95, 95 % CI: 1.38 to 6.51; SMD = 3.26, 95 % CI: 0.38 to 6.15; and SMD = 3.23, 95 % CI: 0.34 to 6.11) compared with zolpidem
, zolpidem
, DORA
, and eszopiclone
, respectively. Compared with the placebo, zopiclone, zolpidem
, and eszopiclone
, DORA significantly increased the TST (SMD = 2.39, 95 % CI: 1.11 to 3.67; SMD = 6.00, 95 % CI: 2.73 to 9.27; SMD = 1.89, 95 % CI: 0.90 to 2.88; and SMD = 1.70, 95 % CI: 0.42 to 2.99, respectively).
We recommend DORA as the best intervention for insomnia because it was highly effective in inducing and maintaining sleep without impairing cognition. Although zolpidem had a more pronounced effect on sleep maintenance, this drug is better for short-term use. Eszopiclone and zopiclone improved sleep, but their cognitive effects have yet to be verified.
We aimed to compare the efficacy and safety profiles of different dosages of dual orexin receptor antagonists (DORAs) and zolpidem on insomnia and cognitive function.
Databases including PubMed, ...Embase, Cochrane Library, Scopus, and Google Scholar were searched for relevant articles. The standard mean difference (SMD) was generated for consecutive variants. A dose‒response meta-regression model was constructed in RStudio 4.2.1 to compare the efficacy and safety of low, medium and high doses of DORAs and zolpidem on cognitive function and insomnia.
A total of 22 studies with 8,223 subjects were included. Compared with the placebo, low and medium doses of DORAs significantly decreased motor vehicle accidents/violations (SMD= -0.02, 95 % CI: -0.21 to 0.17 and SMD= -0.36, 95 % CI: -0.52 to -0.20, respectively), whereas medium and high doses of zolpidem significantly increased this index (SMD=0.77, 95 % CI: 0.39 to 1.16 and SMD=1.17, 95 % CI: 0.62 to 1.72, respectively). In addition, the total sleep time (TST) of low, medium, and high doses of DORAs was SMD=0.28, 95 % CI: - 0.15 to 0.70; SMD=1.36, 95 % CI: 0.87 to 1.86; and SMD=2.59, 95 % CI: 1.89 to 3.30, respectively. The TST of zolpidem at low, medium, and high doses was SMD=1.01, 95 % CI: 0.18 to 1.83; SMD=1.94, 95 % CI: 0.46 to 3.43; and SMD=1.71, 95 % CI: 0.86 to 2.56, respectively.
We recommend DORAs as the best intervention for insomnia. DORAs were highly effective in inducing and maintaining sleep without impairing cognition. More head-to-head studies are needed to extend and consolidate our findings.
Background
Accelerated translation of real-world interventions for hypertension management is critical to improving cardiovascular outcomes and reducing disparities.
Objective
To determine whether a ...positive deviance approach would improve blood pressure (BP) control across diverse health systems.
Design
Quality improvement study using 1-year cross sections of electronic health record data over 5 years (2013–2017).
Participants
Adults ≥ 18 with hypertension with two visits in 2 years with at least one primary care visit in the last year (
N
= 114,950 at baseline) to a primary care practice in Better Health Partnership, a regional health improvement collaborative.
Interventions
Identification of a “positive deviant” and dissemination of this system’s best practices for control of hypertension (i.e., accurate/repeat BP measurement; timely follow-up; outreach; standard treatment algorithm; and communication curriculum) using 3 different intensities (
low
: Learning Collaborative events describing the best practices;
moderate
: Learning Collaborative events plus consultation when requested; and
high
: Learning Collaborative events plus practice coaching).
Main Measures
We used a weighted linear model to estimate the pre- to post-intervention average change in BP control (< 140/90 mmHg) for 35 continuously participating clinics.
Key Results
BP control post-intervention improved by 7.6% 95% confidence interval (CI) 6.0–9.1, from 67% in 2013 to 74% in 2017. Subgroups with the greatest absolute improvement in BP control included Medicaid (12.0%, CI 10.5–13.5), Hispanic (10.5%, 95% CI 8.4–12.5), and African American (9.0%, 95% CI 7.7–10.4). Implementation intensity was associated with improvement in BP control (high: 14.9%, 95% CI 0.2–19.5; moderate: 5.2%, 95% CI 0.8–9.5; low: 0.2%, 95% CI−3.9 to 4.3).
Conclusions
Employing a positive deviance approach can accelerate translation of real-world best practices into care across diverse health systems in the context of a regional health improvement collaborative (RHIC). Using this approach within RHICs nationwide could translate to meaningful improvements in cardiovascular morbidity and mortality.
Lack of consensus regarding the semantics and definitions of pediatric polypharmacy challenges researchers and clinicians alike. We conducted a scoping review to describe definitions and terminology ...of pediatric polypharmacy.
Medline, PubMed, EMBASE, CINAHL, PsycINFO, Cochrane CENTRAL, and the Web of Science Core Collection databases were searched for English language articles with the concepts of "polypharmacy" and "children". Data were extracted about study characteristics, polypharmacy terms and definitions from qualifying studies, and were synthesized by disease conditions.
Out of 4,398 titles, we included 363 studies: 324 (89%) provided numeric definitions, 131 (36%) specified duration of polypharmacy, and 162 (45%) explicitly defined it. Over 81% (n = 295) of the studies defined polypharmacy as two or more medications or therapeutic classes. The most common comprehensive definitions of pediatric polypharmacy included: two or more concurrent medications for ≥1 day (n = 41), two or more concurrent medications for ≥31 days (n = 15), and two or more sequential medications over one year (n = 12). Commonly used terms included polypharmacy, polytherapy, combination pharmacotherapy, average number, and concomitant medications. The term polypharmacy was more common in psychiatry literature while epilepsy literature favored the term polytherapy.
Two or more concurrent medications, without duration, for ≥1 day, ≥31 days, or sequentially for one year were the most common definitions of pediatric polypharmacy. We recommend that pediatric polypharmacy studies specify the number of medications or therapeutic classes, if they are concurrent or sequential, and the duration of medications. We propose defining pediatric polypharmacy as "the prescription or consumption of two or more distinct medications for at least one day". The term "polypharmacy" should be included among key words and definitions in manuscripts.
Herein, we present a new and simple electrochemical method to detect the intracellular electroactive substances by utilizing the electron tunnelling processes at the metal nanoparticles inside the ...cells. Intriguing discrete oxidation and reduction current spikes are obtained when testing the cells with loaded Au nanoparticles at the ultramicroelectrodes, which should come from reactive oxygen species (ROS) inside the single cell. The charges enclosed in the current spikes represent the ROS content inside the living cells, as confirmed by the fluorescence studies. As this simple electron tunnelling approach needs no nanoelectrodes or nanotip penetration processes, we believe it could have great potential applications in electrochemical analysis of single living cells.
1.2 Previous studies have confirmed that air and light pollution can cause damage to a number of systems throughout the body, including the ocular surface and retina. However, the exact effect of air ...pollution and light pollution on tear film function is not clear. This study explored the different operation room environmental exposures on tear film function before and after operation. Sixty medical staff in the operating room were selected and divided into 4 groups according to different surgical methods to evaluate the tear film function before and after operation: Da Vinci surgery group (DVSS), Laparoscopic surgery group (LS), Traditional surgery group (TS), and Ophthalmic microsurgery group (OM). The results showed that the levels of light and air pollution were elevated in operating rooms during the operation and the changes of tear film function in the other three groups were statistically significant except for DVSS group. In TS group, particulate matter (pm) 1 (R = 0.61, p < 0.01), pm2.5 (R = 0.63, p < 0.01), and pm10 (R = 0.67, p < 0.01) were positively correlated with eye redness index, and first and average noninvasive tear film break-up times were positively correlated with illuminance (R = 0.54, p < 0.05; R = 0.97, p < 0.01). In OM group, there was a positive correlation between the operation time and the first (R = 0.69, p < 0.01) and average (R = 0.89, p < 0.01) noninvasive tear film break-up times. Our research found that exposure to different operating room environment will lead to damage of tear film function, but also provide a theoretical basis for the improvement of surgical environment.
•Air pollutants from electrosurgical equipment in traditional surgical groups are more than 10 times the normal national standard.•Environmental pollution and light pollution in the operating room may affect the tear film function of medical personnel.•Increased illuminance will shorten noninvasive tear film breakup time.•Air pollutants will lead to a rise in ocular redness index.
Polypharmacy can be either beneficial or harmful to children. We conducted a scoping review to examine the concept of pediatric polypharmacy: its definition, prevalence, extent and gaps in research. ...In this manuscript, we report our transdisciplinary scoping review methodology.
After establishing a transdisciplinary team, we iteratively developed standard operating procedures for the study's search strategy, inclusion/exclusion criteria, screening, and data extraction. We searched eight bibliographic databases, screened abstracts and full text articles, and extracted data from included studies using standardized forms. We held regular team meetings and performed ongoing internal validity measurements to maintain consistent and quality outputs.
With the aid of EPPI Reviewer collaborative software, our transdisciplinary team of nine members performed dual reviews of 363 included studies after dual screening of 4398 abstracts and 1082 full text articles. We achieved overall agreement of 85% and a kappa coefficient of 0.71 (95% CI 0.68-0.74) while screening full text articles. The screening and review processes required about seven hours per extracted study. The two pharmacists, an epidemiologist, a neurologist, and a librarian on the review team provided internal consultation in these key disciplines. A stakeholder group of 10 members with expertise in evidence synthesis, research implementation, pediatrics, mental health, epilepsy, pharmacoepidemiology, and pharmaceutical outcomes were periodically consulted to further characterize pediatric polypharmacy.
A transdisciplinary approach to scoping reviews, including internal and external consultation, should be considered when addressing complex cross-disciplinary questions.
Revealing the electrocatalytic features of single redox enzyme is significant to both fundamental biological processes and practical catalysis and sensing applications. Herein, we directly reveal the ...electrocatalytic current from a single enzyme inside the carbon nanopipettes via electrochemical collision strategies, based on the increased activity at nanoscale confinement. Besides the staircase current steps from surface blockage, discrete H
O
oxidation and reduction current transients catalyzed by a single enzyme are also displayed and analyzed. The carbon nanopipette would increase the catalytic activities of enzymes and lead to a detectable current response, thus opening a new way to investigate the fundamental enzymatic mechanisms at the single enzyme level.
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