bluuebunny/crossref_metadata_2025 huggingface dataset:
Diabetic Foot Ulcers
Authors: Armstrong David G. , Tan Tze-Woei , Boulton Andrew J. M. , Bus Sicco A.
Published: July 2023

Importance

Approximately 18.6 million people worldwide are affected by a diabetic foot ulcer each year, including 1.6 million people in the United States. These ulcers precede 80% of lower extremity amputations among people diagnosed with diabetes and are associated with an increased risk of death.

Observations

Neurological, vascular, and biomechanical factors contribute to diabetic foot ulceration. Approximately 50% to 60% of ulcers become infected, and about 20% of moderate to severe infections lead to lower extremity amputations. The 5-year mortality rate for individuals with a diabetic foot ulcer is approximately 30%, exceeding 70% for those with a major amputation. The mortality rate for people with diabetic foot ulcers is 231 deaths per 1000 person-years, compared with 182 deaths per 1000 person-years in people with diabetes without foot ulcers. People who are Black, Hispanic, or Native American and people with low socioeconomic status have higher rates of diabetic foot ulcer and subsequent amputation compared with White people. Classifying ulcers based on the degree of tissue loss, ischemia, and infection can help identify risk of limb-threatening disease. Several interventions reduce risk of ulcers compared with usual care, such as pressure-relieving footwear (13.3% vs 25.4%; relative risk, 0.49; 95% CI, 0.28-0.84), foot skin measurements with off-loading when hot spots (ie, greater than 2 °C difference between the affected foot and the unaffected foot) are found (18.7% vs 30.8%; relative risk, 0.51; 95% CI, 0.31-0.84), and treatment of preulcer signs. Surgical debridement, reducing pressure from weight bearing on the ulcer, and treating lower extremity ischemia and foot infection are first-line therapies for diabetic foot ulcers. Randomized clinical trials support treatments to accelerate wound healing and culture-directed oral antibiotics for localized osteomyelitis. Multidisciplinary care, typically consisting of podiatrists, infectious disease specialists, and vascular surgeons, in close collaboration with primary care clinicians, is associated with lower major amputation rates relative to usual care (3.2% vs 4.4%; odds ratio, 0.40; 95% CI, 0.32-0.51). Approximately 30% to 40% of diabetic foot ulcers heal at 12 weeks, and recurrence after healing is estimated to be 42% at 1 year and 65% at 5 years.

Conclusions and Relevance

Diabetic foot ulcers affect approximately 18.6 million people worldwide each year and are associated with increased rates of amputation and death. Surgical debridement, reducing pressure from weight bearing, treating lower extremity ischemia and foot infection, and early referral for multidisciplinary care are first-line therapies for diabetic foot ulcers.
What Is Botulism?
Authors: Jin Jill
Published: July 2023

This JAMA Patient Page describes botulism routes of infection, symptoms, diagnosis, treatment, and prevention measures.
Trends in State-Level Maternal Mortality by Racial and Ethnic Group in the United States
Authors: Fleszar Laura G. , Bryant Allison S. , Johnson Catherine O. , Blacker Brigette F. , Aravkin Aleksandr , Baumann Mathew , Dwyer-Lindgren Laura , Kelly Yekaterina O. , Maass Kelsey , Zheng Peng , Roth Gregory A.
Published: July 2023

Importance

Evidence suggests that maternal mortality has been increasing in the US. Comprehensive estimates do not exist. Long-term trends in maternal mortality ratios (MMRs) for all states by racial and ethnic groups were estimated.

Objective

To quantify trends in MMRs (maternal deaths per 100 000 live births) by state for 5 mutually exclusive racial and ethnic groups using a bayesian extension of the generalized linear model network.

Design, Setting, and Participants

Observational study using vital registration and census data from 1999 to 2019 in the US. Pregnant or recently pregnant individuals aged 10 to 54 years were included.

Main Outcomes and Measures

MMRs.

Results

In 2019, MMRs in most states were higher among American Indian and Alaska Native and Black populations than among Asian, Native Hawaiian, or Other Pacific Islander; Hispanic; and White populations. Between 1999 and 2019, observed median state MMRs increased from 14.0 (IQR, 5.7-23.9) to 49.2 (IQR, 14.4-88.0) among the American Indian and Alaska Native population, 26.7 (IQR, 18.3-32.9) to 55.4 (IQR, 31.6-74.5) among the Black population, 9.6 (IQR, 5.7-12.6) to 20.9 (IQR, 12.1-32.8) among the Asian, Native Hawaiian, or Other Pacific Islander population, 9.6 (IQR, 6.9-11.6) to 19.1 (IQR, 11.6-24.9) among the Hispanic population, and 9.4 (IQR, 7.4-11.4) to 26.3 (IQR, 20.3-33.3) among the White population. In each year between 1999 and 2019, the Black population had the highest median state MMR. The American Indian and Alaska Native population had the largest increases in median state MMRs between 1999 and 2019. Since 1999, the median of state MMRs has increased for all racial and ethnic groups in the US and the American Indian and Alaska Native; Asian, Native Hawaiian, or Other Pacific Islander; and Black populations each observed their highest median state MMRs in 2019.

Conclusion and Relevance

While maternal mortality remains unacceptably high among all racial and ethnic groups in the US, American Indian and Alaska Native and Black individuals are at increased risk, particularly in several states where these inequities had not been previously highlighted. Median state MMRs for the American Indian and Alaska Native and Asian, Native Hawaiian, or Other Pacific Islander populations continue to increase, even after the adoption of a pregnancy checkbox on death certificates. Median state MMR for the Black population remains the highest in the US. Comprehensive mortality surveillance for all states via vital registration identifies states and racial and ethnic groups with the greatest potential to improve maternal mortality. Maternal mortality persists as a source of worsening disparities in many US states and prevention efforts during this study period appear to have had a limited impact in addressing this health crisis.
Migrating Localized ST-Segment Elevation With Ongoing Chest Pain
Authors: Xiao Yunling , Zhou Ruihai
Published: July 2023

A patient in their 60s presented with a 6-hour history of sudden-onset worsening chest pain associated with shortness of breath and diaphoresis. What is your diagnosis?
Frailty and Outcomes Following Cardiopulmonary Resuscitation for Perioperative Cardiac Arrest
Authors: Allen Matthew B. , Orkaby Ariela R. , Justice Samuel , Hall Daniel E. , Hu Frances Y. , Cooper Zara , Bernacki Rachelle E. , Bader Angela M.
Published: July 2023

Importance

Frailty is associated with mortality following surgery and cardiopulmonary resuscitation (CPR) for in-hospital cardiac arrest. Despite the growing focus on frailty as a basis for preoperative risk stratification and concern that CPR in patients with frailty may border on futility, the association between frailty and outcomes following perioperative CPR is unknown.

Objective

To determine the association between frailty and outcomes following perioperative CPR.

Design, Setting, and Participants

This longitudinal cohort study of patients used the American College of Surgeons National Surgical Quality Improvement Program, including more than 700 participating hospitals in the US, from January 1, 2015, through December 31, 2020. Follow-up duration was 30 days. Patients 50 years or older undergoing noncardiac surgery who received CPR on postoperative day 0 were included; patients were excluded if data required to determine frailty, establish outcome, or perform multivariable analyses were missing. Data were analyzed from September 1, 2022, through January 30, 2023.

Exposures

Frailty defined as Risk Analysis Index (RAI) of 40 or greater vs less than 40.

Outcomes and Measures

Thirty-day mortality and nonhome discharge.

Results

Among the 3149 patients included in the analysis, the median age was 71 (IQR, 63-79) years, 1709 (55.9%) were men, and 2117 (69.2%) were White. Mean (SD) RAI was 37.73 (6.18), and 792 patients (25.9%) had an RAI of 40 or greater, of whom 534 (67.4%) died within 30 days of surgery. Multivariable logistic regression adjusting for race, American Society of Anesthesiologists physical status, sepsis, and emergency surgery demonstrated a positive association between frailty and mortality (adjusted odds ratio [AOR], 1.35 [95% CI, 1.11-1.65]; P = .003). Spline regression analysis demonstrated steadily increasing probability of mortality and nonhome discharge with increasing RAI above 37 and 36, respectively. Association between frailty and mortality following CPR varied by procedure urgency (AOR for nonemergent procedures, 1.55 [95% CI, 1.23-1.97]; AOR for emergent procedures, 0.97 [95% CI, 0.68-1.37]; P = .03 for interaction). An RAI of 40 or greater was associated with increased odds of nonhome discharge compared with an RAI of less than 40 (AOR, 1.85 [95% CI, 1.31-2.62]; P < .001).

Conclusions and Relevance

The findings of this cohort study suggest that although roughly 1 in 3 patients with an RAI of 40 or greater survived at least 30 days following perioperative CPR, higher frailty burden was associated with increased mortality and greater risk of nonhome discharge among survivors. Identifying patients who are undergoing surgery and have frailty may inform primary prevention strategies, guide shared decision-making regarding perioperative CPR, and promote goal-concordant surgical care.
Global, Regional, and National Epidemiology of Diabetes in Children From 1990 to 2019
Authors: Zhang Kexin , Kan Chengxia , Han Fang , Zhang Jingwen , Ding Chuanhua , Guo Zhentao , Huang Na , Zhang Yang , Hou Ningning , Sun Xiaodong
Published: July 2023

Importance

Diabetes in children is a global epidemic that causes various medical conditions associated with an increased incidence of premature death.

Objective

To investigate the trends in diabetes incidence, mortality, and disability-adjusted life-years (DALYs) in children, with risk factors for diabetes-associated death, from 1990 to 2019.

Design, Setting, and Participants

This was a cross-sectional study that used data from the Global Burden of Diseases (GBD) 2019 in 204 countries and territories. Children with diabetes who were aged 0 to 14 years were included in the analysis. Data were analyzed from December 28, 2022, to January 10, 2023.

Exposure

Childhood diabetes from 1990 to 2019.

Main Outcome Measures

Incidence, all-cause and cause-specific deaths, DALYs, and corresponding estimated annual percentage changes (EAPCs). These trends were stratified according to region, country, age, sex, and Sociodemographic Index (SDI).

Results

A total of 1 449 897 children (738 923 male [50.96%]) were included in the analysis. In 2019, there were 227 580 incident cases of childhood diabetes worldwide. Cases of childhood diabetes increased by 39.37% (95% uncertainty interval [UI], 30.99%-45.45%) from 1990 to 2019. Over 3 decades, diabetes-associated deaths decreased from 6719 (95% UI, 4823-8074) to 5390 (95% UI, 4450-6507). The global incidence rate increased from 9.31 (95% UI, 6.56-12.57) to 11.61 (95% UI, 7.98-15.98) per 100 000 population; however, the diabetes-associated death rate decreased from 0.38 (95% UI, 0.27-0.46) to 0.28 (95% UI, 0.23-0.33) per 100 000 population. Among the 5 SDI regions, the low SDI region had the highest childhood diabetes-associated mortality rate in 2019. Regionally, North Africa and the Middle East had the largest increase in incidence (EAPC, 2.06; 95% CI, 1.94-2.17). Among 204 countries, Finland had the highest national incidence of childhood diabetes in 2019 (31.60 per 100 000 population; 95% UI, 22.65-40.36), Bangladesh had the highest diabetes-associated mortality rate (1.16 per 100 000 population; 95% UI, 0.51-1.70), and the United Republic of Tanzania had the highest DALYs rate (100.16 per 100 000 population; 95% UI, 63.01-155.88). Globally, environmental/occupational risk, nonoptimal temperature, high temperature, and low temperature were key risk factors for childhood diabetes-associated mortality in 2019.

Conclusions and Relevance

Childhood diabetes is an increasing global health challenge with rising incidence. Results of this cross-sectional study suggest that despite the global decline in deaths and DALYs, the number of deaths and DALYs remains high among children with diabetes, especially in low SDI regions. Improved understanding of the epidemiology of diabetes in children may facilitate prevention and control.
Epoxy Compounds—Olefin Oxides (Ethylene Oxide, Propylene Oxide, and Miscellaneous Oxides)
Authors: Klapacz Joanna , Doskey Claire
Published: July 2023

This chapter discusses the chemistry, uses, health information, and industrial hygiene handling procedures of epoxides, that is, substances containing strained, three‐membered rings with two adjacent carbons and one oxygen atom. This functionality underlies epoxides' high reactivity, physicochemical properties, and toxicity. The majority of the content is dedicated to ethylene oxide and propylene oxide, but other epoxides are also of industrial interest and are described here; their databases have evolved over the last couple of decades and this new understanding is highlighted here. These are 1,2‐butylene oxide, 2,3‐epoxybutane, butadiene diepoxide, vinylcyclohexene monoxide, vinylcyclohexene dioxide, and styrene oxide.
Organophosphorus Pesticides
Authors: Saghir Shakil A. , Husain Kazim , Ansari Rais A.
Published: July 2023

Organophosphates (OP) inhibit serine hydrolases by phosphorylating serine residue. Exposure to OPs always involves acetylcholine esterase (AChE) inhibition, which is responsible for the degradation of acetylcholine (ACh), controlling the levels of ACh at the nerve endings. Inactivation/inhibition of AChE causes excessive accumulation of ACh at the neuromuscular junctions and synapses activating both sympathetic and parasympathetic processes causing both muscarinic and nicotinic toxicity. The muscarinic symptoms include salivation, diaphoresis, abdominal cramps, diarrhea, vomiting, miosis, bronchorrhea, bradycardia, coma, and seizure. Nicotinic symptoms are fasciculations, flaccid paralysis, and tachycardia. The most common cause of death is respiratory failure with refractory hypotension. Recovery from OP toxicity is linked to the restoration of OP‐inhibited AChE, which can be revived by oximes or regeneration of the enzyme, certain OPs bind irreversibly with AChE render it permanently inactive. The secondary OP targets in humans are butyrylcholinesterase (BChE), a sink for OP, and neuropathy target esterase, inhibition of which causes delayed neuropathy. The OPs are not only used for the management of pests in agriculture but also used in the treatment of human diseases, such as glaucoma with echothiophate to increase drainage of intraocular fluid reducing ocular pressure, schistosomiasis, and Alzheimer's with metrifonate. Metrifonate inhibits AChE in schistosomes, which is abundant in the muscles of the parasite. Metrifonate enhances central nervous system (CNS) cholinergic neurotransmission improving cognitive function in Alzheimer's patients. This chapter describes the AChE inhibition and toxicity of each OP and regeneration of AChE by oximes along with regulations based on the available data for individual OPs.
Tuning Electrolyte Solvation Structure and CEI Film to Enable Long Lasting FSI−‐Based Dual‐Ion Battery
Authors: Zhao Yu , Xue Kaiming , Yu Denis Y. W.
Published: July 2023

Dual‐ion battery (DIB) is a promising energy storage system because it can provide high power. However, the stability and rate performance of the battery depend strongly on the type of salt and solvents in the electrolyte. Herein, the use of lithium bis(fluorosulfonyl)imide (LiFSI) is studied, which has better high‐temperature stability, as salt in the DIB and develop a 3 m LiFSI fluoroethylene carbonate/methyl 2,2,2‐trifluoroethyl carbonate (FEC/FEMC) = 3:7 electrolyte, which stabilizes graphite–lithium DIB with 94.1% capacity retention after 2000 cycles at 5C. The DIB also exhibits excellent rate performance with 100.4 mAh g−1 capacity at 30C, with a utilization of 96.3% compared to capacity at 2C. The outstanding electrochemical performance is attributed to the thin cathode electrolyte interface (CEI) layer and fast FSI− transport kinetics, confirmed by X‐ray photoelectron spectroscopy and activation energy calculation. Superior cycle and rate performances are also obtained from a graphite–graphite full cell. Though, increasing salt concentration to 5 and 6 m leads to sluggish FSI− de‐intercalation reaction and lower capacity, which is attributed to solvent co‐intercalation. The research suggests that the electrolyte plays an important role in ion transport, surface film formation, and stability of DIB.
Ultrahigh Energy Density of Antiferroelectric PbZrO3‐Based Films at Low Electric Field
Authors: Li Dongxu , Meng Xiangyu , Zhou Enhao , Chen Xiaoxiao , Shen Zhonghui , Guo Qinghu , Yao Zhonghua , Cao Minghe , Wu Jinsong , Zhang Shujun , Liu Hanxing , Hao Hua
Published: July 2023

Dielectric capacitors play a vital role in advanced electronics and power systems as a medium of energy storage and conversion. Achieving ultrahigh energy density at low electric field/voltage, however, remains a challenge for insulating dielectric materials. Taking advantage of the phase transition in antiferroelectric (AFE) film PbZrO3(PZO), a small amount of isovalent (Sr2+) / aliovalent (La3+) dopants are introduced to form a hierarchical domain structure to increase the polarization and enhance the backward switching fieldEAsimultaneously, while maintaining a stable forward switching fieldEF. An ultrahigh energy density of 50 J cm−3is achieved for the nominal Pb0.925La0.05ZrO3(PLZ5) films at low electric fields of 1 MV cm−1, exceeding the current dielectric energy storage films at similar electric field. This study opens a new avenue to enhance energy density of AFE materials at low field/voltage based on a gradient‐relaxor AFE strategy, which has significant implications for the development of new dielectric materials that can operate at low field/voltage while still delivering high energy density.
Bioactive Bacteria/MOF Hybrids Can Achieve Targeted Synergistic Chemotherapy and Chemodynamic Therapy against Breast Tumors
Authors: Li Jianmei , Dai Jie , Zhao Ling , Lin Sheng , Wen Qinglian , Wen Qian , Lu Yun , Fan Yu , Zeng Fancai , Qian Zhiyong , Fu Shaozhi
Published: July 2023

The hypoxic tumor microenvironment (TME) significantly affects cancer treatment. Conventional chemotherapeutic agents cannot effectively target hypoxic tumor tissue, which decreases efficacy and results in severe toxic side effects. To alleviate this problem, a self‐driving biomotor is developed by functionalizing MCDP nanoparticles containing calcium peroxide and doxorubicin (DOX) loaded onto polydopamine‐coated metal–organic frameworks（MOF）, with the anaerobic Bifidobacterium infantis (Bif) for synergistic chemotherapy and chemodynamic therapy (CDT) against breast cancer. The materials of institute Lavoisier (MIL) frameworks + CaO2 + DOX + polydopamine (MCDP)@Bif biohybrid actively targets hypoxic regions of solid tumors via the inherent targeting ability of Bif. Once it has accumulated in the tumor tissue, MCDP generates hydroxyl radicals through the enhanced Fenton‐type reactions between Fe2+ and self‐generated hydrogen peroxide in the acidic TME. The disruption of Ca2+ homeostasis and resulting mitochondrial Ca2+ overload triggers apoptosis and enhances oxidative stress, promoting tumor cell death. The results found that the DOX concentration in MCDP@Bif‐treated tumors is 3.8 times higher than that in free‐DOX‐treated tumors, which significantly prolongs the median survival of the tumor‐bearing mice to 69 days and reduces the toxic side effects of DOX. Therefore, the novel bacteria‐driven drug delivery system is highly effective in achieving synergistic chemotherapy and CDT against solid tumors.
Magnesium Gradient‐Based Hierarchical Scaffold for Dual‐Lineage Regeneration of Osteochondral Defect
Authors: Gao Chenyuan , Dai Wenli , Wang Xinyu , Zhang Liwen , Wang Yue , Huang Yiqian , Yuan Zuoying , Zhang Xin , Yu Yingjie , Yang Xiaoping , Cai Qing
Published: July 2023

Osteochondral regeneration remains a great challenge due to the limited self‐healing ability and the complexity of its hierarchical structure and composition. Mg2+ and hypoxia are two effective modulators in boosting chondrogenesis. To this end, a double‐layered scaffold (D) consisting of a hydrogel layer on a porous cryogel is fabricated to mimic the hierarchical structure of osteochondral tissue. An Mg2+ gradient is incorporated into the double‐layered scaffold with hypoxia‐mimicking deferoxamine (DFO) embedded in the hydrogel (D‐Mg‐DFO), which remarkably augments the dual‐lineage regeneration of both cartilage and subchondral bone. The higher Mg2+ supplementation from the upper hydrogel, associated with its hypoxia‐mimicking situation and small pore size, exhibits promotive effects on chondrogenic differentiation. The lower Mg2+ supplementation from the bottom cryogel, associated with its interconnected macroporous structure, achieves multiple contributions in stem cell migration from bone marrow cavity, matrix mineralization, and osteogenesis. Furthermore, rabbits’ trochlea osteochondral defects are established to evaluate the regenerative outcome. Compared to control scaffolds containing only Mg2+ or DFO, the D‐Mg‐DFO scaffold presents the best regenerative effect under the synergistic contribution of multiple factors. Overall, this work provides a new design of scaffold toward an effective repair of cartilage defect.
Mechanochromism and Strain‐Induced Crystallization in Thiol‐yne‐Derived Stereoelastomers
Authors: Ritter Virginia C. , McDonald Samantha M. , Dobrynin Andrey V. , Craig Stephen L. , Becker Matthew L.
Published: July 2023

Most elastomers undergo strain‐induced crystallization (SIC) under tension; as individual chains are held rigidly in a fixed position by an applied strain, their alignment along the strain field results in a shift from strain‐hardening (SH) to SIC. A similar degree of stretching is associated with the tension necessary to accelerate mechanically coupled, covalent chemical responses of mechanophores in overstretched chains, raising the possibility of an interplay between the macroscopic response of SIC and the molecular response of mechanophore activation. Here, thiol‐yne‐derived stereoelastomers doped covalently with a dipropiolate‐derivatized spiropyran (SP) mechanophore (0.25–0.38 mol%) are reported. The material properties of SP‐containing films are consistent with undoped controls, indicating that the SP is a reporter of the mechanical state of the polymer. Uniaxial tensile tests reveal correlations between mechanochromism and SIC, which are strain‐rate‐dependent. When mechanochromic films are stretched slowly to the point of mechanophore activation, the covalently tethered mechanophore remains trapped in a force‐activated state, even after the applied stress is removed. Mechanophore reversion kinetics correlate with the applied strain rate, resulting in highly tunable decoloration rates. Because these polymers are not covalently crosslinked, they are recyclable by melt‐pressing into new films, increasing their potential range of strain‐sensing, morphology‐sensing, and shape‐memory applications.
Deep‐Learning‐Enabled Intelligent Design of Thermal Metamaterials
Authors: Wang Yihui , Sha Wei , Xiao Mi , Qiu Cheng‐Wei , Gao Liang
Published: July 2023

Thermal metamaterials are mixture‐based materials that are engineered to manipulate, control, and process the flow of heat, enabling numerous advanced thermal metadevices. Conventional thermal metamaterials are predominantly designed with tractable regular geometries owing to the delicate analytical solution and easy‐to‐implement effective structures. Nevertheless, it is challenging to achieve the design of thermal metamaterials with arbitrary geometry, letting alone intelligent (automatic, real‐time, and customizable) design of thermal metamaterials. Here, an intelligent design framework of thermal metamaterials is presented via a pre‐trained deep learning model, which gracefully achieves the desired functional structures of thermal metamaterials with exceptional speed and efficiency, regardless of arbitrary geometry. It possesses incomparable versatility and is of great flexibility to achieve the corresponding design of thermal metamaterials with different background materials, anisotropic geometries, and thermal functionalities. The transformation thermotics‐induced, freeform, background‐independent, and omnidirectional thermal cloaks, whose structural configurations are automatically designed in real‐time according to shape and background, are numerically and experimentally demonstrated. This study sets up a novel paradigm for an automatic and real‐time design of thermal metamaterials in a new design scenario. More generally, it may open a door to the realization of an intelligent design of metamaterials in also other physical domains.
Enhancing Efficiency of Low‐Grade Heat Harvesting by Structural Vibration Entropy in Thermally Regenerative Electrochemical Cycles
Authors: Choi Ahreum , Song You‐Yeob , Kim Juyoung , Kim Donghyeon , Kim Min‐Ho , Lee Seok Woo , Seo Dong‐Hwa , Lee Hyun‐Wook
Published: July 2023

The majority of waste‐heat energy exists in the form of low‐grade heat (<100 °C), which is immensely difficult to convert into usable energy using conventional energy‐harvesting systems. Thermally regenerative electrochemical cycles (TREC), which integrate battery and thermal‐energy‐harvesting functionalities, are considered an attractive system for low‐grade heat harvesting. Herein, the role of structural vibration modes in enhancing the efficacy of TREC systems is investigated. How changes in bonding covalency, influenced by the number of structural water molecules, impact the vibration modes is analyzed. It is discovered that even small amounts of water molecules can induce the A1g stretching mode of cyanide ligands with strong structural vibration energy, which significantly contributes to a larger temperature coefficient (ɑ) in a TREC system. Leveraging these insights, a highly efficient TREC system using a sodium‐ion‐based aqueous electrolyte is designed and implemented. This study provides valuable insights into the potential of TREC systems, offering a deeper understanding of the intrinsic properties of Prussian Blue analogs regulated by structural vibration modes. These insights open up new possibilities for enhancing the energy‐harvesting capabilities of TREC systems.
Spectroscopic Insight into Customized Iodine Ligands Passivated Red‐Emitting CsPb(Br,I)3 Perovskite Nanocrystals via Time‐Resolved Photoluminescence
Authors: Lee Hyun Jae , Ko Semin , Na Hyejin , Jeong Hyeon Woo , Lee Sun Sook , Lee Seon Joo , Lee Jaemin , Oh Soong Ju , Lee Hyun Seok , Suh Jae Yong , Choi Sungho , Kim Chul Hoon
Published: July 2023

Molecular engineering toward the structure of a passivation ligand is essential to improve the photoluminescence (PL) efficiency of perovskite nanocrystals (PNCs). To establish the surface recovery mechanism of red‐emitting CsPb(Br,I)3 NCs with PbI2 additives in the presence of a tightly bound passivation layer, time‐resolved photoluminescence (TRPL) measurements and their chemometric analysis are employed. Two quaternary alkylammonium ligands, didodecyldimethylammonium iodide (DDAI) and tridodecylmethylammonium iodide (TDAI), are used to form a passivation layer, and then their role in the surface defects recovery is investigated by varying the amount of PbI2 additives. It is found that the structural difference between DDAI and TDAI can affect the accessibility of PbI2 additives to surface defects. The TRPL spectra analysis reveals that the ligand passivation with DDAI does not induce discernible lifetime enhancement with using PbI2 additives, but only a non‐radiative pathway is gradually accelerated with increasing the amount of them. The TDAI ligand, however, shows the opposite behavior to give the best PL performance with a distinct molar ratio of TDAI:PbI2, even though the passivation itself gives a lower PL performance. It is argued that the intrinsic structural properties of the TDAI ligand are responsible for the effective surface recovery with the additives.
Shear Stress Drives the Cleavage Activation of Protease‐Activated Receptor 2 by PRSS3/Mesotrypsin to Promote Invasion and Metastasis of Circulating Lung Cancer Cells
Authors: Zhou Muya , Li Koukou , Luo Kathy Qian
Published: July 2023

When circulating tumor cells (CTCs) travel in circulation, they can be killed by detachment‐induced anoikis and fluidic shear stress (SS)‐mediated apoptosis. Circulatory treatment, which can make CTCs detached but also generate SS, can increase metastasis of cancer cells. To identify SS‐specific mechanosensors without detachment impacts, a microfluidic circulatory system is used to generate arteriosus SS and compare transcriptome profiles of circulating lung cancer cells with suspended cells. Half of the cancer cells can survive SS damage and show higher invasion ability. Mesotrypsin (PRSS3), protease‐activated receptor 2 (PAR2), and the subunit of activating protein 1, Fos‐related antigen 1 (FOSL1), are upregulated by SS, and their high expression is responsible for promoting invasion and metastasis. SS triggers PRSS3 to cleave the N‐terminal inhibitory domain of PAR2 within 2 h. As a G protein‐coupled receptor, PAR2 further activates the Gαi protein to turn on the Src‐ERK/p38/JNK‐FRA1/cJUN axis to promote the expression of epithelial–mesenchymal transition markers, and also PRSS3, which facilitates metastasis. Enriched PRSS3, PAR2, and FOSL1 in human tumor samples and their correlations with worse outcomes reveal their clinical significance. PAR2 may serve as an SS‐specific mechanosensor cleavable by PRSS3 in circulation, which provides new insights for targeting metastasis‐initiating CTCs.
Effect of Extracellular Ribonucleic Acids on Neurovascularization in Osteoarthritis
Authors: Qin Wen‐pin , Wan Qian‐Qian , Yan Jian‐Fei , Han Xiao‐Xiao , Lu Wei‐Cheng , Ma Zhang‐Yu , Ye Tao , Li Yu‐Tao , Li Chang‐Jun , Wang Chen , Tay Franklin R. , Niu Li‐Na , Jiao Kai
Published: July 2023

Osteoarthritis is a degenerative disease characterized by abnormal neurovascularization at the osteochondral junctions, the regulatory mechanisms of which remain poorly understood. In the present study, a murine osteoarthritic model with augmented neurovascularization at the osteochondral junction is used to examine this under‐evaluated facet of degenerative joint dysfunction. Increased extracellular RNA (exRNA) content is identified in neurovascularized osteoarthritic joints. It is found that the amount of exRNA is positively correlated with the extent of neurovascularization and the expression of vascular endothelial growth factor (VEGF). In vitro binding assay and molecular docking demonstrate that synthetic RNAs bind to VEGF via electrostatic interactions. The RNA‐VEGF complex promotes the migration and function of endothelial progenitor cells and trigeminal ganglion cells. The use of VEGF and VEGFR2 inhibitors significantly inhibits the amplification of the RNA‐VEGF complex. Disruption of the RNA‐VEGF complex by RNase and polyethyleneimine reduces its in vitro activities, as well as prevents excessive neurovascularization and osteochondral deterioration in vivo. The results of the present study suggest that exRNAs may be potential targets for regulating nerve and blood vessel ingrowth under physiological and pathological joint conditions.
Hyperplastic Human Macromass Cartilage for Joint Regeneration
Authors: Wen Ya , Chen Yishan , Wu Weiliang , Zhang Hong , Peng Zhi , Yao Xudong , Zhang Xianzhu , Jiang Wei , Liao Youguo , Xie Yuan , Shen Xilin , Sun Heng , Hu Jiajie , Liu Hua , Chen Xiao , Chen Jiansong , Ouyang Hongwei
Published: July 2023

Cartilage damage affects millions of people worldwide. Tissue engineering strategies hold the promise to provide off‐the‐shelf cartilage analogs for tissue transplantation in cartilage repair. However, current strategies hardly generate sufficient grafts, as tissues cannot maintain size growth and cartilaginous phenotypes simultaneously. Herein, a step‐wise strategy is developed for fabricating expandable human macromass cartilage (macro‐cartilage) in a 3D condition by employing human polydactyly chondrocytes and a screen‐defined serum‐free customized culture (CC). CC‐induced chondrocytes demonstrate improved cell plasticity, expressing chondrogenic biomarkers after a 14.59‐times expansion. Crucially, CC‐chondrocytes form large‐size cartilage tissues with average diameters of 3.25 ± 0.05 mm, exhibiting abundant homogenous matrix and intact structure without a necrotic core. Compared with typical culture, the cell yield in CC increases 2.57 times, and the expression of cartilage marker collagen type II increases 4.70 times. Transcriptomics reveal that this step‐wise culture drives a proliferation‐to‐differentiation process through an intermediate plastic stage, and CC‐chondrocytes undergo a chondral lineage‐specific differentiation with an activated metabolism. Animal studies show that CC macro‐cartilage maintains a hyaline‐like cartilage phenotype in vivo and significantly promotes the healing of large cartilage defects. Overall, an efficient expansion of human macro‐cartilage with superior regenerative plasticity is achieved, providing a promising strategy for joint regeneration.
Cable‐Car Electrocatalysis to Drive Fully Decoupled Water Splitting
Authors: Long Yuanzheng , Yang Cheng , Wu Yulong , Deng Bohan , Li Ziwei , Hussain Naveed , Wang Kuangyu , Wang Ruyue , He Xian , Du Peng , Guo Zeliang , Lang Jialiang , Huang Kai , Wu Hui
Published: July 2023

The increasing demand for clean energy conversion and storage has increased interest in hydrogen production via electrolytic water splitting. However, the simultaneous production of hydrogen and oxygen in this process poses a challenge in extracting pure hydrogen without using ionic conducting membranes. Researchers have developed various innovative designs to overcome this issue, but continuous water splitting in separated tanks remains a desirable approach. This study presents a novel, continuous roll‐to‐roll process that enables fully decoupled hydrogen evaluation reaction (HER) and oxygen evolution reaction (OER) in two separate electrolyte tanks. The system utilizes specially designed “cable‐car” electrodes (CCE) that cycle between the HER and OER tanks, resulting in continuous hydrogen production with a purity of over 99.9% and Coulombic efficiency of 98% for prolonged periods. This membrane‐free water splitting system offers promising prospects for scaled‐up industrial‐scale green hydrogen production, as it reduces the cost and complexity of the system, and allows for the use of renewable energy sources to power the electrolysis process, thus reducing the carbon footprint of hydrogen production.
The Role of Polaronic States on the Spin Dynamics in Solution‐Processed Two‐Dimensional Layered Perovskite with Different Layer Thickness
Authors: Song Mu‐Sen , Wang Hai , Hu Zi‐Fan , Zhang Yu‐Peng , Liu Tian‐Yu , Wang Hai‐Yu
Published: July 2023

2D lead halide perovskites (LHPs) show strong excitonic and spin‐orbit coupling effects, generating a facile spin injection. Besides, they possess a polaron character due to the soft crystal lattice, which can prolong the spin lifetime, making them favorable materials for spintronic applications. Here, the spin dynamics of 2D PEA2PbI4(MAPbI3)n−l thin films with different layers by temperature‐ and pump fluence–dependent circularly polarization‐resolved transient absorption (TA) measurements is studied. These results indicate that the spin depolarization mechanism is gradually converted from the Maialle–Silva–Sham (MSS) mechanism to the polaronic states protection mechanism with the layer number increasing from  = 1 to 3, which is determined by the interplay between the strength of Coulomb exchange interaction and the strength of polaronic effect. While for  ≥ 4, the Elliot–Yafet (EY) impurities mechanism is proposed, in which the formed polaronic states with free charge carriers no longer play the protective role.
Ultrasensitive Flexible Thermal Sensor Arrays based on High‐Thermopower Ionic Thermoelectric Hydrogel
Authors: Han Yang , Wei Haoxiang , Du Yanjun , Li Zhigang , Feng Shien‐Ping , Huang Baoling , Xu Dongyan
Published: July 2023

Ionic circuits using ions as charge carriers have demonstrated great potential for flexible and bioinspired electronics. The emerging ionic thermoelectric (iTE) materials can generate a potential difference by virtue of selective thermal diffusion of ions, which provide a new route for thermal sensing with the merits of high flexibility, low cost, and high thermopower. Here, ultrasensitive flexible thermal sensor arrays based on an iTE hydrogel consisting of polyquaternium‐10 (PQ‐10), a cellulose derivative, as the polymer matrix and sodium hydroxide (NaOH) as the ion source are reported. The developed PQ‐10/NaOH iTE hydrogel achieves a thermopower of 24.17 mV K−1, which is among the highest values reported for biopolymer‐based iTE materials. The high p‐type thermopower can be attributed to thermodiffusion of Na+ ions under a temperature gradient, while the movement of OH− ions is impeded by the strong electrostatic interaction with the positively charged quaternary amine groups of PQ‐10. Flexible thermal sensor arrays are developed through patterning the PQ‐10/NaOH iTE hydrogel on flexible printed circuit boards, which can perceive spatial thermal signals with high sensitivity. A smart glove integrated with multiple thermal sensor arrays is further demonstrated, which endows a prosthetic hand with thermal sensation for human–machine interaction.
Bioinspired PVDF Piezoelectric Generator for Harvesting Multi‐Frequency Sound Energy
Authors: Duan Bangyan , Wu Kefan , Chen Xiaoyang , Ni Jinyan , Ma Xin , Meng Weishuai , Lam Kwok‐ho , Yu Ping
Published: July 2023

With the rapid development of micro‐energy harvesting technology, noise has great potential as a new type of micro‐energy source by developing a high‐performance acoustic energy harvester (AEH). Nevertheless, the challenges of harvesting energy from noise are low acoustic energy density, multi‐frequency mixed sound, and unstable sound pressure. Piezoelectric‐based AEHs are proposed as a solution, but most reported devices need to work at a certain frequency and very high sound pressure, and exhibit the disadvantages of being bulky and heavy when using an extra sound‐pressure amplifier. Here, the eardrum and cochlea bioinspired polyvinylidene fluoride (PVDF) piezoelectric generator which is lightweight, compact, has a simple structure and is low‐cost, harvests multi‐frequency sound energy. Although using the commercial pure PVDF membrane, the prepared AEH still presents a high acoustoelectric conversion performance with an output power of 8.45 µW and an acoustic sensitivity of 1 V Pa−1 at 200 Hz and 100 dB without using any sound‐pressure amplifier through optimizing the structure–vibration–frequency relationship. More importantly, the bioinspired AEHs do not only exhibit the ability of acoustic energy harvesting function but also have the abilities of frequency recognition and acoustic sensing, which show great potential in the application of self‐powered acoustic sensors.
Dynamic Perovskite Homojunction Based Light‐Assisted, Direct Current Tribovoltaic Nanogenerators
Authors: Yin Xin , Xu Bingang , Kan Chi‐Wai , Yang Yujue
Published: July 2023

Tribovoltaic nanogenerators (TVNG) are an emerging energy technology featuring high direct current density and continuous power output. Recently, a new kind of perovskite/metal Schottky‐based TVNG has attracted increasing attention, which can co‐harvest mechanical and solar energy to dramatically improve the DC output performance. However, the instability of the perovskite‐metal interface and unnecessary carrier recombination loss limit its practicability. Here, a novel light‐assisted TVNG based on a dynamic N‐type perovskite/P‐type perovskite homojunction is developed. The homojunction design can ensure stable interface contact, and contributes to forming a strong built‐in electric field to promote efficient carrier separation/extraction and decrease interfacial charge recombination loss. In addition, the innovative design of the dual perovskite functional electrode maximizes its photovoltaic characteristics and further facilitates the excitation of more charges based on tribo‐photovoltaic coupling effects. Eventually, the output voltage and current of dynamic perovskite homojunction can boost up to ≈8.72 V and ≈30.84 µA under illumination, showing outstanding performance among the state‐of‐the‐art perovskite‐based TVNGs. These findings demonstrate the great potential of perovskite materials in generating DC power and present a feasible strategy to construct efficient, multifunctional TVNGs.
Clonal dynamics and copy number variants by single‐cell analysis in leukemic evolution of myeloproliferative neoplasms
Authors: Calabresi Laura , Carretta Chiara , Romagnoli Simone , Rotunno Giada , Parenti Sandra , Bertesi Matteo , Bartalucci Niccolò , Rontauroli Sebastiano , Chiereghin Chiara , Castellano Sara , Gentili Giulia , Maccari Chiara , Vanderwert Fiorenza , Mannelli Francesco , Della Porta Matteo , Manfredini Rossella , Vannucchi Alessandro Maria , Guglielmelli Paola
Published: July 2023

Transformation from chronic (CP) to blast phase (BP) in myeloproliferative neoplasm (MPN) remains poorly characterized, and no specific mutation pattern has been highlighted. BP‐MPN represents an unmet need, due to its refractoriness to treatment and dismal outcome. Taking advantage of the granularity provided by single‐cell sequencing (SCS), we analyzed paired samples of CP and BP in 10 patients to map clonal trajectories and interrogate target copy number variants (CNVs). Already at diagnosis, MPN present as oligoclonal diseases with varying ratio of mutated and wild‐type cells, including cases where normal hematopoiesis was entirely surmised by mutated clones. BP originated from increasing clonal complexity, either on top or independent of a driver mutation, through acquisition of novel mutations as well as accumulation of clones harboring multiple mutations, that were detected at CP by SCS but were missed by bulk sequencing. There were progressive copy‐number imbalances from CP to BP, that configured distinct clonal profiles and identified recurrences in genes includingNF1,TET2, andBCOR, suggesting an additional level of complexity and contribution to leukemic transformation.EZH2emerged as the gene most frequently affected by single nucleotide and CNVs, that might result in EZH2/PRC2‐mediated transcriptional deregulation, as supported by combined scATAC‐seq and snRNA‐seq analysis of the leukemic clone in a representative case. Overall, findings provided insights into the pathogenesis of MPN‐BP, identified CNVs as a hitherto poorly characterized mechanism and point to EZH2 dysregulation as target. Serial assessment of clonal dynamics might potentially allow early detection of impending disease transformation, with therapeutic implications.
Changes in body weight and body composition during the menstrual cycle
Authors: Kanellakis Spyridon , Skoufas Efstathios , Simitsopoulou Eleftheria , Migdanis Athanasios , Migdanis Ioannis , Prelorentzou Tzortzia , Louka Aikaterini , Moschonis Georgios , Bountouvi Evangelia , Androutsos Odysseas
Published: July 2023

Objectives

The general perception is that menstrual cycle is a factor related to body weight and body composition fluctuations in women. The lack of a standardized methodology of the so far conducted studies has led to controversial results. The aim of the current study is to identify if there are any changes in body weight and body composition during the menstrual cycle.

Methods

In the current study measurements of body weight, circumferences, skinfolds and body composition with bioelectrical impedance analysis were conducted twice per week in 42 women during their menstrual cycle.

Results

Body weight was found to be statistically significantly higher during menstruation compared to the first week of the menstrual cycle by 0.450 kg, which could be attributed to a statistically significant increase of 0.474 kg observed in extracellular water. No other statistically significant changes were observed regarding body composition.

Conclusions

An increase of approximately 0.5 kg was observed during women's menstrual cycle, mostly due to extracellular fluid retention at menstruation days. These findings could be taken into account to interpret body weight and composition periodic fluctuations in women of reproductive age.
Adverse events associated with budesonide nasal irrigation reported to the US Food and Drug Administration: 2007 to 2022
Authors: Rathi Vinay K. , Sawicki Nicholas W. , Schlosser Rodney J. , Soler Zachary M. , Scangas George A. , Workman Alan D. , Gray Stacey T.
Published: July 2023

KEYPOINTS

Between 2007 and 2022, the FDA received 119 US‐based reports mentioning budesonide nasal irrigation.

Most reports were submitted by patients and alerted FDA to off‐label usage of budesonide.

Notable adverse events reported to the FDA included headache, dyspnea, and blurred vision.
Levels of nasal nitric oxide and nitric oxide synthase expression in chronic rhinosinusitis with nasal polyposis
Authors: Wu Vincent , Cusimano Michael , Marsden Philip , Lee John M.
Published: July 2023

Key points

CRSwNP patients had decreased nNO and increased SNOT‐22, endoscopy, and CT scores.

CRSwNP patients exhibited decreased nNO despite elevated iNOS and eNOS mRNA expression.

The mechanism behind lowered nNO in CRSwNP may not be related to NOS expression.
Interpenetrating polymer network based hydrogel: A smart approach for corroborating wound healing of various capacity
Authors: Sarangi Manoj Kumar , Padhi Sasmita , Patel L. D. , Rath Goutam , Nanda Sitansu Sekhar , Yi Dong Kee
Published: July 2023

Hemorrhage of high intensity usually leads to severe mortality accidents, disaster, and warfare. The concomitant wound thereby induces immense psychological as well as physical trauma to the patients. Hence, a faster hemostasis with smart wound healing approaches are highly essential to deal such critical/life threatening situations. The traditional approaches such as implementation of gauze and bandages are found to be having limited scope for controlling hemorrhage, because of non‐biodegradability, high susceptibility towards infection, unsuitability for irregular wound and ineffective towards wound healing. By virtue of the merits revealed by remodeling interpenetrating polymer network (IPN) based hydrogels (biocompatibility, high porosity, tunability, biomimetic and better retention, and proliferative wound healing tendency), have drawn a rigorous attention to out play their ancestors. This review includes the involvement of numerous synthetic routes, types and physicochemical properties of IPN based hydrogels loaded with diverse therapeutic agents towards wound repair/healing. Moreover, some of the recent patents have been portrayed in the manuscript, dignifying the potentiality of fascinating IPN hydrogels towards effective wound healing. More research is required to engineer multifaceted IPN hydrogels to attain huge potential against the challenges and future perspectives in wound healing.