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Context: Low bone mineral density (BMD) has been linked to elevated risks of mortality and infections in the general population; however, its association with these outcomes in stroke patients remains unclear., Objective: This study aims to investigate the correlation between low BMD and risks of mortality and infections among stroke patients in a Taiwanese cohort., Methods: In this single-center retrospective cohort study, 905 stroke patients from a Taiwanese database (2000-2022) were analyzed. Patients were grouped based on BMD measurements of the femur and spine. The primary outcome was all-cause mortality, and secondary outcomes included urinary tract infection (UTI) and pneumonia. Accelerated failure time regression model analyses evaluated the association between BMD and these outcomes, while the Kaplan-Meier method and log-rank test assessed survival differences between groups., Results: Among the participants (average age 76.1 years, 70.5% female), 33.82% had osteopenia and 55.25% had osteoporosis. Stroke patients with lower spine and right femur BMD had significantly reduced survival rates, especially when the BMD value fell below 0.842 g/cm2 (spine), and 0.624 g/cm2 (right femur), respectively. Regarding secondary outcomes, lower spine BMD was significantly associated with an increased risk of UTI., Conclusion: Low BMD, particularly in the femur and spine, is a significant predictor of mortality and UTI in stroke patients. These findings highlight the importance of assessing and managing BMD in stroke patients to improve outcomes and reduce complications., (© The Author(s) 2024. Published by Oxford University Press on behalf of the Endocrine Society. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com. See the journal About page for additional terms.)

Background: Intensive care unit acquired weakness (ICUAW) is a common neuromuscular complication of critical illness, impacting patients' recovery and long-term outcomes. However, limited evidence is available on pooled prevalence and risk factors of ICUAW specifically in the COVID-19-infected population., Methods: We searched on PubMed, Embase, Cochrane Library, Web of Science, PEDro, and EBSCOhost/CINAHL up to January 31, 2024. Data synthesis was conducted using the Freeman-Tukey double-arcsine transformation model for the pooled prevalence rate and odds ratios with corresponding 95% confidence intervals was used to identify risk factors., Results: The pooled prevalence of ICUAW in COVID-19 patients was 55% in eight studies on 868 patients. Risk factors for developing ICUAW in these patients were: old age (WMD 4.78, 95% CI, 1.06-8.49), pre-existing hypertension (OR = 1.63, 95% CI, 1.02-2.61), medical intervention of prone position (OR = 5.21, 95% CI, 2.72-9.98), use of neuromuscular blocking agents (NMBA) (OR = 12.04, 95% CI, 6.20-23.39), needed tracheostomy (OR = 18.07, 95% CI, 5.64-57.92) and renal replacement therapy (RRT) (OR = 5.24, 95% CI = 2.36-11.63)., Conclusions: The prevalence of ICUAW in patients with COVID-19 was considered relatively high. Older age, pre-existing hypertension, medical intervention of prone position, NMBA use, needed tracheostomy and RRT were likely risk factors. In the future, interdisciplinary medical team should pay attention to high-risk groups for ICUAW prevention and early treatments., Competing Interests: Declaration of Conflicting InterestsThe authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

We explore the effect of complete oral motor intervention (OMI) and nonnutritive sucking (NNS) alone on oral feeding in preterm infants through a meta-analysis. We searched the Embased, Medline, Cochrane Library, and Web of Science databases for randomized controlled trials up to 8 August 2023, based on established selection criteria. Quality evaluations of the studies were carried out by applying both the Cochrane risk of bias assessment tool and the Jadad scale. The outcome measures of three clinical indicators included transition time to oral feeding, weight gain, and hospitalization duration. We conducted a meta-analysis using a random-effects model to determine the pooled effect sizes, expressed as standardized mean differences (SMDs) and their corresponding confidence intervals (CIs). Additionally, we undertook a subgroup analysis and meta-regression to investigate any potential moderating factors. Eight randomized controlled trials with 419 participants were selected. Meta-analysis revealed that receiving a complete OMI had significantly reduced transition time compared with those receiving NNS alone in preterm newborns (SMD, -1.186; 95% CI, -2.160 to -0.212, p = 0.017). However, complete OMI had no significant effect on shortened hospitalization duration (SMD, -0.394; 95% CI, -0.979 to 0.192, p = 0.188) and increased weight gain (SMD, 0.346; 95% CI, -0.147 to 0.838, p = 0.169) compared with NNS alone. In brief, a complete OMI should not be replaced by NNS alone. However, we were unable to draw decisive conclusions because of the limitations of our meta-analysis. Future well-designed randomized controlled trials are necessary to confirm our conclusion.

Duchenne muscular dystrophy (DMD) is a genetic disease characterized by progressive muscle weakness with increased neuromechanical challenge and fall risks, especially during obstructed locomotion. This study aimed to identify the kinematic strategies for obstacle-crossing in DMD via synthesizing the changes in the joint kinematics and associated end-point control. Fourteen boys with DMD (age: 9.0 ± 2.5 years) and fourteen typically developed controls (age: 9.0 ± 2.8 years) each crossed obstacles of three different heights (10%, 20% and 30% of leg length) while the angular motions of the trunk-pelvis-leg apparatus and foot-obstacle clearances were measured. Two-way analyses of variance were used to analyze group and obstacle height effects. Compared to the controls, the DMD group crossed obstacles with significantly increased step width, but decreased crossing speed, crossing step length, trailing toe-obstacle clearance and leading heel-obstacle horizontal distance (p < 0.05). When the leading toe was above the obstacle, the patients showed significantly increased pelvic hiking, pelvic and trunk anterior tilt and ankle plantarflexion, but decreased hip flexion in both limbs (p < 0.05). Similar kinematic changes were found during trailing-limb crossing, except for an additional increase in swing-hip abduction and decrease in contralateral trunk side-bending and stance-knee flexion. Patients with DMD crossed obstacles via a specific kinematic strategy with altered end-point control, predisposing them to a greater risk of tripping during trailing-limb crossing. These results suggest that crossing kinematics in DMD should be monitored-especially in the proximal segments of the pelvis-leg apparatus-that may lead to an increased risk of falling., (© 2023. Springer Nature Limited.)

Background: Robot-assisted gait training is incorporated into guidelines for stroke rehabilitation. It is a promising tool combined with conventional therapy for low ambulatory patients. The heavy weight and bulky appearance of a robotic exoskeleton limits its practicality. On the other hand, soft robotic exosuit (SRE) based on its light weight and inconspicuous property, is better tolerated by patients in daily life. The aim of this study is to review the efficacy of the SRE with regard to walking ability and biomechanical properties in stroke patients., Methods: Electronic searches were carried out in PubMed, Embase, Cochrane Library, Web of Science, and the Physiotherapy Evidence Database. Clinical trials that investigated the effectiveness of SREs on ambulation ability in patients with post-stroke hemiparesis were eligible. Qualitative data synthesis was subsequently performed., Results: Nine studies were identified as relevant, involving a total of 83 patients. For the assessment of SRE efficacy, outcome measures were walking ability and biomechanical properties. In terms of both immediate effect and training effect, SREs improved the walking speed, walking distance, peak ankle dorsiflexion angle during swing phase, peak paretic propulsion, stride length and compensated gait in stroke patients., Conclusions: SRE improved the ambulation ability of stroke patients in terms of walking ability and biomechanical properties. The small number of studies limits the generalizability of interpretation. More controlled studies with better quality are required to reach a more solid conclusion on this issue., (© 2023. BioMed Central Ltd., part of Springer Nature.)

Background: Current anticancer treatments for breast cancer (BC) may cause cardiotoxicity. This study aimed to investigate the effectiveness of aerobic exercise in mitigating cardiotoxicity caused by BC therapy., Materials and Methods: PubMed, Embase, Cochrane Library, Web of Science, and the Physiotherapy Evidence Database were searched until February 7, 2023. Clinical trials investigating the effectiveness of exercise training, including aerobic exercise, in BC patients receiving treatments that could cause cardiotoxicity were eligible. Outcome measures included cardiorespiratory fitness (CRF) (peak oxygen consumption, VO 2 peak), left ventricular ejection fraction, and peak oxygen pulse. Intergroup differences were determined by standard mean differences (SMD) and 95% confidence intervals (CIs). Trial sequential analysis (TSA) was utilized to ensure whether the current evidence was conclusive., Results: Sixteen trials involving 876 participants were included. Aerobic exercise significantly improved CRF measured by VO 2 peak in mL/kg/min (SMD 1.79, 95% CI 0.99-2.59) when compared to usual care. This result was confirmed through TSA. Subgroup analyses revealed that aerobic exercise given during BC therapy significantly improved VO 2 peak (SMD 1.84, 95% CI 0.74-2.94). Exercise prescriptions at a frequency of up to 3 times per week, an intensity of moderate to vigorous, and a >30-minute session length also improved VO 2 peak., Conclusion: Aerobic exercise is effective in improving CRF when compared to usual care. Exercise performed up to 3 times per week, at a moderate-to-vigorous intensity, and having a session length >30 minutes is considered effective. Future high-quality research is needed to determine the effectiveness of exercise intervention in preventing cardiotoxicity caused by BC therapy., (Copyright © 2023 Elsevier Inc. All rights reserved.)

Wearable robotic devices have been strongly put into use in both the clinical and research fields of stroke rehabilitation over the past decades. This study aimed to explore the effectiveness of soft robotic gloves (SRGs) towards improving the motor recovery and functional abilities in patients with post-stroke hemiparesis. Five major bibliographic databases, PubMed, Embase, Cochrane Library, Web of Science, and the Physiotherapy Evidence Database, were all reviewed for enrollment regarding comparative trials prior to 7 March 2023. We included adults with stroke and compared their rehabilitation using SRGs to conventional rehabilitation (CR) on hand function in terms of the Fugl-Meyer Upper Extremity Motor Assessment (FMA-UE), Fugl-Meyer Distal Upper Extremity Motor Assessment (FMA-distal UE), box and blocks test score, grip strength test, and the Jebsen-Taylor hand function test (JTT). A total of 8 studies, comprising 309 participants, were included in the analysis. Compared to CR, rehabilitation involving SRGs achieved better FMA-UE (MD 6.52, 95% CI: 3.65~9.39), FMA-distal UE (MD 3.27, 95% CI: 1.50~5.04), and JJT (MD 13.34, CI: 5.16~21.53) results. Subgroup analysis showed that stroke latency of more than 6 months and training for more than 30 min offered a better effect as well. In conclusion, for patients with stroke, rehabilitation using SRGs is recommended to promote the functional abilities of the upper extremities.

Osteoporosis is a common disease, and the prevalence is increasing in patients with chronic respiratory diseases, with important implications with regard to fractures, hospitalization, and death. Due to inconsistent data and a lack of large cohort follow-up studies on the association between lung function and osteoporosis, the aim of this study was to investigate this issue. We enrolled and followed for a median of 4 years a total of 9059 participants with no history of smoking, bronchitis, emphysema, or asthma from the Taiwan Biobank. Spirometry data, including forced expiratory volume in 1 second (FEV1) and forced vital capacity (FVC), were used to assess lung function. Changes in the calcaneus ultrasound T-score (ΔT-score) were calculated as follow-up T-score-baseline T-score. A ΔT-score ≤ -3 (median value of ΔT-score) meant a fast decline in T-score. Multivariable analysis showed that lower values of FEV1 (β, 0.127, p < 0.001), FVC (β, 0.203, p < 0.001), and FEV1/FVC (β, 0.002, p = 0.013) were significantly associated with a low baseline T-score. In addition, after follow-up, higher values of FEV1 (odds ratio (OR), 1.146, p = 0.001), FVC (OR, 1.110, p = 0.042), and FEV1/FVC (OR, 1.004, p = 0.002) were significantly associated with ΔT-score ≤ -3. FEV1/FVC < 70% (OR, 0.838, p < 0.001) was significantly associated with ΔT-score ≤ -3. In conclusion, lower FEV1, FVC, and FEV1/FVC were associated with a low baseline T-score, and higher FEV1, FVC, and FEV1/FVC were associated with a rapid decline in T-score in follow-up. This suggests that lung disease may be associated with bone mineral density in the Taiwanese population with no history of smoking, bronchitis, emphysema, or asthma. Further research is needed to establish causality.

Background: Air tamponade's effectiveness in treatment of rhegmatogenous retinal detachment (RRD) remains unclear., Objective: We aimed to review the surgical outcomes between air and gas tamponade after vitrectomy for RRD., Method: PubMed, Cochrane Library, EMBASE, and Web of Science were reviewed. The study protocol was registered in the International Prospective Register of Systematic Reviews (PROSPERO CRD42022342284). The primary outcome was the primary anatomical success after vitrectomy. The secondary outcome was the prevalence of postoperative ocular hypertension. Certainty of evidence was evaluated using the Grading of Recommendations Assessment, Development, and Evaluation system., Results: Ten studies involving 2,677 eyes were included. One study was randomized, and the others were non-randomized. The primary anatomical success after vitrectomy was not significantly different between the air and gas groups (odds ratio [OR], 1.00; 95% confidence interval [CI], 0.68-1.48). The risk of ocular hypertension was significantly lower in the air group (OR: 0.14; 95% CI: 0.09-0.24). The certainty of evidence regarding air tamponade having a comparable anatomical outcome and lower frequency of postoperative ocular hypertension in treatment of RRD were low., Discussion: The current evidence base for tamponade selection in treatment of RRD has several major limitations. Further appropriately designed studies are needed to guide tamponade selection., (© 2023 The Author(s). Published by S. Karger AG, Basel.)

Introduction: Mild cognitive impairment (MCI) is considered a transitional stage between soundness of mind and dementia, often involving problems with memory, which may lead to abnormal postural control and altered end-point control when dealing with neuromechanical challenges during obstacle-crossing. The study aimed to identify the end-point control and angular kinematics of the pelvis-leg apparatus while crossing obstacles for both leading and trailing limbs., Methods: 12 patients with MCI (age: 66.7 ± 4.2 y/o; height: 161.3 ± 7.3 cm; mass: 62.0 ± 13.6 kg) and 12 healthy adults (age: 67.7 ± 2.9 y/o; height: 159.3 ± 6.1 cm; mass: 61.2 ± 12.0 kg) each walked and crossed obstacles of three different heights (10, 20, and 30% of leg length). Angular motions of the pelvis and lower limbs and toe-obstacle clearances during leading- and trailing-limb crossings were calculated. Two-way analyses of variance were used to study between-subject (group) and within-subject (obstacle height) effects on the variables. Whenever a height effect was found, a polynomial test was used to determine the trend. A significance level of α = 0.05 was set for all tests., Results: Patients with MCI significantly increased pelvic anterior tilt, hip abduction, and knee adduction in the swing limb during leading-limb crossing when compared to controls ( p  < 0.05). During trailing-limb crossing, the MCI group showed significantly decreased pelvic posterior tilt, as well as ankle dorsiflexion in the trailing swing limb ( p  < 0.05)., Conclusion: Patients with MCI adopt altered kinematic strategies for successful obstacle-crossing. The patients were able to maintain normal leading and trailing toe-obstacle clearances for all tested obstacle heights with a specific kinematic strategy, namely increased pelvic anterior tilt, swing hip abduction, and knee adduction during leading-limb crossing, and decreased pelvic posterior tilt and swing ankle dorsiflexion during trailing-limb crossing. The current results suggest that regular monitoring of obstacle-crossing kinematics for reduced toe-obstacle clearance or any signs of changes in crossing strategy may be helpful for early detection of compromised obstacle-crossing ability in patients with single-domain amnestic MCI. Further studies using a motor/cognitive dual-task approach on the kinematic strategies adopted by multiple-domain MCI will be needed for a complete picture of the functional adaptations in such a patient group., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Lu, Kuan, Wu, Lu, Tsai, Chen and Lu.)

Background: Patients recovered from COVID-19 often suffer from the sequelae of the disease, which can hinder the patients' activity in daily living. Early recognition of the patients at risk of prolonged hospitalization and impaired physical functioning is crucial for early intervention. We aim to identify the predictors of prolonged hospitalization and impaired activity in daily living in this study., Methods: COVID-19 patients hospitalized in a medical center were divided into two groups according to the Barthel index three months after discharge and the median length of hospital stay, respectively. Chi-square test and Mann-Whitney U test were performed to check the differences between the two groups in patient characteristics as well as hematology tests at the emergency department, the intensive care unit mobility scale (ICUMS), and the medical research council sum score (MRCSS). Logistic regression and the receiver operating characteristic curve analysis were further performed for the factors with significant differences between the two groups., Results: Both ICUMS and MRCSS showed significant differences between the groups. The ICUMS had an odds ratio of 0.61 and the MRCSS of 0.93 in predicting a Barthel index score less than 100 three months after discharge. The MRCSS had an odds ratio of 0.82 in predicting a prolonged length of hospital stay., Conclusion: Both ICUMS and MRCSS upon admission are predictive of a Barthel index score of less than 100 three months after discharge. On the other hand, only MRCSS has predictive value of a prolonged hospitalization.

Herein, we report the nickel-catalyzed denitrogenative cyclization reaction of 1,2,3,4-benzothiatriazine-1,1-dioxides with arynes to generate the polysubstituted biaryl sultams with tolerance of a wide diversity of substituents on every subunit. The mechanistic study indicates that the reaction is initiated by the formation of a diradical species, which reacts with a nickel complex to form a nickelacycle intermediate and carries out the subsequent cyclization through insertion of an aryne.

Avascular necrosis of the hip (AVN) is one of the most severe complications of surgical reduction when treating developmental dysplasia of the hip (DDH). The current study identified the differences in the balance control during walking in terms of the inclination angle (IA) of the center of pressure (COP) to the center of mass (COM), and the rate of change of IA (RCIA) between female juveniles with and without secondary AVN at the hip who were treated for unilateral DDH during toddlerhood as compared to their healthy peers. When compared to female healthy controls, the non-AVN group showed bilaterally similar compromised balance control with significantly decreased IA ( p < 0.05) but increased RCIA ( p < 0.04) in the sagittal plane during single-limb support (SLS) of the unaffected side, and in the frontal plane during terminal double-limb support (DLS) of the affected side. In contrast, the AVN increased between-side differences in the sagittal IA ( p = 0.01), and sagittal and frontal RCIA during DLS ( p < 0.04), leading to bilaterally asymmetrical balance control. Secondary AVN significantly reduced IA and RCIA in the sagittal plane ( p < 0.05), and reduced range of RCIA in the frontal plane during initial DLS ( p < 0.05). The trend reversed during terminal DLS, indicating a conservative COM-COP control in the sagittal plane and a compromised control in the frontal plane during body weight acceptance, with a compromised COM-COP control in the frontal plane during weight release. The current results suggest that increased between-side differences in the sagittal IA, and sagittal and frontal RCIA during DLS are a sign of AVN secondary to treated unilateral DDH in female juveniles, and should be monitored regularly for early identification of the disease., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Lee, Lee, Chen, Chen, Wu, Tsai, Wang and Lu.)

Introduction: About 1% of the newborn population has developmental dysplasia of the hip (DDH), altering joint biomechanics, gait performance and balance control. Pemberton's osteotomy is used in early treatment but it remains unclear whether it will help the patient regain normal balance control during gait. The current study aimed to identify the changes of the whole-body balance control during level walking in children treated for unilateral DDH during toddlerhood, in terms of inclination angles (IA) of the line joining the body's center of mass (COM) and center of pressure (COP), and the rate of change of IA (RCIA)., Materials and Methods: Twelve girls (DDH group; age: 7.1 ± 2.1 years) who had been treated with Pemberton's osteotomy for unilateral DDH during toddlerhood and twelve healthy controls (Control group; age: 7.6 ± 2.1 years) walked at their preferred walking speed while IA, RCIA and temporal-spatial parameters were calculated from measured kinematic and forceplate data, and were compared using independent t-tests., Results: Compared to the Control group, the DDH group showed significantly decreased sagittal IA (p = 0.042) but increased range of sagittal RCIA during SLS on the unaffected side (p = 0.006), and increased peak sagittal RCIA during DLS (p < 0.008). In the frontal plane, the altered COM-COP control occurred mainly during stance phase of the affected side, showing a decreased range of RCIA during SLS (p = 0.033) followed by decreased IA (p = 0.045) with an increased peak value of RCIA (p = 0.023) during terminal DLS., Conclusions: The children with treated unilateral DDH showed compromised, bilaterally different balance control strategies with altered COM-COP control during gait, not only during stance in the frontal plane as expected, but even more so during swing in the sagittal plane. It is thus suggested that routine assessment of the morphological changes and/or altered balance control of both the unaffected and affected hips is equally important for early identification of any signs of insidious hip problems, deteriorating balance control or increased risk of loss of balance., (Copyright © 2021 Elsevier B.V. All rights reserved.)

Breast cancer-related lymphedema (BCRL) is one of the most significant complications seen after surgery. Several studies demonstrated that extracorporeal shock wave therapy (ESWT), in addition to conventional complex decongestive therapy (CDT), had a positive effect on BCRL in various aspects. The systematic review and meta-analysis aim to explore the effectiveness of ESWT with or without CDT on BRCL patients. We searched PubMed, Embase, PEDro, Cochrane Library Databases, and Google Scholar for eligible articles and used PRISMA2020 for paper selection. Included studies were assessed by the PEDro score, Modified Jadad scale, STROBE assessment, and GRADE framework for the risk of bias evaluation. The primary outcomes were the volume of lymphedema and arm circumference. Secondary outcome measures were skin thickness, shoulder joint range of motion (ROM), and an impact on quality-of-life questionnaire. Studies were meta-analyzed with the mean difference (MD). Eight studies were included in the systemic review and four in the meta-analysis. In summary, we found that adjunctive ESWT may significantly improve the volume of lymphedema (MD = -76.44; 95% CI: -93.21, -59.68; p < 0.00001), skin thickness (MD = -1.65; 95% CI: -3.27, -0.02; p = 0.05), and shoulder ROM (MD = 7.03; 95% CI: 4.42, 9.64; p < 0.00001). The evidence level was very low upon GRADE appraisal. ESWT combined with CDT could significantly improve the volume of lymphedema, skin thickness, and shoulder ROM in patients with BCRL. There is not enough evidence to support the use of ESWT as a replacement for CDT. This study was registered with PROSPERO: CRD42021277110.

A novel synthetic pathway to approach 3-(imino)isoindolin-1-ones by the Co-catalyzed cyclization reaction of 2-bromobenzamides with carbodiimides has been developed. This catalytic reaction can tolerate a variety of substituents and provide corresponding products in moderate yields for most cases. According to the literature, the reaction mechanism is proposed through the formation of a five-membered aza-cobalacycle complex, which carries out the following reaction subsequence, including nucleophilic addition and substitution, to furnish the desired structures.

In this study, a novel method with the U-Net-based network architecture, 2D U-Net, is employed to segment the position of lung nodules, which are an early symptom of lung cancer and have a high probability of becoming a carcinoma, especially when a lung nodule is bigger than 15 [Formula: see text]. A serious problem of considering deep learning for all medical images is imbalanced labeling between foreground and background. The lung nodule is the foreground which accounts for a lower percentage in a whole image. The evaluation function adopted in this study is dice coefficient loss, which is usually used in image segmentation tasks. The proposed pre-processing method in this study is to use complementary labeling as the input in U-Net. With this method, the labeling is swapped. The no-nodule position is labeled. And the position of the nodule becomes non-labeled. The result shows that the proposal in this study is efficient in a small quantity of data. This method, complementary labeling could be used in a small data quantity scenario. With the use of ROI segmentation model in the data pre-processing, the results of lung nodule detection can be improved a lot as shown in the experiments.

Background: Global aphasia without hemiparesis (GAWH) is a rare stroke syndrome characterized by the dissociation of motor and language functions. Here, we present a case of GAWH with the patient later regaining speech fluency., Case Presentation: A 73-year-old man was admitted to our emergency department immediately after an episode of syncope. On arrival, we noted his global aphasia but without any focal neurologic signs. Computed tomography (CT) perfusion scans showed a large hypodense region over his left perisylvian area. Under the impression of acute ischaemic stroke, he received recombinant tissue plasminogen activator (rtPA) injection and was treated as an inpatient. The patient was later discharged with GAWH status and received regular speech rehabilitation. After 14 months of rehabilitation, the patient gradually recovered his language expression ability. The degree of aphasia was evaluated with the Concise Chinese Aphasia Test (CCAT), and we obtained brain single photon emission computed tomography (SPECT) scans to assess cerebral blood flow., Conclusion: A patient with severe impairments of Broca's and Wernicke's areas was able to talk fluently despite being unintelligible. SPECT revealed relative high level of radioactivity uptake in the right frontal lobe, suggesting the deficits in speech fluency could have been compensated by the right hemisphere. Although this is a single case demonstration, the results may strengthen the role of the right hemisphere in GAWH patients and suggests additional study that examines the possible benefits of stimulating activity at right homologous regions for recovering language function after global aphasia.

In this article, a high-yield method for the synthesis of sulfonyl 9-fluorenylidenes is described, which consists of a one-pot straightforward three-step synthetic route, including (i) CuBr 2 -mediated α-bromination of o -arylacetophenone, (ii) sequential nucleophilic substitution of the resulting α-bromo o -arylacetophenone with sodium sulfinate (RSO 2 Na), and (iii) the CuBr 2 -mediated intramolecular Friedel-Crafts cyclizative dehydration. A plausible mechanism is proposed and discussed. This protocol provides a highly effective regio- and stereoselective annulation via the formation of one carbon-carbon (C-C) bond and one carbon-sulfur (C-S) bond.

Amberlyst 15-controlled one-pot easy-operational intermolecular cyclocondensation of substituted piperidines with arylaldehydes provides diversified 3,5-diarylmethylpyridines in high to excellent yields under refluxing toluene conditions. The uses of various acidic solid supports and reaction solvents are investigated for facile and efficient transformation. A plausible mechanism has been proposed.

Nonylphenols (NPs) are endocrine-disrupting compounds commonly found in the environment and a number of food products. In this study, we constructed a probabilistic risk framework incorporating a Bayesian inference of exposure level in foodstuffs in conjunction with effect analysis of reproduction and renal disease. Our objective was to contrast the risk of dietary exposure to NPs among individuals in various age groups, with a particular focus on fertile females. In this study, seafood presented relatively high NP concentrations; however, seafood accounts for only a small proportion of the total food intake of most individuals. Rice was shown to make the largest contribution to NP daily intake among males and females in most age groups. Chicken made the largest contribution in the 12-16 and 16-18 year age groups. The mean average daily dose of NPs tended to decrease with age, regardless of gender. The estimated distribution of hazard quotients of <1 in all groups means that the risk of reproductive or renal abnormalities due to dietary exposure to NPs is negligible within most of the Taiwanese population. Nonetheless, preschoolers (3-6-year-olds) appear to be more vulnerable to NPs than do individuals in other age groups. There has been growing concern among researchers concerning the neurotoxic effects of NPs on offspring via maternal exposure. We recommend conducting a comprehensive assessment of exposure to NPs via multiple exposure routes, particularly among fertile women and preschoolers., Competing Interests: Declaration of competing interest The authors declare that they have no competing interests related to the work performed in this study., (Copyright © 2020 Elsevier B.V. All rights reserved.)

In this paper, an easy-operational, high-yielding method for the gram-scale synthesis of 3-sulfonyl flavanones is described by a one-pot straightforward POCl 3 mediated intermolecular (5 + 1) annulation of the β-ketosulfones with an o -hydroxyaryl group (dual nucleophile) and arylaldehydes (dual electrophile) in refluxing toluene for 3 h. A plausible mechanism is proposed and discussed. This protocol provides a highly effective annulation via one carbon-oxygen (C-O) and one carbon-carbon (C-C) bond formations.

In this paper, we developed facile and high-yield synthetic routes for the preparation of 2-sulfonyl indenes and indanes, including: (i) Amberlyst-15-promoted Knoevenagel reaction of β-ketosulfones and arylaldehydes in refluxing toluene; (ii) Grignard reagent (R'MgBr) or reducing reagent (NaBH 4 ) promoted regio- and/or stereocontrolled 1,4-addition or 1,4-/1,2-reduction of the resulting sulfonyl chalcones in THF or MeOH/THF at 25 °C; and then (iii) Amberlyst-15 mediated intramolecular Friedel-Crafts annulation of the corresponding β-ketosulfones or β-hydroxysulfones in toluene at reflux. This present method describes a highly efficient (3 + 2) annulation via the formation of two carbon-carbon (C-C) bonds. The DFT calculations were utilized to rationalize the regioselectivity of the addition reaction.

Circulating tumor cells (CTCs) have been suggested as the precursors of metastatic cancer. CTC-based characterization has thus been used to monitor tumor status before the onset of metastasis and has shown to be an independent factor. The low abundance of CTCs, however, makes it challenging to employ CTC as a clinical routine, thus making it impossible to address tumor heterogeneity. Here, we present a cell collection prototype for an efficient capture of CTCs from a large volume of body fluids such as blood. An antibody-PEG modified multilayer matrix column is engineered and connected to an apheresis-based circulation system. This setup allows us to capture CTCs repetitively from an unlimited sample volume through the circulation system, thereby increasing the capture count. Compared to conventional CTC capturing devices where the sample handling is generally limited to 1-10 mL, our collector is able to handle a wide range of fluidic sample (40-2000 mL) at a high flow rate (400 mL/min). By processing 90 min in circulation, we obtained an average capture efficiency of at least 75% for the colorectal cancer cell line HCT116 spiked in either 40-200 mL of buffer solution or 40 mL of a whole blood sample. This result highlights a possibility to construct personalized CTC libraries through high-throughput CTC collection for the study of tumor heterogeneity in precision medicine.

Background: Ankylosing spondylitis (AS) is an inflammatory autoimmune disorder that manifested with sacroiliitis at its early stage and developed extensive inflammation with syndesmophytes of the lumbar, thoracic and cervical spines at its later stage. In the present study, we characterized the trunk isometric strength in patients with AS with different disease severity, defined by the radiological images., Methods: In a cross-sectional study conducted in a university-affiliated hospital, thirty-eight male AS patients (23 in the early AS group whose radiological findings showed no syndesmophyte, Modified Stoke Ankylosing Spinal Score (m-SASSS <3); and 15 in the syndesmophyte group, m-SASSS ≥24), and 22 healthy controls were recruited. All subjects received assessments of maximum isometric strength of trunk flexor and extensor muscles at a variety of trunk postures measured by an isokinetic device., Results: Under all examined trunk postures, the syndesmophyte AS patient group had the lowest isometric trunk muscle strength among the three groups. The flexion/extension ratio, defined by the ratio between isometric trunk flexor and extensor strengths, was highest among the three groups., Conclusions: Trunk muscle strength significantly decreases in patients with syndesmophyte AS. The decrease of trunk muscle is inhomogeneous, which is more profound in extensor than in flexor muscles., (Copyright © 2019 Chang Gung University. Published by Elsevier B.V. All rights reserved.)

In this paper, a novel and efficient route for the synthesis of α,β-bis-sulfonyl arylketones via an NH 2 OH-HCl-mediated intermolecular umpolung α-methylsulfonylation of α-sulfonyl ketones with methylsulfoxides is described. A plausible mechanism is proposed and discussed. Various reaction conditions for this efficient, one-pot, environmentally friendly transformation were investigated.

Study design: Case series. Background: Robot-assisted rehabilitation mediated by exoskeletal devices is a popular topic of research. The biggest difficulty in the development of rehabilitation robots is the consideration of the clinical needs. This study investigated the usability of a novel cable-driven exoskeletal robot specifically designed for hand rehabilitation. Methods: The study consists of three steps, including prototype development, spasticity observation, and usability evaluation. First, we developed the prototype robot DexoHand to manipulate the patient's fingers based on the clinical needs and the cable-driven concept established in our previous work. Second, we applied DexoHand to patients with different levels of spasticity. Finally, we obtained the system usability scale (SUS) and assessed its usability. Results: Two healthy subjects were recruited in the pre-test, and 18 patients with stroke and four healthy subjects were recruited in the formal test for usability. The total SUS score obtained from the patients and healthy subjects was 94.77 ± 2.98 ( n = 22), indicating an excellent level of usability. The satisfaction score was 4.74 ± 0.29 ( n = 22), revealing high satisfaction with DexoHand . The tension profile measured by the cables showed the instantaneous force used to manipulate fingers among different muscle tone groups. Conclusions: DexoHand meets the clinical needs with excellent usability, satisfaction, and reliable tension force monitoring, yielding a feasible platform for robot-assisted hand rehabilitation.

Temperature-controlled intermolecular desulfonylative condensation of α-sulfonyl o-hydroxyacetophenones with 2-formyl azaarenes (pyridines and quinolones) provides azaaryl (pyridyl and quinolyl) aurones and flavones under warming and refluxing toluene reaction conditions via the formation of the intermediate of sulfonyl chroman-4-one. The uses of various solvents are investigated for facile and efficient transformation. A plausible mechanism is proposed.

In this work, a concise route for the synthesis of sulfonyl dibenzo-oxabicyclo[3.3.1]nonanes by a two-step route is described, including (i) NaBH 4 /LiCl-mediated reduction of 3-sulfonyl-2-benzylchromen-4-ones and (ii) sequential BF 3 ·OEt 2 -mediated intramolecular annulation of the resulting 3-sulfonyl-2-benzylchroman-4-ols. A plausible mechanism is proposed and discussed herein. This protocol provides a highly effective stereocontrolled aryl-hydroxyl Friedel-Crafts-type cross-coupling to construct the tetra- or pentacyclic bridged framework. The use of various reaction conditions is investigated for an efficient transformation.

Posttraumatic syringomyelia with an initial presentation of involuntary movement is rare. We describe a 25-year-old patient who sustained complete traumatic spinal cord injury at the thoracic level and presented with rhythmic neck muscle spasms and upper limb muscle myoclonic jerks 1 month after trauma. Magnetic resonance imaging revealed syrinx formation between C3 and T1. Lumbar-peritoneal shunt and decompression were performed. The symptoms completely disappeared after surgery. This report highlights that rhythmic neck muscle spasms and upper limb muscle myoclonic jerks can be the initial and only manifestations of syringomyelia. LEVEL OF EVIDENCE: V., (Copyright © 2018 American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.)

The stereocontrolled reduction of 3-sulfonyl chromen-4-ones by two synthetic methods, NaBH 4 /LiCl and Pd/C/H 2 , provides two kinds of 3-sulfonyl chroman-4-ols with three contiguous chiral centers under different reaction conditions. The use of various reaction conditions is investigated for efficient transformation.

Introduction: In the pathogenesis of asthma, an imbalance between helper T (Th) 1/Th2 and Th17/Treg cells is believed to play a key role in asthmatic inflammatory responses. Some studies indicated that zinc deficiency increases inflammatory factor production and worsens asthma. However, the effects of zinc on T cell profiles to reduce inflammatory response remain unclear., Objectives: We investigated the beneficial effects of zinc on isolated cell populations and cytokine levels from patients with asthma., Methods: Thirty-six individuals Dermatophagoides pteronyssinus (Der p)-allergic and 31 healthy subjects were enrolled in the study, and peripheral blood mononuclear cells (PBMCs) were collected. Harvested PBMCs were stimulated with recombinant Der p antigen in the presence or absence of zinc sulfate (25 μM or 50 μM) for 48 h. Cell surface markers and intracellular cytokine levels were examined by flow cytometry. The pro-inflammatory factors in plasma and culture supernatants were measured by commercial enzyme-linked immunosorbent assay., Results: Zinc sulfate dramatically reduced the proportions of Th2 and Th17 cells, but increased that of Th1 and Treg cells. Zinc sulfate also markedly reduced the levels of interleukin (IL)-4 and IL-17, but increased the levels of IFN-γ., Conclusions: Zinc ameliorates the imbalance in T cell profiles and could be a potential adjuvant therapy for Der p-induced allergic hypersensitivity., (© 2016 John Wiley & Sons Ltd.)

Selective-area growth (SAG) of single-crystal wurtzite GaN nanorods (NRs) directly onto Si(001) substrates with un-etched native SiO x amorphous layer, assisted by a patterning TiN x mask fabricated by nanosphere lithography (NSL), has been realized by reactive magnetron sputter epitaxy (MSE). The GaN NRs were grown vertically to the substrate surface with the growth direction along c-axis in the well-defined nano-opening areas. A 5-step structural and morphological evolution of the SAG NRs observed at different sputtering times depicts a comprehensive growth model, listed in sequence as: formation of a polycrystalline wetting layer, predominating c-axis oriented nucleation, coarsening and coalescence of multi-islands, single NR evolution, and finally quasi-equilibrium crystal shape formation. Room-temperature cathodoluminescence spectroscopy shows a strong GaN bandedge emission with a uniform luminescence across the NRs, indicating that the SAG NRs are grown with high quality and purity. In addition, single-longitudinal-mode lasing, attributed to well-faceted NR geometry forming a Fabry-Pérot cavity, was achieved by optical pumping, paving a way for fabricating high-performance laser optoelectronics using MSE.

In this article, a facile two-step and one-pot synthetic route for the preparation of substituted aryl dihydronaphthalenes starting from 2-allylbenzaldehydes via Grignard 1,2-addition and Bi(OTf) 3 -catalyzed intramolecular olefinic cyclization has been developed. A five-membered ring indene skeleton is also prepared via olefin isomerization, 1,2-addition followed by cyclization. Some key structures are determined using single-crystal X-ray crystallography. A possible mechanism is presented herein.

CuI/DMSO-mediated intramolecular cycloacetalization/ketalization of o-carbonyl allylbenzenes has been achieved for constructing [6,6,5]-tricycles having a ketal motif in good yields. The expeditious one-step route provides a three C-O bond formation. The key products with the structural framework of a benzofused dioxabicyclo[3.2.1]octane core have been confirmed by X-ray crystallographic analysis. Synthesis of dihydroisocoumarin has been studied.

Most thin-film techniques require a multiple vacuum process, and cannot produce high-coverage continuous thin films with the thickness of a few nanometers on rough surfaces. We present a new "paradigm shift" non-vacuum process to deposit high-quality, ultra-thin, single-crystal layers of coalesced sulfide nanoparticles (NPs) with controllable thickness down to a few nanometers, based on thermal decomposition. This provides high-coverage, homogeneous thickness, and large-area deposition over a rough surface, with little material loss or liquid chemical waste, and deposition rates of 10 nm/min. This technique can potentially replace conventional thin-film deposition methods, such as atomic layer deposition (ALD) and chemical bath deposition (CBD) as used by the Cu(In,Ga)Se₂ (CIGS) thin-film solar cell industry for decades. We demonstrate 32% improvement of CIGS thin-film solar cell efficiency in comparison to reference devices prepared by conventional CBD deposition method by depositing the ZnS NPs buffer layer using the new process. The new ZnS NPs layer allows reduction of an intrinsic ZnO layer, which can lead to severe shunt leakage in case of a CBD buffer layer. This leads to a 65% relative efficiency increase.

Intramolecular annulation of o-carbonyl allylbenzenes was achieved to construct novel nitrated [6,6,6]tricycles having an acetal or ketal motif in good yields. The expeditious one-step nitration route provides 4 or 5 new bond formations, including 2 or 3 C-N bonds and 2 C-O bonds. The structural framework of benzobicycle [3.3.1] is confirmed by X-ray crystallographic analysis. A plausible mechanism is proposed.

In this work, we developed a concise synthetic route for the synthesis of polysubstituted naphthalenes starting from commercially available isovanillin and its derivatives. Reaction with styryl bromide via O-styrylation, Claisen rearrangement, ene reaction, and O-alkylation occurred in high yields. The key structures were confirmed by single-crystal X-ray diffraction.

In this research, nano-ring light-emitting diodes (NRLEDs) with different wall width (120 nm, 80 nm and 40 nm) were fabricated by specialized nano-sphere lithography technology. Through the thinned wall, the effective bandgaps of nano-ring LEDs can be precisely tuned by reducing the strain inside the active region. Photoluminescence (PL) and time-resolved PL measurements indicated the lattice-mismatch induced strain inside the active region was relaxed when the wall width is reduced. Through the simulation, we can understand the strain distribution of active region inside NRLEDs. The simulation results not only revealed the exact distribution of strain but also predicted the trend of wavelength-shifted behavior of NRLEDs. Finally, the NRLEDs devices with four-color emission on the same wafer were demonstrated.

A new, four-step synthetic route for substituted 2,3-benzodiazepines 1, starting from aldehyde 4, was developed with excellent overall yields. This route included the 1,2-addition of various aromatic Grignard reagents to 4, PCC oxidation, and aerobic Wacker-type oxidation of the olefinic group of 6, followed by condensation of the resulting 1,5-dicarbonyl 7 with N 2 H 4 . Isoquinolones 9 were obtained when an aldehyde group was used instead of a ketone. The key structures were confirmed by X-ray single-crystal diffraction analysis.

A convenient synthetic route for the construction of functionalized 2-cyano-1,4-diketones has been established from the nucleophilic substitution of 2-bromoacetophenones with NaCN via the in situ-generated β-ketonitriles. This method was further applied to the synthesis of cyanosubstituted furans, pyrroles, or dihydropyridazines, which were obtained in good to excellent yields using Bi(OTf)3, NH4OAc, or N2H4. The key structures were confirmed by X-ray single crystal diffraction analysis.

Earth abundant silicon compounds, including Si3N4, SiO2, SiS2, and SiSe2, were introduced as the electrocatalytic materials for the counter electrodes (CE) in dye-sensitized solar cells (DSSCs). Among these silicon-based materials, Si3N4, SiS2, and SiSe2 were applied in DSSCs for the first time. In the presence of a conducting binder, poly(3,4-ethylenedioxythiophene):poly(styrenesulfonate) (, Pedot: PSS), various silicon-based composites (Si3N4/PEDOT:PSS, SiO2/PEDOT:PSS, SiS2/PEDOT:PSS, and SiSe2/PEDOT:PSS) were successfully coated on the ITO substrates via a simple drop-coating process. In a composite film, silicon-based nanoparticles provided attractive electrocatalytic ability and plenty of electrocatalytic active sites for the triiodine ion (I3(-)) reduction., Pedot: PSS not only acted as a good conducting binder for silicon-based nanoparticles, but also provided a continuous polymer matrix to increase the electron transfer pathways. By adjusting the weight percent (1-5 wt %) of the silicon-based nanoparticles (Si3N4, SiO2, SiS2, and SiSe2) with respect to the weight of, Pedot: PSS, the composite films containing 5 wt % Si3N4 (denoted as Si3N4-5) and 5 wt % SiSe2 (denoted as SiSe2-5) both reached excellent electrocatalytic abilities and rendered the good cell efficiencies (η) of 8.2% to their DSSCs. It can be said that both Si3N4-5 and SiSe2-5 are promising electrocatalytic materials to replace the rare and expensive Pt (η = 8.5%).

Green LEDs do not show the same level of performance as their blue and red cousins, greatly hindering the solid-state lighting development, which is the so-called "green gap". In this work, nano-void photonic crystals (NVPCs) were fabricated to embed within the GaN/InGaN green LEDs by using epitaxial lateral overgrowth (ELO) and nano-sphere lithography techniques. The NVPCs act as an efficient scattering back-reflector to outcouple the guided and downward photons, which not only boost the light extraction efficiency of LEDs with an enhancement of 78% but also collimate the view angle of LEDs from 131.5° to 114.0°. This could be because of the highly scattering nature of NVPCs which reduce the interference giving rise to Fabry-Perot resonance. Moreover, due to the threading dislocation suppression and strain relief by the NVPCs, the internal quantum efficiency was increased by 25% and droop behavior was reduced from 37.4% to 25.9%. The enhancement of light output power can be achieved as high as 151% at a driving current of 350 mA. Giant light output enhancement and directional control via NVPCs point the way towards a promising avenue of solid-state lighting.

Highly efficient zinc compounds (Zn3N2, ZnO, ZnS, and ZnSe) have been investigated as low-cost electrocatalysts for the counter electrodes (CE) of dye-sensitized solar cells (DSSCs). Among them, Zn3N2 and ZnSe are introduced for the first time in DSSCs. The zinc compounds were separately mixed with a conducting binder, poly(3,4-ethylene-dioxythiophene):poly(styrenesulfonate) (, Pedot: PSS), and thereby four composite films of Zn3N2/PEDOT:PSS, ZnO/PEDOT:PSS, ZnS/PEDOT:PSS, and ZnSe/, Pedot: PSS were coated on the tin-doped indium oxide (ITO) substrates through a simple drop-coating process. In the composite film, nanoparticles of the zinc compound form active sites for the electrocatalytic reduction of triiodide ions, and, Pedot: PSS provides a continuous conductive matrix for fast electron transfer. By varying the weight percentage (5-20 wt %) of a zinc compound with respect to the weight of the, Pedot: PSS, the optimized concentration of a zinc compound was found to be 10 wt % in all four cases, based on the photovoltaic performances of the corresponding DSSCs. At this concentration (10 wt %), the composites films with Zn3N2 (Zn3N2-10), ZnO (ZnO-10), ZnS (ZnS-10), and ZnSe (ZnSe-10) rendered, for their DSSCs, power conversion efficiencies (η) of 8.73%, 7.54%, 7.40%, and 8.13%, respectively. The difference in the power conversion efficiency is explained based on the electrocatalytic abilities of those composite films as determined by cyclic voltammetry (CV), Tafel polarization plots, and electrochemical impedance spectroscopy (EIS) techniques. The energy band gaps of the zinc compounds, obtained by density functional theory (DFT) calculations, were used to explain the electrocatalytic behaviors of the compounds. Among all the zinc-based composites, the one with Zn3N2-10 showed the best electrocatalytic ability and thereby rendered for its DSSC the highest η of 8.73%, which is even higher than that of the cell with the traditional Pt CE (8.50%). Therefore, Zn3N2 can be considered as a promising inexpensive electrocatalyst to replace the rare and expensive Pt.

This work demonstrates the enhanced power conversion efficiency (PCE) in InGaN/GaN multiple quantum well (MQWs) solar cells with gradually decreasing indium composition in quantum wells (GQWs) toward p-GaN as absorber. The GQW can improve the fill factor from 42% to 62% and enhance the short current density from 0.8 mA/cm 2 to 0.92 mA/cm 2 , as compares to the typical MQW solar cells. As a result, the PCE is boosted from 0.63% to 1.11% under AM1.5G illumination. Based on simulation and experimental results, the enhanced PCE can be attributed to the improved carrier collection in GQW caused by the reduction of potential barriers and piezoelectric polarization induced fields near the p-GaN layer. The presented concept paves a way toward highly efficient InGaN-based solar cells and other GaN-related MQW devices.

The combination of ZnO, InN, and GaN epitaxial layers is explored to provide long wavelength photodetection capability in the GaN based materials. Growth temperature optimization was performed to obtain the best quality of InN epitaxial layer in the MOCVD system. The temperature dependent photoluminescence (PL) can provide the information about thermal quenching in the InN PL transitions and at least two non-radiative processes can be observed. X-ray diffraction and energy dispersive spectroscopy are applied to confirm the inclusion of indium and the formation of InN layer. The band alignment of such system shows a typical double heterojunction, which is preferred in optoelectronic device operation. The photodetector manufactured by this ZnO/GaN/InN layer can exhibit extended long-wavelength quantum efficiency, as high as 3.55%, and very strong photocurrent response under solar simulator illumination.

In this paper, we proposed a methodology to optimize the parametric window of a liquid crystal display (LCD) system, whose visual performance was deteriorated by the pixel moiré arising in between multiple periodic structures. Conventional analysis and minimization of moiré patterns are limited by few parameters. With the proposed image-based particle swarm optimization (PSO), we enable a multivariable optimization at the same time. A series of experiments was conducted to validate the methodology. Due to its versatility, the proposed technique will certainly have a promising impact on the fast optimization in LCD design with more complex configuration.

In this study, the design and fabrication schemes of back-side illuminated InGaN/GaN solar cells with periodic via-holes etching and Bragg mirror processes are presented. Compared to typical front-side illuminated solar cells, the improvements of open-circuit voltage (V(oc)) from 1.88 to 1.94 V and short-circuit current density (J(sc)) from 0.84 to 1.02 mA/cm(2) are observed. Most significantly, the back-side illuminated InGaN/GaN solar cells exhibit an extremely high fill factor up to 85.5%, leading to a conversion efficiency of 1.69% from 0.66% of typical front-side illuminated solar cells under air mass 1.5 global illuminations. Moreover, the effects of bottom Bragg mirrors on the photovoltaic characteristics of back-side illuminated solar cells are studied by an advanced simulation program. The results show that the J(sc) could further be improved with a factor of 10% from the original back-side illuminated solar cell by the structure optimization of bottom Bragg mirrors.

This paper presents a hybrid design, featuring a traditional GaAs-based solar cell combined with various colloidal quantum dots. This hybrid design effectively boosts photon harvesting at long wavelengths while enhancing the collection of photogenerated carriers in the ultraviolet region. The merits of using highly efficient semiconductor solar cells and colloidal quantum dots were seamlessly combined to increase overall power conversion efficiency. Several photovoltaic parameters, including short-circuit current density, open circuit voltage, and external quantum efficiency, were measured and analyzed to investigate the performance of this hybrid device. Offering antireflective features at long wavelengths and luminescent downshifting for high-energy photons, the quantum dots effectively enhanced overall power conversion efficiency by as high as 24.65% compared with traditional GaAs-based devices. The evolution of weighted reflectance as a function of the dilution factor of QDs was investigated. Further analysis of the quantum efficiency response showed that the luminescent downshifting effect can be as much as 6.6% of the entire enhancement of photogenerated current.

In this review, the concept of utilization of solar spectrum in order to increase the solar cell efficiency is discussed. Among the three mechanisms, down-shifting effect is investigated in detail. Organic dye, rare-earth minerals and quantum dots are three most popular down-shift materials. While the enhancement of solar cell efficiency was not clearly observed in the past, the advances in quantum dot fabrication have brought strong response out of the hybrid platform of a quantum dot solar cell. A multiple layer structure, including PDMS as the isolation layer, is proposed and demonstrated. With the help of pulse spray system, precise control can be achieved and the optimized concentration can be found.