Search

The performance of electrocatalysts is critical for renewable energy technologies. While the electrocatalytic activity can be modulated through structural and compositional engineering following the Sabatier principle, the insufficiently explored catalyst-electrolyte interface is promising to promote microkinetic processes such as physisorption and desorption. By combining experimental designs and molecular dynamics simulations with explicit solvent in high accuracy, we demonstrated that dimethylformamide can work as an effective surface molecular pump to facilitate the entrapment of oxygen and outflux of water. Dimethylformamide disrupts the interfacial network of hydrogen bonds, leading to enhanced activity of the oxygen reduction reaction by a factor of 2 to 3. This strategy works generally for platinum-alloy catalysts, and we introduce an optimal model PtCuNi catalyst with an unprecedented specific activity of 21.8 ± 2.1 mA/cm2 at 0.9 V versus the reversible hydrogen electrode, nearly double the previous record, and an ultrahigh mass activity of 10.7 ± 1.1 A/mgPt.

Abstract Chronic idiopathic neutropenia (CIN) is a rare benign condition caused by an immune attack against neutrophils, either primary or in the context of other autoimmune conditions, lymphoproliferative syndromes, and inborn errors of immunity. In this single-center prospective study, 131 adult CIN patients were enrolled (median age 55 years, range: 20–93). At baseline, 56% had anti-neutrophil autoantibodies and 31% had autoimmune comorbidities. Over a median 3-year follow-up, the rate of grade ≥ 2 infections was 42%, with 10% grade ≥ 3, irrespective of neutrophil counts, demographics, and anti-neutrophil antibodies positivity, and G-CSF was used in 6 patients only. No malignant evolution nor deaths were observed. Bone marrow evaluation showed a large granular lymphocyte (LGL) infiltrate in 52%, mostly polyclonal, and hypocellularity in 31% of cases. Immune-histochemistry highlighted deposits of IgG, IgM, and complement fractions C3 and C4d in most cases. Interestingly, 19% of tested patients displayed somatic mutations of myeloid genes with an association with age. In conclusion, adult CIN appears to be a benign condition without life-threatening infections, yet deserving an extensive hematologic evaluation including bone marrow assessment to inform the differential diagnosis.

Over the last two decades, we have witnessed great advancements in our understanding of the immunological pathways of asthma, leading to the development of targeted therapies, such as biologic drugs, that have radically and definitively changed the clinical outcomes of severe asthma. Despite the numerous therapeutic options available, ~4–10% of all people with asthma have severe or uncontrolled asthma, associated with an increased risk of developing chronic oral corticosteroid use, fixed airflow limitation, exacerbations, hospitalization and, finally, increased healthcare costs. The new concept of disease modification in asthma comes from the evolution of asthma management, which encompasses phenotyping patients with different inflammatory endotypes characterizing the disease, followed by the advent of more effective therapies capable of targeting the proximal factors of airway inflammation. This treat-to-target approach aims to achieve remission of the disease. Because the novel treatment paradigm for severe asthma with the advent of biologic therapies is no longer clinical control but rather clinical remission – a step closer to the concept of cure – a deeper and more accurate understanding of the critical causal mechanisms and endotypes of asthma is necessary to achieve the goal of clinical remission, which has the potential to generate real life-changing benefits for patients. This review aims to frame the evolution of the debated concept of clinical remission and provide clinicians with insights that may be helpful in achieving remission in the greatest number of patients.

Selected crystals of natural K-bearing tourmalines, extracted from a quartzofeldspathic rock from the Kumdy-Kol microdiamond deposit (an ultrahigh-pressure region of Kokchetav Massif, northern Kazakhstan), were characterized using a scanning electron microscope, an electron microprobe and single-crystal X-ray diffraction to investigate the impact of K uptake on the tourmaline structure. All the studied crystals belong to the maruyamaite–oxy-dravite/dravite compositional field, with K contents ranging from 0.03 to 0.47 apfu (atoms per formula unit), and contain a minor fluor-uvite component that increases towards oxy-dravite and dravite. The compositional variability of our samples can be expressed as a sequence of substitutions ranging from maruyamaite to oxy-dravite, dravite and fluor-uvite (or vice versa). Specifically, the substitutions that lead from maruyamaite to oxy-dravite to dravite are (1) XK + AlTOT + O1O ↔ XNa + MgTOT + O1O and (2) XNa + MgTOT + O1O ↔ XNa + MgTOT + O1OH, respectively. Conversely, the substitutions that lead from oxy-dravite to dravite to fluor-uvite are (1) XNa + MgTOT + O1O ↔ XNa + MgTOT + O1OH and (2) XNa + MgTOT + O1OH ↔ XCa + MgTOT + O1F, respectively. By analysing the difference between the bond valence sum and mean formal charge at the X site, we show that an increase in the K content (K > 0.21 apfu) results in the compression of X–O bonds (overbonded cation). Conversely, lower K contents lead to the stretching of the bonds (underbonded cation). Compared to the K-dominant analogues with ZFeO6 povondraite-type framework, K-bearing tourmalines with a smaller ZAlO6 framework such as maruyamaite should only be stable at higher-pressure conditions, as pressure is necessary to squeeze the relatively large K cation into the tighter X cavity. In both cases, the essential condition for the formation of K-dominant tourmalines is the extremely high K activity in the crystallization fluid. The K-tourmaline from the Kokchetav Massif may have crystallized under high-pressure (HP) conditions, with an upper limit between 3.5–7 GPa, during retrograde metamorphism following the ultrahigh-pressure (UHP) metamorphic peak.

Abstract Objective Closure surgery of patent foramen ovale (PFO) has been found to effectively control cryptogenic stroke and migraine, but it is uncertain whether PFO closure could also alleviate epileptic seizures. This study aims to observe the therapeutic effect of PFO closure on epileptic seizures. Methods Since July 11th, 2017, in the neurology department of West China Hospital, Sichuan University, Chengdu, we have been regularly monitoring patients with epilepsy who have undergone PFO closure. The patient's clinical information, such as frequency, duration, and severity of seizures, before and after surgery was recorded in detail as well as postoperative safety events. Results Of the 31 epilepsy patients who confirmed PFO observed (27 cases were drug‐resistant epilepsy, 87.10%), average age of surgery was 23.74 years, and 12 cases were female (38.71%). After one‐year follow‐up, 26 patients (83.87%) achieved remission of seizure frequency, and 22 of whom (70.97%) experienced a remission of more than 50%. Additionally, compared to before surgery, 22 cases (70.97%) reported a decrease in the average seizure duration, and 20 cases (64.52%) reported a reduction in seizure severity. In the seizure indicators of frequency, average duration and severity, significant differences were identified between preoperative and postoperative comparisons with all test p values were

Extensive macroscale two-dimensional (2-D) platinum (Pt) nanowire network (NWN) sheets are created through a hierarchical self-assembly process with the aid of biomolecular ligands. The Pt NWN sheet is assembled from the attachment growth of 1.9 nm-sized 0-D nanocrystals into 1-D nanowires featuring a high density of grain boundaries, which then interconnect to form monolayer network structures extending into centimeter-scale size. Further investigation into the formation mechanism reveals that the initial emergence of NWN sheets occurs at the gas/liquid interfaces of the bubbles produced by sodium borohydride (NaBH4) during the synthesis process. Upon the rupture of these bubbles, an exocytosis-like process releases the Pt NWN sheets at the gas/liquid surface, which subsequently merge into a continuous monolayer Pt NWN sheet. The Pt NWN sheets exhibit outstanding oxygen reduction reaction (ORR) activities, with specific and mass activities 12.0 times and 21.2 times greater, respectively, than those of current state-of-the-art commercial Pt/C electrocatalysts.

Abstract Aqueous zinc‐ion batteries (AZIBs) offer significant advantages, including high safety, environmental protection and abundant zinc sources. V‐based layer‐like oxides are promising candidates as cathode materials for ZIBs; however, they face challenges such as low electrical conductivity, poor cycling stability, and limited Zn2+ storage capacity. In this study, Li‐V3O7 ⋅ H2O electrode materials were successfully synthesized using a hydrothermal method. The doping of lithium ions has led to a significant expansion of the interlayer spacing within the electrode structure, which enhances ion mobility and improves ion transport speed as well as charge‐discharge rates. Additionally, the increased spacing allows for the accommodation of more zinc ions, resulting in greater specific capacity and energy storage. More importantly, this modification reduces structural strain, minimizes the dissolution of vanadium‐based materials, and maintains electrode integrity over multiple cycles, thereby improving cycling stability. Consequently, the properties of V3O7 ⋅ H2O electrodes were substantially enhanced through lithium‐ion doping. The Li‐V3O7 ⋅ H2O cathode has a specific capacity of 411.8 mAh g−1 at low current and maintains 83 % of its capacity at 4.0 A g−1 for 4800 cycles, indicating a noteworthy improvement over pristine V3O7 ⋅ H2O. Exhibiting outstanding conductivity, discharge capacity, and cycling stability, it holds immense promise for future high‐performance energy storage.

Several endotypes of severe asthma with predominantly type 2 inflammation can be distinguished by the immune pathways driving the inflammatory processes. However, in the absence of type 2 inflammation, asthma is less clearly defined and is generally associated with poor responses to conventional anti-asthmatic therapies. Studies have shown that disruption of the epithelial barrier triggers inflammatory responses and increases epithelial permeability. A key aspect of this process is that epithelial cells release alarmin cytokines, including interleukin (IL)-25, IL-33, and thymic stromal lymphopoietin (TSLP), in response to allergens and infections. Among these cytokines, TSLP has been identified as a potential therapeutic target for severe asthma, leading to the development of a new biologic, tezepelumab (TZP). By blocking TSLP, TZP may produce wide-ranging effects. Based on positive clinical trial results, TZP appears to offer a promising, safe, and effective treatment approach. This narrative review examines the evidence for treating severe asthma with TZP, analyses clinical trial findings, and provides clinicians with practical insights into identifying patients who may respond best to this novel biologic therapy.

Studies on modeling the growth of annual crops are typically conducted for economically significant crops like soybeans, corn, and wheat. Conversely, there has been limited exploration of annual forage crops, despite their substantial importance, as they can help address forage supply shortages during periods of low production for perennial tropical forages. This study aimed to parameterize the APSIM-Oats model for simulating the growth of black oats (Avena strigosa Schreb cv. IAPAR 61 Ibiporã) cultivated for forage purposes and managed under a cut-and-carry system. Two experiments were conducted in 2018 and 2019 in Piracicaba, São Paulo State, Brazil, encompassing both irrigated and non-irrigated plots. Various productive, biometric, and soil moisture variables were monitored throughout the crop cycles. Parameters were manually calibrated through a trial-and-error process until the estimates closely matched the observed data. Model evaluation involved comparing observed and simulated data using statistical indices. The most favorable results were obtained for live biomass, leaf mass, and stem mass (with modeling efficiency exceeding 0.55 in the rainfed system and surpassing 0.34 for the irrigated system). Estimates of soil water content exhibited better accuracy for shallower soil layers (0 to 0.30 m). The calibration of the APSIM-Oats model for black oats yielded satisfactory estimates for live biomass under rainfed conditions. The simulations in this study represent an initial step in modeling the growth of black oats.

Objective: to analyze the actions of primary care professionals when faced with situations of psychological distress and/or psychosocial vulnerability among pregnant women and postpartum women. Methods: a descriptive and exploratory study was carried out with 78 health professionals working in the family health strategy, who were asked to complete a questionnaire on professional characterization and situational analysis. Results: most health professionals see pregnant /postpartum women daily (55.1%). For 66.7% of these professionals, they identify signs /symptoms of emotional, psychological, or mental distress in a minority of their visits to this public. Regarding the training of professionals to act and help pregnant /postpartum women concerning mental health, 76.9% have doubts, 89.7% have not participated in training on the subject, and all agreed with its relevance. The textual analysis of the discursive responses resulted in two categories: Qualified listening as a welcoming tool and shared care and referral to specialized professionals. Conclusion: family Health Strategy professionals reported doubts and weaknesses regarding managing the mental health of pregnant and postpartum women. Contributions to practice: these professionals experience situations that require them to deal with issues related to perinatal mental health and perceive training to meet this demand as relevant.

IntroductionStatistical shape analysis (SSA) with clustering is often used to objectively define and categorise anatomical shape variations. However, studies until now have often focused on simplified anatomical reconstructions, despite the complexity of studied anatomies. This work aims to provide insights on the anatomical detail preservation required for SSA of highly diverse and complex anatomies, with particular focus on the left atrial appendage (LAA). This anatomical region is clinically relevant as the location of almost all left atrial thrombi forming during atrial fibrillation (AF). Moreover, its highly patient-specific complex architecture makes its clinical classification especially subjective.MethodsPreliminary LAA meshes were automatically detected after robust image selection and wider left atrial segmentation. Following registration, four additional LAA mesh datasets were created as reductions of the preliminary dataset, with surface reconstruction based on reduced sample point densities. Utilising SSA model parameters determined to optimally represent the preliminary dataset, SSA model performance for the four simplified datasets was calculated. A representative simplified dataset was selected, and clustering analysis and performance were evaluated (compared to clinical labels) between the original trabeculated LAA anatomy and the representative simplification.ResultsAs expected, simplified anatomies have better SSA evaluation scores (compactness, specificity and generalisation), corresponding to simpler LAA shape representation. However, oversimplification of shapes may noticeably affect 3D model output due to differences in geometric correspondence. Furthermore, even minor simplification may affect LAA shape clustering, where the adjusted mutual information (AMI) score of the clustered trabeculated dataset was 0.67, in comparison to 0.12 for the simplified dataset.DiscussionThis study suggests that greater anatomical preservation for complex and diverse LAA morphologies, currently neglected, may be more useful for shape categorisation via clustering analyses.

Resumo Objetivo Descrever o processo de elaboração e validação de conteúdo do instrumento para mensurar a intensificação do trabalho da enfermagem. Métodos Estudo metodológico realizado em cinco das oito etapas propostas por DeVellis. I - Determinar claramente o que se deseja medir; II – Gerar um pool de itens; III - Determinar o formato da medida; IV - Ter o conjunto de itens revisados por especialistas; V - Considerar a inclusão de itens de validação. A produção dos dados ocorreu no segundo semestre de 2021. Os participantes foram 18 trabalhadores de enfermagem na etapa exploratória (elaboração dos itens), 12 doutores que compuseram o comitê de juízes/especialistas e 43 trabalhadores de enfermagem na etapa do pré-teste. O processamento dos dados ocorreu principalmente pelo cálculo do Índice de Validade de Conteúdo. Resultados O instrumento está organizado em 60 itens, dispostos em sete domínios: Interface com o trabalho; Ritmo e exigências do trabalho; Condições para o trabalho; Relações interprofissionais; Aspectos institucionais; Repercussões do trabalho na saúde do trabalhador e; Condições clínicas do paciente. O índice de validade conteúdo variou de 0,44 a 1,00, sendo excluídos os itens com valor inferior a 0,80. No pré-teste com a população alvo, esta medida variou de 0,90 a 1,00. O instrumento em sua formação completa apresentou avaliação global de 0,95. Conclusão O instrumento foi considerado válido pelo comitê de juízes/especialistas e pela população alvo, constituindo-se em uma ferramenta inovadora a ser empregada para mensurar a intensificação do trabalho da enfermagem.

Resumo: Este artigo analisa as evidências sobre a formação em pesquisa qualitativa dos programas de pós-graduação em Saúde Coletiva (PPGSC) credenciados pela Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES), no Brasil, no ano de 2021. Para realizar o mapeamento das disciplinas foi consultada a Plataforma Sucupira para a localização dos PPGSC e busca nos portais institucionais. Foram identificadas 98 disciplinas e utilizando a análise temática reflexiva foi possível agrupar a produção dos dados e caracterização das disciplinas nas seguintes macrocategorias de análise: (1) carga horária e modalidade de oferta (obrigatória ou eletiva); (2) objetivos de ensino-aprendizagens; (3) conteúdos (com destaque para investigação dos paradigmas científicos ou diferentes abordagens teórico-metodológicas da investigação qualitativa); e (4) metodologias de ensino-aprendizagens. Dos resultados, destacam-se que: apenas 40,4% são obrigatórias e predominaram os objetivos de ensino-aprendizagem com foco na instrumentalização e habilitar os(as) pós-graduandos (as) na construção dos projetos de pesquisa. 59,3% não informaram o tipo de metodologia de ensino-aprendizagem. Há uma lacuna quanto à utilização das tecnologias e ambientes digitais e predomínio do formato textual. Constatou-se fragilidade na formação epistemológico-teórica. A aprendizagem do paradigma positivista predomina em relação ao paradigma interpretativo de teorias/tradições críticas. Ao final, são sistematizados elementos para um itinerário formativo com graus crescentes de complexidade, intencionalmente estruturado e desenvolvido em um ambiente institucional que propicie decolonialidade e reparação epistêmica.

Abstract Objective: to analyze the effectiveness of auriculotherapy for decreasing anxiety and stress of perioperative nursing professionals. Method: mixed methods research, embedded experimental model. In the quantitative stage, a randomized, triple-blind clinical trial was conducted with perioperative nursing professionals, who answered a characterization questionnaire, the List of Signs and Symptoms of Stress, and the General Anxiety Disorder-GAD 7. The participants attended eight auriculotherapy sessions with semi-permanent needles. The qualitative stage was exploratory and descriptive, in which data were collected through semi-structured interviews. Data were mixed with the incorporation of qualitative findings to examine the intervention in the experimental study. Results: 13 professionals participated in the intervention group and 14 in the control group. Anxiety and stress levels decreased significantly within groups, though no statistical difference was found between groups (p>0.05). The central category, “Auriculotherapy as an intervention to treat anxiety and stress,” emerged from the qualitative data, which was subdivided into a base unit and three categories concerning the therapy’s benefits. Conclusion: applying real and sham auriculotherapy had the same effect on the participants’ anxiety and stress levels; the reports reinforced such evidence. Non-pharmacological interventions, such as auriculotherapy, are essential for recovering and promoting the health of perioperative nursing professionals. Brazilian Clinical Trials Registry: RBR-3jvmdn.