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BackgroundAlthough we are living in an era of transparency, medical documents are often still difficult to access. Blockchain technology allows records to be both immutable and transparent. ObjectiveUsing blockchain technology, the aim of this study was to develop a medical document monitoring system that informs patients of changes to their medical documents. We then examined whether patients can effectively verify the monitoring of their primary care clinical medical records in a system based on blockchain technology. MethodsWe enrolled participants who visited two primary care clinics in Korea. Three substudies were performed: (1) a survey of the recognition of blockchain medical records changes and the digital literacy of participants; (2) an observational study on participants using the blockchain-based mobile alert app; and (3) a usability survey study. The participants’ medical documents were profiled with HL7 Fast Healthcare Interoperability Resources, hashed, and transacted to the blockchain. The app checked the changes in the documents by querying the blockchain. ResultsA total of 70 participants were enrolled in this study. Considering their recognition of changes to their medical records, participants tended to not allow these changes. Participants also generally expressed a desire for a medical record monitoring system. Concerning digital literacy, most questions were answered with “good,” indicating fair digital literacy. In the second survey, only 44 participants—those who logged into the app more than once and used the app for more than 28 days—were included in the analysis to determine whether they exhibited usage patterns. The app was accessed a mean of 5.1 (SD 2.6) times for 33.6 (SD 10.0) days. The mean System Usability Scale score was 63.21 (SD 25.06), which indicated satisfactory usability. ConclusionsPatients showed great interest in a blockchain-based system to monitor changes in their medical records. The blockchain system is useful for informing patients of changes in their records via the app without uploading the medical record itself to the network. This ensures the transparency of medical records as well as patient empowerment.

This study aimed to investigate the impact of plastic particles on cell viability and tissue toxicity. The cells were subjected to incubation with plastic particles immobilized in agar gels, resulting in minimal cell death and cytotoxicity. Furthermore, direct exposure of various cell types to suspended plastic particles showed negligible effects on cell viability, with no observed lysis or growth inhibition. Staining techniques revealed minimal plastic particle‐induced cell death, with the majority of cells remaining viable. However, histological evaluations of mouse tissues demonstrated that the nondegradable low‐density poly(ethylene) (LDPE) groups exhibited severe irritation, characterized by an excessive presence of macrophages, neutrophils, fibrosis, fat infiltration, and increased blood vessel formation in subcutaneous tissue. In contrast, biodegradable neat poly(butylene succinate) (KRICT‐PBS) and cellulose nanocrystals/PBS nanocomposite (CNC‐PBS) groups induced minimal toxicity. Interestingly, the intravenous injection of KRICT‐PBS and CNC‐PBS degradate solutions in mice exhibited mild toxicity, suggesting no significant damage to normal kidney and liver function. [ABSTRACT FROM AUTHOR]

We developed a new concentration kit, called the ParaEgg (PE), for easy detection trematode eggs from fecal samples in endemic areas of clonorchiasis and metagonimiasis in Korea. To create a standard of detection efficiency, 120 fecal samples were examined using the water–ether concentration method (WECM). The PE kit and Mini ParaSep (PS) kit were used to compare the detection sensitivity of 100 egg-positive and 20 egg-negative samples in WECM. Additionally, stool samples, which were intentionally spiked with 10, 20, and 30 Clonorchis sinensis eggs, were evaluated to assess the sensitivity in low-infection cases. The PE and PS kits showed detection rates of 100% and 92%, respectively, from 100 egg-positive samples in WECM. Meanwhile, eggs were detected in 3 (PE) and 2 (PS) out of 20 egg-negative samples in WECM. The PE kit detected the highest number of eggs per gram of feces (727 on average), followed by the WECM (524) and PS kit (432). In fecal samples that were intentionally spiked with 10, 20, and 30 C. sinensis eggs, PE only detected eggs 2 out of 5 samples in 10 eggs spiked (40%), and the detection rates were 80% and 100%, respectively. The PE kit enabled a more accurate identification of trematode eggs because of the clearance of small fecal debris in the microscopic field. In conclusion, the PE kit is obviously helpful to detect and identify trematode eggs in stool examinations especially in endemic areas of clonorchiasis and metagonimiasis. [ABSTRACT FROM AUTHOR]

To selectively target and treat murine melanoma B16BL6 tumors expressing αvβ3 integrin receptors, we engineered tumor-specific functional extracellular vesicles (EVs) tailored for the targeted delivery of antitumor drugs. This objective was achieved through the incorporation of a pH-responsive adjuvant, cyclic arginine-glycine-aspartic acid peptide (cRGD, serving as a tumor-targeting ligand), and 5-fluorouracil (5-FU, employed as a model antitumor drug). The pH-responsive adjuvant, essential for modulating drug release, was synthesized by chemically conjugating 3-(diethylamino)propylamine (DEAP) to deoxycholic acid (DOCA, a lipophilic substance capable of integrating into EVs' membranes), denoted as DEAP-DOCA. The DOCA, preactivated using N-(2-aminoethyl)maleimide (AEM), was chemically coupled with the thiol group of the cRGD-DOCA through the thiol–maleimide click reaction, resulting in the formation of cRGD-DOCA. Subsequently, DEAP-DOCA, cRGD-DOCA, and 5-FU were efficiently incorporated into EVs using a sonication method. The resulting tumor-targeting EVs, expressing cRGD ligands, demonstrated enhanced in vitro/in vivo cellular uptake specifically for B16BL6 tumors expressing αvβ3 integrin receptors. The ionization characteristics of the DEAP in DEAP-DOCA induced destabilization of the EVs membrane at pH 6.5 through protonation of the DEAP substance, thereby expediting 5-FU release. Consequently, an improvement in the in vivo antitumor efficacy was observed for B16BL6 tumors. Based on these comprehensive in vitro/in vivo findings, we anticipate that this EV system holds substantial promise as an exceptionally effective platform for antitumor therapeutic delivery. [ABSTRACT FROM AUTHOR]

In this study, we have developed pH‐dependent nanogels based on hyaluronic acid (HA) to specifically target acidic tumors. Our initial approach involved modifying HA through the grafting of 3‐(diethylamino)propylamine (DEAP), a molecule known for its responsiveness to changes in pH. This modified HA was termed as HDEA. Subsequently, we performed chemical crosslinking of HDEA using adipic acid dihydrazide (ADH), a crosslinking molecule, resulting in the formation of nanogels referred to as cHDEA. Importantly, the non‐ionized DEAP molecules (with a pKb value of ~pH 7.0) at pH 7.4 support the formation of deswellable cHDEA. This property enables the encapsulation of a photodynamic model drug, chlorin e6 (Ce6), into cHDEA. However, when the DEAP molecules become protonated at pH 6.8, they induce a change in the nanogel structure, causing it to swell due to electrostatic repulsion. As a result, Ce6 is rapidly released from the nanogels. By modulating the pH, we can continuously control the nanogel structure, alternating between swelling and deswelling states. We anticipate that this system offers the advantage of facilitating drug release specifically under acidic tumor conditions while inhibiting drug release under normal pH conditions (i.e., pH 7.4). This approach will serve as an effective strategy for mitigating side effects by efficiently controlling drug release in specific disease areas. [ABSTRACT FROM AUTHOR]

In this study, we reported pH‐responsive microparticles consisting of poly(D,L‐lactide‐co‐glycolide) (PLGA), aminated hyaluronic acid (aHA) conjugated with 2,3‐dimethylmaleic anhydride (DMA, as a pH‐responsive cleavable molecule) (aHA‐DMA), and doxorubicin (DOX, as an antitumor drug) for local tumor treatment. The DOX‐loaded microparticles, denoted as PLGA(aHA‐DMA)/DOX MPs, were fabricated using the W1/O/W2 multi‐emulsification method. These PLGA(aHA‐DMA)/DOX MPs (~10 μm in diameter) accelerated the rate of DOX release at pH 6.8 due to the acidic pH‐responsive cleavage of the DMA moieties followed by electrostatic‐repulsion between aHA and DOX. This event caused the structural destabilization and collapse of the MPs, leading to the rapid release of DOX. Consequently, the PLGA(aHA‐DMA)/DOX MPs resulted in significant inhibition of tumor growth, demonstrating their ability for acidic tumor‐specific treatment. [ABSTRACT FROM AUTHOR]

Achieving precise and cost-effective etching in the field of silicon three-dimensional (3D) structure fabrication remains a significant challenge. Here, we present the successful fabrication of microscale anisotropic Si structures with an etching anisotropy of 0.73 using Cu-metal-assisted chemical etching (Cu-MACE) and propose a mechanism to elucidate the chemical behavior of Cu within the MACE solution. Our study reveals the formation of cuprous oxide (Cu 2 O) within Cu thin films in the presence of hydrogen peroxide (H 2 O 2 ), which plays a key role in Si etching. We propose that the holes generated through the reduction of Cu 2 O back to Cu are transferred to Si, promoting its etching through a galvanic reaction with Cu 2 O. This Cu-Cu 2 O cyclic redox process in the Si-Cu 2 O galvanic cell under the right conditions enables continuous etching of Si and significantly improves the chemical stability of Cu-MACE. Building on this cyclic process mechanism, we demonstrate the catalytic potential of Cu 2 O for oxide-assisted chemical etching (OACE) by directly using Cu 2 O in both thin-film and particle forms, rather than starting from Cu. This study opens possibilities for the precise control of Cu-MACE, extends the existing MACE mechanism, and contributes to our understanding of transition metal oxide behavior in OACE.

Lithium-sulfur batteries (LSBs) have emerged as a promising next-generation energy storage application owing to their high specific capacity and energy density. However, inherent insulating property of sulfur, along with its significant volume expansion during cycling, and shuttling behavior of lithium-polysulfides (LiPSs), hinder their practical application. To overcome these issues, a crosslinked cationic waterborne polyurethane (CCWPU) is rationally designed as a binder for LSBs. The mechanical robustness of CCWPU enables it to withstand the high stress derived from volume expansion of sulfur, facilitating charge-transferring through conserved charge-transfer pathway and promoting interconversion of LiPSs. Additionally, polar urethane groups offer favorable interaction sites with LiPSs, mitigating shuttling behavior of LiPSs via polar-polar interaction. Density functional theory investigations further elucidate that the incorporation of cationic moieties enhances LiPSs immobilization by confining S n x- (x = 1 or 2) in LiPSs, thereby improving sulfur utilization. Benefiting from these, the cell with CCWPU demonstrates reduced polarization, superior LiPSs conversion rates, and stable cycling performance. Moreover, water-processable nature of CCWPU aligns with environmental consciousness. These diverse functionalities of CCWPU provide valuable insights for the development of advanced binder for LSBs, ultimately improving the electrochemical performances of LSBs., (© 2024 Wiley‐VCH GmbH.)

According to recent revisions to medical laws in Korea, changes to electronic medical records are to be documented. To do so, however, a transparent system with which to store original documents and changes thereto is needed. The transparency and immutability of blockchain records are the key characters of blockchain technology. Employing these characteristics, we developed an application with which to monitor changes of medical records using blockchain.