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Balloon atrial septostomy (BAS) is an essential catheterization procedure for congenital heart lesions. Recently, a balloon catheter for static BAS was approved for the first time in Japan as an alternative to the conventional pull-through BAS. Despite the expected increase in the use of static BAS, reports on its safety are scarce worldwide.Methods and Results: Data on static and pull-through BAS registered in a national registry between 2016 and 2018 were collected. During the study period, 247 sessions of static BAS and 588 sessions of pull-through BAS were performed on a total of 674 patients. Patients who underwent static BAS were older (P0.001). The incidence of serious adverse events (4.3% vs. 0.9%, P=0.03) and the overall incidence of adverse events (8.1% vs. 3.2%, P=0.03) were higher in static BAS than in pull-through BAS. Among patients who underwent static BAS, the risk factor for adverse events was a body weight3 kg at the time of the procedure (odds ratio: 4.3 [confidence interval: 1.7-11], P=0.003).This nationwide study revealed differences in patient background between static and pull-through BAS, as well as a higher incidence of adverse events related to static BAS. Patients weighing3 kg are at high risk for adverse events after static BAS and may require surgical and circulatory support backup.

Catheter intervention (CI) for a Blalock-Taussig shunt (BTS) or a ventricle-to-pulmonary artery conduit (VPC) is often required after a palliative surgery for congenital heart disease. Flow regulatory clips help improve interstage mortality; their use necessitates CIs to prevent cyanosis. To study the CI outcomes in patients who underwent palliative surgery with either BTSs or VPCs with flow regulatory clips. This single-center retrospective study evaluated demographic characteristics and interventional outcomes of 49 consecutive pediatric patients who required CI for BTS (BTS group) or VPC (VPC group) between January 2008 and September 2018. Overall, 34 and 18 procedures were performed in the BTS and VPC groups, respectively. Moreover, 19/32 (59.3%) and 12/17 (70.1%) patients from the BTS and VPC groups had flow regulatory clips, respectively. All clips were unclipped successfully; one patient in each group underwent staged unclipping. A higher proportion of "clipped patients" underwent CI due to desaturation [clipped vs. non-clipped: BTS, 10/20 (50.0%) vs. 3/14 (21.4%), p = 0.092; VPC, 9/13 (69.2%) vs. 1/5 (20.0%), p = 0.060]. Most clipped patients successfully progressed to the next stage [BTS, 19/20 (95.0%); VPC, 12/13 (92.3%)]. Severe adverse events (SAEs) were more frequent in the VPC group than in the BTS group [3/13 (23.1%) vs. 0/20 (0%), p = 0.024]. Two patients developed an atrioventricular block (requiring an atropine infusion), while one died due to pulmonary overcirculation. While the indication of CI was cyanosis for a higher proportion of clipped patients, all clips were unclipped successfully. The incidence of CI-related SAEs was higher in the VPC group than in the BTS group.

Flexible solid-state Zn–air batteries with CoS1−δ/SnS2−δ and CBCs demonstrate a high energy density of 256 Wh kgcell−1 including all active and inactive components, high operating rates of 50 to 100 mA cm−2, and a temperature range of +80 to −40 °C.

Recent reproductive technology for cancer patients has provided multiple options to preserve their fertility. Preserving fertility can increase quality of life of cancer patients. However, medical service providers and patients face difficulties in the decision-making process for the fertility preserving treatment because studies focusing on the concept of decision-making and various intervention materials are lack. This review aims to identify the attributes of interventions of studies on decision-making support interventions in cancer patients considering fertility preservation and provide best evidence for health professionals.PubMed, CINAHL, Embase, Cochrane CENTRAL and DBpia databases were searched. An integrated review of the literature was conducted using Whittemore and Knafl's methodology.The search identified 1008 articles, of which 11 studies met eligible criteria. The attributes of the interventions were (1) provision of detailed and practical information of fertility preservation, (2) nondirective approaches to help patients to value their judgements, (3) emphasis on interactions through individualised consultations, (4) establishing connections with available resources and (5) reinforcement of decision-making support resources.Health professionals must acquire current knowledge and ethical and legal standards of fertility preservation and pass this information on to patients before the formation of fertility preservation decision-making support networks within the hospital and health systems.

All-solid-state zinc–air pouch cells promise high energy-to-cost ratios with inherent safety; however, finding earth-abundant high power/energy cathodes and super-ionic electrolytes remains a fundamental challenge. Here we present realistic zinc–air pouch cells designed by the (101)-facet copper phosphosulfide [CPS(101)] as a cathode as well as anti-freezing chitosan-biocellulosics as super-ionic conductor electrolytes. The proposed CPS(101) exhibits trifunctional activity and stability (>30,000 cycles) towards reversible oxygen reactions and hydrogen evolution reactions, outperforming commercial Pt/C and RuO2. Furthermore, hydroxide super-ion conductors utilizing polymerized chitosan-biocellulosics reveal exceptional conductivity (86.7 mS cm−1 at 25 °C) with high mechanical/chemical robustness. High cell-level energy densities of 460 Wh kgcell–1/1,389 Wh l−1 are normally measured in pouch cells (1 Ah) with a cycle lifespan of 6,000/1,100 cycles at 25 mA cm−2 for 20/70% depths of discharge, and the highest densities we could achieve were 523 Wh kgcell–1/1,609 Wh l−1. Flexible pouch cells operate well at rates of 5–200 mA cm−2 over a broad temperature range of −20 to 80 °C. Zinc–air batteries are viewed as a sustainable storage technology, but their commercialization requires a genuine performance leap forwards from the laboratory scale. Here the authors report a cell-level design and demonstrate an ampere-hour pouch cell with exceptionally high energy density and cycle lifespan.

Summary Asymmetric-electrolyte metal–air batteries (AMABs) deliver high operating voltage and energy density. However, the demand for ion-selective transport separator and precious metal electrocatalysts hampers their applications. To address this issue, we develop a polyacrylonitrile (PAN) separator that can selectively transport Zn2+ ions and an atomically dispersed Co electrocatalyst that can catalyze oxygen evolution reactions (OERs) and oxygen reduction reactions (ORRs) in the challenging acidic medium. The selective ion transport behavior was associated with the Zn2+ ions’ bonded ladder structure of PAN, which raises the ion migration energy barrier for the crossover of H+ and OH−. In terms of electrocatalysts, extensive ex situ and in situ characterizations suggest that Co single-atom sites stably catalyze the OER and ORR. Several types of AMABs (metals Zn, Si, Sn) were tested. The assembled asymmetric metal–air Zn-, Si-, and Sn-air batteries delivered enhanced battery performance that surpassed those of recently reported Zn-, Si-, and Sn-air batteries, respectively.

Background: In Japan, the choice of pediatric medical devices is limited because of 2 “device lag” problems: Japan lags behind the USA and Europe in device development, and development of pediatric devices lags behind that of adult devices. We aimed to identify the problems with and impediments to pediatric medical device development as recognized by pediatric physicians in Japan. Methods and Results: A voluntary survey of pediatric medical devices for all council members of the Japanese Society of Pediatric Cardiology and Cardiac Surgery was conducted in 2019. The response rate was 47.1% (154/327). The respondents were 115 pediatric cardiologists (74.7%) and 39 cardiovascular surgeons (25.3%). Approximately 90% believed that difficulties in development existed. Approximately 70% were dissatisfied with the pediatric medical devices currently available in Japan, which was a result of the unavailability of medical devices approved overseas, few types and sizes, and off-label use. Factors that hindered the development of pediatric medical devices included anatomical issues specific to children with congenital heart disease, as well as system issues such as lack of corporate profitability, development cost, and amount of time for development. Conclusions: Pediatric cardiologists and cardiovascular surgeons regard “device lag” and “off-label use” in Japan as important hindrances to the delivery of better medical care for pediatric patients with congenital heart disease.

The foundation of wisdom is rooted in experience, and thus we reflexively call upon our senior leaders, mentors, coaches, and family members for guidance in our personal and professional lives. Witnessing the weathered perspectives of others allows for an internal audit of one's own strengths and deficiencies, which ultimately inspires personal growth. This experience is heightened when both the mentor and the mentee, for example, share a common goal. The field of congenital interventional cardiology, with its constant evolution and diverse technical approaches, requires a lifetime of learning, as well as safe passage of knowledge to the next generation. While there are published recommendations for what to consider when completing this task, hearing the sentiments of those with experience may be more profitable for future fellows and current interventionalists. In part one of a series, we hope to accomplish this goal by presenting an opportunity to learn from our experienced colleagues on the topic of congenital interventional cardiology training. Specifically, we aim to share expert opinions on how to succeed as a congenital interventional fellow, illustrate the diversity of teaching styles and expectations in various healthcare systems, and for the mid-career interventionalists, provide insight into the character traits of a successful mentor of interventional fellows.

Transcatheter closure is an established method to treat coronary artery fistula (CAF). We present transcatheter closure in a 6-year-old girl with CAF and anomalous aortic origin of the left main coronary artery from the right aortic sinus. The CAF originated from the left coronary artery (LCA), coursed through the interventricular septum (intraseptal course) with prominent dilation, and drained into the right ventricular outflow tract. She underwent transcatheter closure and was in a stable condition at the 3-year follow-up with regression of the dilated portion of the intraseptal-type LCA. Hence, transcatheter closure of CAF is feasible in patients with anomalous origins of coronary arteries.

In creating the next generation of crystalline silicon (c-Si) solar cells, the goals are to improve energy conversion efficiency and reduce costs. Here, we demonstrate all-room-temperature-processe...

Purpose Recurrent miscarriage is an unpredictable trauma in a woman's life, and they experience despair and frustration. The purpose of this research was to evaluate the experience of South Korean women after miscarriage. Methods This study conducted to understand the meaning of recurrent miscarriage using a qualitative thematic analysis method based on the posttraumatic growth theory. A total of 23 participants who had repeated miscarriages three or more times participated in this study. The data were collected through in-depth interviews conducted from May to July 2017. Results We identified five properties as follows: 1) confusing as like muddy water, 2) self-reflection on daily life, 3) creating a new relationship through empathy, 4) the culture`s inherent animism or shamanism, and 5) transforming for internal growth were derived. Conclusions Based on the results of this study, it was found that the participants suffering from miscarriage can recover from their losses through resilience and intervention strategies and ultimately improve their quality of life through emotional support. The findings indicated the value of enhanced recovery education, which might help women understand the changes in their lives after miscarriage.

Nurses are very important healthcare providers in disaster situations, and from undergraduate nursing students to professional registered nurses, such practitioners should focus on strengthening their disaster-response-related self-efficacy and competency. The purpose of this study was to develop a Korean version of the Disaster Response Self-Efficacy Scale (DRSES-K) and evaluate its psychometric properties. The DRSES was translated into Korean and developed based on the translation and adaptation of instruments suggested by the World Health Organization. Data were collected from 30 October to 23 November 2020. A total of 209 undergraduate nursing students participated in this study. Psychometric properties were assessed using the programs SPSS/WIN 29.0, AMOS 26.0, and Winsteps 3.68.2, with which Rasch model analysis was carried out. The DRSES-K fit was sufficiently suitable for the unidimensional Rasch model with acceptable goodness of fit (χ2/df = 2.20 (p < 0.001), CFI = 0.92, IFI = 0.92, TLI = 0.91, AGFI = 0.82, and RMSEA = 0.07). The DRSES-K was significantly correlated with the measure of preparedness for disaster response, so concurrent validity was satisfied. The findings in this study suggested that the DRSES-K is a scale with verified validity and reliability. It is expected that the DRSES-K will be used for disaster nursing education to strengthen the competency of undergraduate nursing students.

Background Congenital porto-systemic shunt (CPSS) is a rare disease and can cause fatal complications. Accurate angiographic assessment is mandatory for proper treatment. Although technically difficult, we developed assessment techniques and assessed their accuracy. One technique came from evaluating patients with extrahepatic portal vein obstruction (EHPVO). Methods We conducted a single center retrospective study to evaluate the efficacy of angiographic diagnostic procedure for the assessment of CPSS and EHPVO, and its impact on patients' subsequent interventions and clinical course. Eight patients with CPSS and two patients with EHPVO who underwent diagnostic angiography were included. Assessment of intrahepatic portal vein was performed in all patients. The route of the shunt, and portal vein pressure under shunt occlusion were also evaluated for patients with CPSS. Evaluation was first attempted with balloon angiographic catheter (standard method). Three additional techniques, 1) direct wedge-catheter injection without balloon inflation, 2) use of occlusion balloon in two patients, and 3) hybrid angiography with sheath placement directly into the superior mesenteric vein were performed as needed. Results The standard method was sufficient in four patients. Contrarily, all three techniques were required in two patients each. One lost contact during follow up, but all other patients underwent optimal intervention. There was no complication related to the angiographic procedure. Conclusions Use of direct wedge-catheter injection without balloon inflation, occlusion balloon, and hybrid catheterization improved the diagnostic yield in patients with CPSS or EHPVO.

Background Clinical reasoning is a vital competency for healthcare providers. In 2014, a clinical reasoning assessment rubric (CRAR) composed of analysis, heuristics, inference, information processing, logic, cognition and meta-cognition subdomains was developed for osteopathy students. Methods This study was conducted to verify the validity and reliability of the CRAR in nursing education. A total of 202 case vignette assessments completed by 68 students were used for exploratory factor analysis (EFA) and confirmatory factor analysis (CFA). The Cronbach’s α coefficient of the CRAR was calculated. Results The content validity indices ranged from 0.57 to 1.0. The EFA resulted in three factors: assessment in nursing, nursing diagnosis and planning, and cognition/meta-cognition in nursing. The CFA supported a 3-factor model. The Cronbach’s α coefficient of the CRAR was 0.94. This study confirmed the content validity, construct validity, and reliability of the CRAR. Therefore, the CRAR is a useful rubric for assessing clinical reasoning in nursing students. Conclusions The CRAR is a standardized rubric for assessing clinical reasoning in nurses. This scale will be useful for the development of educational programs for improving clinical reasoning in nursing education.

Rechargeable aqueous zinc-air cells (ZACs) promise an extremely safe and high energy technology. However, they are still significantly limited by sluggish electrochemical kinetics and irreversibility originating from the parasitic reactions of the bifunctional catalysts and electrolytes. Here, we report the preferential in situ building of interfacial structures featuring the edge sites constituted by FeCo single/dual atoms with the integration of Co sites in the nitrogenized graphitic carbon frameworks (FeCo SAs@Co/N-GC) by electronic structure modulation approach. Compared to commercial Pt/C and RuO2, FeCo SAs@Co/N-GC reveals exceptional electrochemical performance, reversible redox kinetics, and durability toward oxygen reduction and evolution reactions under universal pH environments, i.e., alkaline, neutral, and acidic, due to synergistic effect at interfaces and preferred charge/mass transfer. The aqueous (alkaline, nonalkaline, and acidic electrolytes) ZACs constructed with a FeCo SAs@Co/N-GC cathode tolerate stable operations, have significant reversibility, and have the highest energy densities, outperforming those of noble metal counterparts and state-of-the-art ZACs in the ambient atmosphere. Additionally, flexible solid-state ZACs demonstrate excellent mechanical and electrochemical performances with a highest power density of 186 mW cm-2, specific capacity of 817 mAh gZn-1, energy density of 1017 Wh kgZn-1, and cycle life >680 cycles with extremely harsh operating conditions, which illustrates the great potential of triphasic catalyst for green energy storage technologies.

Silicon photoanodes have been studied intensively for efficient photoelectrochemical (PEC)-mediated catalysis of the oxygen evolution reaction, but their performance and stability still need to be improved before they can be applied practically. Here, we demonstrate that the porous, nanocrystalline NiO x electrocatalyst integrated with a thermally-grown SiO 2 protection layer results in unexpectedly high PEC performances as well as long-term stability in Si photoanodes. The porous structure of NiO x and its large active area in contact to the electrolyte improves electrocatalytic activity and greatly reduces the kinetic overpotential required for charge transfer. In addition, the redox-active surface contributed by nanocrystalline nature of NiO x results in the accumulation of charges during the PEC reaction, predominantly affecting the interface energetics of NiO x /n-Si junctions. This feature enables a high open circuit potential of ~0.6 V even without p-n junctions. Stoichiometric SiO 2 affords strong electrochemical corrosion resistance during the PEC water oxidation in 1 M KOH electrolyte, in contrast to the wet chemical-grown, nonstoichiometric SiO x . The porous and nanocrystalline NiO x and stoichiometric SiO 2 incorporated in the n-Si photoanode ensures continuous operation for 100 h at high performance. These results can help inform a new way to design a high performance Si photoanodes with long-term stability.

To identify the type and extent of unmet needs in people with Parkinson's disease and to examine the impact of health locus of control and family support on these needs.A cross-sectional study.This study was conducted from October 2015 - February 2016 in Korea. Data were collected through questionnaires focusing on unmet needs, health locus of control, family support and clinical features.Therapeutic needs represented the highest percentage of unmet needs in people with Parkinson's disease (85.05%), followed by social/spiritual/emotional needs (82.72%). Physical needs were the lowest reported score (75.01%). Unmet needs were more frequent in those with more severe non-motor symptoms. Also, higher family support, internal locus of control and doctor locus of control were correlated with more unmet needs.Understanding factors that determine the type and degree of unmet needs in people with PD is important to provide appropriate nursing care. The findings of this study can be used for providing nursing interventions reflecting unmet needs and reducing their unmet needs to improve the overall well-being of people with PD.This study addressed unmet needs unmet needs specific to Parkinson's disease with respect to their nursing needs. Therapeutic needs were the highest unmet needs in people with PD, followed by social/spiritual/emotional needs, need for certainty and physical needs. The findings may be useful for nurses to identify the unmet needs of people with PD which need to be addressed. By reflecting on unmet needs, nurses can give personally tailored nursing care.目的: 确定帕金森病患者未满足需求的类型和程度并研究健康控制点和家庭支持对这些需求的影响。 设计: 横向研究。 方法: 这项研究于2015年10月至2016年2月在韩国进行。资料收集方式为问卷调查,问卷内容包括未满足的需求、健康控制点、家庭支持和临床特征。 结果: 治疗需求是帕金森病患者未被满足需求的最高比例(85.05%),其次是社会/精神/情感需求(82.72%)。身体需求是最低的报告得分(75.01%)。未满足的需求在非运动症状较严重的患者中更为常见。家庭支持程度、内控倾向、医生倾向与未满足需求呈正相关。 结论: 了解决定PD患者未满足需求类型和程度的因素对提供适当的护理很重要。本研究的结果可用于提供反映未满足需求的护理干预措施,减少未满足需求,以改善PD患者的整体健康状况。 影响: 本研究针对帕金森病患者的护理需求提出了未满足的需求。治疗性需求是PD患者未被满足的最高需求,其次是社会/精神/情感需求、确定性需求和身体需求。这些结果可能对护士识别PD患者未满足的需求是有用的,这些需求需要被处理。通过反思未满足的需求,护士可以提供个性化的护理服务。.

An extremely low birth weight infant (810 g) was born with pulmonary atresia, ventricular septal defect, and major aortopulmonary collateral arteries accompanied by pulmonary overcirculation, which eventually resulted in intestinal hypoperfusion and focal intestinal perforation from the very early stage of life. Based on the echographic findings, we performed banding operations twice to regulate the pulmonary blood flow on day 2 and day 9. At 6 months of age, a definitive repair simultaneous with unifocalization of major aortopulmonary collateral arteries was performed. At 1 year of age, the right ventricle/left ventricle pressure ratio was 0.44 after balloon angioplasty was performed for the right-sided pulmonary artery stenosis. The patient is in a stable condition and was followed-up for more than 2 years after definitive repair. This is the first known successful repair of pulmonary atresia, ventricular septal defect, and major aortopulmonary collateral arteries in an extremely low birth weight infant.

Background Fatigue is one of the most common and burdensome symptoms experienced by cancer patients. In interventions intended to reduce fatigue in such patients, fatigability, or perception of fatigue contextualized to activities of fixed intensity and duration, may also be measured. This study investigated the effects of a 15-month intervention on fatigue and fatigability in breast cancer survivors (BCS); explored the fatigue-fatigability relationship; and evaluated the impacts of fatigue and fatigability on anxiety, depression, sleep disturbance, and endocrine symptoms. Methods A randomized controlled trial design was applied to an exercise program called BLESS (Better Life after cancer, Energy, Strength, and Support). The intervention included this 12-week exercise program and four follow-up contacts intended to promote exercise adherence over the following year. Participants were women aged 20 to 69 who had been diagnosed with stage I, II, or III breast cancer; had completed active treatment; and had moderate or higher fatigue. At the completion of the intervention, the survey responses of 40 BCS were evaluated using the chi-square test and multiple regression analysis. The Korean versions of the Revised Piper Fatigue Scale and Pittsburgh Fatigability Scale were used to measure fatigue and fatigability, respectively. Results There was no significant difference in fatigue or fatigability between the experimental and control groups at intervention completion. However, the control group showed a stronger association than the experimental group between fatigue and physical fatigability. In the control group, fatigue and fatigability were significantly associated with anxiety, depression, sleep disturbance, and endocrine symptoms. In the experimental group, only the cognitive/mood fatigue score and depression were significantly associated. Only endocrine symptoms influenced mental fatigability (B = − 0.185, P P Conclusions Fatigue and fatigability showed different correlations with cancer-related symptoms after the exercise intervention. Future assessments of fatigability in intervention studies will allow measurement of the spectrum of patients’ abilities to overcome fatigue at various physical activity levels while capturing different aspects of cancer-related symptoms. Trial registration This study was retrospectively registered on Clinical Research Information Service (KCT0005763; date of registration: 31/12/2020).

Background Stent implantation for vascular stenosis associated with congenital heart diseases is commonly performed as an off-label procedure in Japan because there is no officially approved stent for any congenital heart disease.Methods and Results:We analyzed data from the Japanese Society of Congenital Interventional Cardiology Registry collected from January 2016 to December 2018. Patients who underwent stent implantation were enrolled in the present analysis. During the study period, there were 470 procedures, 443 sessions, and 391 cases. Of 443 sessions, 427 (96.4%) succeeded procedurally. There were no differences in the procedural success rates among age groups. In all, 416 sessions (367 patients; 94%) resulted in survival to 30 days after catheter intervention. Of 392 admissions, 357 patients (91%) survived to discharge. Only 4 deaths were directly related to stent implantation. Some in-hospital complications were observed during 55 of 443 sessions. Both hospital deaths and serious complications were significantly more frequent in the group with various preoperative risk factors. Conclusions Although not officially approved for congenital heart diseases in Japan, stent implantation in congenital heart diseases has been widely and routinely performed for many years with safety and efficacy. The aim of stenting was variable and broad because of many different applications and morphological variations. These data may facilitate approval of such an important device in Japan.

Background: The loss is common among many people, but not everyone goes through all of the stages or experiences. Miscarriage is a unique loss experience among the women. The loss and grief experienced after a miscarriage may bring both losses and gains in life. The purpose of this research was to identify the experiences of South Korean women after miscarriage.Methods: This was a qualitative study based on the Strauss and Corbin methods. A total of 23 participants who had all experienced more than three miscarriages participated in this study. The data were collected through in-depth interviews conducted from May to July 2017.Results: We found that 47 sub-categories, and 15 categories through the open coding process. Six properties of mastering internal growth and transformation following a miscarriage were identified. “The experience internal growth and transformation through the loss and mother fetal attachment” was proposed as core category. Conclusions: The findings of this study were meaningful in that they revealed the process of women experiencing internal growth and transformation after miscarriage, breaking away from focusing on negative feelings related to miscarriage. We presented a different angle of experiencing internal growth and transformation with a new perspective on life. The findings indicated the valuable support in the enhanced recovery education and might help them understand the changes in their lives after miscarriage, away from the traditional view of women who have experienced miscarriage.

Advanced Zn–air batteries (ZABs) with ultrahigh cycle life, which also harness energy with bifunctional electrochemical reactions, are significantly challenging for the commercialization of hybrid/electric vehicles and wearable electronics. Herein, we demonstrated robust aqueous and flexible ZABs with novel three-dimensional dual-linked hexaiminobenzene metal–organic framework (Mn/Fe-HIB-MOF)-based bifunctional oxygen electrocatalysts and superionic functionalized bio-cellulose electrolytes (64 mS cm−1). The well-defined quintet-shelled hollow sphere MOFs possess a hierarchical porous structure, excellent packing density with a surface area of 2298 m2 g−1, and chemical stability as compared to conventional MOFs. Mn/Fe-HIB-MOF exhibited superior bifunctional oxygen electrocatalytic activity (0.627 V) with half-wave potential (0.883 V) for oxygen reduction and overpotential (280 mV@10 mA cm−2) for oxygen evolution reactions, outperforming commercial Pt/C and RuO2. Their favorable oxygen reactions and surface electronic structures were confirmed by density functional theory. Significantly, the Mn/Fe-HIB-MOF cathode demonstrated the highest lifetimes reported to date for rechargeable ZABs, namely 1000 h (0.75 V voltage gap@10 mA cm−2) over 6000 cycles and 600 h (efficiency ∼65.24%@25 mA cm−2) over 3600 cycles with excellent flexibility for liquid and all-solid-state flexible ZABs, respectively. These promising results illustrate the great potential of these novel hexaiminobenzene MOFs and superionic bio-cellulose membranes for the commercial implementation of rechargeable ZABs.

Background The Harmonization By Doing (HBD) program was established in 2003 as a partnership among stakeholders of academia, industry and regulatory agencies in Japan and the United States, with a primary focus on streamlining processes of global medical device development for cardiovascular medical devices. While HBD has traditionally focused on development of devices intended to treat conditions prevalent in adults, in 2016, HBD established the "HBD-for-Children" program, which focuses on the development of pediatric devices as the development of medical devices for pediatric use lags behind that of medical devices for adults in both countries.Methods and Results:Activities of the program have included: (1) conducting a survey with industry to better understand the challenges that constrain the development of pediatric medical devices; (2) categorizing pediatric medical devices into five categories based on global availability and exploring concrete solutions for the early application and regulatory approval in both geographies; and (3) facilitating global clinical trials of pediatric medical devices in both countries. Conclusions The establishment of the HBD-for-Children program is significant because it represents a global initiative for the introduction of pediatric medical devices for patients in a timely manner. Through the program, academia, industry and regulatory agencies can work together to facilitate innovative pediatric device development from a multi-stakeholder perspective. This activity could also encourage industry partners to pursue the development of pediatric medical devices.

Photoelectrochemical (PEC) cells, which represent a promising technology for the production of hydrogen fuel through water splitting reactions, must meet two criteria to achieve high-performance operation: (i) a high thermodynamic open-circuit potential and (ii) a low kinetic overpotential. Herein, we achieved these criteria in both an oxygen-evolving n-Si photoanode and hydrogen-evolving p-Si photocathode by simple electrodeposition of a nanocrystalline thin film of Ru. The bifunctional electrocatalytic activity of the nanocrystalline Ru led to low overpotentials in both the acidic oxygen evolution reaction (0.27 V) and alkaline hydrogen evolution reaction (0.04 V). In addition, the nanocrystalline Ru/Si junctions influenced the interface energetics via the induction of an extrinsic electrochemical potential on the surface of the Ru nanocrystals through a redox reaction rather than the chemical potential of the electrons (work function) of bulk Ru. The nanocrystalline Ru film exhibited bipolar applicability, enabling both Ru/n-Si and Ru/p-Si junctions with high Voc values of 0.63 and 0.5 V, respectively. As a result, the n-Si photoanode in the acidic electrolyte and the p-Si photocathode in the alkaline electrolyte generated a photocurrent of 10 mA/cm2 at record values of 0.87 and 0.42 V versus the reversible hydrogen electrode, respectively. These results provide insight into the development of high-performance PEC cells based on a nanocrystalline electrocatalyst.

Background: The prevalence of chronic diseases has been rapidly increased due to population aging. As the duration of care needs increase, the caregivers’ socioeconomic burdens have also increased. Objective: This review examines the attributes of caregiving experience and quality of life of caregivers in Korea with a focus on the application of nursing theory. Method: We reviewed studies on caregivers’ caring for adult patients published till 2016 in 4 bio-medical research portal websites or data bases. A total of 1,939 studies were identified through the keyword search. One hundred forty five studies were selected by a process; of which, 17 studies were theory-applied. Selected studies were analyzed in accordance with the structured analysis format. Results: Quantitative studies accounted for 76.6%, while 22.1% were qualitative studies and 1.3% were triangulation studies. Caregiver-related studies increased after 2000. Most frequently, the caregivers were spouses (28.4%), and most frequently, care was provided to a recipient affected by stroke (22.5%). The 17 theory-based studies described 20 theories (70% psychology theories, 30% nursing theories). The most frequent nursing theory was the theory of stress, appraisal and coping. Conclusion: This study sought to better understand caregiving through the analysis of Korean studies on the caregiving experience and caregivers’ QOL and this finding helped presenting empirical data for nursing by identifying the nursing theories applied to the caregiving experience and caregivers’ QOL. The results suggest that the need for further expansion of nursing theories and their greater utilization in the studies of caregiving.