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Abstract Human telomerase assembly is a highly dynamic process. Using biochemical approaches, we find that LARP3 and LARP7/MePCE are involved in the early stage of human telomerase RNA (hTR) and that their binding to RNA is destabilized when the mature form is produced. LARP3 plays a negative role in preventing the processing of the 3′-extended long (exL) form and the binding of LARP7 and MePCE. Interestingly, the tertiary structure of the exL form prevents LARP3 binding and facilitates hTR biogenesis. Furthermore, low levels of LARP3 promote hTR maturation, increase telomerase activity, and elongate telomeres. LARP7 and MePCE depletion inhibits the conversion of the 3′-extended short (exS) form into mature hTR and the cytoplasmic accumulation of hTR, resulting in telomere shortening. Taken together our data suggest that LARP3 and LARP7/MePCE mediate the processing of hTR precursors and regulate the production of functional telomerase.

Abstract Anionic redox allows the direct formation of O─O bonds from lattice oxygens and provides higher catalytic in the oxygen evolution reaction (OER) than does the conventional metal ion mechanism. While previous theories have predicted and experiments have suggested the possible O─O bond, it has not yet been directly observed in the OER process. In this study, operando soft X‐ray absorption spectroscopy (sXAS) at the O K‐edge and the operando Raman spectra is performed on layered double CoFe hydroxides (LDHs) after intercalation with [Cr(C2O4)3]3−, and revealed a three‐step oxidation process, staring from Co2+ to Co3+, further to Co4+ (3d6L), and ultimately leading to the formation of O─O bonds and O2 evolution above a threshold voltage (1.4 V). In contrast, a gradual oxidation of Fe is observed in CoFe LDHs. The OER activity exhibits a significant enhancement, with the overpotential decreasing from 300 to 248 mV at 10 mA cm−2, following the intercalation of [Cr(C2O4)3]3− into CoFe LDHs, underscoring a crucial role of anionic redox in facilitating water splitting.

Abstract Bimetallic PtRu are promising electrocatalysts for hydrogen oxidation reaction in anion exchange membrane fuel cell, where the activity and stability are still unsatisfying. Here, PtRu nanowires were implanted with a series of oxophilic metal atoms (named as i-M-PR), significantly enhancing alkaline hydrogen oxidation reaction (HOR) activity and stability. With the dual doping of In and Zn atoms, the i-ZnIn-PR/C shows mass activity of 10.2 A mgPt+Ru −1 at 50 mV, largely surpassing that of commercial Pt/C (0.27 A mgPt −1) and PtRu/C (1.24 A mgPt+Ru −1). More importantly, the peak power density and specific power density are as high as 1.84 W cm−2 and 18.4 W mgPt+Ru −1 with a low loading (0.1 mg cm−2) anion exchange membrane fuel cell. Advanced experimental characterizations and theoretical calculations collectively suggest that dual doping with In and Zn atoms optimizes the binding strengths of intermediates and promotes CO oxidation, enhancing the HOR performances. This work deepens the understanding of developing novel alloy catalysts, which will attract immediate interest in materials, chemistry, energy and beyond.

Abstract Ruthenium (Ru) is a promising electrocatalyst for the hydrogen evolution reaction (HER), despite suffering from low activity in non‐acidic conditions due to the high kinetic energy barrier of H2O dissociation. Herein, the synthesis of carbon nanosheet‐supported RuP/Ru heterostructures (RuP/Ru@CNS) from a natural polysaccharide is reported and demonstrates its behavior as an effective HER electrocatalyst in non‐acidic conditions. The RuP/Ru@CNS exhibits low overpotential (106 mV at 200 mA·cm−2) in alkaline electrolyte, exceeding most reported Ru‐based electrocatalysts. The electron shuttling between Ru atoms at the RuP/Ru interface results in a lowered energy barrier for H2O dissociation by electron‐deficient Ru atoms in the pure Ru phase, as well as optimized H* adsorption of electron‐gaining Ru atoms in the neighboring RuP. A low H* spillover energy barrier between Ru atoms at the RuP/Ru interface further boosts HER kinetics. This study demonstrates a sustainable method for the fabrication of efficient Ru‐based electrocatalysts and provides a more detailed understanding of interface effects in HER catalysis.

In this work, vanadium pentoxide (V2O5) and titanium-modified V2O5 thin films were synthesized using the sol-gel spin coating route. The effect of Ti-doping concentration on the electrochromic optical properties and atomic/electronic structures of V2O5 smart thin films is examined. As the doping concentration of Ti increases, the surface roughness of the films is reduced. The structure of the films is analyzed using X-ray diffraction (XRD) and Raman spectroscopy, while the electrochromic modulation of atomic and electronic structures is elucidated through Raman and X-ray absorption spectroscopy (XAS) conducted during lithiation and delithiation. The XRD patterns demonstrate that an increase in Ti concentration leads to a more amorphous structure of the films and a shift of the main diffraction peak to a lower angle, attributable to the enlarged spacing between the stacking layers resulting from the incorporation of Ti ions. Soft X-ray absorption spectroscopy (XAS) and in situ hard XAS of the V L-edge, the O K-edge, and the V K-edge revealed a reduction in the charge state of V and local atomic structural symmetry modification upon lithated coloration and delithiated bleaching process. The critical insights provided by in situ XAS provides reveal that a small amount of Ti has the ability to modify the interlayer distance and local atomic structure of V2O5, thereby improving its electrochromic switching rate and stability when utilized in smart windows.

Objective The present study is to analyze the effects of the coronavirus disease 2019 (COVID 2019) outbreak and the subsequent lockdown on the outcomes of spinal metastasis patients. Methods The study was a retrospective analysis of data from a prospective cohort study. All patients underwent surgical intervention for spinal metastases between January 2019 and December 2021 and had at least 3 months of postoperative follow-up. The primary outcome was overall mortality during the 4 different stages (pre-COVID-19 era, COVID-19 pandemic except in Taiwan, national lockdown, lifting of the lockdown). The secondary outcomes were the oncological severity scores, medical/surgical accessibility, and patient functional outcome during the 4 periods as well as survival/mortality. Results A total of 233 patients were included. The overall mortality rate was 41.20%. During the Taiwan lockdown, more patients received palliative surgery than other surgical methods, and no total en bloc spondylectomy was performed. The time from surgeon visit to operation was approximately doubled after the COVID-19 outbreak in Taiwan (75.97, 86.63, 168.79, and 166.91 hours in the 4 periods, respectively). The estimated survival probability was highest after the national lockdown was lifted and lowest during the lockdown. In the multivariate analysis, increased risk of mortality was observed with delay of surgery, with emergency surgery having a higher risk with delays above 33 hours, urgent surgery (below 59 and above 111 hours), and elective surgery (above 332 hours). Conclusion The COVID-19 pandemic and related policies have altered daily clinical practice and negatively impacted the survival of patients with spinal metastases.

Abstract The memory effect property, described as a reversible color persistence while the potential is withdrawn, is of particular importance to reaching zero‐energy consumption electrochromic devices. Nevertheless, often observed in organic materials, it is poorly studied in oxides. In this study, electrochromic tungsten oxide thin films are elaborated at different working pressures by radiofrequency magnetron sputtering. The influence of the deposition pressure on the electrochemical properties of WO3 films as well as on their memory effect is investigated. Three kinds of WO3 films can be distinguished: with irreversible blue coloration, with reversible coloration presenting a high memory effect, and with reversible coloration with a low memory effect. The origin of these discrepancies is studied through the composition, the local atomic environment, and the morphology of the WO3 thin films. An increase of transmittance at 550 nm as low as 15.8% in 48 h in air and 5.2% in 24 h in the electrolyte is recorded. This study highlights a better understanding of the memory effect property of electrochromic oxides for low‐consumption energy electrochromic devices, pointing out morphology as a key parameter.

Abstract Designing efficient catalyst for the oxygen evolution reaction (OER) is of importance for energy conversion devices. The anionic redox allows formation of O-O bonds and offers higher OER activity than the conventional metal sites. Here, we successfully prepare LiNiO2 with a dominant 3d 8 L configuration (L is a hole at O 2p) under high oxygen pressure, and achieve a double ligand holes 3d 8 L 2 under OER since one electron removal occurs at O 2p orbitals for NiIII oxides. LiNiO2 exhibits super-efficient OER activity among LiMO2, RMO3 (M = transition metal, R = rare earth) and other unary 3d catalysts. Multiple in situ/operando spectroscopies reveal NiIII→NiIV transition together with Li-removal during OER. Our theory indicates that NiIV (3d 8 L 2) leads to direct O-O coupling between lattice oxygen and *O intermediates accelerating the OER activity. These findings highlight a new way to design the lattice oxygen redox with enough ligand holes created in OER process.

The Zhang-Rice singlet is known for the superconductivity of high-temperature superconductors cuprate but is rarely studied for an electrochemical catalyst. Here, the authors use operando spectroscopic tools and observe Cu active site evolves into high-valent CuO4 geometry with Cu3+ active species, so-called Zhang-Rice singlet state, during oxygen evolution reaction.

Background Cerebral hyperperfusion syndrome (CHS) is a failure of autoregulation after a revascularization procedure. It has rarely been reported in patients with no pre-existing cerebral hypoperfusion. Case Report We present a rare case of a patient who underwent stent graft implantation to treat postirradiated carotid blowout syndrome. The patient developed hypertension, focal neurological deficit, and seizures after the procedure; neuroimages revealed ipsilateral cerebral edema, swelling, and increased cerebral perfusion. CHS was diagnosed based on clinical and radiological findings. The patient recovered gradually after receiving supportive care. Conclusion Owing to the risk of CHS, monitoring for cerebral perfusion and prevention of hypertension is suggested for patients who undergo stent graft placement for postirradiated carotid blowout syndrome.

Abstract Despite of suitable band structures for harvesting solar light and driving water redox reactions, polymeric carbon nitride (PCN) has suffered from poor charge transfer ability and sluggish surface reaction kinetics, which limit its photocatalytic activity for water splitting. Herein, atomically dispersed Zn-coordinated three-dimensional (3D) sponge-like PCN (Zn-PCN) is synthesized through a novel intermediate coordination strategy. Advanced characterizations and theoretical calculations well evidence that Zn single atoms are coordinated and stabilized on PCN in the form of Zn-N6 configuration featured with an electron-deficient state. Such an electronic configuration has been demonstrated contributive to promoted electron excitation, accelerated charge separation and transfer as well as reduced water redox barriers. Further benefited from the abundant surface active sites derived from the 3D porous structure, Zn-PCN realizes visible-light photocatalysis for overall water splitting with H2 and O2 simultaneously evolved at a stoichiometric ratio of 2:1. This work brings new insights into the design of novel single-atom photocatalysts by deepening the understanding of electronic configurations and reactive sites favorable to excellent photocatalysis for water splitting and related solar energy conversion reactions.

The successful separation of photoexcited charge carriers and their effective utilization are crucial for overcoming the slow kinetics of the four-electron process for photocatalytic oxygen evolution. Herein, a novel strategy utilizing urea as a source of N-doping on Ca _2 Nb _3 O _10 nanosheets is adopted, followed by the successful deposition of Co single atoms (Co-SAs) to achieve a synergistic effect. The presence of N-dopants and Co-SAs is validated via various experimental techniques. It is also observed that the presence of N-doping contributed towards the deposition of higher content of Co-SAs (0.21 wt%) in Ca _2 Nb _3 O _10− _x N _x -Co _SA nanosheets compared to 0.15 wt% for non-doped Ca _2 Nb _3 O _10 -Co _SA . The optimized Ca _2 Nb _3 O _10− _x N _x -Co _SA nanosheets exhibited an impressive photocatalytic O _2 evolution of ∼727.22 µ mol g ^−1 h ^−1 via the synergy of N-dopants and Co-SAs. As a result, the O _2 evolution response of Ca _2 Nb _3 O _10− _x N _x -Co _SA is 3.6 times higher than that of pristine Ca _2 Nb _3 O _10 nanosheets (201.26 µ mol g ^−1 h ^−1 ), 2.24 times better than Ca _2 Nb _3 O _10− _x N _x nanosheets (323.42 µ mol g ^−1 h ^−1 ), and 1.77 times higher compared to Ca _2 Nb _3 O _10 -Co _SA , (409.33 µ mol g ^−1 h ^−1 ), which clearly demonstrated the synergistic effect of N-dopants and Co-SAs in Ca _2 Nb _3 O _10− _x N _x -Co _SA nanosheets. Based on the findings of various characterization techniques, the co-presence of N-dopants and Co-SAs is observed to contribute towards better charge carrier separation, and utilization to achieve superior photocatalytic response. Thus, this study presents a novel approach for incorporating N-dopants and Co-SAs on Ca _2 Nb _3 O _10 nanosheets, which can be extended to a wide range of nanosheets produced by the soft chemical exfoliation method.

Abstract Electrochemical carbon dioxide (CO2) reduction (ECR) is a promising technology to produce valuable fuels and feedstocks from CO2. Despite large efforts to develop ECR catalysts, the investigation of the catalytic performance and electrochemical behavior of complex metal oxides, especially perovskite oxides, is rarely reported. Here, the inorganic perovskite oxide Ag‐doped (La0.8Sr0.2)0.95Ag0.05MnO3–δ (LSA0.05M) is reported as an efficient electrocatalyst for ECR to CO for the first time, which exhibits a Faradaic efficiency (FE) of 84.3%, a remarkable mass activity of 75 A g−1 (normalized to the mass of Ag), and stability of 130 h at a moderate overpotential of 0.79 V. The LSA0.05M catalyst experiences structure reconstruction during ECR, creating the in operando‐formed interface between the perovskite and the evolved Ag phase. The evolved Ag is uniformly distributed with a small particle size on the perovskite surface. Theoretical calculations indicate the reconstruction of LSA0.05M during ECR and reveal that the perovskite–Ag interface provides adsorption sites for CO2 and accelerates the desorption of the *CO intermediate to enhance ECR. This study presents a novel high‐performance perovskite catalyst for ECR and may inspire the future design of electrocatalysts via the in operando formation of metal–metal oxide interfaces.

Abstract Efficient ethanol oxidation reaction (EOR) is challenging due to the multiple reaction steps required to accomplish full oxidation to CO2 in fuel cells. High‐entropy materials with the adjustable composition and unique chemical structure provide a large configurational space for designing high‐performance electrocatalysts. Herein, a new class of structurally ordered PtRhFeNiCu high‐entropy intermetallics (HEIs) is developed as electrocatalyst, which exhibits excellent electrocatalytic activity and CO tolerance for EOR compared to high‐entropy alloys (HEAs) comprising of same elements. When the HEIs are used as anode catalysts to be assembled into a high‐temperature polybenzimidazole‐based direct ethanol fuel cell, the HEIs achieve a high power density of 47.50 mW/cm2, which is 2.97 times of Pt/C (16.0 mW/cm2). Online gas chromatography measurements show that the developed HEIs have a stronger C–C bond‐breaking ability than corresponding HEAs and Pt/C catalysts, which is further verified by density functional theory (DFT) calculations. Moreover, DFT results indicate that HEIs possess higher stability and electrochemical activity for EOR than HEAs. These results demonstrate that the HEIs could provide a new platform to develop high‐performance electrocatalysts for broader applications.

Abstract This study aims to apply a CCTA-derived territory-based patient-specific estimation of boundary conditions for coronary artery fractional flow reserve (FFR) and wall shear stress (WSS) simulation. The non-invasive simulation can help diagnose the significance of coronary stenosis and the likelihood of myocardial ischemia. FFR is often regarded as the gold standard to evaluate the functional significance of stenosis in coronary arteries. In another aspect, proximal wall shear stress ( $$\mathrm{{WSS}_{prox}}$$ WSS prox ) can also be an indicator of plaque vulnerability. During the simulation process, the mass flow rate of the blood in coronary arteries is one of the most important boundary conditions. This study utilized the myocardium territory to estimate and allocate the mass flow rate. 20 patients are included in this study. From the knowledge of anatomical information of coronary arteries and the myocardium, the territory-based FFR and the $$\mathrm{{WSS}_{prox}}$$ WSS prox can both be derived from fluid dynamics simulations. Applying the threshold of distinguishing between significant and non-significant stenosis, the territory-based method can reach the accuracy, sensitivity, and specificity of 0.88, 0.90, and 0.80, respectively. For significantly stenotic cases ( $$\mathrm{FFR}_{m}$$ FFR m $$\le$$ ≤ 0.80), the vessels usually have higher wall shear stress in the proximal region of the lesion.

Abstract This letter presents a second‐order incremental ADC (IADC) operated in three steps, which extends the performance of a second‐order IADC close to that of a fourth‐order IADC with only two amplifiers. It performs a second‐order noise‐shaping quantization in the first step operation. Reusing the same hardware, the circuit is reconfigured to perform fine quantization as a first‐order IADC in the second and third step. Within a conversion time of 60 clock periods (oversampling ratio OSR = 60), 35 dB signal‐to‐quantization‐noise ratio is boosted. The proposed topology is very suitable for low‐bandwidth high‐resolution data conversion.

Abstract We report the first Asian series on stereotactic body radiation (SBRT) for refractory ventricular arrhythmia (VA) in Taiwanese patients. Three-dimensional electroanatomic maps, delayed-enhancement magnetic resonance imaging (DE-MRI), and dual-energy computed tomography (CT) were used to identify scar substrates. The main target volume was treated with a single radiation dose of 25 Gy and the margin volume received 20 Gy using simultaneous integrated boost delivered by the Varian TrueBeam system. Efficacy was assessed according to VA events recorded by an implantable cardioverter-defibrillator (ICD) or a 24-h Holter recorder. Pre- and post-radiation therapy imaging studies were performed. From February 2019 to December 2019, seven patients (six men, one woman; mean age, 55 years) were enrolled and treated. One patient died of hepatic failure. In the remaining six patients, at a median follow-up of 14.5 months, the VA burden and ICD shocks significantly decreased (only one patient with one ICD shock after treatment). Increased intensity on DE-MRI might be associated with a lower risk for VA recurrence, whereas dual-energy CT had lower detection sensitivity. No acute or minimal late adverse events occurred. In patients with refractory VA, SBRT is associated with a marked reduction in VA burden and ICD shocks, and DE-MRI might be useful for monitoring treatment effects.

This paper focuses on the economic power dispatch (EPD) operation of a microgrid in an OPAL-RT environment. First, a long short-term memory (LSTM) network is proposed to forecast the load information of a microgrid to determine the output of a power generator and the charging/discharging control strategy of a battery energy storage system (BESS). Then, a deep reinforcement learning method, the deep deterministic policy gradient (DDPG), is utilized to develop the power dispatch of a microgrid to minimize the total energy expense while considering power constraints, load uncertainties and electricity price. Moreover, a microgrid built in Cimei Island of Penghu Archipelago, Taiwan, is investigated to examine the compliance with the requirements of equality and inequality constraints and the performance of the deep reinforcement learning method. Furthermore, a comparison of the proposed method with the experience-based energy management system (EMS), Newton particle swarm optimization (Newton-PSO) and the deep Q-learning network (DQN) is provided to evaluate the obtained solutions. In this study, the average deviation of the LSTM forecast accuracy is less than 5%. In addition, the daily operating cost of the proposed method obtains a 3.8% to 7.4% lower electricity cost compared to that of the other methods. Finally, a detailed emulation in the OPAL-RT environment is carried out to validate the effectiveness of the proposed method.

Excessive tortuosity is a notable cause of failed endovascular thrombectomy for acute large-vessel occlusion stroke. Transcervical access (TCA) is a commonly proposed solution for overcoming this difficulty. However, the large-bore catheter usually used in TCA increases the risk of serious local complications. This paper presents a modified technique for TCA that uses a pull-through buddy wire (PTBW) to track a large-bore femoral guiding sheath (GS) into the carotid artery via a small carotid puncture site. The carotid puncture site can be easily managed through gentle manual compression. Two illustrative cases using this technique to deal with a large aortic arch and tortuous left common carotid artery are reported. In both cases, recanalization was achieved after successful GS placement. Using a PTBW is feasible in TCA.

Efficient electrocatalysts are crucial to the electrochemical carbon dioxide reduction. Here, the authors use the fast operando technique to explore a silver-based catalyst with improved catalytic performance benefiting from the suitable defect structures.

Abstract Controllable design and synthesis of catalysts with the target active sites are extremely important for their applications such as for the oxygen reduction reaction (ORR) in fuel cells. However, the controllably synthesizing electrocatalysts with a single type of active site still remains a grand challenge. In this study, we developed a facile and scalable method for fabricating highly efficient ORR electrocatalysts with sole atomic Fe–N4 species as the active site. Herein, the use of cost‐effective highly porous carbon as the support not only could avoid the aggregation of the atomic Fe species but also a feasible approach to reduce the catalyst cost. The obtained atomic Fe–N4 in activated carbon (aFe@AC) shows excellent ORR activity. Its half‐wave potential is 59 mV more negative but 47 mV more positive than that of the commercial Pt/C in acidic and alkaline electrolytes, respectively. The full cell performance test results show that the aFe@AC sample is a promising candidate for direct methanol fuel cells. This study provides a general method to prepare catalysts with a certain type of active site and definite numbers.

Background/Purpose: Enteral feeding, mainly by using a nasogastric tube (NGT), is generally favored over parenteral supplementation in head and neck cancer (HNC) patients with dysphagia. However, the placement of a NGT, either blindly or by endoscopy, is technically challenging in these patients due to the obstructive mass and the altered regional anatomy. The aim of this retrospective study was to estimate the clinical feasibility and safety of fluoroscopic-guided NGT placement in patients with advanced HNC. Methods: Between January 2010 and June 2018, a total of 572 fluoroscopic-guided NGT placements were performed on 231 patients. Technical success was defined as successful insertion of the NGT into the stomach with proper positioning, which was verified by air injection into the NGT. Complications, including aspiration pneumonia, and the ones requiring intensive care, or procedure-related death, were recorded. Results: Technical success was obtained in 558 (97.6%) procedures, and the other 14 (2.4%) procedures failed because of patient intolerance (n = 1) and high-grade obstruction (n = 13). Of the high-grade obstruction patients, eight (61.5%) were shifted to percutaneous radiological gastrostomy, two (15.4%) to surgical feeding jejunostomy, one (7.6%) to endoscopic balloon dilatation, and two (15.4%) to orogastric tube insertion. The average procedure time and fluoroscopy time were 11.7 ± 7.4 min and 3.1 ± 3.1 min, respectively. There were no major complications. Conclusion: Our results show that fluoroscopic-guided NGT placement is a highly safe and effective procedure for patients with advanced HNC requiring enteral feeding.

Water oxidation catalysis may provide the electrons needed for sustainable fuel production, but catalysts often degrade under working conditions. Here, authors introduce soluble species into perovskites to exert positive ion leaching effects for enhancing perovskite stability and activity.

Background/purpose: Oral submucous fibrosis (OSF) is an oral precancerous disorder associated with the habit of areca nut chewing. MiR-10b has been shown to be upregulated in the oral cancer cells and induced by Twist. Our previous work has revealed that Twist participated in the pathogenesis of OSF and therefore we aimed to investigate whether Twist/miR-10b axis was involved in the activation of myofibroblast in the oral cavity. Methods: The expression levels of miR-10b in OSF tissues and fibrotic buccal mucosal fibroblasts (fBMFs) were examined. Besides, the expression of miR-10b was determined in fBMFs following knockdown of Twist or in BMFs after arecoline stimulation. Myofibroblast activities, including collagen gel contraction, migration and wound healing abilities, as well as the expression of α-SMA were measured in fBMFs treated with miR-10b inhibitor. Last, we investigated whether the effect of Twist overexpression could be reversed by suppression of miR-10b. Results: MiR-10b expression was overexpressed in both OSF tissues and fBMFs. The silence of Twist resulted in the downregulation of miR-10b in fBMFs and arecoline treatment led to an increase of miR-10b in a dose-dependent manner. Inhibition of miR-10b ameliorated the activation of myofibroblasts and the expression of α-SMA. Moreover, we demonstrated that suppression of miR-10b hindered the increased collagen gel contraction caused by Twist overexpression. Conclusion: MiR-10b upregulation in OSF may be due to the stimulation of areca nut, leading to elevated myofibroblast activation. Our findings showed that the areca nut-induced expression of miR-10b was under the regulation of Twist and inhibition of miR-10b may provide a direction for treatment of OSF.

Abstract Background The routine application of whole-body CT after extracorporeal cardiopulmonary resuscitation (ECPR) in out-of-hospital cardiac arrest (OHCA) has not been extensively investigated. We aimed to evaluate the benefit of CT in this context. Methods We retrospectively analyzed all OHCA patients who had received ECPR between January 2006 to May 2019. Electronic records were reviewed to filter out patients who had a whole-body CT as their first clinical evaluation after ECPR. CT findings and major hospital outcomes were evaluated. Results From January 2006 to May 2019, 700 patients had received ECPR in our institution. We identified 93 OHCA patients who received whole-body CT as the first clinical evaluation after ECPR. 22.6% of those had no acute findings detected on CT requiring immediate treatment. In the remaining 77.4%, CT had findings that might lead to alterations in clinical course. Most important findings were myocardial infarction (57.0%), hypoxic brain injury (29.0%), sternal/rib fractures (16.1%), aortic dissection (7.5%), pulmonary embolism (5.4%), and cardiac tamponade (5.4%). There were no significant differences in ICU/hospitalization days, time on ECMO support, survival and neurological outcomes between those with and without immediate CT. In our OHCA cohort, there were 27 patients with CT evidence of hypoxic brain injury, of whom 22.2% (n = 2) managed to wean from ECMO support, 14.8% (n = 4) survived to discharge, but only 3.7% (n = 1) survived with good neurological outcome. Hypoxic brain injury on CT has a 95% specificity in predicting poor neurological outcome, with a false positive rate of only 3.7%. Logistic regression suggested a potential correlation between CT findings of hypoxic brain injury and poor neurological outcome [Odds ratio (OR) = 12.53 (1.55 to 10.1), p = 0.02)]. Conclusions Routine whole-body CT after ECPR in OHCA patients appears to have a limited role, as the majority is caused by ACS. However, it may be a useful tool when CPR-related injury or non-ACS causes of OHCA are suspected, as well as in cases where the cause of OHCA is unknown. On the contrary, routine brain CT may be a valuable tool in guiding anticoagulant therapy during ECMO and in aiding outcome prediction.

Determining catalyst electronic structures during electrochemical reactions is crucial to understand mechanisms. Here authors perform in operando soft X-ray spectroscopy on a cobalt oxide catalyst during O2 evolution and observe voltage and time-dependent valence state transitions.

Abstract Background Delayed postpancreatectomy hemorrhage (PPH) is a fatal complication caused by arterial erosion. This study reports a single-center experience of managing delayed PPH with different endovascular treatment approaches. Methods We reviewed the data of patients who had delayed PPH due to hepatic artery or gastroduodenal artery stump perforation and underwent endovascular treatment between 2003 and 2018. We categorized endovascular treatment approaches involving hepatic artery sacrifice, superselective pseudoaneurysm embolization with hepatic artery preservation, and covered stent placement. Technical success rates, hemorrhage recurrence rates, major and minor hepatic complication rates, and 30-day and 1-year mortality rates were assessed. Results A total of 18 patients were reviewed; 11 (61%), 4 (22%), and 3 (17%) delayed PPH cases were managed through hepatic artery sacrifice, superselective pseudoaneurysm embolization, and hepatic artery stenting, respectively. Multidetector computed tomography was performed in 14 (78%) patients. The technical success rate was 100%. The overall hemorrhage recurrence rate was 39%, with superselective pseudoaneurysm embolization having a 100% hemorrhage recurrence rate—much higher than that of hepatic artery sacrifice or stent graft placement. The overall major and minor hepatic complication rates were 56% and 83%, respectively. The overall 30-day and 1-year mortality rates were 11% and 25%, respectively. The 30-day and 1-year mortality rates and minor and major hepatic complication rates were similar in each group. Conclusion Hepatic artery sacrifice is more effective than superselective pseudoaneurysm embolization in the management of delayed PPH. Covered stent placement may be a reasonable alternative treatment to hepatic artery sacrifice.

Facile and reliable screening of efficient electrocatalysts is important for energy conversion technologies such as water splitting. Here, authors introduce A-site ionic electronegativity as a descriptor to understand the hydrogen-evolution activities of cobalt-based perovskites.

Bismuth vanadate (BiVO4) has attracted substantial attention on account of its usefulness in producing hydrogen by photoelectrochemical (PEC) water splitting. The exploitation of BiVO4 for this purpose is yet limited by severe charge recombination in the bulk of BiVO4, which is caused by the short diffusion length of the photoexcited charge carriers and inefficient charge separation. Enormous effort has been made to improve the photocurrent density and solar-to-hydrogen conversion efficiency of BiVO4. This study demonstrates that modulating the composition of the electrode and the electronic configuration of BiVO4 by decoration with silver nanoparticles (Ag NPs) is effective in not only enhancing the charge carrier concentration but also suppressing charge recombination in the solar water splitting process. Decoration with a small number of Ag NPs significantly enhances the photocurrent density of BiVO4 to an extent that increases with the concentration of the Ag NPs. At 0.5% Ag NPs, the photocurrent density approaches 4.1 mA cm−2 at 1.23 V versus a reversible hydrogen electrode (RHE) under solar simulated light illumination; this value is much higher than the 2.3 mA cm−2 of pure BiVO4 under the same conditions. X-ray absorption spectroscopy (XAS) is utilized to investigate the electronic structure of pure BiVO4 and its modification by decoration with Ag NPs. Analytical results indicate that increased distortion of the VO4 tetrahedra alters the V 3d–O 2p hybridized states. Additionally, as the Ag concentration increases, the oxygen vacancy defects that act as recombination centers in BiVO4 are reduced. In situ XAS, which is conducted under dark and solar illumination conditions, reveals that the significantly enhanced PEC performance is attributable to the synergy of modulated atomic/electronic structures and the localized surface plasmon resonance effect of the Ag nanoparticles.

A Burkholderia gladioli strain, named BBB-01, was isolated from rice shoots based on the confrontation plate assay activity against several plant pathogenic fungi. The genome of this bacterial strain consists of two circular chromosomes and one plasmid with 8,201,484 base pairs in total. Pangenome analysis of 23 B. gladioli strains suggests that B. gladioli BBB-01 has the closest evolutionary relationship to B. gladioli pv. gladioli and B. gladioli pv. agaricicola. B. gladioli BBB-01 emitted dimethyl disulfide and 2,5-dimethylfuran when it was cultivated in lysogeny broth and potato dextrose broth, respectively. Dimethyl disulfide is a well-known pesticide, while the bioactivity of 2,5-dimethylfuran has not been reported. In this study, the inhibition activity of the vapor of these two compounds was examined against phytopathogenic fungi, including Magnaporthe oryzae, Gibberella fujikuroi, Sarocladium oryzae, Phellinus noxius and Colletotrichumfructicola, and human pathogen Candida albicans. In general, 2,5-dimethylfuran is more potent than dimethyl disulfide in suppressing the growth of the tested fungi, suggesting that 2,5-dimethylfuran is a potential fumigant to control plant fungal disease.

OBJECTIVE: To determine the associations of liver lobe-based magnetic resonance diffusion-weighted imaging findings using multiple b values with the presence and Child-Pugh class of cirrhosis in patients with hepatitis B. METHODS: Seventy-four cirrhotic patients with hepatitis B and 25 healthy volunteers underwent diffusion-weighted imaging using b values of 0, 500, 800 and 1000 sec/mm2. The apparent diffusion coefficients of individual liver lobes for b(0,500), b(0,800) and b(0,1000) were derived from the signal intensity averaged across images obtained using b values of 0 and 500 sec/mm2, 0 and 800 sec/mm2, or 0 and 1000 sec/mm2, respectively, and were statistically analyzed to evaluate cirrhosis. RESULTS: The apparent diffusion coefficients for b(0,500), b(0,800) and b(0,1000) inversely correlated with the Child-Pugh class in the left lateral liver lobe, the left medial liver lobe, the right liver lobe and the caudate lobe (r=-0.35 to -0.60, all p0.05). Among these parameters, the apparent diffusion coefficient for b(0,500) in the left lateral liver lobe best differentiated normal from cirrhotic liver, with an area under the receiver operating characteristic curve of 0.989. The apparent diffusion coefficient for b(0,800) in the right liver lobe best distinguished Child-Pugh class A from B-C and A-B from C, with areas under the receiver operating characteristic curve of 0.732 and 0.747, respectively. CONCLUSION: Liver lobe-based apparent diffusion coefficients for b(0,500) and b(0,800) appear to be associated with the presence and Child-Pugh class of liver cirrhosis.

This paper investigates efficient design of offshore wind turbine (OWT) support structures under ultimate loads and proposes three schemes to overcome excessive computer time due to many required external loads. The first is the assumption of a rigid support structure to find blade wind forces, so that these forces are only dependent on wind profiles, which limits different cases in the structural analyses. Since the blade information is often confidential in turbine companies, this two-stage analysis allows the hub force to be the input data for the support structure design. The second is using a few control loads to perform the steel design between the second and the second-last design cycles. The third is using parallel computational procedures, since all loading cases can be independently executed in different CPU cores and computers. The test cases, with 5044 loading cases, indicate that the proposed method is fully parallel and can complete the design procedures using a few personal computers within several days. Test cases include IEC 61400-3, tropical cyclone, and seismic loads; although there are many loads to be considered, steel design is governed by a limited number of load cases, which are discussed in this paper.

PURPOSE:To investigate whether liver lobe based T2* values measured on gradient recalled echo T2*-weighted imaging are associated with the presence and Child-Pugh class of hepatitis B-related cirrhosis. METHODS:Fifty-six patients with hepatitis B-related cirrhosis and 23 healthy control individuals were enrolled in this study and underwent upper abdominal T2*-weighted magnetic resonance imaging. T2* values of the left lateral lobe (LLL), left medial lobe (LML), right lobe (RL) and caudate lobe (CL) were measured on T2*-weighted imaging. Statistical analyses were performed to determine the association between liver lobe based T2* values and the presence and Child-Pugh class of cirrhosis. RESULTS:The T2* values of the LLL, LML and RL decreased with the progression of cirrhosis from Child-Pugh class A to C (r = -0.231, -0.223, and -0.395, respectively; all P < 0.05), except that of the CL (r = -0.181, P > 0.05). To a certain extent, Mann-Whitney U tests with Bonferroni correction for multigroup comparisons showed that the T2* values of the LLL, LML and RL could distinguish cirrhotic liver from healthy liver (all P < 0.05), whereas the T2* values of the CL could not (P > 0.05). Receiver operating characteristic analysis demonstrated that the T2* value of the RL could best distinguish cirrhosis from healthy liver, with an area under the receiver operating characteristic curve (AUC) of 0.713 among T2* values of the liver lobes, and that only the T2* value of the RL could distinguish Child-Pugh class C from A-B, with an AUC of 0.697 (all P < 0.05). CONCLUSION:The T2* value of the RL can be associated with the presence and Child-Pugh class of hepatitis B-related cirrhosis.

The title compound, C20H19NO, is a substructure of CP-640186, a potent inhibitor of mammalian acetyl-coenzyme A carboxylases. In the crystal structure, the amide group forms a dihedral angle of 87.0 (1)° with the plane of the anthracene unit and the piperidine ring adopts a chair conformation. Molecules are arranged into layers parallel to (100) and adjacent anthracene units within layers form dihedral angles of 13.2 (1)°. C—H...O interactions from the piperidine rings to the C=O group of the amide are observed between layers.