A graphene mesh as a hybrid electrode for foldable devices.

A graphene mesh with arrays of micro-holes was fabricated on a polymer substrate using photolithography for use as an electrode in flexible devices. The optimal mesh structure with high optical transmittance and electrical conductivity was designed using a finite element method, in which the conductivity of the mesh was simulated as a function of structure, size, and periodicity of the hole array. The sheet resistance of the graphene mesh was lowered to that of a graphene monolayer by chemical doping and found to be 330 Ω Sq-1 at 98.5% transparency. The figure of merit of the doped graphene mesh was calculated to be 106 at 98% transmittance, a value that has not yet been reported for any conventional transparent electrode material. Due to strong bonding between the polymer and substrate, the hybrid electrode composed of a silver nanowire (AgNW)/graphene mesh coated with an over-coating layer exhibited more stable electrical characteristics during mechanical fatigue deformation compared to a hybrid film composed of a AgNW/graphene sheet. The AgNW/graphene sheet underwent breakdown at less than 20 000 cycles in cyclic bending tests with 6.5% strain, but the AgNW/graphene mesh showed a 38% increase in resistance at 20 000 cycles and no breakdown even at 100 000 cycles. Therefore, in this study, we propose a hybrid structure composed of a AgNW/graphene mesh, which is optically and mechanically superior to AgNW/graphene sheets, and therefore suitable for application as a transparent electrode in foldable devices with long-term stability.

The prognostic value of pretreatment of systemic inflammatory responses in patients with urothelial carcinoma undergoing radical cystectomy.

BACKGROUND: Systemic inflammatory response (SIR) is important in the relationship between the tumour, the host, and outcome in cancer patients. However, limited data exist regarding the prognostic significance of SIR in bladder cancer. We investigate the utility of pretreatment SIR in patients with urothelial carcinoma undergoing radical cystectomy. METHODS: The study cohort consisted of 419 patients with a median follow-up of 37.7 months. The SIRs used for each described prognostic nomogram are consistent with previously published data: C-reactive protein, albumin, white cell count, neutrophil count, lymphocyte count, and platelet count. Primary end point was disease-specific survival (DSS) and overall survival (OS) after surgery. Cox regression models were used to determine the time to disease-specific and overall mortality. Multivariate regression coefficients of the predictors were used to develop nomograms for predicting 5-year DSS and OS probability. RESULTS: Multivariate Cox regression analyses revealed that albumin, lymphocyte count, and platelet count were significantly associated with a significantly increased risk for death from bladder cancer. The nomograms including each index were developed to predict the probability of 5-year DSS and OS after radical cystectomy. The C statistics were 77.8% and 77.3%, respectively, and exceeded the 2002 AJCC (72.0% and 70.3%, respectively). In the decision curve analyses, the nomograms including SIR demonstrated higher net benefit gains compared with the models without SIR. CONCLUSIONS: Cellular components of SIR have better prognostic values compared with acute-phase protein in patients undergoing radical cystectomy for bladder cancer.

Effect of adjunctive dipyridamole to DAPT on platelet function profiles in stented patients with high platelet reactivity. The result of the ACCEL-DIP Study.

Adjunctive use of phosphodiesterase (PDE) inhibitor can enhance antiplatelet and vasoprotective properties in patients with cardiovascular disease. The aim of this study was to evaluate the impact of PDE5 inhibitor dipyridamole on platelet function in stented patients with high platelet reactivity (HPR) during dual antiplatelet therapy (DAPT) with aspirin and clopidogrel. Patients with HPR after 600-mg clopidogrel loading were randomly assigned to adjunctive dipyridamole 75 mg twice daily to standard DAPT (DIP group; n = 45) or double-dose clopidogrel of 150 mg daily (DOUBLE group; n = 46) for 30 days. Platelet function was assessed at baseline and 30-day follow-up with platelet reactivity index (PRI) by vasodilator-stimulated phosphoprotein-phosphorylation (VASP-P) assay and platelet aggregation (PA) by light transmittance aggregometry (LTA). Primary endpoint was PRI at 30-day follow-up. HPR was defined as PRI > 50%. Baseline platelet function did not differ between the groups. Following 30-day therapy, platelet function was significantly reduced in the DIP and DOUBLE groups (all p-values ≤ 0.004 and ≤ 0.068, respectively). PRI values were not significantly different between the two groups (mean difference: 3.1%; 95% confidence interval: -2.8% to 9.0%: p = 0.295). PA values and prevalence of HPR were similar between the groups. However, a significant number of patients still exhibited HPR in the DIP (75.6%) and DOUBLE (67.4%) groups. In conclusion, among stented HPR patients, adding dipyridamole to DAPT does not reduce platelet reactivity and prevalence of HPR compared with double-dose clopidogrel therapy, and therefore both strategies are inadequate to overcome HPR.

External validation of an online nomogram in patients undergoing radical nephroureterectomy for upper urinary tract urothelial carcinoma.

BACKGROUND: The objective was to validate an online nomogram developed based on the French collaborative national database on upper urinary tract urothelial carcinoma (UUT-UC) using a different cohort. METHODS: The study comprised 328 patients with UUT-UC who underwent radical nephroureterectomy. The discrimination of models was quantified using Harrell's concordance index. The relationship between the model-derived and actuarial cancer-specific mortality was graphically explored within calibration plots. Calibration was also assessed using the quartiles of the predicted survival at 3 and 5 years and calculation of the corresponding observed Kaplan-Meier estimates. Clinical net benefit was evaluated constructing decision curve analysis. RESULTS: The discrimination accuracy of the nomograms at 3 and 5 years was 71.6% and 71.8%, respectively. Although nomograms discriminated well by Kaplan-Meier curves, and log-rank tests were all highly significant, the calibration plots tended to exaggerate the overestimation of mortality between predicted and observed probabilities at 3 and 5 years for survival. When compared with the AJCC/UICC staging system, the nomograms performed well across a wide range of threshold probabilities using decision curve analysis. CONCLUSION: The online nomogram is a highly accurate prognostic tool for patients with UUT-UC treated with radical nephroureterectomy. The model can provide an accurate estimate of the individual risk of cancer-specific mortality. Further improvement and implementation of novel molecular marker is needed.

X-ray absorption fine structure study of cobalt ion distribution in ferromagnetic Zn(1-x)Co(x)O films.

We examined the distribution of Co ions in ferromagnetic n-type Zn(1-x)Co(x)O semiconducting films with Co concentrations of 0.0-0.07 using x-ray absorption fine structure (XAFS) measurements at the Co and Zn K edges. Extended XAFS (EXAFS) revealed that Co ions mainly occupied the zinc sites in the films. X-ray absorption near edge structure (XANES) spectra demonstrated that the pre-edge peak of the Co K edge was substantially affected by the second neighboring Co ions in the zinc sites due to their environmental potential distortion. From the pre-edge peak and EXAFS analysis using ab initio calculations, we found that Co ions uniformly occupied the zinc sites of the Zn0.93Co0.07O film, whereas the Co ions of the Zn0.97Co0.03O and Zn0.95Co0.05O films were substituted at the zinc sites with a non-uniform distribution. The ferromagnetic properties of the Zn0.93Co0.07O film may be induced by direct interaction between the magnetic dipoles of the Co ions with a mean distance of 4.3 Å, or by the Co conduction-electron mediation.

Structural, optical and electrical properties of nitrogen ion implanted ZnO nanorods.

This study examined the micro-structural and electrical properties of N+-ion-implanted ZnO nanorods. Nitrogen ions with energies of 10-90 keV and beam fluxes of 10(13)-10(16) ions/cm2 were implanted on vertically-aligned ZnO nanorods. Energy dispersive X-ray spectroscopy measurements showed that N+ ions were spread uniformly over the nanorods. Extended X-ray absorption fine structure measurements revealed that the implanted N+s had partially substituted for the oxygen sites. Photoluminescence measurements showed a neutral-donor bound exciton peak at 3.36 eV and a two-electron-satellite peak at 3.33 eV independent of the ion energy and flux. The I-V characteristic curves showed that the current density was not changed by the N+ ion energy and flux much. These results strongly suggested that the N ions substituted for the oxygen sites were neutral.

Relationship of statins to clinical presentation and biochemical outcomes after radical prostatectomy in Korean patients.

The aim of this study was to determine whether or not statins influence biochemical recurrence (BCR) in Korean patients undergoing surgical treatment for prostate cancer. We reviewed data from 687 men who underwent radical retropubic prostatectomy and who did not receive neoadjuvant treatment. Of these patients, 87 reported the use of preoperative statins at surgery. BCR-free survival was determined after exclusion of 78 patients with lymph node metastases and/or who received immediate adjuvant treatment. Patients on statin therapy were more likely to have a co-morbid disease (P < 0.05). Mean PSA (9.6 vs 13.6 ng ml(-1), P = 0.002) and PSA density (0.27 vs 0.38 ng ml(-1) ml(-1), P<0.001) were significantly lower in patients on statins. However, in the multivariable linear regression model, statin use was not associated with a decrease in PSA. Overall BCR for the entire cohort was not significantly different between the statin and nonstatin groups. On multivariate analysis, positive surgical margin and seminal vesicle invasion were independent risk factors for BCR-free survival, whereas other variables, including statin use, were not significant in predicting the risk of BCR. Patients with positive surgical margin and seminal vesicle invasion had a 2.1- (odds ratio, 2.15; 95% confidence interval, 1.29-3.57; P = 0.003) and 2.2-fold risk (odds ratio, 2.21; 95% confidence interval, 1.25-3.89; P = 0.006) of BCR. Preoperative statin use is not associated with reduced BCR following radical prostatectomy.

WITHDRAWN: Prognostic factors of biochemical recurrence after radical prostatectomy in Korean men with high-risk prostate cancer.

This article has been withdrawn consistent with Elsevier Policy on Article Withdrawal (http://www.elsevier.com/locate/withdrawalpolicy). The Publisher apologizes for any inconvenience this may cause.

Comparative trend analysis of characteristics of internationally educated nurses and U.S. educated nurses in the United States.

AIM: This study compares characteristics of internationally educated nurses (IENs) and US educated nurses in the USA and examines trends and implications. BACKGROUND: Internationally educated nurses have been an integral part of the US nurse workforce since the end of the Second World War, especially since the immigration reform in 1965. With the worsening nurse shortage, US employers are intensifying their recruitment efforts by targeting IENs. METHODS: Secondary analysis using datasets from the National Sample Survey of Registered Nurses conducted during 1977-2000 in the USA. RESULTS: Findings indicated that there were important differences between IENs and US educated nurses in their trends of demographical, educational and employment characteristics over time. As a group, IENs were younger but more experienced as nurses and better prepared educationally; worked more hours in both primary and secondary nursing positions; and were primarily employed in urban hospitals as staff nurses in direct care roles, with an increasing proportion working in extended care facilities. CONCLUSIONS: Inter-group and intra-group comparisons suggest that (a) IENs were likely to have longer, more productive nursing careers, (b) because of their demographical and employment characteristics, IENs had a greater impact on relieving the US nurse shortage per capita during 1977-2000, and (c) IENs were making increasingly important contributions to the care of Americans, particularly older Americans and those cared for in inner city hospitals.

Total antioxidant status and oxygen free radicals during hepatic regeneration.

OBJECTIVES: The damage induced by oxygen free radicals (OFRs) is caused by an imbalance of the production of versus the antioxidant defenses against OFRs. METHODS: To understand hepatic damage induced by oxygen free radicals after hepatectomy in rats, total antioxidant status and total production of oxygen free radicals were serially measured in regeneration liver. At 1, 2, 3, 7, and 10 days after hepatectomy of Sprague-Dawley rats, blood was obtained into a capillary tube from a tail vein. Total antioxidant status and total production of oxygen free radicals were measured using the Randox kit, a colorimetric method, and the Free Radical Analytical System. We also measured the amount of malonyldialdehyde, which provides an indirect index of oxidative injury. RESULTS: The level of malonyldialdehyde after hepatectomy was higher compared with that before hepatectomy. The level of total oxygen free radicals after hepatectomy was higher compared with that before hepatectomy. Total antioxidant status after hepatectomy was lower compared with that before hepatectomy. CONCLUSIONS: The results suggested that the damage by OFRs to the regenerating liver was caused by increased production of OFRs and decreased antioxidant defense against OFRs.

Effects of cyclosporine and tacrolimus on the oxidative stress in cultured mesangial cells.

OBJECTIVES: Cyclosporine (CsA) and tacrolimus (Tac) are two primary immunosuppressive agents used for the prevention of graft rejection. However, their use is associated with significant side effects, most notably nephrotoxicity. The mechanisms of this toxicity are not fully understood, but they seem to be associated with increases in the production of oxygen free radicals (OFRs). This present work examined the effect of CsA and Tac on the production of OFRs in cultured rat renal mesangial cells (RMCs). METHODS: Varying concentrations of CsA and Tac (0 to 40 micromol/L) were added to RMCs and incubated for 60 minutes at 37 degrees C. The production of OFRs was evaluated by measuring the fluorescent product from the oxidation of an oxidant-sensitive 2', 7'-dichlorofluorescin. RESULTS: At 60 minutes, the relative fluorescence units (RFU) for OFRs production in RMCs exposure to CsA were increased by 2.5%, 11.5%, 22.5%, 57.2%, and 174% at 2.5, 5, 10, 20, and 40 micromol/L, respectively. Tac increased the RFU by 15.9%, 13.6%, 14.8%, 13.2%, 21.4%, 13.2%, and 28.1% at 0.1, 1, 2.5, 5, 10, 20, and 40 micromol/L, respectively. In RMCs, the RFU produced by CsA was higher than that by Tac. CONCLUSIONS: The results of this experiment suggest that CsA and Tac induced renal injury by OFRs.

Effect of tacrolimus on the production of oxygen free radicals in hepatic mitochondria.

OBJECTIVES: Cyclosporine (CsA) causes side effects that occur mainly in the kidney but also in the liver. Several reports have strongly suggested that the production of oxygen free radicals (OFRs) is a common mechanism of CsA toxicity. However, tacrolimus is believed to suppress the production of OFRs. METHODS: We obtained the mitochondrial fraction with 96% purity from rat liver using a sucrose density gradient solution. Zero to 100 micromol/L tacrolimus was incubated with the mitochondrial fraction for 6 hours at 37 degrees C. OFRs were evaluated by measuring the fluorescent product from the oxidation of an oxidant-sensitive 2,7-dichlorefluorescein using a VICTOR3 multilabel counter. RESULTS: The fluorescence units for OFR production were increased as the time of exposure to tacrolimus passed from 1 to 6 hours. The fluorescence units in 0.1 micromol/L tacrolimus were 6.0 x 10(5) at 1 hour, 7.8 x 10(5) at 2 hours, 9.0 x 10(5) at 3 hours, 10.0 x 10(5) at 4 hours, 11.1 x 10(5) at 5 hours, and 11.4 x 10(5) at 6 hours. However, the fluorescence units were similar although the tacrolimus concentration increases from 0.1 to 100 micromol/L. CONCLUSIONS: The results in this experiment suggested that tacrolimus induced the production of OFRs depending on the exposure time.

Apoptosis by cyclosporine in mesangial cells.

INTRODUCTION: The immunosuppressive agent cyclosporine (CsA) is widely used to treat allograft rejection and various autoimmune disorders. A major limiting factor in the use of CsA is chronic nephrotoxicity. The pathogenesis of CsA-induced nephrotoxicity is not fully understood. Several recent studies have suggested that CsA treatment directly induces apoptosis in several cell types. The present study was undertaken to investigate the effects of CsA on apoptosis of cultured rat mesangial cells (RMCs). METHODS: RMCs were treated with CsA at concentrations of 0.1 to 40 mumol/L. Cell viability was determined by MTT assay. Apoptotic protein expression was determined by Western blot analysis. RESULTS: Cell viability was decreased with increasing concentrations of CsA in dose-dependent manner. CsA produced dose-dependent induction of p53, caspase-6, and Bax protein expression. CsA treatment caused proteolytic cleavage of caspase-3 and induced the degradation of 116-kDa PARP into 89-kDa fragment. RMCs with CsA reduced Bcl-2 and cIAP expression. CONCLUSIONS: In this study, CsA induced apoptosis by up-regulating proapoptotic factors, caspase-3 and -6, p53, Bax, cleaving PARP, and down-regulating antiapoptotic factor, Bcl-2, and cIAP. These results suggested that the increased cell apoptosis exerted by CsA may be one of the mechanisms promoting CsA-induced nephrotoxicity.

Ureteric stenting after ureteroscopy for ureteric stones: a prospective randomized study assessing symptoms and complications.

OBJECTIVE: To compare patients with and with no stenting after ureteroscopy for ureteric calculi, as placing such stents is routine, although many patients complain of pain and urinary symptoms. PATIENTS AND METHODS: In all, 45 patients with ureteric calculi amenable to ureteroscopic management were prospectively randomized into a stented (23) or an unstented (22) group. Standard ureteroscopic basketing and lithotripsy was used, through a ureteroscope (8.5 F) with or without ureteric dilatation. Symptom questionnaires were completed by the patients after treatment, and they were followed radiographically to assess stone-free rate and evidence of obstruction. RESULTS: There was no statistically significant difference in age, stone size, operative duration or hospital stay between the groups (P > 0.05). Furthermore, there was no statistical difference in flank pain or urinary symptoms (P > 0.05), except haematuria, between the groups; haematuria was more severe and prolonged in the stented group (P = 0.001). CONCLUSIONS: Uncomplicated ureteroscopy for removing calculi is safe with no stent after treatment, and after considering complications and side-effects we think that the routine use of ureteric stents after uncomplicated ureteroscopy for stone extraction is unnecessary.