Atomic Layer Engineering of Pd Nanosheets for an Enhanced Hydrogen Evolution Reaction.

Thickness control of two-dimensional (2D) metal nanosheets (metallenes) has scientific significance for energy and catalyst applications, yet is unexplored owing to the lack of an efficient approach for the tailored synthesis of metallenes with controlled atomic layers. Here we report a 2D template-directed synthesis of ultrathin Pd nanosheets with well-controlled thicknesses. Molecularly thin single-crystalline Pd nanosheets with well-defined hexagonal morphologies were synthesized via a one-pot method with 2,4,6-trichlorophenyl formate. Such Pd nanosheets were used as hard templates for the tailored synthesis of the Pd nanosheets with controlled thicknesses (9, 11, 13, and 15 atomic layers). Hard X-ray photoelectron spectroscopy and density functional theory calculations revealed unique electronic states in thickness-controlled Pd nanosheets; these states included reduced surface charges to bulk, increased work functions, and decreased d-band centers. Thus, atomic layer engineering of Pd nanosheets enabled the fine-tuning of the surface electronic states to improve the hydrogen evolution reaction.

Solid-state surfactant templating for controlled synthesis of amorphous 2D oxide/oxyhydroxide nanosheets.

As a member of 2D family, amorphous 2D nanosheets have received increasing attention due to their unique properties that are distinct from crystalline 2D nanosheets. However, compared with the vast library of crystalline 2D nanosheets, amorphous 2D nanosheets are still infancy due to the lack of an efficient synthetic approach. Here, we present a strategy that yields a library of 10 distinct amorphous 2D metal oxides/oxyhydroxides using solid-state surfactant crystals. A key feature of this process is a stepwise reaction using solid surfactant; the solid-state surfactant crystals have metal ions arranged in the interlayer space, and hydrolysis of the metal ions leads to the formation of isolated clusters in the surfactant crystals via limited condensation reactions. Immersing the surfactant crystals in formamide promotes nanosheet formation through the self-assembly of clusters by templating the morphologies of the crystals generated from surfactants crystals. Our approach opens a flatland in amorphous 2D world.

Single-channel endoscopic closure of a mucosal defect after endoscopic submucosal dissection using a disposable endoloop and a retrievable clip.

Endoscopic submucosal dissection (ESD) is a treatment with high rate of en bloc resection. It has been suggested that mucosal suture of post-ESD ulcers may reduce the incidence of delayed accidents. Suturing method for the ulcers and deep tears that use a single-channel scope and a reusable endoloop (Olympus, Tokyo, Japan) and ones that use a double-channel scope have been reported. Notably, due to difficulties in using a a reusable loop, we devised a suturing method that uses a single-channel scope, a disposable endoloop, and a SureClip (Micro-tech Endoscopy, Nanjing, China). The SureClip was inserted into the forceps hole and withdrawn from the tip. The loop portion of the endoloop was grasped with the SureClip while the disposable endoloop was halfway out and then delivered into the lumen outside the endoscope. After reaching the target site, the SureClip was opened and secured to one of the mucosa ends. The first clip was placed as far away from the sheath as possible. The use of the SureClip was then continued, for fixation at multiple sites, and the endoloop was tightened and sutured. No complications, such as bleeding or perforation, were observed.

Experience with the new multi-hole self-expandable metallic stent.

Multi-hole self-expandable metallic stent (M.I.Tech/Boston Scientific: MHSEMS) has small holes in the cover part of FCSEMS and has properties between UCSEMS and FCSEMS. The MHSEMS was originally an FCSEMS with holes in all cells. In the distal bile duct, the MHSEMS have the potential to prevent migration by allowing tissue to enter the small holes. In the hilar region, the MHSEMS can potentially prolong the duration of patency of the central bile duct by preventing ingrowth by covering the branches without impeding them. However, because there were reports of cases of inoperable removal due to ingrowth overseas, the model launched in Japan in 2022 had fewer holes, and the cover of the Hanarostent Biliary Full Cover NEO (M.I. Tech/Boston Scientific) had a row of holes in every other row. It was used in 7 cases of malignant biliary obstruction. The primary diseases were gallbladder cancer, cholangiocarcinoma, and pancreatic cancer. The obstruction sites were the hilar region and the distal bile duct. All patients underwent successful implantation with no pancreatitis or cholangitis observed. Five patients continued chemotherapy. One gallbladder cancer patient died after 20 days, one cholangiocarcinoma patient experienced obstruction after 81 days, and the other five cases showed no evidence of obstruction or deviation (ranging from 6 to 119 days after implantation, with an average of 75 days). MHSEMS can be used for malignant biliary obstruction, mainly in the distal bile duct.

A study of traction endoscopic submucosal dissection using a unique traction device with a ring and a clip with an obtuse tip.

Appropriate use of traction devices is important in Endoscopic Submucosal Dissection (ESD). The Sure-Clip Traction Band (Microtec: "traction band") is a disposable clip with a series of three small silicone rings, which can be used as a traction device by inserting the clip through two holes. The SB clip long with a 125-degree tip claw angle (SB Kawasumi: hereafter referred to as SB clip) has an obtuse angle tip, can be re-gripped and is considered to cause less damage to the digestive tract wall when withdrawn after clipping. We performed traction ESD using a traction band and SB clip. These were used for gastric ESD in 4 cases and colorectal ESD in 3 cases.

Ultrafast 2D Nanosheet Assembly via Spontaneous Spreading Phenomenon.

In 2D materials, a key engineering challenge is the mass production of large-area thin films without sacrificing their uniform 2D nature and unique properties. Here, it is demonstrated that a simple fluid phenomenon of water/alcohol solvents can become a sophisticated tool for self-assembly and designing organized structures of 2D nanosheets on a water surface. In situ, surface characterizations show that water/alcohol droplets of 2D nanosheets with cationic surfactants exhibit spontaneous spreading of large uniform monolayers within 10 s. Facile transfer of the monolayers onto solid or flexible substrates results in high-quality mono- and multilayer films with high coverages (>95%) and homogeneous electronic/optical properties. This spontaneous spreading is quite general and can be applied to various 2D nanosheets, including metal oxides, graphene oxide, h-BN, MoS2, and transition metal carbides, enabling on-demand smart manufacture of large-size (>4 inchϕ) 2D nanofilms and free-standing membranes.

Clinical Differences between Radiographic and Physical Horizontal Gaze Deviation: Utility of Using the Two in Patients with Ischemic Stroke.

Background and Purpose: Radiographic horizontal gaze deviation (RHGD) has been identified as a useful finding on computed tomography (CT) that indicates the affected side in supratentorial ischemic stroke; however, it remains unclear whether RHGD is essentially the same phenomenon as physical horizontal gaze deviation (PHGD). To resolve the issue, this study was conducted. Methods: Retrospective analyses were performed for 671 patients with ischemic stroke and 142 controls who were hospitalized and underwent head CT. First, clinical findings were examined to find differences between RHGD-positive and RHGD-negative patients. Second, patients were classified by their stroke mechanisms and/or affected vascular territories. For each subgroup, RHGD was compared with PHGD in frequency. Third, the proportions for patients divided by positivity for PHGD and RHGD were calculated in the subgroups. Results: Patients with RHGD had PHGD more often than those without. In all stroke subgroups, RHGD was more frequent than PHGD. The frequency difference was prominent in small-artery occlusion (SAO) and posterior inferior cerebellar artery (PICA) stroke. In SAO of the basilar artery pontine perforator, RHGD was positive in 25% and largely contralesionally-directed. In PICA stroke, lesions in the vestibulocerebellum were associated with contralesional RHGD. Moreover, lesions in the lateral medulla also caused RHGD, which was mainly directed to the ipsilesional side. PHGD-positive stroke without RHGD was infrequent, whereas RHGD-positive stroke without PHGD was commonly observed (PICA stroke, 45.9%; other subgroups, 21.1%-27.5%). Conclusions: RHGD had different characteristics from PHGD; therefore, assessments of both PHGD and RHGD may lead to more accurate diagnoses.

Raising root zone temperature improves plant productivity and metabolites in hydroponic lettuce production.

While it is commonly understood that air temperature can greatly affect the process of photosynthesis and the growth of higher plants, the impact of root zone temperature (RZT) on plant growth, metabolism, essential elements, as well as key metabolites like chlorophyll and carotenoids, remains an area that necessitates extensive research. Therefore, this study aimed to investigate the impact of raising the RZT on the growth, metabolites, elements, and proteins of red leaf lettuce. Lettuce was hydroponically grown in a plant factory with artificial light at four different air temperatures (17, 22, 27, and 30°C) and two treatments with different RZTs. The RZT was raised 3°C above the air temperature in one group, while it was not in the other group. Increasing the RZT 3°C above the air temperature improved plant growth and metabolites, including carotenoids, ascorbic acids, and chlorophyll, in all four air temperature treatments. Moreover, raising the RZT increased Mg, K, Fe, Cu, Se, Rb, amino acids, and total soluble proteins in the leaf tissue at all four air temperatures. These results showed that raising the RZT by 3°C improved plant productivity and the metabolites of the hydroponic lettuce by enhancing nutrient uptake and activating the metabolism in the roots at all four air temperatures. Overall, this research demonstrates that plant growth and metabolites can be improved simultaneously with an increased RZT relative to air temperature. This study serves as a foundation for future research on optimizing RZT in relation to air temperature. Further recommended studies include investigating the differential effects of multiple RZT variations relative to air temperature for increased optimization, examining the effects of RZT during nighttime versus daytime, and exploring the impact of stem heating. This research has the potential to make a valuable contribution to the ongoing growth and progress of the plant factory industry and fundamental advancements in root zone physiology. Overall, this research demonstrates that plant growth and metabolites can be improved simultaneously with an increased RZT relative to air temperature. This study serves as a foundation for future research on optimizing RZT in relation to air temperature. Further recommended studies include investigating the differential effects of multiple RZT variations relative to air temperature for increased optimization, examining the effects of RZT during nighttime versus daytime, and exploring the impact of stem heating. This research has the potential to make a valuable contribution to the ongoing growth and progress of the plant factory industry and fundamental advancements in root zone physiology.

Anterior Cruciate Ligament-Injured Knees With Meniscal Ramp Lesions Manifest Greater Anteroposterior and Rotatory Instability Compared With Isolated Anterior Cruciate Ligament-Injured Knees.

PURPOSE: To investigate the effects of ramp lesion (RL) and its repair on knee instability in patients with anterior cruciate ligament (ACL) injury by quantitatively assessing anteroposterior and rotational knee instability before and after ACL reconstruction. METHODS: All primary double-bundle ACL reconstructions using hamstring autografts between 2016 and 2021 were evaluated retrospectively. Patients with RLs without other meniscal injuries were included in group R, whereas those with isolated ACL injuries constituted group C. RL was repaired using all-inside devices in all patients in group R. Knee instability, including the amount of anterior tibial translation (ATT), and the acceleration and external rotational angular velocity of the knee joint (ERAV) during the pivot-shift test were assessed at the time of surgery. The pivot-shift test grade was recorded. RESULTS: A total of 73 patients were included in this study. Preoperatively, group R (n = 23) had significantly greater pivot-shift grades (P = .039), ATT (6.0 mm, group R; 4.5 mm, group C, P < .001), acceleration (6.8, 2.8; P = .037), and ERAV (3.9, 2.8; P = .001) than group C (n = 50). Intraoperatively, ATT (-1.0 mm, -1.0 mm; P < .001), acceleration (1.2, 1.1; P < .001), and ERAV (1.4, 1.2; P < .001) were significantly decreased compared with the preoperative values in both groups. No significant differences in these values were observed between groups R and C. CONCLUSIONS: ACL-injured knees accompanied by RLs exhibited significantly greater anteroposterior and rotatory instability than knees with isolated ACL injuries; increased knee instability can be effectively addressed by performing RL repair in conjunction with ACL reconstruction. The quantitative assessments employed-specifically measuring ATT, acceleration, and ERAV during the pivot-shift test-have allowed us to delineate these aspects of knee instability with greater precision. LEVEL OF EVIDENCE: Level Ⅲ, retrospective comparative study.

Factors Associated with Return to Sport After Anterior Cruciate Ligament Reconstruction: A Focus on Athletes Who Desire Preinjury Level of Sport.

INTRODUCTION: In most previous studies investigating return to preinjury level of sport (RTPS) after anterior cruciate ligament reconstruction (ACLR), whether patients continue aiming for RTPS not only before but also after ACLR was unclear because environmental and social factors were not considered. Herein, we aimed to evaluate factors associated with RTPS among athletes who desired to achieve RTPS even after ACLR, excluding patients who no longer desire this goal owing to environmental and social factors. METHODS: Ninety-two patients who underwent primary double-bundle ACLR with a minimum 2-year follow-up and desired to achieve RTPS before surgery were retrospectively enrolled. Twelve (13%) patients who no longer desired to achieve RTPS after ACLR owing to environmental and social factors were excluded. Sixty-nine patients were included in the final cohort. At the final follow-up, the patients were split into two groups: those who achieved (R group) or did not achieve (N group) RTPS based on patient self-assessment. The Knee Injury and Osteoarthritis Outcome Score (KOOS) and Lysholm scores were also determined. The anterior tibial translation in the Lachman test and acceleration and external rotational angular velocity (ERAV) in the pivot shift test were measured at the hardware removal operation. RESULTS: Significant differences were observed for preinjury level of sports between the groups (p < 0.05). The rate of RTPS in competitive athletes was lower than that in recreational athletes (20/46: 43% vs. 16/22: 73%; p =.037). Lysholm score, KOOS symptom, pain, and quality of life showed higher values in the R group than in the N group (p < 0.050). Acceleration was significantly lower in the R group than in the N group (p = 0.028). CONCLUSION: Competitive level of sports is a risk factor for failure to achieve RTPS. The postoperative functional outcomes in the group that achieved RTPS showed more favorable results. These results provide important information to enable the surgeons to consider the appropriate surgical plan for competitive athletes who desire to achieve RTPS after ACLR.

Effects of green tea and roasted green tea on human responses.

Our objective was to elucidate the effects of tea consumption on refreshment and stress reduction/recovery through examining the multiple associations among factors such as various physiological responses and task performance. Participants included 20 healthy young men who performed a mental arithmetic task while 11 physiological responses were measured. The experiments were conducted twice under different beverage consumption conditions on separate days. The mental arithmetic task was executed six times in 1 day; participants ingested hot water, green tea, or roasted green tea (hojicha) before each task. Several subjective assessments: subjective fatigue, stress, mental workload, and flow were evaluated after each task. The R-R intervals, heart rate variability spectral components, the Poincaré plot indices (SD1 and SD2) and plethysmogram amplitude tended to decrease during task periods compared to resting periods. Tissue blood volume/flow (TBV, TBF) and near-infrared spectroscopy responses (NIRS) were lower in the tea condition than in the hot water condition. By scrutinizing various indicators, we found that aromatic stimulation of Japanese tea beverages has the potential to induce positive effects, enhance mental task performance, promote refreshment, and alleviate feelings of fatigue. These positive effects were observed even in small quantities and within a short duration, mirroring responses observed in daily consumption.

Application of ethanol alleviates heat damage to leaf growth and yield in tomato.

Chemical priming has emerged as a promising area in agricultural research. Our previous studies have demonstrated that pretreatment with a low concentration of ethanol enhances abiotic stress tolerance in Arabidopsis and cassava. Here, we show that ethanol treatment induces heat stress tolerance in tomato (Solanum lycopersicon L.) plants. Seedlings of the tomato cultivar 'Micro-Tom' were pretreated with ethanol solution and then subjected to heat stress. The survival rates of the ethanol-pretreated plants were significantly higher than those of the water-treated control plants. Similarly, the fruit numbers of the ethanol-pretreated plants were greater than those of the water-treated ones. Transcriptome analysis identified sets of genes that were differentially expressed in shoots and roots of seedlings and in mature green fruits of ethanol-pretreated plants compared with those in water-treated plants. Gene ontology analysis using these genes showed that stress-related gene ontology terms were found in the set of ethanol-induced genes. Metabolome analysis revealed that the contents of a wide range of metabolites differed between water- and ethanol-treated samples. They included sugars such as trehalose, sucrose, glucose, and fructose. From our results, we speculate that ethanol-induced heat stress tolerance in tomato is mainly the result of increased expression of stress-related genes encoding late embryogenesis abundant (LEA) proteins, reactive oxygen species (ROS) elimination enzymes, and activated gluconeogenesis. Our results will be useful for establishing ethanol-based chemical priming technology to reduce heat stress damage in crops, especially in Solanaceae.

Evaluation of quality of life for patients with resolved facial nerve palsy.

OBJECTIVES: The quality of life (QOL) for patients with resolved facial nerve palsy has not been evaluated adequately. The objective of this study is to investigate QOL for patients with resolved facial nerve palsy. METHODS: Forty-seven patients with resolved facial nerve palsy were included and the patients' QOL was evaluated using the Facial Clinimetric Evaluation Scale (FaCE Scale). RESULTS: Twenty-two of the 47 patients (46.8%) with resolved facial nerve palsy showed impaired QOL, especially in terms of facial comfort and eye comfort. In 10 cases followed-up after the condition was judged to be resolved, the median scores for the FaCE scale at the time the condition was judged to be resolved and at the last visit were 65.5 and 72, respectively. The mean durations from the onset of the palsy to diagnosis of cure and to the last visit were 2.4 ± 1.6 and 4.3 ± 2.2 months, respectively. There was a significant improvement in QOL after the condition was judged to be resolved. CONCLUSION: There were discrepancies between QOL and facial movement as evaluated by physicians in patients in whom facial nerve palsy was resolved as in patients with non-cured facial nerve palsy. Patients' QOL continued to improve even after physicians judged the condition to be resolved and this result indicated that there were cases where improvement in QOL was delayed in comparison to improvement in facial movement.

Pre- and post-operative semicircular canal function evaluated by video head impulse test in patients with vestibular schwannoma.

OBJECTIVES: To evaluate pre- and post-operative semicircular canal function in patients with vestibular schwannoma (VS) by the video Head Impulse Test (vHIT). METHODS: Nineteen patients with VS who underwent surgery were enrolled in this study. The gain in vestibulo-ocular reflex (VOR) and the degree of scatter in catch-up saccades were examined pre- and post-operatively for the semicircular canals in VS patients. RESULTS: Ten of 19 cases (52.6 %) with VS were defined as demonstrating both superior vestibular nerve (SVN) and inferior vestibular nerve (IVN) impairment from the results of pre-operative vHIT. Hearing level and subjective vestibular symptoms showed significant correlations with pre-operative semicircular canal function. Compared to pre-operative vHIT results, VOR gains within 1 month after surgery were significantly reduced in all three canals; however, significant differences had disappeared in the anterior and posterior semicircular canals at 6 months after surgery. Cases of unknown origin had a significantly greater reduction in posterior semicircular canal function after surgery compared with those with disease of IVN origin. CONCLUSIONS: As vHIT could evaluate pre-operative vestibular nerve impairment, post-operative VOR gain reduction and the degree of vestibular compensation, semicircular canal function evaluated by vHIT provides a good deal of useful information regarding VS patients undergoing surgery compared to caloric testing, and vHIT should be performed pre- and post-operatively for patients with VS.

Factors Associated With Residual Pivot Shift After ACL Reconstruction: A Quantitative Evaluation of the Pivot-Shift Test Preoperatively and at Minimum 12-Month Follow-up.

Background: Postoperative residual rotatory laxity remains despite improvement in surgical techniques for anterior cruciate ligament (ACL) reconstruction (ACLR). Purpose: To evaluate factors associated with residual pivot shift after ACLR by quantitative measurement of the pivot shift before and after surgery. Study Design: Case-control study; Level of evidence, 3. Methods: A total of 97 patients who underwent primary double-bundle ACLR between June 2016 and March 2021 and underwent surgery to remove staples, with at least 12 months of follow-up evaluation, were enrolled. Quantitative measurements were performed under general anesthesia immediately before ACLR (preoperatively), after temporary fixation of the ACL graft (intraoperatively), and immediately before staple removal (postoperatively). The laxity of pivot shift was assessed using inertial sensors to measure acceleration and external rotational angular velocity (ERAV). Descriptive data were assessed for associations with postoperative acceleration and ERAV in a univariate analysis. A multiple linear regression analysis was performed to identify factors associated with postoperative acceleration and ERAV. Results: Anterior tibial translation, acceleration, and ERAV increased from intra- to postoperatively (P < .05). Factors significantly associated with postoperative acceleration were age (ß = -0.238; P = .021), lateral posterior tibial slope (PTS) (ß = 0.194; P = .048), and preoperative acceleration (ß = 0.261; P = .008). Factors significantly affecting postoperative ERAV were age (ß = -0.222; P = .029), ramp lesions (ß = 0.212; P = .027), and preoperative ERAV (ß = 0.323; P = .001). Conclusion: Greater preoperative laxity in the pivot shift was the factor having the most significant association with residual pivot shift after ACLR using quantitative measurements under general anesthesia. Younger age, higher lateral PTS, and concomitant ramp lesions were significant predictors of residual pivot shift. These findings can help pre- and intraoperative decision-making regarding whether an anterolateral structure augmentation should be added.