The geometric evolution of aortic dissections: Predicting surgical success using fluctuations in integrated Gaussian curvature.

Clinical imaging modalities are a mainstay of modern disease management, but the full utilization of imaging-based data remains elusive. Aortic disease is defined by anatomic scalars quantifying aortic size, even though aortic disease progression initiates complex shape changes. We present an imaging-based geometric descriptor, inspired by fundamental ideas from topology and soft-matter physics that captures dynamic shape evolution. The aorta is reduced to a two-dimensional mathematical surface in space whose geometry is fully characterized by the local principal curvatures. Disease causes deviation from the smooth bent cylindrical shape of normal aortas, leading to a family of highly heterogeneous surfaces of varying shapes and sizes. To deconvolute changes in shape from size, the shape is characterized using integrated Gaussian curvature or total curvature. The fluctuation in total curvature (δK) across aortic surfaces captures heterogeneous morphologic evolution by characterizing local shape changes. We discover that aortic morphology evolves with a power-law defined behavior with rapidly increasing δK forming the hallmark of aortic disease. Divergent δK is seen for highly diseased aortas indicative of impending topologic catastrophe or aortic rupture. We also show that aortic size (surface area or enclosed aortic volume) scales as a generalized cylinder for all shapes. Classification accuracy for predicting aortic disease state (normal, diseased with successful surgery, and diseased with failed surgical outcomes) is 92.8±1.7%. The analysis of δK can be applied on any three-dimensional geometric structure and thus may be extended to other clinical problems of characterizing disease through captured anatomic changes.

Osmotically Delaminated Silicate Nanosheet-Coated NCM for Ultra-Stable Li+ Storage and Chemical Stability Toward Long-Term Air Exposure.

To ensure the safety and performance of lithium-ion batteries (LIBs), a rational design and optimization of suitable cathode materials are crucial. Lithium nickel cobalt manganese oxides (NCM) represent one of the most popular cathode materials for commercial LIBs. However, they are limited by several critical issues, such as transition metal dissolution, formation of an unstable cathode-electrolyte interphase (CEI) layer, chemical instability upon air exposure, and mechanical instability. In this work, coating fabricated by self-assembly of osmotically delaminated sodium fluorohectorite (Hec) nanosheets onto NCM (Hec-NCM) in a simple and technically benign aqueous wet-coating process is reported first. Complete wrapping of NCM by high aspect ratio (>10 000) nanosheets is enabled through an electrostatic attraction between Hec nanosheets and NCM as well as by the superior mechanical flexibility of Hec nanosheets. The coating significantly suppresses mechanical degradation while forming a multi-functional CEI layer. Consequently, Hec-NCM delivers outstanding capacity retention for 300 cycles. Furthermore, due to the exceptional gas barrier properties of the few-layer Hec-coating, the electrochemical performance of Hec-NCM is maintained even after 6 months of exposure to the ambient atmosphere. These findings suggest a new direction of significantly improving the long-term stability and activity of cathode materials by creating an artificial CEI layer.

Revascularizations and limb outcomes of hospitalized patients with diabetic peripheral arterial disease in the contemporary era.

BACKGROUND: Concomitant diabetes mellitus and peripheral artery disease (PAD) is a complex disease process. This retrospective analysis of the National Inpatient Sample sought to understand trends in limb outcomes of this unique and prevalent cohort of patients. METHODS: The National Inpatient Sample was queried between 2003 and 2017 for hospitalizations of patients with both type 2 diabetes mellitus and PAD. Trends in hospitalizations, limb outcomes, vascular interventions, and costs were analyzed. RESULTS: There were 10,303,673 hospitalizations of patients with concomitant diabetes mellitus and PAD that were identified between 2003 and 2017. The prevalence of hospitalizations associated with this disease process increased from 1644 to 3228 per 100,000 hospitalizations, a 96.4% increase. This included an increase of 288 to 587 per 100,000 hospitalizations of patients aged 18 to 49 years old, which was accompanied by a 10.8% increase in minor amputations. Nontraumatic lower extremity amputations decreased overall. Black and Hispanic ethnicity were associated with an increased risk for amputation, along with Medicaid insurance and lower income quartile. Inpatient endovascular revascularization has increased over time with an associated decrease in open revascularization procedures. Amputation-related hospital costs significantly increased from $6.6 billion in 2003 to $14.8 billion in 2017. CONCLUSIONS: An alarming increase of disease prevalence, negative in-hospital limb outcomes, and costs are seen in the current era in this analysis of patients with concurrent diabetes and PAD.

Recent research trends in textile-based temperature sensors: a mini review.

In this review, the current state of research on textile-based temperature sensors is explored by focusing on their potential use in various applications. The textile-based sensors show various advantages including flexibility, conformability and seamlessness for the wearer. Integration of the textile-based sensors into clothes or fabric-based products enables continuous and sensitive monitoring of change in temperature, which can be used for various medical and fitness applications. However, there are lacks of comprehensive review on the textile-based temperature sensors. This review introduces various types of textile-based temperature sensors, including resistive, thermoelectric and fibre-optical sensors. In addition, the challenges that need to be addressed to fully realise their potential, which include improving sensitivity and accuracy, integrating wireless communication capabilities, and developing low-cost fabrication techniques. The technological advances in textile-based temperature sensors to overcome the limitations will revolutionize wearable devices requiring function of temperature monitoring.

Wood-Derived, Conductivity and Hierarchical Pore Integrated Thick Electrode Enabling High Areal/Volumetric Energy Density for Hybrid Capacitors.

For the proliferation of the supercapacitor technology, it is essential to attain superior areal and volumetric performance. Nevertheless, maintaining stable areal/volumetric capacitance and rate capability, especially for thick electrodes, remains a fundamental challenge. Here, for the first time, a rationally designed porous monolithic electrode is reported with high thickness of 800 µm (46.74 mg cm-2 , with high areal mass loading of NiCo2 S4 6.9 mg cm-2 ) in which redox-active Ag nanoparticles and NiCo2 S4 nanosheets are sequentially decorated on highly conductive wood-derived carbon (WC) substrates. The hierarchically assembled WC@Ag@NiCo2 S4 electrode exhibits outstanding areal capacitance of 6.09 F cm-2 and long-term stability of 84.5% up to 10 000 cycles, as well as exceptional rate capability at 50 mA cm-2 . The asymmetric cell with an anode of WC@Ag and a cathode of WC@Ag@NiCo2 S4 delivers areal/volumetric energy density of 0.59 mWh cm-2 /3.93 mWh cm-3 , which is much-improved performance compared to those of most reported thick electrodes at the same scale. Theoretical calculations verify that the enhanced performance could be attributed to the decreased adsorption energy of OH- and the down-shifted d-band of Ag atoms, which can accelerate the electron transport and ion transfer.

Portal vein thrombosis and food protein-induced allergic proctocolitis in a premature newborn with hypereosinophilia: a case report.

BACKGROUND: Peripheral blood eosinophilia is identified in numerous medical conditions associated with allergic, infectious, and inflammatory processes mostly as reactive eosinophilia with or without tissue eosinophilia. In hospitalized neonates, eosinophilia is common with an inverse relationship with gestational age and occurs solely as mild eosinophilia in the majority of cases. In the literature, eosinophilia has been proposed as a possible risk factor for venous thromboembolism. However, few reports are found on thromboembolic events including portal vein thrombosis (PVT) associated with eosinophilia in the newborn period. Neonates, particularly preterm infants, are vulnerable to thrombosis due to the immature and developing hemostatic system with little reserve capacity, which occurs as catheter-related thrombosis in most cases. CASE PRESENTATION: A male newborn at 34+ 5 weeks' gestation presented with a left portal venous thrombus and hematochezia after initial cow's milk feeding in the setting of blood hypereosinophilia for a prolonged period of time without central venous catheterization. The infant was diagnosed with PVT and food protein-induced allergic proctocolitis (FPIAP) and showed complete resolution of the conditions with expectant management with food avoidance, including the normalized eosinophil count. CONCLUSIONS: Our experience suggests that in the setting of hypereosinophilia with a prolonged duration in premature neonates, FPIAP should be suspected in case of hematochezia in otherwise healthy infants, and considering the increased thrombotic risk by the hypereosinophilia and premature newborn status, evaluation for neonatal thrombosis may be needed, including PVT with the potential risk for the more serious, but uncommon, late complications encompassing portal hypertension.

Explanting the Nellix Endovascular Aortic Sealing Endoprosthesis for Proximal Aortic Neck Failure.

Open conversion after endovascular aortic repair has inherent challenges particular to the device being explanted. The Nellix endograft is unlike any other device as it uses polymer filling of endobags within the aorto-iliac lumen to seal the abdominal aortic aneurysm (AAA) sac, a developing concept known as endovascular aneurysm sealing. Conversion to open repair of AAA treated with the Nellix endograft has rarely been discussed. Explants that have been previously reported were for graft infection. We present 2 Nellix graft explants that were required for device migration and subsequent development of a type IA endoleak. The technique and nuances observed during open conversion of this novel endograft for proximal aortic neck failure is described in this report.

An Impedance-Transduced Chemiresistor with a Porous Carbon Channel for Rapid, Nonenzymatic, Glucose Sensing.

A new type of chemiresistor, the impedance-transduced chemiresistor (ITCR), is described for the rapid analysis of glucose. The ITCR exploits porous, high surface area, fluorine-doped carbon nanofibers prepared by electrospinning of fluorinated polymer nanofibers followed by pyrolysis. These nanofibers are functionalized with a boronic acid receptor and stabilized by Nafion to form the ITCR channel for glucose detection. The recognition and binding of glucose by the ITCR is detected by measuring its electrical impedance at a single frequency. The analysis frequency is selected by measuring the signal-to-noise ( S/ N) for glucose detection across 5 orders of magnitude, evaluating both the imaginary and real components of the complex impedance. On the basis of this analysis, an optimal frequency of 13 kHz is selected for glucose detection, yielding an S/ N ratio of 60-100 for [glucose] = 5 mM using the change in the total impedance, Δ Z. The resulting ITCR glucose sensor shows a rapid analysis time (<8 s), low coefficient of variation for a series of sensors (<10%), an analysis range of 50 µM to 5 mM, and excellent specificity versus fructose, ascorbic acid, and uric acid. These metrics for the ITCR are obtained using a sample size as small as 5 µL.

Development of Angiosarcoma in a Saphenous Vein Graft after Femoral to Above-Knee Popliteal Artery Bypass.

Angiosarcoma is an exceedingly rare and aggressive neoplasm. Owing to early metastasis even in low-grade tumors, it is associated with poor survival. We report a late development of an angiosarcoma in a saphenous vein graft after a femoral artery to above-knee popliteal artery bypass performed for disabling claudication. Chronic inflammation, lymphatic disruption, and thrombosis of the graft may have contributed to the malignant transformation, similar to cases described as occurring after arteriovenous fistulae creation. This case illustrates that angiosarcoma may be a rare, late complication of autogenous vascular bypass.

Hypotension within 1 week of life associated with poor short- and long-term outcomes in very low birth weight infants.

We examined whether hypotension in very low birth weight infants aged⩽1 week was associated with hospital morbidities and overall mortality. Further, we studied whether hypotension was associated with poor neurodevelopmental outcomes in these patients at the corrected age of 18 months. A total of 166 very low birth weight infants were studied during this period. Hospital outcomes and neurodevelopmental outcomes at the corrected age of 18 months were evaluated. Among the 166 very low birth weight infants, 95 patients (57.2%) experienced hypotension at⩽1 week and were associated with an increased incidence of morbidities and mortality. At the corrected age of 18 months, hypotension of the⩽1 week group had significantly lower scores in all three - cognitive, language, and motor - composites of the Bayley Scales of Infant and Toddler Development, Third Edition (Bayley-III) screening tests. In addition, a multivariable logistic regression analysis showed that longer mechanical ventilation and periventricular leukomalacia were additionally associated with worse cognitive and language neurodevelopmental outcomes. Hypotension in very low birth weight infants within 1 week of life was associated with increased morbidities and overall mortality. It was also associated with an increased risk of cognitive and language outcomes.

Formation of a Surficial Bifunctional Nanolayer on Nb2 O5 for Ultrastable Electrodes for Lithium-Ion Battery.

Safe and long cycle life electrode materials for lithium-ion batteries are significantly important to meet the increasing demands of rechargeable batteries. Niobium pentoxide (Nb2 O5 ) is one of the highly promising candidates for stable electrodes due to its safety and minimal volume expansion. Nevertheless, pulverization and low conductivity of Nb2 O5 have remained as inherent challenges for its practical use as viable electrodes. A highly facile method is proposed to improve the overall cycle retention of Nb2 O5 microparticles by ammonia (NH3 ) gas-driven nitridation. After nitridation, an ultrathin surficial layer (2 nm) is formed on the Nb2 O5 , acting as a bifunctional nanolayer that allows facile lithium (Li)-ion transport (10-100 times higher Li diffusivity compared with pristine Nb2 O5 microparticles) and further prevents the pulverization of Nb2 O5 . With the subsequent decoration of silver (Ag) nanoparticles (NPs), the low electric conductivity of nitridated Nb2 O5 is also significantly improved. Cycle retention is greatly improved for nitridated Nb2 O5 (96.7%) compared with Nb2 O5 (64.7%) for 500 cycles. Ag-decorated, nitridated Nb2 O5 microparticles and nitridated Nb2 O5 microparticles exhibit ultrastable cycling for 3000 cycles at high current density (3000 mA g-1 ), which highlights the importance of the surficial nanolayer in improving overall electrochemical performances, in addition to conductive NPs.

In Situ High-Resolution Transmission Electron Microscopy (TEM) Observation of Sn Nanoparticles on SnO2 Nanotubes Under Lithiation.

We trace Sn nanoparticles (NPs) produced from SnO2 nanotubes (NTs) during lithiation initialized by high energy e-beam irradiation. The growth dynamics of Sn NPs is visualized in liquid electrolytes by graphene liquid cell transmission electron microscopy. The observation reveals that Sn NPs grow on the surface of SnO2 NTs via coalescence and the final shape of agglomerated NPs is governed by surface energy of the Sn NPs and the interfacial energy between Sn NPs and SnO2 NTs. Our result will likely benefit more rational material design of the ideal interface for facile ion insertion.

Cytogenetic profiles of 2806 patients with acute myeloid leukemia-a retrospective multicenter nationwide study.

The cytogenetic and molecular data is recognized as the most valuable prognostic factor in acute myeloid leukemia (AML). Our aim was to systemically analyze the cytogenetics of Korean AML patients and to compare the cytogenetic profiles of various races to identify possible geographic heterogeneity. We retrospectively reviewed medical records of 2806 AML patients diagnosed at 11 tertiary teaching hospitals in Korea between January 2007 and December 2011. The most common recurrent chromosomal abnormality was t(8;21) (8.8 %, 238/2717), but t(15;17) showed an almost same number (8.6 %,235/2717). Among de novo AML, the most frequent aberrations were t(15;17), observed in 229 (10.7 %). The most common French-American-British (FAB) classification type was M2 (32.2 %), and recurrent cytogenetic abnormalities correlated with the FAB subtypes. Among 283 secondary AML cases, myelodysplastic syndrome was the most common predisposing factor. About 67.1 % of the secondary AML cases were associated with chromosomal aberrations, and chromosome 7 abnormalities (n = 45, 15.9 %) were most common. The incidence of FLT3 internal tandem duplication mutation was relatively low at 15 %. Our study reports certain similarities and differences in comparison to previous reports. Such discrepancies call for extensive epidemiological studies to clarify the role of genetic as well as geographic heterogeneity in the pathogenesis of AML.

Expanded criteria for retinopathy of prematurity screening in moderately preterm infants: Single-center pilot study.

BACKGROUND: While developed countries seek to lower the gestational age and birthweight parameters in retinopathy of prematurity (ROP) screening, older, larger infants still develop ROP in other parts of the world. The aim of this study was therefore to define criteria to identify potential ROP developers who are outliers of the common screening range. METHODS: A retrospective medical record review was performed in 147 inborn moderately preterm infants admitted to the neonatal intensive care unit during the study period. Univariate and logistic regression analysis was carried out. RESULTS: Forty-two infants developed ROP. Gestational age (31.4 ± 1.1 vs 32.4 ± 1.0 weeks, P = 0.000) and birthweight (1607.7 ± 339.4 vs 1846.4 ± 317.2 g, P = 0.000) were lower in those who developed ROP. Respiratory distress syndrome (P = 0.026) and documented sepsis (P = 0.003) were significant comorbidities on univariate analysis. Inotrope need >72 h starting in the first week of life (P = 0.004; OR, 5.181) and more than three transfusions of packed red blood cells (P = 0.028; OR, 3.891) were also significant, both on univariate and multivariate analysis. CONCLUSIONS: In moderately preterm infants, status should be evaluated in order to effectively select candidates for ROP screening without missing potential ROP developers.

Outcomes of primary ligation of patent ductus arteriosus compared with secondary ligation after pharmacologic failure in very-low-birth-weight infants.

This study aimed to determine whether primary surgical closure of patent ductus arteriosus (PDA) is a risk factor for morbidity and mortality compared with secondary surgical ligation. The study enrolled 178 very-low-birth-weight infants. The surgical group included 34 patients who did not respond to pharmacologic intervention and eventually required ligation of their PDA as well as 35 patients who underwent direct ligation because of contraindications to the use of oral ibuprofen. The overall outcomes for the primary and secondary ligation groups were compared. The outcome during hospitalization showed no statistically significant difference in terms of morbidity and mortality between the two groups. The group that had primary ligation for PDA experienced more complications associated with premature birth such as lower gestational age and birth weight. The two groups did not differ significantly in terms of overall outcomes.

Predisposing Anatomy for Thoracic Outlet Syndrome and Functional Outcomes after Supraclavicular Thoracic Outlet Decompression in Athletes.

Purpose: This study aims to examine predisposing anatomic factors and subsequent post-decompression functional outcomes among high-intensity athletes with thoracic outlet syndrome (TOS). Materials and Methods: A single-institution retrospective review was performed on a prospective database of patients with TOS from 2018 to 2023 who had undergone operative decompression for TOS. Demographics, TOS characteristics, predisposing anatomy, operative details, and postoperative outcomes were examined. The primary outcome was postoperative return to sport. Secondary outcomes included vascular patency. Results: A total of 13 patients who were engaged in high-demand athletic activity at the time of their diagnosis were included. Diagnoses included 8 (62%) patients with venous TOS, 4 (31%) patients with neurogenic TOS, and 1 (8%) patient with arterial TOS. Mixed vascular and neurogenic TOS was observed in 3 (23%) patients. The mean age of the cohort was 30 years. Abnormal scalene structure was observed in 12 (92%) patients, and abnormal bone structures were noted in 4 (27%) patients; 2 (15%) with cervical ribs and 3 (23%) patients with clavicular abnormalities. Prior ipsilateral upper extremity trauma was reported in 4 (27%) patients. Significant joint hypermobility was observed in 8 (62%) patients with a median Beighton score of 6. Supraclavicular cervical and/or first rib resection with scalenectomy was performed in all patients. One case of postoperative pneumothorax was treated non-operatively. Ten (77%) patients returned to sport. Duplex ultrasonography showed subclavian vein patency in all 8 patients with venous TOS and wide patency with no drop in perfusion indices in the patient with arterial TOS. Conclusion: Athletes with TOS who required operative intervention had a high incidence of musculoskeletal aberrations and joint hypermobility. Supraclavicular decompression was associated with a high success rate, with overall good functional outcomes and good likelihood of patients returning to preoperative high-intensity athletics.

Versatile Applications of Silver Nanowire-Based Electrodes and Their Impacts.

Indium tin oxide (ITO) is currently the most widely used material for transparent electrodes; however, it has several drawbacks, including high cost, brittleness, and environmental concerns. Silver nanowires (AgNWs) are promising alternatives to ITO as materials for transparent electrodes owing to their high electrical conductivity, transparency in the visible range of wavelengths, and flexibility. AgNWs are effective for various electronic device applications, such as touch panels, biosensors, and solar cells. However, the high synthesis cost of AgNWs and their poor stability to external chemical and mechanical damages are significant challenges that need to be addressed. In this review paper, we discuss the current state of research on AgNW transparent electrodes, including their synthesis, properties, and potential applications.

Thoroughly Hydrophilized Electrospun Poly(L-Lactide)/ Poly(ε-Caprolactone) Sponges for Tissue Engineering Application.

Biodegradable electrospun sponges are of interest for various applications including tissue engineering, drug release, dental therapy, plant protection, and plant fertilization. Biodegradable electrospun poly(l-lactide)/poly(ε-caprolactone) (PLLA/PCL) blend fiber-based sponge with hierarchical pore structure is inherently hydrophobic, which is disadvantageous for application in tissue engineering, fertilization, and drug delivery. Contact angles and model studies for staining with a hydrophilic dye for untreated, plasma-treated, and surfactant-treated PLLA/PCL sponges are reported. Thorough hydrophilization of PLLA/PCL sponges is found only with surfactant-treated sponges. The MTT assay on the leachates from the sponges does not indicate any cell incompatibility. Furthermore, the cell proliferation and penetration of the hydrophilized sponges are verified by in vitro cell culture studies using MG63 and human fibroblast cells.

A π-Bridge Spacer Embedded Electron Donor-Acceptor Polymer for Flexible Electrochromic Zn-Ion Batteries.

Zinc-ion batteries (ZIBs) have drawn much attention for next-generation energy storage for smart and wearable electronics due to their high theoretical gravimetric/volumetric energy capacities, safety from explosive hazards, and cost-effectiveness. However, current state-of-the-art ZIBs lack the energy capacity necessary to facilitate smart functionalities for intelligent electronics. In this work, a "π-bridge spacer"-embedded electron donor-acceptor polymer cathode combined with a Zn2+ -ion-conducting electrolyte is proposed for a smart and flexible ZIB to provide high electrochromic-electrochemical performances. The π-bridge spacer endows the polymeric skeleton with improved physical ion accessibility and sensitive charge transfer through the cycles, providing extremely stable cyclability with high specific capacity (110 mAh g-1 ) at very fast rates (8 A g-1 ) and large coloration efficiency (79.8 cm2  C-1 ) under severe mechanical deformation over a long period. These results are markedly outstanding compared to the topological analogue without the π-bridge spacer (80 mAh g-1 at current density of 8 A g-1 , 63.0 cm2  C-1 ). The design to incorporate a π-bridge spacer realizes notable electrochromism behaviors and high electrochemical performance, which sheds light on the rational development of multifunctional flexible-ZIBs with color visualization properties for widespread usage in powering smart electronics.

Inspired by Wood: Thick Electrodes for Supercapacitors.

The emergence and development of thick electrodes provide an efficient way for the high-energy-density supercapacitor design. Wood is a kind of biomass material with porous hierarchical structure, which has the characteristics of a straight channel, uniform pore structure, good mechanical strength, and easy processing. The wood-inspired low-tortuosity and vertically aligned channel architecture are highly suitable for the construction of thick electrochemical supcapacitor electrodes with high energy densities. This review summarizes the design concepts and processing parameters of thick electrode supercapacitors inspired by natural woods, including wood-based pore structural design regulation, electric double layer capacitances (EDLCs)/pseudocapacitance construction, and electrical conductivity optimization. In addition, the optimization strategies for preparing thick electrodes with wood-like structures (e.g., 3D printing, freeze-drying, and aligned-low tortuosity channels) are also discussed in detail. Further, this review presents current challenges and future trends in the design of thick electrodes for supercapacitors with wood-inspired pore structures. As a guideline, the brilliant blueprint optimization will promote sustainable development of wood-inspired structure design for thick electrodes and broaden the application scopes.