Research on cognitive impairment and potential risk factors in peritoneal dialysis patients: An observational study.

The objective of this study is to investigate the associated risk factors and their effects on cognitive impairment (CI) in patients undergoing peritoneal dialysis. A retrospective analysis was conducted on the basic information of 268 patients who underwent continuous ambulatory peritoneal dialysis (CAPD) at our hospital from January 2020 to September 2023. Cognitive function was assessed using the Montreal Cognitive Assessment Scale during their subsequent dialysis visits. Participants were categorized into a CI group and a cognitively normal group. Blood and other biological samples were collected for relevant biomarker analysis. Subsequently, we analyzed and compared the factors influencing CI between the 2 groups. The prevalence of CI among CAPD patients was 58.2%. Compared to the cognitively normal group, the CI group had a higher prevalence of alcohol consumption, lower levels of education, and reduced serum uric acid levels (P < .05). There was also a higher incidence of autoimmune diseases such as systemic lupus erythematosus in the CI group (P < .05). In terms of dialysis efficacy, the residual kidney Kt/V and residual kidney Ccr were significantly lower in the CI group compared to the cognitively normal group. In blood parameters, the CI group showed elevated total cholesterol levels and lower serum calcium concentrations (P < .05). Logistic regression analysis identified male gender, older age, lower educational attainment, hypercholesterolemia, and elevated high-sensitivity C-reactive protein levels as independent risk factors for CI in CAPD patients (P < .05). Additionally, in this patient cohort, dialysis duration and residual renal function were protective factors against CI (P < .05). CI is prevalent among PD patients. Elevated high-sensitivity C-reactive protein levels, male gender, older age, lower educational attainment, and hypercholesterolemia constitute an independent risk factor for CI in CAPD patients, whereas residual renal function acts as a protective element.

The role of arsenic in the operation of sulfur-based electrical threshold switches.

Arsenic is an essential dopant in conventional silicon-based semiconductors and emerging phase-change memory (PCM), yet the detailed functional mechanism is still lacking in the latter. Here, we fabricate chalcogenide-based ovonic threshold switching (OTS) selectors, which are key units for suppressing sneak currents in 3D PCM arrays, with various As concentrations. We discovered that incorporation of As into GeS brings >100 °C increase in crystallization temperature, remarkably improving the switching repeatability and prolonging the device lifetime. These benefits arise from strengthened As-S bonds and sluggish atomic migration after As incorporation, which reduces the leakage current by more than an order of magnitude and significantly suppresses the operational voltage drift, ultimately enabling a back-end-of-line-compatible OTS selector with >12 MA/cm2 on-current, ~10 ns speed, and a lifetime approaching 1010 cycles after 450 °C annealing. These findings allow the precise performance control of GeSAs-based OTS materials for high-density 3D PCM applications.

Bladder perforation injury after percutaneous peritoneal dialysis catheterization: A case report.

BACKGROUND: Insertion of a catheter into the bladder is a rare complication of peritoneal dialysis (PD), and is mainly related to surgical injury. This paper reports a case of bladder perforation that was caused by percutaneous PD catheterization. CASE SUMMARY: A 64-year-old man underwent percutaneous PD catheterization for end-stage renal disease. On the second day after the operation, urgent urination and gross hematuria occurred. Urinalysis showed the presence of red and white blood cells. Empirical anti-infective treatment was given. On the third day after the operation, urgent urination occurred during PD perfusion. Ultrasound showed that the PD catheter was located in the bladder, and subsequent computed tomography (CT) showed that the PD catheter moved through the anterior wall into the bladder. The PD catheter was withdrawn from the bladder and catheterization was retained. Repeat CT on the fourth day after the operation showed that the PD catheter was removed from the bladder, but there was poor catheter function. The PD catheter was removed and the patient was changed to hemodialysis. CT cystography showed that the bladder healed well and the patient was discharged 14 d after the operation. CONCLUSION: Bladder perforation injury should be considered and treated timeously in case of bladder irritation during and after percutaneous PD catheterization. The use of Doppler ultrasound and other related technologies may reduce the incidence of such complications.

AKT3 and related molecules as potential biomarkers responsible for cryptorchidism and cryptorchidism-induced azoospermia.

BACKGROUND: Cryptorchidism is a common congenital malformation strongly related to future oligospermia and male infertility. Normally functioning early-stage spermatogonia are vital to ensure fertility. The present study aimed to identify new differentially expressed genes (DEGs) associated with signaling pathways related to spermatogonial stem cell (SSC) maintenance during early spermatogenesis. METHODS: GEO2R was used to screen for genes differentially regulated in cryptorchidism using mRNA expression profiling data in the GEO database. DAVID was used to perform GO and KEGG enrichment analysis of DEGs to analyze their functions. A protein-protein interaction (PPI) network of DEGs was constructed using the STRING database. The hub genes in the PPI networks were identified using Maximal Clique Centrality (MCC) in Cytohubba, and the top 50 genes were displayed as hub genes using Cytoscape software. Then, the miRNAs targeting hub genes were predicted using miRWalk and an mRNA-miRNA interaction network was constructed using Cytoscape. We took the intersection of these target miRNAs and the differentially expressed miRNAs identified from a non-coding RNA sequencing dataset, GSE149084. Furthermore, the intersected miRNAs and their predicted target genes were validated in the testicular tissue of rats with cryptorchidism. RESULTS: A total of 474 DEGs were identified, most of which were annotated to the PI3K-AKT-mTOR signaling pathway. Hub genes related to the pathway were predicted to be targeted by 27 miRNAs. Further miRNA mining revealed that miRNA-7-5p and miRNA-519d-3p were both dysregulated in cryptorchidism patients. Further, we found that these two miRNAs were predicted with high confidence to share a common target gene, AKT3. In the testicular tissue of rats with cryptorchidism, miRNA-519d-3p was upregulated while miRNA-7-5p and AKT3 were downregulated. We also found that AKT3 plays an essential role in regulating SSC state through the PI3K-AKT-mTOR signaling pathway and that AKT3 is one of the key genes related to SSC self-renewal, proliferation, and differentiation. CONCLUSIONS: The PI3K-AKT-mTOR signaling pathway functions in SSC maintenance, and alterations in this pathway may explain defects in spermatogenesis. AKT3-related miRNAs, including hsa-miR-7-5p and hsa-miR-519d-3p, might be responsible for cryptorchidism and cryptorchidism-induced azoospermia and serve as potential biomarkers.

Elemental electrical switch enabling phase segregation-free operation.

Nonvolatile phase-change memory has been successfully commercialized, but further density scaling below 10 nanometers requires compositionally and structurally homogeneous materials for both the memory cell and the associated vertically stacked two-terminal access switch. The selector switches are mostly amorphous-chalcogenide Ovonic threshold switches (OTSs), operating with a nonlinear current response above a threshold voltage in the amorphous state. However, they currently suffer from the chemical complexity introduced by the quaternary or even more diverse chalcogenide compositions used. We present a single-element tellurium (Te) volatile switch with a large (≥11 megaamperes per square centimeter) drive current density, ~103 ON/OFF current ratio, and faster than 20 nanosecond switching speed. The low OFF current arises from the existence of a ~0.95­electron volt Schottky barrier at the Te­electrode interface, whereas a transient, voltage pulse­induced crystal-liquid melting transition of the pure Te leads to a high ON current. Our discovery of a single-element electrical switch may help realize denser memory chips.

A new opportunity for the emerging tellurium semiconductor: making resistive switching devices.

The development of the resistive switching cross-point array as the next-generation platform for high-density storage, in-memory computing and neuromorphic computing heavily relies on the improvement of the two component devices, volatile selector and nonvolatile memory, which have distinct operating current requirements. The perennial current-volatility dilemma that has been widely faced in various device implementations remains a major bottleneck. Here, we show that the device based on electrochemically active, low-thermal conductivity and low-melting temperature semiconducting tellurium filament can solve this dilemma, being able to function as either selector or memory in respective desired current ranges. Furthermore, we demonstrate one-selector-one-resistor behavior in a tandem of two identical Te-based devices, indicating the potential of Te-based device as a universal array building block. These nonconventional phenomena can be understood from a combination of unique electrical-thermal properties in Te. Preliminary device optimization efforts also indicate large and unique design space for Te-based resistive switching devices.

Ultrahigh drive current and large selectivity in GeS selector.

Selector devices are indispensable components of large-scale nonvolatile memory and neuromorphic array systems. Besides the conventional silicon transistor, two-terminal ovonic threshold switching device with much higher scalability is currently the most industrially favored selector technology. However, current ovonic threshold switching devices rely heavily on intricate control of material stoichiometry and generally suffer from toxic and complex dopants. Here, we report on a selector with a large drive current density of 34 MA cm-2 and a ~106 high nonlinearity, realized in an environment-friendly and earth-abundant sulfide binary semiconductor, GeS. Both experiments and first-principles calculations reveal Ge pyramid-dominated network and high density of near-valence band trap states in amorphous GeS. The high-drive current capacity is associated with the strong Ge-S covalency and the high nonlinearity could arise from the synergy of the mid-gap traps assisted electronic transition and local Ge-Ge chain growth as well as locally enhanced bond alignment under high electric field.

Observation of van der Waals reconfiguration in superlattice phase change materials.

Phase change memory (PCM) is a leading candidate for nonvolatile memory applications in the big data era. However, the high power consumption, caused by melting GeTe-Sb2Te3-like phase change materials, hinders their applications. A significant step is the proposal to spatially separate GeTe and Sb2Te3 in the form of a superlattice, enabling a higher operating speed and better cyclability at reduced switching energy. However, the physical origin is under intensive debate. Recently, the swapping of the SbTe terminating layers nearest to the van der Waals (vdWs) gap has been claimed to be the mechanism for the superlattice. Here, we reported a direct atomic-scale chemical identification of two kinds of vdWs reconfigurations together with atomic simulations. The vdWs reconfigurations, which occurred at the GeTe and Sb2Te3 boundary, were demonstrated to change the electrical properties and turn this semiconductor into a conductor, leading to the resistance contrast. Besides, strong intermixing of Ge and Sb atoms was directly observed; in the most severe cases, ∼50% of Ge in the GeTe layer diffused into the adjacent Sb2Te3 layer. Our work paves the way for deeper understanding of the phase transition of the GeTe/Sb2Te3 superlattice and the future design of non-volatile memories towards dynamic random access-like memories.