Patient-related barriers and enablers to the implementation of high-value physiotherapy for chronic pain: a systematic review.

OBJECTIVE: To identify and synthesize patient-related barriers to and enablers of the implementation of high-value physiotherapy (HVP) for chronic pain. Furthermore, to review what patient-related interventions have been used to facilitate the implementation of HVP for chronic pain, as well as their efficacy. METHODS: We systematically searched the APA PsycInfo, Embase, CINAHL, Medline, Scopus, and PEDro databases for peer-reviewed studies (published in English) of adults with chronic pain. We used the Theoretical Domains Framework of behavior change to synthesize identified themes relating to barriers and enablers. Outcomes from studies reporting on interventions were also qualitatively synthesized. RESULTS: Fourteen studies reported on barriers and enablers, 8 of which related to exercise adherence. Themes common to barriers and enablers included perceived efficacy of treatment, interrelationship with the physiotherapist, exercise burden, and the patient's understanding of exercise benefits. Other barriers included fear of movement, fragmented care, and cost. Ten studies explored interventions, 9 of which aimed to improve exercise adherence. Of these, evidence from 4 randomized controlled trials of technology-based interventions demonstrated improved exercise adherence among intervention groups compared with controls. CONCLUSION: Patients with chronic pain experience barriers to HVP, including their beliefs, the nature of their interaction with their physiotherapist, perceived treatment efficacy, and cost. Enablers include rapport with their physiotherapist, achievable exercises, and seamless cost-effective care. Technology-based interventions have demonstrated effectiveness at increasing exercise adherence. Our findings suggest that interventions seeking to enhance implementation of HVP need to consider the multifactorial barriers experienced by patients with chronic pain. STUDY REGISTRATION: Open Science Framework (https://doi.org/10.17605/OSF.IO/AYGZV).

Origin of Superlinear Power Dependence of Reaction Rates in Plasmon-Driven Photocatalysis: A Case Study of Reductive Nitrothiophenol Coupling Reactions.

The superlinear dependence of the reaction rate on the power of the excitation light, which may arise from both thermal and nonthermal effects, has been a hallmark of plasmon-driven photocatalysis on nanostructured metal surfaces. However, it remains challenging to distinguish and quantify the thermal and nonthermal effects because even slight uncertainties in measuring the local temperatures at the active surface sites may lead to significant errors in assessing thermal and nonthermal contributions to the overall reaction rates. Here we employ surface-enhanced Raman scattering as a surface-sensitive in situ spectroscopic tool to correlate detailed kinetic features of plasmon-mediated molecular transformations to the local temperatures at the active sites on photocatalyst surfaces. Our spectroscopic results clearly reveal that the superlinearity in the power dependence of the reaction rate observed in a plasmon-driven model reaction, specifically the reductive coupling of para-nitrothiophenol adsorbates on Ag nanoparticle surfaces, originates essentially from photothermal heating rather than nonthermal plasmonic effects.

Effects of Cascading Optical Processes: Part II: Impacts on Experimental Quantification of Sample Absorption and Scattering Properties.

In Part I of the three companion articles, we reported the effects of light scattering on experimental quantification of scattering extinction, intensity, and depolarization in solutions that contain only scatterers with no significant absorption and photoluminescence activities. The present work (Part II) studies the effects of light scattering and absorption on a series of optical spectroscopic measurements done on samples that contain both absorbers and scatterers, but not emitters. The experimental UV-vis spectrum is the sum of the sample absorption and scattering extinction spectra. However, the upper limit of the experimental Beer's-law-abiding extinction can be limited prematurely by the interference of forward scattered light. Light absorption reduces not only the sample scattering intensity but also the scattering depolarization. The impact of scattering on sample light absorption is complicated, depending on whether the absorption of scattered light is taken into consideration. Scattering reduces light absorption along the optical path length from the excitation source to the UV-vis detector. However, the absorption of the scattered light can be adequate to compensate the reduced light absorption along such optical path, making the impacts of light scattering on the sample total light absorption negligibly small (<10%). The latter finding constitutes a critical validation of the integrating-sphere-assisted resonance synchronous spectroscopic method for experimental quantification of absorption and scattering contribution to the sample UV-vis extinction spectra. The techniques and general guidelines provided in this work should help improve the reliability of optical spectroscopic characterization of nanoscale or larger materials, many of which are simultaneous absorbers and scatterers. The insights from this work are foundational for Part III of this series of work, which is on the cascading optical processes on spectroscopic measurements of fluorescent samples.

Optoelectronic properties of black silicon fabricated by femtosecond laser in ambient air: exploring a large parameter space.

We study the surface morphology, optical absorption (400-1100 nm), and carrier lifetime of black silicon fabricated by femtosecond (fs) laser in air. We explore a large laser parameter space, for which we adopt a single parameter ξ to describe the cumulative fluence delivered to the sample. We also study the laser-oxidized surface layer by measuring its photoluminescence spectra and comparing its effect on the aforementioned properties. Our study in a broad range of ξ is instructive in choosing laser parameters when targeting different applications.

Effect of exercise on chronic neck pain and central sensitization: A protocol for a randomized crossover trial.

Exercise-induced hypoalgesia (EIH) has been found to vary widely within individuals with chronic neck pain (NP). Research has suggested that the presence of central sensitization within a subgroup of individuals with chronic NP might be a mediating factor to explain the relationship between exercise and improvements in patient-reported outcomes. Furthermore, recent work has found that lactate might play a role in the development and maintenance of chronic pain. The immediate effect of a single bout of physical exercise on central sensitization in individuals with chronic NP and the relationship between lactate concentration, central sensitization and pain sensitivity are to be investigated. Eighty adult participants with chronic NP will be recruited for this randomized crossover trial. Outcome measures, including temporal summation, conditioned pain modulation, EIH and lactate concentration, will be assessed before and after low- and high-intensity bicycling exercise. The outcomes of this study will provide new insights into the mechanistic effect of exercise on central sensitization in individuals with chronic NP and have the potential to add important information to the current exercise prescription guidelines for individuals with chronic NP. This study has been approved by the Human Research Ethics Committee, The University of Adelaide (H-2022-082) and registered in the Australian New Zealand Clinical Trials Registry (ACTRN12622000642785p).

Physiological and Cognitive Determinants of Gait Variability of Asian Population: The Yishun Study.

INTRODUCTION: Gait variability is associated with frailty, dementia, and falls. Studies on the association of physiological and cognitive factors with gait variability have seldom included middle-aged adults, even though these adults already experienced loss of muscular strength and postural stability. This study aimed a) to examine and compare the trend of gait variability in men and women, across the adult age spectrum, and b) to identify and compare the contributions of physiological and cognitive factors to gait variability. METHODS: This was a population-based cross-sectional study at a single center. A random sample of 507 community-dwelling, well-functioning adults aged 21-90 years were studied. Cognition was measured using the Repeatable Battery for the Assessment of Neuropsychological Status. Physiological factors examined included visual contrast sensitivity (VCS), postural sway, hand reaction time, handgrip strength (HGS), knee extensor strength, and gait variability (coefficient of variation [CoV]). Multivariable regression models were used to examine the association between physiological and cognitive performance with gait CoV. RESULTS: Women walked with greater stride width CoV (p < 0.01) and double support time (DST) CoV (p < 0.01) than men. The stride width (p = 0.01) and DST variability (p = 0.03) were significantly higher in older men as compared to men in younger age-groups. Gait speed accounted for most of the gait CoV variances and attenuated the effects of physiological performance and/or attention cognition on most gait variability, except for CoV of DST and stride width. Adults with better VCS (ß = -0.19), faster hand reaction (ß = 0.12), and greater HGS (ß = -0.15) had lower variability in step length. CONCLUSION: The trends of stride width CoV and DST CoV across adult age spectrum were different between men and women. Greater stride width variability was partly attributed to greater HGS, possibly to better control lateral stability during walking. Physiological factors outweigh cognition in regulating most of the gait CoV in this study. They are modifiable and potential targets for healthy aging program.

Exercise-induced hypoalgesic effects of different types of physical exercise in individuals with neck pain: A systematic review and meta-analysis.

OBJECTIVE: To evaluate the exercise-induced hypoalgesic (EIH) effects of different types of physical exercise in individuals with neck pain. DESIGN: Systematic review with meta-analysis. LITERATURE SEARCH: An electronic search of six databases was completed to include studies assessing EIH effects on neck pain. STUDY SELECTION CRITERIA: Randomized controlled trials, controlled trials, and observational studies that assessed before and immediate after-effects of a single session of physical exercise in people with neck pain were included. Two reviewers independently screened records, extracted outcomes, assessed the risk of bias, and rated the quality of evidence using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach. DATA SYNTHESIS: EIH is characterized by increased pain threshold, pain tolerance, and/or decreased sensitivity to painful stimuli or unpleasantness, which may last up to 30 min after a single bout of exercise. EIH is usually measured with quantitative sensory testing (QST) and is mostly taken as the difference between pre- and postexercise pressure pain threshold (PPT). Data were pooled and analyzed using a fixed-effect meta-analysis. RESULTS: Eleven articles were included in this review; nine with low risk of bias and two with some concerns about the risk of bias. Three studies with chronic whiplash-associated disorders (WAD) were included in the meta-analysis; isometric exercise had a larger EIH effect at the local testing site compared with submaximal aerobic exercises (MD = -0.21, [95% CI = -0.43, 0.00], p = 0.05, I2  = 92%), submaximal aerobic and isometric exercises had equal EIH effects at the remote testing site (MD = 0.01, [95% CI = -0.33, 0.35], p = 0.95, I2  = 0%), and submaximal aerobic exercises exerted comparably larger EIH effect at the remote testing site than local testing site (MD = -0.01, [95% CI = -0.20, 0.18], p = 0.93, I2  = 56%). The certainty of evidence (GRADE) for these analyses was low to very low. According to the descriptive analysis of the studies of chronic nonspecific neck pain, isometric and range of motion (ROM) exercises have shown EIH effects. Active stretching exercises have illustrated contradictory effects. CONCLUSION: Isometric and ROM exercises exerted hypoalgesia at local and remote sites. A larger EIH effect following submaximal aerobic exercises was exerted at the remote testing site compared with the local site.

Plasmon-driven oxidative coupling of aniline-derivative adsorbates: A comparative study of para-ethynylaniline and para-mercaptoaniline.

Plasmon-driven photocatalysis has emerged as a paradigm-shifting approach, based on which the energy of photons can be judiciously harnessed to trigger interfacial molecular transformations on metallic nanostructure surfaces in a regioselective manner with nanoscale precision. Over the past decade, the formation of aromatic azo compounds through plasmon-driven oxidative coupling of thiolated aniline-derivative adsorbates has become a testbed for developing detailed mechanistic understanding of plasmon-mediated photochemistry. Such photocatalytic bimolecular coupling reactions may occur not only between thiolated aniline-derivative adsorbates but also between their nonthiolated analogs. How the nonthiolated adsorbates behave differently from their thiolated counterparts during the plasmon-driven coupling reactions, however, remains largely unexplored. Here, we systematically compare an alkynylated aniline-derivative, para-ethynylaniline, to its thiolated counterpart, para-mercaptoaniline, in terms of their adsorption conformations, structural flexibility, photochemical reactivity, and transforming kinetics on Ag nanophotocatalyst surfaces. We employ surface-enhanced Raman scattering as an in situ spectroscopic tool to track the detailed structural evolution of the transforming molecular adsorbates in real time during the plasmon-driven coupling reactions. Rigorous analysis of the spectroscopic results, further aided by density functional theory calculations, lays an insightful knowledge foundation that enables us to elucidate how the alteration of the chemical nature of metal-adsorbate interactions profoundly influences the transforming behaviors of the molecular adsorbates during plasmon-driven photocatalytic reactions.

Associations of low handgrip strength and hand laterality with cognitive function and functional mobility - the Yishun Study.

BACKGROUND: Emerging evidence suggest that in addition to low hand grip strength (HGS), HGS asymmetry is associated with declining cognitive and physical functions. We examined the associations of low HGS and asymmetry with cognitive function and functional mobility in older adults. METHODS: Cross-sectional data of 330 community-dwelling adults (55.2% women) aged ≥ 55 years included HGS, Repeated Battery for the Assessment of Neuropsychological Status (RBANS), and Timed-Up-and-Go (TUG). Low HGS was defined as < 28 kg for men and < 18 kg for women. Participants with HGS above 10% stronger on either hand were considered as having HGS asymmetry. Multiple linear regression models were adjusted for sociodemographic, smoking, education, comorbidity count, physical activity participation, obesity, self-rated health and hand dominance. RESULTS: Low HGS, but not asymmetry, was independently associated with lower functional mobility performance (ß = 1.3, 95%CI = 0.6,1.9), global cognitive function (ß = -10.4, 95%CI = -17.0,-3.8), immediate (ß = -2.6, 95%CI = -4.5,-0.7) and delayed (ß = -2.8, 95%CI = -5.0,-0.7) memory. Compared to normal and symmetric HGS participants, low HGS in combination with HGS asymmetry was associated with poorer language scores. In participants with normal HGS, asymmetric HGS was associated with slower TUG than corresponding groups with symmetric HGS. CONCLUSION: Low HGS, but not asymmetry, was associated with lower cognition and functional mobility. Associations of combined low HGS and asymmetry with cognitive and physical functions were driven by grip strength rather than asymmetry.

Efficient photon capture on germanium surfaces using industrially feasible nanostructure formation.

Nanostructured surfaces are known to provide excellent optical properties for various photonics devices. Fabrication of such nanoscale structures to germanium (Ge) surfaces by metal assisted chemical etching (MACE) is, however, challenging as Ge surface is highly reactive resulting often in micron-level rather than nanoscale structures. Here we show that by properly controlling the process, it is possible to confine the chemical reaction only to the vicinity of the metal nanoparticles and obtain nanostructures also in Ge. Furthermore, it is shown that controlling the density of the nanoparticles, concentration of oxidizing and dissolving agents as well as the etching time plays a crucial role in successful nanostructure formation. We also discuss the impact of high mobility of charge carriers on the chemical reactions taking place on Ge surfaces. As a result we propose a simple one-step MACE process that results in nanoscale structures with less than 10% surface reflectance in the wavelength region between 400 and 1600 nm. The method consumes only a small amount of Ge and is thus industrially viable and also applicable to thin Ge layers.

Physiological and Cognitive Determinants of Dual-Task Costs for Gait Parameters: The Yishun Study.

BACKGROUND: Studies indicate that physiological and cognitive aging are causally related and functionally interdependent. However, the relative contribution of physiological factors and cognition to dual-task costs (DTC) of gait parameters has not been well studied. In this cross-sectional study, we examined the trajectory of DTC of gait parameters across the adult age spectrum for both sexes and identified the contributions of physical and cognitive performance to DTC of gait. METHODS: A total of 492 community-dwelling adults, aged 21-90 years, were randomly recruited into the study. Participants were divided into 7 age groups, with 10-year age range for each group. Demographic data, height, body mass, education level, and information on comorbidities were recorded. Cognition was measured using the Repeatable Battery for the Assessment of Neuropsychological Status. Physical performance included visual contrast sensitivity, postural sway, hand reaction time, handgrip strength, knee extensor strength, and single-task and dual-task gait assessments. Stepwise multivariable regression was used to examine the association between physical and cognitive performance with DTC of gait parameters. RESULTS: Women were found to have significantly higher DTC of gait speed (p = 0.01), cadence (p < 0.01), and double support time (p < 0.01) than men. However, significant aging effect on DTC of gait speed (p = 0.01), step length (p = 0.01), and double support time (p = 0.01) was observed in men but not in women. Immediate memory was the primary determinant for the DTC of gait speed (ß = -0.25, p < 0.01), step length (ß = -0.22, p < 0.01), and cadence (ß = -0.15, p = 0.03) in men. Besides immediate memory, postural sway (ß = -0.13, p = 0.03) and hand reaction (ß = 0.14, p = 0.02) were also significantly associated with DTC of step length and cadence, respectively, in women. CONCLUSION: There were sex differences in the amplitude and trajectories of DTC of gait parameters. The DTC increased with age in men but not in women. Immediate memory was the primary determinant of DTC of gait parameters in men while immediate memory, postural sway, and reaction time were associated with DTC of gait in women. Future studies should investigate the clinical implications of the sex differences in the DTC with fall risks.

Relationship between BMI with percentage body fat and obesity in Singaporean adults - The Yishun Study.

BACKGROUND: The main aim of this study was to the determine relationship between Body Mass Index (BMI) and percentage body fat (BF%) in Singaporean adults, derive a prediction model to estimate BF%, and to report population BF%. The secondary aim was to determine the prevalence of overweight and obesity based on BF% threshold and the new risk categories for obesity in Singaporean population. METHODS: This was a population-based study of 542 community-dwelling Singaporeans (21-90 years old, 43.1% men). Anthropometry and body composition were assessed. Relationship between BMI and BF% were analysed using multiple regression models. Prevalence of overweight and obesity were estimated using WHO and Singapore Ministry of Health (MOH) Clinical Practice Guidelines for BMI classification, and BF% cut-off points of 25 and 35% for men and women respectively. RESULTS: We derived a prediction model to estimate BF% based on BMI, age and sex. The current cohort of Singaporeans when compared to Caucasians in the US and Europe as well as a Singapore cohort from 20 years age have higher BF% when matched for BMI, age, and sex. The overall population-adjusted prevalence of obesity according to WHO International classification (BMI ≥30 kg/m2) was 12.9% (14.9% men; 11.0% women); and 26.6% (30.7% men; 22.8% women) according to the MOH classification (BMI ≥27.5 kg/m2). However, using the BF% cut-off (> 25% for men and > 35% for women) resulted in very high prevalence of obesity of 82.0% (80.2% men; 83.8% women). CONCLUSION: There is a large discrepancy between BF% and BMI measured obesity in Singaporean adults. The results confirmed that Singaporean adults have higher BF% at lower BMI compared to US and Europe white counterparts; and that BF% in our population has increased over two decades.

Analysis of 85 Cases of Minimal Media Lower Hemisternotomy for Congenital Cardiac Surgery Under Cardiopulmonary Bypass in Infants.

OBJECTIVE: To investigate the feasibility and effect of minimal media lower hemisternotomy for cardiac surgery under cardiopulmonary bypass (CPB) in infant congenital heart disease. METHODS: In our hospital from May 2019 to October 2019, 170 infants with congenital heart disease underwent surgical treatment (median age 6.6 months; weight 6.0 kg). They were divided into 2 groups: those with conventional chest median incision and those with minimal sternotomy. Minimal lower hemisternotomy began from the third intercostal level and ended 0.5 cm above the xiphoid, just enough to insert a small sternal distractor. RESULTS: There was no significant difference between the 2 groups in CPB time. The operation time of small incision group was slightly longer (P < .05). There was no difference in prognosis between the 2 groups, but the wound length of the small incision group was significantly reduced (4.0 ± 0.5 versus 7.8 ± 0.8 cm, P < .05). Time of intensive care unit and hospital stay was shorter among hemisternotomy patients at a statistically significant level (P < .05). CONCLUSION: Minimal media lower hemisternotomy with the basic advantages of the sternal incision can expose the various parts of the heart, which meets most cardiac exploration and surgical operation needs, and the incision may still be extended if necessary. Lower hemisternotomy appears to be a safe, effective, and versatile alternative for many surgical interventions in infants with congenital heart disease.

Bone mineral density reference values in Singaporean adults and comparisons for osteoporosis establishment - The Yishun Study.

BACKGROUND: While there have been studies in Singapore on the prevalence and economic burden of osteoporotic hip fracture, there is a severe lack of reference data on bone mineral density and prevalence of osteoporosis. The purpose of this study is to establish the reference values for BMD and compare prevalence of osteoporotic conditions using other available reference values so as to better understand the status of bone health in Singaporean adults. METHODS: We carried out a population-based cross-sectional study using dual-energy x-ray absorptiometry (Hologic Discovery Wi) to measure the bone mineral density of Singaporean adults aged ≥21 years. A total of 542 participants were recruited from the large north-eastern residential town of Yishun. We computed T- scores (denoted by TSG) for each individual in the study. Similar diagnoses were also done based on T-scores provided by the densitometer (TDXA), NHANES database (TNHANES), and China (TCHN), and the differences in prevalence compared. We then compared the concordance between TSG and TDXA in the classification of osteoporosis. Osteoporosis was defined according to criteria by the World Health Organization (WHO). RESULTS: Peak lumbar spine BMD was 1.093 ± 0.168 g/cm2 in women, and 1.041 ± 0.098 g/cm2 for men. Peak whole-body BMD was 1.193 ± 0.93 g/cm2 in women at, and 1.224 ± 0.112 g/cm2 for men. Prevalence of osteoporosis based on lumbar spine was 9.3% in postmenopausal women, and 0.7% in men after 50 years of age. The percentage difference in prevalence range from 60.5-163.6%, when using reference values from TDXA, TNHANES, and TCHN. Comparing diagnosis using TDXA and TSG cut-off values, 28 versus 15 women were diagnosed as osteoporotic respectively.  The kappa statistics was 0.81 for women and 0.85 for men. CONCLUSION: Our study shows that T-scores provided by DXA manufacturer over-diagnosed osteoporosis in Singaporeans, and the prevalence of osteoporotic conditions is not accurately represented. This over-diagnosis may result in unnecessary treatment in some individuals.

Exercise-induced changes in central sensitization outcomes in individuals with chronic musculoskeletal pain: A systematic review with meta-analysis.

BACKGROUND AND OBJECTIVE: Temporal summation of pain (TSP) and conditioned pain modulation (CPM) are the two most commonly used clinical measures of central sensitization (CS). However, the effectiveness of exercise on TSP and CPM has yet to be evaluated. This review aims to investigate the effect of exercise alone on CS outcomes in individuals with chronic musculoskeletal pain. DATABASES AND DATA TREATMENT: This is a systematic review and meta-analysis. MEDLINE, EMBASE, CINAHL, PEDro and Cochrane databases were searched. Data were extracted based on the exercise modality and grouped into aerobic, resistance, isometric, or motor control modalities. Risk of bias was assessed using RoB2, RoB2 for crossover trials and ROBINS-I tools. Quality of evidence was assessed using GRADE. Random-effects meta-analyses were conducted, with subgroup analysis conducted for each exercise modality. RESULTS: The meta-analyses included thirteen studies, consisting of eight non-randomized studies, three randomized controlled trials and three randomized crossover trials. Data were categorized into four subgroups for analyses based on exercise modality. No statistically significant effect existed for both TSP and conditioned pain modulation. However, motor control exercise was found to have a significant enhancing effect on conditioned pain modulation. No significant differences were found between the exercise subgroup for both TSP and conditioned pain modulation. CONCLUSIONS: We did not find an overall effect of physical exercise on TSP and CPM. However, subgroup analysis shows favourable effects of motor control exercise in individuals with chronic neck pain. Future research should focus on exercise modality and dosage and their role in the mechanism involved in TSP and CPM in predefined populations. SIGNIFICANCE STATEMENT: Results from this study found that motor control exercise has a significant enhancing effect on conditioned pain modulation, with subgroup analysis showing favourable effects of motor control exercise in individuals with chronic neck pain. This indicates that physical exercise may have a positive effect on central sensitisation in individual with chronic neck pain. However, differential effects may exist between different types of exercise. These findings will inform understanding of neurobiological effects underlying chronic neck pain and may guide the development of more effective, personalised treatments.

Identification of C4BPA as biomarker associated with immune infiltration and prognosis in breast cancer.

Background: C4BPA is a gene that encodes the C4BP protein α chain and is involved in the complement system. C4BPA is regarded as a new biomarker for cancer, especially for non-small cell lung cancer and ovarian cancer. However, its role in breast cancer (BC) has not yet been determined. Methods: In this research, we used a bioinformatics approach to assess the prognostic significance of C4BPA in BC. Utilizing a variety of databases and analysis tools, including The Cancer Genome Atlas (TCGA), Genotype-Tissue Expression (GTEx), Gene Ontology (GO), Kyoto Encyclopedia of Genes and Genomes (KEGG), R, STRING, and the Kaplan-Meier plotter, we specifically assessed the connection between C4BPA and BC. Results: C4BPA expression was markedly decreased in BC tissues compared to its expression in normal breast tissues (P<0.05). Additionally, a receiver operating characteristic (ROC) curve revealed that C4BPA has a significant capacity for prognostication and diagnostics. Additionally, C4BPA expression was linked to some immune infiltrating cells' functionality, according to gene set enrichment analysis (GSEA) and immune infiltration analysis. Low C4BPA expression was additionally related to poor progression-free interval (PFI) and overall survival (OS), according to the Kaplan-Meier method. We also found that C4BPA expression was independently connected to PFI and OS through Cox regression analysis. Finally, prognostic analysis of the various subgroups of breast invasive carcinoma (BRCA/BIC) in TCGA showed that patients with low C4BPA expression might have worse PFI and OS in patients with Luminal A compared to other BC subtypes. Conclusions: In conclusion, these results revealed that C4BPA could potentially act as a diagnostic biomarker for BC patients indicating unfavorable prognoses and offers valuable knowledge for creating therapeutics and prognostic indicators.

Boron-Implanted Black Silicon Photodiode with Close-to-Ideal Responsivity from 200 to 1000 nm.

Detection of UV light has traditionally been a major challenge for Si photodiodes due to reflectance losses and junction recombination. Here we overcome these problems by combining a nanostructured surface with an optimized implanted junction and compare the obtained performance to state-of-the-art commercial counterparts. We achieve a significant improvement in responsivity, reaching near ideal values at wavelengths all the way from 200 to 1000 nm. Dark current, detectivity, and rise time are in turn shown to be on a similar level. The presented detector design allows a highly sensitive operation over a wide wavelength range without making major compromises regarding the simplicity of the fabrication or other figures of merit relevant to photodiodes.

Electron Injection in Metal Assisted Chemical Etching as a Fundamental Mechanism for Electroless Electricity Generation.

Metal-assisted chemical etching (MACE) is a widely applied process for fabricating Si nanostructures. As an electroless process, it does not require a counter electrode, and it is usually considered that only holes in the Si valence band contribute to the process. In this work, a charge carrier collecting p-n junction structure coated with silver nanoparticles is used to demonstrate that also electrons in the conduction band play a fundamental role in MACE, and enable an electroless chemical energy conversion process that was not previously reported. The studied structures generate electricity at a power density of 0.43 mW/cm2 during MACE. This necessitates reformulating the microscopic electrochemical description of the Si-metal-oxidant nanosystems to separately account for electron and hole injections into the conduction and valence band of Si. Our work provides new insight into the fundamentals of MACE and demonstrates a radically new route to chemical energy conversion by solar cell-inspired devices.

Body composition reference values in Singaporean adults using dual-energy X-ray absorptiometry-The Yishun study.

OBJECTIVES: This study establishes age- and sex-specific reference values for fat mass index (FMI), lean mass index (LMI), appendicular LMI (aLMI), and body fat distribution indices including Android/Gynoid % fat ratio and Trunk/Limb % fat ratio in multi-ethnic Singaporean adults. METHODS: A population-based cross-sectional study using dual-energy X-ray absorptiometry (Hologic Discovery Wi) was carried out to measure whole body and regional fat and lean mass in community-dwelling adults. A total of 537 adults (57.5% women), aged from 21 to 90 years, were recruited from the large north-eastern residential town of Yishun. Age- and sex-specific percentile reference values were generated for FMI, LMI, aLMI, Android/Gynoid % fat ratio and Trunk/Limb % fat ratio using the Lambda-Mu-Sigma method. The relationship between the parameters and age were assessed through the Pearson's correlation coefficient. RESULTS: All parameters demonstrated significant correlation with age (p < 0.05) for both men and women, except for LMI in women, with the strength of r ranging from 0.12 (weak correlation) to 0.54 (strong correlation). LMI (r = -0.45) and appendicular LMI (r = -0.54) were negatively associated with age in men while none (r = -0.06) to weak correlation (r = -0.14) were shown in women for the same parameters respectively. The Android/Gynoid % fat ratio and Trunk/Limb % fat ratio were positively related to age for both men (r = 0.37 & 0.43, p < 0.001) and women (r = 0.52 & 0.48, p < 0.001). CONCLUSION: We have established DXA-based body composition reference data for the Singapore adult population. These reference data will be particularly useful in geriatric, obesity and oncology clinics, enabling the prescription of appropriate therapy to individuals at risk of morbidity from unfavorable body composition phenotypes. It also adds on to the limited reference database on Southeast Asian body composition.

Enhanced gait variability index and cognitive performance in Asian adults: Results from the Yishun Study.

BACKGROUND: Although gait variability has been linked to cognitive decline among older adults, the lack of a comprehensive composite gait variability score has dampened the application of gait variability. RESEARCH QUESTION: Does the enhanced gait variability index (EGVI) - a composite score gait variability index - provide differential and useful information on cognitive decline in community-dwelling adults from that using gait speed? METHODS: Healthy community-dwelling adults (n = 311) aged 21-90 were individually administered the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS). Habitual gait speed and spatiotemporal parameters were measured using a 6 m instrumented walkway system. The EGVI for each participant was calculated from five spatiotemporal parameters - step length(cm), step time(s), stance time(s), single support time(s) and stride velocity(cm/s). Linear regression models, controlling for age, gender, and education, were built to examine the independent effects of EGVI or gait speed on global cognition and individual domains. RESULTS: Multiple regression revealed that gait speed contributed significantly to the performance of the domain "Attention" (p = 0.04) whereas EGVI contributed significantly for the performance of the domain "Visuospatial" (p = 0.04) and "Delayed Memory" (p = 0.02). SIGNIFICANCE: EGVI provides differential and useful information from using gait speed alone. The EGVI may offer a solution to measure or track GV changes in relation to cognitive changes.