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Molybdenum carbide MXenes have garnered considerable attention in electronics, energy storage, and catalysis. However, they are prone to oxidative degradation, but the associated mechanisms have not been systematically explored. Therefore, the oxidation mechanisms of Mo-based single-metallic/bimetallic carbide MXenes including Mo2CTx, Mo2TiC2Tx, and Mo2Ti2C3Tx in aqueous suspensions were investigated for the first time in this study. Similar to Ti3C2Tx MXene, Mo-based MXenes were found to undergo oxidative degradation in their aqueous dispersions, leading to the disruption of their crystal structure and subsequent loss of optical and electronic properties. Notably, the Mo2CTx MXene deviated from this typical oxidation behavior as it produced an amorphous product with Mo ions instead of highly crystalline Mo-oxides during oxidation. Similarly, the Mo2TiC2Tx and Mo2Ti2C3Tx MXenes did not yield crystalline Mo-oxides; instead, they produced highly crystalline anatase TiO2 and a Mo-ion-containing amorphous product simultaneously. Furthermore, high-temperature annealing of the oxidized Mo2CTx MXene powder at 800 °C transformed the amorphous Mo-containing product into highly crystalline MoO2 crystals. These findings highlight the unconventional oxidation behavior of Mo-based MXenes, which suggests that the formation of crystalline Mo-based oxides requires a higher activation energy during oxidation than that of TiO2. The unique oxidative pathway reported herein can help elucidate the oxidation mechanisms of Mo-based MXene dispersions and their products. The insights from this study can pave the way for fundamental studies in academia as well as broaden the applications of Mo-based MXenes in various industries.
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Thermoelectric technology, which has been receiving attention as a sustainable energy source, has limited applications because of its relatively low conversion efficiency. To broaden their application scope, thermoelectric materials require a high dimensionless figure of merit (ZT). Porous structuring of a thermoelectric material is a promising approach to enhance ZT by reducing its thermal conductivity. However, nanopores do not form in thermoelectric materials in a straightforward manner; impurities are also likely to be present in thermoelectric materials. Here, a simple but effective way to synthesize impurity-free nanoporous Bi0.4 Sb1.6 Te3 via the use of nanoporous raw powder, which is scalably formed by the selective dissolution of KCl after collision between Bi0.4 Sb1.6 Te3 and KCl powders, is proposed. This approach creates abundant nanopores, which effectively scatter phonons, thereby reducing the lattice thermal conductivity by 33% from 0.55 to 0.37 W m-1 K-1 . Benefitting from the optimized porous structure, porous Bi0.4 Sb1.6 Te3 achieves a high ZT of 1.41 in the temperature range of 333-373 K, and an excellent average ZT of 1.34 over a wide temperature range of 298-473 K. This study provides a facile and scalable method for developing high thermoelectric performance Bi2 Te3 -based alloys that can be further applied to other thermoelectric materials.
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Alkaline water electrolysis (AWE) is considered a promising technology for green hydrogen (H2 ) production. Conventional diaphragm-type porous membranes have a high risk of explosion owing to their high gas crossover, while nonporous anion exchange membranes lack mechanical and thermochemical stability, limiting their practical application. Herein, a thin film composite (TFC) membrane is proposed as a new category of AWE membranes. The TFC membrane consists of an ultrathin quaternary ammonium (QA) selective layer formed via Menshutkin reaction-based interfacial polymerization on a porous polyethylene (PE) support. The dense, alkaline-stable, and highly anion-conductive QA layer prevents gas crossover while promoting anion transport. The PE support reinforces the mechanical and thermochemical properties, while its highly porous and thin structure reduces mass transport resistance across the TFC membrane. Consequently, the TFC membrane exhibits unprecedentedly high AWE performance (1.16 A cm-2 at 1.8 V) using nonprecious group metal electrodes with a potassium hydroxide (25 wt%) aqueous solution at 80 °C, significantly outperforming commercial and other lab-made AWE membranes. Moreover, the TFC membrane demonstrates remarkably low gas crossover, long-term stability, and stack cell operability, thereby ensuring its commercial viability for green H2 production. This strategy provides an advanced material platform for energy and environmental applications.
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Modern electrochemical energy conversion devices require more advanced proton conductors for their broad applications. Phosphonated polymers have been proposed as anhydrous proton conductors for fuel cells. However, the anhydride formation of phosphonic acid functional groups lowers proton conductivity and this prevents the use of phosphonated polymers in fuel cell applications. Here, we report a poly(2,3,5,6-tetrafluorostyrene-4-phosphonic acid) that does not undergo anhydride formation and thus maintains protonic conductivity above 200 °C. We use the phosphonated polymer in fuel cell electrodes with an ion-pair coordinated membrane in a membrane electrode assembly. This synergistically integrated fuel cell reached peak power densities of 1,130 mW cm-2 at 160 °C and 1,740 mW cm-2 at 240 °C under H2/O2 conditions, substantially outperforming polybenzimidazole- and metal phosphate-based fuel cells. Our result indicates a pathway towards using phosphonated polymers in high-performance fuel cells under hot and dry operating conditions.
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INTRODUCTION To examine the impact of COVID-19 pandemic on the presentation, management and outcome of testicular torsion at our institution. MATERIALS AND METHODS: A retrospective review of a prospectively maintained testicular torsion database was performed. Patients ≤ 18 years of age evaluated in our emergency room between 3/11/2020 to 10/1/2020 (during-COVID-19) and the same period in 2018 and 2019 (pre-COVID-19) with US diagnosed and OR confirmed testicular torsion were included. Basic demographics, timing of presentation, referral rate, time to OR and orchiectomy rate were extracted and compared. P < 0.05 was considered statistically significant. RESULTS: A total of 82 torsions were included in the study; 55 pre-COVID-19 and 27 during-COVID-19. The incidence of testicular torsion remained the same; 3.93 cases/month pre-COVID-19 versus 3.86 cases/month during-COVID-19 (p = 0.791). However, there were significantly fewer delayed (> 24 hours) presentations (11.1% versus 45.5% , p = 0.003), shorter time from onset of symptoms to presentation (median 15.5 hours versus 8 hours, p = 0.001), and a lower but not statistically significant overall orchiectomy rate (33.3% versus 50.9% p = 0.1608) during-COVID-19. Among those presenting acutely with torsion (< 24 hours from onset), no statistical differences were found in the median time from US diagnosis to OR, from ED to OR, referral rate, or orchiectomy rate between the two groups. Lastly, SARS-CoV2 testing did not delay median time from ED to OR. CONCLUSIONS: There was a notably less delayed presentation of testicular torsion and shorter ischemia time on presentation during-COVID, however, no significant change of time to OR or orchiectomy rate in those with acute testicular torsion were observed.
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COVID-19/epidemiologia , Orquiectomia , Torção do Cordão Espermático/diagnóstico por imagem , Torção do Cordão Espermático/cirurgia , Ultrassonografia/métodos , Adolescente , COVID-19/diagnóstico , Criança , Serviço Hospitalar de Emergência , Hospitais Pediátricos , Humanos , Masculino , Pandemias , Estudos Retrospectivos , SARS-CoV-2RESUMO
We report successful percutaneous nephrolithotomy (PCNL) in an 8-week-old, 4.12 kg infant with a combined stone burden of > 2 cm in a solitary kidney. The patient was born with thoracolumbar myelomeningocele and had developed recurrent urinary tract infections. Her size precluded retrograde intrarenal surgery and shockwave lithotripsy would be unlikely to clear the stone burden. Stone analysis revealed hydroxyapatite and carbonate apatite stones, and metabolic work up revealed hypercalciuria for which chlorothiazide was started. To our knowledge, this is the youngest patient to undergo PCNL reported in the literature.
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Cálculos Renais/cirurgia , Meningomielocele/diagnóstico por imagem , Nefrolitotomia Percutânea/métodos , Ultrassonografia Doppler , Cateterismo Urinário/métodos , Feminino , Seguimentos , Humanos , Lactente , Cálculos Renais/diagnóstico por imagem , Meningomielocele/cirurgia , Monitorização Intraoperatória/métodos , Segurança do Paciente , Medição de Risco , Resultado do Tratamento , Infecções Urinárias/diagnóstico , Infecções Urinárias/etiologiaRESUMO
Surface wrinkling is a promising route to control the mechanical, electrical, and optical properties of materials in a wide range of applications. However, previous artificial wrinkles are restricted to single or random orientation and lacks selectivity. To address this challenge, this study presents multidirectional wrinkle patterns with high selectivity and orientation through sequential uniaxial strain with conformal polymeric shadow masks. The conformal but nontraceable polymeric stencil with microapertures are adhered to a flat substrate prior to oxidation, which forms discrete and parallel wrinkles in confined domains without any contamination. By fully investigating the process, this study displays compound topography of wrinkles consisting of wrinkle islands and surrounding secondary wrinkles on the same surface. With this topography, various diffusion properties are presented: from semi-transparent yet diffusive films to multidirectional diffusive films, which will be available for new types of optical diffuser applications.
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Polímeros/química , Envelhecimento da Pele/fisiologia , Pele , Humanos , Microscopia Eletrônica de Varredura , Conformação Molecular , Pele/química , Pele/ultraestrutura , Propriedades de SuperfícieRESUMO
Propylene/propane separation is one of the most challenging separations, currently achieved by energy-intensive cryogenic distillation. Despite the great potential for energy-efficient membrane-based separations, no commercial membranes are currently available due to the limitations of current polymeric materials. Zeolitic imidazolate framework, ZIF-8, with the effective aperture size of â¼4.0 Å, has been shown to be very promising for propylene/propane separation. Despite the extensive research on ZIF-8 membranes, only a few reported ZIF-8 membranes have displayed good propylene/propane separation performances presumably due to the challenges of controlling the microstructures of polycrystalline membranes. Here we report the first well-intergrown membranes of ZIF-67 (Co-substituted ZIF-8) by heteroepitaxially growing ZIF-67 on ZIF-8 seed layers. The ZIF-67 membranes exhibited impressively high propylene/propane separation capabilities. Furthermore, when a tertiary growth of ZIF-8 layers was applied to heteroepitaxially grown ZIF-67 membranes, the membranes exhibited unprecedentedly high propylene/propane separation factors of â¼200 possibly due to enhanced grain boundary structure.
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Alcenos/isolamento & purificação , Imidazóis/síntese química , Propano/isolamento & purificação , Zeolitas/síntese química , Alcenos/química , Imidazóis/química , Tamanho da Partícula , Propano/química , Propriedades de Superfície , Zeolitas/químicaRESUMO
INTRODUCTION: The absence of a standardized classification of hypospadias hinders understanding of the anatomic differences among patients and the evaluation of outcomes following surgical repair. In working towards a standardized, objective method of recording patients' hypospadias anatomy, we describe our initial experience using a non-invasive three-dimensional scanner. MATERIAL AND METHODS: An Artec3D Space Spider scanner was used to obtain 3D scans in 29 patients undergoing hypospadias repair. Measurements of the urethral plate width, urethral plate length, glans width, penile shaft length, and penile shaft width were made by 2 pediatric urology attendings and 1 pediatric urology fellow. Measurements were compared and inter-rater reliability was calculated. RESULTS: A total of 435 measurements were made on 29 successfully generated 3D scans, ranging from distal to proximal hypospadias. The inter-rater reliability of measurements from the generated 3D models shown good inter-rater reliability of urethral plate width (ICC0.87 [95%CI:0.76,0.93]), penile shaft length (ICC0.87 [95%CI:0.70,0.94]) and glans width (ICC0.83 [95%CI:0.68,0.92]), excellent inter-rater reliability of urethral plate length (ICC0.96) and moderate inter-rater reliability of penile shaft width (ICC0.69 [95%CI:0.44,0.84]). DISCUSSION: There was a high degree of reliability of measurements made across multiple users. Calculation of the ratio of the urethral plate length/total penile shaft length objectively defined the initial position of the urethral meatus. When compared to the 3-dimensional volume of the glans, a more proximally positioned urethral meatus was associated with a lower glans volume. CONCLUSION: 3D scanning offers a rapid, reproducible, and non-invasive method of documenting hypospadias anatomy. The ability to evaluate three dimensional features (i.e. glans volume) offers an exciting opportunities for robust investigation of hypospadias outcomes and further understanding of the relationship between a patient's genotype and phenotype.
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Hipospadia , Masculino , Humanos , Criança , Lactente , Hipospadia/diagnóstico por imagem , Hipospadia/cirurgia , Reprodutibilidade dos Testes , Resultado do Tratamento , Procedimentos Cirúrgicos Urológicos Masculinos/métodos , Uretra/diagnóstico por imagem , Uretra/cirurgia , DocumentaçãoRESUMO
Porous thermoelectric materials offer exciting prospects for improving the thermoelectric performance by significantly reducing the thermal conductivity. Nevertheless, porous structures are affected by issues, including restricted enhancements in performance attributed to decreased electronic conductivity and degraded mechanical strength. This study introduces an innovative strategy for overcoming these challenges using porous Bi0.4Sb1.6Te3 (BST) by combining porous structuring and interface engineering via atomic layer deposition (ALD). Porous BST powder was produced by selectively dissolving KCl in a milled mixture of BST and KCl; the interfaces were engineered by coating ZnO films through ALD. This novel architecture remarkably reduced the thermal conductivity owing to the presence of several nanopores and ZnO/BST heterointerfaces, promoting efficient phonon scattering. Additionally, the ZnO coating mitigated the high resistivity associated with the porous structure, resulting in an improved power factor. Consequently, the ZnO-coated porous BST demonstrated a remarkable enhancement in thermoelectric efficiency, with a maximum zT of approximately 1.53 in the temperature range of 333-353 K, and a zT of 1.44 at 298 K. Furthermore, this approach plays a significant role in enhancing the mechanical strength, effectively mitigating a critical limitation of porous structures. These findings open new avenues for the development of advanced porous thermoelectric materials and highlight their potential for precise interface engineering through the ALD.
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In this study, we address the significant challenge of overcoming limitations in the catalytic efficiency for the oxygen evolution reaction (OER). The current linear scaling relationships hinder the optimization of the electrocatalytic performance. To tackle this issue, we investigate the potential of designing single-atom catalysts (SACs) on Mo2CO2 MXenes for electrochemical OER using first-principles modeling simulations. By employing the Electrochemical Step Symmetry Index (ESSI) method, we assess OER intermediates to fine-tune the activity and identify the optimal SAC for Mo2CO2 MXenes. Our findings reveal that both Ag and Cu exhibit effectiveness as single atoms for enhancing OER activity on Mo2CO2 MXenes. However, among the 21 chosen transition metals (TMs) in this study, Cu stands out as the best catalyst for tweaking the overpotential (ηOER). This is due to Cu's lowest overpotential compared to other TMs, which makes it more favorable for the OER performance. On the other hand, Ag is closely aligned with ESSI = ηOER, making the tuning of its overpotential more challenging. Furthermore, we employ symbolic regression analysis to identify the significant factors that exhibit a correlation with the OER overpotential. By utilizing this approach, we derive mathematical formulas for the overpotential and identify key descriptors that affect the catalytic efficiency in the electrochemical OER on Mo2CO2 MXenes. This comprehensive investigation not only sheds light on the potential of MXenes in advanced electrocatalytic processes but also highlights the prospect of improved activity and selectivity in OER applications.
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Ladder-type polysilsesquioxanes (LPSQs) containing phenyl as a high refractive index unit and cyclic epoxy as a curable unit were found to be excellent candidates for a transparent color conversion layer for displays due to being miscible with organic solvents and amenable to transparent film formation. Therefore, the LPSQs were combined with luminescent lanthanide metals, europium Eu(III), and terbium Tb(III), to fabricate transparent films with various emission colors, including red, orange, yellow, and green. The high luminescence and transmittance properties of the LPSQs-lanthanide composite films after thermal curing were attributed to chelating properties of hydroxyl and polyether side chains of LPSQs to lanthanide ions, as well as a light sensitizing effect of phenyl side chains of the LPSQs. Furthermore, Fourier-transform infrared (FT-IR) and X-ray photoelectron spectroscopy and nanoindentation tests indicated that the addition of the nanoparticles to the LPSQs moderately enhanced the epoxy conversion rate and substantially improved the wear resistance, including hardness, adhesion, and insusceptibility to atmospheric corrosion in a saline environment. Thus, the achieved LPGSG-lanthanide hybrid organic-inorganic material could effectively serve as a color conversion layer for displays.
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BACKGROUND: Polymerase chain reaction (PCR) is an important means by which to study the urine microbiome and is emerging as possible alternative to urine cultures to identify pathogens that cause urinary tract infection (UTI). However, PCR is limited by its inability to differentiate DNA originating from viable, metabolically active versus non-viable, inactive bacteria. This drawback has led to concerns that urobiome studies and PCR-based diagnosis of UTI are confounded by the presence of relic DNA from non-viable bacteria in urine. Propidium monoazide (PMA) dye can penetrate cells with compromised cell membranes and covalently bind to DNA, rendering it inaccessible to amplification by PCR. Although PMA has been shown to differentiate between non-viable and viable bacteria in various settings, its effectiveness in urine has not been previously studied. We sought to investigate the ability of PMA to differentiate between viable and non-viable bacteria in urine. METHODS: Varying amounts of viable or non-viable uropathogenic E. coli (UTI89) or buffer control were titrated with mouse urine. The samples were centrifuged to collect urine sediment or not centrifuged. Urine samples were incubated with PMA and DNA cross-linked using blue LED light. DNA was isolated and uidA gene-specific PCR was performed. For in vivo studies, mice were inoculated with UTI89, followed by ciprofloxacin treatment or no treatment. After the completion of ciprofloxacin treatment, an aliquot of urine was plated on non-selective LB agar and another aliquot was treated with PMA and subjected to uidA-specific PCR. RESULTS: PMA's efficiency in excluding DNA signal from non-viable bacteria was significantly higher in bacterial samples in phosphate-buffered saline (PBS, dCT=13.69) versus bacterial samples in unspun urine (dCT=1.58). This discrepancy was diminished by spinning down urine-based bacterial samples to collect sediment and resuspending it in PBS prior to PMA treatment. In 3 of 5 replicate groups of UTI89-infected mice, no bacteria grew in culture; however, there was PCR amplification of E. coli after PMA treatment in 2 of those 3 groups. CONCLUSION: We have successfully developed PMA-based PCR methods for amplifying DNA from live bacteria in urine. Our results suggest that non-PMA bound DNA from live bacteria can be present in urine, even after antibiotic treatment. This indicates that viable but non-culturable E. coli can be present following treatment of UTI, and may explain why some patients have persistent symptoms but negative urine cultures following UTI treatment.
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Escherichia coli Uropatogênica , Animais , Azidas , DNA Bacteriano/genética , Humanos , Camundongos , Viabilidade Microbiana , Reação em Cadeia da Polimerase/métodos , Propídio/análogos & derivados , Reação em Cadeia da Polimerase em Tempo Real/métodos , Escherichia coli Uropatogênica/genética , Escherichia coli Uropatogênica/metabolismoRESUMO
INTRODUCTION: Healthcare disparities have been shown to impact outcomes of various acute pediatric conditions. We sought to examine the impact of race, ethnicity and insurance status on the presentation, management and outcome of testicular torsion. MATERIALS AND METHODS: A retrospective review of a prospectively maintained testicular torsion database was performed. Patients ≤18 years of age evaluated in our pediatric institution's emergency room between April 2016-April 2020 with US diagnosed and OR confirmed testicular torsion were included. Basic demographics, timing of presentation, referral rate, time to OR and orchiectomy rate were extracted and compared. P < 0.05 was considered statistically significant. RESULTS: A total of 206 patients were included. 114 (56.2%) were Black or African American (Black/AA), 43 were (21.2%) Hispanic/Latino, 22 (10.8%) were Caucasian, and 24 (11.8%) were designated as Other races. Ninety-eight (48.3%) patients had Medicaid, 90 (44.3%) had private insurance, and 15 (7.4%) patients were uninsured. Sixty-eight (33.0%) presented in a delayed fashion (>24 h). Compared to the Caucasian patients, Black/AA patients were 2.1 years (95% CI: 0.5, 3.8; P = 0.010) older at the time of presentation. When compared to those with Medicaid insurance, uninsured patients had 6.26 times (95% CI: 1.58, 41.88; P = 0.021) higher odds to be referred from an outside hospital for management. In those patients presenting acutely (<24 h, N = 138), there were no significant differences in the odds of orchiectomy for Black/AA or Hispanic/Latino patients when compared to Caucasian patients, however, the odds of orchiectomy in Other races (non-Caucasian, non-Black/AA, non-Hispanic/Latino) was significantly higher (OR: 10.38; 95% CI: 1.13, 246.96; P = 0.049). While the mean time in minutes from ED to OR was longer in those with Medicaid insurance (141 vs 125.4 private vs 115 uninsured, p = 0.042), this did not impact orchiectomy rate (39.8% vs 40.9% vs 46.7%, p = 0.88). CONCLUSIONS: We found no differences in the orchiectomy rates by race with the exception of a higher rate in the diverse and heterogeneous Other race (non-Caucasian, non-Black/AA, non-Hispanic/Latino) group. Those uninsured had a higher referral rate highlighting the potential existence of disparities for those uninsured and the need for further investigation.
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Torção do Cordão Espermático , Doença Aguda , Criança , Serviço Hospitalar de Emergência , Disparidades em Assistência à Saúde , Humanos , Cobertura do Seguro , Masculino , Orquiectomia , Estudos Retrospectivos , Torção do Cordão Espermático/diagnóstico , Torção do Cordão Espermático/cirurgia , Estados UnidosRESUMO
Reverse electrodialysis (RED) generates power directly by transforming salinity gradient into electrical energy. The ion transport properties of the ion-exchange membranes need to be investigated deeply to improve the limiting efficiencies of the RED. The interaction between "counterions" and "ionic species" in the membrane requires a fundamental understanding of the phase separation process. Here, we report on sulfonated poly(vinylidene fluoride-co-hexafluoropropylene)/graphitic carbon nitride nanocomposites for RED application. We demonstrate that the rearrangement of the hydrophilic and hydrophobic domains in the semicrystalline polymer at a nanoscale level improves ion conduction. The rearrangement of the ionic species in polymer and "the functionalized nanosheet with ionic species" enhances the proton conduction in the hybrid membrane without a change in the structural integrity of the membrane. A detailed discussion has been provided on the membrane nanostructure, chemical configuration, structural robustness, surface morphology, and ion transport properties of the prepared hybrid membrane. Furthermore, the RED device was fabricated by combining synthesized cation exchange membrane with commercially available anion exchange membrane, NEOSEPTA, and a maximum power density of 0.2 W m-2 was successfully achieved under varying flow rates at the ambient condition.
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Lithium-sulfur batteries are considered as attractive candidates for next-generation energy storage systems originating from their high theoretical capacity and energy density. However, the severe shuttling of behavior caused by the dissolution of lithium polysulfide intermediates during cycling remains a challenge for practical applications. Herein, porous carbon materials co-doped with nitrogen and sulfur atoms were prepared through a facile hydrothermal reaction of graphene oxide and methylene blue to obtain a suitable host structure for regulating the lithium polysulfide shuttling behavior. Experimental results demonstrated that the abundant heteroatom-containing moieties in the carbon frameworks not only generated favorable active sites for capturing lithium polysulfide but also enhanced redox reaction kinetics of lithium polysulfide intermediates. Consequently, the corresponding sulfur composite electrodes exhibited excellent rate performance and cycling stability along with high Columbic efficiency. This work highlights the approach for the preparation of nitrogen and sulfur co-doped carbon materials derived from organic dye compounds for high performance energy storage systems.
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The interaction energy of base-acid plays a key role in acid retention of phosphoric acid (PA)-doped polymer electrolytes under fuel cell operating conditions. Here, we investigate the energetics of proton-accepting and hydroxide-donating organic bases using density functional theory calculations. Because of their weak basicity, proton-accepting organic bases such as benzimidazole have relatively low interaction energy with the acid in the absence of water (15.3-28.0 kcal mol-1). Energetics of the proton-accepting base-PA complex increases by adding water, indicating that the interactions in the base-acid complex strengthen in the presence of water. On the other hand, hydroxide-donating organic bases, such as tetramethylammonium hydroxide, have high interaction energy with PA (â¼110 kcal mol-1), which remains high in the presence of water. The chemical shifts of 31P NMR support the energetics of the base-acid complexes. This study further discusses the benefit of incorporating hydroxide-donating organic bases into the polymeric structure over proton-accepting bases as a way to increase acid retention.
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A series of UV-curable hybrid composite blends containing a carboxylic acid functionalized polyimidewith varying amounts of high molecular weight (~1 K) PEG-grafted ladder-structured polysilsesquioxanes copolymerized with methacryl groups were fabricated and their structural, thermal, mechanical, and surface properties characterized. At a composite weight ratio of polyimide above 50 wt.%, a stark shift from amorphous to crystalline polyethylene glycol (PEG) phases were observed, accompanied by a drastic increase in both surface moduli and brittleness index. Moreover, fabricated composites were shown to have a wide range water contact angle, 9.8°-73.8°, attesting to the tunable surface properties of these amphiphilic hybrid polymer composites. The enhanced mechanical properties, combined with the utility of tunable surface hydrophilicity allows for the possible use of these hybrid polymer composites to be utilized as photosensitive polyimide negative photoresists for a myriad of semiconductor patterning processes.
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INTRODUCTION: Early proactive treatment of patients with high-risk neurogenic bladder from spina bifida (SB) may preserve renal function and decrease the need for bladder augmentation later in life. Timing of initiation of anticholinergic therapy (AC) medication and clean intermittent catheterization (CIC) is variable and based on imprecise studies. The authors hypothesized that initiation of AC after the initial video-urodynamic study (VUDS) may benefit bladder capacity even in children who do not meet the standard hostile criteria for starting AC. STUDY DESIGN: A retrospective review of a prospectively maintained VUDS database from August 2015 to March 2019 was performed. Patients with SB who had undergone initial VUDS between 1 and 7 months of age and had a subsequent follow-up study between 9 and 18 months of age were included. Multiple VUDS and clinical parameters including expected bladder capacity, actual capacity reached, pressure at actual capacity, presence of detrusor overactivity, presence of urinary tract dilation and reflux, and whether or not AC was started were extracted and compared. P-value of <0.05 was considered statistically significant. RESULTS: A total of 69 patients completed an initial study at median age of 2 months, and follow-up study at median age of 13 months. Anticholinergic therapy was started in 21 patients (10 F, 11 M). Decision to initiate AC was at discretion of the attending pediatric urologist performing the VUDS in real time. Changes between the initial and repeat VUDS are listed in the summary table below. Adverse effects of AC were reported in 25% (5/21) patients: urinary retention/UTIs (3), allergic reaction (1), and fatigue (1). DISCUSSION: The authors findings suggest that AC stabilizes storage pressure for those who initially have a higher storage pressure, while in those with initial low storage pressures, storage pressures worsened over time in the absence of AC. Patients started on AC experienced a faster rate of increase in bladder capacity. Limitations to this study included the unknown long term and sustainability of the improvement in bladder parameters, the lack of uniform criteria for the initiation of AC or CIC, and an unknown long-term degree of upper tract protection. CONCLUSION: This study found early initiation of AC in SB at 2 months of age had significant positive effects on growth of bladder capacity and stabilization of storage pressure. However, long-term effects of AC are still undetermined, and thus, longitudinal studies are needed to understand the precise indications for initiation of early AC treatment.
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Disrafismo Espinal , Bexiga Urinaria Neurogênica , Criança , Seguimentos , Humanos , Lactente , Ácidos Mandélicos , Estudos Retrospectivos , Disrafismo Espinal/complicações , Bexiga Urinária , Bexiga Urinaria Neurogênica/tratamento farmacológico , Bexiga Urinaria Neurogênica/etiologia , UrodinâmicaRESUMO
OBJECTIVE: To inform the development of strategies to improve adherence to guidelines, we sought to identify characteristics of pediatric patients with nephrolithiasis associated with completing 24-hour urine analyses. MATERIALS AND METHODS: We performed a retrospective cohort study of patients with nephrolithiasis aged 3-18years treated in a large pediatric healthcare system from May 2012 to May 2017. Multivariable Cox models were fit to estimate the association between patient characteristics and completion of a 24-hour urine analysis. RESULTS: Among 623 patients, 317 (50.9%) completed a 24-hour urine collection. Median age was 14.4years (interquartile range [IQR] 10.5, 16.3). In adjusted analyses, age at diagnosis (hazard ratio [HR] 1.03; 95% confidence interval [CI] 1.01-1.07), renal colic on presentation (HR 1.72; 95% CI 1.15-2.58), and family history of nephrolithiasis (HR 1.50; 95% CI 1.17-1.93) were associated with an increased likelihood of completion of a 24-hour urine. Public/government assistance insurance (HR 0.68; 95% CI 0.48-0.96) was associated with decreased likelihood of completing a 24-hour urine. CONCLUSION: Patients who had prior painful experiences with stones (renal colic), and potential better understanding of nephrolithiasis (family history, older age on presentation) were more likely to complete a 24-hour urine. Those patients with public insurance/government assistance were less likely to complete a 24-hour urine. These results can be used to develop strategies to improve pediatric patients' adherence to completing 24-hour urine collections.