Efficacy and Safety of High-Dose TBS on Post-Stroke Upper Extremity Motor Impairment: A Randomized Controlled Trial.

BACKGROUND: Upper extremity (UE) motor function impairment is a major poststroke complication whose recovery remains one of the most challenging tasks in neurological rehabilitation. This study examined the efficacy and safety of the personalized neuroimaging-guided high-dose theta-burst stimulation (TBS) for poststroke UE motor function recovery. METHODS: Patients after stroke with UE motor impairment from a China rehabilitation center were randomly assigned to receive high-dose intermittent TBS (iTBS) to ipsilesional UE sensorimotor network, continuous TBS (cTBS) to contralesional UE sensorimotor network, or sham stimulation, along with conventional therapy for 3 weeks. The primary outcome was the score changes on the Fugl-Meyer assessment-UE from baseline to 1 and 3 weeks. The secondary outcomes included the response rate on Fugl-Meyer assessment-UE scores posttreatment (≥9-point improvement) and score changes in multidimensional scales measuring UE, lower extremity, and activities and participation. RESULTS: From June 2021 to June 2022, 45 participants were randomized and 43 were analyzed. The iTBS and continuous TBS groups showed significantly greater improvement in Fugl-Meyer assessment-UE (mean improvement, iTBS: 10.73 points; continuous TBS: 10.79 points) than the sham group (2.43 points) and exhibited significantly greater response rates on Fugl-Meyer assessment-UE (iTBS, 60.0%; continuous TBS, 64.3%) than the sham group (0.0%). The active groups consistently exhibited superior improvement on the other 2 UE assessments at week 3. However, only the iTBS group showed greater efficacy on 1 lower extremity assessment than the sham group at week 3. Both active groups showed significant improvements in activities and participation assessments. CONCLUSIONS: The study provides evidence for the efficacy and safety of high-dose TBS in facilitating poststroke UE rehabilitation. REGISTRATION: URL: www.chictr.org.cn; Unique identifier: ChiCTR2100047340.

Metal-Semiconductor Phase Twinned Hierarchical MoS2 Nanowires with Expanded Interlayers for Sodium-Ion Batteries with Ultralong Cycle Life.

Sodium-ion batteries (SIBs) are considered a prospective candidate for large-scale energy storage due to the merits of abundant sodium resources and low cost. However, a lack of suitable advanced anode materials has hindered further applications. Herein, metal-semiconductor mixed phase twinned hierarchical (MPTH) MoS2 nanowires with an expanded interlayer (9.63 Å) are engineered and prepared using MoO3 nanobelts as a self-sacrificed template in the presence of a trace amount of (NH4 )6 Mo7 O24 ·4H2 O as initiator. The greatly expanded interlayer spacing accelerates Na+ insertion/extraction kinetics, and the metal-semiconductor mixed phase enhances electron transfer ability and stabilizes electrode structure during cycling. Benefiting from the structural merits, the MPTH MoS2 electrode delivers high reversible capacities of 200 mAh g-1 at 0.1 A g-1 for 200 cycles and 154 mAh g-1 at 1 A g-1 for 2450 cycles in the voltage range of 0.4-3.0 V. Strikingly, the electrode maintains 6500 cycles at a current density of 2 A g-1 , corresponding to a capacity retention of 82.8% of the 2nd cycle, overwhelming the all reported MoS2 cycling results. This study provides an alternative strategy to boost SIB cycling performance in terms of reversible capacity by virtue of interlayer expansion and structure stability.

A Self-Repairing Cathode Material for Lithium-Selenium Batteries: Se-C Chemically Bonded Selenium-Graphene Composite.

Lithium-selenium batteries, employing selenium as a cathode material, exhibit some notable advantages, such as high discharge rates and good cycling performance, due to their high electrical conductivity, high output voltages, and high volumetric capacity density. However, an important problem, termed the "shuttle effect", can lead to capacity decay in Li-Se cells (and in Li-S cells), which arises from aggregation and the loss of Se or S from the cathode into the electrolyte. In this work, in order to solve this problem, a new self-repairing system has been devised, in which some Se atoms are chemically bonded to the carbon atoms of graphene and act as reclaiming points for dissociated Se atoms through the establishment of -Se-Se-Se- chains. Se-decorated graphene (Se-GE) was first constructed through a facile high-energy ball-milling process. Its formation was confirmed by XRD, SEM, HRTEM, XPS, and Raman analyses. As we anticipated, in examining cell properties, the as-prepared Se-GE composite underwent an initial capacity decay in the first 20 cycles (from 1050 mAh g-1 to 750 mAh g-1 , ca. 29 % loss), but the capacity then reverted to 970 mAh g-1 (ca. 92 % of the initial value). Other measurements were also consistent with the recapture of dissociated Se atoms.

Spatial separation of electrons and holes for enhancing the gas-sensing property of a semiconductor: ZnO/ZnSnO3 nanorod arrays prepared by a hetero-epitaxial growth.

The construction of semiconductor composites is known as a powerful method used to realize the spatial separation of electrons and the holes in them, which can result in more electrons or holes and increase the dispersion of oxygen ions ([Formula: see text] and O - ) (one of the most critical factors for their gas-sensing properties) on the surface of the semiconductor gas sensor. In this work, using 1D ZnO/ZnSnO3 nanoarrays as an example, which are prepared through a hetero-epitaxial growing process to construct a chemically bonded interface, the above strategy to attain a better semiconductor gas-sensing property has been realized. Compared with single ZnSnO3 nanotubes and no-matching ZnO/ZnSnO3 nanoarrays gas sensors, it has been proven by x-ray photoelectron spectroscopy and photoluminescence spectrum examination that the as-obtained ZnO/ZnSnO3 sensor showed a greatly increased quantity of active surface electrons with exceptional responses to trace target gases and much lower optimum working temperatures (less than about 170 °C). For example, the as-obtained ZnO/ZnSnO3 sensor exhibited an obvious response and short response/recovery time (less than 10 s) towards trace H2S gas (a detection limit down to 700 ppb). The high responses and dynamic repeatability observed in these sensors reveal that the strategy based on the as-presented electron and hole separation is reliable for improving the gas-sensing properties of semiconductors.

Differences in cognitive profiles between traumatic brain injury and stroke: A comparison of the Montreal Cognitive Assessment and Mini-Mental State Examination.

PURPOSE: To investigate the profiles of cognitive impairment through Montreal Cognitive Assessment (MoCA) and Mini-Mental State Examination (MMSE) in patients with chronic traumatic brain injury (TBI) or stroke and to evaluate the sensitivity of the two scales in patients with TBI. METHODS: In this cohort study, a total of 230 patients were evaluated, including TBI group (n = 103) and stroke group (n = 127). The cognitive functions of two groups were evaluated by designated specialists using MoCA (Beijing version) and MMSE (Chinese version). RESULTS: Comparedwith the patientswith stroke, the patientswith TBI received significantly lower score in orientation subtest and recall subtest in both tests.MoCA abnormal rates in the TBI group and stroke group were 94.17% and 86.61% respectively,whileMMSE abnormal rateswere 69.90% and 57.48%, respectively. In the TBI group, 87.10% patientswith normalMMSE score had abnormalMoCA score and in the stroke group, about 70.37% patients with normal MMSE score had abnormal MoCA score. The diagnostic consistency of two scales in the TBI group and the stroke group were 72% and 69%, respectively. CONCLUSION: In our rehabilitation center, patients with TBI may have more extensive and severe cognitive impairments than patients with stroke, prominently in orientation and recall domain. In screening post- TBI cognitive impairment, MoCA tends to be more sensitive than MMSE.

Different doses of intermittent theta burst stimulation for upper limb motor dysfunction after stroke: a study protocol for a randomized controlled trial.

Background: Upper limb motor recovery is one of the important goals of stroke rehabilitation. Intermittent theta burst stimulation (iTBS), a new type of repetitive transcranial magnetic stimulation (rTMS), is considered a potential therapy. However, there is still no consensus on the efficacy of iTBS for upper limb motor dysfunction after stroke. Stimulus dose may be an important factor affecting the efficacy of iTBS. Therefore, we aim to investigate and compare the effects and neural mechanisms of three doses of iTBS on upper limb motor recovery in stroke patients, and our hypothesis is that the higher the dose of iTBS, the greater the improvement in upper limb motor function. Methods: This prospective, randomized, controlled trial will recruit 56 stroke patients with upper limb motor dysfunction. All participants will be randomized in a 1:1:1:1 ratio to receive 21 sessions of 600 pulses active iTBS, 1,200 pulses active iTBS, 1,800 pulses active iTBS, or 1,800 pulses sham iTBS in addition to conventional rehabilitation training. The primary outcome is the Fugl-Meyer Assessment of the Upper Extremity (FMA-UE) score from baseline to end of intervention, and the secondary outcomes are the Wolf Motor Function Test (WMFT), Grip Strength (GS), Modified Barthel Index (MBI), and Stroke Impact Scale (SIS). The FMA-UE, MBI, and SIS are assessed pre-treatment, post-treatment, and at the 3-weeks follow-up. The WMFT, GS, and resting-state functional magnetic resonance imaging (rs-fMRI) data will be obtained pre- and post-treatment. Discussion: The iTBS intervention in this study protocol is expected to be a potential method to promote upper limb motor recovery after stroke, and the results may provide supportive evidence for the optimal dose of iTBS intervention.

Direct Electron Transfer from Upconversion Graphene Quantum Dots to TiO2 Enabling Infrared Light-Driven Overall Water Splitting.

Utilization of infrared light in photocatalytic water splitting is highly important yet challenging given its large proportion in sunlight. Although upconversion material may photogenerate electrons with sufficient energy, the electron transfer between upconversion material and semiconductor is inefficient limiting overall photocatalytic performance. In this work, a TiO2/graphene quantum dot (GQD) hybrid system has been designed with intimate interface, which enables highly efficient transfer of photogenerated electrons from GQDs to TiO2. The designed hybrid material with high photogenerated electron density displays photocatalytic activity under infrared light (20 mW cm-2) for overall water splitting (H2: 60.4 µmol gcat. -1 h-1 and O2: 30.0 µmol gcat. -1 h-1). With infrared light well harnessed, the system offers a solar-to-hydrogen (STH) efficiency of 0.80% in full solar spectrum. This work provides new insight into harnessing charge transfer between upconversion materials and semiconductor photocatalysts and opens a new avenue for designing photocatalysts toward working under infrared light.

Built-in electric field for photocatalytic overall water splitting through a TiO2/BiOBr P-N heterojunction.

Photocatalytic overall water splitting to simultaneously obtain abundant hydrogen and oxygen is still the mountain that stands in the way for the practical applications of hydrogen energy, in which composite semiconductor photocatalysts are critical for providing both electrons and holes to promote the following redox reaction. However, the interface between different components forms a deplete layer to hinder the charge transfer to a large extent. In order to enhance the charger transfer from an interface to the surface and promote the spatial separation of electron-hole pairs, a built-in electric field induced by a p-n heterojunction emerges as the best choice. As a touchstone, a p-n heterojunction of TiO2/BiOBr with a strong built-in electric field has been constructed, which presents a wide spectrum response owing to its interleaved band gaps after composition. The built-in electric field greatly enhances the separation and transportation of photogenerated carriers, resulting in fluorescence quenching due to the carrier recombination. The sample also displayed exceptional photoelectron responses: its photocurrent density (43.3 µA cm-2) was over 10 times that of TiO2 (3.5 µA cm-2) or BiOBr (4.2 µA cm-2). In addition, the sample with a molar ratio of 3 : 1 between TiO2 and BiOBr showed the best photocatalytic overall water splitting performance under visible light (λ > 420 nm): the hydrogen and oxygen production rate were 472.7 µmol gcat.-1 h-1 and 95.7 µmol gcat.-1 h-1, respectively, which are the highest values under visible light without other cocatalysts to have been reported in literature for the photocatalyst.

NiO/Ni/TiO2 nanocables with Schottky/p-n heterojunctions and the improved photocatalytic performance in water splitting under visible light.

Construction of Schottky junction or p-n heterojunction is admitted as an effective way for improving the separation of photo-induced carriers through its built-in electric field. In this work, fabrication of cooperative Schottky and p-n (SPN) heterojunction has been realized by intercalating metal Ni into a NiO/TiO2p-n junction, forming a NiO/Ni/TiO2 Sandwich-like heterojunction. The special heterostructure was confirmed by X-ray powder diffraction (XRD), X-ray photoelectron spectroscopy (XPS), scanning electron microscopy (SEM), transmission electron microscopy (TEM) and the high-resolution transmission electron microscopic (HRTEM), Brunauer Emmett Teller (BET). After a serial of contrast experiments with solo Schottky or p-n junction, it was found that the electron-hole separation in this NiO/Ni/TiO2 SPN heterojunction was enhanced through charge transfer channel, and it was also in accordance with their related optical and photoelectrical properties characterizations, such as photoluminescence (PL) spectrum and UV-Vis diffused reflectance spectra. In the following photocatalytic water splitting process under visible light, the hydrogen generation rate of NiO/Ni/TiO2 reached up to 4653 µmol h-1 g-1, which was 10.2, 6.7 and 2.3 times of those of TiO2 (457 µmol h-1 g-1), Ni/TiO2 (691 µmol h-1 g-1) with a Schottky junction and NiO/TiO2 (2059 µmol h-1 g-1) with a p-n junction, respectively. This SPN heterojunction with excellent photo-induced electron-hole separation ability opens a new window to exploring photocatalyst for water splitting.