Ultrahigh Energy Density and Long-Life Cyclic Stability of Surface-Treated Aluminum-Ion Supercapacitors.

In this study, aluminum-graphene supercapacitors (denoted as aluminum-ion supercapacitors; ASCs), consisting of a battery-type aluminum anode, a capacitor-type graphene cathode, and ionic liquid 1-ethyl-3-methylimidazolium chloride (EMImCl) and aluminum chloride (AlCl3) electrolyte, were prepared. This study primarily aimed to investigate the enhanced electrochemical performance of ASCs arising from changes in the surface oxide layer and morphology via electrochemical surface treatments, including electropolishing and electrodeposition of aluminum anodes. The ASC devices based on an electrodeposited anode at a current density of 3 A g-1 exhibited a high specific capacity of 211 F g-1 compared to that of the electropolished anode (∼186 F g-1); these were 20 and 5.7%, respectively, higher than that of the pristine aluminum anode. In particular, the electrodeposited ASC delivered an energy density of 151 W h kg-1 at a power density of 3,390 W kg-1. Furthermore, a maximum power density of 11,104 W kg-1 was achieved at an energy density of 124.3 W h kg-1. These values are among the best as compared to those of previously reported aluminum-based supercapacitors, suggesting the potential feasibility of these ASCs with outstanding energy and power densities for next-generation energy storage devices.

Instrumental Activities of Daily Living by Subjective and Objective Measures: The Impact of Depression and Personality.

Objective: Previous research shows that depression and personality are independently associated with self- and informant-reports of the ability to perform instrumental activities of daily living (IADLs). However, less is known about the association between depression and personality and performance-based measures of IADLs. We aimed to determine how depression and personality predict self-and informant-reports of IADL compared to performance-based measures of IADLs in a sample of older adults with normal cognition (NC) and Mild Cognitive Impairment (MCI). Methods: Participants consisted of 385 older adults with NC (n = 235), or a diagnosis of MCI (n = 150), aged between 76 and 99-years from the Sydney Memory and Ageing Study. Participants underwent comprehensive neuropsychological and clinical assessments to determine global cognition and clinical diagnoses. Personality traits were measured by the NEO Five-Factor Inventory (NEO-FFI) and depression by the Geriatric Depression Scale (GDS). Subjective IADLs were self- and informant-reported Bayer Activities of Daily Living (B-ADL) scales and objective IADL was the Sydney Test of Activities of Daily Living in Memory Disorders (STAM). Linear regressions examined the relationship between depression and personality and the three types of IADL measures, controlling for all covariates and global cognition. Results: Participant-reported IADL, although associated with global cognition, was more strongly associated with GDS and NEO-FFI scores (conscientiousness and neuroticism). Informant-reported IADL was strongly associated with both global cognition and participants' GDS scores. STAM scores were not associated with participants' GDS or NEO-FFI scores; instead, they were predicted by demographics and global cognition. Conclusion: These results suggest that performance-based measures of IADL may provide more objective and reliable insight into an individual's underlying functional ability and are less impacted by the participants' mood and personality compared to subjectively reported IADL. We argue that performance-based IADL measures are preferable when trying to accurately assess everyday functional ability and its relationship to cognitive status. Where performance-based measures are not available (e.g., in some clinical settings), informant ratings should be sought as they are less influenced by the participant's personality and mood compared to self-reports.

[Delirium Experience of the Intensive Care Unit Patients].

PURPOSE: The study aimed to understand the delirium experience of intensive care unit (ICU) patients. METHODS: We performed a qualitative study using Colaizzi's phenomenological method. Eleven patients, who experienced delirium according to the Confusion Assessment Method for ICU, participated after transferring to general wards from the ICU. Individual in-depth semi-structured interviews ranging from 30 minutes to 2 hours in length were conducted between November 2018 and August 2019. RESULTS: Nine themes and four theme clusters emerged. The four theme clusters were: 1) "Overwhelmed by fear," which describes the experience of a patient close to death and the feeling of difficulty in understanding disorganized thinking; 2) "Anxious about not understanding the situation," which means that patients' sense of time and space were disordered in the ICU; 3) "Being deserted," which indicates the feeling of being separated from others and yourself; and 4) "Resistance to protect my dignity," which indicates that the dignity and autonomy of an individual in the patient's position at the ICU, are ignored. CONCLUSION: Nursing interventions are needed that would enable patients to maintain orientation and self-esteem in the ICU. In addition, healthcare providers need to provide information about the unfamiliar environment in the ICU in advance.

Performance-Based vs Informant-Reported Instrumental Activities of Daily Living in Predicting Dementia.

OBJECTIVES: Identifying individuals at risk of developing dementia may be aided by early detection of functional impairments. The aims of the present study were to examine differences in informant-reported and performance-based measures of instrumental activities of daily living (IADL) and to assess whether a performance-based IADL measure contributes additional unique variance over informant reports in predicting incident dementia over 4 years. DESIGN: Prospective cohort study (Sydney Memory and Ageing Study). SETTING: Eastern Suburbs, Sydney, Australia. PARTICIPANTS: 307 community-dwelling individuals (60.6% female) aged between 76 and 96 years with normal cognition (NC; n = 190) or mild cognitive impairment (MCI; n = 117). METHODS: IADL ability was assessed with the performance-based Sydney Test of Activities of Daily Living in Memory Disorders (STAM) and the Bayer-Activities of Daily Living (B-ADL) informant report, at baseline and 4-year follow-up. Covariates included age, sex, education, Mini-Mental State Examination and Geriatric Depression Scale scores, arthritis, vision impairment, cardiovascular risk, and number of medications. Logistic regressions were conducted to examine the longitudinal association between the 2 types of IADL measures and incident dementia. RESULTS: Logistic regressions showed that performance-based IADL impairment at baseline [odds ratio (OR) = 0.83, 95% confidence interval (CI) 0.77, 0.90; P < .001] and decline in performance-based IADL function (OR = 0.82, 95% CI 0.73, 0.91; P < .001) were associated with incident dementia over 4 years, with the association provided by the STAM being statistically significant over and above the B-ADL. CONCLUSIONS AND IMPLICATIONS: Performance-based measures of IADL can predict progression to dementia over 4 years beyond that provided by an informant report of IADL. Performance-based IADL measures are promising tools for clinical practice to identify individuals at greater risk of developing dementia.

A Systematic Review and Meta-Analysis of Telemonitoring Interventions on Severe COPD Exacerbations.

This systematic review and meta-analysis aimed to provide current evidence regarding the effectiveness of telemonitoring for preventing COPD exacerbations, focusing on severe exacerbations requiring hospitalisation or emergency room (ER) visits. We systematically searched for randomised controlled trials using nine databases from August to September 2020 following the Cochrane Collaboration Guidelines. Of 2159 records identified, 22 studies involving 2906 participants met the inclusion criteria. The participants in 55% and 59% of studies had severe airflow limitations and severe exacerbation histories in the preceding year, respectively. The most commonly telemonitored data were oxygen saturation (91%) and symptoms (73%). A meta-analysis showed that telemonitoring did not reduce the number of admissions (12 studies) but decreased the number of ER visits due to severe exacerbations [7 studies combined, standardised mean difference (SMD) = -0.14; 95% confidence interval (CI): -0.28, -0.01]. Most studies reported no benefit in mortality, quality of life, or cost-effectiveness. All eight studies that surveyed participant satisfaction reported high satisfaction levels. Our review suggested that adding telemonitoring to usual care reduced unnecessary ER visits but was unlikely to prevent hospitalisations due to COPD exacerbations and that telemonitoring was well-accepted by patients with COPD and could be easily integrated into their existing care.

The effect of ILs as co-salts in electrolytes for high voltage supercapacitors.

Ionic liquids (ILs) which have electrical stability are attractive materials to enhance the potential window of electrolyte. According to the potential window is extended, available voltage for supercapacitor is broaden. In this study, the addition of ILs which is 1-ethyl-3-methylimidazolium tetrafluoroborate (EMIBF4) and 1-ethyl-3-methylimidazolium bis(trifluoromethylesulfonyl) imide (EMITFSI) as co-salts, to a supercapacitor electrolyte increases the ionic conductivity and stability of it due to inhibition of electrolyte decomposition. As a result, the electrochemical stability potential windows (ESPWs) of supercapacitor is improved and the supercapacitor exhibited increased cycling stability. The loss of specific capacitance upon addition of 7 wt% EMIBF4 or EMITFSI to the electrolyte was 2.5% and 8.7%, respectively, after 10,000 cycles at 3.5 V, compared to the specific capacitance of the initial discharge.

Bacteremia Prediction Model for Community-acquired Pneumonia: External Validation in a Multicenter Retrospective Cohort.

OBJECTIVE: Many studies have described constructing a prediction model for bacteremia in community-acquired pneumonia (CAP), but these studies were not validated in external heterogeneous groups. The objective of this study was to test the generalizability of a previous bacteremia prediction model for CAP by external validation. METHODS: This multicenter retrospective cohort analysis was performed in eight tertiary urban hospital emergency departments (EDs). We reviewed adult patients who were hospitalized after presentation to the ED with CAP. We categorized the enrolled patients into three groups according to the bacteremia prediction model score and calculated the number of patients with or without a blood culture-positive result. We performed a multivariable analysis to identify significant predictors for bacteremia. RESULTS: Among the enrolled 2,001 patients, 1,592 (79.6%), 371 (18.5%), and 38 (1.9%) were stratified to a low-, moderate-, and high-risk group, respectively, and this proportion was similar with previous study. Each group had a bacteremia-positive rate as follows: 1.2% for the low-risk group, 7.2% for the moderate-risk group, and 31.5% for the high-risk group. The area under the receiver operating characteristic curve for the bacteremia model in the external validation cohort was 0.81, and there was no significant difference with that of the previous internal validation cohort (p = 0.246). Assuming that blood cultures were not performed in the low-risk patients, the sensitivity and specificity of this model were 0.68 and 0.81, respectively. Additionally, the positive predictive value and negative predictive value were 9.54 and 98.87%, respectively. A platelet count less than 130 × 109 cells/L, albumin less than 3.3 mg/dL, and C-reactive protein greater than 17 mg/dL were identified as significant predictors with a sensitivity and specificity of 0.70 and 0.83, respectively. CONCLUSION: The bacteremia prediction model was well validated in the general population and could help physicians make the decision to reduce the number of blood cultures in patients with CAP.

SEALONE (Safety and Efficacy of Coronary Computed Tomography Angiography with Low Dose in Patients Visiting Emergency Room) trial: study protocol for a randomized controlled trial.

OBJECTIVE: Chest pain is one of the most common complaints in the emergency department (ED). Cardiac computed tomography angiography (CCTA) is a frequently used tool for the early triage of patients with low- to intermediate-risk acute chest pain. We present a study protocol for a multicenter prospective randomized controlled clinical trial testing the hypothesis that a low-dose CCTA protocol using prospective electrocardiogram (ECG)-triggering and limited-scan range can provide sufficient diagnostic safety for early triage of patients with acute chest pain. METHODS: The trial will include 681 younger adult (aged 20 to 55) patients visiting EDs of three academic hospitals for acute chest pain or equivalent symptoms who require further evaluation to rule out acute coronary syndrome. Participants will be randomly allocated to either low-dose or conventional CCTA protocol at a 2:1 ratio. The low-dose group will undergo CCTA with prospective ECG-triggering and restricted scan range from sub-carina to heart base. The conventional protocol group will undergo CCTA with retrospective ECG-gating covering the entire chest. Patient disposition is determined based on computed tomography findings and clinical progression and all patients are followed for a month. The primary objective is to prove that the chance of experiencing any hard event within 30 days after a negative low-dose CCTA is less than 1%. The secondary objectives are comparisons of the amount of radiation exposure, ED length of stay and overall cost. RESULTS AND CONCLUSION: Our low-dose protocol is readily applicable to current multi-detector computed tomography devices. If this study proves its safety and efficacy, dose-reduction without purchasing of expensive newer devices would be possible.

The clinical significance of changes in red blood cell distribution width in patients with community-acquired pneumonia.

OBJECTIVE: Red cell distribution width (RDW) is associated with mortality in patients with community-acquired pneumonia (CAP). However, little is known about the effect of changes in RDW during treatment on mortality. Thus, the objective of this study was to evaluate the association between RDW changes and mortality in hospitalized patients with CAP. METHODS: Retrospective analyses were performed using medical records of patients hospitalized for CAP from April 2008 to February 2014. The abstracted laboratory values included RDW (from days one to four), clinical variables, and pneumonia severity index (PSI) scores. The ΔRDWn-1 was defined as the change in RDW calculated as: (RDWday1-RDWday-n)/RDWday1×100 (%), where 'day n' refers to hospital day. RESULTS: During the study period, a total of 1,069 patients were hospitalized for CAP. The 30-day mortality was 100/1,069 (9.4%). The median RDW at baseline was 14.1% (range, 11.1 to 30.2) and differed significantly between survivors and non-survivors (P<0.05). There were 470 patients with available serial RDW data (30-day mortality 58/470 [12.3%]). Of those, age, PSI score, blood urea nitrogen level, total protein concentration, albumin level, RDW at day 1, and the ΔRDW4-1 differed significantly between survivors and non-survivors. Multivariate Cox regression analysis showed that the significance of the relationship between ΔRDW4-1 and 30-day mortality risk remained after adjusting for age, PSI score, RDW at day 1, total protein concentration, and initial albumin level. CONCLUSION: RDW change from day 1 to day 4 was an independent predictor of mortality in patients with CAP.

MotionFlow: Visual Abstraction and Aggregation of Sequential Patterns in Human Motion Tracking Data.

Pattern analysis of human motions, which is useful in many research areas, requires understanding and comparison of different styles of motion patterns. However, working with human motion tracking data to support such analysis poses great challenges. In this paper, we propose MotionFlow, a visual analytics system that provides an effective overview of various motion patterns based on an interactive flow visualization. This visualization formulates a motion sequence as transitions between static poses, and aggregates these sequences into a tree diagram to construct a set of motion patterns. The system also allows the users to directly reflect the context of data and their perception of pose similarities in generating representative pose states. We provide local and global controls over the partition-based clustering process. To support the users in organizing unstructured motion data into pattern groups, we designed a set of interactions that enables searching for similar motion sequences from the data, detailed exploration of data subsets, and creating and modifying the group of motion patterns. To evaluate the usability of MotionFlow, we conducted a user study with six researchers with expertise in gesture-based interaction design. They used MotionFlow to explore and organize unstructured motion tracking data. Results show that the researchers were able to easily learn how to use MotionFlow, and the system effectively supported their pattern analysis activities, including leveraging their perception and domain knowledge.

Hydrogen fermentation of food waste by alkali-shock pretreatment: microbial community analysis and limitation of continuous operation.

In the study, at first, batch tests were performed to investigate the effect of alkali-shock on H2 production from food waste (FW). After alkali-pretreatment of FW at pH 9.0-13.0, the FW was cultivated under mesophilic condition at pH 6.0 for 30 h without external inoculum addition. The amount of H2 production from FW pretreated at pH 11.0 and 12.0 was higher than that achieved in other pretreatment pH. The main metabolite was butyrate, and Clostridium were dominant at pH 11.0 and 12.0. Meanwhile, lactate was the main metabolite with Enterococcus and Streptococcus being the dominant genus at other pretreatment pH. When the batch process was switched to a continuous mode, H2 production was significantly dropped due to the increased activity of H2-consumers. The reliability of alkali-pretreatment at pH 11.0 was proven by repeating the scale-up batch process, recording 1.57±0.11 mol H2/mol hexose(added) (17±2LH2/kg FW) and 4.39±0.32LH2/L/d.

γ-Irradiated cancer cells promote tumor growth by activation of Toll-like receptor 1-mediated inducible nitric oxide synthase in macrophages.

RT is commonly used to treat malignant tumors. However, tumor regrowth is a major limitation to RT as an antitumor treatment. In the present study, we investigated the tumor-promoting effects of high-dose (or ablative) RT treatments on tumor-bearing mice. We focused on the role of macrophages that interact with IR-CCs in the TME, which cause tumor regrowth. We observed that CT26(H-2(d)) tumor growth was enhanced by i.v. injection of IR-CT26 cells compared with NR control CT26 cells. The levels of iNOS gene expression and NO production from RAW264.7 macrophages (H-2(d)) in response to the interaction with IR-CT26 cells were higher than with NR-CT26 cells. When CT26 tumor-bearing mice were treated i.v. with L-NMMA, a NOS inhibitor, the reduction in in vivo tumor growth was higher in the IR-CT26-injected group compared with the NR-CT26-injected control group. In vivo CT26 tumor growth was decreased after transplanting PEM extracted from L-NMMA-treated, tumor-bearing mice. Although iNOS activity was reduced by inhibiting TLR1 expression with TLR1-siRNA, it was enhanced by TLR1 overexpression. Transcriptional activation and protein expression levels of iNOS were also decreased in the presence of TLR1-siRNA but increased as a result of TLR1 overexpression. These results demonstrate that postradiotherapeutic tumor regrowth may be caused by interaction of IR-CCs with macrophages that induce TLR1-mediated iNOS expression and NO production. Our data suggest that iNOS in macrophages could be a useful target to regulate postradiotherapeutic responses in hosts and subsequently limit tumor regrowth.

Effect of the accuracy of pH control on hydrogen fermentation.

pH, known as the most important parameter in H2 fermentation, cannot be precisely controlled in a scaled-up fermenter as in a lab fermenter. In the preset work, to assess the effect of pH control accuracy on H2 fermentation, the pH was controlled at 6.0±0.1, 6.0±0.3, 6.0±0.5, 6.0±0.7, and 6.0±0.9 during batch fermentation of food waste. Up to deviation of ±0.3, a high H2 yield of 1.67-1.73 mol H2/mol hexose(added) was attained with producing butyrate as a major metabolite (>70% of total organic acids produced). A huge drop of H2 production, however, was observed at deviation >±0.5 with lowered substrate utilization and increased production of lactate. Next generation sequencing results showed that Clostridium was found to be the dominant genus (76.4% of total number of sequences) at deviation of ±0.1, whereas the dominant genus was changed to lactic acid bacteria such as Streptococcus and Lactobacillus with increase of deviation value.

Awareness and knowledge of sepsis in the general Korean population: comparison with the awareness and knowledge of acute myocardial infarction and stroke.

OBJECTIVE: Patients with severe sepsis or septic shock require timely, aggressive management to improve their outcomes, and early presentation of patients to the hospital may also be important. Thus, public awareness about sepsis may be important for improved outcomes. However, there are no studies regarding the public awareness of sepsis in the general Korean population. Therefore, the objective of this survey was to gain insight into the public awareness of sepsis. METHODS: Prospective paper-based and web-based surveys were issued between May and June 2013 to adults aged ≥18 years. RESULTS: A total of 1,081 participants responded to the survey (394 paper-based and 687 web-based). Mean age was 38.7±11.4 years, and 541 participants (50%) were men. Of the 1,081 participants, 831 (76.9%) had heard of the term "sepsis." Of these participants, only 295 (35%) responded correctly regarding the definition of sepsis. However, 1,019 participants (94.3%) had heard of acute myocardial infarction, and 817 of these (80%) correctly defined acute myocardial infarction. Regarding stroke, 1,047 (96.9%) had heard of stroke, and 975 of these responded (93.1%) correctly to the definition of stroke. CONCLUSION: There is poor public awareness about sepsis compared with that of acute myocardial infarction and stroke. This may limit the timely management of severe sepsis and septic shock.

Comparison of four different methods for the determination of sulfites in foods marketed in South Korea.

Sulfites in foods were analysed using four methods: optimised Monier-Williams (official method), modified Rankine, HPLC and ion-exchange chromatography (IEC). The modified Rankine and HPLC methods were performed according to the previously reported methods but with some modifications. The IEC method was carried out through a combination of a modified Rankine apparatus and an anion-exchange column for the first time. In false-positive response tests, false-positive results with acetic acid and propionic acid were not observed in the modified Rankine, HPLC or IEC methods, unlike the optimised Monier-Williams method. All methods were evaluated for accuracy, precision and simple correlations. Modified Rankine, HPLC and IEC methods were determined to be suitable for foods with less than 10 mg kg(-1) of sulfur dioxide (SO2). The modified Rankine and HPLC methods were suggested to be the most appropriate for the determination of sulfites in foods due to their high correlation coefficient with the optimised Monier-Williams method (R(2) = 0.9138 and 0.9011, respectively).