Ultrafast Plasmonic Nucleic Acid Amplification and Real-Time Quantification for Decentralized Molecular Diagnostics.

Point-of-care real-time reverse-transcription polymerase chain reaction (RT-PCR) facilitates the widespread use of rapid, accurate, and cost-effective near-patient testing that is available to the public. Here, we report ultrafast plasmonic nucleic acid amplification and real-time quantification for decentralized molecular diagnostics. The plasmonic real-time RT-PCR system features an ultrafast plasmonic thermocycler (PTC), a disposable plastic-on-metal (PoM) cartridge, and an ultrathin microlens array fluorescence (MAF) microscope. The PTC provides ultrafast photothermal cycling under white-light-emitting diode illumination and precise temperature monitoring with an integrated resistance temperature detector. The PoM thin film cartridge allows rapid heat transfer as well as complete light blocking from the photothermal excitation source, resulting in real-time and highly efficient PCR quantification. Besides, the MAF microscope exhibits close-up and high-contrast fluorescence microscopic imaging. All of the systems were fully packaged in a palm size for point-of-care testing. The real-time RT-PCR system demonstrates the rapid diagnosis of coronavirus disease-19 RNA virus within 10 min and yields 95.6% of amplification efficiency, 96.6% of classification accuracy for preoperational test, and 91% of total percent agreement for clinical diagnostic test. The ultrafast and compact PCR system can decentralize point-of-care molecular diagnostic testing in primary care and developing countries.

Activated chemical bonds in nanoporous and amorphous iridium oxides favor low overpotential for oxygen evolution reaction.

To date, the search for active, selective, and stable electrocatalysts for the oxygen evolution reaction (OER) has not ceased and a detailed atomic-level design of the OER catalyst remains an outstanding (if not, compelling) problem. Considerable studies on different surfaces and polymorphs of iridium oxides (with varying stoichiometries and dopants) have emerged over the years, showing much higher OER activity than the conventionally reported rutile-type IrO2. Here, we have considered different metastable nanoporous and amorphous iridium oxides of different chemical stoichiometries. Using first-principles electronic structure calculations, we investigate the (electro)chemical stability, intercalation properties, and electronic structure of these iridium oxides. Using an empirical regression model between the Ir-O bond characteristics and the measured OER overpotentials, we demonstrate how activated Ir-O bonds (and the presence of more electrophilic oxygens) in these less understood polymorphs of iridium oxides can explain their superior OER performance observed in experiments.

Metal-Organic Framework-Derived Hollow CoSx Nanoarray Coupled with NiFe Layered Double Hydroxides as Efficient Bifunctional Electrocatalyst for Overall Water Splitting.

For effective hydrogen production by water splitting, it is essential to develop earth-abundant, highly efficient, and durable electrocatalysts. Herein, the authors report a bifunctional electrocatalyst composed of hollow CoSx and Ni-Fe based layered double hydroxide (NiFe LDH) nanosheets for efficient overall water splitting (OWS). The optimized heterostructure is obtained by the electrodeposition of NiFe LDH nanosheets on metal-organic framework-derived hollow CoSx nanoarrays, which are supported on nickel foam (H-CoSx @NiFe LDH/NF). The unique structure of the hybrid material not only provides ample active sites, but also facilitates electrolyte penetration and gas release during the reactions. Additionally, the strong coupling and synergy between the hydrogen evolution reaction (HER) active CoSx and the oxygen evolution reaction (OER) active NiFe LDH gives rise to the excellent bifunctional properties. Consequently, H-CoSx @NiFe LDH/NF exhibits remarkable HER and OER activities with overpotentials of 95 and 250 mV, respectively at 10 mA cm-2 in 1.0 M KOH. Even at 1.0 A cm-2 , the electrode requires small overpotentials of 375 mV (for HER) and 418 mV (for OER), respectively. An electrolyzer based on H-CoSx @NiFe LDH/NF demonstrates a low cell voltage of 1.98 V at a current density of 300 mA cm-2 and good durability for 100 h in OWS application.

Carbon-Coated Three-Dimensional MXene/Iron Selenide Ball with Core-Shell Structure for High-Performance Potassium-Ion Batteries.

Two-dimensional (2D) MXenes are promising as electrode materials for energy storage, owing to their high electronic conductivity and low diffusion barrier. Unfortunately, similar to most 2D materials, MXene nanosheets easily restack during the electrode preparation, which degrades the electrochemical performance of MXene-based materials. A novel synthetic strategy is proposed for converting MXene into restacking-inhibited three-dimensional (3D) balls coated with iron selenides and carbon. This strategy involves the preparation of Fe2O3@carbon/MXene microspheres via a facile ultrasonic spray pyrolysis and subsequent selenization process. Such 3D structuring effectively prevents interlayer restacking, increases the surface area, and accelerates ion transport, while maintaining the attractive properties of MXene. Furthermore, combining iron selenides and carbon with 3D MXene balls offers many more sites for ion storage and enhances the structural robustness of the composite balls. The resultant 3D structured microspheres exhibit a high reversible capacity of 410 mAh g-1 after 200 cycles at 0.1 A g-1 in potassium-ion batteries, corresponding to the capacity retention of 97% as calculated based on 100 cycles. Even at a high current density of 5.0 A g-1, the composite exhibits a discharge capacity of 169 mAh g-1.

Subscapularis re-tears associated with preoperative advanced fatty infiltration and greater subscapularis involvement, leading to inferior functional outcomes and decreased acromiohumeral distance.

PURPOSE: This study aimed to investigate the influence of repaired subscapularis integrity on midterm results for anterosuperior massive rotator cuff tears (MRCTs) treated with partial rotator cuff repair. METHODS: This study included 57 patients who underwent arthroscopic partial repair for an anterosuperior MRCT. They were assigned to the healed subscapularis group (Group H 37 patients) or subscapularis re-tear group (Group R 20 patients). Preoperative and postoperative functional scores and active ranges of motion (ROMs) were assessed. Preoperative and 6-month follow-up magnetic resonance arthrography (MRA)/computed tomography arthrography (CTA) images were compared between groups. RESULTS: At the final follow-up, mean functional shoulder scores including ROMs improved significantly in both groups compared to preoperative values (p < 0.001), except for forward flexion and internal rotation in Group R. All final functional values and ROMs (excluding external rotation) were better in Group H than in Group R (p < 0.001). Preoperative stage of fatty infiltration in the subscapularis muscle was significantly worse in Group R (p < 0.001). On follow-up MRA/CTA, the immediate residual defect after partial repair increased in 81% (30/37; mean, 17.8 mm) of patients in Group H and 100% (mean 24.6 mm) in Group R (p < 0.001). At final follow-up, mean acromiohumeral distance significantly decreased from 8.2 to 6.0 mm in Group H (p < 0.001) and from 8.3 to 4.9 mm in Group R (p < 0.001). There was a significant difference in final acromiohumeral distance between groups (p < 0.001). CONCLUSION: After a minimum 5-year follow-up after arthroscopic partial repair of anterosuperior MRCT, subscapularis re-tear was identified in 35% of patients (20/57) on early postoperative follow-up MRA/CTA. The subscapularis re-tear group exhibited more preoperative advanced fatty infiltration and greater extents of subscapularis involvement, which led to statistically inferior functional outcomes and decreased acromiohumeral distance at final follow-up. Nonetheless, in terms of a minimal clinically important difference, substantial clinical benefit, and patient-acceptable symptomatic state for clinical significance, there were no significant differences between the groups. LEVEL OF EVIDENCE: III.

Does an "Off-Track" Hill-Sachs Lesion That Is Misclassified as "Non-Engaging" Affect Outcomes From Bankart Repair Alone Compared With Bankart Repair Combined With Remplissage?

PURPOSE: To determine how intraoperative assessment (engagement test) may affect recurrent dislocation rate and to compare the clinical outcomes, recurrence rates, and presence of on-/off-track conditions between cases that received arthroscopic Bankart repair alone (nonengaged Hill-Sachs lesion) and Bankart repair with remplissage (engaged Hill-Sachs lesion). METHODS: We retrospectively reviewed 213 patients who underwent arthroscopic Bankart repair alone (186 patients with nonengaging lesions, group A) or with remplissage (27 patients with engaging lesion, group B) for recurrent anterior shoulder instability with <25% glenoid bone defect. The presence of an engaging Hill-Sachs lesion was determined during arthroscopic evaluation. On-track or off-track lesions were assessed retrospectively from preoperative 3-dimensional (3D) computed tomography (CT). RESULTS: Mean glenoid bone defect was 13.7% in group A and 20.7% in group B (P < .001). Off-track lesions were identified in 8.1% (15/186) and 100% (27/27) in group B. At the final follow-up (minimum 2 years; mean follow-up periods after surgery of 50.1 months in group A and 47.7 months in group B), there were no significant differences in shoulder functional scores and recurrence rates between groups, despite improvement after surgery. In the off-track lesion (group A-1: nonengaging but off-track lesion), recurrence instability occurred in 9 patients (60%, 9/15). Also, comparing group A-1 and group B, we noted significant differences in shoulder functional scores and recurrence rates (P < .001). CONCLUSION: Of 186 patients, 8.1% with nonengaging Hill-Sachs lesions during direct arthroscopic examination under anesthesia actually demonstrated off-track lesions on preoperative 3D CT scans retrospectively, with 60% experiencing recurrent instability. Intraoperative manual assessment for Hill-Sachs engagement was inferior to 3D CT scan in establishing the presence of off-track defects. LEVEL OF EVIDENCE: III, retrospective comparative study.

Bone Marrow Stimulation in Arthroscopic Repair for Large to Massive Rotator Cuff Tears With Incomplete Footprint Coverage.

BACKGROUND: There is no research on incomplete footprint coverage with single-row repair related to bone marrow stimulation (BMS) in large to massive rotator cuff tears (RCTs). PURPOSE/HYPOTHESIS: The purpose was to compare the clinical results and structural integrity between BMS and non-BMS groups that underwent arthroscopic repair of large to massive rotator cuff tears with <50% footprint coverage. It was hypothesized that both groups would exhibit improved clinical outcomes at 2 years after surgery but the BMS group would have significantly better clinical outcomes and structural integrity. STUDY DESIGN: Cohort study; Level of evidence, 3. METHODS: This study included 98 patients who underwent arthroscopic repair with <50% footprint coverage for large to massive RCTs with (BMS group; n = 56) or without (non-BMS group; n = 42) BMS. Functional outcomes at the 2-year follow-up were assessed using the visual analog scale for pain score, subjective shoulder value; American Shoulder and Elbow Surgeons score; University of California, Los Angeles, shoulder score; and active range of motion. Structural integrity was evaluated using magnetic resonance arthrography or computed tomography arthrography results at 6 months postoperatively. RESULTS: At the 2-year follow-up, all functional outcomes significantly improved in both groups compared with preoperative values (P < .001). However, there were no significant postoperative differences between groups. On follow-up magnetic resonance arthrography or computed tomography arthrography, the overall retear rate was not significantly different between the BMS group (30.3%; 17/56) and the non-BMS group (35.7%; 15/42). CONCLUSION: While both groups exhibited functional improvement after single-row repair with <50% footprint coverage for large to massive RCTs, BMS did not produce better clinical outcomes or structural integrity.

A Prospective, Randomized Cross-Over Trial of T2 Paravertebral Block as a Sympathetic Block in Complex Regional Pain Syndrome.

BACKGROUND: Sympathetic block is commonly performed in clinical practice for management of intractable pain conditions. However, stellate ganglion block (SGB) alone often does not achieve sufficient sympatholysis of the upper extremity. The paravertebral space continues up to the cervical sympathetic chain and includes the stellate ganglion. We compared the sympatholytic and analgesic effect of paravertebral block performed at the T2 level (T2 PVB) with that of SGB in patients with complex regional pain syndrome (CRPS) of the upper extremity. OBJECTIVES: The aim of this study was to compare the sympatholytic property of T2 PVB with that of the conventional SGB in patients with CRPS of the upper extremity. STUDY DESIGN: Prospective, randomized cross-over trial. SETTING: University hospital pain center in Korea. METHODS: Fifteen patients with upper extremity CRPS were randomly assigned to 1 of 2 intervention methods (SGB or T2 PVB). After effects of the first block receded, the patients were crossed over to the second procedure. A difference in temperature increase between the treated side and the opposite side (DeltaT) DeltaT greater than or equal to1.5°C was considered as a successful primary outcome. Rate of successful primary outcome, degree of pain reduction, duration of effect, and patient satisfaction scores were compared between the 2 intervention methods. RESULTS: Rate of successful primary outcome (DeltaT greater than or equal to 1.5°C) was significantly higher in the T2 PVB cases than in the SGB cases (80.0% vs. 20.0%; P = 0.003). Numeric Rating Scale scores after the procedure were significantly lower in the T2 PVB group. Patient satisfaction scores were significantly higher, and the duration of the block was significantly longer in the T2 PVB cases than in the SGB cases. LIMITATIONS: The relatively small sample size from a single center, and the lack of standardization of the injected volume of T2 PVB and SGB were limitations. CONCLUSIONS: T2 PVB showed superior sympatholytic effect than SGB; other clinical outcomes were also better with T2 PVB than with SGB. T2 PVB can be a useful option for producing sympatholytic and analgesic effect in patients with CRPS of the upper extremity. KEY WORDS: Sympathetic block, Complex Regional Pain Syndrome, paravertebral block, stellate ganglion block.

Polymorphic expressions of ultrathin oxidic layers of Mo on Au(111).

Ultrathin oxidic layers of Mo (i.e. O/Mo) on the Au(111) substrate are investigated using first-principles density-functional theory calculations. Various polymorphic structural models of these O/Mo layers are proposed and compared with previous experimental results - covering both spectroscopic and microscopic approaches of characterization. We find that, through the control of metal-oxygen coordination in these ultrathin oxidic O/Mo films on Au(111), the oxidation state of Mo atoms in the O/Mo layers can be modulated and reduced without intentional creation of oxygen vacancies. This is also assisted by a charge transfer mechanism from the Au substrate to these oxidic films, providing a direct means to tune the surface electronic properties of ultrathinoxide films on metal substrates.

Clinical effects of pulsed radiofrequency to the thoracic sympathetic ganglion versus the cervical sympathetic chain in patients with upper-extremity complex regional pain syndrome: A retrospective analysis.

Pulsed radiofrequency (PRF) to the thoracic sympathetic ganglion (TSG PRF) or to the cervical sympathetic chain (CSC PRF) can be performed to overcome transient effects of single sympathetic blocks in patients with upper-extremity complex regional pain syndrome (CRPS).We retrospectively compared the clinical effects of TSG PRF and CSC PRF. Seven TSG PRF cases and 10 CSC PRF cases were enrolled in the present analysis. We assessed effectiveness with multiple clinical measurements: a numerical rating scale (NRS) of pain before and 1 week after the procedure, postprocedure temperature, effect duration, and a self-described patient satisfaction score.The temperature was significantly higher in TSG PRF cases than in CSC PRF cases. Pain values (according to the NRS) 1 week after the procedure were significantly lower, and the effect duration was significantly longer, after TSG PRF than after CSC PRF.TSG PRF is a more effective procedure than CSC PRF for managing chronic upper-extremity CRPS.

Electron transport phenomena at the interface of Al electrode and heavily doped degenerate ZnO nanoparticles in quantum dot light emitting diode.

ZnO nanoparticles (NPs) of 4-5 nm, widely adopted as an electron transport layer (ETL) in quantum dot light emitting diodes (QD-LEDs), were synthesized using the solution-precipitation process. It is notable that synthesized ZnO NPs are highly degenerate intrinsic semiconductors and their donor concentration can be increased up to N D = 6.9 × 1021 cm-3 by annealing at 140 °C in air. An optical bandgap increase of as large as 0.16-0.33 eV by degeneracy is explained well by the Burstein-Moss shift. In order to investigate the influence of intrinsic defects of ZnO NP ETLs on the performance of QD-LED devices without a combined annealing temperature between ZnO NP ETLs and the emissive QD layer, pre-annealed ZnO NPs at 60 °C, 90 °C, 140 °C, and 180 °C were spin-coated on the annealed QD layer without further post-annealing. As the annealing temperature increases from 60 °C to 180 °C, the defect density related to oxygen vacancy (V O) in ZnO NPs is reduced from 34.4% to 17.8%, whereas the defect density of interstitial Zn (Zni) is increased. Increased Zni reduces the width (W) of the depletion region from 0.21 to 0.12 nm and lowers the Schottky barrier (ФB) between ZnO NPs and the Al electrode from 1.19 to 0.98 eV. We reveal for the first time that carrier conduction between ZnO NP ETLs and the Al electrode is largely affected by the concentration of Zni above the conduction band minimum, and effectively described by space charge limited current and trap charge limited current models.

Over-Stoichiometry in Heavy Metal Oxides: The Case of Iono-Covalent Tantalum Trioxides.

Oxides of tantalum (common examples including TaO, TaO2, and Ta2O5) are key oxide materials for modern electronic devices, such as dynamic random-access memory and field effect transistors. Of late, new forms of stable tantalum oxides have been proposed as two-dimensional nanosheet structures with a nonconventional stoichiometry of TaO3 via soft-chemical delamination of RbTaO3. However, not much is known about the elusive nanosheet-structured TaO3, unlike other closely related common trioxides of W and Mo. In this work, using first-principles density functional theory calculations, we have studied various TaO3 structures as inspired from previous theoretical and experimental studies and discuss their properties with respect to the more conventional oxide of tantalum, Ta2O5. We have calculated their thermodynamics and lattice properties and have found a new stable-layered ß-TaO3 and its exfoliated monolayer phase (ß'). By further analyzing their electronic structures, we discuss the mixed iono-covalent bonding characteristics in the TaO3 phases, challenging the conventional formal oxidation state model for metal oxides. Finally, we propose how these new TaO3 oxide materials may be potentially useful in photodevice applications.

Extramedullary Tibial Bone Cutting Using Medial Cortical Line in Total Knee Arthroplasty.

Purpose: This study aims to identify the effectiveness of the medial cortical line for attaining a more accurate tibial component alignment in proximal tibial resection using an extramedullary alignment rod. Materials and Methods: The study examined 100 cases of total knee arthroplasty performed from December 2013 to February 2014 in a retrospective manner. On a preoperative anteroposterior (AP) radiograph of the entire tibia, we identified the medial cortical line that runs parallel to the tibial anatomical axis and passes the medial tibial spine, and measured the point where the medial cortical line crosses between the medial malleolus and the lateral malleolus in the ankle joint. Results: The preoperative AP radiograph of the tibia showed the medial cortical line passing the point 40.4%±0.8% medial to the distance from the medial malleolus to the lateral malleolus including the skin thickness in the ankle joint. When the proximal tibial resection was performed with the extramedullary tibial cutting guide aligned with the medial cortical line, the tibial component angle averaged 0.7°±0.3° varus and the alignment accuracy of the tibial component within 0°±3° varus amounted to 97.0%. Conclusions: The use of the medial cortical line in proximal tibial resection with an extramedullary tibial cutting guide allowed for relatively accurate alignment of the tibial component.

Nonvolatile Ferroelectric Memory Circuit Using Black Phosphorus Nanosheet-Based Field-Effect Transistors with P(VDF-TrFE) Polymer.

Two-dimensional van der Waals (2D vdWs) materials are a class of new materials that can provide important resources for future electronics and materials sciences due to their unique physical properties. Among 2D vdWs materials, black phosphorus (BP) has exhibited significant potential for use in electronic and optoelectronic applications because of its allotropic properties, high mobility, and direct and narrow band gap. Here, we demonstrate a few-layered BP-based nonvolatile memory transistor with a poly(vinylidenefluoride-trifluoroethylene) (P(VDF-TrFE)) ferroelectric top gate insulator. Experiments showed that our BP-based ferroelectric transistors operate satisfactorily at room temperature in ambient air and exhibit a clear memory window. Unlike conventional ambipolar BP transistors, our ferroelectric transistors showed only p-type characteristics due to the carbon-fluorine (C-F) dipole effect of the P(VDF-TrFE) layer, as well as the highest linear mobility value of 1159 cm(2) V(-1) s(-1) with a 10(3) on/off current ratio. For more advanced memory applications beyond unit memory devices, we implemented two memory inverter circuits, a resistive-load inverter circuit and a complementary inverter circuit, combined with an n-type molybdenum disulfide (MoS2) nanosheet. Our memory inverter circuits displayed a clear memory window of 15 V and memory output voltage efficiency of 95%.

Altered Quality of Life and Psychological Health (SCL-90-R) in Patients With Chronic Rhinosinusitis With Nasal Polyps.

OBJECTIVES: To investigate the impact of olfactory dysfunction on quality of life (QOL) and psychological status in patients with chronic rhinosinusitis with nasal polyps (CRSwNP). METHODS: A retrospective observational study was conducted from January 2011 to May 2012 with 130 patients with septal deviation (SD) (n = 59) and CRSwNP (n = 71). All patients underwent computed tomography (CT), allergy tests, and sniffin' stick olfactory test. Anosmia was defined by Threshold-Discrimination-Identification (TDI) scores less than 16. QOL and psychological symptoms were assessed with the Sinonasal Outcome Test-20 (SNOT-20) and Symptom Checklist-90-Revised (SCL-90-R). RESULTS: Odor discrimination and identification scores were significantly lower in CRSwNP than in SD (P = .008 and P = .005, respectively). In CRSwNP, identification score decreased with higher CT score (r = -0.29, P = .014). CRSwNP with anosmia showed a decreased QOL (P = .044), and SNOT-20 negatively correlated with TDI in severe CRSwNP (CT score ≥15, r = -0.714, P = .001). Anosmia patients had higher anxiety and phobia scores of SCL-90-R in both SD and CRSwNP. However, depression score increased only in CRSwNP with anosmia (P = .025). CONCLUSION: Olfactory dysfunction may have significant effects on QOL and psychological health. CRSwNP with anosmia is a distinct phenotype having mixed type of olfactory loss that might have a detrimental effect on depression.