Assessing Glycosylated Hemoglobin Thresholds for Development of Cardiovascular Disease by Racial and Ethnic Groups.

BACKGROUND: Diabetes is the strongest risk factor for cardiovascular disease, and although glycosylated hemoglobin (HbA1c) levels are known to vary by race, no racial and ethnic-specific diagnostic thresholds exist for diabetes in prediction of cardiovascular disease events. The purpose of this study is to determine whether HbA1c thresholds for predicting major adverse cardiovascular events (MACEs) differ among racial and ethnic groups. METHODS AND RESULTS: This is a retrospective cohort study of Kaiser Permanente Northern California adult members (n=309 636) with no history of cardiovascular disease who had HbA1c values and race and ethnicity data available between 2014 and 2019. Multivariable logistic regression was used to evaluate the odds of MACEs by the following racial and ethnic groups: Filipino, South Asian, East Asian, Black, White, and Hispanic. A Youden index was used to calculate HbA1c thresholds for MACE prediction by each racial and ethnic group, stratified by sex. Among studied racial and ethnic groups, South Asian race was associated with the greatest odds of MACEs (1.641 [95% CI, 1.456-1.843]; P<0.0001). HbA1c was a positive predictor for MACEs, with an odds ratio of 1.024 (95% CI, 1.022-1.025) for each 0.1% increment increase in HbA1c. HbA1c values varied between 6.0% and 7.6% in MACE prediction by race and ethnicity and sex. White individuals, South Asian individuals, East Asian women, and Black men had HbA1c thresholds for MACE prediction in the prediabetic range, between 6.0% and 6.2%. Black women, Hispanic men, and East Asian men had HbA1c thresholds of 6.2% to 6.6%, less than the typical threshold of 7.0% that is used as a treatment goal. CONCLUSIONS: Findings suggest that the use of race and ethnic- and sex-specific HbA1c thresholds may need to be considered in treatment goals and cardiovascular disease risk estimation.

Wearable mobile health device for monitoring postoperative ambulation among patients with colorectal cancer undergoing minimally invasive surgery: A prospective comparison study.

BACKGROUND: This study aimed to evaluate the feasibility of using mHealth devices for monitoring postoperative ambulation among patients with colorectal cancer undergoing minimally invasive surgery (MIS). METHODS: Patients with colorectal cancer undergoing MIS were prospectively recruited to wear mHealth devices for recording postoperative ambulation between October 2018 and January 2021. The primary outcome was the compliance by evaluating the weekly submission rate of step counts. The secondary outcome was the association of weekly step counts and postoperative length of stay. RESULTS: Of 107 eligible patients, 53 patients wore mHealth devices, whereas 54 patients did not. The average weekly submission rate was 72.6% for the first month after surgery. The total step counts <4000 or >10 000 in the postoperative week one were negatively associated with postoperative length of stay (ß = -2.874, p = 0.038). CONCLUSIONS: mHealth devices provide an objective assessment of postoperative ambulation among patients with colorectal cancer undergoing MIS. CLINICAL TRIAL REGISTRATION: NCT03277235.

Correlation between Subchondral Insufficiency Fracture of the Knee and Osteoarthritis Progression in Patients with Medial Meniscus Posterior Root Tear.

A medial meniscus posterior root tear (MMPRT) contributes to knee joint degeneration. Arthroscopic transtibial pullout repair (ATPR) may restore biomechanical integrity for load transmission. However, degeneration persists after ATPR in certain patients, particularly those with preoperative subchondral insufficiency fracture of the knee (SIFK). We explored the relationship between preoperative SIFK and osteoarthritis (OA) progression in retrospectively enrolled patients who were diagnosed as having an MMPRT and had received ATPR within a single institute. Based on their preoperative magnetic resonance imaging (MRI), these patients were then categorized into SIFK and non-SIFK groups. OA progression was evaluated by determining Kellgren-Lawrence (KL) grade changes and preoperative and postoperative median joint widths. SIFK characteristics were quantified using Image J (Version 1.52a). Both groups exhibited significant post-ATPR changes in medial knee joint widths. The SIFK group demonstrated significant KL grade changes (p < 0.0001). A larger SIFK size in the tibia and a greater lesion-to-tibia length ratio in the coronal view were positively correlated with more significant KL grade changes (p = 0.008 and 0.002, respectively). Thus, preoperative SIFK in patients with an MMPRT was associated with knee OA progression. Moreover, a positive correlation was observed between SIFK lesion characteristics and knee OA progression.

Post-Operative Greater Tuberosity Resorption or Malreduction Is Associated with Poor Prognostic Outcomes in Patients with Proximal Humeral Fractures Treated Operatively-A Single-Center Retrospective Cohort Study.

(1) Background: Proximal humerus fractures can be a debilitating condition if not properly treated. These fracture patterns are varied and differ in every patient. Functional outcomes may be determined by the integrity of the shoulder girdle involving the rotator cuff insertion. The post-operative resorption or malreduction of the greater tuberosity (GT) is an important factor contributing to the poor functional outcome of a patient. Thus, we intend to evaluate the cause-and-effect relationship between GT complications and clinical prognosis and outcomes. (2) Methods: A single-center retrospective comparative study was performed to evaluate the functional outcomes of patients undergoing operative fixation for this injury. A total of 387 consecutive cases treated operatively from 2019-2021 were included for analysis. (3) Results: 94 cases fulfilled our criteria for analysis. A matched-group comparison of 19 patients each was performed to compare demographics, post-operative fracture characteristics and clinical outcomes. (4) Conclusions: The resorption or malreduction of the GT contributes greatly to the prognostic outcome in patients treated with open reduction and internal fixation (ORIF) surgery. In our demographic study, obesity is another contributing factor affecting the parameters of post-operative reduction in proximal humerus fractures. Appropriate surgical planning and post-operative multidisciplinary care must be taken into consideration to attain a satisfactory prognostic outcome.

Reply to Ott, M.; Werneke, U. Comment on "Liu et al. Hemodialysis Treatment for Patients with Lithium Poisoning. Int. J. Environ. Res. Public Health 2022, 19, 10044".

We would like to thank Professor Ott and Professor Werneke for their helpful comments [...].

Paramagnetic Semiconducting Se-Mn Clusters: A Mn3Se4-Stabilized Selenide Radical Intermediate and Its Aggregated Derivatives.

The transition metal-stabilized heavy main group radicals are extremely scarce due to their highly reactive natures, making them difficult to be isolated and identified. We report here a rare class of the Se radical-containing manganese carbonyl anionic cluster, [(µ-Se)(µ3-Se2)2Mn3(CO)9]•2- (1), which was successfully obtained from the one-pot reaction of Se powder and Mn2(CO)10 in concentrated KOH/MeOH/MeCN solutions at 90 °C. Dianion 1 and its dimeric cluster, [(µ4-Se2){(µ3-Se2)2Mn3(CO)9}2]4- [(1)2], could undergo the reversible Se-Se bond breakage or reformation by the thermal cracking of (1)2 or self-dimerization of 1, showing the µ-Se•- radical character of 1. Complex 1 could react with (2,2,6,6-tetramethylpiperidin-1-yl)oxyl (TEMPO) to form the Se radical-captured complex [(µ-Se(TEMPO)) (µ3-Se2)2Mn3(CO)9]2- (1-TEMPO) or could react with alkylene bromides (CH2)nBr2 (n = 1, 2) to give the Mn4-based oxidative coupling products, [(µ4-Se2)(µ-Se2LSe)2Mn4(CO)12]2- (L = CH2, 2-CH2; Se, 2-Se). In addition, dianion 1 and its aggregated derivatives (1)2, 1-TEMPO, 2-CH2, and 2-Se exhibited unusual paramagnetic properties with the spin-state switching from S = 1 (Mn) + 1/2 (Se) to S = 1 (Mn), in which their magnetic centers were proved to be mixed-valent Mn atoms and the µ-Se•- radical, as evidenced by Evans method, superconducting quantum interference device, X-ray photoelectron spectra, electron paramagnetic resonance, and density functional theory calculations. Importantly, these clusters showed semiconducting behaviors with low and tunable energy gaps (1.50-2.01 eV) and varied electrical conductivities (2.52 × 10-8-4.58 × 10-9 S/cm), where efficient electron transports mainly arose from C-H(phenyl)···O(carbonyl) interactions within the solid-state frameworks.

Hemodialysis Treatment for Patients with Lithium Poisoning.

BACKGROUND: Hemodialysis is often recommended to treat severe lithium poisoning. Nevertheless, the application rate of hemodialysis in patients with lithium poisoning is varied across different groups and the effect of hemodialysis is still undetermined. Therefore, this study aimed to analyze the hemodialysis rate of patients with lithium poisoning and to explore the clinical features of lithium-poisoned-patients treated or untreated with hemodialysis. METHODS: Between 2001 and 2019, 36 patients treated at the Chang Gung Memorial Hospital for the management of lithium poisoning were stratified according to whether they were treated with hemodialysis (n = 7) or not (n = 29). RESULTS: The patients were aged 50.7 ± 18.1 years. The poisoning patterns were acute on chronic (61.1%), chronic (25.0%) and acute (13.9%). The precipitating factors of dehydration and infection were noted in 36.1% and 25.0% of patients, respectively. Bipolar disorder (72.2%), depressive disorder (27.8%) and psychotic disorder (11.1%) were the top three psychiatric comorbidities. The hemodialysis group not only had a lower Glasgow Coma Scale (GCS) score (p = 0.001) but also had a higher respiratory failure rate (p = 0.033), aspiration pneumonia rate (p = 0.033) and acute kidney injury network (AKIN) score (p = 0.002) than the non-hemodialysis group. Although none of the patients died of lithium poisoning, the hemodialysis group required more endotracheal intubation (p = 0.033), more intensive care unit admission (p = 0.033) and longer hospitalization (p = 0.007) than the non-hemodialysis group. CONCLUSION: The analytical results revealed zero mortality rate and low hemodialysis rate (1.9%). Compared with patients without hemodialysis, patients receiving hemodialysis suffered severer lithium-associated complications and needed a more intensive care unit admission and longer hospital stay.

Using Text Content From Coronary Catheterization Reports to Predict 5-Year Mortality Among Patients Undergoing Coronary Angiography: A Deep Learning Approach.

Background: Current predictive models for patients undergoing coronary angiography have complex parameters which limit their clinical application. Coronary catheterization reports that describe coronary lesions and the corresponding interventions provide information of the severity of the coronary artery disease and the completeness of the revascularization. This information is relevant for predicting patient prognosis. However, no predictive model has been constructed using the text content from coronary catheterization reports before. Objective: To develop a deep learning model using text content from coronary catheterization reports to predict 5-year all-cause mortality and 5-year cardiovascular mortality for patients undergoing coronary angiography and to compare the performance of the model to the established clinical scores. Method: This retrospective cohort study was conducted between January 1, 2006, and December 31, 2015. Patients admitted for coronary angiography were enrolled and followed up until August 2019. The main outcomes were 5-year all-cause mortality and 5-year cardiovascular mortality. In total, 11,576 coronary catheterization reports were collected. BioBERT (bidirectional encoder representations from transformers for biomedical text mining), which is a BERT-based model in the biomedical domain, was utilized to construct the model. The area under the receiver operating characteristic curve (AUC) was used to assess model performance. We also compared our results to the residual SYNTAX (SYNergy between PCI with TAXUS and Cardiac Surgery) score. Results: The dataset was divided into the training (60%), validation (20%), and test (20%) sets. The mean age of the patients in each dataset was 65.5 ± 12.1, 65.4 ± 11.2, and 65.6 ± 11.2 years, respectively. A total of 1,411 (12.2%) patients died, and 664 (5.8%) patients died of cardiovascular causes within 5 years after coronary angiography. The best of our models had an AUC of 0.822 (95% CI, 0.790-0.855) for 5-year all-cause mortality, and an AUC of 0.858 (95% CI, 0.816-0.900) for 5-year cardiovascular mortality. We randomly selected 300 patients who underwent percutaneous coronary intervention (PCI), and our model outperformed the residual SYNTAX score in predicting 5-year all-cause mortality (AUC, 0.867 [95% CI, 0.813-0.921] vs. 0.590 [95% CI, 0.503-0.684]) and 5-year cardiovascular mortality (AUC, 0.880 [95% CI, 0.873-0.925] vs. 0.649 [95% CI, 0.535-0.764]), respectively, after PCI among these patients. Conclusions: We developed a predictive model using text content from coronary catheterization reports to predict the 5-year mortality in patients undergoing coronary angiography. Since interventional cardiologists routinely write reports after procedures, our model can be easily implemented into the clinical setting.

Investigating Unfavorable Factors That Impede MALDI-TOF-Based AI in Predicting Antibiotic Resistance.

The combination of Matrix-Assisted Laser Desorption/Ionization Time-of-Flight (MALDI-TOF) spectra data and artificial intelligence (AI) has been introduced for rapid prediction on antibiotic susceptibility testing (AST) of Staphylococcus aureus. Based on the AI predictive probability, cases with probabilities between the low and high cut-offs are defined as being in the "grey zone". We aimed to investigate the underlying reasons of unconfident (grey zone) or wrong predictive AST. In total, 479 S. aureus isolates were collected and analyzed by MALDI-TOF, and AST prediction and standard AST were obtained in a tertiary medical center. The predictions were categorized as correct-prediction group, wrong-prediction group, and grey-zone group. We analyzed the association between the predictive results and the demographic data, spectral data, and strain types. For methicillin-resistant S. aureus (MRSA), a larger cefoxitin zone size was found in the wrong-prediction group. Multilocus sequence typing of the MRSA isolates in the grey-zone group revealed that uncommon strain types comprised 80%. Of the methicillin-susceptible S. aureus (MSSA) isolates in the grey-zone group, the majority (60%) comprised over 10 different strain types. In predicting AST based on MALDI-TOF AI, uncommon strains and high diversity contribute to suboptimal predictive performance.

Clinical dyspnea scenario: Using high-fidelity situation simulation teaching program to evaluate learning effectiveness for clinical junior and pre-clinical nurses.

Background: Confronting a patient's breathing difficulties, clinical junior nurses often do not know how to respond, and fail to give proper evaluation and treatment. Sudden changes in the condition make the clinical nursing novices feel pressured, and even, frustrated. Objectives: This study aims at exploring the effectiveness of the high-realistic situational simulation of dyspnea teaching program for pre-clinical and clinical 1st year nurses after graduation. Design: This study adopts a quasi-experimental repeated measure pre-post-test design study with nonequivalent control group pre- and post-test research design. A total of 135 subjects participated in the research: nurses, post graduate year (NPGY) (N = 69), have been employed in the adult ward of a medical center for less than 1 year; and pre-clinical nurses (N = 66), 3rd-year nursing students with nurse licenses from a university in the central part of Taiwan. Simulation-based education instructed and incorporated into the high-realistic situation simulation dyspnea teaching program. Questionnaires were used to measure the effectiveness of learning, data were analyzed with SPSS version 20.0, and the scores were repeatedly measured with the generalized estimating equation. Results: For "cognition, skills, attitude, self-efficacy, teamwork," NPGY and pre-clinical nurses' post-tests are better than pre-tests, with statistically significant results. NPGY nurses' "skills," "attitude" and "teamwork" learning effectiveness are better than those of the pre-clinical nurses. Conclusion: The high-realistic situational simulation of dyspnea teaching program can significantly improve the learning effectiveness of NPGY nurses and pre-clinical nurses in the clinical evaluation and treatment of dyspnea.

Structure-Property Relationships of Inorganic-Organic Hybrid Semiconducting Se-Fe-Cu-CO Polymers.

A novel family of inorganic-organic-hybrid SeFe3(CO)9-dipyridyl two- and one-dimensional Cu polymers was synthesized via the three-component liquid-assisted grinding (LAG) of [Cu(MeCN)4]+, inorganic cluster [SeFe3(CO)9]2- (1), and rigid conjugated dipyridyls 4,4'-dipyridyl (dpy) and 1,2-bis(4-pyridyl)ethylene (bpee) or flexible conjugation-interrupted dipyridyls 1,2-bis(4-pyridyl)ethane (bpea) and 1,3-bis(4-pyridyl)propane (bpp). They included a cluster-linked 2D polymer, [(µ4-Se)Fe3(CO)9Cu2(MeCN)(dpy)1.5]n (1-dpy-2D), a cluster-pendant 1D chain, [(µ3-Se)Fe3(CO)9Cu2(dpy)3]n (1-dpy-1D), cluster-blocked 1D polymers, [(µ3-Se)Fe3(CO)9Cu2(L)]n (1-L-1D, L = bpee, bpea), and a cluster-linked 2D polymer, [(µ4-Se)Fe3(CO)9Cu2(bpp)2]n (1-bpp-2D). The reversible dimensionality transformations of these three types of polymers accompanied by the change in coordination modes of 1 were achieved by the LAG addition of 1/[Cu(MeCN)4]+ or dipyridyl ligands. These polymers were found to possess tunable low-energy gaps (1.49-1.72 eV) that increased in the order regarding their structural features: cluster-linked 1-dpy-2D and 1-bpp-2D, cluster-blocked 1-bpea-1D and 1-bpee-1D, and cluster-pendant 1-dpy-1D and [(µ3-Se)Fe3(CO)9Cu2(L)2.5]n (L = bpee, 1-bpee-2D; bpea, 1-bpea-2D), indicative of the importance of the participation of cluster 1. The measured electrical conductivities of 1-bpp-2D, 1-bpea-1D, and 1-dpy-1D were 3.13 × 10-7, 2.92 × 10-7, and 2.30 × 10-7 S·cm-1, respectively, which were parallel for the trend in their energy gaps, revealing semiconducting behaviors, supported by XPS, XANES, and DFT calculations. The surprising semiconductivity of the conjugation-interrupted bpp-linked 1-bpp-2D was mainly ascribed to electron transport via C-H···O(carbonyl) hydrogen bonds and aromatic C-H···π contacts within its closely packed 2D layers. Water-/light-stable polymers 1-bpp-2D, 1-bpea-2D, and 1-dpy-1D were also demonstrated to exhibit excellent pseudo-first-order photodegradation toward nitroaromatics and organic dyes, where cluster-linked polymer 1-bpp-2D performed the best, as predicted by its structural features and narrow energy gap.

Manganese Telluride Carbonyl Complexes: Facile Syntheses and Exotic Properties-Reversible Transformations, Hydrogen Generation, Paramagnetic, and Semiconducting Properties.

A novel family of five Mn-Te-CO complexes was prepared via facile syntheses: mono spirocyclic [Mn4Te(CO)16]2- (1), four-membered Mn2Te2 ring-type [Mn2Te2(CO)8]2- (2), hydride-containing square pyramidal [HMn3Te2(CO)9]2- (3), and dumbbell-shaped [Mn6Te6(CO)18]4- (4) and [Mn6Te10(CO)18]4- (5). Electron-precise complexes 4 and 5 exhibit unusual paramagnetism arising from two types of Mn atoms in different oxidation states, as determined by X-ray photoelectron spectroscopy, electron paramagnetic resonance, and density functional theory (DFT) calculations. The structural transformations from small-sized Mn4Te 1 and Mn2Te2 2 to the largest Mn6Te10 5 were controllable, the off/on magnetic-switched transformation between HMn3Te2 3 and 5 was reversible, and the magnetic transformation between Mn6Te6 4 and 5 was observed. Interestingly, the reversible dehydridation and hydridation between the HMn3Te2-based cluster 3 and [Mn3Te2(CO)9]- were successfully accomplished, in which the release of a high yield of H2 was detected by gas chromatography. In addition, upon the addition of CO, cluster 3 first forms a carbonyl-inserted intermediate [HMn3Te2(CO)10]2- (3'), detected by the high resolution ESI-MS, which is readily transformed to a dimeric dihydrido cluster [{HMn3Te2(CO)10}2]2- (6) with the introduction of O2. These low- to high-nuclearity complexes exhibit rich redox properties with semiconducting behavior in solids, possessing low but tunable energy gaps (1.06-1.62 eV) due to efficient electron transport via nonclassical C-H···O(carbonyl) interactions. The structural nature, reversible structural transformations, controllable on/off magnetic switches, electron communication networks, and associated chemical properties for hydrogen generation are discussed in detail and supported by DFT calculations, density of states, band structures, and noncovalent interaction analyses.

Vertically integrated photo junction-field-effect transistor pixels for retinal prosthesis.

Optoelectronic retinal prostheses transduce light into electrical current for neural stimulation. We introduce a novel optoelectronic pixel architecture consisting of a vertically integrated photo junction-field-effect transistor (Photo-JFET) and neural stimulating electrode. Experimental measurements demonstrate that optically addressed Photo-JFET pixels utilize phototransistive gain to produce a broad range of neural stimulation current and can effectively stimulate retinal neurons in vitro. The compact nature of the Photo-JFET pixel can enable high resolution retinal prostheses with the smallest reported optoelectronic pixel size to help restore high visual acuity in patients with degenerative retinal diseases.

Synaptic Specializations of Melanopsin-Retinal Ganglion Cells in Multiple Brain Regions Revealed by Genetic Label for Light and Electron Microscopy.

The form and synaptic fine structure of melanopsin-expressing retinal ganglion cells, also called intrinsically photosensitive retinal ganglion cells (ipRGCs), were determined using a new membrane-targeted version of a genetic probe for correlated light and electron microscopy (CLEM). ipRGCs project to multiple brain regions, and because the method labels the entire neuron, it was possible to analyze nerve terminals in multiple retinorecipient brain regions, including the suprachiasmatic nucleus (SCN), olivary pretectal nucleus (OPN), and subregions of the lateral geniculate. Although ipRGCs provide the only direct retinal input to the OPN and SCN, ipRGC terminal arbors and boutons were found to be remarkably different in each target region. A network of dendro-dendritic chemical synapses (DDCSs) was also revealed in the SCN, with ipRGC axon terminals preferentially synapsing on the DDCS-linked cells. The methods developed to enable this analysis should propel other CLEM studies of long-distance brain circuits at high resolution.

Single photon detector with a mesoscopic cycling excitation design of dual gain sections and a transport barrier.

Conventional semiconductor single photon detectors (SPDs) are Geiger-mode avalanche photodiodes made of high-quality crystalline semiconductors and require external quenching circuits. Here we report a design of an SPD having dual gain sections to obtain mesoscopic cycling excitation and an amorphous/crystalline heterointerface to form an electron transport barrier that suppresses gain fluctuations. The dual gain sections comprise a crystalline silicon n/p junction and a thin layer of amorphous silicon. At 100 MHz, the device shows single photon detection efficiency greater than 11%, self-recovery time of less than 1 ns, and an excess noise factor of 1.22 at an average gain around 75,000 under 8.5 V bias.

The First Naked Bismuth-Chalcogen Metal Carbonyl Clusters: Extraordinary Nucleophilicity of the Bi Atom and Semiconducting Characteristics.

Mixed bismuth-chalcogen-iron clusters [{EFe3(CO)9}Bi]- [E = Te (1a) or Se (1b)] were produced via the reduction of BiCl3 with [EFe3(CO)9]2- under mild conditions. X-ray analysis showed that both clusters 1a and 1b had a square-pyramidal geometry, where the naked Bi and chalcogen both adopted a distorted trigonal-pyramidal configuration with a stereoactive lone pair. Complexes 1a and 1b can be further functionalized by methylation and metalation, which permits the nucleophilicity of the 6s/5s and 6s/4s lone pairs to be compared. In the metalation, the 6s pair of the Bi atom in 1a and 1b had an extraordinary nucleophilicity toward the unsaturated Cr(CO)5 fragment, even in the presence of the more chemically active 5s or 4s pair, whereas in the case of methylation, only the 4s pair of Se could be selectively alkylated. Upon oxidation of 1a and 1b with suitable oxidizing agents, NaBiO3 or K2SeO3, Bi-E bonded tetrahedral complexes [{EFe2(CO)6}Bi]- [E = Te (4a) or Se (4b)] were formed by the elimination of one Fe(CO)3 vertex. X-ray photoelectron spectroscopy, X-ray absorption near-edge structure, and density functional theory (DFT) calculations showed that all of the Bi atoms in these complexes had oxidation states close to +1. Due to the electropositive character of the Bi atom, pronounced induced Bi···E inter- and intramolecular interactions were evident in 1a (1b), 4a (4b), and the metalated 3a (3b), where their linear-like ···Bi···E··· or zigzag-like ···Bi-E··· (E = Te or Se) chain or the Bi···E···E···Bi (E = Te or Se) dimeric chain can further expand into the two-dimensional network via nonclassical C-H···O(carbonyl) interactions, supported by noncovalent interaction index and DFT calculations. These positively charged Bi-induced Bi···E (E = Te or Se) and carbonyl-aided weak interactions can facilitate efficient electron transport within these ternary Bi-E-Fe or quaternary Bi-E-Fe-Cr cluster-based frameworks, resulting in semiconducting behavior with surprising ultranarrow energy gaps of 1.01-1.21 eV.

Semiconducting Coordination Polymers Based on the Predesigned Ternary Te-Fe-Cu Carbonyl Cluster and Conjugation-Interrupted Dipyridyl Linkers.

A series of semiconducting cluster-incorporated Cu-based coordination polymers, namely, 1D zigzag polymers [{TeFe3 (CO)9 Cu2 }(L)]n (L=1,2-bis(4-pyridyl)ethane (bpea), 1; L=1,2-bis(4-pyridyl)ethylene (bpee), 5), 2D honeycomb-like polymers [{TeFe3 (CO)9 Cu}Cu(L)2.5 ]n (L=bpea, 2; L=bpee, 6), and 2D wave-like cation-anion polymer [{Cu2 (L)4 }({TeFe3 (CO)9 Cu}2 (L))]n (L=1,3-bis(4-pyridyl)propane (bpp), 4), as well as the macrocycle [{TeFe3 (CO)9 Cu2 }2 (bpp)2 ] (3) have been quantitatively synthesized via the liquid-assisted grinding from the pre-designed cluster [TeFe3 (CO)9 Cu2 (MeCN)2 ] with conjugated or conjugation-interrupted dipyridyl linkers. Notably, the most conjugation-interrupted bpp-bridged polymer 4 exhibited extraordinary semiconducting characteristics with an ultra-narrow bandgap of 1.43 eV and a DC conductivity of 1.5×10-2 Ω-1  cm-1 , which violates our knowledge, mainly attributed to the through-space electron transport via non-classical C-H⋅⋅⋅O(carbonyl) hydrogen bonds and aromatic C-H⋅⋅⋅π interactions. The incorporated Te-Fe-CO anions can not only provide numerous possibilities for secondary interactions within these Cu-based polymers but also serve as a redox-active coordination ligand to promote their conductivities. The intriguing structure-property relationships were studied by X-ray and DFT analyses and further demonstrated by significant change in the oxidation state of Cu atoms by XPS and Cu K-edge XANES.

Bio-Kil, a nano-based disinfectant, reduces environmental bacterial burden and multidrug-resistant organisms in intensive care units.

BACKGROUND/PURPOSE: This prospective before-after study was intended to investigate the effect of Bio-Kil on reducing environmental bacterial burden and healthcare-associated infections (HAIs) in intensive care units (ICUs) at the Municipal Wan-Fang Hospital, Taipei, Taiwan in 2014. METHODS: Four rooms in the medical and surgical ICUs were investigated and designated as study rooms (n = 2) or control rooms (n = 2). Routine disinfection was performed during the pre-intervention period in both room types. Bio-Kil was applied to the fomites and surroundings of the study rooms during the intervention period. Total bacterial burden and proportion of colonization of fomites and surroundings by multidrug-resistance organisms (MDROs) were determined before and after the intervention. The demographic characteristics, underlying conditions, and clinical outcomes of patients were analyzed. RESULTS: After application of Bio-Kil, the bacterial burden declined in both groups, although the reduction was greater in the study rooms as compared with the control rooms (p = 0.001). During the pre-intervention period, 16 patients were admitted to control rooms and 18 patients to study rooms. After the intervention, 22 patients were admitted to control rooms and 21 patients to study rooms. The number of cases of new-onset sepsis declined in the intervention group (from 33% to 23.8%), but increased in the control group (from 25% to 40.9%); however, there was no significant difference in incidence of new-onset sepsis between the study and control rooms after intervention. CONCLUSION: Application of Bio-Kil reduced the environmental bacterial burden and MDROs in ICUs. Further studies are needed to evaluate the efficacy of this nanotechnology-based disinfectant in reducing HAIs.

Complementary metal-oxide-semiconductor compatible 1060 nm photodetector with ultrahigh gain under low bias.

Falling on the tail of the absorption spectrum of silicon, 1060 nm Si detectors often suffer from low responsivity unless an exceedingly thick absorption layer is used, a design that requires high operation voltage and high purity epitaxial or substrate material. We report an all-silicon 1060 nm detector with ultrahigh gain to allow for low operation voltage (<4 V) and thin (200 nm) effective absorption layer, using the recently discovered cycling excitation process. With 1% external quantum efficiency, a responsivity of 93 A/W was demonstrated in a p/n junction device compatible with the complementary metal-oxide-semiconductor process.

Familial expressed emotion among heroin addicts in methadone maintenance treatment: does it matter?

BACKGROUND: Expressed emotion (EE) is the quality of the atmosphere between a relative and a family member with mental illness. Substantial research has focused on the relationship between the level of EE and the outcomes of mental illness. However, no prior study has explored the role of EE relative to heroin addicts. AIM: The aims of this study were to investigate the influence of EE on patient outcome in methadone maintenance treatment (MMT) and the relationship between the EE of heroin addicts and other demographic and psychological variables. METHODS: A total of 117 heroin addicts who entered MMT were enrolled. Each subject underwent a comprehensive interview to record demographic data and drug use history. The Family Emotional Involvement Scale (FEICS), Beck Depression Inventory (BDI), and Beck Anxiety Depression Inventory (BAI) were used at baseline. All subjects were followed for 12 months. The results of monthly urine tests and the treatment retention were recorded for further analysis. RESULTS: Perceived criticism was correlated with depression (r=0.20, P<0.01). The overall retention rate in 12-month MMT was 54.70%. Lower perceived criticism (OR=1.84, 95% CI=1.20-3.60, P<0.01) and lower depression (OR=1.24, 95% CI=0.65-1.80, P=0.02) predicted longer retention in MMT. CONCLUSION: EE, especially perceived criticism, has its influences on outcomes among heroin addicts in MMT. This suggested the potential benefits of family therapy among high EE heroin addicts in MMT. Furthermore, the mechanism how EE affects the outcome of MMT needs to be further investigated.