Peripheral inflammation is associated with impaired sadness recognition in euthymic bipolar patients.

BACKGROUND: Inflammation impairs cognitive function in healthy individuals and people with psychiatric disorders, such as bipolar disorder (BD). This effect may also impact emotion recognition, a fundamental element of social cognition. Our study aimed to investigate the relationships between pro-inflammatory cytokines and emotion recognition in euthymic BD patients and healthy controls (HCs). METHODS: We recruited forty-four euthymic BD patients and forty healthy controls (HCs) and measured their inflammatory markers, including high-sensitivity C-reactive protein (hs-CRP), interleukin-6 (IL-6), and TNF-α. We applied validated cognitive tasks, the Wisconsin Card-Sorting Test (WCST) and Continuous Performance Test (CPT), and a social cognitive task for emotion recognition, Diagnostic Analyses of Nonverbal Accuracy, Taiwanese Version (DANVA-2-TW). We analyzed the relationships between cytokines and cognition and then explored possible predictive factors of sadness recognition accuracy. RESULTS: Regarding pro-inflammatory cytokines, TNF-α was elevated in euthymic BD patients relative to HCs. In euthymic BD patients only, higher TNF-α levels were associated with lower accuracy of sadness recognition. Regression analysis revealed that TNF-α was an independent predictive factor of sadness recognition in patients with euthymic BD when neurocognition was controlled for. CONCLUSIONS: We demonstrated that enhanced inflammation, indicated by increased TNF-α, was an independent predictive factor of impaired sadness recognition in BD patients but not in HCs. Our findings suggested a direct influence of TNF-α on sadness recognition and indicated vulnerability to depression in euthymic BD patients with chronic inflammation.

Facile surface functionalization of triboelectric layers via electrostatically self-assembled zwitterionic molecules for achieving efficient and stable antibacterial flexible triboelectric nanogenerators.

Manipulation of the surface properties of the triboelectric layer has been proven to be one of the key parameters to achieve high-performance and stable triboelectric nanogenerators (TENG). Herein, a pragmatic surface engineering strategy that can substantially boost the performance and stability of flexible TENG is elaborated by incorporating the zwitterionic molecule dimethylethylammoniumpropane sulfonate (NDSB) as the surface modification layer. Given that zwitterionic molecules tend to form aggregated structures, realizing ordered arrangement on the substrate surface remains challenging to date. To address this issue, in this work, a combination of multiple surface treatments and molecular manipulation strategy is proposed. Our results prove that NDSB is effective in modifying the surface properties of the dielectric layer and electrode layer, leading to a remarkable power density and specific power of 2.86 W m-2 and 20.73 mW g-1 for flexible TENG, respectively. In addition, due to the strong interaction between the NDSB/dielectric and NDSB/electrode, a water-resistant long-term stable flexible TENG is realized. More encouragingly, our strategy is compatible with a cost-effective dip-coating technique, and an unprecedented demonstration of batch fabrication of TENG using NDSB to functionalize the surface of the dielectric layer and electrode layer synchronously can be realized, which is advantageous for rapid and up-scalable manufacturing of TENG. We also prove that the TENG based on zwitterionic materials reveals exceptional antibacterial properties against Escherichia coli. This study represents an important step towards the development of long-term stable flexible TENG that possesses a high output performance and excellent antibacterial activity based on a facile and economical strategy, enabling TENG technology to show bright prospects in a wide variety of application domains.

Social cognitive deficit is associated with visuomotor coordination impairment and dopamine transporter availability in euthymic bipolar disorder.

BACKGROUND: Extensive evidence has suggested functional connections between co-occurring visuomotor and social cognitive deficits in neuropsychiatric disorders; however, such association has not been studied in bipolar disorder (BD). We aimed to investigate the relationship between visuomotor coordination and social cognition in the euthymic stage of BD (euBD). Given the shared neurobiological underpinnings involving the dopaminergic system and corticostriatal circuitry, we hypothesized a positive correlation between social cognition and visuomotor coordination in euBD patients. METHODS: 40 euBD patients and 59 healthy control (HC) participants underwent evaluation of social (Diagnostic Analysis of Nonverbal Accuracy 2-Taiwan version (DANVA-2-TW)), non-social cognitive function and visuomotor coordination. A subgroup of participants completed single-photon emission computed tomography for striatal dopamine transporter (DAT) availability assessment. RESULTS: EuBD patients showed impaired nonverbal emotion recognition (ps ≤ 0.033) and poorer visuomotor coordination (ps < 0.003) compared to HC, with a positive correlation between these two abilities (r = 0.55, p < 0.01). However, after considering potential confounding factors, instead of visuomotor coordination, striatal DAT availability was a unique predictor of emotion recognition accuracy in euBD (beta = 0.33, p = 0.001). CONCLUSION: Our study result supported a functional association between social cognition and visuomotor coordination in euBD, with striatal dopaminergic dysfunction emerged as a crucial contributing factor in their interrelation.

Continuous Particle Aggregation and Separation in Acoustofluidic Microchannels Driven by Standing Lamb Waves.

In this study, we realize acoustic aggregation and separation of microparticles in fluid channels driven by standing Lamb waves of a 300-µm-thick double-side polished lithium-niobate (LiNbO3) plate. We demonstrate that the counter-propagating lowest-order antisymmetric and symmetric Lamb modes can be excited by double interdigitated transducers on the LiNbO3 plate to produce interfacial coupling with the fluid in channels. Consequently, the solid-fluid coupling generates radiative acoustic pressure and streaming fields to actuate controlled acoustophoretic motion of particles by means of acoustic radiation and Stokes drag forces. We conducted finite-element simulations based on the acoustic perturbation theory with full-wave modeling to tailor the acoustic and streaming fields in the channels driven by the standing Lamb waves. As a result, the acoustic process and the mechanism of particle aggregation and separation were elucidated. Experiments on acoustic manipulation of particles in channels validate the capability of aggregation and separation by the designed devices. It is observed that strong streaming dominates the particle aggregation while the acoustic radiation force differentially expels particles with different sizes from pressure antinodes to achieve continuous particle separation. This study paves the way for Lamb-wave acoustofluidics and may trigger more innovative acoustofluidic systems driven by Lamb waves and other manipulating approaches incorporated on a thin-plate platform.

Preparation of Nickel Oxide Nanoflakes for Carrier Extraction and Transport in Perovskite Solar Cells.

Hole transport layers (HTLs) with high conductivity, charge extraction ability, and carrier transport capability are highly important for fabricating perovskite solar cells (PSCs) with high power conversion efficiency and device stability. Low interfacial recombination between the HTL and perovskite absorber is also crucial to the device performance of PSCs. In this work, we developed a three-stage method to prepare NiOx nanoflakes as the HTL in the inverted PSCs. Due to the addition of the nanoflake layer, the deposited perovskite films with larger grain sizes and fewer boundaries were obtained, implying higher photogenerated current and fill factors in our PSCs. Meanwhile, the downshifted valence band of the NiOx HTL improved hole extraction from the perovskite absorber and open-circuit voltages of PSCs. The optimized device based on the NiOx nanoflakes showed the highest efficiency of 14.21% and a small hysteresis, which outperformed the NiOx thin film as the HTL. Furthermore, the device maintained 83% of its initial efficiency after 60 days of storage. Our results suggest that NiOx nanoflakes provide great potential for constructing PSCs with high efficiency and long-term stability.

Efficient and stable perovskite solar cells using manganese-doped nickel oxide as the hole transport layer.

Organic/inorganic hybrid perovskite solar cells (PSCs) have represented a promising field of renewable energy in recent years due to the compelling advantages of high efficiency, facile fabrication process and low cost. The development of inorganic p-type metal oxide materials plays an important role in the performance and stability of PSCs for commercial purposes. Herein a facile and effective way to improve hole extraction and conductivity of NiO x films by manganese (Mn) doping is demonstrated in this study. A Mn-doped NiO x layer was prepared by the sol-gel process and served as the hole transport layer (HTL) in inverted PSCs. The results suggest that Mn-doped NiO x is helpful for the growth of perovskite layers with larger grains and higher crystallinity compared with the pristine NiO x . Furthermore, the perovskite films deposited on Mn-doped NiO x exhibit lower recombination and shorter carrier lifetime. The device based on 0.5 mol% Mn-doped NiO x as the HTL displayed the best power conversion efficiency (PCE) of 17.35% and a high fill factor (FF) of 81%, which were significantly higher than those of the one using the pristine NiO x HTL (PCE = 14.71%, FF = 73%). Moreover, the device retained 70% of its initial efficiency after 35 days' storage under a continuous halogen lamp matrix exposure with an illumination intensity of 1000 W m-2. Our results widen the development of PSCs for future production.

Gu Sui Bu (Drynaria fortunei J. Sm.) antagonizes glucocorticoid-induced mineralization reduction in zebrafish larvae by modulating the activity of osteoblasts and osteoclasts.

ETHNOPHARMACOLOGICAL RELEVANCE: Gu Sui Bu (GSB), the dried rhizome of Drynaria fortunei J. Sm., is widely used in traditional Chinese medicine for treating fractures and osteoporosis. Although glucocorticoids are widely prescribed in modern medicine, the efficacy of GSB in treating glucocorticoid-induced osteoporosis (GIOP) remains unclear. AIM OF THE STUDY: GIOP is one of the most prevalent forms of osteoporosis and increases the risk of fracture, which can cause severe complications in elderly people. Safe, efficacious, and cost-effective treatment options for GIOP are thus warranted. The present study investigated the efficacy and mechanism of GSB for treating GIOP. MATERIALS AND METHODS: We established an efficient and robust in vivo GIOP model by optimizing zebrafish larvae rearing conditions and the dose and duration of dexamethasone treatment. Bone calcification was evaluated through calcein staining. To quantify the degree of vertebral mineralization in the larvae, we developed a scoring system based on the rate of vertebral calcification; this system reduced quantification errors among individual zebrafish caused by inconsistencies in staining or imaging parameters. Quantitative real-time polymerase chain reaction was used to access the expression levels of genes essential to the differentiation and function of bone cells. High-performance liquid chromatography was employed to identify naringin in the GSB extract. RESULTS: GSB significantly reversed the dexamethasone-induced calcification delay in zebrafish larvae. GSB enhanced osteoblast activity by increasing the expression of collagen I, osteopontin, and osteonectin and repressed bone resorption by decreasing the expression of matrix metalloproteinases (mmps), including mmp9 and mmp13a. We also identified naringin as one of the constituents of GSB responsible for the herbal extract's anti-GIOP activity. CONCLUSIONS: Using the in vivo zebrafish GIOP model that we established, the efficacy of traditional Chinese medicines in treating GIOP could be systematically investigated. GSB has an osteogenic effect and may thus be an efficacious and cost-effective treatment option for GIOP. Notably, bone resorption activity was found to be retained after GSB treatment, which would be beneficial for maintaining normal bone remodeling.

Effect of dialyzer membranes on mortality in uremic patients undergoing long-term hemodialysis: A Nationwide population-based study using the Taiwan Dialysis Registry Data System 2005-2012.

The characteristics in dialyzer are associated with mortality in patients with end-stage renal disease (ESRD) receiving hemodialysis (HD). This study is to investigate the effects of dialyzer membranes on 3-year mortality in ESRD patients. From the long-term nationwide population database. Prevalent HD patients during 2005-2012 were enrolled. Our main analysis to calculate the effect was cox regression multivariate model. Overall, the mean age of all population (N = 73 565) was 61.0 ± 13.6 years, the observation period is 2.46 years ±0.98 within 3 years and 64.6% used polysulfone (PS), polymethyl methacrylate (PMMA) (11.6%), polyethersulfone (11.4%), and cellulose triacetate (CTA) (10.7%), ethylene vinyl alcohol (EVAL) (hazard ratio [HR] 2.72, 95% confidence interval [CI] 1.71-4.33) and CTA (HR 1.35, 95% CI 1.12-1.64) were associated with higher mortality than PS, but PMMA was not. EVAL and CTA adversely affected mortality and PMMA had no protective role. Further investigations on membrane characters on HD patients are warranted. Taipei Medical University (TMU) (TMU-JIRB (No. N201804051).

Tobacco Smoking and Association between Betel Nut Chewing and Metabolic Abnormalities Among Military Males: The CHIEF Study.

AIM: To investigate the effect of smoking and alcohol intake on the association between betel nut chewing and each metabolic abnormality. BACKGROUND: Betel nut chewing has been associated with metabolic syndrome. OBJECTIVE: Whether the association is affected by tobacco or alcohol use is not clarified so far. METHODS: The authors conducted a cross-sectional study using 6,657 military males, aged 18-50 years in eastern Taiwan in 2013-2014. Metabolic syndrome was defined according to the International Diabetes Federation's ethnic criteria for Asians. The population was classified as non-betel nut chewers (N =5,749), current chewers with both tobacco and alcohol use (N =615), and current chewers without tobacco and/or alcohol use (N =293). Multiple logistic regression analyses were stepwise adjusted for the confounders including alcohol and tobacco use to determine the association of betel chewing with the metabolic abnormalities. RESULTS: As compared to the non-current chewers, the current chewers with both tobacco/alcohol use and those without had a higher risk of metabolic syndrome (odds ratios (OR) and 95% confidence intervals: 2.46 (2.00-3.02), and 2.04 (1.53-2.73), respectively) after controlling for age, service specialty, total cholesterol levels ≥200 mg/dL and exercise frequency (model 1). The association did not change much in the two chewing groups after additionally adjusting for alcohol consumption (model 2) (OR: 2.49 (1.99-3.12), and 2.04 (1.52-2.73), respectively), whereas the relationship reduced significantly in the chewers with both tobacco/alcohol use rather than those without after further adjusting for smoking (model 3) (OR: 2.18 (1.71-2.78) and 2.02 (1.51-2.71), respectively). This was in parallel with the pattern for the association of betel nut chewing with serum triglycerides >150 mg/dL in the chewers with both tobacco/alcohol use and those without in model 1 (OR: 2.90 (2.40-3.51) and 1.90 (1.45-2.49), respectively, p =0.011), in model 2 (OR: 2.82 (2.30-3.46) and 1.89 (1.44-2.49), respectively, p =0.040), and in model 3 (2.26 (1.81-2.81) and 1.87 (1.42-2.45), respectively, p =0.76). CONCLUSION: Our findings suggest that tobacco smoking but not alcohol intake could increase the relationship of betel nut chewing with metabolic syndrome, which is likely mediated by a synergic effect on increasing serum triglycerides levels.

Clinical treatment and medication in decreasing the development of major depression caused by spinal fracture.

BACKGROUND: Chronic pain and limited activities of daily living after spinal fracture may induce the occurrence of major depression (MD); however, risk factors regarding medications, surgical intervention, and severity of fracture are unclear. We aimed to analyze risk factors of MD development after spinal fracture. METHODS: This was a retrospective database study, using the health care database of the Taiwan government. We included 11,225 patients with new spinal fracture (study group), and 33,675 matched patients without fracture (comparison group). We respectively reviewed data of each participant for 3 years to assess the development of MD. The Cox proportional hazards model was used to determine the prevalence of MD, after adjusting for patient demographics, medications, surgical interventions, spinal cord involvement, and postfracture comorbidities. RESULTS: In total, 187 fracture patients (1.7%) and 281 nonfracture patients (0.8%) developed new-onset MD (hazard ratio [HR]:1.96, (95% confidence interval [CI]: 1.63-2.36)). Spinal cord involvement (HR: 2.96, 95% CI: 2.54-3.42) and postfracture comorbidities (HR: 3.51, 95% CI: 2.86-3.97) obviously increased the risk of MD. CONCLUSIONS: Patients with spinal fracture (spinal cord involvement and postfracture comorbidities) were more likely to develop MD. Early surgical interventions (vertebroplasty) and medications (narcotics) may decrease the risk of MD.

Epithelial-Mesenchymal Transition Directs Stem Cell Polarity via Regulation of Mitofusin.

Mitochondria are dynamic organelles that have been linked to stem cell homeostasis. However, the mechanisms involved in mitochondrial regulation of stem cell fate determination remain elusive. Here we discover that epithelial-mesenchymal transition (EMT), a key process in cancer progression, induces mitochondrial fusion through regulation of the miR200c-PGC1α-MFN1 pathway. EMT-activated MFN1 forms a complex with PKCζ and is required for PKCζ-mediated NUMB phosphorylation and dissociation from the cortical membrane to direct asymmetric division of mammary stem cells, where fused mitochondria are tethered by MFN1-PKCζ to the cortical membrane and asymmetrically segregated to the stem cell-like progeny with enhanced glutathione synthesis and reactive oxygen species scavenging capacities, allowing sustaining of a self-renewing stem cell pool. Suppression of MFN1 expression leads to equal distribution of the fragmented mitochondria in both progenies that undergo symmetric luminal cell differentiation. Together, this study elucidates an essential role of mitofusin in stem cell fate determination to mediate EMT-associated stemness.

Leakage-free solution-processed organic light-emitting diode using a ternary host with single-diode emission area up to 6 × 11.5 cm2.

The electrical current leakage and stability are studied for solution-processed OLEDs with areas of 4.45 mm2, 3 × 3.2 cm2, and 6 × 11.5 cm2. The emission layer of the OLED has a ternary or binary mixed host with hole-transporting molecules tris(4-carbazoyl-9-ylphenyl)amine (TCTA) and 9-(4-tert-butylphenyl)-3,6-bis(triphenylsilyl)-9H-carbazole (CzSi), together with the electron-transporting molecule 2,7-bis(diphenylphosphoryl)-9,9'-spirobi[fluorene] (SPPO13). The phosphorescent emitters are Ir(mppy)3 for green and bis[4-(4-tert-butylphenyl)thieno[3,2-c]pyridine][N,N'-diisopropylbenamidinato]iridium(iii) (PR-02) for orange. Poly[(9,9-dioctylfluorenyl-2,7-diyl)-co-(4,4'-(N-(4-sec-butylphenyl))diphenylamine)] (TFB) is used as the hole transport layer and PEDOT:PSS is used as the hole injection layer. On top of the emission layer, CsF/Al is deposited by thermal evaporation as the cathode. All organic layers are deposited by blade coating and the initial current leaking defects can be avoided by careful control of the coating conditions. The detrimental burning point caused by a local current short developed after long-time operation can be avoided by reducing the operation voltage using a ternary mixed host. The operation voltage is only 4 V at 100 cd m-2 and 5 V at 250 cd m-2 for the green emitting device. Furthermore, the crystallization defect is reduced by the ternary host. For the orange emitting device, the binary host is good enough with an operating voltage of 5 V at 100 cd m-2. For an area as large as 6 × 11.5 cm2, the OLED shows good stability and there is no burning point after an operation of over 1600 hours.

The Impact of Emergency Interventions and Patient Characteristics on the Risk of Heart Failure in Patients with Nontraumatic OHCA.

BACKGROUND: Since out-of-hospital cardiac arrest- (OHCA-) related dysfunction (ischemic/reperfusion injury and inflammatory response) might result in long-term impairment, we suspect that new-onset heart failure might be common in long-term survivors. However, these relationships had not been well addressed, and we aimed to analyze the impact of emergency interventions and patient characteristics on the risk of new-onset heart failure in patients with nontraumatic OHCA. METHODS: The Taiwanese government healthcare database contains data for 49,101 nontraumatic OHCA adult patients from 2011-2012, which were analyzed in this study. Nontraumatic OHCA patients who survived to the intensive care unit (ICU) were included as the study group (n = 7,321). Matched patients (n = 21,963) were recruited as a comparison group. Patients with any history of heart failure or cardiac arrest were not included in either group. All patients were followed-up for 6 months for the identification of new-onset heart failure. Adjustments were made for demographics, age, emergency interventions, and comorbidities as potential risk factors. RESULTS: In all, 3.84% (n = 281) of OHCA patients suffered new-onset heart failure, while only 1.24% (n = 272) of matched patients in the comparison group suffered new-onset heart failure. Strong risk factors for heart failure were age (60-75 years, HR: 11.4; 95% CI: 9-14.4), medical history (myocardial infarction, HR: 2.47; 95% CI: 2.05-2.98 and cardiomyopathy, HR: 2.94; 95% CI: 1.45-5.94), and comorbidities during hospitalization (ischemic heart disease, HR: 4.5; 95% CI: 3.46-5.86). Only extracorporeal membrane oxygenation (ECMO) decreased the risk of heart failure. Most (53.6%) heart failure events occurred within 60 days after OHCA. CONCLUSION: An age from 61 to 75 years, a history of myocardial infarction or cardiomyopathy, and ischemic heart disease or infection as comorbidities occurring during hospitalization were strong risk factors for new-onset heart failure in OHCA patients. However, ECMO could decrease this risk. More importantly, most heart failure events occurred within 60 days after OHCA.

Thermally Stable High-Performance Polymer Solar Cells Enabled by Interfacial Engineering.

Interfacial engineering plays an important role in determining the performance and stability of polymer solar cells (PSCs). In this study, thermally stable highly efficient PSCs are fabricated by incorporating a solution-processed cathode interfacial layer (CIL), including 4,4'-({[methyl(4-sulfonatobutyl)ammonio]bis(propane-3,1-diyl)}bis(dimethylammoniumdiyl))bis(butane-1-sulfonate) (MSAPBS) and polyethylenimine (PEI). For PSCs based on blends of poly{4,8-bis[5-(2-ethylhexyl)thiophen-2-yl]benzo[1,2-b;4,5-b']dithiophene-2,6-diyl-alt-[4-(2-ethylhexyl)-3fluorothieno[3,4-b]thiophene-2-carboxylate-2,6-diyl]} (PBDTTT-EFT) and [6,6]-phenyl C71 -butyric acid methyl ester (PC71 BM), the maximum power conversion efficiency (PCE) of inverted PSCs reaches 8.1 % and 7.2 % for MSAPBS and PEI CILs, respectively. The inverted PEI devices exhibit remarkable stability (lifetime >6000 h) under accelerated thermal aging (at 80 °C in ambient environment), which is much superior to that of the device with commonly used LiF CIL (lifetime≈33 h). This stability represents the best result reported for PSCs. The promising results based on this strategy can stimulate further work on the development of novel CILs for PSCs and pave the way towards the realization of commercially viable PSCs with high performance and long-term stability.

Toward Long-Term Stable and Efficient Large-Area Organic Solar Cells.

Here, we report that long-term stable and efficient organic solar cells (OSCs) can be obtained through the following strategies: i) combination of rapid-drying blade-coating deposition with an appropriate thermal annealing treatment to obtain an optimized morphology of the active layer; ii) insertion of interfacial layers to optimize the interfacial properties. The resulting devices based on poly[4,8-bis(5-(2-ethylhexyl)thiophen-2-yl)benzo[1,2-b;4,5-b']dithiophene-2,6-diyl-alt-(4-(2-ethylhexyl)-3-fluorothieno[3,4-b]thiophene-2-carboxylate-2,6-diyl)] (PBDTTT-EFT):[6,6]-phenyl C71 butyric acid methyl ester (PC71 BM) blend as the active layer exhibits a power conversion efficiency (PCE) up to 9.57 %, which represents the highest efficiency ever reported for blade-coated OSCs. Importantly, the conventional structure devices based on poly(3-hexylthiophene) (P3HT):phenyl-C61 -butyric acid methyl ester (PCBM) blend can retain approximately 65 % of their initial PCE for almost 2 years under operating conditions, which is the best result ever reported for long-term stable OSCs under operational conditions. More encouragingly, long-term stable large-area OSCs (active area=216 cm2 ) based on P3HT:PCBM blend are also demonstrated. Our findings represent an important step toward the development of large-area OSCs with high performance and long-term stability.

Efficient and Stable Vacuum-Free-Processed Perovskite Solar Cells Enabled by a Robust Solution-Processed Hole Transport Layer.

Here, efficient and stable vacuum-free processed perovskite solar cells (PSCs) are demonstrated by employing solutionprocessed molybdenum tris-[1-(trifluoroethanoyl)-2-(trifluoromethyl)ethane-1,2-dithiolene] (Mo(tfd-COCF3 )3 )-doped poly(3,4-ethylenedioxythiophene) (PEDOT) film as hole transport layer (HTL). Our results indicate that the incorporation of Mo(tfd-COCF3 )3 dopant can induce p-doping through charge transfer from the highest occupied molecular orbital (HOMO) level of the PEDOT host to the electron affinity of Mo(tfd-COCF3 )3 , leading to an increase in conductivity by more than three orders of magnitude. With this newly developed p-doped film as HTL in planar heterojunction PSCs, a high power conversion efficiency (PCE) up to 18.47 % can be achieved, which exceeds that of the device with commonly used HTL 2,2',7,7'-tetrakis(N,N-di-p-methoxyphenyl-amine)9,9'-spirobifluorene (spiro-OMeTAD). Taking the advantage of the high conductivity of this doped film, a prominent PCE as high as 15.58 % is also demonstrated even when a large HTL thickness of 220 nm is used. Importantly, the high quality film of this HTL is capable of acting as an effective passivation layer to keep the underlying perovskite layer intact during solution-processed Ag-nanoparticles layer deposition. The resulting vacuum-free PSCs deliver an impressive PCE of 14.81 %, which represents the highest performance ever reported for vacuum-free PSCs. Furthermore, the resulting devices show good ambient stability without encapsulation.

High-performance printable hybrid perovskite solar cells with an easily accessible n-doped fullerene as a cathode interfacial layer.

Engineering the interface between the active layer and the electrodes has proven to be a promising strategy to enhance the power conversion efficiency (PCE) of hybrid perovskite solar cells (PeSCs). Here, we present an effective approach to achieve highly efficient PeSCs by inserting an easy-accessible hexamethonium bromide (HMB)-doped [6,6]-phenyl-C61-butyric acid methyl ester (PC61BM) film between the active perovskite layer and the Ag cathode. This doped interfacial layer delivers several remarkable features for use in PeSCs, including solution processability, good electrical conductivity, fine work-function tunability of the Ag electrode, and general applicability to different fullerene materials. As a consequence, planar-heterojunction PeSCs deliver a PCE up to ∼18%, showing an approximately 5.6-fold enhancement compared with the control device using an undoped PC61BM layer. In particular, benefitting from the high conductivity of this doped film, a prominent PCE as high as 15.58% can be achieved even when a large thickness of the PC61BM layer (120 nm) is used. To the best of our knowledge, this is the highest performance ever reported for PeSCs with a PC61BM thickness more than 100 nm. More encouragingly, large-area PeSCs (active area = 1.2 cm2) via the doctor-blade coating technique also exhibit a remarkable PCE (15.23%) and good long-term stability under an inert atmosphere. Our results indicate that the HMB-doped PC61BM film is a promising interfacial layer for PeSCs and can be compatible with high throughput roll-to-roll manufacturing processes.

An Initial Attack of Urinary Stone Disease Is Associated with an Increased Risk of Developing New-Onset Irritable Bowel Syndrome: Nationwide Population-Based Study.

BACKGROUND: The neurotransmitter pathways in irritable bowel syndrome (IBS) and urinary stone attacks are both related to serotonin, and each disease may be influenced by viscero-visceral hyperalgesia. However, the relationship between urinary tract stone disease and IBS has never been addressed. We aimed to investigate the risk of suffering new-onset IBS after an initial urinary stone attack using a nationwide database. METHODS: A study group enrolled a total of 13,254 patients who were diagnosed with an initial urinary stone attack; a comparison group recruited 39,762 matched non-urinary stone participants during 2003 and 2007. We followed each patient for 3 years to determine new-onset IBS. We also used Cox proportional hazards models to analyze the risk of IBS between the study and comparison groups after modified by demographics, residence, patient characteristics and personal histories. RESULTS: The occurrence rates of IBS were 3.3% (n = 440) and 2.6% (n = 1,034) respectively in the study and comparison groups. A covariate-adjusted hazard ratio (HR) of IBS in the study group that was 1.28 times greater (HR = 1.29, 95% CI, 1.15-1.44) than that in the comparison group was showed in the stratified Cox proportional analysis. The adjusted HRs of IBS did not decrease after considering demographics and past histories. The majority of IBS (30.5%) occurred within the first 6 months after the stone attack. CONCLUSION: Patients with an initial urinary stone attack are at increased risk of developing new-onset IBS. The HRs of IBS did not decrease even after adjusting for patient demographics and past histories. Most importantly, 30.5% of IBS occurred within the first 6 months after the urinary stone attack.

Impact of Different Initial Epinephrine Treatment Time Points on the Early Postresuscitative Hemodynamic Status of Children With Traumatic Out-of-hospital Cardiac Arrest.

The postresuscitative hemodynamic status of children with traumatic out-of-hospital cardiac arrest (OHCA) might be impacted by the early administration of epinephrine, but this topic has not been well addressed. The aim of this study was to analyze the early postresuscitative hemodynamics, survival, and neurologic outcome according to different time points of first epinephrine treatment among children with traumatic OHCA.Information on 388 children who presented to the emergency departments of 3 medical centers and who were treated with epinephrine for traumatic OHCA during the study period (2003-2012) was retrospectively collected. The early postresuscitative hemodynamic features (cardiac functions, end-organ perfusion, and consciousness), survival, and neurologic outcome according to different time points of first epinephrine treatment (early: <15, intermediate: 15-30, and late: >30 minutes after collapse) were analyzed.Among 165 children who achieved sustained return of spontaneous circulation, 38 children (9.8%) survived to discharge and 12 children (3.1%) had good neurologic outcomes. Early epinephrine increased the postresuscitative heart rate and blood pressure in the first 30 minutes, but ultimately impaired end-organ perfusion (decreased urine output and initial creatinine clearance) (all P < 0.05). Early epinephrine treatment increased the chance of achieving sustained return of spontaneous circulation, but did not increase the rates of survival and good neurologic outcome.Early epinephrine temporarily increased heart rate and blood pressure in the first 30 minutes of the postresuscitative period, but impaired end-organ perfusion. Most importantly, the rates of survival and good neurologic outcome were not significantly increased by early epinephrine administration.