Interactions of midazolam and propofol on α1ß2γ2L and α1ß2γ2S gamma aminobutyric acid type A receptors expressed in human embryonic kidney cells.

BACKGROUND: The gamma aminobutyric acid type A (GABA(A)) receptor is a prime target of many anesthetics, including midazolam and propofol. Although these anesthetics have sedative and hypnotic properties by enhancing GABA(A) receptor activity, their interactions at the GABA(A) receptors have not been explored. We investigated the interaction of midazolam and propofol with α(1)ß(2)γ(2)L and α(1)ß(2)γ(2)S GABA(A) receptors. METHODS: Using the whole-cell patch clamp technique, we tested the effects of midazolam and propofol on GABA-induced currents in human embryonic kidney 293 T cells transfected with α(1)ß(2)γ(2)L and α(1)ß(2)γ(2)S GABA(A) receptors. RESULTS: Midazolam and propofol on their own enhanced the amplitude of GABA(A) receptor responses in a dose-dependent manner, and they had additive effects on α(1)ß(2)γ(2)S GABA(A) receptors, but not on α(1)ß(2)γ(2)L GABA(A) receptors. However, additive interactions of midazolam and propofol on the α(1)ß(2)γ(2)L GABA(A) receptors were observed when protein kinase C was inhibited. CONCLUSIONS: The interaction between midazolam and propofol is affected by receptor subtype, and protein kinase phosphorylation influences their interaction on the α(1)ß(2)γ(2)L receptor.

Automated remote decision-making algorithm as a primary triage system using machine learning techniques.

OBJECTIVE: An objective and convenient primary triage procedure is needed for prioritizing patients who need help in mass casualty incident (MCI) situations, where there is a lack of medical staff and available resources. This study aimed to develop an automated remote decision-making algorithm that remotely categorize a patient's emergency level using clinical parameters that can be measured with a wearable device. APPROACH: The algorithm was developed according to the following procedures. First, we used the National Trauma Data Bank data set, a large open trauma patient data set assembled by the American College of Surgeons (ACS). In addition, we performed pre-processing to exclude data when the vital sign or consciousness indicator value was missing or physiologically in an abnormal range. Second, we selected the T-RTS method, which classifies emergency levels into four classes (Delayed, Urgent, Immediate and Dead), as the primary outcome. Third, three machine learning methods widely used in the medical field, logistic regression, random forest, and deep neural network (DNN), were applied to build the algorithm. Finally, each method was evaluated using quantitative performance indicators including the macro-averaged f1 score, macro-averaged mean absolute error (MMAE), and the area under the receiver operating characteristic curve (AUC). MAIN RESULTS: For total sets, the logistic regression had a macro-averaged f1 score of 0.673, an MMAE of 0.387 and an AUC value of 0.844 (95% CI, 0.843-0.845), while the random forest and DNN had macro-averaged f1 scores of 0.783 and 0.784, MMAEs of 0.297 and 0.298 and AUC values of 0.882 (95% CI, 0.881-0.883) and 0.883(95% CI, 0.881-0.884), respectively. SIGNIFICANCE: In a comprehensive analysis of these results, our algorithm demonstrated a viable approach that could be practically adopted in an MCI. In addition, it can be employed to transfer patients and to redistribute available resources according to their priorities.

Controlled Electrodeposition of Photoelectrochemically Active Amorphous MoS x Cocatalyst on Sb2Se3 Photocathode.

Amorphous molybdenum sulfide (a-MoS x) is a promising hydrogen evolution catalyst owing to its low cost and high activity. A simple electrodeposition method (cyclic voltammetry) allows uniform formation of a-MoS x films on conductive surfaces. However, the morphology of a-MoS x deposited on a TiO2/Sb2Se3 photocathode could be modulated by varying the starting potential. The cathodically initiated a-MoS x showed conformal filmlike morphology, whereas anodic initiation induced inhomogeneous particulate deposition. The filmlike morphology of a-MoS x was subjected to catalyst activation, which improved the photocurrent density and reduced the charge-transfer resistance at the semiconductor/electrolyte interface, as compared to that of its particulate counterpart. X-ray photoelectron spectroscopy confirmed that different chemical states of a-MoS x (photoelectrochemically active sites) were developed on the basis of the electrodeposited a-MoS x morphology. The research provides an effective approach for uniformly depositing cost-effective a-MoS x on nanostructured photoelectrodes, for photoelectrochemical water splitting.

Photoelectrodes based on 2D opals assembled from Cu-delafossite double-shelled microspheres for an enhanced photoelectrochemical response.

Although a unique light-harvesting property was recently demonstrated in a photocathode based on 2-dimensional (2D) opals of CuFeO2-shelled SiO2 microspheres, the performance of a monolayer of ultra-thin CuFeO2-shelled microspheres is limited by ineffective charge separation. Herein, we propose an innovative design rule, in which an inner CuFeO2/outer CuAlO2 double-shelled heterojunction is formed on each partially etched microsphere to obtain a hexagonally assembled 2D opal photoelectrode. Our Cu-delafossite double-shelled photocathode shows a dramatically improved charge separation capability, with a 9-fold increase in the photocurrent compared to that of the single-shelled counterpart. Electrochemical impedance spectroscopy clearly confirms the reduced charge transport/transfer resistance associated with the Cu-delafossite double-shelled photocathode, while surface photovoltage spectra reveal enhanced polarization of the photogenerated carrier, indicating improved charge separation capability with the aid of the heterojunction. Our finding sheds light on the importance of heterojunction interfaces in achieving optimal charge separation in opal architectures as well as the inner-shell/electrolyte interface to expedite charge separation/transport.

Time-Resolved Observations of Photo-Generated Charge-Carrier Dynamics in Sb2Se3 Photocathodes for Photoelectrochemical Water Splitting.

Solar-energy conversion by photoelectrochemical (PEC) devices is driven by the separation and transfer of photogenerated charge carriers. Thus, understanding carrier dynamics in a PEC device is essential to realizing efficient solar-energy conversion. Here, we investigate time-resolved carrier dynamics in emerging low-cost Sb2Se3 nanostructure photocathodes for PEC water splitting. Using terahertz spectroscopy, we observed an initial mobility loss within tens of picoseconds due to carrier localization and attributed the origin of carrier localization to the rich surface of Sb2Se3 nanostructures. In addition, a possible recombination at the interface between Sb2Se3 and the back contact is elucidated by time-resolved photoluminescence analysis. We also demonstrated the dual role of the RuO x co-catalyst in reducing surface recombination and enhancing charge transfer in full devices using intensity-modulated spectroscopy. The relatively low onset potential of the Sb2Se3 photocathode is attributed to the sluggish charge transfer at a low applied bias rather than to fast surface recombination. We believe that our insights on carrier dynamics would be an important step toward achieving highly efficient Sb2Se3 photocathodes.

Facile Sol-Gel-Derived Craterlike Dual-Functioning TiO2 Electron Transport Layer for High-Efficiency Perovskite Solar Cells.

Organic-inorganic hybrid perovskite solar cells (PSCs) are considered promising materials for low-cost solar energy harvesting technology. An electron transport layer (ETL), which facilitates the extraction of photogenerated electrons and their transport to the electrodes, is a key component in planar PSCs. In this study, a new strategy to concurrently manipulate the electrical and optical properties of ETLs to improve the performance of PSCs is demonstrated. A careful control over the Ti alkoxide-based sol-gel chemistry leads to a craterlike porous/blocking bilayer TiO2 ETL with relatively uniform surface pores of 220 nm diameter. Additionally, the phase separation promoter added to the precursor solution enables nitrogen doping in the TiO2 lattice, thus generating oxygen vacancies. The craterlike surface morphology allows for better light transmission because of reduced reflection, and the electrically conductive craterlike bilayer ETL enhances charge extraction and transport. Through these synergetic improvements in both optical and electrical properties, the power conversion efficiency of craterlike bilayer TiO2 ETL-based PSCs could be increased from 13.7 to 16.0% as compared to conventional dense TiO2-based PSCs.

Estimation of CO2 reduction by parallel hard-type power hybridization for gasoline and diesel vehicles.

The purpose of this study is to investigate possible improvements in ICEVs by implementing fuzzy logic-based parallel hard-type power hybrid systems. Two types of conventional ICEVs (gasoline and diesel) and two types of HEVs (gasoline-electric, diesel electric) were generated using vehicle and powertrain simulation tools and a Matlab-Simulink application programming interface. For gasoline and gasoline-electric HEV vehicles, the prediction accuracy for four types of LDV models was validated by conducting comparative analysis with the chassis dynamometer and OBD test data. The predicted results show strong correlation with the test data. The operating points of internal combustion engines and electric motors are well controlled in the high efficiency region and battery SOC was well controlled within ±1.6%. However, for diesel vehicles, we generated virtual diesel-electric HEV vehicle because there is no available vehicles with similar engine and vehicle specifications with ICE vehicle. Using a fuzzy logic-based parallel hybrid system in conventional ICEVs demonstrated that HEVs showed superior performance in terms of fuel consumption and CO2 emission in most driving modes.

Enhanced Photocurrent of Transparent CuFeO2 Photocathodes by Self-Light-Harvesting Architecture.

Efficient sunlight-driven water-splitting devices can be achieved by using an optically and energetically well-matched pair of photoelectrodes in a tandem configuration. The key for maximizing the photoelectrochemical efficiency is the use of a highly transparent front photoelectrode with a band gap below 2.0 eV. Herein, we propose two-dimensional (2D) photonic crystal (PC) structures consisting of a CuFeO2-decorated microsphere monolayer, which serve as self-light-harvesting architectures allowing for amplified light absorption and high transparency. The photocurrent densities are evaluated for three CuFeO2 2D PC-based photoelectrodes with microspheres of different sizes. The optical analysis confirmed the presence of a photonic stop band that generates slow light and at the same time amplifies the absorption of light. The 410 nm sized CuFeO2-decorated microsphere 2D PC photocathode shows an exceptionally high visible light transmittance of 76.4% and a relatively high photocurrent of 0.2 mA cm-2 at 0.6 V vs a reversible hydrogen electrode. The effect of the microsphere size on the carrier collection efficiency was analyzed by in situ conductive atomic force microscopy observation under illumination. Our novel synthetic method to produce self-light-harvesting nanostructures provides a promising approach for the effective use of solar energy by highly transparent photocathodes.

Photoelectrochemical Properties of Vertically Aligned CuInS2 Nanorod Arrays Prepared via Template-Assisted Growth and Transfer.

Although copper-based chalcopyrite materials such as CuInS2 have been considered promising photocathodes for solar water splitting, the fabrication route for a nanostructure with vertical orientation has not yet been developed. Here, a fabrication route for vertically aligned CuInS2 nanorod arrays from an aqueous solution using anodic aluminum oxide template-assisted growth and transfer is presented. The nanorods exhibit a phase-pure CuInS2 chalcopyrite structure and cathodic photocurrent response without co-catalyst loading. Small particles of CdS and ZnS were conformally decorated onto CuInS2 nanorods using a successive ion layer adsorption and reaction method. With surface modification of CdS/ZnS, the photoelectrochemical properties of CuInS2 nanorod arrays are enhanced via flat-band potential shift, as determined by analyses of onset potential and Mott-Schottky plots.

Retarding Crystallization during Facile Single Coating of NaCl-Incorporated Precursor Solution for Efficient Large-Area Uniform Perovskite Solar Cells.

We demonstrated crystallization retardation of CH3NH3PbI3 thin film during single coating of precursor solution by simple addition of NaCl. NaCl was codissolved into a precursor mixture solution containing PbI2 and methylammonium iodide (MAI). Dissolved NaCl interacted with the PbI2 in solution and produced a stable intermediate phase, which was converted to a full-coverage uniform perovskite absorber layer via reaction with MAI during a single spin-coating. The resulting planar-structure perovskite solar cell made from NaCl-supplemented precursor solution showed a 48% improvement in power conversion efficiency (PCE) (maximum value 15.16%) over the device fabricated without the additive. Our NaCl-supplemented single coating represents an easy approach to effectively obtain highly reproducible uniform performance at an overall position in 5 cm × 5 cm sized cells (divided into 20 subcells with an active area of 0.06 cm2) with average PCEs of 12.00 ± 0.48%.

Analysis of kimchi microflora using denaturing gradient gel electrophoresis.

A polymerase chain reaction-denaturing gradient gel electrophoresis (PCR-DGGE) technique was used to determine the microfloral composition during the fermentation of kimchi, a traditional Korean fermented vegetable food. The kimchi was fermented at 10 degrees C or 20 degrees C for 30 or 20 days, respectively. DGGE of the partially amplified 16S rDNA was performed and the most intense bands sequenced. The application of this culture-independent molecular technique determined that the lactic acid bacteria Weissella confusa, Leuconostoc citreum, Lactobacillus sakei, and Lactobacillus curvatus were the main microorganisms responsible for kimchi fermentation.

Aqueous Solution-Phase Selenized CuIn(S,Se)2 Thin Film Solar Cells Annealed under Inert Atmosphere.

A nonvacuum solution-based approach can potentially be used to realize low cost, roll-to-roll fabrication of chalcopyrite CuIn(S,Se)2 (CISSe) thin film solar cells. However, most solution-based fabrication methods involve highly toxic solvents and inevitably require sulfurization and/or postselenization with hazardous H2S/H2Se gases. Herein, we introduce novel aqueous-based Cu-In-S and Se inks that contain an amine additive for producing a high-quality absorber layer. CISSe films were fabricated by simple deposition of Cu-In-S ink and Se ink followed by annealing under an inert atmosphere. Compositional and phase analyses confirmed that our simple aqueous ink-based method facilitated in-site selenization of the CIS layer. In addition, we investigated the molecular structures of our aqueous inks to determine how crystalline chalcopyrite absorber layers developed without sulfurization and/or postselenization. CISSe thin film solar cells annealed at 550 °C exhibited an efficiency of 4.55% under AM 1.5 illumination. The low-cost, nonvacuum method to deposit chalcopyrite absorber layers described here allows for safe and simple processing of thin film solar cells.

Recovery of Corneal Endothelial Cells from Periphery after Injury.

BACKGROUND: Wound healing of the endothelium occurs through cell enlargement and migration. However, the peripheral corneal endothelium may act as a cell resource for the recovery of corneal endothelium in endothelial injury. AIM: To investigate the recovery process of corneal endothelial cells (CECs) from corneal endothelial injury. METHODS: Three patients with unilateral chemical eye injuries, and 15 rabbit eyes with corneal endothelial chemical injuries were studied. Slit lamp examination, specular microscopy, and ultrasound pachymetry were performed immediately after chemical injury and 1, 3, 6, and 9 months later. The anterior chambers of eyes from New Zealand white rabbits were injected with 0.1 mL of 0.05 N NaOH for 10 min (NaOH group). Corneal edema was evaluated at day 1, 7, and 14. Vital staining was performed using alizarin red and trypan blue. RESULTS: Specular microscopy did not reveal any corneal endothelial cells immediately after injury. Corneal edema subsided from the periphery to the center, CEC density increased, and central corneal thickness decreased over time. In the animal study, corneal edema was greater in the NaOH group compared to the control at both day 1 and day 7. At day 1, no CECs were detected at the center and periphery of the corneas in the NaOH group. Two weeks after injury, small, hexagonal CECs were detected in peripheral cornea, while CECs in mid-periphery were large and non-hexagonal. CONCLUSIONS: CECs migrated from the periphery to the center of the cornea after endothelial injury. The peripheral corneal endothelium may act as a cell resource for the recovery of corneal endothelium.

Role of anions in aqueous sol-gel process enabling flexible Cu(In,Ga)S2 thin-film solar cells.

Recently, environmental-friendly, solution-processed, flexible Cu(In,Ga)(S,Se)2 devices have gained significant interest, primarily because the solution deposition method enables large-scale and low-cost production of photovoltaics, and a flexible substrate can be implemented on uneven surfaces in various applications. Here, we suggest a novel green-chemistry aqueous ink that is readily achievable through the incorporation of molecular precursors in an aqueous medium. A copper formate precursor was introduced to lower the fabrication temperature, provide compatibility with a polyimide plastic substrate, and allow for high photovoltaic performance. Through a comparative spectroscopic study on temperature-dependent chemical/crystal structural evolution, the chemical role of copper formate was elucidated, which led to the chalcopyrite framework that was appropriate to low-temperature annealed Cu(In,Ga)S2 absorber layers at 400 °C. This Cu(In,Ga)S2 solar cell exhibited a power conversion efficiency of 7.04% on a rigid substrate and 5.60% on a polymeric substrate. Our cell on the polymeric substrate also demonstrated both acceptable mechanical flexibility and durability throughout a repeated bending test of 200 cycles.

Altered expression of adrenocorticotropic hormone in the epileptic gerbil hippocampus following spontaneous seizure.

We investigated the temporal alterations of adrenocorticotropic hormone (ACTH) immunoreactivity in the hippocampus after seizure onset. Expression of ACTH was observed within interneurons in the pre-seizure group of seizure sensitive gerbils, whereas its immunoreactivities were rarely detected in seizure resistant gerbil. Three hr after the seizure, ACTH immunoreactivity was significantly increased in interneurons within all hippocampal regions. On the basis of their localization and morphology through immunofluorescence staining, these cells were identified as GABAA α1-containing interneurons. At the 12 hr postictal period, ACTH expression in these regions was down-regulated, in a similar manner to the pre-seizure group of gerbils. These findings support the increase in ACTH synthesis that contributes to a reduction of corticotrophin-releasing factor via the negative feedback system which in turn provides an opportunity to enhance the excitability of GABAergic interneurons. Therefore, ACTH may play an important role in the reduction of excitotoxicity in all hippocampal regions.

Band-gap-graded Cu2ZnSn(S1-x,Se(x))4 solar cells fabricated by an ethanol-based, particulate precursor ink route.

Solution processing of earth-abundant Cu2ZnSn(S1-x,Sex)4 (CZTSSe) absorber materials is an attractive research area in the economical and large-scale deployment of photovoltaics. Here, a band-gap-graded CZTSSe thin-film solar cell with 7.1% efficiency was developed using non-toxic solvent-based ink without the involvement of complex particle synthesis, highly toxic solvents, or organic additives. Despite the high series resistance due to the presence of a thick Mo(S,Se)x layer and Zn(S,Se) aggregates, a high short-circuit current density (JSC) was generated. In addition, there was no significant difference in open circuit voltages (VOC) between CZTS (0.517 V) and CZTSSe (0.505-0.479 V) cells, despite a significant band gap change from 1.51 eV to 1.24 eV. The high JSC and less loss of VOC are attributed to the effect of band gap grading induced by Se grading in the CZTSSe absorber layer. Our environmentally benign ink approach will enable the realization of low-cost, large-area, high-efficiency thin-film solar cells.

Alterations in hyperpolarization-activated cyclic nucleotidegated cation channel (HCN) expression in the hippocampus following pilocarpine-induced status epilepticus.

To understand the effects of HCN as potential mediators in the pathogenesis of epilepsy that evoke long-term impaired excitability; the present study was designed to elucidate whether the alterations of HCN expression induced by status epilepticus (SE) is responsible for epileptogenesis. Although HCN1 immunoreactivity was observed in the hippocampus, its immunoreactivities were enhanced at 12 hrs following SE. Although, HCN1 immunoreactivities were reduced in all the hippocampi at 2 weeks, a re-increase in the expression at 2-3 months following SE was observed. In contrast to HCN1, HCN 4 expressions were un-changed, although HCN2 immunoreactive neurons exhibited some changes following SE. Taken together, our findings suggest that altered expressions of HCN1 following SE may be mainly involved in the imbalances of neurotransmissions to hippocampal circuits; thus, it is proposed that HCN1 may play an important role in the epileptogenic period as a compensatory response.

Altered PLCß-1 expression in the gerbil hippocampal complex following spontaneous seizure.

Although the phospholipase C (PLC)ß-1 isoform is associated with spontaneous seizure and distinctively expressed in the telencephalon, the distribution of PLCß-1 expression in the epileptic gerbil hippocampus remains controversial. Therefore, we determined whether PLCß-1 is associated with spontaneous seizure in an animal model of genetic epilepsy. In the present study, PLCß-1 immunoreactivity was down-regulated in seizure-sensitive (SS) gerbils more than in seizure-resistant (SR) gerbils. The expression of PLCß-1 within calretinin (CR)- positive neurons was rarely detected within the dentate hilar region of SS gerbils. PLCß-1 immunoreactivity in the hippocampus was significantly elevated as compared to that in pre-seizure SS gerbil 3 h post-ictal. These findings suggest that alterations in PLCß-1 immunoreactivity in the SS gerbil hippocampus may be closely related to the epileptic state of the gerbil brain and transiently elevated PLCß-1 protein levels following seizure episodes. Such alterations may be compensatory responses in the SS gerbil hippocampus.

A YIDD Mutation in a Case of Recurrent Hepatitis B after Liver Transplantation Induced by an S-escape Mutant.

A 47-year-old woman underwent orthotopic liver transplantation (OLT) for hepatitis B virus (HBV)-related end-stage liver cirrhosis. The patient received hepatitis B immunoglobulin prophylaxis after OLT. Despite the protective level of the serum anti-hepatitis-B surface antibody, HBV recurred at 22 months post-OLT and induced subacute hepatic failure. The pre-OLT HBV genome contained a complex mutation pattern in overlapping frame regions of the surface (S) and polymerase (P) genes, which is the same mutation pattern as seen in post-OLT HBV DNA. G145R and K141R mutations in the "a" determinant were detected only in the post-OLT sample. Clevudine (30 mg once daily) was administered for recurrent hepatitis B. Hepatitis B was reactivated with a flare-up, and a M204I mutation (YIDD mutant type) appeared with a higher viral load at 9 months after clevudine treatment. We report here a case of a YIDD mutation that developed in recurrent hepatitis B after OLT induced by an S-escape mutant.

A case of hepatocellular carcinoma with pulmonary metastases treated successfully with a combination of repeated hepatic arterial infusion epirubicin and Cisplatin chemotherapy and systemic low-dose infusion of 5-Fluorouracil.

We report a case of hepatocellular carcinoma (HCC) with pulmonary metastases treated with repeated hepatic arterial infusion chemotherapy (HAIC) comprising epirubicin and cisplatin, and systemic infusion of 5-fluorouracil (a modified EC/F protocol), which led to complete remission. A 49-year-old man with compensated liver cirrhosis experienced intrahepatic recurrence of HCC with extensive lung metastases. The modified EC/F therapeutic protocol, which was applied at the tenth cycle every 4-5 weeks, resulted in disappearance of the pulmonary metastases and normalization of serum alpha-fetoprotein levels. A single small HCC lesion was found in the left lobe of the liver 13 months after the final chemotherapy session. HAIC with the same regimen was conducted again, followed by percutaneous intratumoral chemoinjection therapy with 5-fluorouracil and interferon-gamma. Thereafter, there was no evidence of recurrence in either the liver or the lung, as evidenced by image analysis and expression of tumor markers. The disease-free intervals for the liver and lung were 41 and 54 months, respectively.