Temporal trends and regional variations in mortality related to Guillain-Barré syndrome in the United States: a retrospective study from 1999 to 2020.

AIM: Guillain-Barré syndrome (GBS) is an autoimmune neurological disorder, with an estimated 6.4% increase in cases worldwide from 1990 to 2019. We aim to identify the GBS-related mortality trends in the US stratified by age, sex, race, and region. METHODS: We used data from the CDC-WONDER database to calculate crude (CMR) and age-adjusted mortality rates (AAMRs) per 1,000,000 people. We examined the temporal trends through annual percent change (APC) and the average annual percent change (AAPC) in rates using Joinpoint regression. RESULTS: From 1999 to 2020, a total of 10,097 GBS-related deaths occurred in the US. The AAMR decreased till 2014 (APC: -1.91) but increased back to initial levels by 2020 (APC: 3.77). AAMR was higher in males (1.7) than females (1.1), decreasing till 2015 for females and 2014 for males, but increasing thereafter only for females. Non-Hispanic (NH) American Indians or Alaska Natives displayed the highest AAMR (1.8) while NH Asians or Pacific Islanders displayed the lowest (0.6). AAMRs also varied by region (West: 1.5; South: 1.5; Midwest: 1.4; Northeast: 1.1). Rural regions exhibited a higher AAMR (1.7) than urban regions (1.3). Most deaths occurred in medical facilities (60.99%). The adults aged ≥85 years exhibited an alarmingly high CMR (14.0). CONCLUSIONS: While the mortality rates for GBS initially declined till 2014, they climbed back up afterwards. Highest mortality was exhibited by males and NH American Indians or Alaska Natives, residents of rural regions, and adults ≥85 years. Equitable efforts are needed to reduce the burden on high-risk populations.

A Facile Graphene Conductive Polymer Paper Based Biosensor for Dopamine, TNF-α, and IL-6 Detection.

Paper-based biosensors are a potential paradigm of sensitivity achieved via microporous spreading/microfluidics, simplicity, and affordability. In this paper, we develop decorated paper with graphene and conductive polymer (herein referred to as graphene conductive polymer paper-based sensor or GCPPS) for sensitive detection of biomolecules. Planetary mixing resulted in uniformly dispersed graphene and conductive polymer ink, which was applied to laser-cut Whatman filter paper substrates. Scanning electron microscopy and Raman spectroscopy showed strong attachment of conductive polymer-functionalized graphene to cellulose fibers. The GCPPS detected dopamine and cytokines, such as tumor necrosis factor-alpha (TNF-α), and interleukin 6 (IL-6) in the ranges of 12.5-400 µM, 0.005-50 ng/mL, and 2 pg/mL-2 µg/mL, respectively, using a minute sample volume of 2 µL. The electrodes showed lower detection limits (LODs) of 3.4 µM, 5.97 pg/mL, and 9.55 pg/mL for dopamine, TNF-α, and IL-6 respectively, which are promising for rapid and easy analysis for biomarkers detection. Additionally, these paper-based biosensors were highly selective (no serpin A1 detection with IL-6 antibody) and were able to detect IL-6 antigen in human serum with high sensitivity and hence, the portable, adaptable, point-of-care, quick, minute sample requirement offered by our fabricated biosensor is advantageous to healthcare applications.

Evaluation of applying topical tranexamic acid to control septorhinoplasy - induced hemorrhage.

OBJECTIVES: Hemorrhagic events related to surgical field is a common disturbing complication which could worsen the outcomes of operation. This study aimed to evaluate how applying of topical tranexamic acid (TXA) could affect bleeding related to septorhinoplasty operation. MATERIAL AND METHODS: This double-blind controlled trial study finally evaluated 198 candidates for septorhinoplasty repair who were randomly allocated to two groups: TXA receivers (5 mg/kg) and control group (received 5 mg/kg of saline 0.9 %). Then cumulative volume of hemorrhage was calculated by adding total volume of suctioned blood and numbers of fully blood-filled surgical gauzes (15 mL in each). Additionally postoperative 24 h volume of hemorrhage was measured by counting number of bloody surgical gauzes. RESULTS: Of all participants, 90 % were female. The mean age was 26 ± 7 years. Total cumulative volume of hemorrhage during surgery was significantly diminished when topical TXA was applied (p < 0.0001). Additionally drier field of operation was illustrated postoperatively in patients received topical TXA (2 % & 28 % in TXA and saline 0.9 % receivers, respectively) (p < 0.001). CONCLUSION: Using topical TXA could decrease bleeding volume and make surgical field of septorhinoplasty drier either during surgery or postoperatively.

In vitro activity of colistin against multidrug-resistant Acinetobacter baumannii isolates harboring blaOXA-23-like and blaOXA-24-like genes: A multicenter based study.

This study was aimed to evaluate occurrence of antibiotic resistance and the presence of resistance determinants among clinical isolates of Acinetobacter baumannii. This cross-sectional study from January to September 2018 was performed on 59 A. baumannii strains isolated from clinical samples in the north of Iran. Isolates were identified by standard microbiologic tests and molecular method. Antimicrobial susceptibility testing was carried out by disk diffusion and broth microdilution methods. The presence of carbapenem resistance genes was detected by PCR method. All isolates were resistant to cefepime, meropenem, imipenem and ceftazidime. The lowest resistance rate was observed against doxycycline with 33.9%. Minimum inhibitory concentration (MIC) results showed that all carbapenem-resistant A. baumannii (CRAB) isolates were susceptible to colistin with MIC50 and MIC90 values of 1/2 µg/mL. Among 59 CRAB, blaOXA-23-like was the most prevalent gene (86.4%) followed by blaOXA-24-like (69.5%). Meanwhile, none of the clinical isolates harbored blaOXA-58-like gene. We found a high prevalence of CRAB strains harboring OXA-type carbapenemases in the north of Iran. Our results suggests that the presence of OXA-type genes was not directly correlated with the increase of imipenem MIC level, but can be clinically important as they contribute to the selection of CRAB strains.

Hierarchical, Dual-Scale Structures of Atomically Thin MoS2 for Tunable Wetting.

Molybdenum disulfide (MoS2), a well-known solid lubricant for low friction surface coatings, has recently drawn attention as an analogue two-dimensional (2D) material beyond graphene. When patterned to produce vertically grown, nanoflower-structures, MoS2 shows promise as a functional material for hydrogen evolution catalysis systems, electrodes for alkali metal-ion batteries, and field-emission arrays. Whereas the wettability of graphene has been substantially investigated, that of MoS2 structures, especially nanoflowers, has remained relatively unexplored despite MoS2 nanoflower's potential in future applications. Here, we demonstrate that the wettability of MoS2 can be controlled by multiscale modulation of surface roughness through (1) tuning of the nanoflower structures by chemical vapor deposition synthesis and (2) tuning of microscale topography via mechanical strain. This multiscale modulation offers broadened tunability (80-155°) compared to single-scale tuning (90-130°). In addition, surface adhesion, determined from contact angle hysteresis (CAH), can also be tuned by multiscale surface roughness modulation, where the CAH is changed in range of 20-40°. Finally, the wettability of crumpled MoS2 nanoflowers can be dynamically and reversibly controlled through applied strain (∼115-150° with 0-200% strain), and remains robust over 1000 strain cycles. These studies on the tunable wettability of MoS2 will contribute to future MoS2-based applications, such as tunable wettability coatings for desalination and hydrogen evolution.

Treatment of Pediatric Osteoid Osteomas Not Amenable to Radiofrequency Ablation: A Retrospective Review of Surgical Outcomes.

The purpose of this study is to describe the surgical treatment of osteoid osteomas in a pediatric cohort of patients who were found not to be candidates for percutaneous ablative therapies. Medical records for 29 pediatric patients who were treated surgically for osteoid osteomas were reviewed. Reasons for surgical management included diagnostic uncertainty or lesions that were in close proximity to an articular surface or neurovascular structure. Twenty-eight patients experienced complete symptom resolution. Surgical treatment may still be indicated in a select group of osteoid osteoma patients who are not candidates for percutaneous treatment. (Journal of Surgical Orthopaedic Advances 27(4):299-302, 2018).

Evaluation of climate-induced waterlogging hazards in the south-west coast of Bangladesh using Geoinformatics.

Climate-induced waterlogging has been significantly affecting the lives and livelihood of people in the south-west coastal region of Bangladesh for a couple of decades. The objective of this study is to investigate the waterlogging hazards of Tala, a south-western coastal Upazila of Bangladesh by analyzing satellite image. An empirical model based on velocity of flow, depth of flow, and inundation depth has been proposed to assess waterlogging hazard in pre monsoon, monsoon, and post monsoon period. Landsat TM images for the years 1989, 2000, and 2011 were analyzed by using Geoinformatics including GIS and remote sensing techniques to quantify the water hazard. Three dominant land use classes such as "water," "vegetation," and "bare lands and others" were selected to identify the land use land cover change. Both FGD (focus group discussions) and KII (key informant interviews) were also accomplished to assess the waterlogging hazard. It was revealed that 0.7% of the study area (246 ha) was under water in 1989, which increased alarmingly to 34% (11,525 ha) in 2011. There was an increase in 62.9% of water bodies during 1989 to 2000, which was further expanded to 77% during 2000 to 2011. Satellite image analysis between 2011 and 2015 also showed that nearly 89% of the waterlogged area including floodplain is inundated by tidal saline water that supports shrimp cultivation. On the contrary, 11% of the waterlogged area was occupied by trapped rain water. Confirmation of saline water and fresh water was done by measuring electrical conductivity and conducting "mouth taste" during field visit. The decreasing rate of "bare lands and others" category indicates that there is around 69.4% of reduction in this category to accommodate the increasing water covering areas. The hazard model shows that the middle part of the Tala along with the flood plain of the Kabodak River usually have to suffer waterlogged in both pre monsoon and post monsoon period. It was found that low flow in the upstream side, siltation in the Kabodak River, elevated riverbed, and recent increase in total annual rainfall have resulted in waterlogging problem. Combining inputs obtained from FGD, KII, and economic study of drainage, the TRM (tidal river management) followed by re-excavation of silted riverbed may provide a sustainable solution to solve the prolonged waterlogging situation.

One-pot microwave assisted stereoselective synthesis of novel dihydro-2'H-spiro[indene-2,1'-pyrrolo-[3,4-c]pyrrole]-tetraones and evaluation of their antimycobacterial activity and inhibition of AChE.

An efficient one-pot microwave assisted stereoselective synthesis of novel dihydro-2'H-spiro[indene-2,1'-pyrrolo[3,4-c]pyrrole]-tetraone derivatives through three-component 1,3-dipolar cycloaddition of azomethine ylides generated in situ from ninhydrin and sarcosine with a series of 1-aryl-1H-pyrrole-2,5-diones is described. The synthesised compounds were screened for their antimycobacterial and AChE inhibition activities. Compound 4b (IC50 1.30µM) has been found to display twelve fold antimycobacterial activity compared to cycloserine and it is thirty seven times more active than pyrimethamine. Compound 4h displays maximum AchE inhibitory activity with IC50 value of 0.78±0.01µmol/L.

Is There a Deficit After Nonoperative Versus Operative Treatment of Shortened Midshaft Clavicular Fractures in Adolescents?

BACKGROUND: Recent clinical studies in adults have reported a higher incidence of symptomatic malunions and functional deficits in nonoperatively treated shortened midshaft clavicular fractures. We sought to determine whether functional or subjective deficits are found in adolescents after operative versus nonoperative treatment of clavicle fractures. METHODS: Adolescents with displaced midshaft clavicle fractures, >15 mm of shortening, and a minimum of 9 months of follow-up were recruited. Exclusion criteria included concomitant upper extremity injuries or abnormalities that would affect biomechanical strength testing. Sixteen patients, equally divided between nonoperative and operative plate fixation, met inclusion criteria and consented to testing. The average age (±SD) at the time of injury was 14±2 years (range, 10 to 16 y), time from injury was 22±10 months (range, 10 to 41 mo), and shortening was 24±6 mm (range, 16 to 35 mm). Consenting subjects completed a QuickDASH Score, Constant Shoulder Score, and questions regarding satisfaction with treatment. Quantitative isometric strength, range of motion, and abduction fatigue testing was performed on the involved and uninvolved sides for comparison. RESULTS: Treatment groups did not differ in age, time from injury, or fracture shortening. QuickDASH and Constant Shoulder Scores were perfect in all but 1 patient in the operative group who actively complained of persistent symptomatic hardware. This patient and one other in the operative group underwent symptomatic hardware removal. There were no cases of symptomatic malunions in the nonoperative group. All patients expressed satisfaction with their treatment. Two in each treatment group were unsatisfied with the appearance of the clavicle. With the exception of a 3% decrease in abduction strength in the operative group (P=0.03) there were no differences in range of motion, isometric strength, or abduction fatigue of the involved shoulder in either treatment group. CONCLUSIONS: Shortened midshaft clavicular fractures had excellent outcomes after both operative and nonoperative treatments. No subjective or objective differences were observed between treatment groups. LEVEL OF EVIDENCE: Level III-therapeutic, retrospective comparative study.

Doping-Induced Tunable Wettability and Adhesion of Graphene.

We report that substrate doping-induced charge carrier density modulation leads to the tunable wettability and adhesion of graphene. Graphene's water contact angle changes by as much as 13° as a result of a 300 meV change in doping level. Upon either n- or p-type doping with subsurface polyelectrolytes, graphene exhibits increased hydrophilicity. Adhesion force measurements using a hydrophobic self-assembled monolayer-coated atomic force microscopy probe reveal enhanced attraction toward undoped graphene, consistent with wettability modulation. This doping-induced wettability modulation is also achieved via a lateral metal-graphene heterojunction or subsurface metal doping. Combined first-principles and atomistic calculations show that doping modulates the binding energy between water and graphene and thus increases its hydrophilicity. Our study suggests that the doping-induced modulation of the charge carrier density in graphene influences its wettability and adhesion [corrected]. This opens up unique and new opportunities for the tunable wettability and adhesion of graphene for advanced coating materials and transducers.

A facile stereoselective synthesis of dispiro-indeno pyrrolidine/pyrrolothiazole-thiochroman hybrids and evaluation of their antimycobacterial, anticancer and AchE inhibitory activities.

A facile stereoselective synthesis of novel dispiro indeno pyrrolidine/pyrrolothiazole-thiochroman hybrids has been achieved by 1,3-dipolar cycloaddition of azomethine ylides, generated in situ from ninhydrin and sarcosine/thiaproline, on a series of 3-benzylidenethiochroman-4-ones. The synthesised compounds were screened for their antimycobacterial, anticancer and AchE inhibition activities. Compound 4l (IC50 1.07µM) has been found to exhibit the most potent antimycobacterial activity compared to cycloserine (12 times), pyrimethamine (37 times) and ethambutol (IC50 <1.56µM) and 6l (IC50=2.87µM) is more active than both cycloserine (4 times) and pyrimethamine (12 times). Three compounds, 4a, 6b and 6i, display good anticancer activity against CCRF-CEM cell lines. Compounds 6g and 4g display maximum AchE inhibitory activity with IC50 values of 1.10 and 1.16µmol/L respectively.

Heterogeneous, three-dimensional texturing of graphene.

We report a single-step strategy to achieve heterogeneous, three-dimensional (3D) texturing of graphene and graphite by using a thermally activated shape-memory polymer substrate. Uniform arrays of graphene crumples can be created on the centimeter scale by controlling simple thermal processing parameters without compromising the electrical properties of graphene. In addition, we show the capability to selectively pattern crumples from otherwise flat graphene and graphene/graphite in a localized manner, which has not been previously achievable using other methods. Finally, we demonstrate 3D crumpled graphene field-effect transistor arrays in a solution-gated configuration. The presented approach has the capability to conform onto arbitrary 3D surfaces, a necessary prerequisite for adaptive electronics, and will enable facile large-scale topography engineering of not only graphene but also other thin-film and 2D materials in the future.

Assembly and densification of nanowire arrays via shrinkage.

Chemically synthesized semiconductor nanowires (NWs) have demonstrated substantial promise for nanoelectronics, nanoenergy, and nanobiotechnology, but the lack of an effective and controllable assembly process has limited the wide adoption of NWs in these areas. Here we demonstrate a facile, robust, and controllable approach to assembling and densifying a parallel array of NWs using shrinkable shape memory polymers. Using thermal-induced shrinkage of polystyrene, we were able to successfully assemble and densify NW arrays up to close-packing and, furthermore, achieve tunable density (up to ∼300% amplification of density) by controlling the shrinkage process. We also demonstrate scalable assembly and densification of NWs on a 2.5 × 6 inch scale to explore the manufacturability of the shrink-induced assembly process. Finally, we demonstrate the successful transfer of the shrink-assembled NW arrays onto various 2-dimensional and 3-dimensional substrates without compromising the integrity of NW assembly and density.

Spectroscopic investigation of the wettability of multilayer graphene using highly ordered pyrolytic graphite as a model material.

We report the intrinsic water contact angle (WCA) of multilayer graphene, explore different methods of cleaning multilayer graphene, and evaluate the efficiency of those methods on the basis of spectroscopic analysis. Highly ordered pyrolytic graphite (HOPG) was used as a model material system to study the wettability of the multilayer graphene surface by WCA measurements. A WCA value of 45° ± 3° was measured for a clean HOPG surface, which can serve as the intrinsic WCA for multilayer graphene. A 1 min plasma treatment (100 W) decreased the WCA to 6°, owing to the creation of surface defects and functionalization by oxygen-containing groups. Molecular dynamics simulations of water droplets on the HOPG surface with or without the oxygen-containing defect sites confirmed the experimental results. Heat treatment at near atmospheric pressure and wet chemical cleaning methods using hydrofluoric acid and chloroform did not change the WCA significantly. Low-pressure, high-temperature annealing under argon and hydrogen reduced the WCA to 54°, close to the intrinsic WCA of HOPG. Raman spectroscopy and atomic force microscopy did not show any significant change for the HOPG surface after this treatment, confirming low-pressure, high-temperature annealing as an effective technique to clean multilayer graphene without damaging the surface. Time-of-flight secondary ion mass spectrometry indicated the existence of hydrocarbon species on the surface of the HOPG sample that was exposed to air for <5 min and the absence of these impurities in the bulk. X-ray photoelectron spectroscopy analyses of the sample surfaces after the different cleaning techniques were performed to correlate the WCA to the surface chemistry. X-ray photoelectron spectroscopy results revealed that the WCA value changed drastically, depending on the amounts of oxygen-containing and hydrocarbon-containing groups on the surface.

Hospital costs of total hip arthroplasty for developmental dysplasia of the hip.

BACKGROUND: Developmental dysplasia of the hip (DDH) is a leading cause of total hip arthroplasty (THA) in younger patients. It is unknown how the hospital costs of THA in patients with DDH compare with patients with degenerative arthritis. QUESTIONS/PURPOSES: We undertook this study to determine (1) the hospital cost and length of stay associated with primary THA in patients with dysplasia compared with nondysplastic control subjects; (2) the hospital cost and length of stay of THA in severely dysplastic hips compared with mildly dysplastic hips; and (3) perioperative complications in patients with DDH compared with patients without dysplasia. METHODS: This matched-cohort study included 354 patients undergoing primary THA for DDH and 1029 age-, sex-, and calendar year-matched patients undergoing THA for primary osteoarthritis between 2000 and 2008. DDH severity was measured by the Crowe classification. An institutional database was used to calculate the cost of care. Using line item details (date, type, frequency, and billed charge) for every procedure or service billed at our institution for each patient, bottom-up microcosting valuation techniques were used to generate standardized inflation-adjusted estimates of the cost of each service or procedure in constant dollars. Generalized linear random effects models were used to compare length of stay and costs during hospitalization and the 90-day period after surgery. Query of a longitudinal institutional database was used to identify documented complications. RESULTS: Patients with DDH undergoing primary THA incurred higher hospital costs than patients with primary osteoarthritis (USD 16,949 versus USD 16,485, p = 0.012). Operating room costs (USD 3471 versus USD 3417, p = 0.0085) and implant costs (USD 3896 versus USD 3493, p < 0.001) were higher in the DDH group compared with the osteoarthritis group. Length of stay was not different between the two groups (4 versus 4 days, p = 0.46). Crowe 4 hips had higher hospital costs than Crowe 1 hips (USD 21,246 versus USD 16,345, p < 0.001) with an associated longer length of stay (5 days versus 4 days, p = 0.0011) and higher implant costs (USD 4380 versus USD 3788, p = 0.0012). There was no detectible difference in 90-day complications in the case group compared with patients undergoing THA for osteoarthritis. CONCLUSIONS: Hospital cost of primary THA is approximately USD 450 higher in patients with DDH compared with osteoarthritis. Increased severity of dysplasia (Crowe classification) was associated with higher costs. LEVEL OF EVIDENCE: Level IV, economic and decision analyses. See Guidelines for Authors for a complete description of levels of evidence.

Acute and subacute complications of pediatric and adolescent knee arthroscopy.

PURPOSE: The purposes of this study were to determine the frequency of acute and subacute complications (within 6 months) of arthroscopic knee procedures in patients aged 17 years or younger and to determine associated risk factors. METHODS: We identified all patients aged 17 years or younger who underwent arthroscopic knee procedures at our institution from 1997 to 2009. Patient demographic and surgical data were collected from the medical and surgical records, with specific focus on intraoperative and postoperative complications. RESULTS: During the study period, 1,002 knee arthroscopies were reviewed. The overall complication rate was 14.7%. Major complications occurred in 21 surgeries (2.1%) and included the following: septic arthritis (n = 3, 0.3%), wound complication requiring operative revision (n = 9, 0.9%), arthrofibrosis requiring manipulation (n = 4, 0.4%), other unplanned subsequent surgery (n = 4, 0.4%), and death (n = 1, 0.1%). Surgeries with an anesthesia time of 265 minutes or greater (P = .026), operative time of 220 minutes or greater (P = .013), or tourniquet time of 114 minutes or greater (P < .001) and surgeries with 3 or more Current Procedural Terminology codes (P = .003) had a statistically significant increase in risk of major complications. The incidence of minor complications was 12.6%, which included persistent effusion/hemarthrosis requiring arthrocentesis (n = 59, 5.9%) and superficial wound infection (n = 18, 1.8%). CONCLUSIONS: Major complications after knee arthroscopy in children and adolescents are rare, but minor complications are more common. If possible, surgeons should avoid prolonged anesthesia, surgery, and tourniquet times. The pediatric patient's medical and family history should be reviewed to identify important risk factors. LEVEL OF EVIDENCE: Level IV, therapeutic case series.

Gender and racial disparities in obesity-related cardiovascular-induced mortality in the USA, 1999-2020.

Obesity is closely linked to various cardiovascular diseases, leading to increased mortality rates. This study examines the trends in cardiovascular-induced obesity associated mortality among individuals aged 15 years and older in the United States. Data were sourced from the CDC WONDER for the years 1999-2020, encompassing fatalities where cardiovascular disease was the underlying cause of death and obesity was a contributing factor. The dataset was analyzed, considering annual patterns, gender, and ethnic origins. A total of 280,992 deaths were reported, with 56.35 % attributed to males and 43.64 % to females. The age-adjusted mortality rate was 5.8 for males and 4 for females. Non-Hispanic white individuals accounted for 71.049 % of total deaths, while non-Hispanic Black individuals contributed 19.510 %. The highest mortality rate was observed among non-Hispanic Black individuals, with non-Hispanic American Indian or Alaska Native individuals following. Non-Hispanic Asian or Pacific Islander individuals had the lowest mortality rate. The average annual percentage change (AAPC) was 6.1 for males and 4.4 for females. A significant increase in the overall mortality rate was observed from 2018 to 2020, with Hispanics/Latinos exhibiting the highest increase. The elevated AAMR among males as compared to females may be attributed to the cardio-protective properties of estrogen in women. Furthermore, the COVID-19 pandemic introduced unfavorable lifestyle changes, including weight gain and reduced exercise, potentially exacerbating CVD mortality trends after 2019. Further timely and targeted efforts are needed to control obesity and cardiovascular-related mortality in the USA.

Two decades of influenza and pneumonia mortality trends: Demographics, regional shifts and disparities in the United States: 1999 to 2020.

BACKGROUND: In the 20th century, influenza and pneumonia constituted the largest proportion of infectious disease deaths in the United States. Despite progress in management, US mortality trends for these diseases have not been thoroughly investigated. OBJECTIVES: We aim to examine the patterns of influenza and pneumonia-related deaths among US residents. METHODS: Crude death rates and age-adjusted mortality rates (AAMRs) per 100,000 individuals were calculated using influenza and pneumonia mortality data (International Classification of Diseases, 10th revision codes: J09-J18) from the CDC WONDER database. Annual percentage changes with a 95% confidence interval were determined using joinpoint regression analysis. Average annual percentage changes were computed as the weighted average of annual percentage changes. RESULTS: From 1999 to 2020, US influenza and pneumonia deaths totaled 1,257,088 (AAMR: 17.09), with a significantly decreasing AAMR (-2.94). Males had a higher AAMR (20.13) than females (15.02). Non-Hispanic American Indians had the highest AAMR (20.44), while Hispanics had the lowest AAMR (13.91). The Northeast had the highest AAMR (18.02). All other regions had similar AAMRs. Rural regions had a consistently higher AAMR (19.80) than urban regions (AAMR: 16.51). CONCLUSION: Tailoring interventions toward high-risk groups can enhance the effectiveness of preventive measures, vaccination, and health care access.

Laser-Induced Electrochemical Biosensor Modified with Graphene-Based Ink for Label-Free Detection of Alpha-Fetoprotein and 17ß-Estradiol.

In this research, a novel electrochemical biosensor is proposed based on inducing graphene formation on polyimide substrate via laser engraving. Graphene polyaniline (G-PANI) conductive ink was synthesized by planetary mixing and applied to the working zone of the developed sensor to effectively enhance the electrical signals. The laser-induced graphene (LIG) sensor was used to detect alpha-fetoprotein (AFP) and 17ß-Estradiol (E2) in the phosphate buffer saline (PBS) buffer and human serum. The electrochemical performance of the biosensor in determining these biomarkers was investigated by differential pulse voltammetry (DPV) and chronoamperometry (CA). In a buffer environment, alpha-fetoprotein (AFP) and 17ß-Estradiol detection range were 4-400 ng/mL and 20-400 pg/mL respectively. The experimental results showed a limit of detection (LOD) of 1.15 ng/mL and 0.96 pg/mL for AFP and estrogen, respectively, with an excellent linear range (R2 = 0.98 and 0.99). In addition, the designed sensor was able to detect these two types of biomarkers in human serum successfully. The proposed sensor exhibited excellent reproducibility, repeatability, and good stability (relative standard deviation, RSD = 0.96%, 1.12%, 2.92%, respectively). The electrochemical biosensor proposed herein is easy to prepare and can be successfully used for low-cost, rapid detection of AFP and E2. This approach provides a promising platform for clinical detection and is advantageous to healthcare applications.

Graphene Nanocomposite Ink Coated Laser Transformed Flexible Electrodes for Selective Dopamine Detection and Immunosensing.

Novel and flexible disposable laser-induced graphene (LIG) sensors modified with graphene conductive inks have been developed for dopamine and interleukin-6 (IL-6) detection. The LIG sensors exhibit high reproducibility (relative standard deviation, RSD = 0.76%, N = 5) and stability (RSD = 4.39%, N = 15) after multiple bendings, making the sensors ideal for wearable and stretchable bioelectronics applications. We have developed electrode coatings based on graphene conductive inks, poly(3,4-ethylenedioxythiophene):polystyrene sulfonate (G-PEDOT:PSS) and polyaniline (G-PANI), for working electrode modification to improve the sensitivity and limit of detection (LOD). The selectivity of LIG sensors modified with the G-PANI ink is 41.47 times higher than that of the screen-printed electrode with the G-PANI ink modification. We have compared our fabricated bare laser-engraved Kapton sensor (LIG) with the LIG sensors modified with G-PEDOT (LIG/G-PEDOT) and G-PANI (LIG/G-PANI) conductive inks. We have further compared the performance of the fabricated electrodes with commercially available screen-printed electrodes (SPEs) and screen-printed electrodes modified with G-PEDOT:PSS (SPE/G-PEDOT:PSS) and G-PANI (SPE/G-PANI). SPE/G-PANI has a lower LOD of 0.632 µM compared to SPE/G-PEDOT:PSS (0.867 µM) and SPE/G-PANI (1.974 µM). The lowest LOD of the LIG/G-PANI sensor (0.4084 µM, S/N = 3) suggests that it can be a great alternative to measure dopamine levels in a physiological medium. Additionally, the LIG/G-PANI electrode has excellent LOD (2.6234 pg/mL) to detect IL-6. Also, the sensor is successfully able to detect ascorbic acid (AA), dopamine (DA), and uric acid (UA) in their ternary mixture. The differential pulse voltammetry (DPV) result shows peak potential separation of 229, 294, and 523 mV for AA-DA, DA-UA, and UA-AA, respectively.