Use of noninvasive brain stimulation and neurorehabilitation devices to enhance poststroke recovery: review of the current evidence and pitfalls.

Neurorehabilitation devices and technologies are crucial for enhancing stroke recovery. These include noninvasive brain stimulation devices that provide repetitive transcranial magnetic stimulation or transcranial direct current stimulation, which can remodulate an injured brain. Technologies such as robotics, virtual reality, and telerehabilitation are suitable add-ons or complements to physical therapy. However, the appropriate application of these devices and technologies, which target specific deficits and stages, for stroke therapy must be clarified. Accordingly, a literature review was conducted to evaluate the theoretical and practical evidence on the use of neurorehabilitation devices and technologies for stroke therapy. This narrative review provides a practical guide for the use of neurorehabilitation devices and describes the implications of use and potential integration of these devices into healthcare.

Metal-Organic Frameworks for Water Harvesting and Concurrent Carbon Capture: A Review for Hygroscopic Materials.

As water scarcity becomes a pending global issue, hygroscopic materials prove a significant solution. Thus, there is a good cause following the structure-performance relationship to review the recent development of hygroscopic materials and provide inspirational insight into creative materials. Herein, traditional hygroscopic materials, crystalline frameworks, polymers, and composite materials are reviewed. The similarity in working conditions of water harvesting and carbon capture makes simultaneously addressing water shortages and reduction of greenhouse effects possible. Concurrent water harvesting and carbon capture is likely to become a future challenge. Therefore, an emphasis is laid on metal-organic frameworks (MOFs) for their excellent performance in water and CO2 adsorption, and representative role of micro- and mesoporous materials. Herein, the water adsorption mechanisms of MOFs are summarized, followed by a review of MOF's water stability, with a highlight on the emerging machine learning (ML) technique to predict MOF water stability and water uptake. Recent advances in the mechanistic elaboration of moisture's effects on CO2 adsorption are reviewed. This review summarizes recent advances in water-harvesting porous materials with special attention on MOFs and expects to direct researchers' attention into the topic of concurrent water harvesting and carbon capture as a future challenge.

Bioinspired Framework Catalysts: From Enzyme Immobilization to Biomimetic Catalysis.

Enzymatic catalysis has fueled considerable interest from chemists due to its high efficiency and selectivity. However, the structural complexity and vulnerability hamper the application potentials of enzymes. Driven by the practical demand for chemical conversion, there is a long-sought quest for bioinspired catalysts reproducing and even surpassing the functions of natural enzymes. As nanoporous materials with high surface areas and crystallinity, metal-organic frameworks (MOFs) represent an exquisite case of how natural enzymes and their active sites are integrated into porous solids, affording bioinspired heterogeneous catalysts with superior stability and customizable structures. In this review, we comprehensively summarize the advances of bioinspired MOFs for catalysis, discuss the design principle of various MOF-based catalysts, such as MOF-enzyme composites and MOFs embedded with active sites, and explore the utility of these catalysts in different reactions. The advantages of MOFs as enzyme mimetics are also highlighted, including confinement, templating effects, and functionality, in comparison with homogeneous supramolecular catalysts. A perspective is provided to discuss potential solutions addressing current challenges in MOF catalysis.

Creating hierarchical pores in metal-organic frameworks via postsynthetic reactions.

Metal-organic frameworks (MOFs) demonstrate promise for a multitude of applications owing to their high porosity and surface area. However, the majority of conventional MOFs possess only micropores with very limited accessibility to substances larger than 2 nm-especially functional biomacromolecules like some proteins. It is challenging to create an appropriately large pore size while avoiding framework collapse in MOFs. Herein, we present the generation of mesopores in microporous MOFs through three facile and effective techniques, namely Soxhlet washing, linker hydrolysis and linker thermolysis. These postsynthetic elimination approaches have been applied in selected MOFs, including PCN-250, PCN-160 and UiO-66, and controllably generate MOFs with hierarchical pores and high stability. Our work demonstrates reproducible and straightforward methods resulting in hierarchically porous materials that possess the benefits of mesoporosity while borrowing the robustness of a micropore framework. All the procedures can be conducted reliably at a multigram scale and operation time less than 6 h, representing a significant effort in the field of MOF synthesis. These hierarchically porous MOFs show great promise in a wide range of applications as efficient adsorbents, catalysts and drug carriers.

Oxidative stress and nucleic acid oxidation in patients with chronic kidney disease.

Patients with chronic kidney disease (CKD) have high cardiovascular mortality and morbidity and a high risk for developing malignancy. Excessive oxidative stress is thought to play a major role in elevating these risks by increasing oxidative nucleic acid damage. Oxidative stress results from an imbalance between reactive oxygen/nitrogen species (RONS) production and antioxidant defense mechanisms and can cause vascular and tissue injuries as well as nucleic acid damage in CKD patients. The increased production of RONS, impaired nonenzymatic or enzymatic antioxidant defense mechanisms, and other risk factors including gene polymorphisms, uremic toxins (indoxyl sulfate), deficiency of arylesterase/paraoxonase, hyperhomocysteinemia, dialysis-associated membrane bioincompatibility, and endotoxin in patients with CKD can inhibit normal cell function by damaging cell lipids, arachidonic acid derivatives, carbohydrates, proteins, amino acids, and nucleic acids. Several clinical biomarkers and techniques have been used to detect the antioxidant status and oxidative stress/oxidative nucleic acid damage associated with long-term complications such as inflammation, atherosclerosis, amyloidosis, and malignancy in CKD patients. Antioxidant therapies have been studied to reduce the oxidative stress and nucleic acid oxidation in patients with CKD, including alpha-tocopherol, N-acetylcysteine, ascorbic acid, glutathione, folic acid, bardoxolone methyl, angiotensin-converting enzyme inhibitor, and providing better dialysis strategies. This paper provides an overview of radical production, antioxidant defence, pathogenesis and biomarkers of oxidative stress in patients with CKD, and possible antioxidant therapies.

Adult-onset of mitochondrial myopathy, encephalopathy, lactic acidosis, and stroke-like episodes (MELAS) syndrome presenting as acute meningoencephalitis: a case report.

BACKGROUND: Mitochondrial myopathy, encephalopathy, lactic acidosis, and stroke-like episodes (MELAS) syndrome is a rare mitochondrial disorder with a wide range of multisystemic symptoms. Epileptic seizures are common features of both MELAS and meningoencephalitis and are typically treated with anticonvulsants. OBJECTIVES: To provide the reader with a better understanding of MELAS and the adverse effects of valproic acid. CASE REPORT: A 47-year-old man with a history of diabetes, hearing loss, sinusitis, and otitis media was brought to our emergency department due to acute onset of fever, headache, generalized seizure, and agitation. Because acute meningoencephalitis was suspected, the patient was treated with antibiotics on an empirical basis. The seizure activity was aggravated by valproic acid and abated after its discontinuation. MELAS was suspected and the diagnosis was confirmed by the presence of a nucleotide 3243 A→G mutation in the mitochondrial DNA. CONCLUSION: Detailed history-taking and systematic review help emergency physicians differentiate MELAS from meningoencephalitis in patients with the common presentation of epileptic seizures. Use of valproic acid to treat epilepsy in patients suspected of having mitochondrial disease should be avoided. Underlying mitochondrial disease should be suspected if seizure activity worsens with valproic acid therapy.

Genotype and phenotype analysis of patients with sporadic periodic paralysis.

INTRODUCTION: Sporadic periodic paralysis (SPP), the second leading cause of hypokalemic periodic paralysis (HPP) in Asia, has a presentation similar to that of familial periodic paralysis (FPP) and is caused by gene mutations in the calcium (Ca(2+)) (CACNA1S) and sodium (Na(+)) (SCN4A) channels of skeletal muscle. The authors determined whether SPP shares similar genotype and phenotype with FPP. METHODS: Sixty SPP patients who did not have a family history of paralysis, abnormal thyroid function tests and other identifiable causes of HPP, and 8 FPP patients were enrolled. Genomic DNA was isolated from blood leukocytes of all SPP and FPP patients. Genetic analysis of whole S4 segment in CACNA1S and SCN4A was performed. Phenotypic analysis included clinical presentations, laboratory data and precipitating events. RESULTS: All FPP patients had mutations in either CACNA1S or SCN4A, but only 4 SPP patients had de novo mutations in CACNA1S (R1239H) and SCN4A (R669×2, R1135H). SPP patients with de novo mutations manifested a phenotype indistinguishable from that of FPP patients except a later age of onset. SPP patients without mutations also had a later age of onset, significantly fewer attacks of paralysis than FPP patients, and unidentifiable precipitating factors. CONCLUSION: A minority of SPP patients had de novo CACNA1S or SCN4A mutations and may have a variant of FPP. The majority of SPP patients, those without mutations in CACNA1S and SCN4A, represent a unique subgroup of HPP patients, and this form of SPP usually manifests at a later age, is associated with fewer attacks and lacks apparent triggering factors.

Micturitional headache in a young girl.

A 16-year-old girl came to our emergency department because of severe headache. For the past 3 years, she had presented at several emergency departments with a similar problem. When she was hospitalized for further investigation, she developed severe arterial hypertension for which an unusual cause was found by imaging of the abdomen.