A multinational study of acute and long-term outcomes of Type 1 galactosemia patients who carry the S135L (c.404C > T) variant of GALT.

Patients with galactosemia who carry the S135L (c.404C > T) variant of galactose-1-P uridylyltransferase (GALT), documented to encode low-level residual GALT activity, have been under-represented in most prior studies of outcomes in Type 1 galactosemia. What is known about the acute and long-term outcomes of these patients, therefore, is based on very limited data. Here, we present a study comparing acute and long-term outcomes of 12 patients homozygous for S135L, 25 patients compound heterozygous for S135L, and 105 patients homozygous for two GALT-null (G) alleles. This is the largest cohort of S135L patients characterized to date. Acute disease following milk exposure in the newborn period was common among patients in all 3 comparison groups in our study, as were long-term complications in the domains of speech, cognition, and motor outcomes. In contrast, while at least 80% of both GALT-null and S135L compound heterozygous girls and women showed evidence of an adverse ovarian outcome, prevalence was only 25% among S135L homozygotes. Further, all young women in this study with even one copy of S135L achieved spontaneous menarche; this is true for only about 33% of women with classic galactosemia. Overall, we observed that while most long-term outcomes trended milder among groups of patients with even one copy of S135L, many individual patients, either homozygous or compound heterozygous for S135L, nonetheless experienced long-term outcomes that were not mild. This was true despite detection by newborn screening and both early and life-long dietary restriction of galactose. This information should empower more evidence-based counseling for galactosemia patients with S135L.

Risk factors for perioperative blood transfusion in patients undergoing hysterectomy for benign disease in a teaching institution.

PURPOSE: The purpose is to identify risk factors for perioperative blood transfusion in patients undergoing hysterectomy for benign disease. METHODS: This study is a retrospective chart review including all the patients who underwent hysterectomy for benign disease between January 1st 2018 and December 31st 2019. Patients who received perioperative blood transfusion were identified and compared to those who did not. The following risk factors for blood transfusion were analyzed: route of hysterectomy, BMI, presence of adhesions, history of cesarean section, uterine weight. Descriptive statistics was used to analyze the data. RESULTS: A total of 517 patients were identified and included in the study. Forty-seven patients (9.09%) received a perioperative blood transfusion. The abdominal hysterectomy route (TAH) was a significant risk factor for receiving blood transfusion (p = 0.012). Other identified risk factors for blood transfusion included: Body mass index above 33.0 (p = 0.002), and uterine weight (p = 0.002). There was no association between the presence of pelvic adhesions (p = 0.91) or a personal history of cesarean section (p = 0.89) and receiving perioperative blood transfusion. When analyzing only the patients who underwent TLH, the presence of pelvic adhesion was found as a risk factor for perioperative blood transfusion (p = 0.024). CONCLUSION: The abdominal hysterectomy route, the presence of a large uterus, and obesity are risk factors for receiving a blood transfusion. Early identification of the patient at risk of requiring perioperative blood transfusion provides better patient counseling and surgical preparation.

Complexity of Intercalation in MXenes: Destabilization of Urea by Two-Dimensional Titanium Carbide.

MXenes are a new class of two-dimensional materials with properties that make them important for applications that include batteries, capacitive energy storage, and electrocatalysis. These materials can be exfoliated and delaminated to create high surface areas with interlayers accessibility. Intercalation is known to be possible, and it is critical for many applications including electrochemical energy storage, water purification, and sensing. However, little is known about the nature of the intercalant and bonding interactions between the intercalant within the MXene. We have investigated urea interaction within a titanium carbide based MXene using inelastic neutron scattering (INS) to probe the state of intercalated species. By comparison with reference materials, we find that under intercalation conditions urea decomposes readily, leading to intercalation of ammonium cations observable by INS and evolving carbon dioxide detected by infrared spectroscopy. Reactive molecular dynamics calculations were conducted to provide atomistic insights about reaction pathways and their energetics. These results have implications for understanding intercalation in active layered materials.

Synergetic effects of K+ and Mg2+ ion intercalation on the electrochemical and actuation properties of the two-dimensional Ti3C2 MXene.

Two-dimensional materials, such as MXenes, are attractive candidates for energy storage and electrochemical actuators due to their high volume changes upon ion intercalation. Of special interest for boosting energy storage is the intercalation of multivalent ions such as Mg2+, which suffers from sluggish intercalation and transport kinetics due to its ion size. By combining traditional electrochemical characterization techniques with electrochemical dilatometry and contact resonance atomic force microscopy, the synergetic effects of the pre-intercalation of K+ ions are demonstrated to improve the charge storage of multivalent ions, as well as tune the mechanical and actuation properties of the Ti3C2 MXene. Our results have important implications for quantitatively understanding the charge storage processes in intercalation compounds and provide a new path for studying the mechanical evolution of energy storage materials.

Synthesis of two-dimensional materials by selective extraction.

CONSPECTUS: Two-dimensional (2D) materials have attracted much attention in the past decade. They offer high specific surface area, as well as electronic structure and properties that differ from their bulk counterparts due to the low dimensionality. Graphene is the best known and the most studied 2D material, but metal oxides and hydroxides (including clays), dichalcogenides, boron nitride (BN), and other materials that are one or several atoms thick are receiving increasing attention. They may deliver a combination of properties that cannot be provided by other materials. The most common synthesis approach in general is by reacting different elements or compounds to form a new compound. However, this approach does not necessarily work well for low-dimensional structures, since it favors formation of energetically preferred 3D (bulk) solids. Many 2D materials are produced by exfoliation of van der Waals solids, such as graphite or MoS2, breaking large particles into 2D layers. However, these approaches are not universal; for example, 2D transition metal carbides cannot be produced by any of them. An alternative but less studied way of material synthesis is the selective extraction process, which is based on the difference in reactivity and stability between the different components (elements or structural units) of the original material. It can be achieved using thermal, chemical, or electrochemical processes. Many 2D materials have been synthesized using selective extraction, such as graphene from SiC, transition metal oxides (TMO) from layered 3D salts, and transition metal carbides or carbonitrides (MXenes) from MAX phases. Selective extraction synthesis is critically important when the bonds between the building blocks of the material are too strong (e.g., in carbides) to be broken mechanically in order to form nanostructures. Unlike extractive metallurgy, where the extracted metal is the goal of the process, selective extraction of one or more elements from the precursor materials releases 2D structures. In this Account, in addition to graphene and TMO, we focused on MXenes as an example for the use of selective extraction synthesis to produce novel 2D materials. About 10 new carbides and carbonitrides of transition metals have been produced by this method in the past 3 years. They offer an unusual combination of metallic conductivity and hydrophilicity and show very attractive electrochemical properties. We hope that this Account will encourage researchers to extend the use of selective extraction to other layered material systems that in turn will result in expanding the world of nanomaterials in general and 2D materials in particular, generating new materials that cannot be produced by other means.

Role of surface structure on Li-ion energy storage capacity of two-dimensional transition-metal carbides.

A combination of density functional theory (DFT) calculations and experiments is used to shed light on the relation between surface structure and Li-ion storage capacities of the following functionalized two-dimensional (2D) transition-metal carbides or MXenes: Sc2C, Ti2C, Ti3C2, V2C, Cr2C, and Nb2C. The Li-ion storage capacities are found to strongly depend on the nature of the surface functional groups, with O groups exhibiting the highest theoretical Li-ion storage capacities. MXene surfaces can be initially covered with OH groups, removable by high-temperature treatment or by reactions in the first lithiation cycle. This was verified by annealing f-Nb2C and f-Ti3C2 at 673 and 773 K in vacuum for 40 h and in situ X-ray adsorption spectroscopy (XAS) and Li capacity measurements for the first lithiation/delithiation cycle of f-Ti3C2. The high-temperature removal of water and OH was confirmed using X-ray diffraction and inelastic neutron scattering. The voltage profile and X-ray adsorption near edge structure of f-Ti3C2 revealed surface reactions in the first lithiation cycle. Moreover, lithiated oxygen terminated MXenes surfaces are able to adsorb additional Li beyond a monolayer, providing a mechanism to substantially increase capacity, as observed mainly in delaminated MXenes and confirmed by DFT calculations and XAS. The calculated Li diffusion barriers are low, indicative of the measured high-rate performance. We predict the not yet synthesized Cr2C to possess high Li capacity due to the low activation energy of water formation at high temperature, while the not yet synthesized Sc2C is predicted to potentially display low Li capacity due to higher reaction barriers for OH removal.

Structure of nanocrystalline Ti3C2 MXene using atomic pair distribution function.

The structures of nanocrystalline pristine, potassium hydroxide and sodium acetate intercalated new two-dimensional materials Ti3C2 MXenes were studied using the x-ray atomic pair distribution function technique. Pristine MXene has a hexagonal structure with a=b=3.0505(5) Å, c=19.86(2) Å (S.G. P63/mmc No. 194). Both hydroxyl and fluoride terminating species are present. The intercalation of K+ or Na+ ions expands the Ti3C2 layers perpendicular to the planes but shrinks the in-plane a and b lattice parameters.

Room-temperature carbide-derived carbon synthesis by electrochemical etching of MAX phases.

Porous carbons are widely used in energy storage and gas separation applications, but their synthesis always involves high temperatures. Herein we electrochemically selectively extract, at ambient temperature, the metal atoms from the ternary layered carbides, Ti3 AlC2 , Ti2 AlC and Ti3 SiC2 (MAX phases). The result is a predominantly amorphous carbide-derived carbon, with a narrow distribution of micropores. The latter is produced by placing the carbides in HF, HCl or NaCl solutions and applying anodic potentials. The pores that form when Ti3 AlC2 is etched in dilute HF are around 0.5 nm in diameter. This approach forgoes energy-intensive thermal treatments and presents a novel method for developing carbons with finely tuned pores for a variety of applications, such as supercapacitor, battery electrodes or CO2 capture.

Nitrogen-Doped Graphene-Like Carbon Intercalated MXene Heterostructure Electrodes for Enhanced Sodium- and Lithium-Ion Storage.

MXene is investigated as an electrode material for different energy storage systems due to layered structures and metal-like electrical conductivity. Experimental results show MXenes possess excellent cycling performance as anode materials, especially at large current densities. However, the reversible capacity is relatively low, which is a significant barrier to meeting the demands of industrial applications. This work synthesizes N-doped graphene-like carbon (NGC) intercalated Ti3C2Tx (NGC-Ti3C2Tx) van der Waals heterostructure by an in situ method. The as-prepared NGC-Ti3C2Tx van der Waals heterostructure is employed as sodium-ion and lithium-ion battery electrodes. For sodium-ion batteries, a reversible specific capacity of 305 mAh g-1 is achieved at a specific current of 20 mA g-1, 2.3 times higher than that of Ti3C2Tx. For lithium-ion batteries, a reversible capacity of 400 mAh g-1 at a specific current of 20 mA g-1 is 1.5 times higher than that of Ti3C2Tx. Both sodium-ion and lithium-ion batteries made from NGC-Ti3C2Tx shows high cycling stability. The theoretical calculations also verify the remarkable improvement in battery capacity within the NGC-Ti3C2O2 system, attributed to the additional adsorption of working ions at the edge states of NGC. This work offers an innovative way to synthesize a new van der Waals heterostructure and provides a new route to improve the electrochemical performance significantly.

MXene-Derived Oxide Nanoheterostructures for Photocatalytic Sulfamethoxazole Degradation.

Herein, we report for the first time the use of ternary oxide nanoheterostructure photocatalysts derived from (Nb y , Ti1-y )2CT x MXene in the treatment of water. Three different compositions of binary MXenes, viz., (Ti0.75Nb0.25)2CT x , (Ti0.5Nb0.5)2CT x , and (Ti0.25Nb0.75)2CT x (with T x = OH, F, and Cl), were used as single-source precursor to produce TiNbO x -3:1, TiNbO x -1:1, and TiNbO x -1:3 by controlled-atmosphere thermal oxidation. Phase identification and Le Bail refinements confirmed the presence of a mixture of rutile TiO2 and monoclinic Ti2Nb10O29. Morphological investigations through scanning and transmission electron microscopies revealed the retention of layered nanostructures from the MXene precursors and the fusion of TiO2 and Ti2Nb10O29 nanoparticles in forming nanosheets. Among the three oxide nanoheterostructures, TiNbO x -3:1 exhibited the best photocatalytic performance by the removal of 83% of sulfamethoxazole (SMX) after 2 h of reaction. Such a result is explained by a complex influence of structural, morphological, and electronic properties since TiNbO x -3:1 consisted of small-sized crystallites (40-70 nm) and possessed a higher surface area. The suggested electronic band structure is a type-II heterojunction, where the recombination of electrons and holes is minimized during photocatalytic reactions. The photocatalytic degradation of SMX was promoted by the attack of •OH, as evidenced by the detection of 2.2 µM •OH, using coumarin as a probe. This study highlights the potential application of MXene-derived oxide nanoheterostructures in wastewater treatment.

New two-dimensional niobium and vanadium carbides as promising materials for Li-ion batteries.

New two-dimensional niobium and vanadium carbides have been synthesized by selective etching, at room temperature, of Al from Nb2AlC and V2AlC, respectively. These new matrials are promising electrode materials for Li-ion batteries, demonstrating good capability to handle high charge-discharge rates. Reversible capacities of 170 and 260 mA·h·g(-1) at 1 C, and 110 and 125 mA·h·g(-1) at 10 C were obtained for Nb2C and V2C-based electrodes, respectively.

Engineering the surface of Nbn+1CnTx MXenes to versatile bio-activity towards microorganisms.

Two-dimensional (2D) transition metal carbides/nitrides (MXenes) are potential antibacterial agents. However, their activity against microorganisms is not fully understood. It could relate to MXenes' surface which further influences their biocidal action. Herein, we report no continuous biocidal activity for delaminated 2D niobium-based MXenes (Nbn+1XnTx) such as Nb2CTx and Nb4C3Tx prepared with HF/TMAOH protocol. Biocidal activity towards Bacillus subtilis and Staphylococcus aureus microorganisms was achieved by surface-functionalization with lysozyme macromolecule. MXenes' engineering with lysozyme changed MXene's surface charge from negative into positive thus enabling the elimination of bacteria cells during 48 h of incubation. In contrast, Nb4C3Tx functionalized with collagen stimulated the growth of Bacillus subtilis by 225 %, showing MXene's biocompatibility towards this particular strain. Altogether, our results show that MXenes are incredibly bio-tunable. Opposing bio-effects such as antimicrobial or growth-stimulating can be achieved towards various microorganisms with rational surface engineering.

Two-Dimensional MXenes Derived from Medium/High-Entropy MAX Phases M2 GaC (M = Ti/V/Nb/Ta/Mo) and their Electrochemical Performance.

Two-dimensional (2D) transition metal carbides and/or nitrides, MXenes, are prepared by selective etching of the A-site atomically thin metal layers from their MAX phase precursors. High entropy MXenes, the most recent subfamily of MXenes, are in their infancy and have attracted great interest recently. They are currently synthesized mainly through wet chemical etching of Al-containing MAX phases, while various MAX phases with A-sites elements other than Al have not been explored. It is important to embody non-Al MAX phases as precursors for the high entropy MXenes synthesis to allow for new compositions. In this work, it is reported on the design and synthesis of Ga-containing medium/high entropy MAX phases and then their corresponding medium/high entropy MXenes. Gallium atomic layer etching is carried out using a Lewis acid molten salt (CuCl2). The as-prepared (Ti1/4 V1/4 Nb1/4 Ta1/4 )2 CTx exhibits a Li+ specific capacity of ≈400 mAh g-1 . For (Ti1/5 V1/5 Nb1/5 Ta1/5 Mo1/5 )2 CTx a specific capacity of 302 mAh g-1 is achieved after 300 cycles, and high cycling stability is observed at high current densities. This work is of great significance for expanding the family members of MXenes with tunable chemistries and structures.

Toward MBenes Battery Electrode Materials: Layered Molybdenum Borides for Li-Ion Batteries.

Lithium-ion and sodium-ion batteries (LIBs and SIBs) are crucial in our shift toward sustainable technologies. In this work, the potential of layered boride materials (MoAlB and Mo2 AlB2 ) as novel, high-performance electrode materials for LIBs and SIBs, is explored. It is discovered that Mo2 AlB2 shows a higher specific capacity than MoAlB when used as an electrode material for LIBs, with a specific capacity of 593 mAh g-1 achieved after 500 cycles at 200 mA g-1 . It is also found that surface redox reactions are responsible for Li storage in Mo2 AlB2 , instead of intercalation or conversion. Moreover, the sodium hydroxide treatment of MoAlB leads to a porous morphology and higher specific capacities exceeding that of pristine MoAlB. When tested in SIBs, Mo2 AlB2 exhibits a specific capacity of 150 mAh g-1 at 20 mA g-1 . These findings suggest that layered borides have potential as electrode materials for both LIBs and SIBs, and highlight the importance of surface redox reactions in Li storage mechanisms.

Impaired receptivity of thin endometrium: therapeutic potential of mesenchymal stem cells.

The endometrium is a resilient and highly dynamic tissue, undergoing cyclic renewal in preparation for embryo implantation. Cyclic endometrial regeneration depends on the intact function of several cell types, including parenchymal, endothelial, and immune cells, as well as adult stem cells that can arise from endometrial or extrauterine sources. The ability of the endometrium to undergo rapid, repeated regeneration without scarring is unique to this tissue. However, if this tissue renewal process is disrupted or dysfunctional, women may present clinically with infertility due to endometrial scarring or persistent atrophic/thin endometrium. Such disorders are rate-limiting in the treatment of female infertility and in the success of in vitro fertilization because of a dearth of treatment options specifically targeting the endometrium. A growing number of studies have explored the potential of adult stem cells, including mesenchymal stem cells (MSCs), to treat women with disorders of endometrial regeneration. MSCs are multipotent adult stem cells with capacity to differentiate into cells such as adipocytes, chondrocytes, and osteoblasts. In addition to their differentiation capacity, MSCs migrate toward injured sites where they secrete bioactive factors (e.g. cytokines, chemokines, growth factors, proteins and extracellular vesicles) to aid in tissue repair. These factors modulate biological processes critical for tissue regeneration, such as angiogenesis, cell migration and immunomodulation. The MSC secretome has therefore attracted significant attention for its therapeutic potential. In the uterus, studies utilizing rodent models and limited human trials have shown a potential benefit of MSCs and the MSC secretome in treatment of endometrial infertility. This review will explore the potential of MSCs to treat women with impaired endometrial receptivity due to a thin endometrium or endometrial scarring. We will provide context supporting leveraging MSCs for this purpose by including a review of mechanisms by which the MSC secretome promotes regeneration and repair of nonreproductive tissues.

Ambient Processed rGO/Ti3CNTx MXene Thin Film with High Oxidation Stability, Photosensitivity, and Self-Cleaning Potential.

Solution-based processing offers advantages for producing thin films due to scalability, low cost, simplicity, and benignity to the environment. Here, we develop conductive and photoactivated self-cleaning reduced graphene oxide (rGO)/Ti3CNTx MXene thin films via spin coating under ambient conditions. The addition of a thin rGO layer on top of Ti3CNTx resulted in up to 45-fold improvement in the environmental stability of the film compared to the bare Ti3CNTx film. The optimized rGO/Ti3CNTx thin film exhibits an optical transmittance of 74% in the visible region of the spectrum and a sheet resistance of 19 kΩ/sq. The rGO/Ti3CNTx films show high rhodamine B discoloration activity upon light irradiation. Under UV irradiation, the electrically conductive MXene in combination with in situ formed semiconducting titanium oxide induces photogenerated charge carriers, which could potentially be used in photocatalysis. On the other hand, due to film transparency, white light irradiation can bleach the adsorbed dye via photolysis. This study opens the door for using MXene thin films as multifunctional coatings with conductive and potentially self-cleaning properties.

Transition Metal Carbo-Chalcogenide "TMCC:" A New Family of 2D Materials.

Here, a new family of 2D transition metal carbo-chalcogenides (TMCCs) is reported, which can be considered a combination of two well-known families, TM carbides (MXenes) and TM dichalcogenides (TMDCs), at the atomic level. Single sheets are successfully obtained from multilayered Nb2 S2 C and Ta2 S2 C using electrochemical lithiation followed by sonication in water. The parent multilayered TMCCs are synthesized using a simple, scalable solid-state synthesis followed by a topochemical reaction. Superconductivity transition is observed at 7.55 K for Nb2 S2 C. The delaminated Nb2 S2 C outperforms both multilayered Nb2 S2 C and delaminated NbS2 as an electrode material for Li-ion batteries. Ab initio calculations predict the elastic constant of TMCC to be over 50% higher than that of TMDC.

Understanding the mechanism of Nb-MXene bioremediation with green microalgae.

Rapidly developing nanotechnologies and their integration in daily applications may threaten the natural environment. While green methods of decomposing organic pollutants have reached maturity, remediation of inorganic crystalline contaminants is major problem due to their low biotransformation susceptibility and the lack of understanding of material surface-organism interactions. Herein, we have used model inorganic 2D Nb-based MXenes coupled with a facile shape parameters analysis approach to track the mechanism of bioremediating 2D ceramic nanomaterials with green microalgae Raphidocelis subcapitata. We have found that microalgae decomposed the Nb-based MXenes due to surface-related physicochemical interactions. Initially, single and few-layered MXene nanoflakes attached to microalgae surfaces, which slightly reduced algal growth. But with prolonged surface interaction, the microalgae oxidized MXene nanoflakes and further decomposed them into NbO and Nb2O5. Since these oxides were nontoxic to microalgal cells, they consumed Nb-oxide nanoparticles by an uptake mechanism thus enabling further microalgae recovery after 72 h of water treatment. The uptake-associated nutritional effects were also reflected by cells' increased size, smoothed shape and changed growth rates. Based on these findings, we conclude that short- and long-term presence of Nb-based MXenes in freshwater ecosystems might cause only negligible environmental effects. Notably, by using 2D nanomaterials as a model system, we show evidence of the possibility of tracking even fine material shape transformations. In general, this study answers an important fundamental question about the surface interaction-associated processes that drive the mechanism of 2D nanomaterials' bioremediation as well as provides the fundamental basis for further short- and long-term investigations on the environmental effects of inorganic crystalline nanomaterials.

Ten Years of Progress in the Synthesis and Development of MXenes.

Since their discovery in 2011, the number of 2D transition metal carbides and nitrides (MXenes) has steadily increased. Currently more than 40 MXene compositions exist. The ultimate number is far greater and in time they may develop into the largest family of 2D materials known. MXenes' unique properties, such as their metal-like electrical conductivity reaching ≈20 000 S cm-1 , render them quite useful in a large number of applications, including energy storage, optoelectronic, biomedical, communications, and environmental. The number of MXene papers and patents published has been growing quickly. The first MXene generation is synthesized using selective etching of metal layers from the MAX phases, layered transition metal carbides and carbonitrides using hydrofluoric acid. Since then, multiple synthesis approaches have been developed, including selective etching in a mixture of fluoride salts and various acids, non-aqueous etchants, halogens, and molten salts, allowing for the synthesis of new MXenes with better control over their surface chemistries. Herein, a brief historical overview of the first 10 years of MXene research and a perspective on their synthesis and future development are provided. The fact that their production is readily scalable in aqueous environments, with high yields bodes well for their commercialization.