Cord blood albumin as a predictor of neonatal jaundice.

Background and Aim: Bilirubin can have a toxic effect on the brain, so newborns must be carefully checked to identify those who may develop significant hyperbilirubinemia and bilirubin encephalopathy (kernicterus). The study aimed to determine if cord blood albumin could be utilized to predict the onset of significant newborn jaundice in healthy-term babies. Patients and Methods: A cohort study was carried out in AL-Zahraa teaching hospital in AL-Najaf city during the period from January 1 to November 1, 2020. A randomized 100 full-term healthy neonates were enrolled. A blood sample was drawn by milking the cord and sent for serum albumin estimation. Patients were then followed up on the third and fifth days of life for total serum bilirubin (TSB). Results: Out of 100 healthy-term neonates that were included in this study, 60 of them had low cord blood albumin (<2.8 g/dl), and 40 of them had normal cord blood albumin (≥2.8 g/dl) with an age range of 1-5 days. There is a statistically significant difference between low cord blood albumin and significant neonatal jaundice on the third day with a 5 times more risk of developing significant jaundice than neonates with normal cord blood albumin. Conclusion: Cord blood albumin levels are sensitive to predicting subsequent neonatal jaundice in the healthy term newborn.

Cloning of Dirac fermions in graphene superlattices.

Superlattices have attracted great interest because their use may make it possible to modify the spectra of two-dimensional electron systems and, ultimately, create materials with tailored electronic properties. In previous studies (see, for example, refs 1-8), it proved difficult to realize superlattices with short periodicities and weak disorder, and most of their observed features could be explained in terms of cyclotron orbits commensurate with the superlattice. Evidence for the formation of superlattice minibands (forming a fractal spectrum known as Hofstadter's butterfly) has been limited to the observation of new low-field oscillations and an internal structure within Landau levels. Here we report transport properties of graphene placed on a boron nitride substrate and accurately aligned along its crystallographic directions. The substrate's moiré potential acts as a superlattice and leads to profound changes in the graphene's electronic spectrum. Second-generation Dirac points appear as pronounced peaks in resistivity, accompanied by reversal of the Hall effect. The latter indicates that the effective sign of the charge carriers changes within graphene's conduction and valence bands. Strong magnetic fields lead to Zak-type cloning of the third generation of Dirac points, which are observed as numerous neutrality points in fields where a unit fraction of the flux quantum pierces the superlattice unit cell. Graphene superlattices such as this one provide a way of studying the rich physics expected in incommensurable quantum systems and illustrate the possibility of controllably modifying the electronic spectra of two-dimensional atomic crystals by varying their crystallographic alignment within van der Waals heterostuctures.

Interaction phenomena in graphene seen through quantum capacitance.

Capacitance measurements provide a powerful means of probing the density of states. The technique has proved particularly successful in studying 2D electron systems, revealing a number of interesting many-body effects. Here, we use large-area high-quality graphene capacitors to study behavior of the density of states in this material in zero and high magnetic fields. Clear renormalization of the linear spectrum due to electron-electron interactions is observed in zero field. Quantizing fields lead to splitting of the spin- and valley-degenerate Landau levels into quartets separated by interaction-enhanced energy gaps. These many-body states exhibit negative compressibility but the compressibility returns to positive in ultrahigh B. The reentrant behavior is attributed to a competition between field-enhanced interactions and nascent fractional states.

Landau level spectroscopy of electron-electron interactions in graphene.

We present magneto-Raman scattering studies of electronic inter-Landau level excitations in quasineutral graphene samples with different strengths of Coulomb interaction. The band velocity associated with these excitations is found to depend on the dielectric environment, on the index of Landau level involved, and to vary as a function of the magnetic field. This contradicts the single-particle picture of noninteracting massless Dirac electrons but is accounted for by theory when the effect of electron-electron interaction is taken into account. Raman active, zero-momentum inter-Landau level excitations in graphene are sensitive to electron-electron interactions due to the nonapplicability of the Kohn theorem in this system, with a clearly nonparabolic dispersion relation.

Electronic properties of graphene encapsulated with different two-dimensional atomic crystals.

Hexagonal boron nitride is the only substrate that has so far allowed graphene devices exhibiting micrometer-scale ballistic transport. Can other atomically flat crystals be used as substrates for making quality graphene heterostructures? Here we report on our search for alternative substrates. The devices fabricated by encapsulating graphene with molybdenum or tungsten disulfides and hBN are found to exhibit consistently high carrier mobilities of about 60 000 cm(2) V(-1) s(-1). In contrast, encapsulation with atomically flat layered oxides such as mica, bismuth strontium calcium copper oxide, and vanadium pentoxide results in exceptionally low quality of graphene devices with mobilities of ∼1000 cm(2) V(-1) s(-1). We attribute the difference mainly to self-cleansing that takes place at interfaces between graphene, hBN, and transition metal dichalcogenides. Surface contamination assembles into large pockets allowing the rest of the interface to become atomically clean. The cleansing process does not occur for graphene on atomically flat oxide substrates.

Singular phase nano-optics in plasmonic metamaterials for label-free single-molecule detection.

The non-trivial behaviour of phase is crucial for many important physical phenomena, such as, for example, the Aharonov-Bohm effect and the Berry phase. By manipulating the phase of light one can create 'twisted' photons, vortex knots and dislocations which has led to the emergence of the field of singular optics relying on abrupt phase changes. Here we demonstrate the feasibility of singular visible-light nano-optics which exploits the benefits of both plasmonic field enhancement and the peculiarities of the phase of light. We show that properly designed plasmonic metamaterials exhibit topologically protected zero reflection yielding to sharp phase changes nearby, which can be employed to radically improve the sensitivity of detectors based on plasmon resonances. By using reversible hydrogenation of graphene and binding of streptavidin-biotin, we demonstrate an areal mass sensitivity at a level of fg mm(-2) and detection of individual biomolecules, respectively. Our proof-of-concept results offer a route towards simple and scalable single-molecule label-free biosensing technologies.

Cross-sectional imaging of individual layers and buried interfaces of graphene-based heterostructures and superlattices.

By stacking various two-dimensional (2D) atomic crystals on top of each other, it is possible to create multilayer heterostructures and devices with designed electronic properties. However, various adsorbates become trapped between layers during their assembly, and this not only affects the resulting quality but also prevents the formation of a true artificial layered crystal upheld by van der Waals interaction, creating instead a laminate glued together by contamination. Transmission electron microscopy (TEM) has shown that graphene and boron nitride monolayers, the two best characterized 2D crystals, are densely covered with hydrocarbons (even after thermal annealing in high vacuum) and exhibit only small clean patches suitable for atomic resolution imaging. This observation seems detrimental for any realistic prospect of creating van der Waals materials and heterostructures with atomically sharp interfaces. Here we employ cross sectional TEM to take a side view of several graphene-boron nitride heterostructures. We find that the trapped hydrocarbons segregate into isolated pockets, leaving the interfaces atomically clean. Moreover, we observe a clear correlation between interface roughness and the electronic quality of encapsulated graphene. This work proves the concept of heterostructures assembled with atomic layer precision and provides their first TEM images.

In vitro hypoxic cytotoxicity and hypoxic radiosensitization. Efficacy of the novel 2-nitroimidazole N,N,N-tris[2-(2-nitro-1H-imidazol-1-yl)ethyl]amine.

BACKGROUND AND PURPOSE: Tumor hypoxia is a major problem in radiation therapy of solid tumors because of the radiosensitizing effect of oxygen. Nitroimidazole-containing compounds are oxygen mimetics accumulating in hypoxic tumor areas. However, the broad use of 2-nitroimidazoles as a hypoxic radiosensitizer is limited by their partially low efficacy and/or high neurotoxicity. MATERIALS AND METHODS: Here, we characterized the in vitro hypoxic cytotoxicity and hypoxic radiosensitizing efficacy of N,N,N-tris [2-(2-nitro-1H-imidazol-1-yl)ethyl]amine (PRC) in a hypoxia-sensitive lymphoma and a hypoxia-resistant glioblastoma cell line by colony formation assay and flow cytometry. RESULTS: PRC exerted high hypoxic cytotoxic and radiosensitizing action on both cell lines at almost absent toxicity under normoxic conditions. In particular, under hypoxia, but not normoxia, PRC targeted the mitochondria resulting in oxidative stress, G(2)/M cell cycle arrest, and triggering of the intrinsic apoptosis pathway. CONCLUSION: Our in vitro findings suggest that PRC might be a promising new 2-nitroimidazole for improving radiation therapy of hypoxic tumors in vivo.

Porous carboxymethyl cellulose carbon of lignocellulosic based materials incorporated manganese oxide for supercapacitor application.

The present work developed porous carboxymethyl cellulose (CMC) carbon film from lignocellulosic based materials as supercapacitor electrode. Porous CMC carbon films of bamboo (B) and oil palm empty fruit bunch (O) were prepared through simple incipient wetness impregnation method followed by calcination process before incorporation with manganese oxide (Mn2O3). The carbonization produced porous CMC carbon whereby CMCB exhibited higher surface area than CMCO. After Mn2O3 incorporation, the crystallite size of CMCB and CMCO were calculated as 50.09 nm and 42.76 nm, respectively whereas Mn2O3/CMCB and Mn2O3/CMCO composite films were revealed to be 26.71 nm and 35.60 nm in size, respectively. Comparatively, the Mn2O3/CMCB composite film exhibited higher electrochemical performance which was 31.98 mF cm-2 as compared to 24.15 mF cm-2 by Mn2O3/CMCO composite film and both CMC carbon films with fairly stable cycling stability after 1000 charge-discharge cycles. Therefore, it can be highlighted that Mn2O3/CMC composite film as prepared from bamboo and oil palm fruit can potentially become the new electrode materials for supercapacitor application.

Fetal Atrial Ectopic Rhythm Detected Using Handheld Doppler.

Atrial ectopic rhythm is one of the most common fetal arrhythmias that can present during the prenatal period. Detection of fetal arrhythmia can be made by auscultating fetal heart rate and rhythm using a fetal handheld Doppler, and this can be done even in a resource-limited setting. The finding of an abnormal fetal heart rate and rhythm should prompt early referral to a pediatric cardiologist, as this may improve clinical outcomes. We present a case of atrial ectopic rhythm detected in utero using a handheld Doppler.

Systematic review of studies of mental health nurses' experience of anger and of its relationships with their attitudes and practice.

WHAT IS KNOWN ON THE SUBJECT?: It is generally felt that it is helpful for mental health nurses to control their emotions during their work. There are different approaches, but there is growing acceptance that different emotions may need different coping strategies. There is lots of evidence that nurses sometimes feel anger in a number of situations, but the research about anger in mental health nurses has never been examined as a whole. WHAT THIS PAPER ADDS TO EXISTING KNOWLEDGE?: We have systematically identified all previous research where nurses completed measures that tried to measure their anger in certain situations, compared it to other people or investigated how it affected them or what its relationship was with their practice. Only a few studies have measured nurses' anger. However, it seems that while nurses are not generally angrier than any other group, they do often feel anger in relation to management of patient aggression and their job situation more generally. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Anger is the most commonly reported problematic emotion for mental health nurses. It may influence their practice and affect their well-being. This has implications for staff support and training. ABSTRACT: Introduction Emotional regulation is important in mental health nursing practice, but individual emotions may require different regulation strategies. There is ample evidence that nurses experience anger specifically during their work, for example when experiencing patient aggression. It is, therefore, important to consolidate what is known about how anger manifests in mental health nursing practice. AIM: We aimed to systematically identify, evaluate and synthesize results from studies about mental health nurses and anger, where anger was measured objectively. METHODS: Systematic literature review based on PRISMA guidelines. RESULTS: We identified 12 studies. A range of validated and nonvalidated instruments was used. Mental health nurses may have lower levels of anger than normative samples, but anger is commonly reported as an issue for them. Anger was studied in relation to its links with (1) clinical management of patients, notably violence containment; and (2) employment issues more generally, notably job motivation. Anger is related to nurses' attitudes about the acceptability of coercion, but there is no evidence that it results in more coercion. IMPLICATIONS FOR PRACTICE: Nurses should be aware of the potential influence of anger on their practice. Anger, specifically, should be considered when supporting mental health nurses, for example in clinical supervision. Emotional regulation training should target anger.

Prevalence of the angiotensin I converting enzyme insertion/deletion polymorphism, plasma angiotensin converting enzyme activity, and left ventricular mass in a normotensive Chilean population.

The aim of this study was to estimate the prevalence of the different alleles of the angiotensin converting enzyme (ACE) gene insertion/deletion (I/D) polymorphism and associated plasma ACE activity, as well as cardiac echocardiographic structure, in a healthy Chilean population. We selected 117 healthy normotensive subjects (aged 45 to 60 years, middle socioeconomic status, nonobese, and nondiabetic) from a population-based study concerning the prevalence of risk factors for chronic diseases (Conjunto de Acciones Para la Reducción Multifactorial de las Enfermedades no Transmisibles [CARMEN]). The frequencies of the I and D alleles were 0.57 and 0.43, respectively. Mean plasma ACE activity was 15.3 +/- 3.9 U/mL. Compared with subjects with the II genotype, plasma ACE activity was significantly higher in subjects with the ID and DD genotypes with no difference between them. No correlation was observed between blood pressure and plasma ACE activity. Among the three different genotypes there was no difference in left ventricular (LV) dimensions or in LV mass. No correlation between plasma ACE activity and LV mass was observed for either gender or different genotypes. Multivariate linear regression analysis using LV mass and LV mass index as dependent variables showed independent effects (P < .05) for gender (higher LV mass in men) and diastolic blood pressure, but not for the DD genotype. In conclusion, in this population, the presence of the D allele on the ACE gene determined higher circulating ACE activity. However, in this normotensive healthy population, male gender and diastolic blood pressure, but not the presence of the D allele, were associated with increased LV mass.

The relationship between 48-h dental plaque accumulation in young human adults and the concentrations of hypothiocyanite, 'free' and 'total' lysozyme, lactoferrin and secretory immunoglobulin A in saliva.

Samples of resting and stimulated whole saliva and stimulated parotid saliva were collected from 40 young adults. One week later, after 48 h on a standardized diet without oral hygiene, all available plaque was collected for dry weighing. An inverse relationship was found between the 'free' lysozyme concentration in stimulated parotid saliva and plaque dry weight (r = -0.46, p less than 0.01). There were no other statistically significant correlation coefficients between concentrations of individual salivary constituents and plaque dry weight. However, cluster analysis of constituents in resting whole saliva revealed three groups of subjects with different salivary profiles, and in particular with different concentrations of both IgA and hypothiocyanite. Subsequent analysis revealed differences in plaque dry weight between the groups, demonstrating the potential biological significance of cluster membership based on salivary factors.

Relationship between calcium and inorganic phosphorus concentrations of both resting and stimulated saliva and dental plaque in children and young adults.

Calcium and inorganic phosphorus concentrations of both resting and paraffin-wax stimulated whole saliva and dental plaque were estimated in 39 young adults and 98 children aged 12-14 yr. Plaque was collected from the adults after 48 h without tooth-brushing and consumption of a standardized diet. Plaque was collected from the children without any dietary or oral hygiene restrictions. The results from the study with children provided consistent evidence for a statistically significant relationship between salivary and plaque concentrations of both calcium and inorganic phosphorus. However, multiple regression indicated that only the concentrations in the stimulated secretion were directly associated with concentrations in plaque. The apparent relationship between concentrations in resting saliva and plaque was due to correlation between resting and stimulated saliva. These relationships were less apparent in the young adults, in whom the controlled conditions resulted in a narrower range of mineral concentrations in dental plaque.

Correlating Streptococcus mutans counts in saliva with plaque amount, gingival inflammation and caries experience in school children.

Samples of stimulated whole saliva were obtained from ninety-four 12-14-year-old school children living in inner London to evaluate if there was a correlation between Streptococcus mutans counts in saliva with plaque amount, gingival inflammation and caries experience. S. mutans counts were obtained by a dip-slide method (Dentocult 'Strip Mutans') in which the count was expressed as 0, 1, 2, 3, or 4 based on visual estimation of the colony density. There was no association between counts' of S. mutans in saliva with plaque amount and gingival inflammation. However, there was a significant trend of increased decayed, missing, filled surfaces (DMFS) with increasing S. mutans counts.

Graphene-protected copper and silver plasmonics.

Plasmonics has established itself as a branch of physics which promises to revolutionize data processing, improve photovoltaics, and increase sensitivity of bio-detection. A widespread use of plasmonic devices is notably hindered by high losses and the absence of stable and inexpensive metal films suitable for plasmonic applications. To this end, there has been a continuous search for alternative plasmonic materials that are also compatible with complementary metal oxide semiconductor technology. Here we show that copper and silver protected by graphene are viable candidates. Copper films covered with one to a few graphene layers show excellent plasmonic characteristics. They can be used to fabricate plasmonic devices and survive for at least a year, even in wet and corroding conditions. As a proof of concept, we use the graphene-protected copper to demonstrate dielectric loaded plasmonic waveguides and test sensitivity of surface plasmon resonances. Our results are likely to initiate wide use of graphene-protected plasmonics.

Strong light-matter interactions in heterostructures of atomically thin films.

The isolation of various two-dimensional (2D) materials, and the possibility to combine them in vertical stacks, has created a new paradigm in materials science: heterostructures based on 2D crystals. Such a concept has already proven fruitful for a number of electronic applications in the area of ultrathin and flexible devices. Here, we expand the range of such structures to photoactive ones by using semiconducting transition metal dichalcogenides (TMDCs)/graphene stacks. Van Hove singularities in the electronic density of states of TMDC guarantees enhanced light-matter interactions, leading to enhanced photon absorption and electron-hole creation (which are collected in transparent graphene electrodes). This allows development of extremely efficient flexible photovoltaic devices with photoresponsivity above 0.1 ampere per watt (corresponding to an external quantum efficiency of above 30%).

Field-effect tunneling transistor based on vertical graphene heterostructures.

An obstacle to the use of graphene as an alternative to silicon electronics has been the absence of an energy gap between its conduction and valence bands, which makes it difficult to achieve low power dissipation in the OFF state. We report a bipolar field-effect transistor that exploits the low density of states in graphene and its one-atomic-layer thickness. Our prototype devices are graphene heterostructures with atomically thin boron nitride or molybdenum disulfide acting as a vertical transport barrier. They exhibit room-temperature switching ratios of ≈50 and ≈10,000, respectively. Such devices have potential for high-frequency operation and large-scale integration.

Posterior tibial slope changes after opening- and closing-wedge high tibial osteotomy: a comparative prospective multicenter study.

INTRODUCTION: Valgus high tibial osteotomy is considered to be an effective treatment for unicompartmental medial osteoarthritis. It is generally admitted that tibial slope increases after open-wedge high tibial osteotomy and decreases after closing-wedge high tibial osteotomy. However, the effects on posterior tibial slope of closing- or opening-wedge osteotomies remain controversial. HYPOTHESIS: We analyzed the modifications of tibial slope after opening- and closing-wedge high tibial osteotomies and compared the results of these two procedures. We hypothesized that there was no difference in postoperative tibial slope between opening and closing-wedge osteotomies. PATIENTS AND METHODS: This prospective consecutive nonrandomized multicenter study was conducted between January 2008 and March 2009 and included 321 patients: 205 men and 116 women. A total of 224 patients underwent an opening-wedge high tibial osteotomy and 97 a closing-wedge osteotomy. The mean age was 52 years ± 9 and the mean body mass index was 28kg/m(2) ± 5. The main etiology was primary arthritis. Posterior tibial slope was measured preoperatively and at the last follow-up on a lateral radiograph in relation to the posterior tibial cortex. RESULTS: In the opening-wedge group, a definite 0.6° increase in tibial slope (P=0.016) was observed. In the closing-wedge group, a definite 0.7° decrease in tibial slope (P=0.02) was found. Fourteen percent of the opening-wedge osteotomies increased tibial slope by 5° or more versus only 2% of the closed-wedge osteotomies (P<0.001). Twelve percent of the closing-wedge high tibial osteotomies led to a decrease of 5° or more of the tibial slope versus 7% of the opening-wedge osteotomies (P<0.02). DISCUSSION AND CONCLUSION: These results confirm what is generally reported in the literature, i.e., an increase in tibial slope in opening-wedge high tibial osteotomy and a decrease in the slope in closing-wedge osteotomies. These tibial slope changes appear to be very limited in this series, less than 1° on average. However, there was a bias since the open-wedge technique was preferred in cases with substantial varus deformity. We emphasize the importance of surgical technique to avoid alteration of the tibial slope, particularly in opening-wedge high tibial osteotomy for which we recommend a release of posterior soft tissue and a complete osteotomy of the posterior cortex of the tibia. LEVEL OF EVIDENCE: III. Prospective consecutive nonrandomized multicenter study.