Impact of mechanical circulatory support on out-of-hospital cardiac arrest outcomes stratified by vasoactive-inotropic score: A retrospective cohort study.

Aims: To assess whether mechanical circulatory support (MCS), including intra-aortic balloon pump (IABP) or veno-arterial extracorporeal membrane oxygenation (ECMO), can help improve neurological outcomes in patients with out-of-hospital cardiac arrest (OHCA). Methods: This is a retrospective observational cohort study performed in China Medical University Hospital, Taichung, Taiwan. Adult patients with OHCA admitted between January 2015 and June 2023. Quantitative score of vasoactive-inotropic agents and qualitative interventions of MCS, including IABP and ECMO after OHCA. Multivariate regression evaluated the efficacy of each MCS approach in patients stratified by the vasoactive-inotropic score (VIS). Results: A total of 334 patients were included and analyzed, 122 (36.5%) had favorable neurological outcomes and 215 (64.4%) survived ≥90 days. These patients were stratified by VIS: 0-25, 26-100, 101-250, and >250. In patients with a VIS > 100, ECMO with or without IABP ensured favorable neurological outcomes and survival after OHCA compared to non-MCS interventions (p < 0.001). For patients with a VIS ≤ 100, IABP alone was beneficial, with no significant outcome difference from non-MCS interventions (p > 0.05). Conclusions: ECMO with or without IABP therapy may improve post-OHCA neurological outcomes and survival in patients with an expected VIS-24 h > 100 (e.g., epinephrine dose reaches 3 mg during CPR).

Role of HIF-1α-Activated IL-22/IL-22R1/Bmi1 Signaling Modulates the Self-Renewal of Cardiac Stem Cells in Acute Myocardial Ischemia.

Impaired tissue regeneration negatively impacts on left ventricular (LV) function and remodeling after acute myocardial infarction (AMI). Little is known about the intrinsic regulatory machinery of ischemia-induced endogenous cardiac stem cells (eCSCs) self-renewing divisions after AMI. The interleukin 22 (IL-22)/IL-22 receptor 1 (IL-22R1) pathway has emerged as an important regulator of several cellular processes, including the self-renewal and proliferation of stem cells. However, whether the hypoxic environment could trigger the self-renewal of eCSCs via IL-22/IL-22R1 activation remains unknown. In this study, the upregulation of IL-22R1 occurred due to activation of hypoxia-inducible factor-1α (HIF-1α) under hypoxic and ischemic conditions. Systemic IL-22 administration not only attenuated cardiac remodeling, inflammatory responses, but also promoted eCSC-mediated cardiac repair after AMI. Unbiased RNA microarray analysis showed that the downstream mediator Bmi1 regulated the activation of CSCs. Therefore, the HIF-1α-induced IL-22/IL-22R1/Bmi1 cascade can modulate the proliferation and activation of eCSCs in vitro and in vivo. Collectively, investigating the HIF-1α-activated IL-22/IL-22R1/Bmi1 signaling pathway might offer a new therapeutic strategy for AMI via eCSC-induced cardiac repair.

[Pharmacovigilance guidelines for clinical application of traditional Chinese medicine injections].

In 2019, the newly revised Drug Administration Law of the People's Republic of China was issued and implemented,clearly proposing that China should establish a pharmacovigilance system. As a new traditional Chinese medicine(TCM) dosage form created in China, TCM injections have been widely used in clinic, and its pharmacovigilance has attracted much attention. In response to this situation, the project team convened a group of clinical, pharmaceutical and evidence-based medicine experts from all over the country to form an expert group, which formulated the Pharmacovigilance guidelines for clinical application of traditional Chinese medicine injections in strict accordance with the requirements of the group standards of the Chinese Association of Chinese Medicine.From the perspective of clinical application and considering the key elements of pharmacovigilance for clinical application of TCM injections, the guidelines put forward suggestions on the decision making of pharmacovigilance for clinical application of TCM injections from four key links, namely the monitoring and reporting, signal recognition, risk assessment and risk control, according to China's pharmacovigilance regulations and learning from foreign pharmacovigilance guidelines.

Effect of targeted temperature management on systemic inflammatory responses after out-of-hospital cardiac arrest: A prospective cohort study.

BACKGROUND: Interleukin (IL)-6 is a major inflammatory cytokine that predicts mortality after out-of-hospital cardiac arrest (OHCA). Targeted temperature management (TTM) is associated with improved all-cause mortality in patients with OHCA. However, the effect of TTM on IL-6 production remains unclear. This study investigated whether TTM has additional anti-inflammatory effects after OHCA. METHODS: This prospective cohort study included a total of 141 hospitalized patients with OHCA who were treated between January 2015 and June 2023. The study was conducted in the intensive care unit of China Medical University Hospital, Taichung. Postcardiac arrest care included TTM or the control approach (no TTM). The primary outcomes included the 90-day mortality rate and neurologic outcomes after OHCA. Differences between the TTM and control groups were examined using Student t test, chi-square test, and Kaplan-Meier survival curve analysis. Multivariate analysis of variance model was used to examine interaction effects. RESULTS: Plasma IL-6 and IL-6/soluble IL-6 receptor complex levels were measured at 6 and 24 hours after resuscitation. IL-6 and IL-6/soluble IL-6 receptor complex production was lower in the TTM group than in the control group (-50.0% vs +136.7%, P < .001; +26.3% vs +102.40%, P < .001, respectively). In addition, the 90-day mortality rate and poor neurologic outcomes were lower in the TTM group than in the control group (36.8% vs 63.0%, relative risk 0.39, 95% confidence interval 0.24-0.64, P < .001; 65.5% vs 81.5%, relative risk 0.80, 95% confidence interval 0.66-0.98, P = .04). CONCLUSION: TTM improves both the mortality rate and neurologic outcomes in patients resuscitated from OHCA, possibly by reducing IL-6-induced proinflammatory responses.

Ultralow Power, Cleft Size-Adjustable and pH-Sensitive Hyaluronic Acid (HA) Biodevices for Acid-Sensing Ion Channels Emulation.

The burgeoning implantable biodevices have unlocked new frontiers in healthcare, promising personalized monitoring strategies tailored to specific needs. Herein, hyaluronic acid (HA) is harnessed to create fully biocompatible, acidity-sensitivity and cleft-adjustable neuromorphic devices. These HA-biodevices exhibit remarkable sensitivity to pH variations, effectively mimicking biological acid-sensing ion channels (ASICs) through protonation reactions between electronegative atoms and hydrogen ions, even at ultralow driving voltage (5 mV). They can monitor joint cartilage acidity by tracking changes in proton concentration and successfully diagnose the onset of arthritis. Furthermore, by adjusting the synaptic device's cleft distance, which determines responsiveness, power efficiency and plasticity, HA-based neuromorphic devices can be tailored to meet the unique demands of various implantation sites, providing both high-sensitivity and low-heat dissipation, thus broadening their application scopes. Moreover, the HA-biodevices maintain stable performance across various bending degrees, up to a curvature radius of 7.5 mm, with flexibility and deformation resilience enabling installation on joints of varying curvatures. The combination of all-biocompatibility, high sensitivity, low heat dissipation, ultralow low power (2 pW), and extraordinary deformation tolerance paves the way for the development of versatile, multipurpose medical monitoring devices with immense potential in the field of healthcare.

Long-term prognostic effect of serum albumin concentration in diabetic patients with stable coronary artery disease: A multicenter cohort study.

BACKGROUND: Diabetes and insulin resistance alter the physiological state of serum albumin (SA), which is a prognostic marker for stable coronary artery disease (CAD). However, whether the SA concentration is associated with long-term cardiovascular (CV) outcomes in diabetic patients with stable CAD remains unclear. METHODS: In total, 1148 patients were retrospectively identified from a nationwide multicenter cohort study on patients with stable CAD. They were categorized into four groups according to their diabetes mellitus (DM) status and SA concentration (cutoff: 4 g/dL). RESULTS: The patients' mean age was 62.5 years, and 83.5% were male. Of the total patients, 405 were included in group 1 (SA ≥ 4/non-DM), 322 in group 2 (SA < 4/non-DM), 201 in group 3 (SA ≥ 4/ DM), and 220 in group 4 (SA < 4/DM). Group 4 had the oldest age and a higher prevalence of prior myocardial infarction and stroke. During the median 4.5-year follow up (interquartile range: 1.5-6.7 year), the highest and lowest survival rates in terms of all-cause and CV mortality were found in groups 1 and 4, respectively. However, no prognostic differences were noted in nonfatal stroke and myocardial infarction among the groups. The data were consistent after covariate adjustment. Using group 1 as the reference, HRs (95% CIs) for all-cause mortality in groups 2, 3, and 4 were 3.64 (1.22-10.83), 3.26 (0.95-11.33), and 5.74 (1.92-16.95), respectively, and those for CV mortality were 2.8 (0.57-13.67), 2.62 (0.40-17.28), and 6.15 (1.32-28.58), respectively. CONCLUSION: In diabetic patients with stable CAD, a low SA concentration (<4 g/dL) was associated with increased long-term mortality regardless of all-cause or CV reasons but not nonfatal CV events.

Novel Genes Associated With Atrial Fibrillation and the Predictive Models for AF Incorporating Polygenic Risk Score and PheWAS-Derived Risk Factors.

BACKGROUND: Atrial fibrillation (AF), the most common atrial arrhythmia, presents with varied clinical manifestations. Despite the identification of genetic loci associated with AF, particularly in specific populations, research within Asian ethnicities remains limited. In this study we aimed to develop predictive models for AF using AF-associated single-nucleotide polymorphisms (SNPs) from a genome-wide association study (GWAS) on a substantial cohort of Taiwanese individuals, to evaluate the predictive efficacy of the model. METHODS: There were 75,121 subjects, that included 5694 AF patients and 69,427 normal control subjects with GWAS data, and we merged polygenic risk scores from AF-associated SNPs with phenome-wide association study-derived risk factors. Advanced statistical and machine learning techniques were used to develop and evaluate AF predictive models for discrimination and calibration. RESULTS: The study identified the top 30 significant SNPs associated with AF, predominantly on chromosomes 10 and 16, implicating genes like NEURL1, SH3PXD2A, INA, NT5C2, STN1, and ZFHX3. Notably, INA, NT5C2, and STN1 were newly linked to AF. The GWAS predictive power using polygenic risk score-continuous shrinkage analysis for AF exhibited an area under the curve of 0.600 (P < 0.001), which improved to 0.855 (P < 0.001) after adjusting for age and sex. Phenome-wide association study analysis showed the top 10 diseases associated with these genes were circulatory system diseases. CONCLUSIONS: Integrating genetic and phenotypic data enhanced the accuracy and clinical relevance of AF predictive models. The findings suggest promise for refining AF risk assessment, enabling personalized interventions, and reducing AF-related morbidity and mortality burdens.

Constructing drain surrounded double gate structure in AlGaN/GaN HEMT for boosting breakdown voltage.

AlGaN/GaN high electron mobility transistors (HEMTs) play an important role in the field of high-voltage and high-frequency power devices. However, the current collapse effect of the HEMTs under high voltage greatly limits the development of AlGaN/GaN HEMTs. In this work, a breakdown performance enhanced drain surrounded double gate (DSDG) AlGaN/GaN HEMT is investigated. This structure has two separate gates located on the right and the left of the drain. The optimized off-state characteristics are analyzed by the Sentaurus TCAD simulation tool. The additional gate contributes to restraining the movement of electrons injected by the source therefore reducing the source-to-drain punch-through current. Moreover, the energy band pulled up by the relatively low voltage of the right gate helps to alleviate the drain induced barrier lower (DIBL) effect. As a result, DSDG-HEMT could postpone the breakdown by approximately 100 V through suppressing buffer leakage.

Lactate-to-albumin ratio and cholesterol levels predict neurological outcome in cardiac arrest survivors.

BACKGROUND: Out-of-hospital cardiac arrest (OHCA) increases lactate levels and reduces albumin levels on admission and tends to lead to a poor neurological prognosis. In our experience, reduced cholesterol levels predict poor neurological prognosis. However, the relationship between cholesterol levels and neurological prognosis in OHCA survivors remains unclear. METHODS: This retrospective observational study included data from January 2015 to June 2023 on 219 OHCA survivors at our intensive care unit. Patients were categorized into two groups based on cerebral functional classification (CPC) scores: Group A (CPC score of 1 or 2), including patients with a favorable neurological outcome, and Group B (CPC scores of 3 to 5), comprising those with a poor neurological outcome. We analyzed their lactate, albumin levels, and lipid profiles measured at 6 h after resuscitation. A model to predict the neurological prognosis of admission of OHCA survivors was developed. RESULTS: Approximately 40% of the patients had favorable neurological outcomes at the 30-day follow-up. The lactate-to-albumin ratio (LAR) was significantly lower in Group A than in Group B (3.1 vs. 5.0 mmol/dag, p < 0.001). However, the albumin, total cholesterol, and high-density lipoprotein (HDL) cholesterol levels were significantly higher in Group A than in Group B (3.6 vs. 2.9 g/dL, 166.1 vs. 131.4 mg/dL, and 38.8 vs. 29.7 mg/dL, respectively, p < 0.001). Favorable neurological outcome was indicated at the following thresholds: LAR < 3.7 mmol/dag, albumin level > 3.1 g/dL, total cholesterol level > 146.4 mg/dL, and HDL-cholesterol level > 31.9 mg/dL. These findings underscore the high sensitivity and negative predictive value of the biomarkers. Furthermore, the area under the curve values for LAR, albumin, total cholesterol, and HDL-cholesterol levels were 0.70, 0.75, 0.71, and 0.71, respectively. The corresponding odds ratios were 3.37, 7.08, 3.67, and 3.94, respectively. CONCLUSIONS: The LAR, albumin, total cholesterol, and HDL-cholesterol levels measured on admission may predict neurological prognosis in OHCA survivors. Thus, routine practice should include the measurement of these biomarkers at 6 h after resuscitation, especially in patients with a lactate level of > 5 mmol/L. TRIAL REGISTRATION: ClinicalTrials.gov ID: NCT02633358.

Cosmetically Approved Short-Chain Alcohol/Triethyl Citrate/Water Surfactant-Free Microemulsions and Potential Application to Transdermal Penetration of α-Arbutin.

Surfactant-free microemulsions (SFMEs) exhibited remarkable advantages and potential, attributed to their similarity to traditional surfactant-based microemulsions and the absence of surfactants. Herein, a novel SFME was developed utilizing cosmetically approved materials, such as short-chain alcohol as an amphi-solvent, triethyl citrate (TEC) as the nonpolar phase, and water as the polar phase. 1,2-Pentanediol (PtDO)/TEC/water combination can form the largest monophasic zone, accounting for ∼74% of the total phase diagram area, due to an optimal hydrophilic (water)-lipophilic (TEC) balance. Comparable to surfactant-based microemulsion, PtDO/TEC/water SFME can also be categorized into three types: water-in-oil, discontinuous, and oil-in-water. As TEC or water is increased, or PtDO is decreased, the nanoaggregates in PtDO/TEC/water SFME grow from <5 nm to tens of nanometers. The addition of α-arbutin (ABN) does not disrupt PtDO/TEC/water SFME, but rather enhances its formation, resulting in a larger monophasic area and consistent size (2.8-3.8 nm) through participating in interface assembly. Furthermore, ABN-loaded PtDO/TEC/water SFME exhibits remarkable resistance to dilution, exceptional stability, and minimal irritation. Notably, PtDO/TEC/water SFME significantly boosts ABN's solubility in water by 2 times, its percutaneous penetration rate by 3-4 times, and enables a slow-release DPPH• radical scavenging effect. This SFME serves as a safe and cosmetically suitable nanoplatform for the delivery of bioactive substances.

Novel prognostic impact and cell specific role of endocan in patients with coronary artery disease.

BACKGROUND: Both the clinical and mechanistic impacts of endocan were not well elucidated especially in coronary artery disease (CAD). OBJECTIVE: This study aimed to investigate the prognostic and potential pathological role of endocan for cardiovascular (CV) events in stable CAD patients. METHODS: A total of 1,071 stable CAD patients with previous percutaneous coronary intervention (PCI) were enrolled prospectively in a nationwide Biosignature study. Another cohort of 76 CAD patients with or without PCI were enrolled for validation. Baseline biomarkers including endocan level was measured and total CV events especially hard CV events (including CV mortality, non-fatal myocardial infection and stroke) during follow-up were identified. Circulating endothelial progenitor cells (EPCs) as an in vivo biological contributor to vascular repairment from CAD patients were used for the in vitro functional study. RESULTS: After 24 months, there were 42 patients (3.92%) with hard CV events and 207 (19.3%) with total CV events in the study group. The incidence of both events was increased with the tertiles of baseline endocan level (hard events: 1.7%,3.4%, and 6.7% in 1st,2nd, and 3rd tertile respectively, p = 0.002; total events: 13.8%vs.16.2%vs.28.0%, p < 0.0001). Multivariate regression analysis revealed the independent association of endocan level with total and hard CV events. These findings were validated in another cohort with a 5-year follow-up. Furthermore, in vitro inhibition of endocan improved cell migration and tube formation capacities, and reduced cell adhesiveness of EPCs from CAD patients. CONCLUSIONS: Endocan might be a novel prognostic indicator, mechanistic mediator, and potential therapeutic target for clinical CAD.

Integrating ultraviolet sensing and memory functions in gallium nitride-based optoelectronic devices.

Optoelectronic devices present a promising avenue for emulating the human visual system. However, existing devices struggle to maintain optical image information after removing external stimuli, preventing the integration of image perception and memory. The development of optoelectronic memory devices offers a feasible solution to bridge this gap. Simultaneously, the artificial vision for perceiving and storing ultraviolet (UV) images is particularly important because UV light carries information imperceptible to the naked eye. This study introduces a multi-level UV optoelectronic memory based on gallium nitride (GaN), seamlessly integrating UV sensing and memory functions within a single device. The embedded SiO2 side-gates around source and drain regions effectively extend the lifetime of photo-generated carriers, enabling dual-mode storage of UV signals in terms of threshold voltage and ON-state current. The optoelectronic memory demonstrates excellent robustness with the retention time exceeding 4 × 104 s and programming/erasing cycles surpassing 1 × 105. Adjusting the gate voltage achieves five distinct storage states, each characterized by excellent retention, and efficiently modulates erasure times for rapid erasure. Furthermore, the integration of the GaN optoelectronic memory array successfully captures and stably stores specific UV images for over 7 days. The study marks a significant stride in optoelectronic memories, showcasing their potential in applications requiring prolonged retention.

Extracorporeal cardiopulmonary resuscitation for patients with refractory out-of-hospital cardiac arrest: a propensity score matching, observational study.

Extracorporeal cardiopulmonary resuscitation (ECPR) is increasingly performed as an adjunct to conventional cardiopulmonary resuscitation (CCPR) for refractory out-of-hospital cardiac arrest (OHCA). However, the specific benefits of ECPR concerning survival with favorable neurological outcomes remain uncertain. This study aimed to investigate the potential advantages of ECPR in the management of refractory OHCA. We conducted a retrospective cohort study involved OHCA patients between January 2016 and May 2021. Patients were categorized into ECPR or CCPR groups. The primary endpoint assessed was survival with favorable neurological outcomes, and the secondary outcome was survival rate. Multivariate logistic regression analyses, with and without 1:2 propensity score matching, were employed to assess ECPR's effect. In total, 1193 patients were included: 85underwent ECPR, and 1108 received CCPR. Compared to the CCPR group, the ECPR group exhibited notably higher survival rate (29.4% vs. 2.4%; p < 0.001). The ECPR group also exhibited a higher proportion of survival with favorable neurological outcome than CCPR group (17.6% vs. 0.7%; p < 0.001). Multivariate logistic regression analysis demonstrated that ECPR correlated with increased odds of survival with favorable neurological outcome (adjusted odds ratio: 13.57; 95% confidence interval (CI) 4.60-40.06). Following propensity score matching, the ECPR group showed significantly elevated odds of survival with favorable neurological outcomes (adjusted odds ratio: 13.31; 95% CI 1.61-109.9). This study demonstrated that in comparison to CCPR, ECPR may provide survival benefit and increase the odds of favorable neurological outcomes in selected OHCA patients.

[Economic evaluation of Annao Pills combined with antihypertensive drugs in treatment of primary hypertension: a study based on decision tree model].

The purpose of this study was to evaluate the economics of Annao Pills combined with antihypertensive drugs in the treatment of primary hypertension in the Chinese medical setting. TreeAge pro 2018 was used for cost-effect analysis and sensitivity analysis of the two treatment regimens. The intervention time of the simulation model was 2 weeks. The cost parameters were derived from Yaozhi.com, and the effect parameters were based on Meta-analysis of randomized controlled trial(RCT) involving Annao Pills. The experimental group was treated with Annao Pills combined with anti-hypertensive drugs(nifedipine controlled-release tablets + losartan potassium tablets), and the control group was treated with anti-hypertensive drugs(nifedipine controlled-release tablets + losartan potassium tablets). The basic analysis showed that the incremental cost-effect ratio(ICER) of the two groups was 2 678.67 yuan, which was less than 7.26% of the per capita disposable income in 2022. That is, compared with anti-hypertensive drugs alone, Annao Pills combined with antihypertensive drugs cost 2 678.67 yuan more for each additional patient with primary hypertension. The results of sensitivity analysis verified the robustness of the basic analysis results. The probability sensitivity results showed that when the patient's personal willingness to pay the price was higher than 2 650 yuan, the probability of the regimen in the experimental group was higher, which was consistent with the results of the basic analysis. In conclusion, when the price was higher than 2 650 yuan, Annao Pills combined with anti-hypertensive drugs was more economical than anti-hypertensive drugs alone in terms of improving the response rate of the patients with primary hypertension.

Role of low-density lipoprotein electronegativity and sexual dimorphism in contributing early ventricular tachyarrhythmias following ST-elevation myocardial infarction.

Background: Early ventricular tachycardia/fibrillation (VT/VF) in patients with ST-elevation myocardial infarction (STEMI) has higher morbidity and mortality. This study examines gender-differentiated risk factors and underlying mechanisms for early onset VT/VF in STEMI. Methods: We analyzed data from 2,964 consecutive STEMI patients between January 1, 2008 and December 31, 2021. Early VT/VF was defined as occurrence of spontaneous VT/VF of ≥30 s or requirement of immediate cardioversion/defibrillation within the first 48 h after symptoms. An ex vivo ischemic-reperfusion experiments were conducted in 8-week-old ApoE-/- mice fed a high-fat diet to explore the underlying mechanisms of early VT/VF. Results: In 255 of out 2,964 STEMI patients who experienced early VT/VF, the age was younger (58.6 ± 13.8 vs. 61.0 ± 13.0 years old, P = 0.008) with a male predominance. The plasma levels of L5, the most electronegative subclass of low-density lipoprotein, was higher in early VT/VF patients compared to those without early VT/VF (n = 21, L5: 14.1 ± 22.6% vs. n = 46, L5: 4.3 ± 9.9%, P = 0.016). In the experimental setup, all male mice (n = 4) developed VT/VF post sham operation, whereas no such incidence was observed in the female mice (n = 3). Significantly, male mice exhibited considerably slower cardiac conduction velocity as compared to their female counterparts in whole heart preparations (25.01 ± 0.93 cm/s vs.42.32 ± 5.70 cm/s, P < 0.001), despite analogous action potential durations. Furthermore, isolated ventricular myocytes from male mice showed a distinctly lower sodium current density (-29.20 ± 3.04 pA/pF, n = 6) in comparison to female mice (-114.05 ± 6.41 pA/pF, n = 6, P < 0.001). This decreased sodium current density was paralleled by a reduced membrane expression of Nav1.5 protein (0.38 ± 0.06 vs. 0.89 ± 0.09 A.U., P < 0.001) and increased cytosolic Nav1.5 levels (0.59 ± 0.06 vs. 0.29 ± 0.04 A.U., P = 0.001) in male mice. Furthermore, it was observed that the overall expressions of sorting nexin 27 (SNX27) and vacuolar protein sorting 26 (VPS26) were significantly diminished in male mice as compared to female littermates (0.91 ± 0.15 vs. 1.70 ± 0.28, P = 0.02 and 0.74 ± 0.09 vs. 1.57 ± 0.13, P < 0.01, respectively). Conclusions: Our findings reveal that male STEMI patients with early VT/VF are associated with elevated L5 levels. The gender-based discrepancy in early VT/VF predisposition might be due to compromised sodium channel trafficking, possibly linked with increased LDL electronegativity.

Ultraflexible, High-Performance Transistors and Logic Circuits on Biocompatible Polylactic Acid (PLA) Substrate.

Wearable and implantable devices have gained significant popularity, playing a crucial role in smart healthcare and human-machine interfaces, which necessitates the development of more complex electronic devices and circuits on biocompatible flexible materials. Polylactic acid (PLA) stands out due to its biodegradability, cost-effectiveness, and low immunogenicity. In this study, we utilize a solution-based spin-coating method to produce high-quality PLA thin films, serving as substrates for the fabrication of thin-film transistors (TFTs) in which the dielectric layer material is silicon dioxide, the channel layer material is IGZO, and the gate, drain, and source material is ITO at low temperatures (<40 °C) through a shadow masking technique. The resulting PLA-TFT devices exhibited remarkable flexibility, biocompatibility, and impressive electrical characteristics, including a charge carrier mobility of 27.81 cm2/(V s), a subthreshold swing of 162.8 mV/decade, and an ON/OFF current ratio of up to 1 × 106, and maintained performance under various deformations. We successfully constructed fundamental logic gate circuits using PLA-TFTs, including AND, OR, and NOT gates, which effectively performed logical functions and demonstrated stability under diverse bending conditions. These research findings provide valuable support for future endeavors in fabricating intricate logic circuits and realizing advanced functionalities on biocompatible flexible materials.

Reconnection of cysteine in reduced hair with alkylene dimaleates via thiol-Michael click chemistry.

OBJECTIVES: Conventional hair permanent waving (PW) and permanent straightening processes typically involve two steps: reduction, for breaking -S-S- bond in cystine into cysteine and oxidation for -S-S- bond reconnection. However, it is known that the hair incurs damage during the oxidation step. In this work, we proposed a novel strategy to reconnect reduced disulfide bonds in hair via the thiol-Michael click reaction, by using a symmetric Michael reagent. METHODS: Virgin black Chinese hair was reduced using 8% wt thioglycolic acid and employed as model hair containing a high content of broken disulfide bonds. The reduced hair was treated with 1,4-n-butylene dimaleate. Raman spectroscopy and Fourier transform infrared spectroscopy (FT-IR) were used to verify the chemical changes occurred in untreated and treated hair fibre. Single-fibre mechanical properties and thermal properties of the hair were evaluated using tensile testing and differential scanning calorimetry (DSC), respectively. RESULTS: The 1,4-n-butylene dimaleate could reconnect free thiol groups generated by disulfide bond reduction via thiol-Michael click reaction and significantly improve the mechanical strength of hair compared to that of the reduced hair. Secondary conformational resolution analysis of FT-IR results revealed that the content of α-helix structure could be restored after treatment with 1,4-n-butylene dimaleate. The intermolecular forces established by the newly generated C-S bonds compensate the broken disulfide bonds and enhance the fracture strength of the hair compared to that of reduced hair. Michael reagents of similar structure also showed similar performance in restoring the mechanical properties of reduced hair. CONCLUSIONS: Our data suggest that 1,4-n-butylene dimaleate can restore the mechanical properties of reduced hair by reconnecting reduced disulfide bonds and restoring the secondary conformation of hair keratin.

OBJECTIFS: Les processus classiques d'ondulation permanente (OP) et de lissage permanent des cheveux impliquent généralement deux étapes : la réduction, pour rompre la liaison ­S­S­ de la cystine en cystéine, et l'oxydation, pour reconnecter la liaison ­S­S­. Cependant, on sait que les cheveux subissent des dommages pendant l'étape d'oxydation. Dans ce travail, nous avons proposé une nouvelle stratégie pour reconnecter les liaisons disulfures réduites dans les cheveux via la réaction de thiol­Michael, en utilisant un réactif de Michael symétrique. MÉTHODES: Des cheveux noirs vierges chinois ont été réduits à l'aide d'acide thioglycolique à 8 % en poids et utilisés comme modèle de cheveux contenant une grande quantité de liaisons disulfures cassées. Les cheveux réduits ont été traités avec du dimaléate de 1,4­n­butylène. La spectroscopie de Raman et la spectroscopie infrarouge à transformée de Fourier (FT­IR) ont été utilisées pour vérifier les changements chimiques survenus dans les fibres capillaires non traitées et traitées. Les propriétés mécaniques à fibre unique et les propriétés thermiques des cheveux ont été évaluées à l'aide d'un test de traction et d'une calorimétrie différentielle à balayage (Differential Scan Calorimetry, DSC), respectivement. RÉSULTATS: Le dimaléate de 1,4­n­butylène pourrait reconnecter les groupes thiol libre générés par la réduction des liaisons disulfures via la réaction de thiol­Michael et améliorer de manière significative la résistance mécanique des cheveux par rapport à celle des cheveux réduits. L'analyse de la résolution conformationnelle secondaire des résultats de la FT­IR a révélé que le contenu de la structure en hélice alpha pouvait être restauré après un traitement avec le dimaléate de 1,4­n­butylène. Les forces intermoléculaires établies par les nouvelles liaisons C­S compensent les liaisons disulfures cassées et améliorent la résistance à la rupture des cheveux par rapport à celle des cheveux réduits. Les réactifs de Michael de structure similaire ont également montré des performances similaires dans la restauration des propriétés mécaniques des cheveux réduits. CONCLUSIONS: Nos données montrent que le dimaléate de 1,4­n­butylène peut restaurer les propriétés mécaniques des cheveux réduits en reconnectant les liaisons disulfures réduites et en restaurant la conformation secondaire de la kératine des cheveux.

Fatty acid-binding protein-3 and renal function decline in patients with chronic coronary syndrome.

BACKGROUND: Renal dysfunction is common in patients with coronary artery disease. Due to the shared vascular pathogenesis between the two conditions, novel biomarkers such as the fatty acid-binding protein-3 (FABP-3) have been proposed for diagnosis and prognosis prediction. This multicentre prospective cohort study investigates the association between FABP-3 and renal dysfunction. HYPOTHESIS: We hypothesized that higher FABP-3 levels are correlated to worse renal outcome. METHODS: Patients with chronic coronary syndrome were classified into three groups based on the initial serum FABP-3 levels. The Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation was used to estimate the patient's renal function. Renal events were defined as >25% and >50% decline in estimated glomerular filtration rate (eGFR). Cox multivariable regression was employed to delineate the correlation between FABP-3 and renal dysfunction. RESULTS: A total of 1606 subjects were included. During a mean follow-up of 35.9 months, there were 239 patients with eGFR >25% reduction and 60 patients with >50% reduction. In the Kaplan-Meier survival curve and log-rank test, increased levels of FABP-3 were significantly correlated with eGFR >25% reduction (p < .001) and >50% reduction (p < .001). Multivariate Cox regression model revealed that subjects with higher FABP-3 exhibited a greater risk of eGFR >25% reduction (Group 2: hazard ratio [HR] = 2.328, 95% confidence interval [CI] = 1.521-3.562, p < .001; Group 3: HR = 3.054, 95% CI = 1.952-4.776, p < .001) and >50% reduction (Group 3: HR = 4.838, 95% CI = 1.722-13.591, p = .003). CONCLUSIONS: Serum FABP-3 may serve as a novel biomarker to predict eGFR decline in patients with chronic coronary syndrome.

Axially Coordinated Gold Nanoclusters Tailoring Fe-N-C Nanozymes for Enhanced Oxidase-Like Specificity and Activity.

Metal-organic frameworks (MOF) derived nitrogen-doped carbon-supported monodisperse Fe (Fe-N-C) catalysts are intensively studied, but great challenges remain in understanding the relationship between the coordination structure and the performance of Fe-N-C nanozymes. Herein, a novel nanocluster ligand-bridging strategy is proposed for constructing Fe-S1 N4 structures with axially coordinated S and Au nanoclusters on ZIF-8 derived Fe-N-C (labeled Aux /Fe-S1 N4 -C). The axial Au nanoclusters facilitate electron transfer to Fe active sites, utilizing the bridging ligand S as a medium, thereby enhancing the oxygen adsorption capacity of composite nanozymes. Compared to Fe-N-C, Aux /Fe-S1 N4 -C exhibits high oxidase-like specificity and activity, and holds great potential for detecting acetylcholinesterase activity with a detection limit of 5.1 µU mL-1 , surpassing most reported nanozymes.

Ultraflexible Monolithic Three-Dimensional Static Random Access Memory.

Flexible static random access memory (SRAM) plays an important role in flexible electronics and systems. However, achieving SRAM with a small footprint, high flexibility, and high thermal stability has always been a big challenge. In this work, an ultraflexible six-transistor SRAM with high integration density is realized based on a monolithic three-dimensional (M3D) design. In this design, vertical stacked n-type indium gallium zinc oxide thin film transistors and p-type carbon nanotube transistors share common gate and drain electrodes, respectively, saving interlayer vias used in traditional M3D designs. This compact architecture reduces the footprint of the SRAM cell from a six-transistor to a four-transistor area, saving 33% of the area, and significantly enables the SRAM to have the highest flexibility among the reported ones, withstanding a harsh deforming process (6000 cycles of bending at a radius of 500 µm) without performance degradation. Moreover, this design facilitates the thermal stability of the SRAM under high temperature (333 K). It also exhibits great static and dynamic performance, with the highest normalized hold noise margin of 73.6%, a maximum gain of 151.2, and a minimum static power consumption of 3.15 µW in hold operation among the reported flexible SRAMs. This demonstration provides possibilities for SRAMs to be used in advanced wearable system applications.