Unlocking the Potential: Atomically Thin 2D Fluoritene from Exfoliated Fluorite Ore and Its Electrochemical Activity.

Fluorite mineral holds significant importance because of its optoelectronic properties and wide range of applications. Here, we report the successful exfoliation of bulk fluorite ore (calcium fluoride, CaF2) crystals into atomically thin two-dimensional fluoritene (2D CaF2) using a highly scalable liquid-phase exfoliation method. The microscopic and spectroscopy characterizations show the formation of (111) plane-oriented 2D CaF2 sheets with exfoliation-induced material strain due to bond breaking, leading to the changes in lattice parameter. Its potential role in electrocatalysis is further explored for deeper insight, and a probable mechanism is also discussed. The 2D CaF2 with long-term stability shows overpotential values of 670 and 770 mV vs RHE for hydrogen evolution reaction (HER) and oxygen evolution reaction (OER), respectively, at 10 mA cm-2. Computational simulations demonstrate the unique "direct-indirect" band gap switching with odd and even numbers of layers. Current work offers new avenues for exploring the structural and electrochemical properties of 2D CaF2 and its potential applicability.

Exploring Anticancer Properties of Medicinal Plants against Breast Cancer by Downregulating Human Epidermal Growth Factor Receptor 2.

Plants have a history of being employed in managing breast cancer. However, no scientific evidence supports the idea that these plants can effectively reduce the level of HER2 expression. In this study, extracts from 10 medicinal plants were evaluated for their anticancer properties against HER2-positive breast cancer cells through various methods, including the SRB assay, comet assay, annexin V-FITC dual staining, and immunoblotting. All extracts exerted antiproliferative activity against HER2-positive breast cancer cells. Furthermore, Terminalia chebula (T. chebula), Berberis aristata (B. aristata), and Mucuna pruriens (M. pruriens) reduced HER2 expression in tested cell lines. In addition, an increased Bax/Bcl-2 ratio was observed after the treatment. A comparative proteomics study showed modulation in the proteome profile of breast cancer cells after treatment with T. chebula, B. aristata, Punica granatum, M. pruriens, and Acorus calamus. Metabolic profiling of lead plants revealed the existence of multiple anticancer compounds. Our study demonstrates the considerable potential of the mentioned plants as innovative therapies for HER2-positive breast cancer.

What dictates soft clay-like lithium superionic conductor formation from rigid salts mixture.

Soft clay-like Li-superionic conductors, integral to realizing all-solid-state batteries, have been recently synthesized by mixing rigid-salts. Here, through computational and experimental analysis, we clarify how a soft clay-like material can be created from a mixture of rigid-salts. Using molecular dynamics simulations with a deep learning-based interatomic potential energy model, we uncover the microscopic features responsible for soft clay-formation from ionic solid mixtures. We find that salt mixtures capable of forming molecular solid units on anion exchange, along with the slow kinetics of such reactions, are key to soft-clay formation. Molecular solid units serve as sites for shear transformation zones, and their inherent softness enables plasticity at low stress. Extended X-ray absorption fine structure spectroscopy confirms the formation of molecular solid units. A general strategy for creating soft clay-like materials from ionic solid mixtures is formulated.

Evaluation of the Outcome of Osteoarthritis among Patients Undergoing Total Knee Replacement.

Background: To assess the outcome of osteoarthritis among patients undergoing total knee replacement (TKR). Materials and Methods: One hundred and four subjects with one hundred and fifty-two cemented total knee arthroplasties have been analyzed in the current research. Functional assessment was carried out using the preoperative and postoperative Knee Injury and Osteoarthritis Outcome Score (KOOS) score and its five subscales: pain, other symptoms, function in activity of daily living (ADL), function in sport and recreation (Sport/Rec), and knee-related quality of life (QOL). Results: A significant improvement in the KOOS symptom score was seen with score grade changing to excellent from poor. The average postoperative KOOS symptom score occurred to be 89.9198, whereas the mean preoperative KOOS score was 30.7960 with a mean difference of 59.02385. The mean postoperative KOOS pain score was 94.6304 and the mean preoperative KOOS score was 18.4831 with a mean difference of 76.14731. A significant improvement in the KOOS pain score was seen with score grade changing to excellent from poor. Sixty patients of 104 (57.7%) had an excellent satisfaction level with a postoperative range of motion, twenty-eight patients (26.9%) had a good, eleven patients (10.6%) had a fair, and five patients (4.8%) had a poor satisfaction level with a postoperative range of motion. Conclusion: Surgery for a TKR is successful in reducing individuals' pain and restoring their functional ability. Preoperative expectations and KOOS subscale scores are factors in patients' satisfaction, which is determined a year following surgery.

Successes and challenges of artificial intelligence in cardiology.

In the past decades there has been a substantial evolution in data management and data processing techniques. New data architectures made analysis of big data feasible, healthcare is orienting towards personalized medicine with digital health initiatives, and artificial intelligence (AI) is becoming of increasing importance. Despite being a trendy research topic, only very few applications reach the stage where they are implemented in clinical practice. This review provides an overview of current methodologies and identifies clinical and organizational challenges for AI in healthcare.

Single-Photon Emission from Two-Dimensional Materials, to a Brighter Future.

Single photons, often called flying qubits, have enormous promise to realize scalable quantum technologies ranging from an unhackable communication network to quantum computers. However, finding an ideal single-photon emitter (SPE) is a great challenge. Recently, two-dimensional (2D) materials have shown great potential as hosts for SPEs that are bright and operate under ambient conditions. This Perspective enumerates the metrics required for an SPE source and highlights that 2D materials, because of reduced dimensionality, exhibit interesting physical effects and satisfy several metrics, making them excellent candidates to host SPEs. The performance of SPE candidates discovered in 2D materials, hexagonal boron nitride and transition metal dichalcogenides, will be assessed based on the metrics, and the remaining challenges will be highlighted. Lastly, strategies to mitigate such challenges by developing design rules to deterministically create SPE sources will be presented.

Dengue virus induced autophagy is mediated by HMGB1 and promotes viral propagation.

Dengue virus (DENV) exploits various cellular pathways including autophagy to assure enhanced virus propagation. The mechanisms of DENV mediated control of autophagy pathway are largely unknown. Our investigations have revealed a novel role for high-mobility group box1 protein (HMGB1) in regulation of cellular autophagy process in DENV-2 infected A549 cell line. While induction of autophagy by rapamycin treatment resulted in enhanced DENV-2 propagation, the blockade of autophagy flux with bafilomycin A1 suppressed viral replication. Furthermore, siRNA-mediated silencing of HMGB1 significantly abrogated dengue induced autophagy, while LPS induced HMGB1 expression counteracted these effects. Interestingly, silencing of HMGB1 showed reduction of BECN1 and stabilization of BCL-2 protein. On the contrary, LPS induction of HMGB1 resulted in enhanced BECN1 and reduction in BCL-2 levels. This study shows that the modulation of autophagy by DENV-2 is HMGB1/BECN1 dependent. In addition, glycyrrhizic acid (GA), a potent HMGB1 inhibitor suppressed autophagy as well as DENV-2 replication. Altogether, our data suggests that HMGB1 induces BECN1 dependent autophagy to promote DENV-2 replication.

STAT3 inhibition mediated upregulation of multiple immune response pathways in dengue infection.

Dengue infection is a world-wide public health threat infecting millions of people annually. Till date no specific antiviral or vaccine is available against dengue virus. Recent evidence indicates that targeting host STAT3 could prove to be an effective antiviral therapy against dengue infection. To explore the potential of STAT3 inhibition as an antiviral strategy, we utilized a STAT3 inhibitor stattic as antiviral agent and performed whole proteome analysis of mammalian cells by mass spectrometry. Differentially expressed proteins among the infected and stattic treated groups were sorted based on their fold change expression and their functional annotation studies were carried out to establish their biological networks. The results presented in the current study indicated that treatment with stattic induces several antiviral pathways to counteract dengue infection. Together with this, we also observed that treatment with stattic downregulates pathways involved in viral transcription and translation thus establishing STAT3 as a suitable target for the development of antiviral interventions. This study establishes the role of STAT3 inhibition as an alternative strategy to counteract DENV pathogenesis. Targeting STAT3 by stattic or similar molecules may help in identifying novel therapeutic interventions against DENV and probably other flaviviruses.

Designing 1D correlated-electron states by non-Euclidean topography of 2D monolayers.

Two-dimensional (2D) bilayers, twisted to particular angles to display electronic flat bands, are being extensively explored for physics of strongly correlated 2D systems. However, the similar rich physics of one-dimensional (1D) strongly correlated systems remains elusive as it is largely inaccessible by twists. Here, a distinctive way to create 1D flat bands is proposed, by either stamping or growing a 2D monolayer on a non-Euclidean topography-patterned surface. Using boron nitride (hBN) as an example, our analysis employing elastic plate theory, density-functional and coarse-grained tight-binding method reveals that hBN's bi-periodic sinusoidal deformation creates pseudo- electric and magnetic fields with unexpected spatial dependence. A combination of these fields leads to anisotropic confinement and 1D flat bands. Moreover, changing the periodic undulations can tune the bandwidth, to drive the system to different strongly correlated regimes such as density waves, Luttinger liquid, and Mott insulator. The 1D nature of these states differs from those obtained in twisted materials and can be exploited to study the exciting physics of 1D quantum systems.

N95 respirator and surgical mask effectiveness against respiratory viral illnesses in the healthcare setting: A systematic review and meta-analysis.

OBJECTIVE: To examine the results, level of evidence, and methodologic quality of original studies regarding surgical mask effectiveness in minimizing viral respiratory illness transmission, and, in particular, the performance of the N95 respirator versus surgical mask. METHODS: Meta-analysis was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines with use of PubMed, MEDLINE, and the Cochrane Library databases. RESULTS: Eight studies (9164 participants) were included after screening 153 articles. Analyses showed statistically significant differences between N95 respirator versus surgical mask use to prevent influenza-like-illness (risk ratio [RR] = 0.81, 95% confidence interval [CI] = 0.68-0.94, P < 0.05), non-influenza respiratory viral infection (RR = 0.62, 95% CI = 0.52-0.74, P < 0.05), respiratory viral infection (RR = 0.73, 95% CI = 0.65-0.82, P < 0.05), severe acute respiratory syndrome coronavirus (SARS-CoV) 1 and 2 virus infection (RR = 0.17, 95% CI = 0.06-0.49, P < 0.05), and laboratory-confirmed respiratory viral infection (RR = 0.75, 95% CI = 0.66-0.84, P < 0.05). Analyses did not indicate statistically significant results against laboratory-confirmed influenza (RR = 0.87, CI = 0.74-1.03, P > 0.05). CONCLUSIONS: N95 respirator use was associated with fewer viral infectious episodes for healthcare workers compared with surgical masks. The N95 respirator was most effective in reducing the risk of a viral infection in the hospital setting from the SARS-CoV 1 and 2 viruses compared to the other viruses included in this investigation. Methodologic quality, risk of biases, and small number of original studies indicate the necessity for further research to be performed, especially in front-line healthcare delivery settings.

Ameliorative Effect of Surface Proteins of Probiotic Lactobacilli in Colitis Mouse Models.

The increase in concern from viable cells of probiotics specifically in acute inflammatory conditions has led to the emergence of the concept of postbiotics as a safer alternative therapy in the field of health and wellness. The aim of the present study was to evaluate the efficacy of surface proteins from three probiotic strains in dextran sodium sulfate and trinitrobenzenesulphonic acid = induced colitis mouse models. The molecular weight of total surface proteins extracted from the three probiotic strains ranged from ∼25 to ∼250 kDa with the presence of negligible levels of endotoxins. Surface layer proteins (SLPs) (∼45 kDa) were found to be present only in the Lactobacillus acidophilus NCFM strain. In the in vivo study, significant differences were not observed in the weight loss and general appetite, however, the decrease in colon length was apparent in TNBS colitis control mice. Further, the administration of these surface proteins significantly reversed the histopathological damages induced by the colitogens and improved the overall histological score. The oral ingestion of these surface proteins also led to a decrease in myeloperoxidase activity and TNF-α expression while the IL-10 levels significantly increased for the strain NCFM followed by MTCC 5690 and MTCC 5689. Overall, the present study signifies the ameliorative role of probiotic surface proteins in colitis mice, thereby, offering a potential and safer alternative for the management of inflammatory bowel disorders.

Bicompartmental Bucket Handle Meniscal Tear with Chronic ACL Deficiency Causing a Rare Triple PCL and Triple Cruciate Sign: A Case Report.

CASE: A 16-year-old football player presented with chronic ACL deficiency along with bicompartmental bucket handle meniscal tears. CONCLUSION: We present a "triple cruciate" sign in addition to the triple posterior cruciate ligament (PCL) sign seen on Magnetic Resonance Imaging (MRI) to aid in diagnosing this injury.

Dimensionality-Reduced Fermi Level Pinning in Coplanar 2D Heterojunctions.

Electronic transport through a metal|semiconductor (M|S) heterojunction is largely determined by its Schottky barrier. In 3D M|S junctions, the barrier height determines the turn-on voltage and is often pinned by the interface states, causing Fermi level pinning (FLP). The pinning strength in 3D depends on the ratio Ci/CM between the interface quantum capacitance Ci and the metal surface capacitance CM. In 2D, the interface dipole does not influence the band alignment, but still affects the Schottky barrier and transport. In light of the general interest in building 2D electronics, in this work we discover the relevant material parameters which dictate the behavior and strength of FLP in 2D M|S contacts. Using a multiscale model combining first-principles, continuum electrostatics, and transport calculations, we study a realistic Gr|MoS2 interface as an example with high interface state density (Ci/CM ≫ 1). Transport calculations show partial pinning with a strength P ∼ 0.6, while a 3D junction with similar heterogeneity gives full pinning with P = 1 as expected. We further show that in 2D M|S contacts the turn-on voltage and pinning strength are affected by a physical parameter l/λD, the ratio between the interface width l, and the thermal de Broglie wavelength λD. Pinning is absent for ideal line-contacts (l/λD = 0), but increases for realistic l/λD values.

What Dictates Rashba Splitting in 2D van der Waals Heterobilayers.

Rashba spin-orbit coupling enables electric control of spin states, promising enormous advances from conventional charge-based computing. Until now, a general scheme or a descriptor to find an optimal system with isolated spin states with large tunable splitting is still lacking. Here, based on first-principles calculations, we explore the microscopic physicochemical mechanism responsible for the Rashba effect in 2D van der Waals heterobilayers. We find that the difference in the Born effective charge of atoms at the interface can be used as a single-layer descriptor to predict heteropairs with large Rashba splitting, thus reducing the scaling factor in materials search. Moreover, we discover that for most 2D materials, the routinely used Rashba parameter αR is not a good gauge of the effect's strength. From our general scheme, MoTe2|Tl2O and MoTe2|PtS2, with spin splitting above 120 meV, Rashba energy ER = 94 meV, and wavenumber difference 2k0 = 0.36 Å-1 ("effective" αR > 1 eVÅ), emerge as the best candidates for spin transistors at room temperature.

Dual Role of Adsorbent and Non-monotonic Transfer p-Doping of Diamond.

Exposure to oxygen is usually detrimental for materials and devices as it leads to undesirable surface oxidation or even deeper corrosion. However, experiments with hydrogen-terminated H-diamond show that oxygen adsorption plays an instrumental role in inducing the p-type surface conductivity. Using first-principles calculations, we explore how the surface-physisorbed molecular O2 serves as an electron acceptor in the transfer doping of diamond. On the other hand, calculations reveal that in a chemisorbed state, oxygen groups substitute H, which lowers the bands in diamond and inhibits the transfer doping. This explains the non-monotonic carrier density dependence on the exposure to oxygen (or, similarly, other adsorbent-acceptor). We further find that ozone can be more efficient for p-type doping of H-diamond due to O3 having lower LUMO energy levels than in molecular O2.

Surgical Outcomes After Single-Level Endoscopic Transforaminal Lumbar Interbody Fusion: A Systematic Review and Meta-Analysis.

Background and objective Novel surgical advancements have introduced endoscopic operative techniques for low back surgery, including transforaminal lumbar interbody fusion (TLIF), which theoretically allows for improved decompression with minimal invasiveness. In addition, endoscopically performed TLIF has allowed for the use of local anesthesia as an alternative method to general anesthesia for patients. We aimed to evaluate the clinical outcomes in patients undergoing endoscopic TLIF and also compare the outcomes in patients undergoing general versus local anesthesia. Methods The databases of PubMed, Medline, Embase, and the Cochrane Library were queried for all studies involving patients undergoing endoscopic TLIF. After the extraction of the data and assessment of study quality via the Newcastle-Ottawa Scale, statistical analysis was performed with the R software (The R Foundation, Vienna, Austria) metafor package. The random-effects model was used as the data was largely heterogeneous (I2 >50%). Results In total, 15 studies involving a total of 441 patients were selected for the final quantitative meta-analysis. The overall mean difference between the postoperative visual analog scale (VAS) leg scores and preoperative VAS scores was 3.45 (95% CI: 4.93-1.97, p: <0.01). Postoperative VAS low back scores revealed a mean difference of 3.36 (95% CI: 5.09-1.63, p: <0.01). The overall mean difference of ODI scores was 4.58 (95% CI: 6.76-2.40, p: <0.01). Mean blood loss was 136.32 mL and the mean operative time was 149.15 minutes. The mean length of stay postoperatively was lower in the local anesthesia group compared to the general anesthesia group (1.40 vs 5.99 days respectively). There were no outcome variables of patients undergoing general anesthesia versus local anesthesia that showed statistically significant differences in this analysis due to the small amount of data published on patients undergoing endoscopic TLIF with local anesthesia. In addition, the failure of studies in reporting standard deviations as data parameters further limited the quantitative analysis. Conclusion Endoscopic TLIF appears to be a viable option for patients undergoing lumbar interbody fusion. Initial data reveal that endoscopic TLIF with local anesthesia may offer patients outcomes similar to those in patients undergoing endoscopic TLIF with general anesthesia, with lower operative times and length of stay.

Medically Necessary Orthopaedic Surgery During the COVID-19 Pandemic: Safe Surgical Practices and a Classification to Guide Treatment.

BACKGROUND: Coronavirus disease 2019 (COVID-19) has rapidly evolved as a viral pandemic. Countries worldwide have been affected by the recent outbreak caused by the SARS (severe acute respiratory syndrome)-CoV-2 virus. As with prior viral pandemics, health-care workers are at increased risk. Orthopaedic surgical procedures are common in health-care systems, ranging from emergency to elective procedures. Many orthopaedic surgical procedures are life or limb-saving and cannot be postponed during the COVID-19 pandemic because of potential patient harm. Our goal is to analyze how orthopaedic surgeons can perform medically necessary procedures during the pandemic and to help guide decision-making perioperatively. METHODS: We performed a review of the existing literature regarding COVID-19 and prior viral outbreaks to help guide clinical practice in terms of how to safely perform medically necessary orthopaedic procedures during the pandemic for both asymptomatic patients and high-risk (e.g., COVID-19-positive) patients. We created a classification system based on COVID-19 positivity, patient health status, and COVID-19 prevalence to help guide perioperative decision-making. RESULTS: We advocate that only urgent and emergency surgical procedures be performed. By following recommendations from the American College of Surgeons, the Centers for Disease Control and Prevention, and the recent literature, safe orthopaedic surgery and perioperative care can be performed. Screening measures are needed for patients and perioperative teams. Surgeons and perioperative teams at risk for contracting COVID-19 should use appropriate personal protective equipment (PPE), including N95 respirators or powered air-purifying respirators (PAPRs), when risk of viral spread is high. When preparing for medically necessary orthopaedic procedures during the pandemic, our classification system will help to guide decision-making. A multidisciplinary care plan is needed to ensure patient safety with medically necessary orthopaedic procedures during the COVID-19 pandemic. CONCLUSIONS: Orthopaedic surgery during the COVID-19 pandemic can be performed safely when medically necessary but should be rare for COVID-19-positive or high-risk patients. Appropriate screening, PPE use, and multidisciplinary care will allow for safe medically necessary orthopaedic surgery to continue during the COVID-19 pandemic. LEVEL OF EVIDENCE: Prognostic Level V. See Instructions for Authors for a complete description of levels of evidence.

Heterobilayers of 2D materials as a platform for excitonic superfluidity.

Excitonic condensate has been long-sought within bulk indirect-gap semiconductors, quantum wells, and 2D material layers, all tried as carrying media. Here, we propose intrinsically stable 2D semiconductor heterostructures with doubly-indirect overlapping bands as optimal platforms for excitonic condensation. After screening hundreds of 2D materials, we identify candidates where spontaneous excitonic condensation mediated by purely electronic interaction should occur, and hetero-pairs Sb2Te2Se/BiTeCl, Hf2N2I2/Zr2N2Cl2, and LiAlTe2/BiTeI emerge promising. Unlike monolayers, where excitonic condensation is hampered by Peierls instability, or other bilayers, where doping by applied voltage is required, rendering them essentially non-equilibrium systems, the chemically-specific heterostructures predicted here are lattice-matched, show no detrimental electronic instability, and display broken type-III gap, thus offering optimal carrier density without any gate voltages, in true-equilibrium. Predicted materials can be used to access different parts of electron-hole phase diagram, including BEC-BCS crossover, enabling tantalizing applications in superfluid transport, Josephson-like tunneling, and dissipationless charge counterflow.

How soon can we identify at-risk patients: examining initial depressive symptomology and opioid use in musculoskeletal trauma survivors?

OBJECTIVES: This study evaluates the associations between post injury depressive symptomology and opioid use from the initial time of injury in orthopedic trauma patients without pre-existing psychiatric conditions. DESIGN AND SETTING: This is a prospective study following the development of symptoms after orthopedic trauma injury conducted at a Level-1 trauma center. PATIENTS: Orthopedic trauma patients (N=96; 43.4±16.5 yrs, 40.6% women) MAIN OUTCOME MEASURES AND ANALYSIS METHODS: Beck Depression Inventory (BDI-II) was administered during index hospitalization and at 2-weeks, 6-weeks, and 3- months, and 6-months. In-hospital and out-patient opioid use were tracked. Regression analyses determined the relationship of opioid use and depressive symptoms during follow-up. RESULTS: Twenty percent of patients had moderate depressive symptom levels (BDI 20-28 points) and 11% had severe depressive symptom levels (BDI ≥29) at the time of their index hospitalization. Inpatient BDI-II depressive symptom severity levels were significantly related to depressive symptomology at 2 -weeks, 6 -weeks, and 3 -months. In-hospital or discharge opioid dose was not associated with initial or persistent depressive symptomology. Patients with persistent opioid use at 6 weeks had higher depressive symptoms six months following post-discharge than those who ceased opioid use by 6 -weeks post-discharge. CONCLUSIONS: This study suggests that depressive symptomology immediately following musculoskeletal trauma is predictive for persistent depressive symptomology in a subset of our patient population. Inpatient BDI-II depressive symptom severity levels in the hospital were significantly related to BDI-II at 2-weeks, 6-weeks, and 3-months, and persistent opioid use, past 6-weeks, was independently associated with prolonged depressive symptomology as well. Further study into effective treatment and monitoring of mental health disturbances following trauma is needed, particularly in patients with continued need for and use of opioids after discharge.