Comparative transcriptome analysis between long- and short-term survival after pig-to-monkey cardiac xenotransplantation reveals differential heart failure development.

Cardiac xenotransplantation is the potential treatment for end-stage heart failure, but the allogenic organ supply needs to catch up to clinical demand. Therefore, genetically-modified porcine heart xenotransplantation could be a potential alternative. So far, pig-to-monkey heart xenografts have been studied using multi-transgenic pigs, indicating various survival periods. However, functional mechanisms based on survival period-related gene expression are unclear. This study aimed to identify the differential mechanisms between pig-to-monkey post-xenotransplantation long- and short-term survivals. Heterotopic abdominal transplantation was performed using a donor CD46-expressing GTKO pig and a recipient cynomolgus monkey. RNA-seq was performed using samples from POD60 XH from monkey and NH from age-matched pigs, D35 and D95. Gene-annotated DEGs for POD60 XH were compared with those for POD9 XH (Park et al. 2021). DEGs were identified by comparing gene expression levels in POD60 XH versus either D35 or D95 NH. 1,804 and 1,655 DEGs were identified in POD60 XH versus D35 NH and POD60 XH versus D95 NH, respectively. Overlapped 1,148 DEGs were annotated and compared with 1,348 DEGs for POD9 XH. Transcriptomic features for heart failure and inhibition of T cell activation were observed in both long (POD60)- and short (POD9)-term survived monkeys. Only short-term survived monkey showed heart remodeling and regeneration features, while long-term survived monkey indicated multi-organ failure by neural and hormonal signaling as well as suppression of B cell activation. Our results reveal differential heart failure development and survival at the transcriptome level and suggest candidate genes for specific signals to control adverse cardiac xenotransplantation effects.

A prospective observational study evaluating the use of remote patient monitoring in ED discharged COVID-19 patients in NYC.

OBJECTIVES: We investigated whether continuous remote patient monitoring (RPM) could significantly reduce return Emergency Department (ED) revisits among coronavirus disease 2019 (COVID-19) patients discharged from the emergency Department. MATERIALS AND METHODS: A prospective observational study was conducted from a total of 2833 COVID-19 diagnosed patients who presented to the Montefiore Medical Center ED between September 2020-March 2021. Study patients were remotely monitored through a digital platform that was supervised 24/7 by licensed healthcare professionals. Age and time-period matched controls were randomly sampled through retrospective review. The primary outcome was ED revisit rates among the two groups. RESULTS: In our study, 150 patients enrolled in the RPM program and 150 controls were sampled for a total of 300 patients. Overall, 59.1% of the patients identified as Hispanic/Latino. The RPM group had higher body mass index (BMI) (29 (25-35) vs. 27 (25-31) p-value 0.020) and rates of hypertension (50.7% (76) vs. 35.8% (54) p-value 0.009). There were no statistically significant differences in rates of ED revisit between the RPM group (8% (12)) and control group (9.3% (14)) (OR: 0.863; 95% CI:0.413-1. 803; p- 0.695). DISCUSSION AND CONCLUSION: Our study explored the impact of continuous monitoring versus intermittent monitoring for reducing ED revisits in a largely underrepresented population of the Bronx. Our study demonstrated that continuous remote patient monitoring showed no significant difference in preventing ED revisits compared to non-standardized intermittent monitoring. However, potential other acute care settings where RPM may be useful for identifying high-risk patients for early interventions warrant further study.

Minimally Invasive Anesthesia in Pediatric Circumcision: A Case Series.

Anesthetic management of pediatric circumcisions typically involves intravenous access and advanced airway management. We explored the use of a minimally invasive anesthetic protocol for pediatric circumcisions akin to the anesthetic management for bilateral myringotomy and tympanostomy. Five pediatric circumcisions were performed under mask ventilation without intravenous access and evaluated for intraoperative anesthesia times, patient outcomes, and complications. The mean (standard deviation) intraoperative anesthesia time was 41.4 (5.7) minutes, and 1 patient experienced a mild intraoperative complication with emesis at induction. Pediatric circumcisions can be efficiently and safely performed with minimally invasive anesthesia.

On-admission anemia predicts mortality in COVID-19 patients: A single center, retrospective cohort study.

OBJECTIVES: We investigated the impact of anemia based on admission hemoglobin (Hb) level as a prognostic risk factor for severe outcomes in hospitalized patients with coronavirus disease 2019 (COVID-19). METHODS: A single-center, retrospective cohort study was conducted from a random sample of 733 adult patients (age ≥ 18 years) obtained from a total of 4356 laboratory confirmed SARS-CoV-2 cases who presented to the Emergency Department of Montefiore Medical Center between March-June 2020. The primary outcome was a composite endpoint of in-hospital severe outcomes of COVID-19. A secondary outcome was in-hospital all-cause mortality. RESULTS: Among the 733 patients included in our final analysis, 438 patients (59.8%) presented with anemia. 105 patients (14.3%) had mild, and 333 patients (45.5%) had moderate-severe anemia. Overall, 437 patients (59.6%) had a composite endpoint of severe outcomes. On-admission anemia was an independent risk factor for all-cause mortality, (Odds Ratio 1.52, 95% CI [1.01-2.30], p = 0.046) but not for composite severe outcomes. However, moderate-severe anemia (Hb < 11 g/dL) on admission was independently associated with both severe outcomes (OR1.53, 95% CI [1.05-2.23], p = 0.028) and mortality (OR 1.67, 95% CI [1.09-2.56], p = 0.019) during hospitalization. CONCLUSION: Anemia on admission was independently associated with increased odds of all-cause mortality in patients hospitalized with COVID-19. Furthermore, moderate-severe anemia (Hb <11 g/dL) was an independent risk factor for severe COVID-19 outcomes. Moving forward, COVID-19 patient management and risk stratification may benefit from addressing anemia on admission.

Interstratified heterostructures of metal hydroxide nanoclusters and MoS2 monolayers with improved electrode performance.

Interstratified 2D nanohybrids of chromium hydroxide-molybdenum disulfide with improved electrode functionality are synthesized by the self-assembly of anionic monolayered MoS2 nanosheets with cationic chromium hydroxide nanoclusters. The intercalative hybridization of MoS2 with chromium hydroxide nanoclusters leads to a significant increase of basal spacing as well as to the formation of an open porous stacking structure. This is the first example of metal hydroxide nanocluster-pillared transition metal dichalcogenide (TMD) hybrid materials. According to extended X-ray absorption fine structure analysis, open tetrameric chromium hydroxide nanoclusters are stabilized in-between metallic 1T'-MoS2 monolayers. In comparison with the pristine MoS2 material, the chromium hydroxide-pillared molybdenum disulfide nanohybrids show remarkably improved charge storage capacity with excellent rate performance for lithium ion batteries, highlighting the beneficial effect of pillaring with metal hydroxides on the electrode performance of MoS2. The improvement of electrode functionality upon hybridization is attributable to the increase of basal spacing, the stabilization of metallic 1T'-MoS2 content, the improvement of charge transfer kinetics, and the stabilization of the open porous structure upon electrochemical cycling. The present study clearly demonstrates that an electrostatically-driven self-assembly between exfoliated TMD nanosheets and cationic inorganic nanoclusters can provide an effective way of synthesizing heterostructured hybrid electrode materials with improved performance.

Critical Role of the Chemical Environment of Interlayer Na Sites: An Effective Way To Improve the Na Ion Electrode Activity of Layered Titanate.

The chemical environments of the interlayer Na sites of layered titanate are finely controlled by the intercalation of n-alkylamine with various alkyl chain lengths to explore an effective way to improve its electrode functionality for sodium-ion batteries (SIBs). The n-alkylamine intercalation via ion-exchange and exfoliation-restacking routes allows the modification of in-plane structures of layered titanate to be tuned. Among the present n-alkylamine-intercalates, the n-pentylamine-intercalated titanate shows the largest discharge capacity with the best rate characteristics, underscoring the critical role of optimized intracrystalline structure in improving the SIB electrode performance of layered titanate. The creation of turbostratic in-plane structure degrades the SIB electrode performance of layered titanate, indicating the detrimental effect of in-plane structural disorder on electrode activity. 23Na magic-angle spinning nuclear magnetic resonance spectroscopy demonstrates that the n-alkylamine-intercalated titanates possess two different interlayer Na+ sites near ammonium head groups/titanate layers and near alkyl chains. The intercalation of long-chain molecules increases the population of the latter site and the overall mobility of Na+ ions, which is responsible for the improvement of electrode activity upon n-alkylamine intercalation. The present study highlights that the increased population of interlayer metal sites remote from the host layers is effective in improving the electrode functionality of layered metal oxide for SIBs and multivalent ion batteries.

Recent Applications of 2D Inorganic Nanosheets for Emerging Energy Storage System.

Among many types of nanostructured inorganic materials, highly anisotropic 2D nanosheets provide unique advantages in designing and synthesizing efficient electrode and electrocatalyst materials for novel energy storage technologies. 2D inorganic nanosheets boast lots of unique characteristics such as high surface area, short ion diffusion path, tailorable compositions, and tunable electronic structures. These merits of 2D inorganic nanosheets render them promising candidate materials as electrodes for diverse secondary batteries and supercapacitors, and electrocatalysts. A wide spectrum of examples is presented for inorganic nanosheet-based electrodes and electrocatalysts. Future perspectives in research about 2D nanosheet-based functional materials are discussed to provide insight for the development of next-generation energy storage systems using 2D nanostructured materials.

A 2D Metal Oxide Nanosheet as an Efficient Additive for Improving Na-Ion Electrode Activity of Graphene-Based Nanocomposites.

An efficient way to improve the Na-ion electrode activity of graphene-based nanocomposite is developed by employing exfoliated metal oxide nanosheet as an additive. The titanate-nanosheet-incorporated Na-SnS2 -reduced graphene oxide (rG-O) nanocomposites can be synthesized by the electrostatically derived restacking of the colloidal mixture of SnS2 , rG-O, and titanate nanosheets with the Na+ cation. The incorporation of titanate into the Na-SnS2 -rG-O nanocomposites is effective in improving the nanoscale mixing of component nanosheets and the porosity of the composite structure. The resulting nanocomposites deliver superior discharge capacities and rate properties to the titanate-free nanocomposite. The universal applicability is further confirmed by MoS2 -rG-O nanocomposites upon the addition of titanate. This study highlights that the exfoliated metal oxide nanosheet can be used as an efficient additive for graphene-based nanocomposites to explore Na-ion electrode materials.

Improvement of Na Ion Electrode Activity of Metal Oxide via Composite Formation with Metal Sulfide.

The composite formation with a conductive metal sulfide domain can provide an effective methodology to improve the Na-ion electrode functionality of metal oxide. The heat treatment of TiO2(B) under CS2 flow yields an intimately coupled TiO2(B)-TiS2 nanocomposite with intervened TiS2 domain, since the reaction between metal oxide and CS2 leads to the formation of metal sulfide and CO2. The negligible change in lattice parameters and significant enhancement of visible light absorption upon the reaction with CS2 underscore the formation of conductive metal sulfide domains. The resulting TiO2(B)-TiS2 nanocomposites deliver greater discharge capacities with better rate characteristics for electrochemical sodiation-desodiation process than does the pristine TiO2(B). The 23Na magic angle spinning nuclear magnetic resonance analysis clearly demonstrates that the electrode activities of the present nanocomposites rely on the capacitive storage of Na+ ions, and the TiS2 domains in TiO2(B)-TiS2 nanocomposites play a role as mediators for Na+ ions to and from TiO2(B) domains. According to the electrochemical impedance spectroscopy, the reaction with CS2 leads to the significant enhancement of charge transfer kinetics, which is responsible for the accompanying improvement in electrode performance. The present study provides clear evidence for the usefulness in composite formation between the semiconducting metal oxide and metal sulfide in exploring new efficient NIB electrode materials.

Unusually Huge Charge Storage Capacity of Mn3O4-Graphene Nanocomposite Achieved by Incorporation of Inorganic Nanosheets.

Remarkable improvement in electrode performance of Mn3O4-graphene nanocomposites for lithium ion batteries can be obtained by incorporation of a small amount of exfoliated layered MnO2 or RuO2 nanosheets. The metal oxide nanosheet-incorporated Mn3O4-reduced graphene oxide (rGO) nanocomposites are synthesized via growth of Mn3O4 nanocrystals in the mesoporous networks of rGO and MnO2/RuO2 2D nanosheets. Incorporation of metal oxide nanosheets is highly effective in optimizing porous composite structure and charge transport properties, resulting in a remarkable increase of discharge capacity of Mn3O4-rGO nanocomposite with significant improvement of cyclability and rate performance. The observed enormous discharge capacity of synthesized Mn3O4-rGO-MnO2 nanocomposite (∼1600 mA·h·g(-1) for the 100th cycle) is the highest value among reported data for Mn3O4-rGO nanocomposite. Despite much lower electrical conductivity of MnO2 than RuO2, the MnO2-incorporated nanocomposite at optimal composition (2.5 wt %) shows even larger discharge capacities with comparable rate characteristics compared with the RuO2-incorporated homologue. This finding underscores that the electrode performance of the resulting nanosheet-incorporated nanocomposite is strongly dependent on its pore and composite structures rather than on the intrinsic electrical conductivity of the additive nanosheet. The present study clearly demonstrates that, regardless of electrical conductivity, incorporation of metal oxide 2D nanosheet is an effective way to efficiently optimize the electrode functionality of graphene-based nanocomposites.

Phase Tuning of Nanostructured Gallium Oxide via Hybridization with Reduced Graphene Oxide for Superior Anode Performance in Li-Ion Battery: An Experimental and Theoretical Study.

The crystal phase of nanostructured metal oxide can be effectively controlled by the hybridization of gallium oxide with reduced graphene oxide (rGO) at variable concentrations. The change of the ratio of Ga2O3/rGO is quite effective in tailoring the crystal structure and morphology of nanostructured gallium oxide hybridized with rGO. This is the first example of the phase control of metal oxide through a change of the content of rGO hybridized. The calculations based on density functional theory (DFT) clearly demonstrate that the different surface formation energy and Ga local symmetry of Ga2O3 phases are responsible for the phase transition induced by the change of rGO content. The resulting Ga2O3-rGO nanocomposites show promising electrode performance for lithium ion batteries. The intermediate Li-Ga alloy phases formed during the electrochemical cycling are identified with the DFT calculations. Among the present Ga2O3-rGO nanocomposites, the material with mixed α-Ga2O3/ß-Ga2O3/γ-Ga2O3 phase can deliver the largest discharge capacity with the best cyclability and rate characteristics, highlighting the importance of the control of Ga2O3/rGO ratio in optimizing the electrode activity of the composite materials. The present study underscores the usefulness of the phase-control of nanostructured metal oxides achieved by the change of rGO content in exploring novel functional nanocomposite materials.

An Effective Way to Optimize the Functionality of Graphene-Based Nanocomposite: Use of the Colloidal Mixture of Graphene and Inorganic Nanosheets.

The best electrode performance of metal oxide-graphene nanocomposite material for lithium secondary batteries can be achieved by using the colloidal mixture of layered CoO2 and graphene nanosheets as a precursor. The intervention of layered CoO2 nanosheets in-between graphene nanosheets is fairly effective in optimizing the pore and composite structures of the Co3O4-graphene nanocomposite and also in enhancing its electrochemical activity via the depression of interaction between graphene nanosheets. The resulting CoO2 nanosheet-incorporated nanocomposites show much greater discharge capacity of ~1750 mAhg(-1) with better cyclability and rate characteristics than does CoO2-free Co3O4-graphene nanocomposite (~1100 mAhg(-1)). The huge discharge capacity of the present nanocomposite is the largest one among the reported data of cobalt oxide-graphene nanocomposite. Such a remarkable enhancement of electrode performance upon the addition of inorganic nanosheet is also observed for Mn3O4-graphene nanocomposite. The improvement of electrode performance upon the incorporation of inorganic nanosheet is attributable to an improved Li(+) ion diffusion, an enhanced mixing between metal oxide and graphene, and the prevention of electrode agglomeration. The present experimental findings underscore an efficient and universal role of the colloidal mixture of graphene and redoxable metal oxide nanosheets as a precursor for improving the electrode functionality of graphene-based nanocomposites.

A direct hybridization between isocharged nanosheets of layered metal oxide and graphene through a surface-modification assembly process.

An efficient and universal method to directly hybridize isocharged nanosheets of layered metal oxide and reduced graphene oxide (rGO) is developed on the basis of the surface modification and an electrostatically driven assembly process. On the basis of this synthetic method, the CoO2 -rGO nanocomposite can be synthesized with exfoliated CoO2 and rGO nanosheets, and transformed into CoO-CoO2 -rGO nanocomposites with excellent electrode performance for lithium-ion batteries. Also, this surface-modification assembly route is successfully applied for the synthesis of another mesoporous TiO2 -rGO nanocomposite. This result provides clear evidence for the usefulness of the present method as a universal way of hybridizing isocharged anionic nanosheets of inorganic solids and graphene.

Composition-tailored 2 D Mn(1-x)Ru(x)O(2) nanosheets and their reassembled nanocomposites: improvement of electrode performance upon Ru substitution.

Composition-tailored Mn1-x Rux O2 2 D nanosheets and their reassembled nanocomposites with mesoporous stacking structure are synthesized by a soft-chemical exfoliation reaction and the subsequent reassembling of the exfoliated nanosheets with Li(+) cations, respectively. The tailoring of the chemical compositions of the exfoliated Mn1-x Rux O2 2 D nanosheets and their lithiated nanocomposites can be achieved by adopting the Ru-substituted layered manganese oxides as host materials for exfoliation reaction. Upon the exfoliation-reassembling process, the substituted ruthenium ions remain stabilized in the layered Mn1-x Rux O2 lattice with mixed Ru(3+) /Ru(4+) oxidation state. The reassembled Li-Mn1-x Rux O2 nanocomposites show promising pseudocapacitance performance with large specific capacitances of approximately 330 F g(-1) for the second cycle and approximately 360 F g(-1) for the 500th cycle and excellent cyclability, which are superior to those of the unsubstituted Li-MnO2 homologue and many other MnO2 -based materials. Electrochemical impedance spectroscopy analysis provides strong evidence for the enhancement of the electrical conductivity of 2 D nanostructured manganese oxide upon Ru substitution, which is mainly responsible for the excellent electrode performance of Li-Mn1-x Rux O2 nanocomposites. The results underscore the powerful role of the composition-controllable metal oxide 2 D nanosheets as building blocks for exploring efficient electrode materials.