Bio-Inspired Dynamically Morphing Microelectronics toward High-Density Energy Applications and Intelligent Biomedical Implants.

Choreographing the adaptive shapes of patterned surfaces to exhibit designable mechanical interactions with their environment remains an intricate challenge. Here, a novel category of strain-engineered dynamic-shape materials, empowering diverse multi-dimensional shape modulations that are combined to form fine-grained adaptive microarchitectures is introduced. Using micro-origami tessellation technology, heterogeneous materials are provided with strategic creases featuring stimuli-responsive micro-hinges that morph precisely upon chemical and electrical cues. Freestanding multifaceted foldable packages, auxetic mesosurfaces, and morphable cages are three of the forms demonstrated herein of these complex 4-dimensional (4D) metamaterials. These systems are integrated in dual proof-of-concept bioelectronic demonstrations: a soft foldable supercapacitor enhancing its power density (≈108 mW cm-2 ), and a bio-adaptive device with a dynamic shape that may enable novel smart-implant technologies. This work demonstrates that intelligent material systems are now ready to support ultra-flexible 4D microelectronics, which can impart autonomy to devices culminating in the tangible realization of microelectronic morphogenesis.

Impact of Planar and Vertical Organic Field-Effect Transistors on Flexible Electronics.

The development of flexible and conformable devices, whose performance can be maintained while being continuously deformed, provides a significant step toward the realization of next-generation wearable and e-textile applications. Organic field-effect transistors (OFETs) are particularly interesting for flexible and lightweight products, because of their low-temperature solution processability, and the mechanical flexibility of organic materials that endows OFETs the natural compatibility with plastic and biodegradable substrates. Here, an in-depth review of two competing flexible OFET technologies, planar and vertical OFETs (POFETs and VOFETs, respectively) is provided. The electrical, mechanical, and physical properties of POFETs and VOFETs are critically discussed, with a focus on four pivotal applications (integrated logic circuits, light-emitting devices, memories, and sensors). It is pointed out that the flexible function of the relatively newer VOFET technology, along with its perspective on advancing the applicability of flexible POFETs, has not been reviewed so far, and the direct comparison regarding the performance of POFET- and VOFET-based flexible applications is most likely absent. With discussions spanning printed and wearable electronics, materials science, biotechnology, and environmental monitoring, this contribution is a clear stimulus to researchers working in these fields to engage toward the plentiful possibilities that POFETs and VOFETs offer to flexible electronics.

Wearing duration of respiratory protectors for COVID-19 in slaughterhouses.

The work in the production of animal protein in slaughterhouses involves the exposure to several occupational risk factors. At present, it has been recently associated with the pandemic context related to the biological agent severe acute respiratory syndrome coronavirus (SARS-CoV-2). The slaughterhouse sector has been shown to be a critical focus of concentration and spread of cases in Brazil and worldwide. Among the strategies adopted for worker's protection, there is a clear need for collective protection, supplemented by individual protection. With regard to SARS-CoV-2 and to the risk for coronavirus disease (COVID-19), respiratory protection is essential and well-established by the competent agencies and by the scientific community, since the respiratory route is considered the route of transmission and of risk of contagion. The aim of this review was to analyze the indication of use with regard to the frequency for changing respiratory protectors when working at slaughterhouses. The study involved a literature review, conducted on databases available on the internet. The search considered journal articles, dissertations, and theses published in Portuguese and English on scientific data bases from 2006 to 2020. Based on this review, it was possible to show that, in slaughterhouses, especially due to temperature and humidity conditions, facial respirator masks should be discarded after each work shift.

Reorganization Energy upon Controlled Intermolecular Charge-Transfer Reactions in Monolithically Integrated Nanodevices.

Intermolecular electron-transfer reactions are key processes in physics, chemistry, and biology. The electron-transfer rates depend primarily on the system reorganization energy, that is, the energetic cost to rearrange each reactant and its surrounding environment when a charge is transferred. Despite the evident impact of electron-transfer reactions on charge-carrier hopping, well-controlled electronic transport measurements using monolithically integrated electrochemical devices have not successfully measured the reorganization energies to this date. Here, it is shown that self-rolling nanomembrane devices with strain-engineered mechanical properties, on-a-chip monolithic integration, and multi-environment operation features can overcome this challenge. The ongoing advances in nanomembrane-origami technology allow to manufacture the nCap, a nanocapacitor platform, to perform molecular-level charge transport characterization. Thereby, employing nCap, the copper-phthalocyanine (CuPc) reorganization energy is probed, ≈0.93 eV, from temperature-dependent measurements of CuPc nanometer-thick films. Supporting the experimental findings, density functional theory calculations provide the atomistic picture of the measured CuPc charge-transfer reaction. The experimental strategy demonstrated here is a consistent route towards determining the reorganization energy of a system formed by molecules monolithically integrated into electrochemical nanodevices.

Ultrahigh-Gain Organic Electrochemical Transistor Chemosensors Based on Self-Curled Nanomembranes.

Organic electrochemical transistors (OECTs) are technologically relevant devices presenting high susceptibility to physical stimulus, chemical functionalization, and shape changes-jointly to versatility and low production costs. The OECT capability of liquid-gating addresses both electrochemical sensing and signal amplification within a single integrated device unit. However, given the organic semiconductor time-consuming doping process and their usual low field-effect mobility, OECTs are frequently considered low-end category devices. Toward high-performance OECTs, microtubular electrochemical devices based on strain-engineering are presented here by taking advantage of the exclusive shape features of self-curled nanomembranes. Such novel OECTs outperform the state-of-the-art organic liquid-gated transistors, reaching lower operating voltage, improved ion doping, and a signal amplification with a >104  intrinsic gain. The multipurpose OECT concept is validated with different electrolytes and distinct nanometer-thick molecular films, namely, phthalocyanine and thiophene derivatives. The OECTs are also applied as transducers to detect a biomarker related to neurological diseases, the neurotransmitter dopamine. The self-curled OECTs update the premises of electrochemical energy conversion in liquid-gated transistors, yielding a substantial performance improvement and new chemical sensing capabilities within picoliter sampling volumes.

Síndrome hipoglucémico asociado a tumor solitario pulmonar. Reporte de caso / Severe hypoglycemia associated with solitary pulmonary tumor. Case report

El síndrome paraneoplásico de Doege-Potter (SDP) se asocia a la presencia de tumores intratorácicos y diafragmáticos que generan un cuadro de hipoglucemia por excesivo consumo de glucosa por parte del tumor, y aumento de producción de IGF-2 (insulin growth factor 2) con mayor captación de glucosa periférica. Comunicamos el caso de una paciente femenina de 57 años, sin antecedentes de diabetes ni ingestión de fármacos hipoglucemiantes, que ingresó por un cuadro de hipoglucemia severa con glucemia de 38 mg/dL. Otros resultados: péptido C 1,05 ng/mL, insulinemia 10,5 uUI/mL, IGF-1 de 174 ng/mL, cortisol y prolactina normales. No disponíamos del dosaje de IGF-2. Ecografía abdominal sin patología evidente. Se inició alimentación rica en carbohidratos complejos. Continuó con hipoglucemias. A raíz de cervicalgia, se solicitó radiografía cervical y de tórax, evidenciándose opacidad en vértice izquierdo. La tomografía de tórax informó proceso pulmonar atípico. Por punción se diagnosticó carcinoma pulmonar pobremente diferenciado. Se inició quimioterapia, con reducción del tumor, y de la frecuencia y magnitud de las hipoglucemias. Concluimos que frente a cuadros de hipoglucemia en ausencia de factores causales debería sospecharse la presencia de un SD

Doege-Potter (SDP) is a paraneoplastic syndrome mostly associated with big intrathoracic or diaphragmatic tumors, causing hypoglycemia in non-diabetic patient due to an increased glucose consumption by the tumor cells and excessive production of IGF-2 (insulin growth factor 2). Case report: 57-year-old female patient without diabetes mellitus and not receiving hypoglycemic drugs who was assisted by severe hypoglycemia (38 mg/dL) with the following laboratory tests: C peptide 1.05 ng/mL, 10.5 uIU/mL insulinemia, 174 ng/mL IGF-1, normal cortisol and prolactin. IGF-2 was not available. Non-pathological abdominal ultrasound. In spite of a feeding rich in complex carbohydrate continued with hypoglycaemia. She started with neck pain and a cervical and chest X-ray was requested, which shows opacity in the left vertex. Chest tomography reported atypical lung process. The biopsy reported poorly differentiated carcinoma of the lung. After treatment with chemotherapy a reduction in tumor size and less episodes of hypoglycemia were observed. Conclusion: in the event of recurrent hypoglycaemia and in the absence of known etiologies we should consider the presence of SDP

Reporte de caso. Abdomen agudo nutricional en el adulto mayor: apendagitis epiploica / Case report. Acute nutritional abdomen in the elderly: epiloic appendagitis

Se presentó un paciente de sexo masculino de 71 años de edad que consultó por un cuadro compatible con abdomen agudo médico de comienzo brusco. Refirió antecedentes de diabetes mellitus tipo 2, obesidad, dislipemia e hipertensión arterial. Al examen físico se encontró: afebril, presión arterial (PA) 128/75 mmHg; a la palpación del abdomen se halló un abdomen globoso, blando, depresible, doloroso en ambas fosas iliacas, signo de Mc Burney negativo, sin signos de re-acción peritoneal, catarsis y diuresis conservadas. Se solicitó una tomografía computada (TC) abdominal con con-traste oral y endovenoso (EV). La TC informó, a nivel del sigma sobre el borde antimesentérico, una imagen nodular de densi-dad grasa con halo hiperintenso y alteración tomodensitometría de la grasa adyacente, además de imágenes diverticulares no complicadas. Con el cuadro clínico del paciente y los hallazgos tomográficos se arribó al diagnóstico de apendagitis epiploica. Se inició tratamiento conservador con abordaje nutricional.

Interacciones relevantes del jugo de pomelo con fármacos. Revisión bibliográfica y soporte para conductas clínicas / Relevant grapefruit juice interactions with drugs. Literature review and support for clinical behaviours

Las interacciones fármaco-nutriente (F-N) tienen el potencial de alterar significativamente la eficacia y seguridad de las terapias farmacológicas. Esta revisión se enfoca en las interacciones del jugo de pomelo con fármacos selectos. Los mecanismos involucrados incluyen la inhibición del sistema metabolizador microsomal CYP3A y del transportador glicoproteína P en el enterocito. El conocimiento y la evitación de estas interacciones clínicamente relevantes aumentarán la seguridad del paciente

Interactions between drugs and nutrients (F-N) have the potential to significantly alter the efficacy and safety of pharmacological therapies. This review focuses on the interactions between grapefruit juice and selected drugs. Involved mechanisms include the inhibition of both CYP 3A4 microsomal metabolizing enzymes and P glycoprotein transporter within the enterocyte. Knowledge (and avoidance) of this clinically relevant interactions will enhance patient safety

Detección de neuropatía autonómica cardíaca con maniobras de baja complejidad en atención ambulatoria / Detection of cardiac autonimic neuropathy with low complexity tests in outpatient-care

Introducción: la neuropatía autonómica cardíaca (NAC) es una de las complicaciones más seria y menos estudiada de la diabetes. La alteración en la variabilidad de la frecuencia cardíaca es el indicador más precoz de NAC. Actualmente el diagnóstico se realiza con las maniobras de Ewing. No todos los centros del país cuentan con los profesionales capacitados y/o el equipo necesario. Objetivo: detectar NAC con maniobras de baja complejidad y comparar resultados con las pruebas de Ewing. Materiales y métodos: estudio observacional y transversal. Se evaluaron 24 pacientes de la Unidad de Nutrición del Hospital Carlos G. Durand entre el 1 de junio y el 30 de noviembre del 2011. Se realizaron los test de Ewing, se efectuó la medición de FC y TA en tres posiciones, y se midió el QTc. Resultados: la media de la edad de la muestra poblacional fue de 56,54 años (47-72), y 15 eran mujeres (62,5%). En las variables de TA y QTc, se hallaron valores dentro de lo normal. En 20 pacientes (83,3%), los valores de FC se encontraron fuera de la normalidad, con un valor predictivo positivo del 80% (VPP) y un valor predictivo negativo del 25% (VPN), con una sensibilidad del 84% (S) y una especificidad del 20% (E). Los resultados de las pruebas de Ewing fueron patológicos en 19 pacientes (S 93%). Conclusión: las maniobras de baja complejidad como la falta de variedad en la frecuencia cardíaca (FVFC), no suplantan al gold estándar pero aportan un elemento de alta sospecha clínica.

Detección de neuropatía autonómica cardíaca con maniobras de baja complejidad en atención ambulatoria / Detection of cardiac autonimic neuropathy with low complexity tests in outpatient-care

Introducción: la neuropatía autonómica cardíaca (NAC) es una de las complicaciones más seria y menos estudiada de la diabetes. La alteración en la variabilidad de la frecuencia cardíaca es el indicador más precoz de NAC. Actualmente el diagnóstico se realiza con las maniobras de Ewing. No todos los centros del país cuentan con los profesionales capacitados y/o el equipo necesario. Objetivo: detectar NAC con maniobras de baja complejidad y comparar resultados con las pruebas de Ewing. Materiales y métodos: estudio observacional y transversal. Se evaluaron 24 pacientes de la Unidad de Nutrición del Hospital Carlos G. Durand entre el 1 de junio y el 30 de noviembre del 2011. Se realizaron los test de Ewing, se efectuó la medición de FC y TA en tres posiciones, y se midió el QTc. Resultados: la media de la edad de la muestra poblacional fue de 56,54 años (47-72), y 15 eran mujeres (62,5%). En las variables de TA y QTc, se hallaron valores dentro de lo normal. En 20 pacientes (83,3%), los valores de FC se encontraron fuera de la normalidad, con un valor predictivo positivo del 80% (VPP) y un valor predictivo negativo del 25% (VPN), con una sensibilidad del 84% (S) y una especificidad del 20% (E). Los resultados de las pruebas de Ewing fueron patológicos en 19 pacientes (S 93%). Conclusión: las maniobras de baja complejidad como la falta de variedad en la frecuencia cardíaca (FVFC), no suplantan al gold estándar pero aportan un elemento de alta sospecha clínica.(AU)

Tumores adrenocorticais na criança: da abordagem clínica à avaliação molecular / Childhood adrenocortical tumors: from a clinical to a molecular approach

Tumores do córtex adrenal (TCA) são mais frequentes em crianças, mas podem ocorrer em qualquer faixa etária. São classificados como funcionantes, não funcionantes (predominam no adulto), e mistos. O diagnóstico é baseado na avaliação clínica, hormonal e exames de imagem. Em crianças, o método de escolha para diferenciar entre benigno ou maligno é a classificação baseada no estadiamento do tumor. Alguns marcadores moleculares merecem destaque: além de mutações inativadoras no gene supressor tumoral TP53, há evidências de envolvimento do IGF2 em 90 por cento de TAC malignos, e mutações no éxon 3 do gene CTNNB1 foram encontradas em 6 por cento dos TAC pediátricos. Além disso, microRNAs podem atuar como reguladores negativos da expressão gênica e participar da tumorigênese adrenocortical. Métodos para análise da expressão gênica permitem identificar TCA com prognóstico bom ou ruim, e espera-se que esses estudos possam facilitar o desenvolvimento de drogas para tratar pacientes de acordo com as vias de sinalização específicas que estiverem alteradas.

Adrenocortical tumors (ACT) are more frequent during childhood, but they can appear at any age. ACTs can be classified in functioning, nonfunctioning (mainly observed in adults) and mixed. The diagnosis is based on clinical, biochemical findings and imaging. In children, in order to classify ACT as benign or malignant, tumor staging classification is recommended. Regarding molecular markers some studies should be taken into account: besides TP53 mutations, previous studies have also provided evidences of IGF2 involvement in 90 percent of the malignant ACT. Mutations altering exon 3 of CTNNB1 gene have been found in 6 percent of childhood ACTs. In addition, microRNAs can act as negative regulators of gene expression by targeting mRNA controlling cell growth, differentiation and apoptosis and have been implicated in adrenal tumorigenesis. High-throughput methods to analyze genome-wide expression have been developed over the last decade and identified a subset of tumors with good or poor prognosis. In the future, these studies can provide the basis of specific drug development, which can treat patients according to specific altered signaling pathway.

[Childhood adrenocortical tumors: from a clinical to a molecular approach]. / Tumores adrenocorticais na criança: da abordagem clínica à avaliação molecular.

Adrenocortical tumors (ACT) are more frequent during childhood, but they can appear at any age. ACTs can be classified in functioning, nonfunctioning (mainly observed in adults) and mixed. The diagnosis is based on clinical, biochemical findings and imaging. In children, in order to classify ACT as benign or malignant, tumor staging classification is recommended. Regarding molecular markers some studies should be taken into account: besides TP53 mutations, previous studies have also provided evidences of IGF2 involvement in 90% of the malignant ACT. Mutations altering exon 3 of CTNNB1 gene have been found in 6% of childhood ACTs. In addition, microRNAs can act as negative regulators of gene expression by targeting mRNA controlling cell growth, differentiation and apoptosis and have been implicated in adrenal tumorigenesis. High-throughput methods to analyze genome-wide expression have been developed over the last decade and identified a subset of tumors with good or poor prognosis. In the future, these studies can provide the basis of specific drug development, which can treat patients according to specific altered signaling pathway.