Taking a Tailored Approach to Material Design: A Mechanistic Study of the Selective Localization of Phase-Separated Graphene Microdomains

To achieve multifunctional properties using nanocomposites, selectively locating nanofillers in specific areas by tailoring a mixture of two immiscible polymers has been widely investigated. Forming a phase-separated structure from entirely miscible molecules is rarely reported, and the related mechanisms to govern the formation of assemblies from molecules have not been fully resolved. In this work, a novel method and the underlying mechanism to fabricate self-assembling, bicontinuous, biphasic structures with localized domains made up of amine-functionalized graphene nanoplatelets are presented, involving the tailoring of compositions in a liquid processable multicomponent epoxy blend. Kinetics studies were carried out to investigate the differences in reactivity of various epoxy-hardener pairs. Molecular dynamics simulations and in situ optical photothermal infrared spectroscopy measurements revealed the trajectories of different components during the early stages of polymerization, supporting the migration (phase behavior) of each component during the curing process. Confirmed by the phase structure and the correlated chemical maps down to the submicrometer level, it is believed that the bicontinuous phase separation is driven by the change of the miscibility between various building blocks forming during polymerization, leading to the formation of nanofiller domains. The proposed morphology evolution mechanism is based on combining solubility parameter calculations with kinetics studies, and preliminary experiments are performed to validate the applicability of the mechanism of selectively locating nanofillers in the phase-separated structure. This provides a simple yet sophisticated engineering model and a roadmap to a mechanism for fabricating phase-separated structures with nanofiller domains in nanocomposite films.

Solvent-derived Fluorinated Secondary Interphase for Reversible Zn-graphite Dual-ion Batteries

The irreversibility of anion intercalation-deintercalation is a fundamental issue in determining the cycling stability of a dual-ion battery (DIB). In this work, we demonstrate that using a partially fluorinated carbonate solvent can drive a beneficial fluorinated secondary interphase layer formation. Such layer facilitates reversible anion (de-)intercalation processes by impeding solvent molecule co-intercalation and the associated graphite exfoliation. The enhanced reversibility of anion transport contributes to the overall cycling stability for a Zn-graphite DIB-a high Coulombic efficiency of 98.5 % after 800 cycles, with an attractive discharge capacity of 156 mAh g-1 and a mid-point discharge voltage of ≈1.7 V (at 0.1 A g-1 ). In addition, the formed fluorinated secondary interphase suppresses the self-discharge behavior, preserving 29 times of the capacity retention rate compared to the battery with a commonly used carbonate solvent, after standing for 24 hours. This work provides a simple and effective strategy for addressing the critical challenges in graphite-based DIBs and contributes to fundamental understanding to help accelerate their practical application.

Rational Design of Solid Polymer Electrolyte Based on Ionic Liquid Monomer for Supercapacitor Applications via Molecular Dynamics Study

The safety concern arising from flammable liquid electrolytes used in batteries and supercapacitors drives technological advances in solid polymer electrolytes (SPEs) in which flammable organic solvents are absent. However, there is always a trade-off between the ionic conductivity and mechanical properties of SPEs due to the lack of interaction between the ionic liquid and polymer resin. The inadequate understanding of SPEs also limits their future exploitation and applications. Herein, we provide a complete approach to develop a new SPE, consisting of a cation (monomer), anion and hardener from ions-monomers using molecular dynamics (MD) simulations. The results show that the strong solid-liquid interactions between the SPE and graphene electrode lead to a very small gap of ∼5.5 Å between the components of SPE and electrode, resulting in a structured solid-to-liquid interface, which can potentially improve energy storage performance. The results also indicated the critical role of the mobility of free-standing anions in the SPE network to achieve high ionic conductivity for applications requiring fast charge/discharge. In addition, the formations of hardener-depleted regions and cation-anion-poor/rich regions near the uncharged/charged electrode surfaces were observed at the molecular level, providing insights for rationally designing the SPEs to overcome the boundaries for further breakthroughs in energy storage technology.

P-683 High Serum Progesterone Levels on Day of Embryo Transfer for Pregnancy Outcomes in Patients Undergoing Artificial Frozen-thawed Blastocyst Transfer; Is There a Ceiling Effect?

Study question

Is there a ceiling effect of high serum progesterone levels on day of embryo transfer for pregnancy outcomes in patients undergoing artificial frozen-thawed blastocyst transfer?

Summary answer

There is no ceiling effect of high serum progesterone levels on day of embryo transfer(>40 ng/mL)for pregnancy outcomes in patients undergoing artificial frozen-thawed blastocyst transfer.

What is known already

In recent studies, 10 ng/mL was usually used as the lower threshold value for serum progesterone (P4) level on the day of embryo transfer in patients undergoing artificial frozen-thawed blastocyst transfers and pregnancy outcomes were compared between patients with P4 levels above and below this threshold. The main reason for choosing this threshold in the studies is that it reflects the healthy corpus luteum function. Although many studies have investigated the lower threshold value, there is paucity of data on the high threshold value that can indicate the possible ceiling effect of P4 in the literature.

Study design, size, duration

This was a retrospective cohort study including 595 patients undergoing artificial frozen-thawed blastocyst transfer between 2017 to 2021. In order to eliminate the age-related bias, only patients performed euploid embryo transfer according to preimplantation genetic testing for aneuploidy from patients above aged 35 years were included.

Participants/materials, setting, methods

When we evaluated the percentiles of according to the progesterone levels,40.6 ng/ml corresponded to 90th percentile and 23.9 ng/ml corresponded to 50th percentile. Based on this finding, rounding up the numbers, we determined the progesterone levels cut-off as < 20ng/mL,n=220(37.0%);20-40ng/mL,n=312(52.4%) and ≥40ng/mL,n=63(10.6%). The main outcome measure was pregnancy outcomes as clinical pregnancy and live birth rate. We compared pregnancy outcomes according to age, BMI, blastocyst expansion, trophectoderm and inner cell mass grade and progesterone cut-off levels .

Main results and the role of chance

The median age of the patients was 31 (Range 20-46) and the mean body mass index (BMI) of the patients was 24.5±4.0 kg/m2. The overall clinical pregnancy rate and live birth rate were 61.8% (368/595) and 52.9% (315/595), respectively. Patients were subdivided into two different groups according to clinical pregnancy and live birth rate outcomes as follows; positive and negative. Age and BMI of patients were comparable between groups.

Blastocyst morphology grade as expansion, trophectoderm and inner cell mass grade are statistically significantly associated with clinical pregnancy (p<.001 for all) and progesterone level between 20-40ng/mL is associated with higher clinical pregnancy rate (p:0.043). In multivariate analysis; only blastocyst expansion and inner cell mass grade were the independently and significantly factors that are associated with clinical pregnancy rate (p:0.011, OR: 1.6, CI95%: 1.13-2.39 and p:0.007, OR: 1.65, CI95%: 1.14-2.39, respectively). Progesterone level and trophectoderm grade were not fount statistically significant (p: 0.310 and p:0.489, respectively).

In evaluation of the association between factors and live birth rate, only blastocyst expansion grade equal or over 4 and trophectoderm grade A or B were associated with statistically significant live birth rates.

Limitations, reasons for caution

The main limitations of current study were the retrospective design and the limited sample size of the ≥40 ng/mL cohort of serum progesterone levels.

Wider implications of the findings

According to this data, we speculated that if the serum P4 level is above 40 ng/mL on the day of embryo transfer in patients undergoing artificial frozen-thawed blastocyst transfer, there is no need to reduce the dose of progesterone used.

Trial registration number

N/A

New Framework for Computing a General Local Self-Diffusion Coefficient Using Statistical Mechanics

Widely applicable, modified Green-Kubo expressions for the local diffusion coefficient (D_l) are obtained using linear response theory. In contrast to past definitions in use, these expressions are statistical mechanical results. Molecular simulations of systems with anisotropic diffusion and an inhomogeneous density profile confirm the validity of the results. Diffusion coefficients determined from different expressions in terms of currents and velocity correlations agree in the limit of large systems. Furthermore, they apply to arbitrarily small local regions, making them readily applicable to nanoscale and inhomogeneous systems where knowledge of D_l is important.

A Computational Procedure for Atomistic Modelling of Polyphosphazenes towards Better Capturing Molecular-Level Structuring and Thermo-Mechanical Properties

Poly(phosphazenes)(PZ) are versatile polymers due to their tunable properties that can be tailored for specific applications. Despite extensive experimental research, not all properties are tested, and the list of PZs studied via molecular simulations is limited. Further, a general procedure to generate and test PZ systems is lacking. We present an in situ polymerization procedure developed to make, test, and tune the thermo-mechanical properties of four PZs—poly(dichlorophosphazene)(PZ-DC), poly[bis(2,2,2-trifluoroethoxy)]phosphazene (PZ-TFE), poly(2,2,2-trifluoroethoxy-5,6-diazidohexanoxy) phosphazene (PZ-Azido), and poly(2,2,2-trifluoroethoxy-5,6-dinitratohexanoxy)phosphazene (PZ-Nitrato) via molecular dynamics simulations. The predicted thermo-mechanical properties (i.e., density and glass transition temperature) agreed with experimental values when a direct comparison of PZ systems was possible. This demonstrates the reproducibility and reliability of our procedure which will help understand the behaviour of PZs at the molecular scale.

Selectively tuning ionic thermopower in all-solid-state flexible polymer composites for thermal sensing

There has been increasing interest in the emerging ionic thermoelectric materials with huge ionic thermopower. However, it's challenging to selectively tune the thermopower of all-solid-state polymer materials because the transportation of ions in all-solid-state polymers is much more complex than those of liquid-dominated gels. Herein, this work provides all-solid-state polymer materials with a wide tunable thermopower range (+20~-6 mV K-1), which is different from previously reported gels. Moreover, the mechanism of p-n conversion in all-solid-state ionic thermoelectric polymer material at the atomic scale was presented based on the analysis of Eastman entropy changes by molecular dynamics simulation, which provides a general strategy for tuning ionic thermopower and is beneficial to understand the fundamental mechanism of the p-n conversion. Furthermore, a self-powered ionic thermoelectric thermal sensor fabricated by the developed p- and n-type polymers demonstrated high sensitivity and durability, extending the application of ionic thermoelectric materials.

Thermoresponsive Supramolecular Assemblies from Dendronized Amphiphiles To Form Fluorescent Spheres with Tunable Chirality

Balance between self-association of structural units and self-repulsion from crowding-induced steric hindrance accounts for the supramolecular assembly of the amphiphilic entities to form ordered structures, and solvation provides a toolbox to conveniently modulate the assemblies through differential interactions to various structural units. Here we report solvation-modulated supramolecular chiral assembly in aqueous solutions of amphiphilic dendronized tetraphenylethylenes (TPEs) with three-folded dendritic oligoethylene glycols (OEGs) through dipeptide Ala-Gly linkage. These dendronized amphiphiles can form supramolecular spheres with enhanced supramolecular chirality, which is tunable and dependent on solvation. These nanosized spherical aggregates exhibit thermoresponsive behavior, and their cloud point temperatures are dependent on mixed solvent of water and THF. The phase transition temperatures increase with water fractions due to water-driven shifting of OEG moieties from interiors of the aggregates to their peripheries. Furthermore, the thermally induced dehydration and collapse of OEG moieties mediate the reversible aggregation and deaggregation between the spheres, imparting tunable aggregation-induced fluorescent emission (AIE) and supramolecular chirality. Both experimental results and molecular dynamic simulations have highlighted that reversible chirality transformations of the amphiphilic dendronized assemblies mediated by solvation through change solvent quality or thermally dehydration are dependent on the balance between interactions of OEG dendrons with TPE moieties and with the solvent molecules.

Dendronized polydiacetylenes via photo-polymerization of supramolecular assemblies showing thermally tunable chirality

Transformation of supramolecular chiral assemblies into covalent polymers integrates characteristics of supramolecular chemistry together with covalent entities, leading to fabrication of covalent chiral materials through versatile supramolecular chiral assemblies. Here, we report supramolecular assembly of an amphiphilic dendronized 10,12-pentacosadiynoic amide (PCDA) in aqueous solutions to form twisted ribbons, which were transferred into covalent dendronized polydiacetylenes (PDAs) via photopolymerization. These supramolecular dendronized PCDA and the corresponding covalent dendronized PDAs showed unprecedent thermoresponsive properties. The thermally-induced dehydration and aggregations tuned reversibly their chiralities, which can be visually inspected through colour changes.

Efficacy of pulse steroid therapy in patients critically ill with COVID-19

OBJECTIVES

The aim of this study was to determine the efficacy of pulse steroid therapy administered to patients critically ill with COVID-19 progressing into severe pneumonia.

METHODS

A total of 600 patients included in this retrospective study were divided into three groups. Group 1 (control group): 200 patients who did not receive steroid treatment, Group 2: 200 patients who received dexamethasone 1x8 milligram (mg) or methylprednisolone 1x80 mg, Group 3: (pulse steroid therapy group): 200 patients who received 1 g methylprednisolone followed by 1x80 mg methylprednisolone. Demographic and laboratory data were recorded.

RESULTS

Mortality rates in groups 1, 2 and 3 were 77 %, 53.55 %, and 58.5 %, respectively. The ratios of intubated patients in groups 1, 2 and 3 were 70 %, 45.5 % and 56 %, respectively. The numbers of patients whose D‑dimer values were above 2,250 ng/mL (cut-off value for D-dimer in this study) in groups 2, 1 and 3 were 65, 107, and 105, respectively.

CONCLUSION

Pulse steroid therapy does not shorten the duration of hospital stay, does not reduce the need for intubation and increases the risk of thrombosis by significantly increasing the level of D-dimer among patients critically and severely ill with COVID-19 (Tab. 4, Fig. 3, Ref. 20) Keywords: COVID-19, pulse steroid therapy, thrombosis, d-dimer, corticosteroid.

P–411 Does subcutaneous progesterone (SC-P) administration eliminate the necessity of serum progesterone level monitoring in frozen embryo transfer (FET) cycles?

Study question

Does SC-P provide similar ongoing pregnancy rates (OPRs) as intramuscular progesterone(IM-P) in hormone replacement therapy (HRT)-FET cycles and do serum progesterone (P) levels on FET day effect on pregnancy outcome? Summary answer: SC-P administration had similar OPR compared to IM-P in HRT-FET cycles. In SC-P group embryo transfer(ET) day P found to be insignificant factor for outcome.

What is known already

Different P routes can be used in HRT-FET cycles such as vaginal P, IM-P and recently SC-P. Only retrospective studies evaluated the comparison of SC-P with other routes in HRT-FET cycles. Here, we assessed prospectively whether SC-P is effective for HRT-FET cycles. Previous studies reported that serum P levels on ET day after vaginal P administration clinical outcomes were closely correlated. The correlation between serum P after IM-P administration and clinical outcomes were conflicting. In addition, there is lack of data on the serum P levels after SC-P administration. Serum P levels on ET day were evaluated in this study.

Study design, size, duration

This prospective cohort study was performed between July 1-October 31 2020, enrolled 224 patients scheduled for HRT-FET cycles with SC-P(25 mg twice daily) or IM-P(50 mg once daily). The route of P was decided according to the patient’s eligibility to hospital. First FET cycle was included after freeze-all cycles for each patients. Female age>35, PGT-A cycles, cleavage ET, >1 ET, patients with uterine pathology and hydrosalpinx, FET with surplus embryos, endometrial thickness<7mm were excluded.

Participants/materials, setting, methods

Female age ≤ 35 years old with a triple-layer endometrium >7 mm underwent transfer of single blastocysts after the first ET after freeze-all cycles. The indications for freeze-all were ovarian hyperstimuation syndrome and trigger day P level>1.5 ng/ml. 224 patients were eligible for study; 133 in SC-P group and 91 in IM-P group.The primary endpoint was the ongoing pregnancy rate (OPR) beyond pregnancy week 12.

Main results and the role of chance

The demographic, cycle, embryologic characteristics were similar between groups. The median circulating P levels on the day of ET were 19.92(15.195–27.255)ng/
ml and 21(16.48–28)ng/ml in the SC-P and IM-P groups,(p = 0.786). The clinical pregnancy rates [86/133(64.7%) vs 57/91(62.6%);p=0.757], miscarriage rates [21/86(24.4%) vs 10/57(17.5%) ;p=0.329], and OPR [65/133 (48.9%) vs 47/91(51.6%); p = 0.683] were comparable between the SC-P and IM-P. Binary logistic regression was performed for ongoing pregnancy as the dependent factor blastocyst morphology was found to be the only significant independent prognostic factor (p = 0.006), whereas the route of P was insignificant. In the SC-P and IM-P 
groups, the effect of ET day P levels were divided into quartiles(Q) to evaluate the effect on ongoing pregnancy. In SC-P group OPR were similar in four Q [Q1:33.3%(11/33),Q2:50%(17/34),Q3:60.6%(20/33),Q4:51.5%(17/33) (p = 0.1)].For IM-P group; Q1 had a significantly reduced OPR than Q2, Q3, Q4. [26.1%(6/23),65.2%(15/23),54.5%(12/22) and 60.9%(14/23), p = 0.031]. Logistic regression analysis for OP was performed separately in SC-P group and IM-P group. Although in SC-P group, ET day P levels was not found to be a significant factor, in IM-P ET day P level was found to be an independent factor for OP in IM-P group (Q1vs Q2+Q3+Q4; OR: 8,178 95% CI: [1.387–48.223] p:0.02).

.

Limitations, reasons for caution

Although this study has the advantage of being prospective and in a homogenous study population, randomized controlled trials are warranted to evaluate the effectiveness of SC-P to other routes of P. Extrapolation to unselected populations of this study is needed.

Wider implications of the findings: Assignment of threshold of serum P on the day of ET for HRT-FET cycles to optimize outcomes is critical for every route of P. Regarding these results, individual luteal phase for HRT-FET cycles can improve IVF outcome.

Trial registration number

None

Assessment of nail findings in children with atopic dermatitis

BACKGROUND

Cutaneous findings are well known in atopic dermatitis (AD), but nail changes have not received as much attention.

AIM

To determine the clinical and disease-related capillaroscopic findings of nail findings in paediatric patients with AD.

METHODS

In total, 100 participants aged 2-16 years were sourced from the dermatology outpatient clinic: 50 of these had been diagnosed with AD according to the Hanifin-Rajka criteria, and the others were 50 healthy controls (HCs) without AD. The AD severity score (SCORing Atopic Dermatitis; SCORAD) was calculated for all patients with AD. A digital epiluminescence device was used for nailfold capillaroscopy.

RESULTS

The nail findings detected in patients with AD were pitting, punctate leuconychia, trachyonychia, onycholysis and onychomadesis. Pitting was significantly (P < 0.01) more frequent in the patient group (26%) than in the HC group (6%). Similarly, the patient group had significantly higher rates for capillary density decrease (P < 0.01), capillary array irregularity (P < 0.001), capillary dilatation increase (P < 0.001), tortuosity (P = 0.04), ramification increase (P = 0.02), bush-like appearance (P = 0.02) and avascular areas (P < 0.01). Significant correlations were determined between pitting and trachyonychia (P < 0.05, r = 0.21), capillary density decrease (P < 0.05, r = 0.25), avascular areas (P < 0.001; r = 0.29) and SCORAD (P < 0.05, r = 0.35).

CONCLUSION

The nailfold capillaroscopic images of children with AD were similar to those of scleroderma spectrum disorder. Thus, we believe it would be beneficial to support detailed clinical examination of patients with a capillaroscopic examination.

Molecular-Level Investigation of Cycloaliphatic Epoxidised Ionic Liquids as a New Generation of Monomers for Versatile Poly(Ionic Liquids)

Recently, a new generation of polymerised ionic liquids with high thermal stability and good mechanical performances has been designed through novel and versatile cycloaliphatic epoxy-functionalised ionic liquids (CEILs). From these first promising results and unexplored chemical structures in terms of final properties of the PILs, a computational approach based on molecular dynamics simulations has been developed to generate polymer models and predict the thermo–mechanical properties (e.g., glass transition temperature and Young’s modulus) of experimentally investigated CEILs for producing multi-functional polymer materials. Here, a completely reproducible and reliable computational protocol is provided to design, test and tune poly(ionic liquids) based on epoxidised ionic liquid monomers for future multi-functional thermoset polymers.

Efficacy of balloon Eustachian tuboplasty as a first line treatment for otitis media with effusion in children

OBJECTIVE

This study aimed to compare the outcomes of ventilation tube insertion and balloon Eustachian tuboplasty as a first line treatment for otitis media with effusion in children.

METHOD

This was a retrospective evaluation of 62 children, 30 cases that underwent balloon Eustachian tuboplasty (group 1) and 32 cases that underwent ventilation tube insertion (group 2), from July 2016 to April 2018.

RESULTS

The pre-operative air-bone gap of patients who underwent balloon Eustachian tuboplasty was 15-35 dB (mean: 27.6 ± 8.2 dB). The mean pre-operative air-bone gap decreased to 9.6 dB after a mean of 14.4 months (p < 0.05). The air-bone gap decreased from 25.6 dB to 17.6 dB in the ventilation tube group. There was a significant improvement in the air-bone gap values in both groups; however, this decrease was significantly higher in the balloon Eustachian tuboplasty group (p = 0.043).

CONCLUSION

Balloon Eustachian tuboplasty may be an effective and safe method for use as a first-line treatment of otitis media with effusion in children.

Posterior Reversible Encephalopathy Syndrome in a Five-Year-Old Child: A Case Report

Posterior reversible encephalopathy syndrome (PRES) is a neuroradiologic syndrome. The etiology of PRES is still unclear. Some factors were described. We present a case of a pediatric patient with liver transplant who developed PRES following blood transfusion while receiving tacrolimus therapy. A 5½-year-old boy who underwent living donor liver transplantation, and PRES developed on the sixth day post transplant under tacrolimus treatment after 6 hours of red blood transfusion. PRES is a rare condition; it should be kept in mind about patients who have received organ transplants and develop sudden neurologic symptoms.

Deformity correction with total knee arthroplasty for severe knee osteoarthritis accompanying extra-articular femoral deformity: the results are promising

PURPOSE

This study aimed to evaluate patients with severe degenerative osteoarthritis of the knee and extra-articular femoral deformities treated with total knee arthroplasty (TKA) and acute deformity correction.

METHODS

Ten patients with severe degenerative osteoarthritis of the knee and extra-articular femoral deformities were included, and the median age was 63 years (range 38-67). The etiology was post-traumatic malunion in four patients, rickets sequelae in four patients, and surgical sequelae due to multiple epiphyseal dysplasia in two patients. The severity of degenerative osteoarthritis and deformity analyses were assessed according to the Kellgren-Lawrence and Paley criteria, respectively. The median number of previous operations the patients had undergone was two (range 0-3), and the median Oxford Knee Society score was 9 (range 5-13) before treatment. All patients were treated with primary TKA and deformity correction in the same surgery. The TKA was completed first, followed by an osteotomy at the apex of the deformity. Finally, a retrograde intramedullary nail was inserted.

RESULTS

The median follow-up period was 44 (31-60) months. A stable and functional knee joint, a physiological mechanical axis, and solid osseous union were achieved in all patients. Late prosthetic failure was seen in one patient due to deep infection. The median Oxford Knee Society score was 42 (range 37-47) at the final follow-up.

CONCLUSIONS

Combining several procedures in single setting for the treatment of severe knee osteoarthritis accompanied by extra-articular deformity may eliminate the need for multiple surgeries. Furthermore, a proper physiological mechanical axis can be obtained without causing substantial bone loss.

LEVEL OF EVIDENCE

IV.

Elliptic Fourier based analysis and multivariate approaches for size and shape distinctions of walnut (

Size and shape data of agricultural crops provide great sources for food processing technologies. The physical attributes of different fruits should be known for the design, developing and innovation of food technologies. In this study, the size and shape distinctions of fifteen national and international walnut cultivars (Midland, Sütyemez-1, Serr, Maraş-18, Maraş-12, Sütyemez-2, Kaman-1, Kaman-5, Pedro, Howard, Chandler, Şebin, Şen-2, Bilecik and KR-1) were determined using elliptic Fourier and multivariate approaches. Firstly, the gravitational features of walnut cultivars were determined, and their dimensional, area and shape attributes were revealed by image processing. Cluster analysis was used to designate the walnut cultivars. Elliptic Fourier descriptors obtained from walnut outlines provided the comparisons among walnut cultivars in shape. The shape index indicated that Serr, Sütyemez-2, Midland and Şen-2 cultivars were oval-shaped, and the others were spherical. The cluster analysis divided the walnut cultivars into four subgroups. Elliptic Fourier descriptors perfectly distinguished the walnut cultivars according to shape.