Boosting output performance of sliding mode triboelectric nanogenerator by charge space-accumulation effect

The sliding mode triboelectric nanogenerator (S-TENG) is an effective technology for in-plane low-frequency mechanical energy harvesting. However, as surface modification of tribo-materials and charge excitation strategies are not well applicable for this mode, output performance promotion of S-TENG has no breakthrough recently. Herein, we propose a new strategy by designing shielding layer and alternative blank-tribo-area enabled charge space-accumulation (CSA) for enormously improving the charge density of S-TENG. It is found that the shielding layer prevents the air breakdown on the interface of tribo-layers effectively and the blank-tribo-area with charge dissipation on its surface of tribo-material promotes charge accumulation. The charge space-accumulation mechanism is analyzed theoretically and verified by experiments. The charge density of CSA-S-TENG achieves a 2.3 fold enhancement (1.63 mC m-2) of normal S-TENG in ambient conditions. This work provides a deep understanding of the working mechanism of S-TENG and an effective strategy for promoting its output performance.

The Evaluation and Prediction of Laminoplasty Surgery Outcome in Patients with Degenerative Cervical Myelopathy Using Diffusion Tensor MRI

BACKGROUND AND PURPOSE

DTI has been proved valuable for the diagnosis of degenerative cervical myelopathy, whereas its capacity for predicting the outcome of surgery is still under debate. Here we conduct a prospective cohort study to analyze the capacity of DTI for evaluating and predicting laminoplasty surgery outcome for degenerative cervical myelopathy.

MATERIALS AND METHODS

We recruited 55 patients with degenerative cervical myelopathy who underwent DTI before surgery and at 3- and 6-month follow-up stages, and 20 healthy subjects. For clinical assessment, the modified Japanese Orthopedic Association scale was recorded for each patient at different stages. DTI metrics were compared between patients before surgery and healthy subjects. Spearman correlation and receiver operating characteristic were used to analyze the evaluation and prediction capacity of DTI for the modified Japanese Orthopedic Association scale, respectively. We analyzed different vertebral levels: maximal compression level, average of all compression levels, and C2 level.

RESULTS

DTI metrics were significantly different between patients before surgery and healthy subjects. Before surgery, DTI for the maximal compression level or DTI for the average of all compression levels had no significant correlation with the modified Japanese Orthopedic Association scale. For all stages, DTI at the C2 level was correlated with the modified Japanese Orthopedic Association scale. DTI metrics at the C2 level before surgery were significantly correlated with the postoperative modified Japanese Orthopedic Association scale recovery rate. Receiver operating characteristic analysis demonstrated that fractional anisotropy at C2 was capable of predicting the postoperative modified Japanese Orthopedic Association scale recovery rate (P = .04).

CONCLUSIONS

The DTI metrics before laminoplasty surgery, especially fractional anisotropy at the C2 level, have the potential for evaluating and predicting the degenerative cervical myelopathy surgery outcome.

Correlation of lipid peroxidation and ATP enzyme on erythrocyte membrane with fetal distress in the uterus in patients with intrahepatic cholestasis of pregnancy

OBJECTIVE

This paper aims to investigate the correlation of lipid peroxide in erythrocytes and ATP (Adenosine Triphosphate) enzyme activity of erythrocyte membrane with fetal distress in patients with intrahepatic cholestasis of pregnancy (ICP).

PATIENTS AND METHODS

Forty-three patients with ICP treated at Jining No. 1 People's Hospital were enrolled as a study group, and another forty healthy parturient women in the same period were enrolled as a control group, to extract their elbow venous blood and fetal umbilical cord blood. Thiobarbituric acid (TBA) was used to detect superoxide dismutase (SOD) activity of erythrocytes, malondialdehyde (MDA) activity in plasma, Na+-K+-ATP enzyme activity and Ca2+-Mg2+-ATP enzyme activity of erythrocytes, which were compared between the study and control groups. The correlation of MDA, Na+-K+-ATP enzyme and Ca2+-Mg2+-ATP enzyme activities with fetal distress in the study group was analyzed, and the correlation of MDA with Na+-K+-ATP enzyme activity was investigated.

RESULTS

SOD and MDA activities of erythrocytes in maternal blood of the study group were significantly higher than those in the control group (p<0.05, p<0.001, respectively), but MDA activity in umbilical cord blood of the study group was markedly higher than that in the control group (p<0.001). Na+-K+-ATP enzyme and Ca2+-Mg2+-ATP enzyme activities of maternal and fetal erythrocytes of the study group were remarkably lower than those of the control group (p<0.001). MDA in the fetal distress group was significantly higher than that in the no fetal distress group in the study group (p<0.001). Na+-K+-ATP enzyme activity was negatively correlated with MDA concentration in maternal and fetal erythrocytes of patients with ICP (both p<0.001).

CONCLUSIONS

Lipid peroxidation in patients with ICP will affect ATP enzyme activity of erythrocyte membrane, and the down-regulation of ATP enzyme activity in umbilical cord blood of patients with ICP may cause fetal distress in the uterus.

Ternary Electrification Layered Architecture for High-Performance Triboelectric Nanogenerators

The triboelectric nanogenerator (TENG) has been proved to be a green and efficient energy harnessing technology for electricity generation from ambient mechanical motions based on its ability to leverage the triboelectrification process. Enhancing TENG output performance through rational structural design still triggers increasing research interest. Here, we report a ternary electrification layered architecture beyond the current binary TENG systems, with improved performance for mechanical energy harvesting. Introducing a ternary Kapton layer into the traditional binary electrification layered architecture of TENGs consisting of copper and fluorinated ethylene propylene, yields a 2.5 times enhancement of peak power output, representing a 6.29-fold increase compared to the TENG composed of copper and Kapton. A wide-range of material configurations were systematically tested using this ternary electrification layered architecture to prove its practical effectiveness. The ternary electrification layered architecture invented in this work provides an alternative strategy to enhance TENG output performance, which represents a solid step for TENGs application in high-performance mechanical energy harvesting.

Obesity and Cancer Treatment Outcomes: Interpreting the Complex Evidence

A wealth of epidemiological evidence, combined with plausible biological mechanisms, present a convincing argument for a causal relationship between excess adiposity, commonly approximated as body mass index (BMI, kg/m²), and incident cancer risk. Beyond this relationship, there are a number of challenges posed in the context of interpreting whether being overweight (BMI 25.0-29.9 kg/m²) or obese (BMI ≥ 30.0 kg/m²) adversely influences disease progression, cancer mortality and survival. Elevated BMI (≥ 25.0 kg/m²) may influence treatment selection of, for example, the approach to surgery; the choice of chemotherapy dosing; the inclusion of patients into randomised clinical trials. Furthermore, the technical challenges posed by an elevated BMI may adversely affect surgical outcomes, for example, morbidity (increasing the risk of surgical site infections), reduced lymph node harvest (and subsequent risk of under-staging and under-treatment) and increased risk of margin positivity. Suboptimal chemotherapy dosing, associated with capping chemotherapy in obese patients as an attempt to avoid excess toxicity, might be a driver of poor prognostic outcomes. By contrast, the efficacy of immune checkpoint inhibition may be enhanced in patients who are obese, although in turn, this observation might be due to reverse causality. So, a central research question is whether being overweight or obese adversely affects outcomes either directly through effects of cancer biology or whether adverse outcomes are mediated through indirect pathways. A further dimension to this complex relationship is the obesity paradox, a phenomenon where being overweight or obese is associated with improved survival where the reverse is expected. In this overview, we describe a framework for evaluating methodological problems such as selection bias, confounding and reverse causality, which may contribute to spurious interpretations. Future studies will need to focus on prospective studies with well-considered methodology in order to improve the interpretation of causality.

Correlations of analgesic dosage of morphine with SLC6A4 gene polymorphisms in patients with lung cancer

OBJECTIVE

To investigate the correlations of analgesic dosage of morphine with solute carrier family 6 member 4 (SLC6A4) gene polymorphisms in patients with lung cancer.

PATIENTS AND METHODS

A total of 200 lung cancer patients without cancer pain were selected as painless group, and another 200 lung cancer patients with cancer pain as cancer pain group. Visual Analogue Scale (VAS) was applied to grade the pain, the patients in cancer pain group were treated with morphine, and the dosage of morphine within 24 h was recorded. Then, the genomic deoxyribonucleic acid (DNA) was extracted from the peripheral blood of the research subjects, and the polymorphisms rs1042173 and rs7224199 of SLC6A4 gene were detected.

RESULTS

There was a difference in the genotype distribution of SLC6A4 gene rs7224199 between painless group and cancer pain group (p=0.004), and the frequency of GG genotype was remarkably higher in cancer pain group [75 (0.375)]. The frequency of heterozygous model AC of rs1042173 and recessive model GT + TT of rs7224199 in cancer pain group was evidently lower than that in painless group (p=0.048, p=0.043). Besides, the lung cancer patients in cancer pain group had markedly lower frequency of AG haplotype (p=0.000), but notably higher frequency of AT (p=0.000) and CG (p=0.000) haplotypes of SLC6A4 gene rs1042173 and rs7224199 than those in painless group. No significant differences in genotypes of SLC6A4 gene rs1042173 (p=0.241) and rs7224199 (p=0.316) were detected among the degrees of cancer pain in cancer pain group. The analgesic dosage of morphine for the lung cancer patients was prominently correlated with the genotypes of SLC6A4 gene rs1042173 in cancer pain group. Moreover, in cancer pain group, there were significant differences in the dosage within 24 h (p=0.025), at 24 h after weight correction (p=0.001) and at 24 h after correction of weight and body surface area (p=0.000) among the genotypes, and the morphine dosage for the patients with CC genotype was significantly lower. Furthermore, the morphine dosage within 24 h (p=0.047), at 24 h after weight correction (p=0.042) and at 24 h after correction of weight and body surface area (p=0.031) were distinctly associated with the haplotypes of SLC6A4 gene in cancer pain group, of which the patients with CT haplotype were administered with a remarkably lower morphine dosage.

CONCLUSIONS

The morphine dosage for analgesia has significant correlations with SLC6A4 gene polymorphisms in patients with lung cancer.

Seasonal nitrogen uptake strategies in a temperate desert ecosystem depends on N form and plant species

Symbiotic plants might be able to regulate a limited nitrogen (N) pool, thus avoiding and reducing competition for resources, through the uptake of different chemical N forms. Our aim was to see whether coexisting herbs showed preference for different forms of N in a temperate desert. We conducted a situ experiment using the ¹⁵ N labeling method in the Gurbantunggut Desert of Northwestern China dominated by Erodium oxyrrhynchum, Hyalea pulchella, Nonea caspica and Lactuca undulata during their growing period (April and May). Four desert herb species preferentially relied on ¹⁵ N-NO₃ for their N nutrition. Multi-factor analysis of variance (ANOVA) analysis results showed that species, N forms, months, and soil depths strongly affected N uptake rate. The uptake rate by herbs was higher in May than in April, and higher at 0-5 cm than at 5-15 cm soil layers. Erodium oxyrrhynchum, N. caspica and L. undulata showed different preference on N form over months. Erodium oxyrrhynchum and L. undulata changed their uptake preference from more ¹⁵ N-Glycine in April to more ¹⁵ N-NH4 in May. Although the N uptake rate of four desert herbs varied across different soil depths and months, all species absorbed more inorganic N compared with organic N. The higher preference for ¹⁵ N-NO₃ and ¹⁵ N-NH4 over ¹⁵ N-Gly possibly reflects adaptation to different N forms in temperate desert.

Direct Current Fabric Triboelectric Nanogenerator for Biomotion Energy Harvesting

Triboelectric nanogenerators (TENGs) have demonstrated their promising potential in biomotion energy harvesting. A combination of the TENG and textile materials presents an effective approach toward smart fabric. However, most traditional fabric TENGs with an alternating current (AC) have to use a stiff, uncomfortable, and unfriendly rectifier bridge to obtain direct current (DC) to store and supply power for electronic devices. Here, a DC fabric TENG (DC F-TENG) with the most common plain structure is designed to harvest biomotion energy by tactfully taking advantage of the harmful and annoying electrostatic breakdown phenomenon of clothes. A small DC F-TENG (1.5 cm × 3.5 cm) can easily light up 416 serially connected light-emitting diodes. Furthermore, some yarn supercapacitors are fabricated and woven into the DC F-TENG to harvest and store energy and to power electronic devices, such as a hygrothermograph or a calculator, which shows great convenience and high efficiency in practice. This low-cost and efficient DC F-TENG which can directly generate DC energy without using the rectifier bridge by harvesting energy from unhealthy electrostatic breakdown has great potential as a lightweight, flexible, wearable, and comfortable energy-harvesting device in the future.

microRNA-331-3p attenuates neuropathic pain following spinal cord injury via targeting RAP1A

Neuropathic pain (NP) after spinal cord injury (SCI) leads to compromised physical and cognitive functions in a majority of patients. Aberrant miRNA expression plays vital roles in the pathogenesis of SCI. This study aims to investigate the effect of miR-331-3p in rats following SCI. Microarray assay was performed in SCI- and sham-operated rats to evaluate the expression of miR-331-3p. Assigned SCI rats were treated with miR-331-3p agomiR alone or miR-331-3p agomiR plus RAP1A-expressing lentivirus or control agomiR. Rat locomotor performance was evaluated by BBB locomotor rating scale. Neuronal tissue damage and apoptosis were detected by histological analyses and Western blot. Inflammation in spinal cord was determined by detection of the expression of inflammatory genes with qRT-PCR, and ELISA. Downstream expression of RAP1A was measured by Western blot. The results showed that SCI induced the downregulation of miR-331-3p in the spinal cord of SCI rats. Overexpression of miR-331-3p improved the locomotor performance, reduced tissue damage, neuronal apoptosis and inflammation in rat SCI model. Rap1a (Ras-related protein Rap-1A) was predicted as a downstream target for miR-331-3p, and upregulation of RAP1A impaired the beneficial effect of miR-331-3p post- SCI, which was shown as worse locomotor activity, more severe tissue damage, as well as promoting apoptosis and inflammation in SCI rats. Furthermore, miR-331-3p reduced the activation of RAP1A downstream genes via inhibiting RAP1A expression. These findings indicate a protective role of miR- 331-3p in the development of SCI via the modulation of RAP1A, and may help to develop novel therapy against SCI-induced complications.

Switched-capacitor-convertors based on fractal design for output power management of triboelectric nanogenerator

Owing to the advantages of integration and being magnet-free and light-weight, the switched-capacitor-convertor plays an increasing role compared to traditional transformer in some specific power supply systems. However, the high output impedance and switching loss largely reduces its power efficiency, due to imperfect topology and transistors. Herein, we propose a fractal-design based switched-capacitor-convertors with characteristics including high conversion efficiency, minimum output impedance, and electrostatic voltage applicability. As a double-function output power management system for triboelectric nanogenerators, it delivers over 67 times charge boosting and 954 W m-2 power density in pulse mode, and achieves over 94% total energy transfer efficiency in constant mode. The establishment of the fractal-design switched-capacitor-convertors provides significant guidance for the development of power management toward multi-functional output for numerous applications. The successful demonstration in triboelectric nanogenerators also declares its great potential in electric vehicles, DC micro-grids etc.

Quantifying contact status and the air-breakdown model of charge-excitation triboelectric nanogenerators to maximize charge density

Surface charge density is the key factor for developing high performance triboelectric nanogenerators (TENG). The previously invented charge excitation TENG provides a most efficient way to achieve maximum charge output of a TENG device. Herein, criteria to quantitatively evaluate the contact efficiency and air breakdown model on charge excitation TENG are established to enhance and evaluate charge density. The theoretical results are further verified by systematic experiments. A high average charge density up to 2.38 mC m-2 is achieved using the 4 μm PEI film and homemade carbon/silicone gel electrode in ambient atmosphere with 5% relative humidity. This work also reveals the actual charge density (over 4.0 mC m-2) in a TENG electrode based on quantified surface micro-contact efficiency and provides a prospective technical approach to improve the charge density, which could push the output performance of TENG to a new horizon.

Large-Area Triboelectric Nanogenerator Mass Spectrometry: Expanded Coverage, Double-Bond Pinpointing, and Supercharging

Efficient ionization is a necessary condition for mass spectrometric analysis, but many compounds fail to ionize well enough to yield sufficient detection limits. Triboelectric nanogenerators (TENG) coupled to nanoelectrospray ionization (nanoESI) mass spectrometry (MS) are a highly effective approach to high sensitivity MS analysis. Here, we report on new, large-area TENG that constructively leverage the relationship between electrode size, created charges, and open-circuit voltage, leading to wider chemical coverage. Large-area TENG were found to also promote electrospray gas-phase oxidation reactions that enabled double bond position pinpointing for unsaturated lipids and species-specific lipid quantitation. Furthermore, large-area TENG MS of proteins was observed to yield higher charge state distributions (i.e., supercharging) without the need for high surface tension additives.

Tobacco control in China and the road to Healthy China 2030

Healthy China 2030 aims to reduce the adult smoking rate from 27.7% in 2015 to 20% by 2030. Achieving this goal requires a review of the tobacco control measures introduced in China to date, the gaps that remain and the opportunities ahead. In 2008, the World Health Organization introduced six measures to reduce demand for tobacco called MPOWER. The progress China has made in implementing these measure varies: 1) monitor tobacco use and prevention policies. The surveillance on tobacco use has been rigorous, but the monitoring and evaluation of tobacco control policies needs to be strengthened; 2) protect people from tobacco use: pushes for national tobacco control legislation have stalled, but 18 subnational legislations have passed; 3) offer help to quit tobacco use. The accessibility and quality of cessation services needs to be improved; 4) warn about the dangers of tobacco. While there are no pictorial health warnings, tobacco control advocates have launched a series of anti-smoking media campaigns to inform the public; 5) enforce bans on tobacco advertising, promotion, and sponsorship. Legal loopholes and poor enforcement remain challenges; 6) raise taxes on tobacco: cigarettes in China are relatively cheap and increasingly affordable, which demonstrates the need for further tobacco tax increases indexed to inflation and income. China maintains a tobacco monopoly that interferes with tobacco control efforts and fails to regulate tobacco products from the public health perspective. Effective MPOWER measures, which depend upon the removal of tobacco industry interference from policymaking, are key to achieving the goal set by Healthy China 2030.

Dietary Inflammatory Index and Leukoaraiosis in Patients with Ischemic Stroke

OBJECTIVES

Diet may change the chronic levels of systemic inflammation, which in turn influence the development of leukoaraiosis (LA). This study aimed to examine the association between dietary inflammatory index (DII) and LA in patients with ischemic stroke.

METHODS

Patients with first-ever ischemic stroke were enrolled from two centers. A semi-quantitative food frequency questionnaire (FFQ) was used to evaluate diet contents. The DII score of each patient was calculated based on the reported diet contents. Presence and degree of LA were evaluated with a magnetic resonance imaging (MRI) scan. LA was graded according to Fazekas scale.

RESULTS

Of the 497 enrolled patients, 337 (67.8%) were detected with LA. Patients with LA had a higher DII score (0.23 vs -0.88, P < 0.001). Logistic regression analysis detected that patients with highest quartile of DII score had an OR of 3.61 (95% CI: 2.05-6.36, P < 0.001) for LA compared with those with lowest quartile of DII. After adjusting for major confounders, the highest DII quartile remained as an independent predictor for LA (OR = 2.66, 95% CI: 1.41-5.00, P = 0.008).

CONCLUSIONS

A pro-inflammatory diet pattern, as indicated by higher DII values, appears to be associated with a higher risk of LA. This result suggested that dietary-mediated inflammation may involved in the pathogenesis of LA, which warrant further study.

Anthropogenic control over wintertime oxidation of atmospheric pollutants

During winter in the mid-latitudes, photochemical oxidation is significantly slower than in summer and the main radical oxidants driving formation of secondary pollutants, such as fine particulate matter and ozone, remain uncertain, owing to a lack of observations in this season. Using airborne observations, we quantify the contribution of various oxidants on a regional basis during winter, enabling improved chemical descriptions of wintertime air pollution transformations. We show that 25-60% of NO_x is converted to N₂O₅ via multiphase reactions between gas-phase nitrogen oxide reservoirs and aerosol particles, with ~93% reacting in the marine boundary layer to form >2.5 ppbv ClNO₂. This results in >70% of the oxidizing capacity of polluted air during winter being controlled, not by typical photochemical reactions, but from these multiphase reactions and emissions of volatile organic compounds, such as HCHO, highlighting the control local anthropogenic emissions have on the oxidizing capacity of the polluted wintertime atmosphere.

Signal Output of Triboelectric Nanogenerator at Oil-Water-Solid Multiphase Interfaces and its Application for Dual-Signal Chemical Sensing

A liquid-solid contact triboelectric nanogenerator (TENG) based on poly(tetrafluoroethylene) (PTFE) film, a copper electrode, and a glass substrate for harvesting energy in oil/water multiphases is reported. There are two distinctive signals being generated, one is from the contact electrification and electrostatic induction between the liquid (water/oil) and the PTFE film (V_TENG and I_TENG ); and the other is from the electrostatic induction in the copper electrode by the oil/water interfacial charges (ΔV_interface and I_interface ), which is generated only when the liquid-solid contact TENG is inserted across the oil/water interface. The two signals show interesting opposite changing trends that the V_TENG and I_TENG decrease while the oil/water interfacial signals of ΔV_interface and I_interface increase after coating a layer of polydopamine on the surfaces of PTFE and glass via self-polymerization. As an application of the observed phenomena, both the values of I_TENG and I_interface have a good linear relationship versus the natural logarithm of the concentration of the dopamine. Based on this, the first self-powered dual-signal detection of dopamine using TENG is demonstrated.

A phase II feasibility study of palbociclib in combination with adjuvant endocrine therapy for hormone receptor-positive invasive breast carcinoma

BACKGROUND

The CDK4/6 inhibitor palbociclib prolongs progression-free survival in hormone receptor-positive/HER2-negative (HR+/HER2-) metastatic breast cancer when combined with endocrine therapy. This phase II trial was designed to determine the feasibility of adjuvant palbociclib and endocrine therapy for early breast cancer.

PATIENTS AND METHODS

Eligible patients with HR+/HER2- stage II-III breast cancer received 2 years of palbociclib at 125 mg daily, 3 weeks on/1 week off, with endocrine therapy. The primary end point was discontinuation from palbociclib due to toxicity, non-adherence, or events related to tolerability. A discontinuation rate of 48% or higher would indicate the treatment duration of 2 years was not feasible, and was evaluated under a binomial test using a one-sided α = 0.025.

RESULTS

Overall, 162 patients initiated palbociclib; over half had stage III disease (52%) and most received prior chemotherapy (80%). A total of 102 patients (63%) completed 2 years of palbociclib; 50 patients discontinued early for protocol-related reasons (31%, 95% CI 24% to 39%, P = 0.001), and 10 discontinued due to protocol-unrelated reasons. The cumulative incidence of protocol-related discontinuation was 21% (95% CI 14% to 27%) at 12 months from start of treatment. Rates of palbociclib-related toxicity were congruent with the metastatic experience, and there were no cases of febrile neutropenia. Ninety-one patients (56%) required at least one dose reduction.

CONCLUSION

Adjuvant palbociclib is feasible in early breast cancer, with a high proportion of patients able to complete 2 years of therapy. The safety profile in the adjuvant setting mirrors that observed in metastatic disease, with approximately half of the patients requiring dose-modification. As extended duration adjuvant palbociclib appears feasible and tolerable for most patients, randomized phase III trials are evaluating clinical benefit in this population.

CLINICALTRIALS.GOV REGISTRATION

NCT02040857.

Ti-Doped Tunnel-Type Na4Mn9O18 Nanoparticles as Novel Anode Materials for High-Performance Supercapacitors

Nanomaterials with tunnel structures are extremely attractive to be used for electrode materials in electrochemical energy storage devices. Tunnel-structured Ti-doped Na₄Mn₉O₁₈ nanoparticles (TNMO-NPs) were synthesized by a facile and high-production method of the solid-state reaction with a high-energy ball-milling process. As electrode materials in the supercapacitor cell, the as-synthesized TNMO-NPs exhibit a high specific capacity of 284.93 mA h g^-1 (0.57 mA h cm^-2/1025.75 F g^-1). A superior rate capability with a decay of 36% is achieved by increasing the scan rates from 2 to 25 mV s^-1. To further explore the storage mechanism of Ti-doped Na₄Mn₉O₁₈ materials, density functional theory (DFT) calculations were used to calculate the activation energy for the ion immigration in the electrode, and the results show that the minimum ion diffusion barrier energy is 0.272 eV, indicating that the sodium ions could insert into the system easily. Through the scan-rate-dependent cyclic voltammetry analysis, the capacity value indicates a mixed charge storage of capacitive behavior and Na⁺ intercalation progress. A maximum energy density of 77.81 W h kg^-1 at a power density of 125 W kg^-1 is achieved, and a high energy density of 54.79 W h kg^-1 is maintained even at an ultrahigh power density of 3750 W kg^-1. The TNMO-NP supercapacitors show excellent flexibility at various bent (0-180°) states. The capacitive performance of the TNMO-NPs makes them promising cathode materials for flexible supercapacitors with high specific capacities and high energy densities.

[Different anthropometric indices and incident risk of hypertension in elderly population: a prospective cohort study]

Objective: To explore the relationship between anthropometric indices and the incident risk of hypertension, compare novel anthropometric indices with traditional indices in hypertension prediction and establish hypertension prediction models among elderly Chinese. Methods: A total of 27 009 retirees from the Dongfeng Motor Corporation were recruited at baseline in 2008 and the first follow-up was conducted in 2013. After the exclusion of participants less than 60 years old, participants with hypertension, coronary heart disease, stroke, cancer, and those with missing data, a total of 6 784 elderly participants were enrolled in this study. A multivariate logistic regression model was used to analyze the relationship between traditional anthropometric indices, body mass index (BMI), waist circumference (WC), waist-to-height ratio (WHtR), novel anthropometric indices, visceral adiposity index (VAI), body shape index (ABSI), body roundness index (BRI), and the incident risk of hypertension. Meanwhile, a multivariate logistic regression model was used to establish hypertension prediction models. Receiver operating characteristic (ROC) curve was applied to compare the prediction ability of different models. Results: A total of 1 787 incident cases of hypertension were identified, with the incidence of hypertension about 27.59%. Significant positive associations were detected between BMI, WC, WHtR, VAI, BRI and the incident risk of hypertension after adjusting for potential confounders (all P values<0.05). In men, the OR (95%CI) (upper tertile vs lower tertile) was 1.45 (1.22-1.73) for VAI, and 1.86 (1.55-2.23) for BRI. In women, the OR (95% CI) (upper tertile vs lower tertile) was 1.55 (1.22-1.96) for VAI, and 1.60 (1.27-2.01) for BRI. For ABSI, no significant association was observed in either men (OR (95%CI): 1.07 (0.90-1.28)) or women (OR (95%CI): 1.03 (0.82-1.29), both P values >0.05). The basic hypertension prediction model included age, drinking (only in men), education status (only in men), systolic blood pressure (SBP), diastolic blood pressure (DBP), and fasting blood glucose levels. Based on the basic prediction model, BMI (in men: AUC=0.697) and BRI (only in men: AUC=0.696) improved area under ROC curve (AUC) significantly (P<0.05). BMI was the strongest predictor in both men (AUC=0.697) and women (AUC=0.685) in the extended model. Conclusion: Significant positive associations were detected between BMI, WC, WHtR, VAI, BRI and the incident risk of hypertension among elderly Chinese. BMI was the strongest predictor in hypertension prediction model compared with other anthropometric indices.

[Preliminary evaluation of endoscopic selective varices devascularization in children]

Objective: To investigate the effect of the endoscopic selective varices devascularization (ESVD) for the esophageal gastric varices bleeding (EGVB) in children. Methods: The clinical data of the patients diagnosed with EGVB and treated with ESVD from January 2018 to March 2018 were retrospectively analyzed. The effects, safety and complications of ESVD were evaluated. Results: There were five patients (including 2 males and 3 females, age ranged from 4 to 7 years) in the study. No rebleeding was found at the first follow-up on one week post operation. Three patients were treated with the endo-therapy at the twice follow-up (3 months after surgery): 2 patients had ESVD again and 1 patient had resection under endoscopy due to stenosis caused by surgical scar. After the second procedure, there was no rebleeding but one patient had abdominal pain caused by mesenteric thrombosis, cured with low molecular weight heparin. Conclusion: The ESVD for EGVB is safe and effective, but the long-term curative effect should be further studied.

Hormone replacement therapies, oral contraceptives, reproductive factors and colorectal adenoma risk: a systematic review and dose-response meta-analysis of observational studies

AIM

The association between the use of oral contraceptives and hormone replacement therapy (HRT) or other reproductive factors and the risk of colorectal adenoma (CRA) remains controversial. Our study aimed to review the evidence by conducting a dose-response meta-analysis to investigate this association.

METHODS

We searched PubMed and Embase databases for relevant studies published until May 2017. Traditional and dose-response meta-analyses were conducted. Sensitivity analysis was performed to evaluate the robustness of the results. Cumulative meta-analysis was used to assess the risk of different oral contraceptive formulations or generations.

RESULTS

A total of 19 observational studies, with 21 923 CRA cases and 1 030 711 participants, were included in the meta-analysis. Ever HRT use showed a potential inverse association with CRA risk [relative risk (RR) 0.83, 95% CI 0.70-1.00]. The dose-response meta-analysis further demonstrated that HRT use could reduce CRA risk. Compared with no HRT use, the predicted RRs were 0.82 (95% CI 0.67-0.99), 0.76 (95% CI 0.59-0.98) and 0.77 (95% CI 0.62-0.96) for 3, 6 and 9 years of HRT use, respectively. All other factors were not statistically significantly associated with CRA risk.

CONCLUSIONS

This study indicated that only HRT use might reduce the risk of developing CRA. Any advice regarding HRT use to prevent CRA should be tailored to the individual risks and potential benefits. Large, well-designed prospective studies with long-term follow-up are required to further clarify the aetiology of CRA.