Flexible ureteroscopy with ultrasound guidance for the treatment of parapelvic renal cysts: A complementary approach for locating the cystic wall

Background

Flexible ureteroscopic incision and drainage is a relatively new surgical method for treating parapelvic cysts. Considering that the intraoperative localization of the cyst may fail with a flexible ureteroscope, we use an innovative ultrasound-guided method to locate the cystic wall during flexible ureteroscopic surgery.

Methods

We retrospectively reviewed 17 consecutive cases of parapelvic renal cysts treated by ultrasound-guided flexible ureteroscopy between March 2017 and May 2020. The differences between the simple flexible ureteroscopic technique and ultrasound-guided flexible ureteroscopic technique were compared. The surgical procedures, postoperative complications, results and patient follow-ups were evaluated.

Results

The cyst wall was seen clearly in 10 patients with ureteroscopic vision. Another 7 patients underwent ultrasound-guided flexible ureteroscopic surgery since it was difficult to identify the cyst wall. The mean operative time was 25.9 ± 8.7 min and 37.1 ± 10.1 min for the conventional and modified techniques, respectively (P = 0.004); the mean time to search for cysts was 17.6 ± 5.8 min and 26.5 ± 8.4 min, respectively (P = 0.002); and the mean incision time was 7.1 ± 4.9 min and 12.1 ± 5.6 min, respectively (P = 0.000). All of the patients were followed-up for 12 months, and no serious complications or recurrence were observed.

Conclusions

We demonstrated that it is feasible and safe to treat parapelvic renal cysts by ultrasound-guided flexible ureteroscopic incision and drainage. The small sample size and need for further studies were the limitations of our work.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12894-022-00960-6.

The role of the exocytic pathway in cell wall assembly in yeast

The cell wall is a dynamic organelle which is tightly controlled for cell morphology, viability, and pathogenesis. It was previously shown that exocytosis is involved in the secretion of some components and enzymes of the cell wall. However, how the secretory pathway affects the cell wall integrity and assembly remains unclear. Here we show that the secretory pathway mutant (sec) cells were sensitive to cell wall antagonists in Saccharomyces cerevisiae, and they were lysed at restrictive conditions but can be rescued by osmotic stabilizers, indicating their cell walls were disrupted. Although glucans were reduced at the cell surface in sec mutants as speculated, the other two main cell wall components, chitins, and mannoproteins, were accumulated at the cell surface. We also found that both the protein level and the phosphorylation level of Slt2 increased in sec mutants. These results suggest that the exocytic pathway has a critical role in cell wall assembly. Our study will help to understand the mechanism of cell wall formation.

Analysis of long-term outcome of image-guided volumetric modulated arc therapy (VMAT) for primary malignant tumor of the cervical spine

OBJECTIVE

Retrospective analysis of the long-term clinical outcome and acute toxicity of the primary malignant tumor of cervical spine receiving CBCT image-guided VMAT.

METHODS

Thirty patients with primary malignant tumor of the cervical spine included in our center, from December 2013 to January 2016, 28 patients were retrospectively studied. The prescription dosage 95% PTV volume dose was 44 Gy, 2.0 Gy/fraction, and a total of 22 times. The median PGTV synchronized volume dose was 60 Gy (45-62.1 Gy), median 2.5 Gy (2-2.7 Gy)/fraction. In volumetric modulated, two arc volumetric modulated arc therapy (VMAT) was used, with spinal cord dosage DMAX< 45 Gy. Early response rate and acute toxicities were analyzed.

RESULT

The follow-up duration was 6-76 months (median 53 months). At the end of follow-up of June 1, 2019, 78.6% (22/28) patients were still alive. 3 and 5-y local control rates were 67.3% and 56.5% while 3 and 5-y OS were both 78.6% in the whole group of patients, respectively. Fourteen patients with chordoma 5-y local control rates and OS were 57.1% and 85.7%, respectively. Nine patients with giant-cell tumor of bone had a 5-y local control rate and OS were 77.8% and 85.7%, respectively. The response rate for moderate pain or above was 80% (8/10). Eleven patients (39.3%) suffered from grade 1 acute skin toxicity. Twenty-four patients (85.7%) had grade 1/2 mucositis. No radiation-induced spinal cord injury was found.

CONCLUSION

The image-guided VMAT for primary malignant tumor of the cervical spine provided a satisfactory long-term local control rate.

[Epidemiological features of injuries in middle and primary schools students of Hui and Han nationalities in Ningxia]

OBJECTIVE

To find out the present situation and causes of injuries and risk factors of accidental injuries among students and to provide evidence for prevention and reduction of accidental injuries.

METHODS

A cluster sampling study on the situation of injuries was conducted in 21 civic middle and primary schools with 7,000 (6-19 years old) students during the December 1999 and November 2000 in Ningxia province.

RESULTS

Results showed that the total rate of injuries was 20.40% with boys higher than girls (P < 0.01). Five kinds of injuries took the leading place: injuries from falls (9.27%), bumps (4.55%), knive-cutting (2.99%), traffic accidents (2.00%) burns and scalds (1.66%). The rate of injuries was 22.11% in students of Hui nationality, higher than the ones in Han nationality (19.6%, P < 0.025). The rate of injuries among junior middle school students was the highest (24.11%), followed by high school students 22.15%, and primary students 17.63%. Causes, times, places, parts of the bodies and the treatment regarding injuries were analysed.

CONCLUSION

The challenge of accidental injuries in middle and primary school students was although serious but avoidable. Comprehensive preventive measures should be take actively and effectively.

Effect of Addition Amount of Ethylenediamine on Interlayer Nanochannels and the Separation Performance of Graphene Oxide Membranes

In recent years, graphene oxide (GO)-based two-dimensional (2D) laminar membranes have attracted considerable attention because of their unique well-defined nanochannels and deliver a wide range of molecular separation properties and fundamentals. However, the practical application of 2D GO layered membranes suffers from instability in aqueous solutions as the interlayer d-spacing of GO membranes is prone to expansion caused by the hydration effect. In this study, the effects of the ethylenediamine (EDA) addition amount on the structure, crosslinking mechanism and separation performance of GO membranes were investigated systematically, and membrane performance was evaluated using water permeability and dye/salt rejection tests. The experimental results show that the amine groups of EDA chemically bond with the hydroxyl functional group (O=C-OH) of GO after intercalation, as evident from Fourier transform infrared spectroscopy (FTIR) and X-ray photoelectron spectroscopy (XPS). By further controlling the amount of the intercalated EDA, the as-prepared GO composite membranes show nanoscale-tuned d-spacing promising for downstream applications. In the demonstrated dye/salt nanofiltration scenario, the EDA intercalated and crosslinked GO membrane has enhanced permeability by over five times and a better dye rejection rate of over 96% compared with pure GO membranes. These findings highlight a facile strategy for controlling nanochannels by tuning the amounts of reactive intercalants.

Antimicrobial resistance and virulence profiles of staphylococci isolated from clinical bovine mastitis

Staphylococci, mainly including Staphylococcus aureus and coagulase-negative staphylococci (CNS), are one of the most common pathogens causing bovine mastitis worldwide. In this study, we investigated the antimicrobial resistance and virulence profiles of staphylococci from clinical bovine mastitis in Ningxia Hui Autonomous Region of China. Antimicrobial resistance was determined by disc diffusion combined with E-test method. Genes of antimicrobial resistance and virulence factors were determined by PCR. A total of 332 staphylococcal isolates were confirmed from 1,519 mastitic milk samples, including 172 S. aureus and 160 CNS isolates. Fifteen CNS species were identified, with S. chromogenes being the most frequent found (49.4%), followed by S. equorum (13.8%). Noticeably, 2 S. agnetis isolates were found among the CNS isolates. To our knowledge, this is the first report documenting the presence of S. agnetis from bovine mastitis in China. The S. aureus and CNS isolates showed high resistance against penicillin, followed by erythromycin and tetracycline. Multidrug resistance was found in 11.6 and 16.3% of the S. aureus and CNS isolates, respectively. Resistance to penicillin was attributed to the presence of blaZ, erythromycin resistance to ermC (alone or combined with ermB) and tetracycline resistance to tetK (alone or combined with tetM). Notably, one S. equorum isolate and one S. saprophyticus isolate were both methicillin-resistant and mecA positive. Additionally, all S. aureus isolates carried the adhesin genes fnbpA, clfA, clfB, and sdrC, and most of them contained cna and sdrE. Conversely, only a few of the CNS isolates carried clfA, cna, and fnbA. Regarding toxin genes, all S. aureus isolates harbored hlb, and most of them were hlg positive. The lukE-lukD, lukM, sec, sed, sei, sen, seo, tst, seg, seh, and sej were also detected with low frequencies. However, no toxin genes were observed in CNS isolates. This study reveals high species diversity of staphylococci from clinical bovine mastitis in Ningxia Hui Autonomous Region of China. The findings for the genetic determinants of antimicrobial resistance and virulence factor provide valuable information for control and prevention of staphylococcal bovine mastitis.

Suboptimal status of tummy time for infants in early childhood education institutions in urban China: A cross-sectional study

Background

Although tummy time is recommended as a form of physical activity for non-movable infants worldwide, little is known regarding the current status of tummy time practices among Chinese infants. Early childhood education (ECE) institutions provide children with rich learning experiences; however, tummy time practices among infants in these ECE institutions were unclear. This study aimed to investigate the status of tummy time among infants within the context of ECE institutions.

Methods

We conducted a cross-sectional survey with primary caregivers of infants aged 0-11 months across 31 provinces of China from 1 March to 30 April 2023. To recruit participants, we collaborated with Gymboree Play & Music, an ECE institution with over 500 centres in nearly 200 cities in urban China. Our survey instrument was developed based on the World Health Organization (WHO) guidelines and literature to collect data on infants' tummy time practices, caregivers' tummy time knowledge and information sources. We used self-administered questionnaires through WeChat, in which participants scanned a quick response (QR) code to complete the questionnaire.

Results

We included 1040 infants and their primary caregivers, with 504 infants aged 0-5 and 536 infants aged 6-11 months old. Less than half of infants (48.2%) started tummy time in the neonatal period, with 20.5% starting within two weeks after birth. Only 27.2% of infants engaged in at least 30 minutes of tummy time during the last 24 hours, with infants aged 0-5 months significantly lower than those aged 6-11 months (21.6 vs 32.5%, P < 0.0001). No significant difference was found between attending ECE class and non-attending ECE class groups for the proportion of infants with tummy time ≥30 minutes per day (28.9 vs 23.4%, P = 0.0625); however, infants aged 0-5 months in the attending group engaged in longer duration of tummy time than those in the non-attending group (P = 0.0005). The compliance with the tummy time guidelines in infants receiving long-nurturing care was significantly higher than those receiving short-nurturing care (30.4 vs 22.1%, P = 0.0036). Only 42.7% of caregivers knew that at least 30 minutes daily tummy time was necessary for infant, and more primary caregivers in the attending group knew that, compared to the non-attending group (45.3 vs 36.8%, P = 0.0098).

Conclusions

The current status of infants' tummy time practices and caregivers' knowledge are generally suboptimal within the context of ECE institutions in urban China. Longer nurturing time contributes to higher compliance with tummy time guidelines. Effectively promoting tummy time practices through multiple channels in China is crucial.

[Culture of human nasal polyp epithelial cells at an air-liquid surface]

OBJECTIVE

To study the human nasal ciliated epithelial cells at an air-liquid surface (ALI) so as to establish a reliable cell culture model for nasal mucociliary transport study.

METHODS

The human nasal ciliated epithelial cells were cultured by low-temperature enzymatic digestion method at an air-liquid surface, the cell growth behavior was observed under the inverted phase-contrast microscope, the proliferation, confluence and differentiation of cultured cells were examined by scanning electron microscope and immunocytochemistry, the basal and stimulated ciliary beat frequency (CBF) of cultured epithelial cells were measured by using high-speed digital microscopic imaging system. Prism 4.0 software was used to analyze the data.

RESULTS

(1) Under microscope, the cells on transwell membrane adhered well at 24 h and locked tightly to display with a cobblestone-like appearance; the monolayer cells got confluence to 80%-90% after one-week submersion culture, and thereafter exposed to air-liquid interface. (2) Under scanning electron microscope, the cilia and also the small microvilli could be observed to protrude from the cell's surface at ALI day 7; the ciliated cells differentiated well and distributed in cluster; goblet cells and nonciliated columnar cells distributed between ciliated cells. (3) Immunocytochemistry of β-tubulin IV and zona occludens-1 showed a good confluence and differentiation of cilia in cultured epithelial cells at ALI day 14, and the percentage of ciliated epithelial cells was 50%-60 %. (4) The basal CBF of cultured epithelial cells was (8.42 ± 1.24), (8.71 ± 1.11), (9.17 ± 1.11), (8.89 ± 0.91), (8.99 ± 0.91) Hz at ALI day 7, 14 , 21, 28, 35, respectively, no significant difference was found among them(F = 1.451, P > 0.05). (5) At the concentration of 100 µmol/L ATP, an exogenous stimulating agent, significantly increased the CBF of cultured epithelial cells.

CONCLUSIONS

Air-liquid interface cultured human nasal epithelial cells by enzymatic digestion method manifest with good confluence and differentiation status; the cells could maintain differentiated morphology and physiological function close to in vivo epithelium for a long term, therefore, it may serve as an ideal cell model for mucociliary transport study.

Prognostic value of plasma diquat concentration in patients with acute oral diquat poisoning: a retrospective study

Objectives

Diquat poisoning is an important public health and social security agency. This study aimed to develop a prognostic model and evaluate the prognostic value of plasma diquat concentration in patients with acute oral diquat poisoning, focusing on how its impact changes over time after poisoning.

Methods

This was a retrospective cohort study using electronic healthcare reports from the Second Hospital of Hebei Medical University. The study sample included 80 patients with acute oral Diquat poisoning who were admitted to the hospital between January 2019 and May 2022. Time-to-event analyses were performed to assess the risk of all-cause mortality (30 days and 90 days), controlling for demographics, comorbidities, vital signs, and other laboratory measurements. The prognostic value of plasma DQ concentration on admission was assessed by computing the area under a time-dependent receiver operating characteristic curve (ROC).

Results

Among the 80 patients, 29 (36.25%) patients died, and 51 (63.75%) patients survived in the hospital. Non-survivors had a median survival time (IQR) of 1.3(1.0) days and the longest survival time of 4.5 days after DQ poisoning. Compared with non-survivors, survivors had significantly lower amounts of ingestion, plasma DQ concentration on admission, lungs injury within 24 h after admission, liver injury within 24 h after admission, kidney injury within 24 h after admission, and CNS injury within 36 h after admission, higher APACHE II score and PSS within 24 h after admission (all p < 0.05). Plasma Diquat concentration at admission (HR = Exp (0.032-0.059 × ln (t))) and PSS within 24 h after admission (HR: 4.470, 95%CI: 1.604 ~ 12.452, p = 0.004) were independent prognostic factors in the time-dependent Cox regression model.

Conclusion

Plasma DQ concentration at admission and PSS within 24 h after admission are independent prognostic factors for the in-hospital case fatality rate in patients with acute oral DQ poisoning. The prognostic value of plasma DQ concentration decreased with time.

[Changes of oxidative stress in peripheral serum of patients with allergic rhinitis]

OBJECTIVE

To examine the changes of oxidative stress biomarkers in peripheral serum of patients with allergic rhinitis (AR), so as to investigate the role of oxidative stress in pathogenesis of AR.

METHODS

The levels of serum nitric oxide (NO), malondialdehyde (MDA), as well as the activities of serum nitric oxide synthase (NOS), antioxidant enzymes including superoxide dismutase (SOD) and glutathione peroxidase (GSH-Px) were measured in 48 AR patients and 23 healthy controls. Statistical analysis was performed using a SPSS 13.0 software.

RESULTS

The level of serum NO in AR group [(97.92 ± 73.42) µmol/L] was higher than that in healthy control group [(64.04 ± 29.54) µmol/L], the difference was significant (t = -0.281, P < 0.05). The ratio of inducible NOS (iNOS) to total NOS (TNOS) in AR group (0.51 ± 0.11) was higher than that in healthy control group(0.45 ± 0.15), the difference was significant (t = -2.061, P < 0.05). The activity of serum GSH-Px in AR group [(258.24 ± 45.25) U/(ml·min)] was higher than that in healthy control group (215.11 ± 47.62) U/(ml·min)], the difference was significant (t = -2.235, P < 0.05). Although activity of SOD, concentration of MDA in AR group had a tendency to increase and decrease, respectively, no significant statistical difference was found as compared to the control group (P > 0.05).

CONCLUSION

Oxidative stress is involved in the pathophysiology of AR, however, iNOS-NO pathway may play a more important role in AR pathogenesis.

Regulating the Grain-Growth Surface for Efficient Near-Infrared Perovskite Light-Emitting Diodes

Metal halide perovskites hold great potential for next-generation light-emitting diodes (PeLEDs). Despite significant progress, achieving high-performance PeLEDs hinges on optimizing the interface between the perovskite crystal film and the charge transport layers, especially the buried interface, which serves as the starting point for perovskite growth. Here, we develop a bottom-up perovskite film modulation strategy using formamidine acetate (FAAc) to enhance the buried interface. This multifaceted approach facilitates the vertical-oriented growth of high-quality perovskites with minimized defects. Meanwhile, the in situ deprotonation between FA+ and ZnO could eliminate the hydroxyl (-OH) defects and modulate the energy level of ZnO. The resulting FAPbI3-PeLED exhibits a champion EQE of 23.84% with enhanced operational stability and suppressed EQE roll-off. This strategy is also successfully extended to other mixed-halide PeLEDs (e.g., Cs0.17FA0.83Pb(I0.75Br0.25)3), demonstrating its versatility as an efficient and straightforward method for enhancing the PeLEDs' performance.

Complementary feeding practices for children aged 6-23 months in early childhood education institutions in urban China: A cross-sectional study

Background

Appropriate infant and young child feeding (IYCF) plays a crucial role in promoting the healthy growth of children. Currently, many Chinese urban parents are seeking care of children from the early childhood education (ECE) institutions, however, little is known about the feeding practices of infants and young children in ECE institutions. This study aims to investigate the complementary feeding practices for Chinese urban children aged 6-23 months in ECE institutions and explore potential factors influencing their feeding practices.

Methods

This cross-sectional study was conducted among primary caregivers of children aged 6-23 months in ECE institutions across 31 provinces in China from 1 March to 30 April 2023. Convenience sampling was used to recruit caregivers from centres of Gymboree Play & Music (an ECE institution). Self-administered questionnaires were designed using the online survey tool Sojump and distributed through WeChat platform, which collected information on 1) children's complementary feeding practices; 2) food frequency of seven food groups; 3) caregivers' feeding knowledge and practices; 4) frequency of children attended ECE classes and the primary caregivers' daily nurturing care time; 5) source of information on complementary feeding.

Results

A total of 2731 children and their caregivers were surveyed, with 416 children aged 6-11 months and 2315 children aged 12-23 months. The prevalence of minimum dietary diversity (MDD), minimum meal frequency (MMF), and minimum acceptable diet (MAD) was 59.4, 60.6, and 39.2%, respectively. Only 17.3% caregivers believed that continued breastfeeding should be at two years or above, and 29.5% children were continuously breastfed at 12-23 months (CBF). The proportion of non-responsive feeding practices among caregivers ranged from 28 to 64%. Except for CBF, the prevalence of other key complementary feeding practices was higher among children who attending ECE classes than those not attending ECE classes (all P < 0.05). Moreover, children aged 12-23 months who received long-nursing care time (≥4h/d) had significantly higher MMF and MAD prevalence than those in short-nursing care time group (MMF = 66.2 vs. 58.8%, P = 0.0003; MAD = 44.2 vs. 38.3%, P = 0.0047).

Conclusions

The complementary feeding practices of children aged 6-23 months in ECE institutions in urban China remained suboptimal, and non-responsive feeding practices among caregivers were common. The attendance of ECE classes and the caregivers' daily nurturing care time could be beneficial in ensuring children to comply with complementary feeding recommendations.

Preparation of Highly Antibacterial Polyethersulfone/Sulfonated Polyethersulfone Blend Composite Membrane and Research on Its Dye Separation Performance

Bringing sulfonic acid groups into conventional polyethersulfone (PES) materials to prepare PES/sulfonated polyethersulfone (SPES) composite membranes has been shown to markedly enhance the hydrophilicity of the membranes and boost their separation efficiency in water treatment applications. However, membrane fouling due to microbial activity remains a critical challenge in the practical use of these membranes. Despite this, research into the antibacterial capabilities of PES/SPES composite membranes is scarce. This study employed the nonsolvent-induced phase inversion technique to prepare PES/SPES blend membranes and examined how the solid content influences their microstructure and separation performance. The findings indicated that an increase in solid content leads to higher casting solution viscosity, a reduction in membrane porosity from 10.8% to 4.06%, an increase in tensile strength from 0.79 MPa to 5.06 MPa, and a significant improvement in methylene blue rejection from 50% to nearly 100%. Additionally, the study revealed that the incorporation of SPES into the blend membranes enhances their resistance to bacterial adhesion, effectively suppressing microbial growth. Notably, the higher the sulfonic acid group content, the better the antibacterial properties of the composite membranes.

The U-shaped relationship between admission peripheral oxygen saturation and all-cause hospital mortality in acute exacerbation of chronic obstructive pulmonary disease: a retrospective analysis using the MIMIC III database

Background

Chronic obstructive pulmonary disease (COPD) and acute exacerbation of chronic obstructive pulmonary disease (AECOPD) pose global challenges, with oxygen saturation (SpO2) levels crucial in evaluating mortality. This study explored the correlation between admission SpO2 levels and all-cause hospital mortality in patients with AECOPD, assessing whether SpO2 can serve as an independent risk factor for predicting in-hospital mortality in these patients.

Methods

This study involved 996 AECOPD patients sourced from the Medical Information Mart for Intensive Care (MIMIC) III database (version 1.3), with 134 fatalities. Patients were categorized into a death group (n=134) and a survival group (n=862). The average admission SpO2 value was recorded for all 996 AECOPD patients. Subsequently, a generalized additive model (GAM) curve was employed to examine the association between admission SpO2 levels and all-cause hospital mortality. Following this, Cox regression analysis and survival analysis were conducted to further investigate the link between admission SpO2 and all-cause hospital mortality.

Results

The GAM curve demonstrated a non-linear, U-shaped relationship between admission SpO2 and all-cause hospital mortality in AECOPD patients. The nadir of all-cause hospital mortality was associated with an SpO2 of 89.5%. Notably, an SpO2 of 89.5% served as the optimal cutoff for predicting all-cause hospital mortality. Cox regression analysis identified SpO2 as a risk factor for all-cause hospital mortality in AECOPD patients. Patients with SpO2 ≥89.5% exhibited independently lower death risk compared to those with SpO2 <89.5% (hazard ratio: 0.52; 95% confidence interval: 0.37-0.74; P<0.001).

Conclusions

Admission SpO2 level is an independent risk factor for predicting all-cause hospital mortality in AECOPD patients and can serve as a prognostic indicator. A U-shaped relationship was observed, with an admission SpO2 level of 89.5% associated with the lowest mortality, suggesting an optimal range for improved prognosis.

1134 Light Exposure At Daytime On Sleep Quality In Stroke Patient During Rehabilitation

Introduction

Lights maintain the day and night rhythm to set patients’ “wake-up cycle” and to stabilize their physiological functions, which may be expected to improve sleep. This study was aimed to investigate the relations between sleep quality and daytime light exposure in stroke patient during rehabilitation.

Methods

A cross-sectional study design was adopted and 120 stroke patients were recruited from rehabilitation wards of two medical centers and 116 patients completed this study. Research instruments including the Pittsburgh Sleep Quality Index, Epworth Sleepiness Scale, Sleep Log, and Somnowatch (Germany) for actigaphy sleep and light were used to collect data and urinary melatonin concentration were measured.

Results

47.4% of the patients had poor sleep quality (PSQI&gt;5), 74.1% had actigraphic sleep efficiency less than 85%, and 90.5% waked more than 30 minutes after sleep onset. The average exposure time at lower level light (≤149 lux) were 288.8 minutes, accounting for 48% of the day (8:00-18:00). Compared to lower light exposure group (less than 319.5 min at &gt;150 lux), those who exposed to higher level light (more than 319.5 min at &gt;150 lux) had increased 52.1 minutes in actigraphic total sleep time (TST, t=-2.134, p=0.035), increased 8% in actigraphic sleep efficiency (SE, t=-2.053, p=0.042), and decreased 41.1 minutes in actigraphic wake-after-sleep-onset (WASO, t=2.209, p=0.029). Urinary melatonin concentration increased 52.7 pg/ml, but not statistically significant (t=-1.277, p=0.205). Result of multiple regression analysis showed that after controlling for age, gender, post-stroke complications, and environmental interference, time of bright light exposure significantly affected subjective sleep satisfaction (p=0.014), TST (p=0.04), SE (p=0.041), and WASO (p=0.026).

Conclusion

Increasing time of bright illumination (≥150 lux) during daytime may improve sleep quality. Results of this study provide empirical references for non-drug intervention to improve sleep quality in patients with stroke.

Support

This study was supported by the Ministry of Science and Technology, MOST 105-2628-B-040 -005 -MY2.

Constructing Unsaturated Ru Atom Arrays Confined in Mn Oxides to Boost Neutral Water Reduction

Recently, Ru single atoms supported on carbon nanomaterials have demonstrated ultrahigh activity for acid hydrogen evolution reaction (HER), however their neutral HER activity remains low due to the sluggish kinetics for both the water dissociation step to generate H* intermediates and subsequent H* recombination in neutral electrolytes. Here, we synthesize ordered low-coordinated Ru atom arrays confined in Mn oxides (i.e., Li4Mn5O12) for concurrently boosting the water dissociation and H* recombination, thus achieving a 6-fold HER activity enhancement than commercial Pt/C in neutral media. Control experiments indicate that low-coordinated Ru atoms with strong affinity to oxygen atoms of water molecules facilitate the water dissociation to rapidly generate H*. More importantly, both electrochemical and theoretic results uncover that the array-like structure allows the activation of two water molecules on two adjacent Ru atoms for enabling direct H*-H* recombination via the Tafel step, while isolated Ru atoms can only activate water one by one for recombining H* via the sluggish Heyrovsky step. Clearly, this work paves new avenues to boosting the electrocatalytic activity by constructing ordered metal atoms assembles with controllable coordination environments.