An exploratory study comparing the quality of contraceptive counseling provided via telemedicine versus in-person visits

OBJECTIVE

Telemedicine for contraceptive services is purported to improve contraceptive access, yet few studies assess the quality of contraceptive counseling provided remotely. We assessed the quality of contraceptive counseling during telemedicine and office visits.

STUDY DESIGN

We conducted a cross-sectional study at Cleveland Clinic Women's Health Institute to compare contraceptive counseling quality between telemedicine (synchronous video) and office visits. We identified eligible patients through ambulatory encounters with primary contraceptive management or counseling ICD-10 codes. Respondents completed a survey assessing demographics, quality of contraceptive counseling, contraceptive method choice, affinity for technology, and attitudes toward telemedicine. We used the validated Interpersonal Quality of Family Planning (IQFP) scale to assess counseling quality. We used the Wilcoxon rank sum test, Pearson's chi-square test and Fisher's exact test to compare baseline characteristics.

RESULTS

Of all eligible patients, 110/380 (29%) completed the survey. Of those who were successfully contacted by phone or mail, 110/201 (55%) completed the survey. The IQFP scores were 'high quality' for 28/52 (54%) of telemedicine-visit respondents versus 37/58 (64%) of office-visit respondents (p = 0.29). The birth control pill was the most popular method, chosen by 27/52 (52%) of telemedicine-visit respondents and 24/58 (41%) of office-visit respondents (p = 0.27). Telemedicine respondents identified ease of communication and less scheduling difficulty as factors that promote telemedicine use. Office-visit respondents identified privacy and communication concerns as factors that deter telemedicine use.

CONCLUSION

When patients self-select the encounter type, their assessment of the quality of contraceptive counseling among telemedicine and office visits is similar, with no statistically significant differences in contraceptive method chosen. Results from this single-center study support the integration of telemedicine in contraceptive service provision.

IMPLICATIONS

The quality of contraceptive counseling is similar among telemedicine and office visits. Telemedicine visits for contraceptive counseling should be routinely offered, and existing services should be expanded.

The impact of endometriosis on embryo morphokinetics: embryos from endometriosis patients exhibit delayed cell cycle milestones and decreased blastulation rates

PURPOSE

To compare morphokinetic parameters in embryos obtained from women with and without endometriosis.

METHODS

We evaluated a total of 3471 embryos resulting from 434 oocyte retrievals performed at a single academic center. One thousand seventy-eight embryos were obtained from women affected by endometriosis and 2393 came from unaffected controls. All embryos were cultured in a time-lapse incubator chamber for up to 6 days. IVF cycle outcomes and morphokinetic parameters collected prospectively were retrospectively reviewed.

RESULTS

Morphokinetic data suggest that embryo development is impaired in embryos obtained from women with endometriosis (EE). EE were slower to achieve the 2-8 cell stages compared to control embryos (CE) (p < 0.001); additionally, time to compaction was delayed compared to CE (p = 0.015). The timing of late developmental events, including morulation and blastulation was also delayed in the endometriosis cohort (p < 0.001). In addition to demonstrating delayed cell cycle milestones, EE were less likely than controls to progress to morula, blastocyst, and expanded blastocyst stages (p < 0.001). Furthermore, a smaller proportion of embryos in the endometriosis group fell into optimal kinetic ranges for cc2 (p = 0.003), t5 (p = 0.019), tSB (p < 0.001), and tEB (p = 0.007). There were no significant differences in clinical pregnancy or live birth rates between groups.

CONCLUSION

Embryos from endometriosis patients demonstrate impairments in both early and late developmental events, and progress to the morula, blastocyst, and expanded blastocyst stages at lower rates than control embryos. Despite these differences, IVF outcomes are similar for patients with and without endometriosis.

Integral evaluation of production safety and genotoxicity of recycling residual sludge for drinking water treatment plants

Recycling residual sludge in drinking water treatment plants (DWTPs) may release excessive heavy metals and organic matter, which are substances of concern because of their toxic and carcinogenic potential. The aim of this study was to investigate potential genotoxic, cytotoxic, and mutagenic effects of recycled residual sludge in terms of quality of water in potable water works. Genotoxic effects of reusing residual sludge were evaluated using: the Ames test, sperm abnormality test in mice, micronucleus assay, comet assay, and single-cell gel electrophoresis assay. The results of the Ames assay show that the disinfected water sample displays bacteriostasis at a dose of 7 L/dish regardless of treatment styles, but mutagenicity ratio (MR) < 2 can still be judged as negative. The micronucleus rates of conventional treatment were slightly genotoxic but only at 4 and 40 L/kg·bw, whereas micronucleus rates of filtered water and disinfectant from the recycling process were negative in all of the dose groups. The levels of DNA damage that are caused by different treatment processes were equivalent. Reusing residual sludge for DWTPs did not contribute to the release of genotoxic or mutagenic compounds, but it did have a remarkable effect on saving the drug dose and increasing drinking water yield. Thus, reusing residual sludge for DWTPs should be widely recommended.

Environmental DNA captures native and non-native fish community variations across the lentic and lotic systems of a megacity

Globally, urbanization poses a major threat to terrestrial biodiversity, yet its impact on fish diversity is poorly understood, mainly because of surveying difficulties. In this study, environmental DNA metabarcoding was used to survey fish communities at 109 lentic and lotic sites across Beijing, and how environmental variables affect fish biodiversity at fine urban spatial scales was investigated. We identified 52 native and 23 non-native taxa, with lentic and lotic waters harboring both common and habitat-specific species. Water quality strongly affected native fish diversity, especially in lentic systems, but had little influence on non-native diversity. Fish diversity showed little response to urban land cover variation, but the relative sequence abundance of non-natives in lotic waters increased linearly with distance from the city center. Our findings illustrate the complex effects of urbanization on native versus non-native fishes in different aquatic habitats and highlight the distinctive considerations needed to conserve urban aquatic biodiversity.

Efficacy and safety of iodine-125 particle implantation for treatment of bone metastatic tumor pain: a retrospective analysis

OBJECTIVE

Patients with advanced tumors often suffer from spinal metastatic tumor pain. The current drugs are less effective and have side effects. The objective was to explore the efficacy of iodine-125 particle implantation in the treatment of bone metastatic tumor pain.

PATIENTS AND METHODS

In a retrospective study, a total of 27 patients with bone metastatic tumors who could not receive surgery or radiotherapy and chemotherapy were analyzed. All patients received conventional treatment, with the visual analog scale (VAS) of >3 points, and the daily onset pain of >3 times. All patients received CT-guided iodine-125 particle implantation to treat local painful lesions. VAS scores were recorded before treatment (T0) and 1 day (T1), 7 days (T2), 30 days (T3), 90 days (T4), and 180 days (T5) after treatment. Kaplan-Meier analytical method was used to calculate the local control rate (LCR) and survival rate (SR).

RESULTS

All patients successfully completed the CT-guided iodine-125 particle implantation. There was no significant difference in VAS scores before and 1 day after surgery. However, compared with pre-operation, the VAS scores decreased at 7, 30, 90, and 180 days after surgery. The postoperative follow-up was 6-38 months, with a median of 16 months; the LCR at 1, 2, and 3 years after the follow-up were 87%, 51%, and 21%, respectively, and the SR was 84%, 43%, and 16%, respectively. Moreover, no serious adverse reactions were observed.

CONCLUSIONS

Iodine-125 particle implantation was effective in the treatment of bone metastatic tumor pain without serious complications, and hence, can be used clinically.

A multimodal approach to reducing post-caesarean opioid use: a quality improvement initiative

OBJECTIVE

To evaluate the impact of a QI initiative to reduce post-caesarean opioid use.

DESIGN

Retrospective cohort study.

SETTING

Academic hospital in the USA.

POPULATION

Women over 18 years undergoing caesarean section.

METHODS

A quality improvement (QI) initiative titled Reduced Option for Opioid Therapy (ROOT) was implemented in women undergoing caesarean section. The intervention included implementation of a postpartum order set maximising the use of scheduled NSAIDs and acetaminophen. Additionally, nursing education promoted non-opioid therapy as first-line, with opioids reserved for breakthrough pain. Performance feedback was provided to nursing staff on a bimonthly basis. Post-caesarean opioid use was reviewed in the 6 months before and after implementation of ROOT.

MAIN OUTCOME MEASURES

The primary outcome was the total morphine milligram equivalents (MME) consumed during the postpartum admission. Secondary outcomes included opioid use per postoperative day, the proportion of opioid-free admissions, the percentage of patients discharged with a prescription for opioids, prescription size, and pain scores.

RESULTS

Following implementation of ROOT, median inpatient opioid use decreased by more than 60%, from 75 to 30 MME per admission (P < 0.001). The proportion of opioid-free admissions increased from 12.6% pre-intervention to 30.7% post-intervention (P < 0.001). Additionally, the median opioid dose prescribed at discharge decreased in the post-intervention cohort, and the proportion of patients discharged without an opioid prescription increased. The reduction in opioids was associated with a slight decrease in patient-reported pain scores.

CONCLUSIONS

Implementation of ROOT significantly reduced opioid use while achieving comparable pain control.

Transmission of severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) through infant feeding and early care practices: A systematic review

BACKGROUND

Perinatal practices such as breast-feeding, kangaroo mother care, rooming-in, and delayed cord clamping have varied by institution during the COVID-19 pandemic. The goal of this systematic review was to examine the success of different practices in preventing viral transmission between SARS-CoV-2 positive mothers and their infants.

METHODS

Electronic searches were performed in the Ovid MEDLINE, Ovid Embase, Cochrane Library, EBSCOhost CINAHL Plus, Web of Science, and Scopus databases. Studies involving pregnant or breastfeeding patients who tested positive for SARS-CoV-2 by RT-PCR were included. Infants tested within 48 hours of birth who had two tests before hospital discharge were included. Infants older than one week with a single test were also included.

RESULTS

Twenty eight studies were included. In the aggregated data, among 190 breastfeeding infants, 22 tested positive for SARS-CoV-2 (11.5%), while 4 of 152 (2.63%) among bottle-fed (Fisher's exact test p = 0.0006). The positivity rates for roomed in infants (20/103, 19.4%) were significantly higher than those isolated (5/300, 1.67%) (P < 0.0001). There was no significant difference in positivity rate among infants who received kangaroo care (25%vs 9%, p = 0.2170), or delayed cord clamping (3.62%vs 0.9%, p = 0.1116).

CONCLUSIONS

Lack of robust studies involving large patient population does not allow meaningful conclusions from this systematic review. Aggregated data showed increased positivity rates of SARS-CoV-2 among infants who were breast fed and roomed-in. There were no differences in SARS-CoV-2 positivity rates in infants received skin to skin care or delayed cord clamping.

Decision-making for prenatal genetic screening: how will pregnant women navigate a growing number of aneuploidy and carrier screening options?

BACKGROUND

Prenatal genetic screens, including carrier screening (CS) and aneuploidy screening (AS), comprise an important component of reproductive healthcare delivery. Clinical practice guidelines emphasize the importance of informed decision-making and patient's preferences regarding the use of these screens. Yet, it is unclear how to achieve this ideal as prenatal genetic screening options rapidly become more complex and increasingly available to patients. With increased complexity and availability of reproductive testing options, decision-support strategies are critical to prepare patients to consider AS and/or CS.

METHODS

A self-administered survey evaluated knowledge and decision-making preferences for expanded carrier (CS) and aneuploidy (AS) prenatal screening. The survey was administered to participants before their first prenatal visit to assess baseline decision-making needs and preference at the initiation of prenatal care. Analysis was approached as a descriptive process.

RESULTS

Participants had similar familiarity with the concepts associated with AS compared to CS; mean knowledge scores for CS was 0.59 [possible range 0.00 to 1.00] and 0.55 for AS. Participants reported preferences to learn about a range of conditions, including those with severe or mild impact, childhood-onset, and adult-onset. Decision-making preference with respect to learning about the associated disease phenotypes for the contained on AS and CS panel shifted with the complexity of the panel, with a greater preference to learn about conditions post-test compared pre-test education as panels increased from 5 to 100 conditions.

CONCLUSION

Patients' baseline knowledge of prenatal genetic screens coupled with evolving decision-making preferences presents challenges for the delivery of prenatal genetic screens. This calls for the development and implementation of innovative approaches to support pregnant patients' decision-making commensurate with advances in prenatal genomics.

Snow Leopard Dietary Preferences and Livestock Predation Revealed by Fecal DNA Metabarcoding: No Evidence for Apparent Competition Between Wild and Domestic Prey

Accurate assessments of the patterns and drivers of livestock depredation by wild carnivores are vital for designing effective mitigation strategies to reduce human-wildlife conflict. Snow leopard’s (Panthera uncia) range extensively overlaps pastoralist land-use and livestock predation there is widely reported, but the ecological determinants of livestock consumption by snow leopards remain obscure. We investigated snow leopard dietary habits at seven sites across the Sanjiangyuan region of the Qinghai–Tibetan Plateau (QTP), an area central to the species’ global range. Snow leopard abundance, wild prey composition, and livestock density varied among those sites, thus allowing us to test the effects of various factors on snow leopard diet and livestock predation. Using DNA metabarcoding, we obtained highly resolved dietary data from 351 genetically verified snow leopard fecal samples. We then analyzed the prey preferences of snow leopards and examined ecological factors related to their livestock consumption. Across the sites, snow leopard prey was composed mainly of wild ungulates (mean = 81.5% of dietary sequences), particularly bharal (Pseudois nayaur), and supplemented with livestock (7.62%) and smaller mammals (marmots, pikas, mice; 10.7%). Snow leopards showed a strong preference for bharal, relative to livestock, based on their densities. Interestingly, both proportional and total livestock consumption by snow leopards increased linearly with local livestock biomass, but not with livestock density. That, together with a slight negative relationship with bharal density, supports apparent facilitation between wild and domestic prey. We also found a significant positive correlation between population densities of snow leopard and bharal, yet those densities showed slight negative relationships with livestock density. Our results highlight the importance of sufficient wild ungulate abundance to the conservation of viable snow leopard populations. Additionally, livestock protection is critically needed to reduce losses to snow leopard depredation, especially where local livestock abundances are high.

Prey partitioning and livestock consumption in the world's richest large carnivore assemblage

Large mammalian carnivores have undergone catastrophic declines during the Anthropocene across the world. Despite their pivotal roles as apex predators in food webs and ecosystem dynamics, few detailed dietary datasets of large carnivores exist, prohibiting deep understanding of their coexistence and persistence in human-dominated landscapes. Here, we present fine-scaled, quantitative trophic interactions among sympatric carnivores from three assemblages in the Mountains of Southwest China, a global biodiversity hotspot harboring the world's richest large-carnivore diversity, derived from DNA metabarcoding of 1,097 fecal samples. These assemblages comprise a large-carnivore guild ranging from zero to five species along with two mesocarnivore species. We constructed predator-prey food webs for each assemblage and identified 95 vertebrate prey taxa and 260 feeding interactions in sum. Each carnivore species consumed 6-39 prey taxa, and dietary diversity decreased with increased carnivore body mass across guilds. Dietary partitioning was more evident between large-carnivore and mesocarnivore guilds, yet different large carnivores showed divergent proportional utilization of different-sized prey correlating with their own body masses. Large carnivores particularly selected livestock in Tibetan-dominated regions, where the indigenous people show high tolerance toward wild predators. Our results suggest that dietary niche partitioning and livestock subsidies facilitate large-carnivore sympatry and persistence and have key implications for sustainable conservation promoting human-carnivore coexistence.

[Abnormal expression of CD44 aggravates liver disease progression in patients with non-alcoholic fatty liver disease accompanied with hepatitis B virus replication]

Objective: To analyze the expression of CD44 in non-alcoholic fatty liver disease (NAFLD) accompanied with hepatitis B virus (HBV) infection and its clinical significance. Methods: Blood sample of hospitalized patients with NAFLD, chronic hepatitis B, cirrhosis, and healthy population (control) was collected. The study was approved by the hospital ethics committee. Serum CD44 level and clinopathological characteristics were analyzed quantitatively by enzyme-linked immunosorbent-assay. Flow cytometry was used to analyze the proportion of CD44(+)T lymphocytes in patients with NAFLD and chronic hepatitis B. NAFLD model was prepared with high-fat diet to verify the abnormal expression of CD44. Results: Compared with the healthy control group, the expression of serum CD44 in the cirrhosis group, chronic hepatitis B group and NAFLD group was increased, and the difference between the groups were statistically significant (P < 0.01). NAFLD patients graded as mild or severe group were equally accompanied by hepatocyte injury, abnormal blood glucose, lipid or CD44. In NAFLD patients accompanied with HBV infection, serum CD44 concentrations were significantly higher in HBsAg, HBeAg and HBV DNA positive group than HBsAg, HBeAg and HBV DNA negative group (P < 0.01). The proportion of CD44(+)T lymphocytes in peripheral blood of NAFLD and chronic hepatitis B group were 78.2% ± 16.3% and 68.5% ± 20.9%, respectively, and both groups (NAFLD and chronic hepatitis B) were significantly higher than the healthy control group (46.5% ± 20.5%) (P < 0.05). The high-fat diet model confirmed that in rat liver tissues the CD44 was overexpressed with fat deposition accompanied with liver cell damage, especially remarkable in liver tissues containing carcinogens. Conclusion: The abnormal expression of CD44 in patients with NAFLD may be related to the malignant transformation of HBV-related liver disease.

Perioperative outcomes in a nationwide sample of patients undergoing surgical treatment of ovarian endometriomas

OBJECTIVE

To evaluate the perioperative outcomes of premenopausal women undergoing cystectomy or oophorectomy for ovarian endometriomas (OMAs) and other benign neoplasms.

DESIGN

Retrospective cohort study.

SETTING

Clinical database containing information from 580 US hospitals.

PATIENT(S)

Women 18 to 50 years old who underwent ovarian cystectomy or oophorectomy for benign indications between 2010 and 2020.

INTERVENTION(S)

We compared procedure route, length of hospital stay, and complication rates by surgical indication (OMA vs. other benign neoplasms) and surgical procedure (cystectomy vs. oophorectomy).

MAIN OUTCOME MEASURE(S)

Thirty-day perioperative adverse events following adnexal surgery, including conversion to laparotomy, blood transfusion, ileus, urinary tract injury, bowel injury, readmission, and death.

RESULT(S)

We identified 120,208 ovarian cystectomies (28,182 OMAs and 92,026 other indications) and 53,476 oophorectomies (8,622 OMAs and 44,854 other indications). During cystectomy, patients with OMAs more commonly experienced conversion to laparotomy (5.1% vs. 3.1%) and readmission (8.5% vs. 7.1%). For oophorectomies, patients with OMAs less frequently had minimally invasive surgery (55.8% vs. 64.8%) or outpatient procedures (33.8% vs. 41.8%). Urinary tract and bowel injuries were rare. Multivariable logistic regression demonstrated that the presence of OMA predicted composite complications during cystectomy (adjusted odds ratio [aOR] 1.23, 95% confidence interval [CI] 1.18-1.28) but not during oophorectomy (aOR 1.05, 95% CI 0.99-1.12). Patients with OMAs had 1.37 times the odds of a composite complication during oophorectomy than during cystectomy (95% CI 1.28-1.47).

CONCLUSION(S)

Patients undergoing ovarian cystectomy for OMAs had higher rates of perioperative adverse events than patients undergoing ovarian cystectomy for other benign neoplasms. Laparotomies were performed more often during oophorectomies for OMAs than for other benign indications.

Efficacy of hyperthermic intraperitoneal chemotherapy and interval debulking surgery in women with advanced uterine serous carcinoma

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In this small series, HIPEC is well tolerated in patients with advanced USC.

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HIPEC at IDS is associated with favorable PFS and OS in advanced USC.

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Further investigation of HIPEC in women with advanced USC is warranted.

Objective(s)

To investigate the efficacy and safety of hyperthermic intraperitoneal chemotherapy (HIPEC) at the time of iterval debulking surgery (IDS) in women with advanced uterine serous carcinoma (USC) following neoadjuvant chemotherapy (NACT).

Methods

An IRB-approved single-institution prospective registry was queried to identify women with incidentally identified USC at the time of IDS + HIPEC for high-grade serous carcinoma. Patient demographic, oncologic, and surgical outcomes data were recorded. Univariate analysis determined progression-free survival (PFS) and overall survival (OS).

Results

In total, seven patients were found to have advanced USC after undergoing IDS + HIPEC, with a median age of 64.5 years. The majority had stage IV, (n = 6, 85.7%), MMR proficient (n = 5, 71.4%), p53 mutant (n = 6, 85.1%) USC. The median pre-operative CA125 was 24.0U/mL. HIPEC regimen was cisplatin (n = 3, 42.9%) or cisplatin with paclitaxel (n = 4, 57.1%). All patients underwent optimal cytoreduction, with 71.4% (n = 5) having no gross residual disease. Accordion post-operative complications were mild in 14.3% (n = 1), moderate in 57.1% (n = 4) and severe in 14.3% (n = 1); 14.3% (n = 1) had no complications. The median length of stay was 6.5 days (IQR 4–8 days) with a median time to chemotherapy of 33.0 days. The median PFS was 14.0 months (95% CI 3.5–20.8 months), and the median OS was 27.0 months (95% CI 5.1- not reached).

Conclusions

In this small, prospective series, we demonstrate that IDS + HIPEC is well tolerated in patients with USC and is associated with favorable PFS and OS following NACT. Further prospective investigation is needed to validate these promising findings in larger, heterogeneous cohorts of women with advanced USC who are not candidates for primary surgical management.

MicroRNA-376b-3p targets RGS1 mRNA to inhibit proliferation, metastasis, and apoptosis in osteosarcoma

Background

To investigate the role of microRNA-376b-3p (miR-376b-3p) and regulator of G protein signaling 1 (RGS1) in the proliferation, metastasis, and apoptosis of osteosarcoma.

Methods

Differentially expressed genes (DEGs) between tumor and normal tissues from GSE14359 and GSE33382 in the cancer genome atlas (TCGA) dataset were analyzed with GEO2R online. Similarly, differentially expressed miRNAs from GSE70367 were also analyzed with GEO2R. The interaction between the differentially expressed miRNAs and the shared distal metastasis-related DEGs from the two datasets were analyzed using miRWalk and Cytoscape. RGS1 and miR-376-3p were chosen to verify the prediction. RGS1 stably expressing and silencing cells were established based on the MG63 and U2OS cell lines. The targeting of RGS1 with miR-376b-3p was confirmed with Starbase prediction and luciferase reporter assay. Cell proliferation, metastasis, and apoptosis were characterized in vitro and in xenograft mice.

Results

A total of 10 up-regulated and 8 down-regulated DEGs were characterized as shared metastasis-related DEGs for GSE14359 and GSE33382. Among these DEGs, RGS1 was targeted with miR-376b-3p, a predicted down-regulated miRNA in GSE70367. High expression of RGS1 predicted proliferation, invasion, metastases, and poor prognosis in osteosarcoma. Overexpression of RGS1 promoted proliferation, invasion, mobility, and stemness in MG63 and U2OS cells, while silencing of RGS1 had the opposite effect in both cell lines. High expression of RGS1 promoted tumor growth in xenograft nude mice. RGS1 was targeted with miR-376b-3p; the addition of miR-376b-3p down-regulated RGS1, and suppressed cell proliferation, invasion, and metastasis. Meanwhile, sponging of miR-376b-3p had the opposite effect. The suppressive effects of miR-376b-3p could be abolished with RGS1, as cell proliferation, stemness, metastasis, and invasion were all promoted with RGS1 co-transfection in both cell lines.

Conclusions

Our study indicated that RGS1 is a tumor-promoting gene in osteosarcoma, which could be inhibited with miR-376b-3p.

High-Voltage and Wide-Temperature Lithium Metal Batteries Enabled by Ultrathin MOF-Derived Solid Polymer Electrolytes with Modulated Ion Transport

Solid polymer electrolytes (SPEs) of superior ionic conductivity, long-term cycling stability, and good interface compatibility are regarded as promising candidates to enable the practical applications of solid lithium metal batteries (SLMBs). Here, a mixed-matrix SPE (MMSE) with incorporated metal-organic frameworks (MOFs) and ionic liquid is prepared. The dissociation of Li salt in MMSE can be promoted effectively due to the introduction of MOF via the Fourier-transform infrared spectroscopy (FT-IR) analysis, density functional theory calculation, and molecular dynamics simulation. The as-formed MMSE exhibits an ultralow thickness of 20 μm with a satisfactory ionic conductivity and lithium-ion transference number (1.1 mS cm^-1 at 30 °C, 0.72). The optimized SLMBs with high-voltage LiMn_0.75Fe_0.25PO₄ (LMFP) exhibit an excellent cyclability at 4.2 V under room temperature. Moreover, Li/MMSE/LiFePO₄ cells have desirable cycle performance from -20 to 100 °C, and their capacity remains 143.3 mA h g^-1 after being cycled 300 times at 10 C at 100 °C. The Li/LiFePO₄ pouch cells also show excellent safety under extreme conditions. The Li symmetric cells can work steadily even at a supreme current density of 4 mA cm^-2 at 100 °C. From the above analysis, these MMSEs present new opportunities for the development of SLMBs with good electrochemical properties.

Pre-oxidation induced in situ interface strengthening in biodegradable Zn/nano-SiC composites prepared by selective laser melting

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Zn/nano-SiC biocomposites were prepared via pre-oxidation and selective laser melting.

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In situ reaction improved the interface bonding between nano-SiC and the Zn matrix.

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The improved interfacial bonding enhanced the mechanical properties of the biocomposite.

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The biocomposite exhibited favorable biocompatibility on cell proliferation and adhesion.

Introduction

Nano-SiC has attracted great attention as ceramic reinforcement in metal matrix composites, but the weak interface bonding between them remains a bottleneck for efficient strengthening.

Objective

In this study, pre-oxidation treatments and selective laser melting (SLM) were employed to prepare Zn/nano-SiC biocomposites with strengthened interface bonding via in situ reaction.

Methods

Nano-SiC and Zn powders were pre-oxidized respectively, and then used to prepare Zn/nano-SiC biocomposites via SLM. The powder microstructure, and the interface characteristics and mechanical properties of the biocomposites were investigated. The degradation properties and cell response were analyzed to evaluate their feasibility for orthopedic applications.

Results

The results indicated that the pre-oxidation treatments generated a uniform oxide layer on the surface of both nano-SiC and Zn particles and the thickness of the oxide layer increased with pre-oxidation temperature. During the SLM process, the oxide layers not only improved the metal-ceramic wettability by reducing interface energy, but also induced in situ reaction to form chemical bonding between the Zn matrix and nano-SiC, thereby improving the interface bonding. Consequently, the Zn biocomposite reinforced by nano-SiC with a pre-oxidation temperature of 1000 °C (ZS1000 biocomposite) exhibited more transgranular fracture and significantly enhanced compressive yield strength of 171.5 MPa, which was 31.6% higher than that of the Zn biocomposite reinforced by nano-SiC without pre-oxidation. Moreover, the ZS1000 biocomposite presented slightly accelerated degradation which might be ascribed to the facilitated electron transfer by the interface product (Zn₂SiO₄). In addition, the ZS1000 biocomposite also showed appropriate biocompatibility for MG-63 cell adhesion, growth, and proliferation.

Conclusion

This study shows the potential practical applicability for the preparation of Zn-based biocomposites with strong interface bonding and mechanical properties for orthopedic applications.

Reducing autocorrelation time in determinant quantum Monte Carlo using the Wang-Landau algorithm: Application to the Holstein model

When performing a Monte Carlo calculation, the running time should, in principle, be much longer than the autocorrelation time in order to get reliable results. Among different lattice fermion models, the Holstein model is notorious for its particularly long autocorrelation time. In this paper, we employ the Wang-Landau algorithm in the determinant quantum Monte Carlo to achieve the flat-histogram sampling in the "configuration weight space," which can greatly reduce the autocorrelation time by sacrificing some sampling efficiency. The proposal is checked in the Holstein model on both square and honeycomb lattices. Based on such a Wang-Landau assisted determinant quantum Monte Carlo method, some models with long autocorrelation times can now be simulated possibly.

Factors Associated With Unplanned Admission in Patients Intended for Same Day Discharge After Minimally Invasive Hysterectomy for Endometrial Cancer

Objectives. To identify factors that lead to successful same-day discharge compared with unplanned and planned admission after minimally invasive hysterectomy for endometrial cancer. Methods. Patients undergoing laparoscopic or robotic hysterectomy for endometrial cancer between 2016 and 2019 were retrospectively reviewed. 3 groups were created: same-day discarge (SDD), unplanned admission (UA), and planned admission(PA). Demographic/perioperative factors and encounters after discharge were compared. A multivariable logistic regression was performed. Results. 262 patients were included. By year, the success of SDD increased from 59.1% to 82.5%. Patients who underwent SDD compared with admission were younger (62.2 vs 66.2, P = .003) and had a lower Charlson Comorbidity Index (4 vs 5, P < .001). BMI was not significant. Comparing SDD and UA, shorter operative time (100.3 min vs 130.6 min, P = .037) was associated with SDD. Postoperative pain scores were not significant (3.8 vs 4.7, P = .086). The rate of unscheduled encounters within 30 days of discharge was not significantly different. On multivariable analysis, the odds of SDD decreased by 4% with each 1-year increase in age (OR .96, P = .017). Each 1-minute increase in operative time decreased the odds of SDD by 2% (OR .98, P < .001). Intraoperative acetaminophen (OR 2.78, P = .003) and ketorolac (OR 2.27, P = .031) were predictive of SDD. Conclusion. SDD can be safely incorporated into clinical practice in gynecologic oncology patients undergoing minimally invasive hysterectomy, even for patients older than previously reported. Shorter operative time was associated with SDD. The role of perioperative acetaminophen and ketorolac should be further investigated.