Recent Advancement in Rational Design Modulation of MXene: A Voyage from Environmental Remediation to Energy Conversion and Storage

Use of MXenes (Ti₃ C₂ T_x ), which belongs to the family of two-dimensional transition metal nitrides and carbides by encompassing unique combination of metallic conductivity and hydrophilicity, is receiving tremendous attention, since its discovery as energy material in 2011. Owing to its precursor selective chemical etching, and unique intrinsic characteristics, the MXene surface properties are further classified into highly chemically active compound, which further produced different surface functional groups i. e., oxygen, fluorine or hydroxyl groups. However, the role of surface functional groups doesn't not only have a significant impact onto its electrochemical and hydrophilic characteristics (i. e., ion adsorption/diffusion), but also imparting a noteworthy effect onto its conductivity, work function, electronic structure and properties. Henceforth, such kind of inherent chemical nature, robust electrochemistry and high hydrophilicity ultimately increasing the MXene application as a most propitious material for overall environment-remediation, electrocatalytic sensors, energy conversion and storage application. Moreover, it is well documented that the role of MXenes in all kinds of research fields is still on a progress stage for their further improvement, which is not sufficiently summarized in literature till now. The present review article is intended to critically discuss the different chemical aptitudes and the diversity of MXenes and its derivates (i. e., hybrid composites) in all aforesaid application with special emphasis onto the improvement of its surface characteristics for the multidimensional application. However, this review article is anticipated to endorse MXenes and its derivates hybrid configuration, which is discussed in detail for emerging environmental decontamination, electrochemical use, and pollutant detection via electrocatalytic sensors, photocatalysis, along with membrane distillation and the adsorption application. Finally, it is expected, that this review article will open up new window for the effective use of MXene in a broad range of environmental remediation, energy conversion and storage application as a novel, robust, multidimensional and more proficient materials.

Impact of cardiac resynchronisation therapy in patients with cardiac sarcoidosis

Background

Implantation of a device is usually required in cardiac sarcoidosis (CS) patients presenting with advanced conduction abnormalities or ventricular arrhythmias. A cardiac resynchronisation therapy (CRT) device is often chosen in patients with concomitant left ventricular systolic impairment. The role of CRT in CS is not well established.

Purpose

To describe the cohort of CS patients with CRT device in situ in our hospital focusing on the short-term effect in serial echocardiography and long-term outcomes on morbidity and mortality.

Methods

All consecutive CS patients with a CRT device in situ were identified in our CS database (2005–2022). A confident CS diagnosis was provided after review of all relevant clinical and imaging baseline data in our CS multi-disciplinary meeting and a consensus decision for CRT-D implantation was made based on international guidelines. All patients were followed up for at least 6 months with serial echocardiography. Serial data regarding symptoms, rhythm disturbance and echocardiographic parameters were obtained and comparisons were performed using Wilcoxon signed rank test.

Results

A total of 51 CS patients with CRT-D were identified (mean age: 57±10 years old). Patients were male predominant (64.7%) and Caucasian in origin (86.2%). Extra-cardiac sarcoidosis was confirmed histologically in 33 (64.7%) patients. The prevalence of smoking, diabetes, hypertension and ischaemic heart disease was 27.5%, 21.6%, 49.0% and 7.8% respectively. At the time of device implantation or during follow-up, 43 (84.3%) patients were found to have active cardiac sarcoidosis on cardiac PET.

Post CRT implantation there was a significant difference in LV ejection fraction (35.9±15.0% vs 42.2±14.1%, p<0.001), LV end-systolic diameter (4.90±1.46 cm vs 4.62±1.32 cm, p=0.012) and LV end-diastolic diameter (5.99±1.18 cm vs 5.66±1.06 cm, p<0.001). No significant changes were observed in the right ventricular function (p=0.09) and severity of mitral regurgitation (p=0.40). There was one patient who experienced acute heart failure decompensation admission within six months of CRT-D implantation. The New York Heart Association (NYHA) class improved in 26 patients (51.0%), worsened in 4 (7.8%) patients and remained the same in 21 (41.2%) patients at 6 months post CRT-implantation. During the mean follow up of 47.6 months, the composite end-point of death and cardiac transplantation was reached in 9 (17.6%) patients (8 deaths and 1 cardiac transplantation). 5 patients had major complications including a large haematoma, a small atrio-septal defect, haemothorax, device associated endocarditis and lead fracture. Minor wound infections were seen in 3 patients and 4 patients received inappropriate shock or anti-tachycardia pacing.

Conclusions

CRT in cardiac sarcoidosis patients is associated with short-term improvement in LV remodelling and functional status but over a four year follow up, morbidity and mortality are common.

Funding Acknowledgement

Type of funding sources: None.

Digital health technology for remote care in response to the COVID-19 pandemic: a scoping review

COVID-19 pandemic has forced the emergency deployment of digital health technology (DHT) to provide remote care. DHT is a promising option to enable telehealth, and, by the same token, it contributes to the implementation of social distance measures. The objective of this scoping review is to investigate existing DHT solutions that have been put in place to enable remote care in response to the COVID-19 pandemic. Structured literature searches were performed in Medline (Ovid), Scopus and CINAHL with Full Text (EBSCOhost), with a mix of keywords and controlled vocabulary unique to each database. The librarian utilized the search strategy on respiratory pandemics created in April 2020 for Medline (Ovid) by Canadian Agency for Drugs and Technology in Health (CADTH). An additional search for grey literature was performed including pre-prints and reports in Google Advanced, LitCovid and MedRx. Two independent reviewers assessed the articles retrieved from the databases (n=131) based on pre-established inclusion criteria and included six articles. Analysis of the results revealed six different types of DHT, including 5 dedicated to telemedicine and one used to track activity of people who were confined to their homes. The results showed positive health-related outcomes and user behavior outcomes. This review revealed that there is limited literature on the use of DHT to enable remote care in response to a pandemic and therefore calls for more documentation of the ongoing deployment of DHTs to support patient safety and the delivery of quality care during the COVID-19 pandemic and beyond.

Perioperative intravenous contrast administration and the incidence of acute kidney injury after major gastrointestinal surgery: prospective, multicentre cohort study

BACKGROUND

This study aimed to determine the impact of preoperative exposure to intravenous contrast for CT and the risk of developing postoperative acute kidney injury (AKI) in patients undergoing major gastrointestinal surgery.

METHODS

This prospective, multicentre cohort study included adults undergoing gastrointestinal resection, stoma reversal or liver resection. Both elective and emergency procedures were included. Preoperative exposure to intravenous contrast was defined as exposure to contrast administered for the purposes of CT up to 7 days before surgery. The primary endpoint was the rate of AKI within 7 days. Propensity score-matched models were adjusted for patient, disease and operative variables. In a sensitivity analysis, a propensity score-matched model explored the association between preoperative exposure to contrast and AKI in the first 48 h after surgery.

RESULTS

A total of 5378 patients were included across 173 centres. Overall, 1249 patients (23·2 per cent) received intravenous contrast. The overall rate of AKI within 7 days of surgery was 13·4 per cent (718 of 5378). In the propensity score-matched model, preoperative exposure to contrast was not associated with AKI within 7 days (odds ratio (OR) 0·95, 95 per cent c.i. 0·73 to 1·21; P = 0·669). The sensitivity analysis showed no association between preoperative contrast administration and AKI within 48 h after operation (OR 1·09, 0·84 to 1·41; P = 0·498).

CONCLUSION

There was no association between preoperative intravenous contrast administered for CT up to 7 days before surgery and postoperative AKI. Risk of contrast-induced nephropathy should not be used as a reason to avoid contrast-enhanced CT.

Influence of levodropropizine and hydroxypropyl-β-cyclodextrin association on the physicochemical characteristics of levodropropizine loaded in hydroxypropyl-β-cyclodextrin microcontainers: Formulation and in vitro characterization

BACKGROUND

Poorly water-soluble drugs do not dissolve well in aqueous-based gastrointestinal fluid; therefore, they are not well absorbed. Thus, employing a suitable solubility enhancing technique is necessary for such a drug. Drug/HP‑β‑CD complexation is a promising way to improve solubility and dissolution of a poorly water-soluble drug. Levodropropizine was used as a model drug in this study.

OBJECTIVES

The purpose of this research was to enhance the aqueous solubility and dissolution rate of levodropropizine by employing the inclusion complexation technique.

MATERIAL AND METHODS

A microparticle formulation was prepared from levodropropizine and hydroxypropyl-β-cyclodextrin (HP‑β‑CD) in a 1:1 molar ratio through the spray-drying technique. The host-guest relationship between levodropropizine and HP‑β‑CD was also investigated using the molecular docking computational methodology. The aqueous solubility and dissolution rate of levodropropizine in formulations were assessed and compared with those of the drug alone. X-ray diffraction (XRD), differential scanning calorimetry (DSC), scanning electron microscopy (SEM), and Fourier transform infrared spectroscopy (FTIR) were applied for the solid-state characterization of the prepared samples.

RESULTS

According to the research outcomes, the levodropropizine/HP‑β‑CD formulation had enhanced the aqueous solubility (351.12 ±13.26 vs 92.76 ±5.00 mg/mL) and dissolution rate (97.83 ±3.36 vs 3.12 ±1.76% in 10 min) of levodropropizine, compared to the plain drug powder. The levodropropizine/ HP‑β‑CD formulation had converted the crystalline drug into its amorphous counterpart. Furthermore, no covalent interaction was found to exist between levodropropizine and HP‑β‑CD. The spray-dried particles were discrete. Each particle had a shriveled appearance.

CONCLUSIONS

The levodropropizine/HP‑β‑CD formulation is, therefore, recommended for the more effective administration of levodropropizine through the oral route.

Multilocular cyst of kidney with embryonic tissue

A case of a multilocular cyst in a child is documented, and a brief review of reported cases of multilocular cysts in pediatric age groups is presented. These cases can be divided into two subgroups based on the presence or absence of embryonic tissue within the cysts. The significance of this embryonic tissue with regard to histogenesis and prognosis of the multilocular cysts is discussed.