Exploring chemical space, scaffold diversity, and activity landscape of spleen tyrosine kinase active inhibitors

This study aims to comprehensively characterize 576 inhibitors targeting Spleen Tyrosine Kinase (SYK), a non-receptor tyrosine kinase primarily found in haematopoietic cells, with significant relevance to B-cell receptor function. The objective is to gain insights into the structural requirements essential for potent activity, with implications for various therapeutic applications. Through chemoinformatic analyses, we focus on exploring the chemical space, scaffold diversity, and structure-activity relationships (SAR). By leveraging ECFP4 and MACCS fingerprints, we elucidate the relationship between chemical compounds and visualize the network using RDKit and NetworkX platforms. Additionally, compound clustering and visualization of the associated chemical space aid in understanding overall diversity. The outcomes include identifying consensus diversity patterns to assess global chemical space diversity. Furthermore, incorporating pairwise activity differences enhances the activity landscape visualization, revealing heterogeneous SAR patterns. The dataset analysed in this work has three activity cliff generators, CHEMBL3415598, CHEMBL4780257, and CHEMBL3265037, compounds with high affinity to SYK are very similar to compounds analogues with reasonable potency differences. Overall, this study provides a critical analysis of SYK inhibitors, uncovering potential scaffolds and chemical moieties crucial for their activity, thereby advancing the understanding of their therapeutic potential.

Second Skin as Self-Protection Against γ-Hydroxybutyrate

γ-Hydroxybutyrate (GHB), a date-rape drug, causes certain symptoms, such as amnesia, confusion, ataxia, and unconsciousness, when dissolved in beverages and consumed by a victim. Commonly, assailants use GHB in secret for the crime of drug-facilitated sexual assault because it is tasteless, odorless, and colorless when dissolved in beverages. Generally, GHB detection methods are difficult to use promptly and secretly in situ and in real life because of the necessary detection equipment and low selectivity. To overcome this problem, we have developed a fast, simple, and easy-to-use second skin platform as a confidential self-protection platform that can detect GHB in situ or in real life without equipment. The second skin platform for naked-eye detection of GHB is fabricated with poly(vinyl alcohol) (PVA), polyurethane (PU), and polyacrylonitrile (PAN) included in the chemical receptor 2-(3-bromo-4-hydroxystyryl)-3-ethylbenzothiazol-3-ium iodide (BHEI). PAN conjugated with BHEI nanofibers (PB NFs) has various characteristics, such as ease of use, high sensitivity, and fast color change. PB NFs rapidly detected GHB at 0.01 mg/mL. Furthermore, the second-skin platform attached to the fingertip and wrist detected both 1 and 0.1 mg/mL GHB in solution within 50 s. The color changes caused by the interaction of GHB and the second skin platform cannot be stopped due to strong chemical reactions. In addition, a second skin platform can be secretly utilized in real life because it can recognize fingerprints and object temperatures. Therefore, the second skin platform can be used to aid daily life and prevent drug-facilitated sexual assault crime when attached to the skin because it can be exposed anytime and anywhere.

Energy-Efficient Power Management Interface With Adaptive HV Multimode Stimulation for Power-Sensor Integrated Patch-Type Systems

An energy-efficient power management interface (PMI) with adaptive high-voltage (HV) stimulation capability is presented for patch-type healthcare devices where power management and sensor readout circuits are integrated. For efficient power supply, it proposes a multimode buck converter with an adaptive mode controller, delivering 95.6% peak power conversion efficiency and over 90% efficiency across a wide 4-440 mA output current range. For energy-efficient stimulation, a HV stimulation system is designed to perform mode-adaptive on/off control, where the charge pump (CP) is adopted for periodic power saving. The CP output is adaptively tuned to minimize the stimulator's power waste by utilizing a bio-impedance path in the sensor circuit. The stimulation core supports multimode functionality of current-/voltage-controlled stimulations with monopolar and bipolar modes, providing ten kinds of various stimulation waveform shape. For efficient system operation, battery interface circuits are included to monitor state-of-charge (SOC) conditions, and a device power adjustment scheme is proposed to provide SOC-based maximum 28% power reduced optimal operation of high-resolution and low-power. The power-sensor integrated circuits were fabricated in a 0.18-μm CMOS process, and the proposed schemes were experimentally verified. For system-level feasibility, a patch-type device prototype was manufactured, and both power and bio-signal interfaces were functionally demonstrated.

Effect of Tablet-based Cognitive Intervention on Cognition in Patients With Mild Cognitive Impairment: A Pilot Study

Background and Purpose

Growing evidence has shown that cognitive interventions can mitigate cognitive decline in patients with mild cognitive impairment (MCI). However, most previous cognitive interventions have been group-based programs. Due to their intrinsic limitations, group-based programs are not widely used in clinical practice. Therefore, we have developed a tablet-based cognitive intervention program. This preliminary study investigated the feasibility and effects of a 12-week structured tablet-based program on cognitive function in patients with MCI.

Methods

We performed a single-arm study on 24 patients with MCI. The participants underwent a tablet-based cognitive intervention program 5 times a week over a 12-week period. The primary outcome was changes in cognitive function, measured using the Korean version of the Consortium to Establish a Registry for Alzheimer's Disease Assessment Packet (CERAD-K). Outcomes were evaluated at baseline, within two weeks of the last program (post-intervention), and at the six-month follow-up session.

Results

The completion rate of the tablet-based program was 83.3% in patients with MCI. The program improved cognitive function based on the CERAD-K total score (p=0.026), which was maintained for at least three months (p=0.004). There was also an improvement in the depression scale score (p=0.002), which persisted for three months (p=0.027).

Conclusions

Our 12-week structured tablet-based program is feasible for patients with MCI. Furthermore, although further studies with a double-arm design are required, the program appears to be an effective strategy to prevent cognitive decline in patients with MCI.

An optical-based multipoint 3-axis pressure sensor with a flexible thin-film form

Multipoint 3-axis tactile pressure sensing by a high-resolution and sensitive optical system provides rich information on surface pressure distribution and plays an important role in a variety of human interaction-related and robotics applications. However, the optical system usually has a bulky profile, which brings difficulties to sensor mounting and system integration. Here, we show a construction of thin-film and flexible multipoint 3-axis pressure sensor by optical methods. The sensor can detect the distribution of 3-axis pressure on an area of 3 centimeter by 4 centimeter, with a high-accuracy normal and tangential pressure sensing up to 360 and 100 kilopascal, respectively. A porous rubber is used as a 3-axis pressure-sensitive optical modulator to omit the thick and rigid focusing system without sacrificing the sensitivity. In addition, by integrating thin and flexible backlight and imager, the sensor has a total thickness of 1.5 milimeter, making it function properly even when bent to a radius of 18 milimeter.

Batch Nanofabrication of Suspended Single 1D Nanoheaters for Ultralow-Power Metal Oxide Semiconductor-Based Gas Sensors

The demand for power-efficient micro-and nanodevices is increasing rapidly. In this regard, electrothermal nanowire-based heaters are promising solutions for the ultralow-power devices required in IoT applications. Herein, a method is demonstrated for producing a 1D nanoheater by selectively coating a suspended pyrolyzed carbon nanowire backbone with a thin Au resistive heater layer and utilizing it in a portable gas sensor system. This sophisticated nanostructure is developed without complex nanofabrication and nanoscale alignment processes, owing to the suspended architecture and built-in shadow mask. The suspended carbon nanowires, which are batch-fabricated using carbon-microelectromechanical systems technology, maintain their structural and functional integrity in subsequent nanopatterning processes because of their excellent mechanical robustness. The developed nanoheater is used in gas sensors via user-designable localization of the metal oxide semiconductor nanomaterials onto the central region of the nanoheater at the desired temperature. This allows the sensing site to be uniformly heated, enabling reliable and sensitive gas detection. The 1D nanoheater embedded gas sensor can be heated immediately to 250 °C at a remarkably low power of 1.6 mW, surpassing the performance of state-of-the-art microheater-based gas sensors. The presented technology offers facile 1D nanoheater production and promising pathways for applications in various electrothermal devices.

Ferroelectricity-Coupled 2D-MXene-Based Hierarchically Designed High-Performance Stretchable Triboelectric Nanogenerator

Triboelectric nanogenerators based on the state-of-the-art functional materials and device engineering provide an exciting platform for future multifunctional electronics, but it remains challenging to realize due to the lack of in-depth understanding on the functional properties of nanomaterials that are compatible with microstructural engineering. In this study, a high-performance stretchable (∼60% strain) triboelectric nanogenerator is demonstrated via an interlocked microstructural device configuration sandwiched between silver-nanowire-(Ag-NW) electrodes and hierarchically engineered spongy thermoplastic polyurethane (TPU) polymer composite with ferroelectric barium-titanate-coupled (BTO-coupled) 2D MXene (Ti₃C₂T_x) nanosheets. The use of MXene results in an increase in the dielectric constant whereas the dielectric loss is lowered via coupling with the ferroelectricity of BTO, which increases the overall output performance of the nanogenerator. The spongy nature of the composite film increases the capacitance variation under deformation, which results in improved energy-conversion efficiency (∼79%) and pressure sensitivity (4.6 VkPa^-1 and 2.5 mAkPa^-1) of the device. With the quantum-mechanically calculated electronic structure, the device converts biomechanical energy to electrical energy and generates an open-circuit output voltage of 260 V, short-circuit output current of 160 mA/m², and excellent power output of 6.65 W/m², which is sufficient to operate several consumer electronics. Owing to its superior pressure sensitivity and efficiency, the device enables a broad range of applications including real-time clinical human vital-sign monitoring, acoustic sensing, and multidimensional gesture-sensing functionality of a robotic hand. Considering the ease of fabrication, excellent functionality of the hierarchical polymer nanocomposite, and outstanding energy-harvesting performance of nanogenerators, this work is expected to stimulate the development of next-generation self-powered technology.

On-skin paintable biogel for long-term high-fidelity electroencephalogram recording

Long-term high-fidelity electroencephalogram (EEG) recordings are critical for clinical and brain science applications. Conductive liquid-like or solid-like wet interface materials have been conventionally used as reliable interfaces for EEG recording. However, because of their simplex liquid or solid phase, electrodes with them as interfaces confront inadequate dynamic adaptability to hairy scalp, which makes it challenging to maintain stable and efficient contact of electrodes with scalp for long-term EEG recording. Here, we develop an on-skin paintable conductive biogel that shows temperature-controlled reversible fluid-gel transition to address the abovementioned limitation. This phase transition endows the biogel with unique on-skin paintability and in situ gelatinization, establishing conformal contact and dynamic compliance of electrodes with hairy scalp. The biogel is demonstrated as an efficient interface for long-term high-quality EEG recording over several days and for the high-performance capture and classification of evoked potentials. The paintable biogel offers a biocompatible and long-term reliable interface for EEG-based systems.

Frequency-selective acoustic and haptic smart skin for dual-mode dynamic/static human-machine interface

Accurate transmission of biosignals without interference of surrounding noises is a key factor for the realization of human-machine interfaces (HMIs). We propose frequency-selective acoustic and haptic sensors for dual-mode HMIs based on triboelectric sensors with hierarchical macrodome/micropore/nanoparticle structure of ferroelectric composites. Our sensor shows a high sensitivity and linearity under a wide range of dynamic pressures and resonance frequency, which enables high acoustic frequency selectivity in a wide frequency range (145 to 9000 Hz), thus rendering noise-independent voice recognition possible. Our frequency-selective multichannel acoustic sensor array combined with an artificial neural network demonstrates over 95% accurate voice recognition for different frequency noises ranging from 100 to 8000 Hz. We demonstrate that our dual-mode sensor with linear response and frequency selectivity over a wide range of dynamic pressures facilitates the differentiation of surface texture and control of an avatar robot using both acoustic and mechanical inputs without interference from surrounding noise.

Surface decontamination of protective duplex oxide layers on stainless steel waste using deep eutectic solvents

The decontamination capabilities of deep eutectic solvents (DESs) formed from choline chloride (ChCl) and p-toluenesulfonic acid monohydrate (PtsA), ChCl:PtsA, under different conditions (hydrated, heated, and agitated) were tested with simulant oxidized stainless steel 304 specimens. Although the leaching rates were satisfactory under all conditions, hydrated and stirred ChCl:PtsA at 60 °C showed the fastest leaching rate of 0.1647 mg/min. Oxidized specimens with an average mass gain of 1.2 ± 1 mg were leached, and their masses were reduced by 558 ± 22 mg after 26 h. These results were understood by improved physical properties of ChCl:PtsA upon hydration. Metal oxide solubility of CoO and NiO increased with water, and those of Cr₂O₃ and Fe₃O₄ decreased with hydration. Importantly, the use of choline chloride-based DESs in decontamination applications may significantly reduce the cost of decontamination because these DESs can be mass-produced and their components are both easily obtainable and economical. Also, DESs are biodegradable and eco-friendly. The different speciation of Co and Ni, which bond with Cl^-, compared with Fe and Cr, which bond with H₂O, illustrated the potential for a metal recovery for secondary liquid waste reduction.

Correction to: Large‑scale pathway specific polygenic risk and transcriptomic community network analysis identifies novel functional pathways in Parkinson disease

A correction to this paper has been published: https://doi.org/10.1007/s00401-021-02309-z

Scaling Up Maternal Mental healthcare by Increasing access to Treatment (SUMMIT) through non-specialist providers and telemedicine: a study protocol for a non-inferiority randomized controlled trial

BACKGROUND

Depression and anxiety impact up to 1 in 5 pregnant and postpartum women worldwide. Yet, as few as 20% of these women are treated with frontline interventions such as evidence-based psychological treatments. Major barriers to uptake are the limited number of specialized mental health treatment providers in most settings, and problems with accessing in-person care, such as childcare or transportation. Task sharing of treatment to non-specialist providers with delivery on telemedicine platforms could address such barriers. However, the equivalence of these strategies to specialist and in-person models remains unproven.

METHODS

This study protocol outlines the Scaling Up Maternal Mental healthcare by Increasing access to Treatment (SUMMIT) randomized trial. SUMMIT is a pragmatic, non-inferiority test of the comparable effectiveness of two types of providers (specialist vs. non-specialist) and delivery modes (telemedicine vs. in-person) of a brief, behavioral activation (BA) treatment for perinatal depressive and anxiety symptoms. Specialists (psychologists, psychiatrists, and social workers with ≥ 5 years of therapy experience) and non-specialists (nurses and midwives with no formal training in mental health care) were trained in the BA protocol, with the latter supervised by a BA expert during treatment delivery. Consenting pregnant and postpartum women with Edinburgh Postnatal Depression Scale (EPDS) score of ≥ 10 (N = 1368) will be randomized to one of four arms (telemedicine specialist, telemedicine non-specialist, in-person specialist, in-person non-specialist), stratified by pregnancy status (antenatal/postnatal) and study site. The primary outcome is participant-reported depressive symptoms (EPDS) at 3 months post-randomization. Secondary outcomes are maternal symptoms of anxiety and trauma symptoms, perceived social support, activation levels and quality of life at 3-, 6-, and 12-month post-randomization, and depressive symptoms at 6- and 12-month post-randomization. Primary analyses are per-protocol and intent-to-treat. The study has successfully continued despite the COVID-19 pandemic, with needed adaptations, including temporary suspension of the in-person arms and ongoing randomization to telemedicine arms.

DISCUSSION

The SUMMIT trial is expected to generate evidence on the non-inferiority of BA delivered by a non-specialist provider compared to specialist and telemedicine compared to in-person. If confirmed, results could pave the way to a dramatic increase in access to treatment for perinatal depression and anxiety.

TRIAL REGISTRATION

ClinicalTrials.gov NCT04153864 . Registered on November 6, 2019.

On-site identification of ozone damage in fruiting plants using vapor-deposited conducting polymer tattoos

Climate change is leading to increased concentrations of ground-level ozone in farms and orchards. Persistent ozone exposure causes irreversible oxidative damage to plants and reduces crop yield, threatening food supply chains. Here, we show that vapor-deposited conducting polymer tattoos on plant leaves can be used to perform on-site impedance analysis, which accurately reveals ozone damage, even at low exposure levels. Oxidative damage produces a unique change in the high-frequency (>10⁴ Hz) impedance and phase signals of leaves, which is not replicated by other abiotic stressors, such as drought. The polymer tattoos are resilient against ozone-induced chemical degradation and persist on the leaves of fruiting plants, thus allowing for frequent and long-term monitoring of cellular ozone damage in economically important crops, such as grapes and apples.

Large-scale pathway specific polygenic risk and transcriptomic community network analysis identifies novel functional pathways in Parkinson disease

Polygenic inheritance plays a central role in Parkinson disease (PD). A priority in elucidating PD etiology lies in defining the biological basis of genetic risk. Unraveling how risk leads to disruption will yield disease-modifying therapeutic targets that may be effective. Here, we utilized a high-throughput and hypothesis-free approach to determine biological processes underlying PD using the largest currently available cohorts of genetic and gene expression data from International Parkinson's Disease Genetics Consortium (IPDGC) and the Accelerating Medicines Partnership-Parkinson's disease initiative (AMP-PD), among other sources. We applied large-scale gene-set specific polygenic risk score (PRS) analyses to assess the role of common variation on PD risk focusing on publicly annotated gene sets representative of curated pathways. We nominated specific molecular sub-processes underlying protein misfolding and aggregation, post-translational protein modification, immune response, membrane and intracellular trafficking, lipid and vitamin metabolism, synaptic transmission, endosomal-lysosomal dysfunction, chromatin remodeling and apoptosis mediated by caspases among the main contributors to PD etiology. We assessed the impact of rare variation on PD risk in an independent cohort of whole-genome sequencing data and found evidence for a burden of rare damaging alleles in a range of processes, including neuronal transmission-related pathways and immune response. We explored enrichment linked to expression cell specificity patterns using single-cell gene expression data and demonstrated a significant risk pattern for dopaminergic neurons, serotonergic neurons, hypothalamic GABAergic neurons, and neural progenitors. Subsequently, we created a novel way of building de novo pathways by constructing a network expression community map using transcriptomic data derived from the blood of PD patients, which revealed functional enrichment in inflammatory signaling pathways, cell death machinery related processes, and dysregulation of mitochondrial homeostasis. Our analyses highlight several specific promising pathways and genes for functional prioritization and provide a cellular context in which such work should be done.

Double MgO-Based Perpendicular Magnetic Tunnel Junction for Artificial Neuron

A perpendicular spin transfer torque (p-STT)-based neuron was developed for a spiking neural network (SNN). It demonstrated the integration behavior of a typical neuron in an SNN; in particular, the integration behavior corresponding to magnetic resistance change gradually increased with the input spike number. This behavior occurred when the spin electron directions between double Co₂Fe₆B₂ free and pinned layers in the p-STT-based neuron were switched from parallel to antiparallel states. In addition, a neuron circuit for integrate-and-fire operation was proposed. Finally, pattern-recognition simulation was performed for a single-layer SNN.

A209 ROLE OF SEROTONIN-AUTOPHAGY AXIS IN REGULATION OF EPITHELIAL CELL FUNCTION AND MICROBIOTA COMPOSITION IN GUT

Background

Serotonin (5-hydroxytryptamine; 5-HT), an enteric signalling molecule mainly produced by the enterochromaffin (EC) cells of the intestinal epithelium regulates various processes of the gut. Tryptophan hydroxylase 1 (Tph1) is the rate-limiting enzyme of 5-HT biosynthesis in EC cells. In inflammatory bowel disease (IBD) and experimental colitis, there are alterations in 5-HT content and microbiota composition in the gut. Previously we reported, Tph1-deficient (Tph1-/-) mice with reduced 5-HT in the gut exhibit reduced susceptibility to colitis. The mechanism by which 5-HT regulates colitis is unknown. Autophagy, a catabolic process regulates the function of intestinal epithelial cells (IECs), gut microbiota, and protects against intestinal inflammation. Both aberrant 5-HT signalling and autophagy is implicated in colitis. It is unclear whether they interact in regulation of production of pro-inflammatory cytokines from IECs and gut microbiota composition in relation to colitis. Our hypothesis is, an increase in 5-HT signalling inhibits autophagy in the IECs, which results in up-regulation of colitis by increasing the production of pro-inflammatory cytokines, and by selection for a more colitogenic microbiota.

Aims

To define the role of 5-HT-autophagy axis in the production of pro-inflammatory cytokines from IECs and gut microbiota composition in intestinal inflammation.

Methods

We investigated level of autophagy with or without 5% dextran sodium sulphate (DSS) in colons, mucosal scraping and IECs of Tph1-/- and their wild-type (WT) littermates. In addition, autophagy and proinflammatory cytokine production were investigated in human colonic epithelial cells (HT-29) following stimulation by 5-HT. We evaluated colitis and gut microbiota composition in WT, Tph1-/-, epithelial-specific autophagy gene Atg7 deficient (Atg7ΔIEC), and Atg7ΔIECTph1-/- (double knock out; DKO) mice.

Results

Tph1 -/- mice, with less 5-HT in the gut than WT mice following DSS administration exhibited an up-regulation of autophagy markers in the colon, mucosal scraping and IECs along with reduction of colitis severity. 5-HT treatment of HT-29 cells resulted in down-regulation of autophagy and upregulation of pro-inflammatory cytokine, IL-8. DKO mice exhibited increased severity of DSS-colitis, and altered microbiota composition compared to Tph1-/- mice.

Conclusions

These findings suggest, an increase in 5-HT in colitis inhibits autophagy in the IECs that contribute to alteration of the gut microbiota and disease severity. Blocking 5-HT signalling may promote autophagy in the IECs and alleviate the severity of colitis. Understanding the contribution of 5-HT in autophagy may identify new therapeutic target in IBD and other intestinal inflammatory conditions that exhibit dysregulated autophagy.

Funding Agencies

CAG, CIHR

Real-time and noninvasive detection of UV-Induced deep tissue damage using electrical tattoos

Understanding longterm deep tissue damage caused by UV radiation is imperative for ensuring the health and safety of living organisms that are regularly exposed to radiation sources. While existing UV dosimeters can quantify the cumulative amount of radiation to which an organism is exposed, these sensors cannot reveal the presence and extent of internal tissue damage caused by such exposure. Here we describe a method that uses conducting polymer tattoos to detect UV radiation-induced deep tissue damage in living organisms using bioimpedance analysis (BIA), which allows for noninvasive, real-time measurements of body composition and point-of-care assessment of clinical condition. To establish a performance baseline for this method, we quantify the effects of UVA radiation on live plant leaves. Low-energy UVA waves penetrate further into biological tissue, as compared to UVB, UVC and ionizing radiation, and cause longlasting deep tissue damage that cannot be immediately and readily detected using surface-sensitive techniques, such as photogrammetry and epidermal sensors. We show that single-frequency bioimpedance analysis allows for sensitive, real-time monitoring of UVA damage: as UVA dose increases, the bioimpedance of a plant leaf measured at a frequency of 1 kHz linearly decreases until the extent of radiation damage saturates and the specimen is effectively necrotized. We establish a strong correlation between radiation fluence, internal biological damage and the bioimpedance signal measured using our conducting polymer tattoos, which supports the efficacy of our method as a new type of internal biodosimetry.

Development and validation of a clinical prediction-score model for distant metastases in major salivary gland carcinoma

BACKGROUND

The most common pattern of failure in major salivary gland carcinoma (SGC) is development of distant metastases (DMs). The objective of this study was to develop and validate a prediction score for DM in SGC.

PATIENTS AND METHODS

Patients with SGC treated curatively at four tertiary cancer centers were divided into discovery (n = 619) and validation cohorts (n = 416). Multivariable analysis using competing risk regression was used to identify predictors of DM in the discovery cohort and create a prediction score of DM; the optimal score cut-off was determined using a minimal P value approach. The prediction score was subsequently evaluated in the validation cohort. The cumulative incidence and Kaplan-Meier methods were used to analyze DM and overall survival (OS), respectively.

RESULTS

In the discovery cohort, DM predictors (risk coefficient) were: positive margin (0.6), pT3-4 (0.7), pN+ (0.7), lymphovascular invasion (0.8), and high-risk histology (1.2). High DM-risk SGC was defined by sum of coefficients greater than two. In the discovery cohort, the 5-year incidence of DM for high- versus low-risk SGC was 50% versus 8% (P < 0.01); this was similar in the validation cohort (44% versus 4%; P < 0.01). In the pooled cohorts, this model performed similarly in predicting distant-only failure (40% versus 6%, P < 0.01) and late (>2 years post surgery) DM (22% versus 4%; P < 0.01). Patients with high-risk SGC had an increased incidence of DM in the subgroup receiving postoperative radiation therapy (46% versus 8%; P < 0.01). The 5-year OS for high- versus low-risk SGC was 48% versus 92% (P < 0.01).

CONCLUSION

This validated prediction-score model may be used to identify SGC patients at increased risk for DM and select those who may benefit from prospective evaluation of treatment intensification and/or surveillance strategies.

A Large Anisotropic Enhancement of the Charge Carrier Mobility of Flexible Organic Transistors with Strain: A Hall Effect and Raman Study

Utilizing the intrinsic mobility-strain relationship in semiconductors is critical for enabling strain engineering applications in high-performance flexible electronics. Here, measurements of Hall effect and Raman spectra of an organic semiconductor as a function of uniaxial mechanical strain are reported. This study reveals a very strong, anisotropic, and reversible modulation of the intrinsic (trap-free) charge carrier mobility of single-crystal rubrene transistors with strain, showing that the effective mobility of organic circuits can be enhanced by up to 100% with only 1% of compressive strain. Consistently, Raman spectroscopy reveals a systematic shift of the low-frequency Raman modes of rubrene to higher (lower) frequencies with compressive (tensile) strain, which is indicative of a reduction (enhancement) of thermal molecular disorder in the crystal with strain. This study lays the foundation of the strain engineering in organic electronics and advances the knowledge of the relationship between the carrier mobility, low-frequency vibrational modes, strain, and molecular disorder in organic semiconductors.

A Multi-Functional Physiological Hybrid-Sensing E-Skin Integrated Interface for Wearable IoT Applications

This paper presents a flexible multi-functional physiological sensing system that provides multiple noise-immune readout architectures and hybrid-sensing capability with an analog pre-processing scheme. The proposed multi-functional system is designed to support five physiological detection methodologies of piezo-resistive, pyro-resistive, electro-metric, opto-metric and their hybrid, utilizing an in-house multi-functional e-skin device, in-house flexible electrodes and a LED-photodiode pair. For their functional verification, eight representative physiological detection capabilities were demonstrated using wearable device prototypes. Especially, the hybrid detection method includes an innovative continuous measurement of blood pressure (BP) while most previous wearable devices are not ready for it. Moreover, for effective implementation in the form of the wearable device, post-processing burden of the hybrid method was much reduced by integrating a proposed analog pre-processing scheme, where only simple counting process and calibration remain to estimate the BP. This multi-functional sensor readout circuits and their hybrid-sensing interface are fully integrated into a single readout integrated circuit (ROIC), which is designed to implement three readout paths: two electrometric readout paths and one impedometric readout path. For noise-immune detection of the e-skin sensor, a pseudo-differential front-end with a ripple reduction loop is proposed in the impedometric readout path, and also state-of-the-art body-oriented noise reduction techniques are adopted for the electrometric readout path. The ROIC is fabricated in a CMOS process and in-house e-skin devices and flexible electrodes are also fabricated.

In Vitro Models, Standards, and Experimental Methods for Tobacco Products

Traditional tobacco products have well-known systemic and local oral effects, including inflammation, vasoconstriction, delayed wound healing, and increased severity of periodontal disease. Specifically in the oral cavity and the lung, cigarette smoking produces cancer, increased infectivity, acute and chronic inflammation, changes in gene expression in epithelial lining cells, and microbiome changes. In recent years, cigarette smoking has greatly decreased in the United States, but the use of new tobacco products has gained tremendous popularity. Without significant knowledge of the oral sequelae of products such as electronic cigarettes, researchers must evaluate current in vitro and in vivo methods to study these agents, as well as develop new tools to adequately study their effects. Some in vitro testing has been performed for electronic cigarettes, including toxicologic models and assays, but these mostly study the effect on the respiratory tract. Recently, direct exposure of the aerosol to in vitro 3-dimensional tissue constructs has been performed, demonstrating changes in cell viability and inflammatory cytokines. For in vivo studies, a universal e-cigarette testing machine or standard vaping regime is needed. A standard research electronic cigarette has recently been developed by the National Institute of Drug Abuse, and other devices delivering aerosols with different nicotine concentrations are becoming available. One of the biggest challenges in this research is keeping up with the new products and the rapidly changing technologies in the industry.

P3520Admission hyperglycemia is a predictor of mortality of acute heart failure: comparison between patients with and without diabetes mellitus

Background

Regardless of diabetes mellitus (DM), admission hyperglycemia is not uncommon in patients with acute heart failure (AHF). Although DM is a well-known predictor of mortality in AHF, the impacts of admission hyperglycemia on clinical outcomes in non-DM patients with AHF have been poorly studied. The aim of this study, therefore, was to compare the impact of admission hyperglycemia on long-term clinical outcomes in AHF patients with or without DM.

Methods

Among 5,625 AHF patients enrolled in a nationwide registry, a total of 5,541 patients were enrolled and divided into 2 groups; DM group (n=2,125, 70.4±11.4 years) vs. non-DM group (n=3,416, 67.3±16.0 years). Each group were further divided into 2 groups according to the presence of admission hyperglycemia (admission serum glucose level >200mg/dl); admission hyperglycemia (n=248) and no hyperglycemia (n=3,168) in non-DM; admission hyperglycemia (n=799) and no hyperglycemia (n=1,326) in DM. All-cause death and hospitalization due to HF (HHF) during 1-year follow-up were compared.

Results

Death was developed in 1,220 patients (22.2%) including 269 inhospital deaths (4.9%) during 1-year of follow-up. Death rate were significantly higher in DM than in non-DM group (24.8% vs 20.5%, p<0.001), however there was no difference in inhospital death (5.1% vs 4.7%, p=0.534). Both inhospital death (7.6% vs. 4.2%, p<0.001) and 1-year death (26.2% vs. 21.3%, p=0.001) were more frequent in AHF patients with hyperglycemia. On Kaplan-Meier survival curve analysis, however, admission hyperglycemia was associated with significantly higher death (p<0.001 by log-rank test) and rehospitalization (p=0.006 by log-rank test) in non-DM group, but not in DM group. In non-DM group, admission hyperglycemia was an independent predictor of 1-year mortality (HR 1.46, 95% CI 1.10–1.93, p=0.009).

Conclusion

DM was a significant predictor of long-term mortality in patients with AHF. Admission hyperglycemia was associated with both higher inhospital and 1-year mortality. The present study also demonstrated that admission hyperglycemia is an independent predictor of mortality in non-DM patients with AHF, but not in DM patients. In addition to the presence of DM, admission hyperglycemia would be a useful marker in the risk stratification of AHF, especially in non-DM patients.

P3453Gender difference in impact of ischemic heart disease on long-term outcome in patients with heart failure reduced ejection fraction

Background

Ischemic heart disease (IHD) is a major underlying etiology in patients with heart failure (HF). Although the impact of IHD on HF is evolving, there is a lack of understanding of how IHD affects long-term clinical outcomes and uncertainty about the role of IHD in determining the risk of clinical outcomes by gender.

Purpose

This study aims to evaluate the gender difference in impact of IHD on long-term clinical outcomes in patients with heart failure reduced ejection fraction (HFrEF).

Methods

Study data were obtained from the nationwide registry which is a prospective multicenter cohort and included patients who were hospitalized for HF composed of 3,200 patients. A total of 1,638 patients with HFrEF were classified into gender (women 704 and men 934). The primary outcome was all-cause death during follow-up and the composite clinical events of all-cause death and HF readmission during follow-up were also obtained. HF readmission was defined as re-hospitalization because of HF exacerbation.

Results

133 women (18.9%) were died and 168 men (18.0%) were died during follow-up (median 489 days; inter-quartile range, 162–947 days). As underlying cause of HF, IHD did not show significant difference between genders. Women with HFrEF combined with IHD had significantly lower cumulative survival rate than women without IHD at long-term follow-up (74.8% vs. 84.9%, Log Rank p=0.001, Figure 1). However, men with HFrEF combined with IHD had no significant difference in survival rate compared with men without IHD (79.3% vs. 83.8%, Log Rank p=0.067). After adjustment for confounding factors, Cox regression analysis showed that IHD had a 1.43-fold increased risk for all-cause mortality independently only in women. (odds ratio 1.43, 95% confidence interval 1.058–1.929, p=0.020). On the contrary to the death-free survival rates, there were significant differences in composite clinical events-free survival rates between patients with HFrEF combined with IHD and HFrEF without IHD in both genders.

Figure 1

Conclusions

IHD as predisposing cause of HF was an important risk factor for long-term mortality in women with HFrEF. Clinician need to aware of gender-based characteristics in patients with HF and should manage and monitor them appropriately and gender-specifically. Women with HF caused by IHD also should be treated more meticulously to avoid a poor prognosis.

Acknowledgement/Funding

None

SMPDL3b modulates insulin receptor signaling in diabetic kidney disease

Sphingomyelin phosphodiesterase acid-like 3b (SMPDL3b) is a lipid raft enzyme that regulates plasma membrane (PM) fluidity. Here we report that SMPDL3b excess, as observed in podocytes in diabetic kidney disease (DKD), impairs insulin receptor isoform B-dependent pro-survival insulin signaling by interfering with insulin receptor isoforms binding to caveolin-1 in the PM. SMPDL3b excess affects the production of active sphingolipids resulting in decreased ceramide-1-phosphate (C1P) content as observed in human podocytes in vitro and in kidney cortexes of diabetic db/db mice in vivo. Podocyte-specific Smpdl3b deficiency in db/db mice is sufficient to restore kidney cortex C1P content and to protect from DKD. Exogenous administration of C1P restores IR signaling in vitro and prevents established DKD progression in vivo. Taken together, we identify SMPDL3b as a modulator of insulin signaling and demonstrate that supplementation with exogenous C1P may represent a lipid therapeutic strategy to treat diabetic complications such as DKD.

Vapor-printed polymer electrodes for long-term, on-demand health monitoring

We vapor print conformal conjugated polymer electrodes directly onto living plants and use these electrodes to probe the health of actively growing specimens using bioimpedance spectroscopy. Vapor-printed polymer electrodes, unlike their adhesive thin-film counterparts, do not delaminate from microtextured living surfaces as the organism matures and do not observably attenuate the natural growth pattern and self-sustenance of the plants investigated here. On-demand, noninvasive bioimpedance spectroscopy performed with long-lasting vapor-printed polymer electrodes can reliably detect deep tissue damage caused by dehydration and ultraviolet A exposure throughout the life cycle of a plant.

A Portable Phase-Domain Magnetic Induction Tomography Transceiver with Phase-Band Auto-Tracking and Frequency-Sweep Capabilities

This paper presents a portable magnetic induction tomography (MIT) transceiver integrated circuit to miniaturize conventional equipment-based MIT systems. The miniaturized MIT function is enabled through single-chip transceiver implementation. The proposed MIT transceiver utilizes a phase-locked loop (PLL) for frequency sweeping and a phase-domain sigma⁻delta modulator with phase-band auto-tracking for a full-range fine-phase resolution. The designed transceiver is fabricated and verified to achieve the measured signal to noise and distortion ratio (SNDR) of 101.7 dB. Its system-level prototype including in-house magnetic sensor coils is manufactured and functionally verified for four different material types.

Enhanced Device Efficiency and Long-Term Stability via Boronic Acid-Based Self-Assembled Monolayer Modification of Indium Tin Oxide in a Planar Perovskite Solar Cell

Interfacial engineering is essential for the development of highly efficient and stable solar cells through minimizing energetic losses at interfaces. Self-assembled monolayers (SAMs) have been shown as a handle to tune the work function (WF) of indium tin oxide (ITO), improving photovoltaic cell performance and device stability. In this study, we utilize a new class of boronic acid-based fluorine-terminated SAMs to modify ITO surfaces in planar perovskite solar cells. The SAM treatment demonstrates an increase of the WF of ITO, an enhancement of the short-circuit current, and a passivation of trap states at the ITO/[poly(3,4ethylenedioxylenethiophene):poly(styrenesulfonic acid)] interface. Device stability improves upon SAM modification, with efficiency decreasing only 20% after one month. Our work highlights a simple treatment route to achieve hysteresis-free, reproducible, stable, and highly efficient (16%) planar perovskite solar cells.

MLCK-mediated intestinal permeability promotes immune activation and visceral hypersensitivity in PI-IBS mice

BACKGROUND

Alterations in intestinal permeability regulated by tight junctions (TJs) are associated with immune activation and visceral hypersensitivity in irritable bowel syndrome (IBS). Myosin light chain kinase (MLCK) is an important mediator of epithelial TJ. The aim of this study is to investigate the role of MLCK in the pathogenesis of IBS using a post infectious IBS (PI-IBS) mouse model.

METHODS

Trichinella spiralis-infected PI-IBS mouse model was used. Urine lactulose/mannitol ratio was measured to assess intestinal epithelial permeability. Western blotting was used to evaluate intestinal TJ protein (zonula occludens-1) and MLCK-associated protein expressions. Immune profile was assessed by measuring Th (T helper) 1/Th2 cytokine expression. Visceral sensitivity was determined by abdominal withdrawal reflex in response to colorectal distension.

RESULTS

Eight weeks after inoculation with T. spiralis, PI-IBS mice developed decreased pain and volume thresholds during colorectal distention, increased urine lactulose/mannitol ratio, elevated colonic Th1/Th2 cytokine ratio, and decreased zonula occludens-1 expression compared to the control mice. MLCK expression was dramatically elevated in the colonic mucosa of PI-IBS mice compared to the control mice, alongside increased pMLC/MLC and decreased MLCP expression. Administration of MLCK inhibitor and TJ blocker both reversed the increased intestinal permeability, visceral hypersensitivity, and Th1-dominant immune profile in PI-IBS mice.

CONCLUSION

MLCK is a pivotal step in inducing increased intestinal permeability promoting low-grade intestinal immune activation and visceral hypersensitivity in PI-IBS mice. MLCK inhibitor may provide a potential therapeutic option in the treatment of IBS.

Correlating Crystal Thickness, Surface Morphology, and Charge Transport in Pristine and Doped Rubrene Single Crystals

The relationship between charge transport and surface morphology is investigated by utilizing rubrene single crystals of varying thicknesses. In the case of pristine crystals, the surface conductivities decrease exponentially as the crystal thickness increases until ∼4 μm, beyond which the surface conductivity saturates. Investigation of the surface morphology using optical and atomic force microscopy reveals that thicker crystals have a higher number of molecular steps, increasing the overall surface roughness compared with thin crystals. The density of molecular steps as a surface trap is further quantified with the subthreshold slope of rubrene air-gap transistors. This thickness-dependent surface conductivity is rationalized by a shift from in-plane to out-of-plane transport governed by surface roughness. The surface transport is disrupted by roughening of the crystal surface and becomes limited by the slower vertical crystallographic axis on molecular step edges. Separately, we investigate surface-doping of rubrene crystals by using fluoroalkyltrichrolosilane and observe a different mechanism for charge transport which is independent of surface roughness. This work demonstrates that the correlation between crystal thickness, surface morphology, and charge transport must be taken into account when measuring organic single crystals. Considering the fact that these molecular steps are universally observed on organic/inorganic and single/polycrystals, we believe that our findings can be widely applied to improve charge transport understanding.

Clinicopathological features and outcome of type 3 gastric neuroendocrine tumours

BACKGROUND

With the widespread use of endoscopy, small and low-grade type 3 gastric neuroendocrine tumours (NETs) are increasingly being detected. The clinicopathological features, biological behaviour and appropriate treatment strategy for these NETs remain unclear.

METHODS

Patients with biopsy-proven gastric NET and a normal fasting serum gastrin level were identified from a prospectively maintained database. Clinicopathological features and long-term outcome of local resection for type 3 NETs were reviewed retrospectively and compared according to tumour grade.

RESULTS

Some 32 patients with type 3 gastric NETs were included (25 patients with NET grade G1, 5 with G2 and 2 with G3). Pathological tumour size was 2·0 cm or less in 30 patients. All tumours were well differentiated, even G3 lesions, and all tumours but one were confined to the submucosal layer. G1 NETs were significantly smaller and had a significantly lower lymphovascular invasion rate than G2 and G3 NETs. Twenty-two patients with a G1 NET without lymphovascular invasion were treated with wedge or endoscopic resection. After a median follow-up of 59 (range 6-102) months, no patient with a G1 NET of 1·5 cm or smaller developed recurrence and one patient with a G1 NET larger than 1·5 cm had recurrence in a perigastric lymph node. Among seven patients with a G2 or G3 NET, two had lymph node metastasis and one had liver metastases.

CONCLUSION

Low-grade type 3 gastric NET has non-aggressive features and a favourable prognosis. Wedge or endoscopic resection may be a valid option for patients with type 3 gastric G1 NET no larger than 1·5 cm without lymphovascular invasion.

Direct Printing of Graphene Electrodes for High-Performance Organic Inverters

Scalable fabrication of high-resolution electrodes and interconnects is necessary to enable advanced, high-performance, printed, and flexible electronics. Here, we demonstrate the direct printing of graphene patterns with feature widths from 300 μm to ∼310 nm by liquid-bridge-mediated nanotransfer molding. This solution-based technique enables residue-free printing of graphene patterns on a variety of substrates with surface energies between ∼43 and 73 mN m^-1. Using printed graphene source and drain electrodes, high-performance organic field-effect transistors (OFETs) are fabricated with single-crystal rubrene (p-type) and fluorocarbon-substituted dicyanoperylene-3,4:9,10-bis(dicarboximide) (PDIF-CN₂) (n-type) semiconductors. Measured mobilities range from 2.1 to 0.2 cm² V^-1 s^-1 for rubrene and from 0.6 to 0.1 cm² V^-1 s^-1 for PDIF-CN₂. Complementary inverter circuits are fabricated from these single-crystal OFETs with gains as high as ∼50. Finally, these high-resolution graphene patterns are compatible with scalable processing, offering compelling opportunities for inexpensive printed electronics with increased performance and integration density.

Melding Vapor-Phase Organic Chemistry and Textile Manufacturing To Produce Wearable Electronics

Body-mountable electronics and electronically active garments are the future of portable, interactive devices. However, wearable devices and electronic garments are demanding technology platforms because of the large, varied mechanical stresses to which they are routinely subjected, which can easily abrade or damage microelectronic components and electronic interconnects. Furthermore, aesthetics and tactile perception (or feel) can make or break a nascent wearable technology, irrespective of device metrics. The breathability and comfort of commercial fabrics is unmatched. There is strong motivation to use something that is already familiar, such as cotton/silk thread, fabrics, and clothes, and imperceptibly adapt it to a new technological application. (24) Especially for smart garments, the intrinsic breathability, comfort, and feel of familiar fabrics cannot be replicated by devices built on metalized synthetic fabrics or cladded, often-heavy designer fibers. We propose that the strongest strategy to create long-lasting and impactful electronic garments is to start with a mass-produced article of clothing, fabric, or thread/yarn and coat it with conjugated polymers to yield various textile circuit components. Commonly available, mass-produced fabrics, yarns/threads, and premade garments can in theory be transformed into a plethora of comfortably wearable electronic devices upon being coated with films of electronically active conjugated polymers. The definitive hurdle is that premade garments, threads, and fabrics have densely textured, three-dimensional surfaces that display roughness over a large range of length scales, from microns to millimeters. Tremendous variation in the surface morphology of conjugated-polymer-coated fibers and fabrics can be observed with different coating or processing conditions. In turn, the morphology of the conjugated polymer active layer determines the electrical performance and, most importantly, the device ruggedness and lifetime. Reactive vapor coating methods allow a conjugated polymer film to be directly formed on the surface of any premade garment, prewoven fabric, or fiber/yarn substrate without the need for specialized processing conditions, surface pretreatments, detergents, or fixing agents. This feature allows electronic coatings to be applied at the end of existing, high-throughput textile and garment manufacturing routines, irrespective of dye content or surface finish of the final textile. Furthermore, reactive vapor coating produces conductive materials without any insulating moieties and yields uniform and conformal films on fiber/fabric surfaces that are notably wash- and wear-stable and can withstand mechanically demanding textile manufacturing routines. These unique features mean that rugged and practical textile electronic devices can be created using sewing, weaving, or knitting procedures without compromising or otherwise affecting the surface electronic coating. In this Account, we highlight selected electronic fabrics and garments created by melding reactive vapor deposition with traditional textile manipulation processes, including electrically heated gloves that are lightweight, breathable, and sweat-resistant; surface-coated cotton, silk, and bast fiber threads capable of carrying large current densities and acting as sewable circuit interconnects; and surface-coated nylon threads woven together to form triboelectric textiles that can convert surface charge created during small body movements into usable and storable power.

Micro-inflammation in functional dyspepsia: A systematic review and meta-analysis

Functional dyspepsia (FD) is a gastrointestinal disorder of unknown etiology. Although micro-inflammation appears to be important in the pathogenesis, studies evaluating immune activation in FD have been inconsistent. A systematic review of literature and meta-analysis was performed to compare immunologic cell counts and cytokine levels in the mucosa and peripheral blood of individuals with FD and healthy controls. PubMed, Embase, and the Cochrane library were searched. Data on immunologic cell counts and cytokines levels among individuals with FD and control groups were extracted and compared by calculating standard mean differences (SMD). Thirty-seven studies met the inclusion criteria. Mast cell (SMD = 0.94, 95%CI 0.26-1.62, P = .007) and eosinophil counts (SMD = 0.36, 95%CI 0.06-0.68, P = .03) in the stomach were increased, among individuals with FD compared to controls. Similarly, mast cell (SMD = 0.66, 95%CI 0.20-1.13, P = 0.005) and eosinophil (SMD = 0.95, 95%CI 0.66-1.24; P < .001) counts in the duodenum were also increased in those with FD compared to controls. In a subgroup analysis, elevated eosinophil counts in the duodenum were observed in both post-prandial distress syndrome (SMD = 0.97, 95%CI 0.46-1.47, P = .0002) and epigastric pain syndrome subtypes (SMD = 1.16, 95%CI 0.48-1.83, P = .0008). No differences in mucosal intraepithelial lymphocyte, enterochromaffin cell, and neutrophil counts, as well as, peripheral interlukin-6 (IL-6) and IL-10 levels were observed among individuals with FD and controls. Micro-inflammation in the form of local immune cell infiltration, particularly eosinophils and mast cells, characterizes the pathogenesis of FD.

A Three-Step Resolution-Reconfigurable Hazardous Multi-Gas Sensor Interface for Wireless Air-Quality Monitoring Applications

This paper presents a resolution-reconfigurable wide-range resistive sensor readout interface for wireless multi-gas monitoring applications that displays results on a smartphone. Three types of sensing resolutions were selected to minimize processing power consumption, and a dual-mode front-end structure was proposed to support the detection of a variety of hazardous gases with wide range of characteristic resistance. The readout integrated circuit (ROIC) was fabricated in a 0.18 μm CMOS process to provide three reconfigurable data conversions that correspond to a low-power resistance-to-digital converter (RDC), a 12-bit successive approximation register (SAR) analog-to-digital converter (ADC), and a 16-bit delta-sigma modulator. For functional feasibility, a wireless sensor system prototype that included in-house microelectromechanical (MEMS) sensing devices and commercial device products was manufactured and experimentally verified to detect a variety of hazardous gases.

Clinicomanometric factors associated with clinically relevant esophagogastric junction outflow obstruction from the Sandhill high-resolution manometry system

BACKGROUND

Integrated relaxation pressure (IRP) is a key metric for diagnosing esophagogastric junction outflow obstruction (EGJOO). However, its normal value might be different according to the manufacturer of high-resolution manometry (HRM). This study aimed to investigate optimal value of IRP for diagnosing EGJOO in Sandhill HRM and to find clinicomanometric variables to segregate clinically relevant EGJOO.

METHODS

We analyzed 262 consecutive subjects who underwent HRM between June 2011 and December 2016 showing elevated median IRP (> 15 mm Hg) but did not satisfy criteria for achalasia. Clinically relevant subjects were defined as follows: (i) subsequent HRM met achalasia criteria during follow-up (early achalasia); (ii) Eckardt score was decreased at least two points without exceeding a score of 3 after pneumatic dilatation (variant achalasia); and (iii) significant passage disturbance on esophagogram without structural abnormality (possible achalasia).

KEY RESULTS

Seven subjects were clinically relevant, including two subjects with early achalasia, four subjects with variant achalasia, and one subject with possible achalasia. All clinically relevant subjects had IRP 20 mm Hg or above. Among subjects (n = 122) with IRP 20 mm Hg or more, clinically relevant group (n = 7) had significantly higher rate of dysphagia (100% vs 24.3%, P < .001) and compartmentalized pressurization (85.7% vs 21.7%, P = .001) compared to clinically non-relevant group (n = 115).

CONCLUSIONS & INFERENCES

Our results suggest that IRP of 20 mm Hg or higher could segregate clinically relevant subjects showing EGJOO in Sandhill HRM. Additionally, if subjects have both dysphagia and compartmentalized pressurization, careful follow-up is essential.

Frequency and risk factors of drug-induced liver injury during treatment of multidrug-resistant tuberculosis

OBJECTIVES

To investigate the risk factors for drug-induced liver injury (DILI) during the treatment of multidrug-resistant tuberculosis (MDR-TB) and to compare the frequency of DILI in patients with and those without chronic liver disease (CLD).

SETTING

This was a retrospective observational cohort study including 299 consecutive patients who started MDR-TB treatment from January 2009 to December 2013.

DESIGN

Of the 299 patients, 35 had alcoholic liver disease (ALD group), 16 had hepatitis B virus infection (HBV group) and 11 had hepatitis C virus infection (HCV group). The remaining 237 patients without CLD were selected as the control group.

RESULTS

DILI occurred in 29 (9.7%) patients. The frequency of DILI was significantly higher in the ALD (17.1%, P = 0.038), HBV (31.3%, P = 0.005) and HCV groups (27.3%, P = 0.037) than in the control group (6.3%). Among all patients taken together, having HBV and HCV infection were independent risk factors for the occurrence of DILI during MDR-TB treatment.

CONCLUSION

DILI during MDR-TB treatment occurred more frequently in patients with CLD due to ALD, HBV and HCV infection than in those without CLD.

Effective Condition for Whole Testis Cryopreservation of Endangered Miho Spine Loach (Cobitis choii) Through the Optimization of Mud Loach (Misgurnus mizolepis) Whole Testis Cryopreservation Condition

　　BACKGROUND: Miho spine loach (Cobitis choii) is an endangered Korean endemic fish. Whole testis cryopreservation is a good way for species preservation, but needs to the sacrifice of a large number of fish to optimize the freezing condition. Considering this limitation, a surrogate fish species was used for the protocol development.

OBJECTIVE

This study was to establish the effective condition for Miho spine loach whole testis cryopreservation by optimizing the conditions for whole testis cryopreservation in an allied species, mud loach (Misgurnus mizolepis).

MATERIALS AND METHODS

The condition for whole testis cryopreservation was optimized in mud loach first, and then the optimal condition was applied to Miho spine loach testes.

RESULTS

The optimal condition for mud loach testis cryopreservation consists of the freezing medium containing 1.3 M dimethyl sulfoxide, 6% fetal bovine serum and 0.3 M trehalose, -1 C/min cooling rate and 26 degree C thawing temperature, which also permits effective cryopreservation of Miho spine loach testes.

CONCLUSION

An effective cryopreservation condition for whole testis of the endangered Miho spine loach has been established by using mud loach as a surrogate fish.

A Triple-Mode Flexible E-Skin Sensor Interface for Multi-Purpose Wearable Applications

This study presents a flexible wireless electronic skin (e-skin) sensor system that includes a multi-functional sensor device, a triple-mode reconfigurable readout integrated circuit (ROIC), and a mobile monitoring interface. The e-skin device's multi-functionality is achieved by an interlocked micro-dome array structure that uses a polyvinylidene fluoride and reduced graphene oxide (PVDF/RGO) composite material that is inspired by the structure and functions of the human fingertip. For multi-functional implementation, the proposed triple-mode ROIC is reconfigured to support piezoelectric, piezoresistance, and pyroelectric interfaces through single-type e-skin sensor devices. A flexible system prototype was developed and experimentally verified to provide various wireless wearable sensing functions-including pulse wave, voice, chewing/swallowing, breathing, knee movements, and temperature-while their real-time sensed data are displayed on a smartphone.

Influence of esophagectomy on the gastroesophageal reflux in patients with esophageal cancer

This study aims to assess the influence of esophagectomy with gastric transposition on the gastroesophageal reflux (GER) and gastric acidity in patients with esophageal cancer. Data on 53 esophageal cancer patients who underwent 24-hour impedance-pH monitoring after esophagectomy were retrospectively analyzed. We used a solid-state esophageal pH probe in which the esophageal pH sensor is placed 1.5 cm distal to the upper esophageal sphincter and the gastric pH sensor is located 15 cm distal to the esophageal pH channel. 24-hour impedance-pH monitoring data and other clinical data including anastomosis site stricture and incidence of pneumonia were collected. We defined pathologic reflux with reference to known normative data. Stricture was defined when an intervention such as bougienage or balloon dilatation was required to relieve dysphagia. The esophageal and gastric mean pH were 5.47 ± 1.51 and 3.33 ± 1.64, respectively. The percent time of acidic pH (<4) was 6.66 ± 12.49% in the esophagus and 70.53 ± 32.19% in the stomach. Esophageal pathologic acid reflux was noticed in 32.1%, 20.8%, and 35.8% during total, upright, and recumbent time, respectively. Esophageal pathologic bolus reflux was noted in 83.0%, 77.4%, and 64.2% during total, upright, and recumbent time, respectively. Gastric acidity increased with time after esophagectomy. Esophageal acid exposure time correlated with intragastric pH. However, esophageal pathologic acid reflux was not associated with anastomosis site stricture or pneumonia. In conclusion, GER frequently occurs after esophagectomy. Thus, strict lifestyle modifications and acid suppression would be necessary in patients following esophagectomy.

Polycystic ovary syndrome with hyperandrogenism as a risk factor for non-obese non-alcoholic fatty liver disease

BACKGROUND

Non-alcoholic fatty liver disease (NAFLD) is known to be associated with polycystic ovary syndrome (PCOS). However, most studies investigated the prevalence of NAFLD in obese PCOS patients.

AIM

To compare the prevalence of non-obese NAFLD in women with or without PCOS, and to assess an independent association between PCOS and NAFLD in a non-obese Asian cohort.

METHODS

This was a case-control study using a prospective PCOS cohort. After subjects with other potential causes of chronic liver disease were excluded, 275 non-obese women with PCOS and 892 non-obese controls were enrolled. NAFLD was determined by hepatic ultrasonography. Main outcomes were the prevalence of NAFLD on hepatic ultrasonography between non-obese women with or without PCOS, and an independent association between non-obese NAFLD and PCOS.

RESULTS

Non-obese women with PCOS had a significantly higher prevalence of NAFLD than those without PCOS (5.5% vs. 2.8%, P = 0.027). PCOS was associated with non-obese NAFLD (odds ratio: 2.62, 95% confidence intervals: 1.25-5.48) after adjustment for age and body mass index (BMI). In women with PCOS, the level of androgenicity represented by free testosterone or free androgen index was associated with NAFLD after adjustment for age, BMI, lipid profile, insulin resistance or glycaemic status.

CONCLUSIONS

Non-obese NAFLD is more prevalent in women with polycystic ovary syndrome than in those without. In non-obese patients with polycystic ovary syndrome, hyperandrogenemia may be an independent risk factor for non-obese NAFLD.

Homoepitaxy of Crystalline Rubrene Thin Films

The smooth surface of crystalline rubrene films formed through an abrupt heating process provides a valuable platform to study organic homoepitaxy. By varying growth rate and substrate temperature, we are able to manipulate the onset of a transition from layer-by-layer to island growth modes, while the crystalline thin films maintain a remarkably smooth surface (less than 2.3 nm root-mean-square roughness) even with thick (80 nm) adlayers. We also uncover evidence of point and line defect formation in these films, indicating that homoepitaxy under our conditions is not at equilibrium or strain-free. Point defects that are resolved as screw dislocations can be eliminated under closer-to-equilibrium conditions, whereas we are not able to eliminate the formation of line defects within our experimental constraints at adlayer thicknesses above ∼25 nm. We are, however, able to eliminate these line defects by growing on a bulk single crystal of rubrene, indicating that the line defects are a result of strain built into the thin film template. We utilize electron backscatter diffraction, which is a first for organics, to investigate the origin of these line defects and find that they preferentially occur parallel to the (002) plane, which is in agreement with expectations based on calculated surface energies of various rubrene crystal facets. By combining the benefits of crystallinity, low surface roughness, and thickness-tunability, this system provides an important study of attributes valuable to high-performance organic electronic devices.

A Reconfigurable Readout Integrated Circuit for Heterogeneous Display-Based Multi-Sensor Systems

This paper presents a reconfigurable multi-sensor interface and its readout integrated circuit (ROIC) for display-based multi-sensor systems, which builds up multi-sensor functions by utilizing touch screen panels. In addition to inherent touch detection, physiological and environmental sensor interfaces are incorporated. The reconfigurable feature is effectively implemented by proposing two basis readout topologies of amplifier-based and oscillator-based circuits. For noise-immune design against various noises from inherent human-touch operations, an alternate-sampling error-correction scheme is proposed and integrated inside the ROIC, achieving a 12-bit resolution of successive approximation register (SAR) of analog-to-digital conversion without additional calibrations. A ROIC prototype that includes the whole proposed functions and data converters was fabricated in a 0.18 μm complementary metal oxide semiconductor (CMOS) process, and its feasibility was experimentally verified to support multiple heterogeneous sensing functions of touch, electrocardiogram, body impedance, and environmental sensors.

The Global Engagement in Care Convening: Recommended Actions to Improve Health Outcomes for People Living With HIV

The National HIV AIDS Strategy (NHAS) calls for a more coordinated response to the HIV epidemic. The Global Engagement in Care Convening created a forum for domestic and international experts to identify best practices in HIV care. This manuscript summarizes the meeting discussions and recommendations from meeting notes and an audio recording of the meeting. Recommendations include: further standardization of performance goals and performance measures; additional research; a more robust system to support competing needs of clients receiving services; electronic information exchanges for HIV-related data; an expansion of the role of other health professionals to extend the capacity of physicians and other members of the care team; and revisions to current financing systems to increase reimbursement for and access to services that promote linkage to and retention in HIV care. The recommendations provide a unique example of "reverse technical assistance" and will inform U.S. program development, research, and policy.