Homonymous hemianopia due to cerebral venous thrombosis: A case report

RATIONALE

Diagnosing cerebral venous thrombosis (CVT) can be difficult because of nonspecific symptoms, such as headache and homonymous hemianopia (HH). Herein, we present a case of delayed CVT diagnosis due to nonspecific neurological symptoms and nonprominent lesions in a patient with HH.

PATIENT CONCERN

A 65-year-old woman presented with a sudden onset headache accompanied by right HH that lasted for 1 day. Brain computed tomography and magnetic resonance imaging were initially performed due to suspicion of ischemic lesions or hemorrhage in the left postchiasmal visual pathway; however, no remarkable acute brain lesions were detected. Ophthalmological examinations revealed no notable findings, except for a definite field defect in the Humphrey visual field test. The headaches then waxed and waned but recurred 3 days after the initial symptom.A repeat brain magnetic resonance imaging was performed, which revealed left sectoral gyral swelling and vascular enhancement in the occipital lobe. To further evaluate venous drainage, additional 3-dimensional cerebral computed tomography angiography and 4-vessel angiography were conducted, revealing a partial filling defect in the left transverse sinus and superior venous drainage impairment. These findings suggested the presence of venous thrombosis in the left transverse sinus.

DIAGNOSIS

The patient was diagnosed with thrombosis of the left transverse sinus, which subsequently caused the right HH.

INTERVENTION

Anticoagulation therapy with parenteral heparin was started as soon as the diagnosis of CVT was confirmed. Eventually, the patient was solely managed with oral warfarin administration.

OUTCOMES

Following 3 days of treatment, her headache resolved, and a subsequent visual field testing conducted 2 weeks later revealed a definite improvement in the field defect.

LESSONS

Despite its favorable prognosis, CVT can be challenging to diagnose. CVT should be considered as a differential diagnosis when diagnosing patients who present with headaches accompanied by HH without prominent brain lesions.

Te-rP-C Anodes Prepared Using a Scalable Milling Process for High-Performance Lithium-Ion Batteries

Red phosphorus (rP) is one of the most promising anode materials for lithium-ion batteries, owing to its high theoretical capacity. However, its low electronic conductivity and large volume expansion during cycling limit its practical applications, as it exhibits low electrochemical activity and unstable cyclability. To address these problems, tellurium (Te)-rP-C composites, which have active materials (Te, rP) that are uniformly distributed within the carbon matrix, were fabricated through a simple high-energy ball milling method. Among the three electrodes, the Te-rP (1:2)-C electrode with a 5% FEC additive delivers a high initial CE of 80% and a high reversible capacity of 734 mAh g-1 after 300 cycles at a current density of 100 mA g-1. Additionally, it exhibits a high-rate capacity of 580 mAh g-1 at a high current density of 10,000 mA g-1. Moreover, a comparison of the electrolytes with and without the 5% FEC additive demonstrated improved cycling stability when the FEC additive was used. Ex situ XRD analysis demonstrated the lithiation/delithiation mechanism of Te-rP (1:2)-C after cycling based on the cyclic voltammetry results. Based on the electrochemical impedance spectroscopy analysis results, a Te-rP-C composite with its notable electrochemical performance as an anode can sufficiently contribute to the battery anode industry.

Exotic Magnetic Anisotropy Near Digitized Dimensional Mott Boundary

The magnetic anisotropy of low-dimensional Mott systems exhibits unexpected magnetotransport behavior useful for spin-based quantum electronics. Yet, the anisotropy of natural materials is inherently determined by the crystal structure, highly limiting its engineering. The magnetic anisotropy modulation near a digitized dimensional Mott boundary in artificial superlattices composed of a correlated magnetic monolayer SrRuO3 and nonmagnetic SrTiO3 , is demonstrated. The magnetic anisotropy is initially engineered by modulating the interlayer coupling strength between the magnetic monolayers. Interestingly, when the interlayer coupling strength is maximized, a nearly degenerate state is realized, in which the anisotropic magnetotransport is strongly influenced by both the thermal and magnetic energy scales. The results offer a new digitized control for magnetic anisotropy in low-dimensional Mott systems, inspiring promising integration of Mottronics and spintronics.

Controlled Electronic and Magnetic Landscape in Self-Assembled Complex Oxide Heterostructures

Complex oxide heterointerfaces contain a rich playground of novel physical properties and functionalities, which give rise to emerging technologies. Among designing and controlling the functional properties of complex oxide film heterostructures, vertically aligned nanostructure (VAN) films using a self-assembling bottom-up deposition method presents great promise in terms of structural flexibility and property tunability. Here, the bottom-up self-assembly is extended to a new approach using a mixture containing a 2Dlayer-by-layer film growth, followed by a 3D VAN film growth. In this work, the two-phase nanocomposite thin films are based on LaAlO3 :LaBO3 , grown on a lattice-mismatched SrTiO3001 (001) single crystal. The 2D-to-3D transient structural assembly is primarily controlled by the composition ratio, leading to the coexistence of multiple interfacial properties, 2D electron gas, and magnetic anisotropy. This approach provides multidimensional film heterostructures which enrich the emergent phenomena for multifunctional applications.

Giant Enhancement of Electron-Phonon Coupling in Dimensionality-Controlled SrRuO3 Heterostructures

Electrons in crystals interact closely with quantized lattice degree of freedom, determining fundamental electrodynamic behaviors and versatile correlated functionalities. However, the strength of the electron-phonon interaction is so far determined as an intrinsic value of a given material, restricting the development of potential electronic and phononic applications employing the tunable coupling strength. Here, it is demonstrated that the electron-phonon coupling in SrRuO₃ can be largely controlled by multiple intuitive tuning knobs available in synthetic crystals. The coupling strength of quasi-2D SrRuO₃ is enhanced by ≈300-fold compared with that of bulk SrRuO₃ . This enormous enhancement is attributed to the non-local nature of the electron-phonon coupling within the well-defined synthetic atomic network, which becomes dominant in the limit of the 2D electronic state. These results provide valuable opportunities for engineering the electron-phonon coupling, leading to a deeper understanding of the strongly coupled charge and lattice dynamics in quantum materials.

Atomic-Scale Modulation of Synthetic Magnetic Order in Oxide Superlattices

Atomic-scale precision control of magnetic interactions facilitates a synthetic spin order useful for spintronics, including advanced memory and quantum logic devices. Conventional modulation of synthetic spin order has been limited to metallic heterostructures that exploit Ruderman-Kittel-Kasuya-Yosida interaction through a nonmagnetic metallic spacer; however, they face issues arising from Joule heating and/or electric breakdown. The practical realization and observation of a synthetic spin order across a nonmagnetic insulating spacer will lead to the development of spin-related devices with a completely different concept. Herein, the atomic-scale modulation of the synthetic spiral spin order in oxide superlattices composed of ferromagnetic metal and nonmagnetic insulator layers is reported. The atomically controlled superlattice exhibits an oscillatory magnetic behavior, representing the existence of a spiral spin structure. Depth-sensitive polarized neutron reflectometry evidences modulated spiral spin structures as a function of the nonmagnetic insulator layer thickness. Atomic-scale customization of the spin state can move the field one step further to actual spintronic applications.

Study on superconducting properties of CeIrIn5thin films grown via pulsed laser deposition

We report the growth of CeIrIn₅thin films with different crystal orientations on a MgF₂(001) substrate using pulsed laser deposition technique. X-ray diffraction analysis showed that the thin films were either mainlya-axis-oriented (TF1) or a combination ofa- andc-axis-oriented (TF2). The characteristic features of heavy-fermion superconductors, i.e. Kondo coherence and superconductivity, were clearly observed, where the superconducting transition temperature (T_c) and Kondo coherence temperature (T_coh) are 0.58 K and 41 K for TF1 and 0.52 K and 37 K for TF2, respectively. The temperature dependencies of the upper critical field (H_c2) of both thin films and the CeIrIn₅single crystal revealed a scaling behavior, indicating that the nature of unconventional superconductivity has not been changed in the thin film. The successful synthesis of CeIrIn₅thin films is expected to open a new avenue for novel quantum phases that may have been difficult to explore in the bulk crystalline samples.

Atomistic Engineering of Phonons in Functional Oxide Heterostructures

Engineering of phonons, that is, collective lattice vibrations in crystals, is essential for manipulating physical properties of materials such as thermal transport, electron-phonon interaction, confinement of lattice vibration, and optical polarization. Most approaches to phonon-engineering have been largely limited to the high-quality heterostructures of III-V compound semiconductors. Yet, artificial engineering of phonons in a variety of materials with functional properties, such as complex oxides, will yield unprecedented applications of coherent tunable phonons in future quantum acoustic devices. In this study, artificial engineering of phonons in the atomic-scale SrRuO₃ /SrTiO₃ superlattices is demonstrated, wherein tunable phonon modes are observed via confocal Raman spectroscopy. In particular, the coherent superlattices led to the backfolding of acoustic phonon dispersion, resulting in zone-folded acoustic phonons in the THz frequency domain. The frequencies can be largely tuned from 1 to 2 THz via atomic-scale precision thickness control. In addition, a polar optical phonon originating from the local inversion symmetry breaking in the artificial oxide superlattices is observed, exhibiting emergent functionality. The approach of atomic-scale heterostructuring of complex oxides will vastly expand material systems for quantum acoustic devices, especially with the viability of functionality integration.

Wafer as an adjunct to plating patient-specific implants for the multi-segment maxilla: a useful tool

Virtual surgical planning for orthognathic surgery using patient-specific implants (PSI) is usually waferless nowadays. However, without an occlusal wafer, difficulties arise in controlling the accuracy of multi-segment maxillary osteotomies, especially for expansion and rotational movements of each segment. It is technically challenging intraoperatively to manipulate multiple segments to fit into the PSI, as the relatively small bone segments need to be secured into the PSI while simultaneously achieving individual segment movements in all planes and with potential bony interferences with each other. Therefore, the use of a maxillary tooth-supported surgical guide is proposed and described. When the guide is inserted before the PSI, it overcomes difficulties in handling multiple maxillary segments and facilitates achieving maximal positional precision of each individual bone segment. The guide enables multiple smaller segments to behave as one unit with the designated occlusion whilst visualizing bony interferences before PSI plating is commenced. Adding a tooth-borne surgical guide in the form of a wafer and a customized arch bar is a cost-effective method to enhance accuracy in virtually planned multi-segment maxillary surgery. Further investigations are required to validate the accuracy and advantages of using wafers and PSI in multi-segment maxillary and mandibular orthognathic surgeries.

Unconventional interlayer exchange coupling via chiral phonons in synthetic magnetic oxide heterostructures

Chiral symmetry breaking of phonons plays an essential role in emergent quantum phenomena owing to its strong coupling to spin degree of freedom. However, direct experimental evidence of the chiral phonon-spin coupling is lacking. In this study, we report a chiral phonon-mediated interlayer exchange interaction in atomically controlled ferromagnetic metal (SrRuO₃)-nonmagnetic insulator (SrTiO₃) heterostructures. Owing to the unconventional interlayer exchange interaction, we have observed rotation of spins as a function of nonmagnetic insulating spacer thickness, resulting in a spin spiral state. The chiral phonon-spin coupling is further confirmed by phonon Zeeman effect. The existence of the chiral phonons and their interplay with spins along with our atomic-scale heterostructure approach unveil the crucial roles of chiral phonons in magnetic materials.

Effect of Mask Mandates on the Intraocular Pressure Measured via Goldmann Applanation Tonometry

Purpose: The corona virus disease-19 (COVID-19) pandemic has resulted in mandatory masking of patients and physicians during outpatient visits. This study evaluated the changes in intraocular pressure (IOP) according to mask use.Methods: This prospective study enrolled 30 healthy volunteers (60 eyes). IOP was measured via Goldmann applanation tonometry (GAT) for the subjects wearing one of four commonly used masks: dental, bi-folding Korean Filter (KF)94, tri-folding KF94, and dust masks. Subjects with IOP measurement errors of more than 5 mmHg were rechecked with another GAT type.Results: The mean IOP measured via GAT before mask wearing was 13.7 ± 1.7 mmHg. It was 13.5 ± 2.1, 14.0 ± 2.3, 14.3 ± 2.5, and 13.8 ± 1.6 mmHg with the dental, bi-folding KF94, tri-folding KF94, and dust masks, respectively. There were no significant differences in IOP according to mask type (p = 0.635). IOP errors above 5 mmHg were detected in three subjects who had contact between the GAT feeler arm and tri-folding KF94 mask during IOP measurement.Conclusions: The IOP as measured via GAT is artificially elevated by mechanical interference from the tri-fold KF94 mask. To minimize such mask-induced artifacts in GAT measurements, compress the patient’s mask or change the mask type to prevent any contact during measurement.

Two-year Changes in Postoperative Central Macular Thickness and Subfoveal Choroidal Thickness in Epiretinal Membrane Patients

Purpose: To evaluate changes in central macular thickness (CMT) and subfoveal choroidal thickness (SFCT) after phacovitrectomy over a 2-year period in idiopathic epiretinal membrane (ERM) patients.Methods: The records of 52 idiopathic ERM patients (52 eyes) who underwent phacovitrectomy, without recurrence of the condition over a 2-year follow-up period, were reviewed retrospectively. Changes in CMT and SFCT, as measured by optical coherence tomography, were analyzed and compared with those of a normal control group over a 2-year period.Results: The mean preoperative CMT and SFCT were 425.67 ± 84.67 and 257.56 ± 90.13 μm, respectively. Postoperative CMT was reduced significantly to 372.17 ± 45.26 μm at 1 year and 363.15 ± 47.35 μm at 2 years (p < 0.001). SFCT at 1 and 2 years postoperatively was significantly reduced to 238.85 ± 84.85 and 230.31 ± 87.95 μm, respectively (p < 0.001). In the control group, there was no significant change in CMT; however, the SFCT decreased by 11.09 ± 22.36 μm during the 2-year follow-up (p = 0.007). In contrast, in the patient group, CMT and SFCT decreased by 62.52 ± 71.45 and 27.25 ± 41.97 μm, respectively, showing a significant difference from the control group (p < 0.001 and p = 0.043, respectively). Both before surgery and at 1 year postoperatively, the thinner the CMT, the better the best-corrected visual acuity (BCVA) (p = 0.010 and p = 0.018, respectively). A better postoperative BCVA at 2 years was associated with a thinner CMT and better BCVA before surgery (p < 0.001 and p < 0.001, respectively).Conclusions: Following a phacovitrectomy procedure, ERM patients showed significant reductions in both the CMT and SFCT at the 2-year follow-up.

Adherence Improvement in Glaucoma Patients: Effects of Educational Intervention Using an Eye Drop Chart

Purpose: To evaluate the effects of an educational intervention using an eye drop chart and supplementary education on glaucoma patients’ adherence.Methods: In this multicenter prospective study, medically treated glaucoma patients were educated on the administration of eye drops using an eye drop chart. At the time of recruitment, all of the patients completed a questionnaire on demographic characteristics and adherence. Three months after the initial educational intervention, the patients were randomly divided into two groups: an education group and a control group. The education group received supplementary education. Immediately thereafter and at 6 months, all of the patients completed the questionnaire on adherence again. Changes in instillation behavior, the relationship between the adherence score and demographic characteristics, and factors contributing to an improvement in adherence and intraocular pressure were then analyzed.Results: The adherence scores were significantly higher in patients with fewer medications, a higher annual income and higher educational level, and an urban residence (p = 0.038, p = 0.033, p = 0.041 and p = 0.047, respectively). Education on the administration of eye drops and use of the eye drop chart improved adherence scores from 23.05 ± 3.52 to 21.30 ± 3.95 (p = 0.021) and significantly reduced the average intraocular pressure from 14.3 ± 2.9 to 12.4 ± 3.1 mmHg (p < 0.001). Working indoors (odds ratio [OR] = 5.47, p = 0.032) and supplementary education at 3 months (OR = 4.53, p = 0.030) were also correlated with improved adherence.Conclusions: An eye drop chart is an effective tool for improving adherence and intraocular pressure control in glaucoma patients. Improvement in adherence was especially notable in patients whose work predominantly involved indoor activity. The effectiveness of the eye drop chart was improved by supplementary education.

Contribution of the Sub-Surface to Electrocatalytic Activity in Atomically Precise La0.7 Sr0.3 MnO3 Heterostructures

Electrocatalytic reactions are known to take place at the catalyst/electrolyte interface. Whereas recent studies of size-dependent activity in nanoparticles and thickness-dependent activity of thin films imply that the sub-surface layers of a catalyst can contribute to the catalytic activity as well, most of these studies consider actual modification of the surfaces. In this study, the role of catalytically active sub-surface layers was investigated by employing atomic-scale thickness control of the La_0.7 Sr_0.3 MnO₃ (LSMO) films and heterostructures, without altering the catalyst/electrolyte interface. The activity toward the oxygen evolution reaction (OER) shows a non-monotonic thickness dependence in the LSMO films and a continuous screening effect in LSMO/SrRuO₃ heterostructures. The observation leads to the definition of an "electrochemically-relevant depth" on the order of 10 unit cells. This study on the electrocatalytic activity of epitaxial heterostructures provides new insight in designing efficient electrocatalytic nanomaterials and core-shell architectures.

Correlated oxide Dirac semimetal in the extreme quantum limit

Quantum materials (QMs) with strong correlation and nontrivial topology are indispensable to next-generation information and computing technologies. Exploitation of topological band structure is an ideal starting point to realize correlated topological QMs. Here, we report that strain-induced symmetry modification in correlated oxide SrNbO₃ thin films creates an emerging topological band structure. Dirac electrons in strained SrNbO₃ films reveal ultrahigh mobility (μ_max ≈ 100,000 cm²/Vs), exceptionally small effective mass (m* ~ 0.04m_e), and nonzero Berry phase. Strained SrNbO₃ films reach the extreme quantum limit, exhibiting a sign of fractional occupation of Landau levels and giant mass enhancement. Our results suggest that symmetry-modified SrNbO₃ is a rare example of correlated oxide Dirac semimetals, in which strong correlation of Dirac electrons leads to the realization of a novel correlated topological QM.

Strain-Induced Atomic-Scale Building Blocks for Ferromagnetism in Epitaxial LaCoO3

The origin of strain-induced ferromagnetism, which is robust regardless of the type and degree of strain in LaCoO₃ (LCO) thin films, is enigmatic despite intensive research efforts over the past decade. Here, by combining scanning transmission electron microscopy with ab initio density functional theory plus U calculations, we report that the ferromagnetism does not emerge directly from the strain itself but rather from the creation of compressed structural units within ferroelastically formed twin-wall domains. The compressed structural units are magnetically active with the rocksalt-type high-spin/low-spin order. Our study highlights that the ferroelastic nature of ferromagnetic structural units is important for understanding the intriguing ferromagnetic properties in LCO thin films.

Spatial deviations of the temporomandibular joint after oncological mandibular reconstruction

Spatial deviations of the temporomandibular joint (TMJ) after oncological mandibular reconstruction are important to the aesthetic and functional rehabilitation. The aim of this study was to clarify whether and how three dimensionally (3D) printed patient-specific surgical plates, and the preservation of the condyle or ramus, affect spatial deviations of the TMJ. A total of 33 patients who underwent mandibular reconstruction via computer-assisted surgery were included. Regarding absolute deviations, patients in the 3D-printed plate group showed smaller TMJ deviations compared to those in the conventional plate group. There was no difference in absolute deviations of the TMJ regardless of whether the condyle or ramus was preserved. Regarding physiological deviations, the impact on the contralateral TMJ was smaller in the 3D-printed plate group. Patients with both the condyle and ramus removed had significantly higher deviations of the condyle and joint space. In summary, 3D-printed patient-specific surgical plates improved the spatial accuracy of the TMJ. Under physiological conditions, TMJ deviations on the operated side were mainly affected by the preservation of the condyle. Removal of both the condyle and ramus caused more severe spatial interference to the TMJ; this should be further confirmed.

Color of Copper/Copper Oxide

Stochastic inhomogeneous oxidation is an inherent characteristic of copper (Cu), often hindering color tuning and bandgap engineering of oxides. Coherent control of the interface between metal and metal oxide remains unresolved. Coherent propagation of an oxidation front in single-crystal Cu thin film is demonstrated to achieve a full-color spectrum for Cu by precisely controlling its oxide-layer thickness. Grain-boundary-free and atomically flat films prepared by atomic-sputtering epitaxy allow tailoring of the oxide layer with an abrupt interface via heat treatment with a suppressed temperature gradient. Color tuning of nearly full-color red/green/blue indices is realized by precise control of the oxide-layer thickness; the samples cover ≈50.4% of the standard red/green/blue color space. The color of copper/copper oxide is realized by the reconstruction of the quantitative yield color from the oxide "pigment" (complex dielectric functions of Cu₂ O) and light-layer interference (reflectance spectra obtained from the Fresnel equations) to produce structural color. Furthermore, laser-oxide lithography is demonstrated with micrometer-scale linewidth and depth through local phase transformation to oxides embedded in the metal, providing spacing necessary for semiconducting transport and optoelectronics functionality.

Surgical morbidities of sagittal split ramus osteotomy versus intraoral vertical ramus osteotomy for the correction of mandibular prognathism: a randomized clinical trial

The sagittal split ramus osteotomy (SSRO) and intraoral vertical ramus osteotomy (IVRO) are two common orthognathic procedures for the treatment of mandibular prognathism. This randomized clinical trial compared the surgical morbidities between SSRO and IVRO for patients with mandibular prognathism over the first 2 years postoperative. Ninety-eight patients (40 male, 58 female) with a mean age of 24.4±3.5 years underwent bilateral SSRO (98 sides) or IVRO (98 sides) as part or all of their orthognathic surgery. IVRO presented less short-term and long-term surgical morbidity in general. The SSRO group had a greater incidence of inferior alveolar nerve deficit at all follow-up time points (P< 0.01). There was more TMJ pain at 6 weeks (P= 0.047) and 3 months (P= 0.001) postoperative in the SSRO group. The SSRO group also presented more minor complications, which were related to titanium plate exposure and infection. There were no major complications for either technique in this study. Despite the need for intermaxillary fixation, IVRO appears to be associated with less surgical morbidity than SSRO when performed as a mandibular setback procedure to treat mandibular prognathism.

Considerations on the Implementation of the Telemedicine System Encountered with Stakeholders' Resistance in COVID-19 Pandemic

Background: Non-face-to-face consultation, which ensures physical distance between patients and doctors, is increasing as a substitute mode for dealing with highly infectious diseases. Korea, with its remarkable Information and Communications Technology infrastructure, introduced telemedicine in 1988, yet it has not been formally accepted owing to stakeholders' resistance and legal restrictions. Purpose: This study aims to determine the feasibility of implementing the telemedicine system and find solutions of its development and resistance by stakeholders. Method and Material: The authors present a unique case of Korea where telemedicine, despite its solid technological base, has not yet gained a foothold 32 years after its first pilot project. A narrative review was condected according to the timeline of government-driven telemedicine adoption in Korea, and an analysis was performed on the tendency of stakeholder resistance. Results: The analysis revealed that the relevant stakeholders were classified into doctors, patients, governments and some political parties. Among stakeholders as a whole, private healthcare physicians, who provide over 90% of primary care in Korea, amount to the largest demographic against the implementation of telemedicine. Their resistance was found to be the product of policies and problems arising from the coexistence of telemedicine and conventional healthcare regimes. With the COVID-19 pandemic, policymakers are at odds with these stakeholders while implementing a pilot project. Conclusion: Fostering smooth policy implementation necessitates adopting an approach that reduces conflicts with private healthcare providers.

Propagation Control of Octahedral Tilt in SrRuO3 via Artificial Heterostructuring

Bonding geometry engineering of metal-oxygen octahedra is a facile way of tailoring various functional properties of transition metal oxides. Several approaches, including epitaxial strain, thickness, and stoichiometry control, have been proposed to efficiently tune the rotation and tilt of the octahedra, but these approaches are inevitably accompanied by unnecessary structural modifications such as changes in thin-film lattice parameters. In this study, a method to selectively engineer the octahedral bonding geometries is proposed, while maintaining other parameters that might implicitly influence the functional properties. A concept of octahedral tilt propagation engineering is developed using atomically designed SrRuO3/SrTiO3 (SRO/STO) superlattices. In particular, the propagation of RuO6 octahedral tilt within the SRO layers having identical thicknesses is systematically controlled by varying the thickness of adjacent STO layers. This leads to a substantial modification in the electromagnetic properties of the SRO layer, significantly enhancing the magnetic moment of Ru. This approach provides a method to selectively manipulate the bonding geometry of strongly correlated oxides, thereby enabling a better understanding and greater controllability of their functional properties.

Benign postoperative hepaticojejunostomy stricture: percutaneous recanalisation using the reverse end of a microwire

AIM

To evaluate the technical feasibility and safety of percutaneous recanalisation of benign postoperative hepaticojejunostomy strictures using the reverse end of a microwire.

MATERIALS AND METHODS

Twenty-one patients with benign postoperative hepaticojejunostomy strictures that had failed to recanalise following management with conventional percutaneous techniques from January 2012 to March 2019 were included in the study. The stricture was punctured by the reverse end of a microwire. Subsequently, serial balloon dilatation and covered stent placement was performed. Technical as well as clinical success, complications, and patency of the hepaticojejunostomy were evaluated.

RESULTS

Technical success was achieved in 19 of 21 (90.5%) patients. The mean number of treatment sessions was 1.2 (range, 1-2). The obstructive symptoms were resolved within 3 days after the procedure in 19 patients (100%). There were no major complications. The 1-year and 3-year patency rates were 76.9% and 61.5%, respectively.

CONCLUSION

Percutaneous recanalisation using the reverse end of a microwire is technically feasible and safe in the treatment of benign postoperative hepaticojejunostomy strictures. This technique is useful when the conventional percutaneous technique cannot be used to cross the stricture.

Spin-phonon coupling in epitaxial SrRuO3 heterostructures

Spin-phonon coupling is one of the fundamental interactions in functional materials, indispensable for understanding their unexpected magnetic ground states. Ferromagnetic SrRuO₃ is a correlated metal with the potential for utilization in novel spintronic devices and serves as a promising platform for studying spin-phonon interactions. In this study, we used Raman spectroscopy to identify spin-phonon coupling in SrRuO₃ heterostructures. We deliberately decreased the exchange interactions within SrRuO₃ by reducing system dimensions, which was coherently observed in both temperature-dependent magnetization measurements and phonon spectra. To collect the Raman signals from the very thin (quasi-2D) SrRuO₃ layers while maintaining the layer thickness, we fabricated epitaxial oxide superlattices with 50 repetitions of the layers. We also present polarization-dependent Raman spectra of SrRuO₃, with accurate identification of the Raman modes. These results show that the phonon dynamics of SrRuO₃ is strongly influenced by the spin ordering, which can be efficiently tailored via atomically controlled epitaxial heterostructuring.

Timing of antibiotics in septic patients: a prospective cohort study

OBJECTIVES

To evaluate the effect of timing and appropriateness of antibiotics administration on mortality in patients diagnosed with sepsis according to the Sepsis-3 definition.

METHODS

This prospective cohort study was conducted in patients diagnosed with sepsis according to the Sepsis-3 definition at the emergency department of Korea University Ansan Hospital from January 2016 to January 2019. The time to antibiotics was defined as the time in hours from emergency department arrival to the first antibiotic administration. Cox proportional hazards regression analysis was used to estimate the association between time to antibiotics and 7-, 14- and 28-day mortality.

RESULTS

Of 482 patients enrolled onto this study, 203 (42.1%) of 482 and 312 (64.7%) of 482 were diagnosed with septic shock and high-grade infection respectively. The median time to receipt of antibiotic therapy was 115 minutes. Antibiotics were administered within 3 and 6 hours in 340 (70.4%) of 482 and 450 (93.2%) of 482 patients respectively. Initial appropriate empirical antibiotics were administered in 375 (77.8%) of 482 patients. The time to and appropriateness of the initial antibiotics were not associated with 7-, 14- and 28-day mortality in multivariate analysis. The Sequential Organ Failure Assessment (SOFA) score (adjusted hazard ratio (aHR) 1.229, 95% confidence interval (CI) 1.093-1.381, p 0.001) and initial lactate levels (aHR 1.128, 95% CI 1.034-1.230, p 0.007), Charlson comorbidity index (aHR 1.115, 95% CI 1.027-1.210, p 0.014), 2-hour lactate level (aHR 1.115, 95% CI 1.027-1.210, p 0.009) and SOFA score (aHR 1.077, 95% CI 1.013-1.144, p 0.018) affected 7-, 14- and 28-day mortality respectively. Subgroup analysis with septic shock, bacteraemia and high-grade infection did not affect mortality rates.

CONCLUSIONS

Time to receipt of antibiotics may not affect the prognosis of patients with sepsis if a rapid and well-trained resuscitation is combined with appropriate antibiotic administration within a reasonable time.

Phase Instability amid Dimensional Crossover in Artificial Oxide Crystal

Artificial crystals synthesized by atomic-scale epitaxy provide the ability to control the dimensions of the quantum phases and associated phase transitions via precise thickness modulation. In particular, the reduction in dimensionality via quantized control of atomic layers is a powerful approach to revealing hidden electronic and magnetic phases. Here, we demonstrate a dimensionality-controlled and induced metal-insulator transition (MIT) in atomically designed superlattices by synthesizing a genuine two-dimensional (2D) SrRuO_{3} crystal with highly suppressed charge transfer. The tendency to ferromagnetically align the spins in an SrRuO_{3} layer diminishes in 2D as the interlayer exchange interaction vanishes, accompanying the 2D localization of electrons. Furthermore, electronic and magnetic instabilities in the two SrRuO_{3} unit cell layers induce a thermally driven MIT along with a metamagnetic transition.

Understanding Moderators of Home Blood Pressure Telemonitoring Systems in Urban Hypertensive Patients: A Systematic Review and Meta-Analysis

Background: Factors affecting the effectiveness of telemonitoring in home blood pressure telemonitoring (HBPT) must be examined in an integrated analysis in urban hypertensive patients. Materials and Methods: In a systematic review of electronic databases, we retrieved 1,433 citations and selected 34 comparisons. Specified moderators were the duration of the intervention, the frequency of remote transmission of blood pressure (BP) data, the additional intervention, and the intervention pathway. Results: For the duration of follow-up of HBPT, the weighted mean difference (WMD) in systolic blood pressure (SBP) between two groups was 11.900 mmHg (p-value <0.001) at 2 months and 3.024 mmHg (p = 0.002) at 12 months. The WMD in SBP was 5.512 mmHg (p < 0.001) in cases where data were transmitted daily and 1.818 mmHg (p = 0.084) for monthly transmission. For the group in which further interventions with HBPT were conducted, the WMD in SBP was 3.813 mmHg (p < 0.001). For patients who did not receive additional interventions, the WMD was 2.747 mmHg (p = 0.005). For the pathway of HBPT, the WMD was 6.800 mmHg (p = 0.053) when BP values were remote transmitted through letter, 3.041 mmHg (p = 0.001) through mobile phone/web, 2.224 mmHg (p = 0.043) through telephone-linked computer system, and 4.352 mmHg (p < 0.001) through telephone. Conclusions: The effects of moderators of HBPT systems utilized with urban hypertensive patients differ from those in interventions that did not distinguish urban from rural areas. Results for duration of implementation and frequency of data transmission were significant. Among the interventions using telecommunications, the telephone was the most effective in comparison to other channels.

Factors related to the use of opioids as early treatment in patients with knee osteoarthritis

Objective

To examine factors related to the use of opioids as an early treatment option for knee OA patients

Methods

Using the Korean nationwide claim database, we selected knee OA patients between 2013 and 2015. Among them, patients without any claim of knee OA for 2 years before the index date were included as our study population. We analyzed their first claim for prescriptions, including tramadol and stronger opioids, at the index date of each patient. Using a multinomial model, we identified factors associated with the early use of tramadol and stronger opioids in knee OA patients.

Results

Among a total of 2,857,999 knee OA patients, 12.2% (n = 348,516) were treated with opioids as their first treatment. However, the prevalence of stronger opioid use was only 0.07% (n = 1972). Male sex (OR 1.28 in tramadol, OR 1.13 in stronger opioids) and comorbidities with depression (OR 1.05, 1.46), low back pain (OR 1.13, 1.30), intervertebral disc disorder (OR 1.11, 1.40), and spinal stenosis (OR 1.27, 1.55) were the factors for the early use of tramadol or stronger opioids in knee OA patients. Patients in a tertiary referral hospital tended to use tramadol or stronger opioids than those in clinics (OR 1.04, 56.63, respectively).

Conclusion

In Korea, 12.2% of knee OA patients were treated with opioids as an early treatment, and tramadol was used more commonly than stronger opioids. Male sex and having comorbidities such as depression or musculoskeletal disease are patient factors associated with the early use of opioids in knee OA patients.

Effects of Remote Monitoring of Blood Pressure in Management of Urban Hypertensive Patients: A Systematic Review and Meta-Analysis

Background: Remote home blood pressure monitoring (RBPM) has been shown as effective in managing hypertension in underserved areas. Effects on urban patients, who are more easily provided with high-quality medical services, are still unclear. We systematically review previously published randomized controlled trials on the effect of RBPM for urban hypertensive patients. Methods: We searched electronic databases for studies published in English up to October 2018. Studies comparing the use of RBPM to face-to-face care were included. Outcome measures were changes in office blood pressure (BP) and the rate of BP control. Results: We identified 1,433 potential references for screening, of which 27 were eligible for review. Substantial heterogeneity was evident for the investigated variables. A significant standardized mean difference (SMD) was observed for RBPM for systolic BP, but the effect size was small compared to face-to-face care and was clinically irrelevant in avoiding cardiovascular events (0.212, 95% confidence interval 0.148-0.275; p < 0.001). For diastolic BP, the SMD between the two groups was small (0.170, p < 0.001) and the effect of RBPM was irrelevant in preventing cardiovascular events. The effect on the rate of BP control was significantly high for the intervention group (relative risk: 1.136; p = 0.018). Conclusions: This review demonstrates that RBPM performed on urban hypertensive patients has limited value and seems not to be superior to ordinary care in avoidance of cardiovascular events. Further studies are needed to provide more reliable information about the effectiveness of RBPM in preventing hypertensive cardiovascular complications.

Nanoscale heat transport through the hetero-interface of SrRuO3 thin films

A SrRuO₃ thin film has been widely used as a metal electrode in electronic devices based on transition metal oxides, and hence it is important to understand its thermal transport properties to minimize a thermal degradation problem during the device operation. Using the time-domain thermoreflectance measurement technique, we investigate the cross-plane thermal conductivity of the SrRuO₃ thin films with a thickness variation from 1 μm to 8 nm. We find that the thermal conductivity is reduced from about 6 W m^-1 K^-1 for the 1 μm thick film to about 1.2 W m^-1 K^-1 for the 8 nm thick film, and attribute this behavior to the boundary scattering of thermal carriers which originally have the mean free path of about 20 nm in a bulk state. Also, we observe a clear dip behavior of the thermal conductivity in the intermediate thickness around 30 nm which suggests an existence of a strong scattering source other than the film boundary. We explain this result by considering an additional interfacial scattering at the tetragonal-orthorhombic phase boundary which is formed during the strain relaxation with an increase of the film thickness.

Synergetic Behavior in 2D Layered Material/Complex Oxide Heterostructures

The marriage between a 2D layered material (2DLM) and a complex transition metal oxide (TMO) results in a variety of physical and chemical phenomena that cannot be achieved in either material alone. Interesting recent discoveries in systems such as graphene/SrTiO₃ , graphene/LaAlO₃ /SrTiO₃ , graphene/ferroelectric oxide, MoS₂ /SrTiO₃ , and FeSe/SrTiO₃ heterostructures include voltage scaling in field-effect transistors, charge state coupling across an interface, quantum conductance probing of the electrochemical activity, novel memory functions based on charge traps, and greatly enhanced superconductivity. In this context, various properties and functionalities appearing in numerous different 2DLM/TMO heterostructure systems are reviewed. The results imply that the multidimensional heterostructure approach based on the disparate material systems leads to an entirely new platform for the study of condensed matter physics and materials science. The heterostructures are also highly relevant technologically as each constituent material is a promising candidate for next-generation optoelectronic devices.

A Room-Temperature Ferroelectric Ferromagnet in a 1D Tetrahedral Chain Network

Ferroelectricity occurs in crystals with broken spatial inversion symmetry. In conventional perovskite oxides, concerted ionic displacements within a 3D network of transition-metal-oxygen polyhedra (MO_x ) manifest spontaneous polarization. Meanwhile, some 2D networks of MO_x foster geometric ferroelectricity with magnetism, owing to the distortion of the polyhedra. Because of the fundamentally different mechanism of ferroelectricity in a 2D network, one can further challenge an uncharted mechanism of ferroelectricity in a 1D channel of MO_x and estimate its feasibility. Here, ferroelectricity and coupled ferromagnetism in a 1D FeO₄ tetrahedral chain network of a brownmillerite SrFeO_2.5 epitaxial thin film are presented. The result provides a new paradigm for designing low-dimensional MO_x networks, which is expected to benefit the realization of macroscopic ferro-ordering materials including ferroelectric ferromagnets.

Transfer printing of vertical-type microscale light-emitting diode array onto flexible substrate using biomimetic stamp

We report the transfer printing of GaN-based microscale vertical-type light-emitting diodes (μ-VLEDs) using a functional layer and a biomimetic stamp. An oxide-based functional layer is inserted onto the structure of a μ-VLED and used to separate the chip from the μ-VLED wafer by absorbing the pulse of a UV pulse laser during pick-up of the transfer printing process. Polydimethylsiloxane (PDMS)-based biomimetic stamps have been fabricated to mimic the gecko lizard cilia for improved adhesion and repeatability. The biomimetic stamp has an adhesion force of 25.6 N/cm², which is 12 times the adhesion of a flat stamp; an adhesion force of 10 N/cm² or more was maintained after 100,000 repeated adhesion tests. A flexible 10 × 10 prototype array on a polyimide substrate was fabricated, and its bending test results indicated that the strain effect on the forward voltage and the output power was less than 1%. The stable bending test results of the prototype indicate that μ-VLEDs using biomimetic stamps allow the necessary stability for practical transfer printing.

Ferroelectric Polarization Rotation in Order-Disorder-Type LiNbO3 Thin Films

The direction of ferroelectric polarization is prescribed by the symmetry of the crystal structure. Therefore, rotation of the polarization direction is largely limited, despite the opportunity it offers in understanding important dielectric phenomena such as piezoelectric response near the morphotropic phase boundaries and practical applications such as ferroelectric memory. In this study, we report the observation of continuous rotation of ferroelectric polarization in order-disorder-type LiNbO₃ thin films. The spontaneous polarization could be tilted from an out-of-plane to an in-plane direction in the thin film by controlling the Li vacancy concentration within the hexagonal lattice framework. Partial inclusion of monoclinic-like phase is attributed to the breaking of macroscopic inversion symmetry along different directions and the emergence of ferroelectric polarization along the in-plane direction.

Oxygen-deficient triple perovskites as highly active and durable bifunctional electrocatalysts for oxygen electrode reactions

Highly active and durable bifunctional oxygen electrocatalysts have been of pivotal importance for renewable energy conversion and storage devices, such as unitized regenerative fuel cells and metal-air batteries. Perovskite-based oxygen electrocatalysts have emerged as promising nonprecious metal bifunctional electrocatalysts, yet their catalytic activity and stability still remain to be improved. We report a high-performance oxygen electrocatalyst based on a triple perovskite, Nd_1.5Ba_1.5CoFeMnO_9-δ (NBCFM), which shows superior activity and durability for oxygen electrode reactions to single and double perovskites. When hybridized with nitrogen-doped reduced graphene oxide (N-rGO), the resulting NBCFM/N-rGO catalyst shows further boosted bifunctional oxygen electrode activity (0.698 V), which surpasses that of Pt/C (0.801 V) and Ir/C (0.769 V) catalysts and which, among the perovskite-based electrocatalysts, is the best activity reported to date. The superior catalytic performances of NBCFM could be correlated to its oxygen defect-rich structure, lower charge transfer resistance, and smaller hybridization strength between O 2p and Co 3d orbitals.

Total and Methyl Mercury Concentrations in Antarctic Toothfish (Dissostichus mawsoni): Health Risk Assessment

The concentrations of total mercury (THg) in different organs of the Antarctic toothfish (Dissostichus mawsoni) collected from CCAMLR research blocks in Subarea 88.3 and Division 58.4.1 off the coast of Antarctica were determined. The results revealed THg concentrations of 0.165 ± 0.095 mg/kg (0.023-0.454 mg/kg, wet weight) in the Antarctic toothfish. In muscle, methyl mercury (MeHg) accounted for approximately 40% of the THg. In a comparison analysis, muscle and liver tended to bioaccumulate the highest levels of THg, and both THg and MeHg contents showed correlations with fish length and weight. Compared with international guidelines, fish contained 2.5-6.4% and 4.0-10.3% of the provisional tolerable weekly intake for THg recommended by the Joint FAO/WHO Expert Committee on Food Additives and the tolerable weekly intake for MeHg proposed by the European Food Safety Authority, respectively. These results suggest that consumption of the Antarctic toothfish presents no health risk to humans.

Stakeholders' resistance to telemedicine with focus on physicians: Utilizing the Delphi technique

INTRODUCTION

Sufficient infrastructure for information and communications technology (ICT) and a well-established policy are necessary factors for smooth implementation of telemedicine. However, despite these necessary conditions being met, there are situations where telemedicine still fails to be accepted as a system due to the low receptivity of stakeholders. In this study, we analyse stakeholders' resistance to an organization's implementation of telemedicine. Focusing on the physicians' interests, we propose a strategy to minimize conflicts and improve acceptance.

METHODS

The Delphi study involved 190 telemedicine professionals who were recommended by 485 telemedicine-related personnel in South Korea.

RESULTS

Out of 190 professionals, 60% of enrolled participants completed the final questionnaires. The stakeholders were categorized into four groups: policy-making officials, physicians, patients, and industrialists. Among these, the physicians were most opposed to the adoption of telemedicine. The main causes of such opposition were found to be the lack of a medical services delivery system and the threat of disruption for primary care clinics. Very little consensus was observed among the stakeholders, except on the following points: the need for expansion of the national health insurance budget by the government, and the need for enhancement of physicians' professional autonomy to facilitate smooth agreements.

DISCUSSION

Our analysis on the causes of the resistance to telemedicine, carried out with the groups mentioned above, has important implications for policy-makers deriving strategies to achieve an appropriate consensus.

It's not just about recruitment: An exploratory look at tobacco education sessions to increase participation into smoking cessation programs among American Indians

American Indians (AI) have the highest smoking rates and lowest quit rates of any racial/ethnic group in the U.S. Researchers and community members from the American Indian Health Research and Education Alliance (AIHREA) created and evaluated a culturally-tailored smoking cessation program, All Nations Breath of Life (ANBL) as a recruitment tool for smoking cessation programs among AI. To increase enrollment in ANBL, AI smokers were approached at cultural events and asked to attend a 30-minute educational session (in-person, n= 179; tele-video, n=97). Tele-video (30%) and in-person (9%) session participants were recruited into ANBL. Pre- and post-tests showed participants in both sessions demonstrated increased motivation and confidence to quit smoking but significant differences were present in both sessions (p < 0.0001). Results indicate that theoretically guided and culturally tailored education sessions are viable approaches to educate and recruit underserved populations into programs that promote smoking cessation.

Enhanced magnetic and thermoelectric properties in epitaxial polycrystalline SrRuO3 thin films

Transition metal oxide thin films show versatile electric, magnetic, and thermal properties which can be tailored by deliberately introducing macroscopic grain boundaries via polycrystalline solids. In this study, we focus on the modification of magnetic and thermal transport properties by fabricating single- and polycrystalline epitaxial SrRuO₃ thin films using pulsed laser epitaxy. Using the epitaxial stabilization technique with an atomically flat polycrystalline SrTiO₃ substrate, an epitaxial polycrystalline SrRuO₃ thin film with the crystalline quality of each grain comparable to that of its single-crystalline counterpart is realized. In particular, alleviated compressive strain near the grain boundaries due to coalescence is evidenced structurally, which induced the enhancement of ferromagnetic ordering of the polycrystalline epitaxial thin film. The structural variations associated with the grain boundaries further reduce the thermal conductivity without deteriorating the electronic transport, and lead to an enhanced thermoelectric efficiency in the epitaxial polycrystalline thin films, compared with their single-crystalline counterpart.

Directing Oxygen Vacancy Channels in SrFeO2.5 Epitaxial Thin Films

Transition-metal oxides (TMOs) with brownmillerite (BM) structures possess one-dimensional oxygen vacancy channels (OVCs), which play a key role in realizing high ionic conduction at low temperatures. The controllability of the vacancy channel orientation, thus, possesses a great potential for practical applications and would provide a better visualization of the diffusion pathways of ions in TMOs. In this study, the orientations of the OVCs in BM-SrFeO_2.5 are stabilized along two crystallographic directions of the epitaxial thin films. The distinctively orientated phases are found to be highly stable and exhibit a considerable difference in their electronic structures and optical properties, which could be understood in terms of orbital anisotropy. The control of the OVC orientation further leads to modifications in the hydrogenation of the BM-SrFeO_2.5 thin films. The results demonstrate a strong correlation between crystallographic orientations, electronic structures, and ionic motion in the BM structure.

Strongly Coupled Magnetic and Electronic Transitions in Multivalent Strontium Cobaltites

The topotactic phase transition in SrCoO_x (x = 2.5–3.0) makes it possible to reversibly transit between the two distinct phases, i.e. the brownmillerite SrCoO_2.5 that is a room-temperature antiferromagnetic insulator (AFM-I) and the perovskite SrCoO₃ that is a ferromagnetic metal (FM-M), owing to their multiple valence states. For the intermediate x values, the two distinct phases are expected to strongly compete with each other. With oxidation of SrCoO_2.5, however, it has been conjectured that the magnetic transition is decoupled to the electronic phase transition, i.e., the AFM-to-FM transition occurs before the insulator-to-metal transition (IMT), which is still controversial. Here, we bridge the gap between the two-phase transitions by density-functional theory calculations combined with optical spectroscopy. We confirm that the IMT actually occurs concomitantly with the FM transition near the oxygen content x = 2.75. Strong charge-spin coupling drives the concurrent IMT and AFM-to-FM transition, which fosters the near room-T magnetic transition characteristic. Ultimately, our study demonstrates that SrCoO_x is an intriguingly rare candidate for inducing coupled magnetic and electronic transition via fast and reversible redox reactions.

Topotactic Metal-Insulator Transition in Epitaxial SrFeOx Thin Films

Topotactic phase transformation enables structural transition without losing the crystalline symmetry of the parental phase and provides an effective platform for elucidating the redox reaction and oxygen diffusion within transition metal oxides. In addition, it enables tuning of the emergent physical properties of complex oxides, through strong interaction between the lattice and electronic degrees of freedom. In this communication, the electronic structure evolution of SrFeO_x epitaxial thin films is identified in real-time, during the progress of reversible topotactic phase transformation. Using real-time optical spectroscopy, the phase transition between the two structurally distinct phases (i.e., brownmillerite and perovskite) is quantitatively monitored, and a pressure-temperature phase diagram of the topotactic transformation is constructed for the first time. The transformation at relatively low temperatures is attributed to a markedly small difference in Gibbs free energy compared to the known similar class of materials to date. This study highlights the phase stability and reversibility of SrFeO_x thin films, which is highly relevant for energy and environmental applications exploiting the redox reactions.

Quantum Conductance Probing of Oxygen Vacancies in SrTiO3 Epitaxial Thin Film using Graphene

Quantum Hall conductance in monolayer graphene on an epitaxial SrTiO₃ (STO) thin film is studied to understand the role of oxygen vacancies in determining the dielectric properties of STO. As the gate-voltage sweep range is gradually increased in the device, systematic generation and annihilation of oxygen vacancies, evidenced from the hysteretic conductance behavior in the graphene, are observed. Furthermore, based on the experimentally observed linear scaling relation between the effective capacitance and the voltage sweep range, a simple model is constructed to manifest the relationship among the dielectric properties of STO with oxygen vacancies. The inherent quantum Hall conductance in graphene can be considered as a sensitive, robust, and noninvasive probe for understanding the electronic and ionic phenomena in complex transition-metal oxides without impairing the oxide layer underneath.

Hematite-Based Photoelectrode Materials for Photoelectrocatalytic Inhibition of Alzheimer's β-Amyloid Self-Assembly

A visible light-active, hematite-based photoelectrode platform for suppressing β-amyloid (Aβ) self-assembly in vitro is reported. Upon illumination of a light-emitting diode with an anodic bias, the hematite photoanode generates reactive radical species, such as superoxide ions and hydroxyl radicals, via photoelectrocatalytic process. According to our analyses, the hematite photoanode exhibited a strong inhibitory effect on Aβ aggregation under visible light illumination and anodic bias. We found that hole-derived radicals played a significant role of oxidizing Aβ peptides, which effectively blocked further aggregation. The efficacy of photoelectrocatalytic inhibition on Aβ aggregation was enhanced by introducing cobalt phosphate (Co-Pi) as a co-catalyst on the hematite photoanode, which facilitated the separation of electron-hole pairs. We verified that both bare and Co-Pi@hematite photoanodes are biocompatible and effective in reducing Aβ aggregation-induced cytotoxicity.

Highly Oriented SrTiO3 Thin Film on Graphene Substrate

Growth of perovskite oxide thin films on Si in crystalline form has long been a critical obstacle for the integration of multifunctional oxides into Si-based technologies. In this study, we propose pulsed laser deposition of a crystalline SrTiO₃ thin film on a Si using graphene substrate. The SrTiO₃ thin film on graphene has a highly (00l)-oriented crystalline structure which results from the partial epitaxy. Moreover, graphene promotes a sharp interface by highly suppressing the chemical intermixing. The important role of graphene as a 2D substrate and diffusion barrier allows the expansion of device applications based on functional complex oxides.

Surveillance of the Middle East respiratory syndrome (MERS) coronavirus (CoV) infection in healthcare workers after contact with confirmed MERS patients: incidence and risk factors of MERS-CoV seropositivity

Given the mode of transmission of Middle East respiratory syndrome (MERS), healthcare workers (HCWs) in contact with MERS patients are expected to be at risk of MERS infections. We evaluated the prevalence of MERS coronavirus (CoV) immunoglobulin (Ig) G in HCWs exposed to MERS patients and calculated the incidence of MERS-affected cases in HCWs. We enrolled HCWs from hospitals where confirmed MERS patients had visited. Serum was collected 4 to 6 weeks after the last contact with a confirmed MERS patient. We performed an enzyme-linked immunosorbent assay (ELISA) to screen for the presence of MERS-CoV IgG and an indirect immunofluorescence test (IIFT) to confirm MERS-CoV IgG. We used a questionnaire to collect information regarding the exposure. We calculated the incidence of MERS-affected cases by dividing the sum of PCR-confirmed and serology-confirmed cases by the number of exposed HCWs in participating hospitals. In total, 1169 HCWs in 31 hospitals had contact with 114 MERS patients, and among the HCWs, 15 were PCR-confirmed MERS cases in study hospitals. Serologic analysis was performed for 737 participants. ELISA was positive in five participants and borderline for seven. IIFT was positive for two (0.3%) of these 12 participants. Among the participants who did not use appropriate personal protective equipment (PPE), seropositivity was 0.7% (2/294) compared to 0% (0/443) in cases with appropriate PPE use. The incidence of MERS infection in HCWs was 1.5% (17/1169). The seroprevalence of MERS-CoV IgG among HCWs was higher among participants who did not use appropriate PPE.

Human Urine-Fueled Light-Driven NADH Regeneration for Redox Biocatalysis

Human urine is considered as an alternative source of hydrogen and electricity owing to its abundance and high energy density. Here we show the utility of human urine as a chemical fuel for driving redox biocatalysis in a photoelectrochemical cell. Ni(OH)2 -modified α-Fe2 O3 is selected as a photoanode for the oxidation of urea in human urine and black silicon (bSi) is used as a photocathode material for nicotinamide cofactor (NADH: hydrogenated nicotinamide adenine dinucleotide) regeneration. The electrons extracted from human urine are used for the regeneration of NADH, an essential hydride mediator that is required for numerous redox biocatalytic reactions. The catalytic reactions at both the photoanode and the photocathode were significantly enhanced by light energy that lowered the overpotential and generated high currents in the full cell system.