Self-Cleaning Highly Porous TiO2 Coating Designed by Swelling-Assisted Sequential Infiltration Synthesis (SIS) of a Block Copolymer Template

Photocatalytic self-cleaning coatings with a high surface area are important for a wide range of applications, including optical coatings, solar panels, mirrors, etc. Here, we designed a highly porous TiO2 coating with photoinduced self-cleaning characteristics and very high hydrophilicity. This was achieved using the swelling-assisted sequential infiltration synthesis (SIS) of a block copolymer (BCP) template, which was followed by polymer removal via oxidative thermal annealing. The quartz crystal microbalance (QCM) was employed to optimize the infiltration process by estimating the mass of material infiltrated into the polymer template as a function of the number of SIS cycles. This adopted swelling-assisted SIS approach resulted in a smooth uniform TiO2 film with an interconnected network of pores. The synthesized film exhibited good crystallinity in the anatase phase. The resulting nanoporous TiO2 coatings were tested for their functional characteristics. Exposure to UV irradiation for 1 h induced an improvement in the hydrophilicity of coatings with wetting angle reducing to unmeasurable values upon contact with water droplets. Furthermore, their self-cleaning characteristics were tested by measuring the photocatalytic degradation of methylene blue (MB). The synthesized porous TiO2 nanostructures displayed promising photocatalytic activity, demonstrating the degradation of approximately 92% of MB after 180 min under ultraviolet (UV) light irradiation. Thus, the level of performance was comparable to the photoactivity of commercial anatase TiO2 nanoparticles of the same quantity. Our results highlight a new robust approach for designing hydrophilic self-cleaning coatings with controlled porosity and composition.

Optical anisotropy of CsPbBr3 perovskite nanoplatelets

The two-dimensional CsPbBr3 nanoplatelets have a quantum well electronic structure with a band gap tunable with sample thicknesses in discreet steps based upon the number of monolayers. The polarized optical properties of CsPbBr3 nanoplatelets are studied using fluorescence anisotropy and polarized transient absorption spectroscopies. Polarized spectroscopy shows that they have absorption and emission transitions which are strongly plane-polarized. In particular, photoluminescence excitation and transient absorption measurements reveal a band-edge polarization approaching 0.1, the limit of isotropic two-dimensional ensembles. The degree of anisotropy is found to depend on the thickness of the nanoplatelets: multiple measurements show a progressive decrease in optical anisotropy from 2 to 5 monolayer thick nanoplatelets. In turn, larger cuboidal CsPbBr3 nanocrystals, are found to have consistently positive anisotropy which may be attributed to symmetry breaking from ideal perovskite cubes. Optical measurements of anisotropy are described with respect to the theoretical framework developed to describe exciton fine structure in these materials. The observed planar absorption and emission are close to predicted values at thinner nanoplatelet sizes and follow the predicted trend in anisotropy with thickness, but with larger anisotropy than theoretical predictions. Dominant planar emission, albeit confined to the thinnest nanoplatelets, is a valuable attribute for enhanced efficiency of light-emitting devices.

High-intensity interval training in cardiac rehabilitation (HIIT or MISS UK): A multi-centre randomised controlled trial

BACKGROUND

There is a lack of international consensus regarding the prescription of high-intensity interval exercise training (HIIT) for people with coronary artery disease (CAD) attending cardiac rehabilitation (CR).

AIM

To assess the clinical effectiveness and safety of low-volume HIIT compared with moderate intensity steady-state (MISS) exercise training for people with CAD.

METHODS

We conducted a multi-centre RCT, recruiting 382 patients from 6 outpatient CR centres. Participants were randomised to twice-weekly HIIT (n = 187) or MISS (n = 195) for 8 weeks. HIIT consisted of 10 × 1-minute intervals of vigorous exercise (>85% maximum capacity) interspersed with 1-minute periods of recovery. MISS was 20-40 minutes of moderate intensity continuous exercise (60-80% maximum capacity). The primary outcome was the change in cardiorespiratory fitness (peak oxygen uptake, VO2 peak) at 8-week follow-up. Secondary outcomes included cardiovascular disease risk markers, cardiac structure and function, adverse events, and health-related quality of life.

RESULTS

At 8 weeks, VO2  peak improved more with HIIT (2.37 mL.kg-1.min-1; SD, 3.11) compared with MISS (1.32 mL.kg-1.min-1; SD, 2.66). After adjusting for age, sex and study site, the difference between arms was 1.04 mL.kg-1.min-1 (95% CI, 0.38 to 1.69; p = 0.002). Only 1 serious adverse event was possibly related to HIIT.

CONCLUSIONS

In stable CAD, low-volume HIIT improved cardiorespiratory fitness more than MISS by a clinically meaningful margin. Low-volume HIIT is a safe, well tolerated, and clinically effective intervention that produces short-term improvement in cardiorespiratory fitness. It should be considered by all CR programmes as an adjunct or alternative to MISS.

TRIAL REGISTRATION

ClinicalTrials.gov: NCT02784873. https://clinicaltrials.gov/ct2/show/NCT02784873.

Symmetry-breaking in patch formation on triangular gold nanoparticles by asymmetric polymer grafting

Synthesizing patchy particles with predictive control over patch size, shape, placement and number has been highly sought-after for nanoparticle assembly research, but is fraught with challenges. Here we show that polymers can be designed to selectively adsorb onto nanoparticle surfaces already partially coated by other chains to drive the formation of patchy nanoparticles with broken symmetry. In our model system of triangular gold nanoparticles and polystyrene-b-polyacrylic acid patch, single- and double-patch nanoparticles are produced at high yield. These asymmetric single-patch nanoparticles are shown to assemble into self-limited patch‒patch connected bowties exhibiting intriguing plasmonic properties. To unveil the mechanism of symmetry-breaking patch formation, we develop a theory that accurately predicts our experimental observations at all scales—from patch patterning on nanoparticles, to the size/shape of the patches, to the particle assemblies driven by patch‒patch interactions. Both the experimental strategy and theoretical prediction extend to nanoparticles of other shapes such as octahedra and bipyramids. Our work provides an approach to leverage polymer interactions with nanoscale curved surfaces for asymmetric grafting in nanomaterials engineering.

Heart failure with preserved ejection fraction (HFpEF) pathophysiology study (IDENTIFY-HF): rise in arterial stiffness associates with HFpEF with increase in comorbidities

Background

There has been a shift in paradigm proposing that comorbidities play a significant role towards the pathophysiology of the heart failure with preserved ejection fraction (HFpEF) syndrome. Further, HFpEF patients have abnormal macrovascular function, potentially contributing significantly in altered ventricular-vascular coupling in these patients. However, our full understanding of the role of comorbidities, arterial stiffness and it relationship with HFpEF remains incomplete.

Purpose

The IDENTIFY-HF study aims to shed light on the HFpEF pathophysiology and investigates whether gradually increase in arterial stiffness (in addition to ageing) due to increasing common comorbidities, such as hypertension and diabetes, is associated with HFpEF.

Methods

Arterial compliance was assessed in five groups (Groups A to E) matched for age, (≥70 years), sex and renal function: Group A; normal healthy volunteers without major comorbidities (control). Group B; patients with hypertension only. Group C; patients with hypertension and diabetes mellitus only. Group D; patients with HFpEF. Group E; patients with heart failure and reduced ejection fraction (HFrEF); the parallel group. Arterial compliance was assessed using pulse wave velocity (PWV), as the primary outcome measure and was compared between Group A to D. A separate comparison was made between Groups D and E. To avoid confounding factors, participants were asked to omit their morning blood pressure medication and abstain from caffeine for 12 hours prior to the study.

Results

From the 95 volunteers recruited, PWV was obtained in 94 subjects. The mean PWV in group A, B, C, D and E was 10.2-, 12.2-, 13.0-, 13.7- and 10.0 m/s respectively. After adjusting for covariance (age, sex, BMI and renal function), the mean difference between Group A (healthy volunteers) and D (HFpEF) was 2.14 m/s (p=0.023). Whilst the mean difference between the HFpEF and HFrEF group D and E respectively was 2.68 m/s (p=0.003).

Conclusion

Rise in comorbidities increases arterial stiffness, as measured by pulse wave velocity, which in turn significantly associates with HFpEF (p=0.023). It is therefore possible that the HFpEF syndrome may not be due to a primary cardiac pathology but rather an end-result of non-cardiac comorbidities affecting vascular resistance with perhaps some secondary cardiac involvement.

Funding Acknowledgement

Type of funding sources: Public Institution(s). Main funding source(s): 1)West Midlands Clinical Research Network, National Institute of Health Research, UK2)Research, Development & Innovation department of the University Hospitals Coventry & Warwickshire NHS Trust (RDI, UHCW), UK.

Real-world evaluation of follow up strategies after implantable cardiac-defibrillator therapies in patients with ventricular tachycardia (REFINE-VT)

Introduction

Implantable cardiac-defibrillators (ICD) can prevent sudden cardiac death but the risk of recurrent ventricular arrhythmia (VA) and ICD therapies persists. Established strategies to minimize such risks include medication optimization, device reprogramming or ventricular tachycardia (VT) catheter ablation (CA). However, the timing and choice of these strategies at ICD follow-up may not be as consistent in the real-world as the regulated conditions of clinical trials. Furthermore, whether these decisions at follow-up are influenced by the type of arrhythmia, ICD therapy or patient characteristics remain unclear.

Purpose

We evaluated ICD follow-up strategies in patients with ischaemic (ICM) and non-ischaemic cardiomyopathy (NICM) to refine the outpatient management of these complex patients and ultimately improve overall patient outcome.

Methods

REFINE-VT is a retrospective study of 514 patients with ICD/CRT-D who attended ICD follow-up between June 2018 to September 2019 at the University Hospital Coventry & Warwickshire (UHCW) tertiary cardiology department. All follow-ups were face-to-face. Patients were divided into 2 groups according to the absence or presence of sustained VA (e.g. >30 seconds of VT and/or appropriate ICD therapy), described as “negative event” and “positive event” groups respectively. The type of strategy employed in response to a positive event were categorized into 4 groups: (1) Medication change only (2) Device programming +/− medication (3) Referral for VT CA (4) No intervention

Results

514 consecutive patients with ICD (52%) or CRT-D (48%) were analysed. Overall mean age was 67±14 years with 79% male patients. ICM was diagnosed in 329 (64%) patient and NICM in 185 (36%). 437 (85%) patients had no significant VA and/or ICD therapy referred to as the negative group. A total of 77 patients (15%) suffered VA and/or ICD therapies, of whom 22 patients (26%) experienced a second event. 31% (n=24) of this positive event group received no preventative strategy (Table 1). We observed an inconsistent approach to the choice of strategies across different types of arrhythmias and ICD therapies. E.g. the odds of intervening were significantly higher if ICD shock was detected compared to anti-tachycardia pacing (OR 8.4, 95% CI 1.7–39.6, p=0.007). Even in patients with two events, the rate of referral for VT ablation and escalation of antiarrhythmics were similarly as low as patients with a single event (Table 2).

Conclusion

This is the first contemporary study that has evaluated how strategies that reduce the risk of recurrent ICD events are executed in a real-world population. We have demonstrated that the decision to intervene and choices of strategy remain inconsistent and partially biased by the type of arrhythmia and ICD therapy at follow-up. This supports the need for an evidence-driven multi-disciplinary VT clinic to refine and standardize our approach to this heterogeneous population.

Funding Acknowledgement

Type of funding sources: None.

Enhancing hyperspectral EELS analysis of complex plasmonic nanostructures with pan-sharpening

Nanoscale hyperspectral techniques-such as electron energy loss spectroscopy (EELS)-are critical to understand the optical response in plasmonic nanostructures, but as systems become increasingly complex, the required sampling density and acquisition times become prohibitive for instrumental and specimen stability. As a result, there has been a recent push for new experimental methodologies that can provide comprehensive information about a complex system, while significantly reducing the duration of the experiment. Here, we present a pan-sharpening approach to hyperspectral EELS analysis, where we acquire two datasets from the same region (one with high spatial resolution and one with high spectral fidelity) and combine them to achieve a single dataset with the beneficial properties of both. This work outlines a straightforward, reproducible pathway to reduced experiment times and higher signal-to-noise ratios, while retaining the relevant physical parameters of the plasmonic response, and is generally applicable to a wide range of spectroscopy modalities.

HEMOPHAGOCYTOSIS SECONDARY TO PHARYNGEAL ABSCESS IN AN IMMUNOCOMPETENT PATIENT (case report)

Background. Hemophagocytosis is a rare, potentially fatal disorder, comprising pancytopenia, liver dysfunction, hepatosplenomegaly, hypertriglyceridemia, and hyperferritinemia presenting as fever, lympha­denopathy and skin rashes. Objective. To attract the clinicians’ attention to a problem of hemophagocytosis in Critical Care management.Methods. Hemophagocytosis secondary to pharyngeal abscess in a 58 year old male is being reported.Results. A 58-year-old immunocompetent patient presenting with hemophagocytosis secondary to pharyngeal abscess, was managed on ventilator and inotropic support, when he developed heathcare-associated urinary tract infection by Escherichia coli and ventilator-associated pneumonia by Acinetobacter baumanii. He developed neutropenic septic shock and multi-organ dysfunction and went through a downhill course leading to demise.Conclusions. Hemophagocytosis remains a sinister entity in modern intensive care despite astute clinical management. Secondary superinfections with opportunistic multidrug resistant pathogens are difficult to treat. A high index of clinical suspicion, aggressive diagnosis and prompt treatment for hemophagocytosis and polymicrobial opportunistic superinfections with multidrug-resistant healthcare-associated pathogens needs to be addressed upfront.

STM Imaging of Localized Surface Plasmons on Individual Gold Nanoislands

An optically modulated scanning tunneling microscopy technique developed for measurement of single-molecule optical absorption is used here to image the light absorption by individual Au nanoislands and Au nanostructures. The technique is shown to spatially map, with nanometer resolution, localized surface plasmons (LSPs) excited within the nanoislands. Electrodynamic simulations demonstrate the correspondence of the measured images to plasmonic near-field intensity maps. The optical STM imaging technique captures the wavelength, polarization, and geometry dependence of the LSP resonances and their corresponding near-fields. Thus, we introduce a tool for real-space, nanometer-scale visualization of optical energy absorption, transport, and dissipation in complex plasmonic nanostructures.

Effect of chronic kidney disease on serum resistin level

BACKGROUND

Chronic Kidney Diseases (CKD) of all etiologies are usually associated with Insulin Resistance (IR). Resistin is also a protein associated with IR. Some studies conducted abroad have shown that resistin level is higher among CKD patients.

OBJECTIVE

To test if serum resistin level is significantly higher in CKD patients compared to normal individuals.

PATIENTS AND METHODS

96 CKD patients and 97 normal individuals were included in the study. Written informed consent was obtained from every individual.

RESULTS

Serum resistin level was higher in CKD patients compared to control subjects. The difference in serum resistin level between two groups was statistically significant.

CONCLUSION

Our study is probably the first study in India comparing serum resistin levels of CKD patients vis-à-vis control subjects. Further cellular research may be needed to explore this relation.

Colossal dielectric permittivity in Co-doped ZnO ceramics prepared by a pressure-less sintering method

Dielectric properties and impedance spectroscopic studies of single phase Zn_1−xCo_xO (0 ≤ x ≤ 0.05) ceramics, synthesized by a pressure-less solid state reaction method, have been carried out to investigate the origin of colossal dielectric permittivity (CP), ε′ ∼ 10⁵, in a wide frequency (2 × 10¹–2 × 10⁶ Hz) range.

Mechanism of sulfidation of small zinc oxide nanoparticles

ZnO has industrial utility as a solid sorbent for the removal of polluting sulfur compounds from petroleum-based fuels. Small ZnO nanoparticles may be more effective in terms of sorption capacity and ease of sulfidation as compared to bulk ZnO. Motivated by this promise, here, we study the sulfidation of ZnO NPs and uncover the solid-state mechanism of the process by crystallographic and optical absorbance characterization. The wurtzite-structure ZnO NPs undergo complete sulfidation to yield ZnS NPs with a drastically different zincblende structure. However, in the early stages, the ZnO NP lattice undergoes only substitutional doping by sulfur, while retaining its wurtzite structure. Above a threshold sulfur-doping level of 30 mol%, separate zincblende ZnS grains nucleate, which grow at the expense of the ZnO NPs, finally yielding ZnS NPs. Thus, the full oxide to sulfide transformation cannot be viewed simply as a topotactic place-exchange of anions. The product ZnS NPs formed by nucleation-growth share neither the crystallographic structure nor the size of the initial ZnO NPs. The reaction mechanism may inform the future design of nanostructured ZnO sorbents.

In the sulfidation of small ZnO nanoparticles, the nanoparticles first undergo sulfur doping followed by the nucleation-growth of ZnS domains.

Cord blood NK cells engineered to express IL-15 and a CD19-targeted CAR show long-term persistence and potent antitumor activity

Chimeric antigen receptors (CARs) have been used to redirect the specificity of autologous T cells against leukemia and lymphoma with promising clinical results. Extending this approach to allogeneic T cells is problematic as they carry a significant risk of graft-versus-host disease (GVHD). Natural killer (NK) cells are highly cytotoxic effectors, killing their targets in a non-antigen-specific manner without causing GVHD. Cord blood (CB) offers an attractive, allogeneic, off-the-self source of NK cells for immunotherapy. We transduced CB-derived NK cells with a retroviral vector incorporating the genes for CAR-CD19, IL-15 and inducible caspase-9-based suicide gene (iC9), and demonstrated efficient killing of CD19-expressing cell lines and primary leukemia cells in vitro, with marked prolongation of survival in a xenograft Raji lymphoma murine model. Interleukin-15 (IL-15) production by the transduced CB-NK cells critically improved their function. Moreover, iC9/CAR.19/IL-15 CB-NK cells were readily eliminated upon pharmacologic activation of the iC9 suicide gene. In conclusion, we have developed a novel approach to immunotherapy using engineered CB-derived NK cells, which are easy to produce, exhibit striking efficacy and incorporate safety measures to limit toxicity. This approach should greatly improve the logistics of delivering this therapy to large numbers of patients, a major limitation to current CAR-T-cell therapies.

Liquid-like cationic sub-lattice in copper selenide clusters

Super-ionic solids, which exhibit ion mobilities as high as those in liquids or molten salts, have been employed as solid-state electrolytes in batteries, improved thermoelectrics and fast-ion conductors in super-capacitors and fuel cells. Fast-ion transport in many of these solids is supported by a disordered, 'liquid-like' sub-lattice of cations mobile within a rigid anionic sub-lattice, often achieved at high temperatures or pressures via a phase transition. Here we show that ultrasmall clusters of copper selenide exhibit a disordered cationic sub-lattice under ambient conditions unlike larger nanocrystals, where Cu⁺ ions and vacancies form an ordered super-structure similar to the bulk solid. The clusters exhibit an unusual cationic sub-lattice arrangement wherein octahedral sites, which serve as bridges for cation migration, are stabilized by compressive strain. The room-temperature liquid-like nature of the Cu⁺ sub-lattice combined with the actively tunable plasmonic properties of the Cu₂Se clusters make them suitable as fast electro-optic switches.

Structural and functional diversity of nonapeptide hormones from an evolutionary perspective: A review

The article presents an overview of the comparative distribution, structure and functions of the nonapeptide hormones in chordates and non chordates. The review begins with a historical preview of the advent of the concept of neurosecretion and birth of neuroendocrine science, pioneered by the works of E. Scharrer and W. Bargmann. The sections which follow discuss different vertebrate nonapeptides, their distribution, comparison, precursor gene structures and processing, highlighting the major differences in these aspects amidst the conserved features across vertebrates. The vast literature on the anatomical characteristics of the nonapeptide secreting nuclei in the brain and their projections was briefly reviewed in a comparative framework. Recent knowledge on the nonapeptide hormone receptors and their intracellular signaling pathways is discussed and few grey areas which require deeper studies are identified. The sections on the functions and regulation of nonapeptides summarize the huge and ever increasing literature that is available in these areas. The nonapeptides emerge as key homeostatic molecules with complex regulation and several synergistic partners. Lastly, an update of the nonapeptides in non chordates with respect to distribution, site of synthesis, functions and receptors, dealt separately for each phylum, is presented. The non chordate nonapeptides share many similarities with their counterparts in vertebrates, pointing the system to have an ancient origin and to be an important substrate for changes during adaptive evolution. The article concludes projecting the nonapeptides as one of the very first common molecules of the primitive nervous and endocrine systems, which have been retained to maintain homeostatic functions in metazoans; some of which are conserved across the animal kingdom and some are specialized in a group/lineage-specific manner.

Submandibular intubation in awake patient of panfacial trauma

Maxillofacial trauma patients present with airway problems. Submandibular intubation is an effective means of intubation to avoid tracheostomy for operative procedures. Airway is secured with oral endotracheal intubation in paralyzed patient and tube is then transplaced in sub mental or submandibular region. However there may be instances when paralyzing such trauma patients is not safe and short term tracheostomy is the only airway channel available for conduction of anesthesia. We report a case of submandibular intubation in awake patient of maxillofacial trauma with anticipated intubation problems.

A dynamic landscape of allergen associations in delayed-type cutaneous hypersensitivity

BACKGROUND

Delayed-type hypersensitivity represents a significant clinical and public health challenge. Patients undergoing patch testing may exhibit positive reactions to more than one allergen. It is recognized that reactions to specific pairs of allergens are associated, reflecting a combination of exposure patterns and structural similarity.

OBJECTIVES

To explore the influence of time of testing, age, sex and atopy status on allergen pair associations in a series of 45 110 consecutive patients tested over 30 years.

METHODS

Patch test records of all patients undergoing testing with a modified European baseline series between 1985 and 2014 were retrieved from a database at St John's Institute of Dermatology. Reactions were read on days 2 and 4. For each allergen it was recorded whether the allergen was tested and whether the result was positive or negative.

RESULTS

This is the largest reported study of patch test allergen pair relationships. Our analysis shows a high degree of variability in allergen pair associations. Rigorous statistical analysis reveals a large number of differences between groups, including a significant increase in the association between formaldehyde and multiple formaldehyde-releasing preservatives over the study period, in addition to pair associations with cobalt and formaldehyde-releasing preservatives. These were present to a significantly greater extent in men than in women.

CONCLUSIONS

These observations extend our understanding of cutaneous allergy, with implications for both clinical practice and mechanisms of cutaneous hypersensitivity.