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Dressings and securement devices to prevent complications for peripheral arterial catheters
No full textBackground: Peripheral arterial catheters (ACs) are used in anaesthesia and intensive care settings for blood sampling and monitoring. Despite their importance, ACs often fail, requiring reinsertion. Dressings and securement devices maintain AC function and prevent complications such as infection. Objectives: To evaluate the effectiveness of peripheral AC dressing and securement devices to prevent failure and complications in hospitalised people. Search methods: We searched the Cochrane Wounds Specialised Register, CENTRAL, MEDLINE, Embase, and CINAHL Plus up to 16 May 2023. We also searched ClinicalTrials.gov and the World Health Organization International Clinical Trials Registry Platform up to 16 May 2023. Selection criteria: We included randomised controlled trials (RCTs) comparing different dressing and securement devices for the stabilisation of ACs in hospitalised people. Data collection and analysis: Two review authors independently selected trials for inclusion, extracted data, and assessed risk of bias using Cochrane's RoB 1 tool. We resolved disagreements by discussion, or by consulting a third review author when necessary. We assessed the certainty of evidence using GRADE. Main results: We included five RCTs with 1228 participants and 1228 ACs. All included studies had high risk of bias in one or more domains. We present the following four comparisons, with the remaining comparisons reported in the main review. Standard polyurethane (SPU) plus tissue adhesive (TA) compared with SPU: we are very uncertain whether use of SPU plus TA impacts rates of AC failure (risk ratio (RR) 0.44, 95% confidence interval (CI) 0.20 to 0.98; I² = 0%; 2 studies, 165 participants; very low-certainty evidence). Neither study (165 participants) reported catheter-related bloodstream infections (CRBSI), thus we are very uncertain whether SPU plus TA impacts on the incidence of CRBSI (very low-certainty evidence). It is very uncertain whether use of SPU plus TA impacts AC dislodgement risk (RR 0.54, 95% CI 0.03 to 9.62; I² = 44%; 2 studies, 165 participants; very low-certainty evidence). We are very uncertain whether use of SPU plus TA impacts AC occlusion rates (RR 1.20, 95% CI 0.37 to 3.91; I² = 3%; 2 studies, 165 participants; very low-certainty evidence). We are very uncertain whether use of SPU plus TA impacts rates of adverse events with few reported events across groups (RR 0.89, 95% CI 0.09 to 8.33; I² = 0%; 2 studies, 165 participants; very low-certainty evidence). Bordered polyurethane (BPU) compared to SPU: we are very uncertain whether use of BPU impacts rates of AC failure (RR 0.67, 95% CI 0.21 to 2.13; 1 study, 60 participants; very low-certainty evidence). BPU may make little or no difference to CRBSI compared to SPU (RR 3.05, 95% CI 0.12 to 74.45; I² = not applicable as 1 study (60 participants) reported 0 events; 2 studies, 572 participants; low-certainty evidence). BPU may make little or no difference to the risk of AC dislodgement compared with SPU (RR 0.75, 95% CI 0.17 to 3.22; I² = 0%; 2 studies, 572 participants; low-certainty evidence). BPU may make little or no difference to occlusion risk compared with SPU (RR 0.80, 95% CI 0.60 to 1.07; I² = 0%; 2 studies, 572 participants; low-certainty evidence). It is very uncertain whether BPU impacts on the risk of adverse events compared with SPU (RR 0.33, 95% CI 0.01 to 7.87; 1 study, 60 participants; very low-certainty evidence). SPU plus sutureless securement devices (SSD) compared to SPU: we are very uncertain whether SPU plus SSD impacts risk of AC failure compared with SPU (RR 0.78, 95% CI 0.40 to 1.52; I² = 0%; 2 studies, 157 participants; very low-certainty evidence). We are very uncertain if SPU plus SSD impacts CRBSI incidence rate with no events in both groups (2 studies, 157 participants; very low-certainty evidence). It is very uncertain whether SPU plus SSD impacts risk of dislodgement (RR 0.14, 95% CI 0.01 to 2.57; I² = not applicable as 1 study (96 participants) reported 0 events; 2 studies, 157 participants; very low-certainty evidence). It is very uncertain whether SPU plus SSD impacts risk of AC occlusion (RR 1.94, 95% CI 0.50 to 7.48; I² = 38%; 2 studies, 157 participants; very low-certainty evidence). We are very uncertain whether SPU plus SSD impacts on the risk of adverse events (RR 1.94, 95% CI 0.19 to 20.24; I² = not applicable as 1 study (96 participants) reported 0 events; 2 studies, 157 participants; very low-certainty evidence). Integrated securement dressings compared to SPU: integrated securement dressings may result in little or no difference in risk of AC failure compared with SPU (RR 1.96, 95% CI 0.80 to 4.84; 1 study, 105 participants; low-certainty evidence); may result in little or no difference in CRBSI incidence with no events reported (1 study, 105 participants; low-certainty evidence); may result in little or no difference in the risk of dislodgement (RR 0.33, 95% CI 0.04 to 3.04; 1 study, 105 participants; low-certainty evidence), may result in little or no difference in occlusion rates with no events reported (1 study, 105 participants; low-certainty evidence), and may result in little or no difference in the risk of adverse events (RR 0.35, 95% CI 0.01 to 8.45; 1 study, 105 participants; low-certainty evidence). Authors' conclusions: There is currently limited rigorous RCT evidence available about the relative clinical effectiveness of AC dressing and securement products. Limitations of current evidence include small sample size, infrequent events, and heterogeneous outcome measurements. We found no clear difference in the incidence of AC failure, CRBSI, or adverse events across AC dressing or securement products including SPU, BPU, SSD, TA, and integrated securement products. The limitations of current evidence means further rigorous RCTs are needed to reduce uncertainty around the use of dressing and securement devices for ACs
Familial Alzheimer’s Disease Neurons Bearing Mutations in PSEN1 Display Increased Calcium Responses to AMPA as an Early Calcium Dysregulation Phenotype
No full textFamilial Alzheimer’s disease (FAD) can be caused by mutations in PSEN1 that encode presenilin-1, a component of the gamma-secretase complex that cleaves amyloid precursor protein. Alterations in calcium (Ca2+) homeostasis and glutamate signaling are implicated in the pathogenesis of FAD; however, it has been difficult to assess in humans whether or not these phenotypes are the result of amyloid or tau pathology. This study aimed to assess the early calcium and glutamate phenotypes of FAD by measuring the Ca2+ response of induced pluripotent stem cell (iPSC)-derived neurons bearing PSEN1 mutations to glutamate and the ionotropic glutamate receptor agonists NMDA, AMPA, and kainate compared to isogenic control and healthy lines. The data show that in early neurons, even in the absence of amyloid and tau phenotypes, FAD neurons exhibit increased Ca2+ responses to glutamate and AMPA, but not NMDA or kainate. Together, this suggests that PSEN1 mutations alter Ca2+ and glutamate signaling as an early phenotype of FAD
Micro RNA Dysregulation in Keratinocyte Carcinomas: Clinical Evidence, Functional Impact, and Future Directions
No full textThe keratinocyte carcinomas, basal cell carcinoma (BCC), and cutaneous squamous cell carcinoma (cSCC), are the most common cancers in humans. Recently, an increasing body of literature has investigated the role of miRNAs in keratinocyte carcinoma pathogenesis, progression and their use as therapeutic agents and targets, or biomarkers. However, there is very little consistency in the literature regarding the identity of and/or role of individual miRNAs in cSCC (and to a lesser extent BCC) biology. miRNA analyses that combine clinical evidence with experimental elucidation of targets and functional impact provide far more compelling evidence than studies purely based on clinical findings or bioinformatic analyses. In this study, we review the clinical evidence associated with miRNA dysregulation in KCs, assessing the quality of validation evidence provided, identify gaps, and provide recommendations for future studies based on relevant studies that investigated miRNA levels in human cSCC and BCC. Furthermore, we demonstrate how miRNAs contribute to the regulation of a diverse network of cellular functions, and that large-scale changes in tumor cell biology can be attributed to miRNA dysregulation. We highlight the need for further studies investigating the role of miRNAs as communicators between different cell types in the tumor microenvironment. Finally, we explore the clinical benefits of miRNAs as biomarkers of keratinocyte carcinoma prognosis and treatment.</p
Advancing Metallic Lithium Anodes: A Review of Interface Design, Electrolyte Innovation, and Performance Enhancement Strategies
No full textLithium (Li) metal is one of the most promising anode materials for next-generation, high-energy, Li-based batteries due to its exceptionally high specific capacity and low reduction potential. Nonetheless, intrinsic challenges such as detrimental interfacial reactions, significant volume expansion, and dendritic growth present considerable obstacles to its practical application. This review comprehensively summarizes various recent strategies for the modification and protection of metallic lithium anodes, offering insight into the latest advancements in electrode enhancement, electrolyte innovation, and interfacial design, as well as theoretical simulations related to the above. One notable trend is the optimization of electrolytes to suppress dendrite formation and enhance the stability of the electrode–electrolyte interface. This has been achieved through the development of new electrolytes with higher ionic conductivity and better compatibility with Li metal. Furthermore, significant progress has been made in the design and synthesis of novel Li metal composite anodes. These composite anodes, incorporating various additives such as polymers, ceramic particles, and carbon nanotubes, exhibit improved cycling stability and safety compared to pure Li metal. Research has used simulation computing, machine learning, and other methods to achieve electrochemical mechanics modeling and multi-field simulation in order to analyze and predict non-uniform lithium deposition processes and control factors. In-depth investigations into the electrochemical reactions, interfacial chemistry, and physical properties of these electrodes have provided valuable insights into their design and optimization. It systematically encapsulates the state-of-the-art developments in anode protection and delineates prospective trajectories for the technology’s industrial evolution. This review aims to provide a detailed overview of the latest strategies for enhancing metallic lithium anodes in lithium-ion batteries, addressing the primary challenges and suggesting future directions for industrial advancement
Insolvent trading laws in Saudi Arabia and Australia: A critical appraisal
No full textThe abstract for this item has not been populate
LURAD: Design study of a comprehensive radiation monitor package for the gateway and the lunar surface
No full textMoon is an auspicious environment for the study of Galactic cosmic rays (GCR) and Solar Particle Events (SEP) due to the absence of magnetic field and atmosphere. The same characteristics raise the radiation risk for human presence in orbit around it or at the lunar surface. The secondary (albedo) radiation resulting from the interaction of the primary radiation with the lunar soil adds an extra risk factor, because neutrons are produced, but also it can be exploited to study the soil composition. In this paper, the design of a comprehensive radiation monitor package tailored to the lunar environment is presented. The detector, named LURAD, will perform spectroscopic measurements of protons, electrons, heavy ions, as well as gamma-rays, and neutrons. A microdosimetry monitor subsystem is foreseen which can provide measurements of LET(Si) spectra in a wide dynamic range of LET(Si) and flux for SPE and GCR, detection of neutrons and biological dose for radiation protection of astronauts. The LURAD design leverages on the following key enabling technologies: (a) Fully depleted Si monolithic active pixel sensors; (b) Scintillators read by silicon photomultipliers (SiPM); (c) Silicon on Insulator (SOI) microdosimetry sensors; These technologies promise miniaturization and mass reduction with state-of-the-art performance. The instrument's design is presented, and the Monte Carlo study of the feasibility of particle identification and kinetic energy determination is discussed
Humidity-Responsive Liquid Metal Core–Shell Materials for Enduring Heat Retention and Insulation
No full textHigh humidity in extremely cold weather can undermine the insulation capability of the clothing, imposing serious life risks. Current clothing insulation technologies have inherent deficiencies in terms of insulation efficiency and humidity adaptability. Here, humidity-stimulated self-heating clothing using aluminum core–liquid metal shell microparticles (Al@LM-MPs) as the filler is reported. Al@LM-MPs exhibit a distinctive capability to react to water molecules in the air to generate heat, exhibiting remarkable sensitivity across a broad temperature range. This ability leads to the creation of intelligent clothing capable of autonomously responding to extreme cold and wet weather conditions, providing both enduring heat retention and insulation capabilities
High-temperature energy storage with a new tri-layers polymer composites via hybrid assembly engineering
No full textDielectric film capacitors are fundamental components in advanced electrical fields such as smart grids and hybrid electric vehicle. The commercial film capacitors made by biaxially oriented polypropylene (BOPP) have high energy efficiency, but low energy density of only 2.0-3.0 J/cm3, while the inferior thermal stability restricts their high temperature applications. In this work, hybrid assembly engineering is proposed to design composite films with a new polymer of poly(acrylonitrile butadiene styrene) (ABS) as the matrix, boron nitride nanosheets (BNNS) and Na0.5Bi0.5TiO3-Sr0.7Bi0.2TiO3 (NBT-SBT) as two different fillers to improve high-temperature performance. The optimized composites SBS (NBT-SBT/ABS composites layer in the outside and BNNS/ABS composites layer in the middle) exhibit excellent high temperature energy storage characteristics, and its underlying mechanism is also understood by phase-field simulations. In particular, the maximum energy density at 120 °C can reach 15.0 J/cm3 at 575 MV/m, which is 8 times that of BOPP, while the efficiency is maintained at 89 %, far exceeding the performance of BOPP (<70 % at 120 °C). Together with their excellent cycling reliability (106 cycles) and thermal stability, this strategy shows a great potential for high-temperature and high-power energy storage capacitors
Accelerated Proton Transfer in Asymmetric Active Units for Sustainable Acidic Oxygen Evolution Reaction
No full textThe poor durability of Ru-based catalysts limits the practical application in proton exchange membrane water electrolysis (PEMWE). Here, we report that the asymmetric active units in Ru1-xMxO2 (M = Sb, In, and Sn) binary solid solution oxides are constructed by introducing acid-resistant p-block metal sites, breaking the activity and stability limitations of RuO2 in acidic oxygen evolution reaction (OER). Constructing highly asymmetric Ru-O-Sb units with a strong electron delocalization effect significantly shortens the spatial distance between Ru and Sb sites, improving the bonding strength of the overall structure. The unique two-electron redox couples at Sb sites in asymmetric active units trigger additional chemical steps at different OER stages, facilitating continuous proton transfer. The optimized Ru0.8Sb0.2O2 solid solution requires a superlow overpotential of 160 mV at 10 mA cm-2 and a record-breaking stability of 1100 h in an acidic electrolyte. Notably, the scale-prepared Ru0.8Sb0.2O2 achieves efficient PEMWE performance under industrial conditions. General mechanism analysis shows that the enhanced proton transport in the asymmetric Ru-O-M unit provides a new working pathway for acidic OER, breaking the scaling relationship without sacrificing stability
Mechanocatalytic Hydrogen Generation in Centrosymmetric Barium Dititanate
No full textNovel phase of nano materials that break the traditional structural constraints are highly desirable, particularly in the field of mechanocatalysis, offering versatile applications ranging from energy to medical diagnosis and treatment. In this work, a distinct layered barium dititanate (BaTi2O5) nanocrystals using a pH-modulated hydrothermal method is successfully synthesized. These nanocrystals exhibit outstanding hydrogen generation capability (1160 µmol g−1 h−1 in pure water) and demonstrate remarkable performance in organic dye degradation using ultrasonication. The crystal structure of this newly discovered BaTi2O5 phase, is determined by a combination of synchrotron Powder Diffraction refinement and X-ray adsorption techniques, including X-ray Absorption Near Edge Structure (XANES) and Extended X-ray Absorption Fine Structure (EXAFS). Density Functional Theory calculations revealed that the newly-discovered BaTi2O5 phase demonstrates dipole moments along the z-axis, distributed in an antiparallel direction within a single unit cell. These inherent dipoles induce a surface polarization and a ferroelectric-flexoelectric response under mechanical stimuli when the materials go to nano dimension. With a band alignment well-suitable for hydrogen and reactive oxygen species generation, this BaTi2O5 phase demonstrates promising potential for Mechanocatalysis. The discovery of this distinct phase not only enriches the material candidates for mechanocatalysis but also provides valuable insights