Persistent surgical wound bleeding: A rare condition related to acquired hemophilia A

SummaryAcquired hemophilia A (AHA) is a rare condition that predisposes affected patients to a bleeding tendency, even after a trivial physical insult. We present our experience with a 45-year-old male patient who was referred to our institute because of persistent bleeding from a left forearm surgical wound after fasciotomy. He was diagnosed as having AHA. Surgical treatment in combination with recombinant activated factor VII (rFVIIa) led to a satisfactory result. Clinical awareness and multidisciplinary professional connections are necessary in the treatment of AHA. Acquired hemophilia should be considered in the differential diagnosis of patients with uncontrolled bleeding episodes

Toward controllable and predictable synthesis of high-entropy alloy nanocrystals.

High-entropy alloy (HEA) nanocrystals have attracted extensive attention in catalysis. However, there are no effective strategies for synthesizing them in a controllable and predictable manner. With quinary HEA nanocrystals made of platinum-group metals as an example, we demonstrate that their structures with spatial compositions can be predicted by quantitatively knowing the reduction kinetics of metal precursors and entropy of mixing in the nanocrystals under dropwise addition of the mixing five-metal precursor solution. The time to reach a steady state for each precursor plays a pivotal role in determining the structures of HEA nanocrystals with homogeneous alloy and core-shell features. Compared to the commercial platinum/carbon and phase-separated counterparts, the dendritic HEA nanocrystals with a defect-rich surface show substantial enhancement in catalytic activity and durability toward both hydrogen evolution and oxidation. This quantitative study will lead to a paradigm shift in the design of HEA nanocrystals, pushing away from the trial-and-error approach

Novel Nanohybrids of Silver Particles on Clay Platelets for Inhibiting Silver-Resistant Bacteria

We develop a novel nanohybrid showing a strong antibacterial activity on all of the tested pathogens, including methicillin-resistant Staphylococcus auerus and silver-resistant E. coli. The nanohybrid consists of silver nanoparticles (AgNPs) supported on 1 nm-thick silicate platelets (NSPs). The AgNP/NSP nanohybrid enables to encapsulate bacteria and triggers death signals from the cell membrane. The geographic shape of the NSPs concentrates AgNPs but impedes their penetration into attached cells, mitigating the detrimental effect of silver ion deposition in applied tissues. Moreover, the tightly tethered AgNPs on NSP surface achieve a stronger biocidal effect than silver nitrate, but bypassing Ag+ mechanism, on silver-resistant bacteria. This nanohybrid presents an effective and safe antimicrobial agent in a new perspective

Genotype-phenotype correlation in Taiwanese children with diazoxide-unresponsive congenital hyperinsulinism

ObjectiveCongenital hyperinsulinism (CHI) is a group of clinically and genetically heterogeneous disorders characterized by dysregulated insulin secretion. The aim of the study was to elucidate genetic etiologies of Taiwanese children with the most severe diazoxide-unresponsive CHI and analyze their genotype-phenotype correlations.MethodsWe combined Sanger with whole exome sequencing (WES) to analyze CHI-related genes. The allele frequency of the most common variant was estimated by single-nucleotide polymorphism haplotype analysis. The functional effects of the ATP-sensitive potassium (KATP) channel variants were assessed using patch clamp recording and Western blot.ResultsNine of 13 (69%) patients with ten different pathogenic variants (7 in ABCC8, 2 in KCNJ11 and 1 in GCK) were identified by the combined sequencing. The variant ABCC8 p.T1042QfsX75 identified in three probands was located in a specific haplotype. Functional study revealed the human SUR1 (hSUR1)-L366F KATP channels failed to respond to intracellular MgADP and diazoxide while hSUR1-R797Q and hSUR1-R1393C KATP channels were defective in trafficking. One patient had a de novo dominant mutation in the GCK gene (p.I211F), and WES revealed mosaicism of this variant from another patient.ConclusionPathogenic variants in KATP channels are the most common underlying cause of diazoxide-unresponsive CHI in the Taiwanese cohort. The p.T1042QfsX75 variant in the ABCC8 gene is highly suggestive of a founder effect. The I211F mutation in the GCK gene and three rare SUR1 variants associated with defective gating (p.L366F) or traffic (p.R797Q and p.R1393C) KATP channels are also associated with the diazoxide-unresponsive phenotype

Electrode Materials, Thermal Annealing Sequences, and Lateral/Vertical Phase Separation of Polymer Solar Cells from Multiscale Molecular Simulations

The nanomorphologies of the bulk heterojunction (BHJ) layer of polymer solar cells are extremely sensitive to the electrode materials and thermal annealing conditions. In this work, the correlations of electrode materials, thermal annealing sequences, and resultant BHJ nanomorphological details of P3HT:PCBM BHJ polymer solar cell are studied by a series of large-scale, coarse-grained (CG) molecular simulations of system comprised of PEDOT:PSS/P3HT:PCBM/Al layers. Simulations are performed for various configurations of electrode materials as well as processing temperature. The complex CG molecular data are characterized using a novel extension of our graph-based framework to quantify morphology and establish a link between morphology and processing conditions. Our analysis indicates that vertical phase segregation of P3HT:PCBM blend strongly depends on the electrode material and thermal annealing schedule. A thin P3HT-rich film is formed on the top, regardless of bottom electrode material, when the BHJ layer is exposed to the free surface during thermal annealing. In addition, preferential segregation of P3HT chains and PCBM molecules toward PEDOT:PSS and Al electrodes, respectively, is observed. Detailed morphology analysis indicated that, surprisingly, vertical phase segregation does not affect the connectivity of donor/acceptor domains with respective electrodes. However, the formation of P3HT/PCBM depletion zones next to the P3HT/PCBM-rich zones can be a potential bottleneck for electron/hole transport due to increase in transport pathway length. Analysis in terms of fraction of intra- and interchain charge transports revealed that processing schedule affects the average vertical orientation of polymer chains, which may be crucial for enhanced charge transport, nongeminate recombination, and charge collection. The present study establishes a more detailed link between processing and morphology by combining multiscale molecular simulation framework with an extensive morphology feature analysis, providing a quantitative means for process optimization

Women with endometriosis have higher comorbidities: Analysis of domestic data in Taiwan

AbstractEndometriosis, defined by the presence of viable extrauterine endometrial glands and stroma, can grow or bleed cyclically, and possesses characteristics including a destructive, invasive, and metastatic nature. Since endometriosis may result in pelvic inflammation, adhesion, chronic pain, and infertility, and can progress to biologically malignant tumors, it is a long-term major health issue in women of reproductive age. In this review, we analyze the Taiwan domestic research addressing associations between endometriosis and other diseases. Concerning malignant tumors, we identified four studies on the links between endometriosis and ovarian cancer, one on breast cancer, two on endometrial cancer, one on colorectal cancer, and one on other malignancies, as well as one on associations between endometriosis and irritable bowel syndrome, one on links with migraine headache, three on links with pelvic inflammatory diseases, four on links with infertility, four on links with obesity, four on links with chronic liver disease, four on links with rheumatoid arthritis, four on links with chronic renal disease, five on links with diabetes mellitus, and five on links with cardiovascular diseases (hypertension, hyperlipidemia, etc.). The data available to date support that women with endometriosis might be at risk of some chronic illnesses and certain malignancies, although we consider the evidence for some comorbidities to be of low quality, for example, the association between colon cancer and adenomyosis/endometriosis. We still believe that the risk of comorbidity might be higher in women with endometriosis than that we supposed before. More research is needed to determine whether women with endometriosis are really at risk of these comorbidities

PSII-LHCII Supercomplex Organizations in Photosynthetic Membrane by Coarse-Grained Simulation

Green plant Photosystem II (PSII) and light-harvesting complex II (LHCLI) in the stacked grana regions of thylakoid membranes can self-organize into various PSII LHCII supercomplexes With crystalline Of fluid-like supramolecular structures to adjust themselves with external stimuli suth as high/low light and 'temperatures, reuclering tunable solar light absorption spectrum and photosynthesis efficiencies. However, the mechanisms controlling the PSII LHCH Supercomplex organizations remain elusive: In this work, We constructed a coarse-grained (CO) model of the thylakoid membrane including lipid molecules and a PSII LHCII supercomplex considering association/dissociation of moderately bound-LHCHs. The CG interaction between CG beads were constructed based on electron microscope (EM) experimental results, and we were able to Simulate the PSII LHCII supramolecular organization of a 500 X 500 nm(2) thylakoid membrane, which is compatible with experiments. Our CGMD simulations can successfully reproduce order structures of PSII LHCII supercomplexes under various protein packing fractions, free-LHCII:PSII ratios, and temperatures, thereby providing insights into mechanisms leading to PSH LHCII stipercornplex organizations in photosynthetic membranes

Solubility of [6,6]-Phenyl-C₆₁-butyric Acid Methyl Ester and Optimal Blending Ratio of Bulk Heterojunction Polymer Solar Cells

The nanoscale mechanism determining the optimal electron donor/acceptor blending ratios is not yet clear. In this study, we used coarse-grained molecular simulations to simulate the thermal annealing process of poly-2,5-bis­(3-tetradecylthiophene-2-yl)­thieno­[3,2-<i>b</i>]­thiophene (PBTTT):[6,6]-phenyl-C₆₁-butyric acid methyl ester (PCBM) blends to reveal the correlation between solubility of PCBM in electron donor materials and the optimal electron donor/acceptor blending ratio of the bulk heterojunction polymer solar cells. Substantial intercalation of PCBM into PBTTT is observed, and an interpenetrating network comprising two phasesPBTTT-plus-PCBM and pure PCBMis formed when the blending ratio is beyond 1:1. By comparing morphological properties of PBTTT:PCBM blends with those of the poly­(3-hexylthiophene) (P3HT):PCBM blend, a blend which we investigated earlier, we reveal that, in addition to specific interfacial area and percolation probabilities, the solubility of PCBM in PBTTT also has significant effects in determining the optimal blending ratio. Due to PCBM intercalation into PBTTT, more PCBM must be inserted for the precipitation of pure PCBM domains for electron transport. Herein, we provide insight into the effects of PCBM solubility and the nanoscale mechanisms determining the optimal blending ratios and demonstrate how multiscale simulation can potentially aid the development of novel bulk heterojunction blends