Distance-Dependent Evolution of Electronic States in Kagome- Honeycomb Lateral Heterostructures in FeSn

In this work, we demonstrate the formation and electronic influence of lateral heterointerfaces in FeSn containing Kagome and honeycomb layers. Lateral heterostructures offer spatially resolved property control, enabling the integration of dissimilar materials and promoting phenomena not typically observed in vertical heterostructures. Using the molecular beam epitaxy technique, we achieve a controllable synthesis of lateral heterostructures in the Kagome metal FeSn. With scanning tunneling microscopy/spectroscopy in conjunction with first-principles calculations, we provide a comprehensive understanding of the bonding motif connecting the Fe3Sn-terminated Kagome and Sn2-terminated honeycomb surfaces. More importantly, we reveal a distance-dependent evolution of the electronic states in the vicinity of the heterointerfaces. This evolution is significantly influenced by the orbital character of the flat bands. Our findings suggest an approach to modulate the electronic properties of the Kagome lattice, which should be beneficial for the development of future quantum devices.Comment: To appear ACS Nan

Undiagnosed diseases: Needs and opportunities in 20 countries participating in the Undiagnosed Diseases Network International

Introduction: Rare diseases (RD) are a health priority worldwide, overall affecting hundreds of millions of people globally. Early and accurate diagnosis is essential to support clinical care but remains challenging in many countries, especially the low- and medium-income ones. Hence, undiagnosed RD (URD) account for a significant portion of the overall RD burden. Methods: In October 2020, the Developing Nations Working Group of the Undiagnosed Diseases Network International (DNWG-UDNI) launched a survey among its members, belonging to 20 countries across all continents, to map unmet needs and opportunities for patients with URD. The survey was based on questions with open answers and included eight different domains. Conflicting interpretations were resolved in contact with the partners involved. Results: All members responded to the survey. The results indicated that the scientific and medical centers make substantial efforts to respond to the unmet needs of patients. In most countries, there is a high awareness of RD issues. Scarcity of resources was highlighted as a major problem, leading to reduced availability of diagnostic expertise and research. Serious equity in accessibility to services were highlighted both within and between participating countries. Regulatory problems, including securing informed consent, difficulties in sending DNA to foreign laboratories, protection of intellectual property, and conflicts of interest on the part of service providers, remain issues of concern. Finally, most respondents stressed the need to strengthen international cooperation in terms of data sharing, clinical research, and diagnostic expertise for URD patients in low and medium income countries. Discussion: The survey highlighted that many countries experienced a discrepancy between the growing expertise and scientific value, the level of awareness and commitment on the part of relevant parties, and funding bodies. Country-tailored public health actions, including general syllabus of medical schools and of the education of other health professionals, are needed to reduce such gaps.VSh is supported by Health Systems Research Institute of Thailand (65-040). SJ is supported by National Medical Research Council, Singapore (Grants ID CSAINV21jun-0003 and CIRG22jul-0003).S

Unmet needs in countries participating in the undiagnosed diseases network international: an international survey considering national health care and economic indicators

BackgroundPatients, families, the healthcare system, and society as a whole are all significantly impacted by rare diseases (RDs). According to various classifications, there are currently up to 9,000 different rare diseases that have been recognized, and new diseases are discovered every month. Although very few people are affected by each uncommon disease individually, millions of people are thought to be impacted globally when all these conditions are considered. Therefore, RDs represent an important public health concern. Although crucial for clinical care, early and correct diagnosis is still difficult to achieve in many nations, especially those with low and middle incomes. Consequently, a sizeable amount of the overall burden of RD is attributable to undiagnosed RD (URD). Existing barriers and policy aspects impacting the care of patients with RD and URD remain to be investigated.MethodsTo identify unmet needs and opportunities for patients with URD, the Developing Nations Working Group of the Undiagnosed Diseases Network International (DNWG-UDNI) conducted a survey among its members, who were from 20 different nations. The survey used a mix of multiple choice and dedicated open questions covering a variety of topics. To explore reported needs and analyze them in relation to national healthcare economical aspects, publicly available data on (a) World Bank ranking; (b) Current health expenditure per capita; (c) GDP per capita; (d) Domestic general government health expenditure (% of GDP); and (e) Life expectancy at birth, total (years) were incorporated in our study.ResultsThis study provides an in-depth evaluation of the unmet needs for 20 countries: low-income (3), middle-income (10), and high-income (7). When analyzing reported unmet needs, almost all countries (N = 19) indicated that major barriers still exist when attempting to improve the care of patients with UR and/or URD; most countries report unmet needs related to the availability of specialized care and dedicated facilities. However, while the countries ranked as low income by the World Bank showed the highest prevalence of referred unmet needs across the different domains, no specific trend appeared when comparing the high, upper, and low-middle income nations. No overt trend was observed when separating countries by current health expenditure per capita, GDP per capita, domestic general government health expenditure (% of GDP) and life expectancy at birth, total (years). Conversely, both the GDP and domestic general government health expenditure for each country impacted the presence of ongoing research.ConclusionWe found that policy characteristics varied greatly with the type of health system and country. No overall pattern in terms of referral for unmet needs when separating countries by main economic or health indicators were observed. Our findings highlight the importance of identifying actionable points (e.g., implemented orphan drug acts or registries where not available) in order to improve the care and diagnosis of RDs and URDs on a global scale

Does the Energy Restriction Intermittent Fasting Diet Alleviate Metabolic Syndrome Biomarkers? A Randomized Controlled Trial

The aim of this study was to determine the efficacy of an energy restriction intermittent fasting diet in metabolic biomarkers and weight management among adults with metabolic syndrome. This randomized controlled study was performed with metabolic syndrome patients, aged 18-65 years, at an academic institution in Istanbul, Turkey (n = 70). All participants were randomized to the Intermittent Energy Restriction (IER) intervention group and Continuous Energy Restriction (CER) control group. Biochemical tests including lipid profile, fasting plasma glucose, insulin, glycosylated hemoglobin Type A1c (HbA1c), homeostatic model assessment of insulin resistance (HOMA-IR), blood pressure, and body composition were evaluated at baseline and at the 12th week in diet interviews. Dietary intake was measured with the 24-h dietary recall method and dietary quality was evaluated with the Healthy Eating Index-2010. Changes in body weight (approximate to 7% weight loss) and composition were similar in both groups. Blood pressure, total cholesterol, triglyceride, low-density lipoprotein (LDL), fasting glucose, and insulin at the 12th week decreased in both groups (p < 0.05). No significant differences were observed in metabolic syndrome biomarkers between the IER and CER groups. The energy-restricted intermittent fasting diet did not cause any deficiencies in macronutrient and fiber intake in the subjects. Healthy Eating Index (HEI) index scores were achieved similarly in both groups, and subjects' dietary intakes were close to daily reference nutritional intake values. The technique used to achieve energy restriction, whether intermittent or continuous, appears to alleviate the metabolic syndrome biomarkers activated by weight loss

Crystal structure and photoluminescence properties of a new Cd-II coordination polymer catena-poly[bis[4-bromo-2-({[2-(pyrrolidin-1-yl)ethyl]imino}methyl)phenolato-kappa N-3,N ',O]di-mu(3)-chlorido-di-mu(2)-chlorido-bis(methanol-kappa O)tricadmium(II)]

Schiff base-metal complexes have been used widely as catalysts for many organic reactions, such as ring-opening polymerization and oxidation. In view of the importance of Cd-II coordination polymers and in an effort to enlarge the library of such complexes, the title novel polymeric Cd-II tridentate Schiff base complex, [Cd-3(C13H16BrN2O)(2)Cl-4(CH4O)(2)](n), has been synthesized and characterized by elemental analyses, UV and IR spectroscopies, and single-crystal X-ray diffraction. The complex crystallizes in the triclinic P space group with two symmetry-independent Cd-II atoms, one of which lies on an inversion centre, and analysis of the crystal structure shows that both Cd-II atoms are six-coordinated; the environment around one Cd-II atom can be described as distorted octahedral, while that around the second Cd-II atom is octahedral. The Cd-II atoms are linked by chloride ligands to form a one-dimensional coordination polymer. The nonbonding intermolecular Cd center dot center dot center dot Cd distances are 3.7009 (4) and 4.3563 (5) angstrom. Furthermore, the photoluminescence properties of the complex have been investigated and it displays a strong red emission in the solid state at room temperature

Anesthesia for Craniotomy Comparison of Sevoflurane, Desflurane, or Isoflurane Anesthesia Supplemented With an Infusion of Dexmedetomidine During Supratentorial Craniotomy

WOS: 000266283300005The aim of this study was to compare the effects of 3 inhalation agents that combined with dexmedetomidine infusion on hemodynamic stability and postoperative recovery in patients undergoing supratentorial tumor surgery. After the institute's ethics committee approved this study and written informed consent was obtained from each participant, 90 patients with ASA I and III, who were scheduled for supratentorial tumor surgery, were recruited for this prospective, randomized controlled study. Routine monitoring was applied for unpremedicated patients on arrival in the operating room. All the patients received IV dexmedetomidine 0.5 mu g/kg over 10 minutes, followed by 0.9 mu g/kg/h infusion during maintenance. Patients were randomly divided into 3 groups. Anesthesia was maintained by sevoflurane in group I, desflurane in group 2, and isoflurane in group 3. Hemodynamaic variables, brain relaxation scores, intraoperative anesthetics requirement, and recovery characteristics were recorded. Demographic were similar among the groups. Mean arterial pressure was higher after intubation at the first minute in all groups than at baseline values. Hypertension was reported in 4 of 30 patients in group 1, 8 of 30 patients in group 2, and 5 of 30 patients in group 3, intraoperatively. Eye opening, following the verbal commands, was significantly lesser in patients receiving desflurane-dexmedetomidine than the other groups (P = 0.001). We conclude that dexmedetomidine infusion is not sufficient for suppressing hemodynamic responses, decreasing the requirement of inhalation agents, and providing adequate brain relaxation in patients undergoing supratentorial craniotomy. Desflurane-dexmedetomidine anesthesia offers lesser eye opening and a slower response to verbal commands postoperatively

The cartonectin levels at different stages of chronic kidney disease and related factors

Introduction: Cartonectin was defined as a new adipokine released from rat and human adipocyte tissues, which is also known as CORS 26 or CTRP3 protein. Although there are several studies investigating the effects of cartonectin with obesity, anti-inflammatory mechanisms, and cardioprotective effects, there is no study about the effects of cartonectin in patients with chronic kidney disease yet. We aimed to investigate cartonectin levels in predialysis and dialysis patient groups, in other words, at different stages of chronic kidney disease, by comparing with the control group. In addition, we aimed to discuss the probable causes of the differences between the patient groups that would be determined, together with the factors that might be effective. Methods: A total of 150 patients, including 47 hemodialysis patients, 73 predialysis CKD patients, and 30 healthy individuals were enrolled in the study. Serum cartonectin levels were determined by using enzyme-linked immunosorbent assay (ELISA) method. Findings: Serum cartonectin levels were found to be significantly higher in the hemodialysis patient group compared to predialysis group and healthy individuals (p < 0.01). Furthermore, serum cartonectin levels were found to be negatively correlated with GFR, BMI, glucose, LDL, and platelet levels, whereas a positive correlation was observed with creatinine levels. Discussion: In our study, we found that the cartonectin levels increased as GFR decreased and were significantly higher in hemodialysis patients. Cartonectin is structurally closely related to adiponectin. It is remarkable that the level of cartonectin is also high in hemodialysis patients, like adiponectin

Patient-controlled analgesia - Comparison of morphine to Dexmedetomidine plus morphine in patients undergoing laminectomy

WOS: 000258715700005The aim of this study was to compare the analgesic effect of patient-controlled morphine with that of patient-controlled morphine plus dexmedetomidine oil postoperative pain in patients undergoing laminectomy. Ethics committee of the institute approved this Study. and after a written informed consent obtained from each participant, 64 patients with American Society of Anesthesiologist physical status I and II, scheduled for laminectomy were recruited for this prospective, randomized controlled Study. A standardized load morphine dose of 0.15 mg/kg was given to all patients. Patients were randomized into 2 groups postoperatively. The settings were IV morphine, bolus dose 0.02mg/kg, with a lock out time of 15 minutes in group morphine (n = 32). The settings were bolus dose 0.02 mg/kg and 0.1 mu g/k dexmedetomidine with a lock out time of 15 minutes in group morphine Plus dexmedetomidine (n = 32). Hemodynamic variables, pain scores, and sedation scores were recorded postoperatively. No differences were detected in the demographic data, hemodynamic variables, and pain scores. Total morphine consumption was 46.37 +/- 12.05 mg in group morphine and 16.03 +/- 8.55 mg in group morphine plus dexmedetomidine. Sedation scores were significantly higher ill group morphine plus dexmedetomidine after the first hour. Using morphine or morphine plus dexmedetomidine in patient-controlled analgesia provided effective postoperative analgesia. In the morphine plus dexmedetomidine group, postoperative morphine consumption was lesser than that of the group with only morphine. This result may be explained as a synergistic effect of dexmedetomidine with the analgesic action of morphine