Clinical characteristics of asymptomatic Terson syndrome in the patients with aneurysmal subarachnoid hemorrhage

●AIM:To investigate clinical characteristics of asymptomatic Terson syndrome and its clinical impact in patients with aneurysmal subarachnoid hemorrhage(SAH).●METHODS:This retrospective,interventional study included 31 patients with aneurysmal SAH,and the medical records were reviewed.In addition to baseline characteristics of the study population such as age,sex,and underlying medical history,multi-modal imaging analysis,including fluorescein angiography(FA),spectral domain optical coherence tomography(SD-OCT),were also reviewed.Glasgow Coma Scale(GCS),Hunt-Hess(HH)grade,and Fisher scale at the time of admission,and functional outcome by using modified Rankin Scale(mRS)at 6 mo were compared.●RESULTS:Of the 31 patients,10 patients(32.3%)were diagnosed with Terson syndrome.All the patients with Terson syndrome did not report visual symptoms at the time of ophthalmologic screening.FA showed microvascular changes of retinal capillaries and varying degrees of disc leakage.SD-OCT allowed intuitive anatomical localization of multi-layered retinal hemorrhages and assessment of ellipsoid zone integrity.The patients with Terson syndrome showed significantly worse GCS(P=0.047)and HH grade(P=0.025)than those without,except Ficher scale(P=0.385).There was no significant difference in the mRS(P=0.250)at 6 mo.Among baseline factors,the HH grade was the only significant factor associated with Terson syndrome(B=1.079,P=0.016).●CONCLUSION:In our study,32.3%of the patients have Terson syndrome without visual symptoms.The baseline HH grade is significantly correlated with Terson syndrome,and there is no significant difference in the functional outcome between the patients with and without Terson syndrome.Terson syndrome may develop without any visual symptoms as shown in our study,and ophthalmologic screening may be recommended to prevent further visual deterioration especially in the patients with poor HH grade at the time of aneurysmal SAH.

Pre-operative factors that can predict neoplastic polypoid lesions of the gallbladder

AIM:To investigate the preoperative factors that can predict neoplastic polypoid lesions of the gallbladder(PLGs) as well as malignant PLGs.METHODS:A retrospective analysis was conducted on the 210 consecutively enrolled patients who underwent cholecystectomy due to a PLG larger than 10 mm,as was determined by preoperative trans-abdominal ultrasonography or endoscopic ultrasonography.We ana-lyzed the medical,laboratory,radiologic data and the pathologic results.RESULTS:In 210 cases,146 had non-neoplastic polyps(69.5%) and 64 cases were neoplastic polyps(30.5%).An older age(≥ 65 years),the presence of diabetes mellitus(DM) and the size of polyp(≥ 15 mm) were revealed to be independent predictive variables for neoplastic polyps with odd ratios(OR) of 2.27(P = 0.044),2.64(P = 0.021) and 4.94(P < 0.01),respectively.Among the neoplastic PLGs,an older age(≥ 65 years),the presence of DM and polyp size(≥ 15 mm) were associated with malignancy with ORs of 4.97(P = 0.005),6.13(P = 0.001) and 20.55(P < 0.001),respectively.CONCLUSION:Among patients with PLGs larger than 10 mm in size,higher risk groups such as elderly patients more than 65 years old,those with DM or a large polyp size(≥ 15 mm) should be managed by cholecystectomy.

Porous Mixed Ionic Electronic Conductor Interlayers for Solid-State Batteries

Rechargeable solid-state batteries(SSBs)have emerged as the next-generation energy storage device based on lowered fire hazard and the potential of realizing advanced battery chemistries,such as alkali metal anodes.However,ceramic solid electrolytes(SEs)generally have limited capability in relieving mechanical stress and are not chemically stable against body-centered cubic alkali metals or their alloys with minor solute elements(β-phase).Swelling-then-retreating ofβ-phase often causes instabilities such as SE fracture and corrosion as well as the loss of electronic/ionic contact,which leads to high charge-transfer resistance,short-circuiting,etc.These challenges have called for the cooperation from other classes of materials and novel nanocomposite architectures in relieving stress and preserving essential contacts while minimizing detrimental disruptions.In this review,we summarize recent progress in addressing these issues by incorporating other classes of materials such as mixed ion-electron conductor(MIEC)porous interlayers and ion-electron insulator(IEI)binders,in addition to SE and metals(e.g.,β-phase and current collectors)that are the traditional SSB components.In particular,we focus on providing theoretical interpretations on how open nanoporous MIEC interlayers manipulateβ-phase deposition and stripping behavior and thereby suppress such instabilities,referring to the fundamental thermodynamics and kinetics governing the nucleation and growth of theβ-phase.The review concludes by describing avenues for the future design of porous MIEC interlayers for SSBs.

Electrochemically stable lithium-ion and electron insulators(LEIs)for solid-state batteries

Rechargeable solid-state Li metal batteries demand ordered flows of Li-ions and electrons in and out of solid structures,with repeated waxing and waning of Ubcc phase near contact interfaces which gives rise to various electro-chemo-mechanical challenges.There have been approaches that adopt three-dimensional(3D)nanoporous architectures consisting of mixed ion-electron conductors(MIECs)to combat these challenges.However,there has remained an issue of LiBcc nucleation at the interfaces between different solid components(e.g.,solid electrolyte/MlEC interface),which could undermine the interfacial bonding,thereby leading to the evolution of mechanical instability and the loss of ionic/electronic percolation.In this regard,the present work shows that the Li-ion and electron insulators(LEIs)that are thermodynamically stable against LiBcc could combat such challenges by blocking transportation of charge carriers on the interfaces,analogous to dielectric layers in transistors.We searched the ab initio database and have identified 48 crystalline compounds to be LEI candidates(46 experimentally reported compounds and 2 hypothetical compounds predicted to be stable)with a band gap greater than 3 eV and vanishing Li solubility.Among these compounds,those with good adhesion to solid electrolyte and mixed ion-electron conductor of interest,but are lithiophobic,are expected to be the most useful.We also extended the search to Na or K metal compatible alkali-ion and electron insulators,and identified some crystalline compounds with a property to resist corresponding alkali-ions and electrons.

Lubricant skin on diverse biomaterials with complex shapes via polydopamine-mediated surface functionalization for biomedical applications

Implantable biomedical devices require an anti-biofouling,mechanically robust,low friction surface for a prolonged lifespan and improved performance.However,there exist no methods that could provide uniform and effective coatings for medical devices with complex shapes and materials to prevent immune-related side effects and thrombosis when they encounter biological tissues.Here,we report a lubricant skin(L-skin),a coating method based on the application of thin layers of bio-adhesive and lubricant-swellable perfluoropolymer that impart anti-biofouling,frictionless,robust,and heat-mediated self-healing properties.We demonstrate biocompatible,mechanically robust,and sterilization-safe L-skin in applications of bioprinting,microfluidics,catheter,and long and narrow medical tubing.We envision that diverse applications of L-skin improve device longevity,as well as anti-biofouling attributes in biomedical devices with complex shapes and material compositions.

Machine learning of metal-ceramic wettability

The adhesion and wetting between metal and ceramic is a basic problem in materials science and engineering.For example,past materials selection for metal-ceramic composites has relied on random trials and heuristics due to a limited understanding of their adhesion;the large chemical/structural variability that such interfaces can have hinders the identification of the governing factors.Here based on literature data,we have developed a database with~1,000 experimentally measured wetting angles at different temperatures and atmospheric conditions,and come up with a model for the wettability of ionocovalent ceramics(ICs)by metals using a machine learning(ML)algorithm.The random forest model uses the testing temperature and~40 features generated based on the chemical compositions of the metal and the ceramic as predictors and exhibits strong predictive power with an R^(2) of~0.86.Moreover,this model and the featurization code are integrated into a single computational pipeline to enable(1)predicting metal-IC wettability of interest and(2)high-throughput searching of ICs with the desired wettability by certain metals in the entire Inorganic Crystallographic Structure Database.As a demonstration of this pipeline,the wettability of a Li-ion and electron insulator(LEI),CaO,by molten Li is estimated and compared with ab initio molecular dynamics simulation result.This ML pipeline can serve as a practical tool for methodical design of materials in systems where certain metalceramic wettability is desired.