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Graphene-covering is a promising approach for achieving an acid-stable, non-noble-metal-catalysed hydrogen evolution reaction (HER). Optimization of the number of graphene-covering layers and the density of defects generated by chemical doping is crucial for achieving a balance between corrosion resistance and catalytic activity. Here, we investigate the influence of charge transfer and proton penetration through the graphene layers on the HER mechanisms of the non-noble metals Ni and Cu in an acidic electrolyte. We find that increasing the number of graphene-covering layers significantly alters the HER performances of Ni and Cu. The proton penetration explored through electrochemical experiments and simulations reveals that the HER activity of the graphene-covered catalysts is governed by the degree of proton penetration, as determined by the number of graphene-covering layers. Graphene-covering technology provides a promising approach for achieving a non-noble-metal-catalyst with corrosion protection and catalytic activity under acidic media. Here, the authors unveil that the electrochemical hydrogen evolution mechanism is governed by the proton penetration phenomenon.

Purpose Postoperative delirium is one of the most common complications after cardiovascular surgery in older adults. Benzodiazepines are a reported risk factor for delirium; however, there are no studies investigating remimazolam, a novel anesthetic agent. Therefore, we prospectively investigated the effect of remimazolam on postoperative delirium. Methods We included elective cardiovascular surgery patients aged ≥ 65 years at Hamamatsu University Hospital between August 2020 and February 2022. Patients who received general anesthesia with remimazolam were compared with those who received other anesthetics (control group). The primary outcome was delirium within 5 days after surgery. Secondary outcomes were delirium during intensive care unit stay and hospitalization, total duration of delirium, subsyndromal delirium, and differences in the Mini-Mental State Examination scores from preoperative to postoperative days 2 and 5. To adjust for differences in the groups’ baseline covariates, we used stabilized inverse probability weighting as the primary analysis and propensity score matching as the sensitivity analysis. Results We enrolled 200 patients; 78 in the remimazolam group and 122 in the control group. After stabilized inverse probability weighting, 30.3% of the remimazolam group patients and 26.6% of the control group patients developed delirium within 5 days (risk difference, 3.8%; 95% confidence interval −11.5% to 19.1%; p  = 0.63). The secondary outcomes did not differ significantly between the groups, and the sensitivity analysis results were similar to those for the primary analysis. Conclusion Remimazolam was not significantly associated with postoperative delirium when compared with other anesthetic agents.

Urinary incontinence symptoms are highly prevalent among women, have a substantial effect on health-related quality of life and are associated with considerable personal and societal expenditure. Two main types are described: stress urinary incontinence, in which urine leaks in association with physical exertion, and urgency urinary incontinence, in which urine leaks in association with a sudden compelling desire to void. Women who experience both symptoms are considered as having mixed urinary incontinence. Research has revealed overlapping potential causes of incontinence, including dysfunction of the detrusor muscle or muscles of the pelvic floor, dysfunction of the neural controls of storage and voiding, and perturbation of the local environment within the bladder. A full diagnostic evaluation of urinary incontinence requires a medical history, physical examination, urinalysis, assessment of quality of life and, when initial treatments fail, invasive urodynamics. Interventions can include non-surgical options (such as lifestyle modifications, pelvic floor muscle training and drugs) and surgical options to support the urethra or increase bladder capacity. Future directions in research may increasingly target primary prevention through understanding of environmental and genetic risks for incontinence. Urinary incontinence symptoms in women are prevalent and substantially affect health-related quality of life. These issues are compounded by the limited attention that urinary incontinence receives at the policy or research-funding levels. Despite these challenges, the field has witnessed considerable innovations in practice over the past decade, which are summarized in this Primer.

The previously reported randomized controlled trial showed that after adjusting for baseline differences, the difference in the mean Mini-Mental State Examination score between patients who developed postoperative delirium and those who did not was significant at 30 days postoperatively [4]. Furthermore, evaluation of delirium over a long period may be influenced by systemic factors, such as complications unrelated to the choice of anesthetic. [...]we believe that it was reasonable to assess delirium during the first 5 postoperative days and do not accept that this setting would have been a source of bias in our study. Patient-reported outcomes after cardiac surgery, such as survival status at home and quality of life, have also been investigated [7].

Background/Objectives: MBNL1 is an RNA-binding protein involved in RNA metabolism, including splicing. It colocalizes with RNA foci, a pathological hallmark of myotonic dystrophy, and plays a central role in its disease mechanism. Moreover, MBNL1 has been implicated in other neuromuscular disorders and cancers. In these pathological and biochemical studies, the detection of MBNL1 using antibodies is essential. Given that MBNL1 has multiple splicing-derived isoforms, different antibodies may recognize distinct isoforms. This study aims to compare six commercially available antibodies regarding their specificity in Western blotting, colocalization with RNA foci, and suitability for immunoprecipitation. Methods: Western blot analysis was performed using MBNL1 isoforms and deletion mutants expressed in HEK293 cells, as well as endogenous MBNL1 from various cell lines. RNA fluorescence in situ hybridization (FISH) and immunofluorescence (IF) were conducted in DM1 model cells and patient-derived fibroblasts to assess MBNL1 colocalization with RNA foci. Immunoprecipitation experiments were performed in HEK293 cells to evaluate antibody suitability for protein isolation. Results: Western blot analysis revealed that different antibodies target distinct regions of MBNL1, with three recognizing exon 3 and the remaining antibodies recognizing exon 4, exon 5, and exon 6, respectively. In the FISH-IF experiments, the clarity of RNA foci colocalization varied depending on the antibody used, with some antibodies failing to detect colocalization. The immunoprecipitation analysis showed that four antibodies were able to isolate endogenous MBNL1. Conclusions: This study clarifies the recognition properties and application suitability of MBNL1 antibodies, providing a valuable resource for research on MBNL1-related diseases and RNA metabolism.

The expansion of the polyglutamine tract in ATXN1 contributes to the pathogenesis of SCA1. ATXN1 functions as a transcriptional regulator that interacts with multiple transcription factors, and transcriptional dysregulation has been observed in SCA1. In addition, splicing dysregulation has been identified in cells derived from SCA1 patients and model mouse tissues. Although ATXN1 binds to RNA and splicing factors, its direct involvement in pre-mRNA splicing remains unclear. Here, we demonstrate that ATXN1 regulates the alternative splicing of several minigenes. Using an Mbnl1 minigene, we found that neither expansion nor deletion of the polyglutamine tract affected ATXN1-mediated splicing regulation. Deletion analysis revealed that its splicing regulatory activity involves a central region of ATXN1, the AXH domain, and a nuclear localization signal in the C-terminal region. The AXH domain alone failed to exhibit splicing regulatory activity, whereas the central region demonstrated weak but significant splicing regulation. Full regulatory function required at least one of these regions, suggesting their redundant role in splicing modulation. Importantly, we newly identified the central region as mediating RNA binding. These findings suggest a novel role for ATXN1 in alternative splicing, providing new insights into the mechanisms underlying SCA1 pathogenesis.

Protonic solid oxide electrolysis cells (P‐SOECs) operating at intermediate temperatures, which have low costs, low environmental impact, and high theoretical electrolysis efficiency, are considered promising next‐generation energy conversion devices for green hydrogen production. However, the developments and applications of P‐SOECs are restricted by numerous material‐ and interface‐related issues, including carrier mismatch between the anode and electrolyte, current leakage in the electrolyte, poor interfacial contact, and chemical stability. Over the past few decades, considerable attempts have been made to address these issues by improving the properties of P‐SOECs. This review comprehensively explores the recent advances in the mechanisms governing steam electrolysis in P‐SOECs, optimization strategies, specially designed components, electrochemical performance, and durability. In particular, given that the lack of suitable anode materials has significantly impeded P‐SOEC development, the relationships between the transferred carriers and the cell performance, reaction models, and surface decoration approaches are meticulously probed. Finally, the challenges hindering P‐SOEC development are discussed and recommendations for future research directions, including theoretical calculations and simulations, structural modification approaches, and large‐scale single‐cell fabrication, are proposed to stimulate research on P‐SOECs and thereby realize efficient electricity‐to‐hydrogen conversion. Protonic solid oxide electrolysis cells (P‐SOECs) are among the most promising green hydrogen production technologies. This review comprehensively summarizes and discusses the fundamental mechanisms, key materials, specially designed components, and electrochemical performance of P‐SOECs by highlighting their latest achievements. Additionally, issues hindering P‐SOEC development are identified, and perspectives on the future development of highly efficient P‐SOECs are provided.

The Japanese Intensive care PAtient Database (JIPAD) was established to construct a high-quality Japanese intensive care unit (ICU) database. A data collection structure for consecutive ICU admissions in adults (≥16 years) and children (≤15 years) has been established in Japan since 2014. We herein report a current summary of the data in JIPAD for admissions between April 2015 and March 2017. There were 21,617 ICU admissions from 21 ICUs (217 beds) including 8416 (38.9%) for postoperative or procedural monitoring, defined as adult admissions following elective surgery or for procedures and discharged alive within 24 h, 11,755 (54.4%) critically ill adults other than monitoring, and 1446 (6.7%) children. The standardized mortality ratios (SMRs) based on the Acute Physiology and Chronic Health Evaluation (APACHE) III-j, APACHE II, and Simplified Acute Physiology Score II scores in adults ranged from 0.387 to 0.534, whereas the SMR based on the Paediatric Index of Mortality 2 in children was 0.867. The data revealed that the SMRs based on general severity scores in adults were low because of high proportions of elective and monitoring admission. The development of a new mortality prediction model for Japanese ICU patients is needed. •The Japanese Intensive care PAtient Database (JIPAD) project started in 2014.•The primary aim of JIPAD is to improve the quality of intensive care in Japan.•A total of 21 ICUs (217 beds) contributed to this report examined in the two years.•In Japanese ICUs, the proportion of elective and monitoring admissions was high.•The standardized mortality ratios based on severity scores in adults were low.

Additionally, propensity score analysis produces more correct effect estimates than regression analysis when the sample size is small [4]. [...]the authors need to justify the analysis method used in this study. [...]it is likely that this study did not successfully identify all patients with postoperative delirium. [...]the authors’ primary endpoint was the incidence of delirium within 3 days postoperatively, although several previous studies reported 5 days after cardiac surgery as a reasonable period of cognitive recovery [6, 7–8].