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Herein, we report a facile hydrothermal synthesis of MoSe 2 nanoflowers composed of several MoSe 2 nanosheets for electrochemical energy storage. As an electrode material of supercapacitor, MoSe 2 nanoflower exhibits high specific capacitance (95 Fg −1 ) and excellent cycling stability (90% after 10,000 cycles) due to their porous morphology, indicating their applicability as a potential electrode material for energy storage devices.

Background Primary care medical homes may improve health outcomes for children with special healthcare needs (CSHCN), by improving care coordination. However, community-based primary care practices may be challenged to deliver comprehensive care coordination to complex subsets of CSHCN such as children with medical complexity (CMC). Linking a tertiary care center with the community may achieve cost effective and high quality care for CMC. The objective of this study was to evaluate the outcomes of community-based complex care clinics integrated with a tertiary care center. Methods A before- and after-intervention study design with mixed (quantitative/qualitative) methods was utilized. Clinics at two community hospitals distant from tertiary care were staffed by local community pediatricians with the tertiary care center nurse practitioner and linked with primary care providers. Eighty-one children with underlying chronic conditions, fragility, requirement for high intensity care and/or technology assistance, and involvement of multiple providers participated. Main outcome measures included health care utilization and expenditures, parent reports of parent- and child-quality of life [QOL (SF-36®, CPCHILD © , PedsQL™)], and family-centered care (MPOC-20®). Comparisons were made in equal (up to 1 year) pre- and post-periods supplemented by qualitative perspectives of families and pediatricians. Results Total health care system costs decreased from median (IQR) $244 (981) per patient per month (PPPM) pre-enrolment to $131 (355) PPPM post-enrolment (p=.007), driven primarily by fewer inpatient days in the tertiary care center (p=.006). Parents reported decreased out of pocket expenses (p<.0001). Parental QOL did not significantly change over the course of the study. Child QOL improved between baseline and 6 months in two PedsQL™ domains [Social (p=.01); Emotional (p=.003)], and between baseline and 1 year in two CPCHILD © domains [Health Standardization Section (p=.04); Comfort and Emotions (p=.03)], while total CPCHILD © score decreased between baseline and 1 year (p=.003). Parents and providers reported the ability to receive care close to home as a key benefit. Conclusions Complex care can be provided in community-based settings with less direct tertiary care involvement through an integrated clinic. Improvements in health care utilization and family-centeredness of care can be achieved despite minimal changes in parental perceptions of child health.

Magnetic resonance-guided focused ultrasound (MRgFUS) has been demonstrated to be able to thermally ablate tendons with the aim to non-invasively disrupt tendon contractures in the clinical setting. However, the biomechanical changes of tendons permitting this disrupting is poorly understood. We aim to obtain a dose-dependent biomechanical response of tendons following magnetic resonance-guided focused ultrasound (MRgFUS) thermal ablation. Ex vivo porcine tendons (n = 72) were embedded in an agar phantom and randomly assigned to 12 groups based on MRgFUS treatment. The treatment time was 10, 20, or 30s, and the applied acoustic power was 25, 50, 75, or 100W. Following each MRgFUS treatment, tendons underwent biomechanical tensile testing on an Instron machine, which calculated stress-strain curves during tendon elongation. Rupture rate, maximum treatment temperature, Young's modulus and ultimate strength were analyzed for each treatment energy. The study revealed a dose-dependent response, with tendons rupturing in over 50% of cases when energy delivery exceeded 1000J and 100% disruption at energy levels beyond 2000J. The achieved temperatures during MRgFUS were directly proportional to energy delivery. The highest recorded temperature was 56.8°C ± 9.34 (3000J), while the lowest recorded temperate was 18.6°C ± 0.6 (control). The Young's modulus was highest in the control group (47.3 MPa ± 6.5) and lowest in the 3000J group (13.2 MPa ± 5.9). There was no statistically significant difference in ultimate strength between treatment groups. This study establishes crucial thresholds for reliable and repeatable disruption of tendons, laying the groundwork for future in vivo optimization. The findings prompt further exploration of MRgFUS as a non-invasive modality for tendon disruption, offering hope for improved outcomes in patients with musculotendinous contractures.

Background To develop a priority-based patient/parent reported outcome measure for children with lower-limb differences (LD) by adapting the Gait Outcomes Assessment List (GOAL) questionnaire. Methods Guided by a conceptual framework of patient priorities, the GOAL questionnaire was iteratively modified and its sensibility evaluated by field-testing it on children with LD, and their parents. Cognitive interviews were conducted with a subgroup of these children, and an e-survey administered to a multidisciplinary group of health care professionals with expertise in paediatric LD. Findings were integrated to create the final version of the GOAL-LD. Results Twenty-five children (9–18 years), 20 parents, and 31 healthcare professionals evaluated the content and sensibility of the GOAL, with an emphasis on the relevance and importance of the items to patients’ health related quality of life (HRQL). This resulted in the retention of 26 of the original 50 items, elimination of 12, modification of 12, and addition of seven new items. The new 45-item GOAL-LD questionnaire was shown to be sensible, and its content deemed important. Conclusions The GOAL-LD questionnaire has a high level of face and content validity, and sensibility. It comprehensively captures the HRQL goals and outcomes that matter to children with LD and their parents. Following further psychometric evaluation, the GOAL-LD may serve as a much needed patient and parent reported outcome measure for this population.

We successfully fabricated dye sensitized solar cells (DSSCs) employing a quasi-solid state electrolyte based on pristine insulator natural rubber latex from Hevea brasiliensis and iodide electrolyte. Optimized devices exhibited a maximum power conversion efficiency (PCE) of 1.14% under simulated sunlight with 90 mW/cm 2 illumination, 0.46% under 100 mW/cm 2 and 7.85% under low intensity illumination of 1000 lx (Daylight LED). This gives a new perspective for the introduction of natural rubber latex abundant in nature as an additive to the water based redox mediator in order to improve the PCE in DSSC. A detailed study on the interfacial charge transfer in fabricated devices revealed that the introduction of rubber helped in arresting the back electron transfer, which was predominant in aqueous electrolyte based dye sensitized solar cell. This opens up opportunities for water-based electrolyte based on natural raw materials to be used in nature inspired DSSC technology.

IntroductionThe aim of this study was to assess the feasibility of robotic assisted kidney transplantation in graft with multiple vessels.Materials and methodsEighteen patients underwent RAKT with grafts with multiple vessels (GMVs) from living donor performed by a single surgeon in single institution. The retrospective data obtained were compared to patients who underwent robotic assisted kidney transplant (RAKT) with single vessel and also open kidney transplant with GMVs.ResultsThere were no significant differences in graft function outcome and perioperative parameters in all three groups. In comparison with OKT in GMVs we found that RAKT with GMVs had less pain score on post op 4th day. There was also a significant difference in mean analgesic requirement and incision length.ConclusionWith increasing experience, grafts with challenging vascular anatomy can be taken up for RAKT and GMVs should not be considered as a contraindication for RAKT.

Undoped zinc oxide (ZnO) and nitrogen-doped zinc oxide (NZO) thin films were prepared on transparent conducting oxide-coated glass substrates by employing sol–gel technique. The effect of different solvents and nitrogen doping on the optical, structural, and electrical properties was investigated by UV–visible absorption spectroscopy, atomic force microscopy (AFM), X-ray diffraction (XRD), profilometry, and Hall effect studies. ZnO films yielded transmittance above 85% and the bandgap of ZnO thin films decreased with doping. XRD pattern confirmed hexagonal wurtzite structure of ZnO. NZO thin films were found to be in the nano-thin film phase with thickness of 40 nm. Hall effect studies yielded carrier concentration of 1.2 × 10 15 cm −3 and 2.03 × 10 14 cm −3 , respectively, for undoped and doped ZnO thin films. The changes in vibrational modes of ZnO due to nitrogen doping were detected using Fourier transform infrared (FTIR) analysis. It was found that p-type doping, leading to an improved surface morphology, led to a reduction in optical bandgap and an increased charge carrier mobility. The choice of the solvent was found to have a profound influence on the surface morphology, optical bandgap, tail states distribution, and charge carrier mobility.

Light energy is utilized as an extensive tool for actuation of fluid flow in microfluidic devices. We report a novel method of droplet actuation using LED (light-emitting diode) that can be utilized for microfluidic mixing applications. This low power LED which emits light of peak wavelength 395 nm delivering luminous power of less than 300 millicandela (mcd) was used to create an interfacial tension gradient on solid–liquid interface containing photoresponsive molecule of azobenzene (C12H10N2). LED-induced photoisomerization of azobenzene creates a spatial gradient in interfacial energy on the solid–liquid interface, which enhances the droplet movement. The concept of LED-enhanced fluidic actuation was demonstrated using droplets of water, urine, blood serum over photoresponsive substrate. The substrates were prepared by coating the surface of silicon substrate with azobenzene dissolved in silicone resin solution. Detailed experimental characterization of LED-actuated droplet velocity was performed, where the effect of parameters such as frequency of light actuation, droplet volume, concentration of azobenzene was evaluated. Droplet transport of DI water (de-ionized) of volume 60 µL was achieved at a velocity of 160 µm/s corresponding to LED actuation frequency of 1 Hz. In vitro quantification of blood calcium and urine pH was performed using fabricated chip scale opto-wetting platforms. The proposed work could be useful in the development of droplet microfluidic chips, where combinatorial mixing can be achieved using an array of LEDs.

Demonstration of monoclonal immunoglobulin molecule in serum forms the mainstay in the diagnosis of monoclonal gammopathies. The major tests that help in this regard are serum protein electrophoresis (SPEP), serum immunofixation electrophoresis (sIFE) and serum free light chain assay (sFLC). Our objectives were to study the accuracy of sFLC and sIFE in the diagnosis of monoclonal gammopathies and also to study the role of combination of SPEP + sIFE + sFLC in the diagnosis of the same. 46 patients who attended the hemato-oncology clinic with signs and symptoms suggestive of monoclonal gammopathy were enrolled in this study. SPEP, sIFE, sFLC and pre-treatment serum beta-2 microglobulin levels were analysed among the study population. Both SPEP and sIFE were performed in the Interlab Genios fully automated machine. Serum beta-2 microglobulin and sFLC were estimated by immunoturbidimetry in Beckman Coulter AU 2700 analyzer. The accuracy of sIFE came to be 80% with respect to sFLC assay. Sensitivity, specificity, positive and negative predictive value of sIFE with respect to sFLC were 81.3, 78.6, 89.7 and 64.7% respectively. It was observed that a combination panel of SPEP + sIFE + sFLC could detect all the cases of myeloma included in this study. Further testing in large samples is required for generalising the findings of this study. The pre-treatment beta-2 microglobulin levels were significantly higher in the group which was positive for myeloma. A combination panel of SPEP + sIFE + sFLC prove to be more useful than individual tests for the detection of myeloma.