Intergranular Shielding for Ultrafine-Grained Mo-Doped Ni-Rich Li[Ni0.96 Co0.04 ]O2 Cathode for Li-Ion Batteries with High Energy Density and Long Life.

Deploying Ni-enriched (Ni≥95 %) layered cathodes for high energy-density lithium-ion batteries (LIBs) requires resolving a series of technical challenges. Among them, the structural weaknesses of the cathode, vigorous reactivity of the labile Ni4+ ion species, gas evolution and associated cell swelling, and thermal instability issues are critical obstacles that must be solved. Herein, we propose an intuitive strategy that can effectively ameliorate the degradation of an extremely high-Ni-layered cathode, the construction of ultrafine-scale microstructure and subsequent intergranular shielding of grains. The formation of ultrafine grains in the Ni-enriched Li[Ni0.96 Co0.04 ]O2 (NC96) cathode, achieved by impeding particle coarsening during cathode calcination, noticeably improved the mechanical durability and electrochemical performance of the cathode. However, the buildup of the strain-resistant microstructure in Mo-doped NC96 concurrently increased the cathode-electrolyte contact area at the secondary particle surface, which adversely accelerated parasitic reactions with the electrolyte. The intergranular protection of the refined microstructure resolved the remaining chemical instability of the Mo-doped NC96 cathode by forming an F-induced coating layer, effectively alleviating structural degradation and gas generation, thereby extending the battery's lifespan. The proposed strategies synergistically improved the structural and chemical durability of the NC96 cathode, satisfying the energy density, life cycle performance, and safety requirements for next-generation LIBs.

Monoradiculopathy-induced abdominal pseudohernia caused by T11-12 soft disc herniation: a case report and literature review.

BACKGROUND: An abdominal pseudohernia is a rare clinical entity that consists of an abnormal bulging of the abdominal wall that can resemble a true hernia but does not have an associated underlying fascial or muscle defect. Abdominal pseudohernia is believed to result from denervation of the abdominal muscles in cases of herpes zoster infection, diabetes mellitus, lower thoracic or upper lumbar disc herniation, surgical injuries, and rib fracture. To date, nine cases of abdominal pseudohernia caused by disc herniation at the lower thoracic or upper lumbar levels have been reported. CASE PRESENTATION: A 35-year-old man with no underlying disease or traumatic event presented with chief complaints of left flank pain and a protruding left lower abdominal mass that had formed one day earlier. There was no true abdominal hernia on abdominal computed tomography (CT), although CT and magnetic resonance imaging (MRI) showed a herniated soft (non-calcified) disc into the left neural foramen at the T11-12 level. A nonsteroidal anti-inflammatory drug was prescribed for the flank pain, and the patient was followed on a regular basis for six months. Follow-up MRI taken at the last visit showed complete resorption of the herniated disc. Abdominal pseudohernia and flank pain were also completely resolved. CONCLUSION: We report a rare case of monoradiculopathy-induced abdominal pseudohernia caused by foraminal soft disc herniation at the T11-12 level. In patients who have an abdominal pseudohernia without herpes zoster infection, diabetes mellitus, or traumatic events, lower thoracic disc herniations should be included in differential diagnosis.

Recanalization of external iliac artery occlusion in a patient with spinal stenosis using medications: a case report.

BACKGROUND: Iliac artery occlusion accompanied by spinal canal stenosis is rare. All reported cases were treated with endovascular stenting for iliac artery occlusion. We report the first case of external iliac artery occlusion accompanied by spinal stenosis, which was successfully treated with conservative treatment. CASE PRESENTATION: A 66-year-old man with lower extremity pain and claudication visited the outpatient spine clinic. He complained of a tingling sensation in the L5 dermatome of the right leg and L4 dermatome of the left leg. Magnetic resonance imaging showed central stenosis in at the L4-5 and L5-S1 levels, and lateral recess stenosis at the L5-S1 level. The patient's symptoms were ambiguous with mixed neurological claudication and vascular claudication. Computed tomography of the lower extremity artery showed complete occlusion in the right external iliac artery. Conservative treatment with clopidogrel and beraprost sodium was performed. After treatment, his symptoms gradually improved. Clopidogrel and beraprost sodium were continued for 4 years. Follow-up computed tomography at 4 years showed recanalization of the right external iliac artery occlusion. CONCLUSIONS: We describe a rare case of external iliac artery occlusion and spinal stenosis. External iliac artery occlusion may be successfully treated only with conservative treatment using medication.

Effect of Lumbar Spinal Stenosis on Treatment of Osteoporosis: Comparison of Three Oral Bisphosphonate Therapies.

(1) Background: Lumbar spinal stenosis (LSS) causes uncomfortable neuropathic symptoms, which can negatively affect osteoporosis. The aim of this study was to investigate the effect of LSS on bone mineral density (BMD) in patients treated with one of three oral bisphosphonates (ibandronate, alendronate and risedronate) for initially diagnosed osteoporosis. (2) Methods: We included 346 patients treated with oral bisphosphonates for three years. We compared annual BMD T-scores and BMD increases between the two groups according to symptomatic LSS. The therapeutic efficacies of the three oral bisphosphonates in each group were also evaluated. (3) Results: Annual and total increases in BMD were significantly greater in group I (osteoporosis) compared to group II (osteoporosis + LSS). The total increase in BMD for three years was significantly greater in the ibandronate and alendronate subgroups than that in the risedronate subgroup (0.49 vs. 0.45 vs. 0.25, p < 0.001). Ibandronate showed a significantly greater increase in BMD than that of risedronate in group II (0.36 vs. 0.13, p = 0.018). (4) Conclusions: Symptomatic LSS may interfere with the increase in BMD. Ibandronate and alendronate were more effective in treating osteoporosis than risedronate. In particular, ibandronate was more effective than risedronate in patients with both osteoporosis and LSS.

Self-Disclosure and Post-traumatic Growth in Korean Adults: A Multiple Mediating Model of Deliberate Rumination, Positive Social Responses, and Meaning of Life.

Background: To explore how self-disclosure leads to post-traumatic growth (PTG) in adults who have experienced traumatic events, this study identified the relationship between self-disclosure and post-traumatic growth in Korean adults. We examined a parallel multiple mediating model for this relationship. Methods: Participants were 318 Korean male and female adult participants aged 20 years or older who had experienced trauma. We measured deliberate rumination, positive social responses, and the meaning of life as mediating variables. Results: The results revealed that the study variables positively correlated with PTG. Self-disclosure was positively correlated with deliberate rumination, positive social responses, and meaning of life. In the multiple mediating model, deliberate rumination, positive social responses, and meaning of life mediated the relationship between self-disclosure and PTG. Conclusion: Self-disclosure, deliberate rumination, positive social responses, and meaning of life play an important role in the growth of adults who have experienced traumatic events. The findings of this study should provide valuable information for future research and for mental health professionals who want to promote the PTG of their clients.

A sweat-activated, wearable microbial fuel cell for long-term, on-demand power generation.

In this work, we enabled on-demand, long-functioning, sweat-based power generation through a wearable paper-based microbial fuel cell (MFC) using a novel spore-forming biocatalyst, Bacillus subtilis. The MFC is sustainable and survivable even in the extreme environmental conditions of human skin. B. subtilis, usually found on the skin, was able to form endospores that endure extreme dryness or nutrient limitation when sweat access was limited or unpredictable for humans at rest, offering long-term operation and stable storage. When human sweat was introduced, spore germination and gradual power generation were observed without adding nutrient germinants. Through repeated sporulation and germination depending on the sweat availability, B. subtilis provided a sustainable solution for an innovative sweat-activated power source that can result in the long-lasting vision of self-sustaining wearable electronics. Even after the 48-h operation, the device generated a maximum power density of 24 µW/cm2 and a maximum current density of 175 µA/cm2, which is comparable to or even higher than the previously reported paper-based MFCs using well-known strong exoelectrogens in an optimized bacterial medium. Furthermore, B. subtilis in sweat was shown to be commensal with other skin microorganisms while producing antibiotic substances that were effective against potential pathogens, exhibiting a great potential for seamless and intimate integration with skin-mountable applications.

Rapidly progressive gas-forming infection involving the spine as a life-threatening fatal condition : a case report.

BACKGROUND: Gas forming infection of the spine is a consequence of vertebral osteomyelitis, necrotizing fasciitis, or a gas-forming epidural abscess, which is very rare and fatal conditions. This is the rare case of necrotizing fasciitis that rapidly progressed from the lumbar area to upper thoracic area. CASE PRESENTATION: A 58-year-old male complained of lower back pain with fever and chills. The patient had a history of uncontrolled diabetes mellitus without diabetic medication over the previous 3 months, and he had received several local injections around the lumbar area. Laboratory data revealed white blood cell count of 19,710 /mm3, erythrocyte sedimentation of 40 mm/h, and C-reactive protein of 30.7 mg/L. Radiological findings revealed a small amount of air bubbles in the paraspinal area and lumbar epidural spaces. The patient refused emergency surgery and was discharged from the hospital. The patient re-visited the emergency department two days after discharge complaining of more severe back pain with persistent fever, and his vital signs had deteriorated, with low blood pressure and tachycardia. K. pneumoniae was isolated in cultures from ultrasound-guided aspirates and peripheral blood. The follow-up radiographs revealed aggressive dissemination of innumerable air bubbles from the lumbar area to the T5 level. The patient underwent emergent decompressive laminectomy and debridement of infected paravertebral fascia and musculature. Despite intensive care for deteriorated vital signs and his back wound, the patient died on postoperative day 3 due to multi-organ failure. CONCLUSIONS: Necrotizing fasciitis involving the spine is a very rare disease with life-threatening conditions, rapid progression, and a high mortality rate. Therefore, prompt surgical treatment with a high index of suspicion is imperative to prevent potentially fatal conditions in similar extremely rare cases.

Long-Segmental Posterior Fusion Combined With Vertebroplasty and Wiring: Alternative Surgical Technique for Kummell's Disease With Neurologic Deficits-A Retrospective Case Series.

PURPOSE: Various surgical methods have been reported for Kummell's disease with neurologic deficits. The aim of this study was to introduce long-segmental posterior fusion (LPF) combined with vertebroplasty (VP) and wiring as an alternative surgical technique. MATERIAL AND METHODS: We retrospectively analyzed 10 patients undergoing posterior decompression and LPF combined with VP and wiring for Kummell's disease with neurologic deficits from January 2011 to December 2014. The radiologic outcomes included the local kyphotic angle (LKA) and segmental kyphotic angle (SKA). Clinical outcomes, including the visual analog scale (VAS), the Oswestry Disability Index (ODI) and the Frankel grade were assessed. Surgery-related complications were also evaluated. RESULTS: The mean age of the included patients was 77 ± 8 years with a mean follow-up period of 31.4 ± 4.9 months and a mean bone mineral density of -3.5 ± 0.7 (T-score). The mean operation time was 220 ± 32.3 minutes with a mean blood loss of 555 ± 125.7 mL. The preoperative LKA and SKA were significantly corrected postoperatively (37.9 ± 8.7° vs. 15.3 ± 5.3°, p = 0.005 for LKA; 21.3 ± 5.1° vs. 7.6 ± 2.8°, p = 0.005 for SKA) without a loss of correction at the last follow-up. The VAS and ODI were also significantly improved (7.7 ± 1.1 vs. 3.0 ± 1.6, p = 0.007 for VAS; 90.3 ± 8.9 vs. 49.6 ± 22.7, p = 0.007 for ODI). The Frankel grade of all patients was improved by at least 1 or 2 grades at the last follow-up. Surgery-related complications such as intraoperative cement leakage and implant loosening during the follow-up were not observed. CONCLUSIONS: LPF combined with VP and wiring might be an effective surgical option for Kummell's disease with neurologic deficits, especially for the elderly patients with morbidities. LEVEL OF EVIDENCE: level IV.

Bioelectricity production from sweat-activated germination of bacterial endospores.

A microbial fuel cell is created that uses a bacterium's natural ability to revive from dormancy to provide on-demand power for next-generation wearable applications. In adverse conditions, Bacillus subtilis responds by becoming endospores that serve as a dormant biocatalyst embedded in a skin-mountable paper-based microbial fuel cell. When activated by nutrient-rich human sweat, the germinating bacteria produce enough electricity to operate small devices, such as the calculator that we operated to test our methodology. The spore germination is artificially accelerated by nutritious germinants, which are pre-loaded on the skin-contacting bottom layer of the device, absorb the released sweat, and deliver a mixture of the dissolved germinants and sweat to the spores. When the skin-mountable device is applied to the arm of a sweating volunteer, it can generate a maximum power density of 16.6 µW/cm2 through bacterial respiratory activity. A potential risk of bacteria leakage from the device is minimized by packaging with a small pore size paper so that bacterial spores and germinated cells cannot pass through. When three serially connected devices are integrated into a single on-chip platform and energized by sweat, a significantly enhanced power density of 56.6 µW/cm2 is generated, powering an electrical calculator. After three weeks of dormant storage, the device exhibits no significant decrease in electrical output when activated by sweat. After use, the device is easily incinerated without risking bacterial infection. This work demonstrates the promising potential of the spore-forming microbial fuel cell as a disposable and long storage life power source for next-generation wearable applications.

Cervical foraminal stenosis causing unilateral diaphragmatic paralysis without neurologic manifestation: A case report and review of the literature.

RATIONALE: Unilateral diaphragmatic paralysis due to cervical spondylosis has rarely been reported. We present the first case of unilateral diaphragmatic paralysis without radicular pain or motor weakness due to cervical foraminal stenosis and a review of the related literature. PATIENT CONCERNS: A 59-year-old man presented with dyspnea and fever. His chest radiograph revealed right hemidiaphragmatic paralysis. DIAGNOSES: The differential diagnosis of phrenic nerve palsy excluded mediastinal and neurodegenerative diseases. Imaging studies showed right foraminal stenosis caused by cervical spondylosis at C3-4 and C4-5. INTERVENTIONS: The patient underwent foraminotomy at C3-4 and C4-5 on the right side. The operative findings revealed a severe compression of the C4 root. OUTCOMES: At 3 months postoperatively, the unilateral diaphragmatic paralysis and dyspnea were recovered. LESSONS: Hemidiaphragmatic paralysis deserves careful evaluation for the presence of cervical spondylosis, even without concomitant neurologic manifestations.

A simple, inexpensive, and rapid method to assess antibiotic effectiveness against exoelectrogenic bacteria.

A sufficiently fast and simple antimicrobial susceptibility testing (AST) is urgently required to guide effective antibiotic usages and to surveil the antimicrobial resistance rate. Here, we establish a rapid, quantitative, and high-throughput phenotypic AST by measuring electrons transferred from the interiors of microbial cells to external electrodes. Because the transferred electrons are based on microbial metabolic activities and are inversely proportional to the concentration of potential antibiotics, the changes in electrical outputs can be readily used as a transducing signal to efficiently monitor bacterial growth and antibiotic susceptibility. The sensing is performed by directly measuring the total energy, or all the accumulated microbial electricity, generated by microbial fuel cells (MFCs) arranged in a large-capacity disposable, paper-based testbed. A common Gram-negative pathogenic bacterium Pseudomonas aeruginosa wild-type PAO1 and first-line antibiotic gentamicin (GEN) are used in our experiments. The minimum inhibitory concentration (MIC) values generated from our technique are validated by the gold standard broth microdilution (BMD). Our new approach provides quantitative, actionable MIC results within just 5 h because it measures electricity produced by bacterial metabolism instead of the days needed for growth-observation methods. Moreover, as the equipment needed is simple, common, and inexpensive, our test has immense potential to be adopted in the field or resource-limited hospitals and labs to provide insightful assessments for research and clinical practices.

Portable, Disposable, Paper-Based Microbial Fuel Cell Sensor Utilizing Freeze-Dried Bacteria for In Situ Water Quality Monitoring.

Water quality monitoring is becoming an essential part of our lives as increasing human activities continue to spill unknown and unexpected contaminants into our water systems. To ensure the provision of safe and clean water to the public and the ecosystem, the development of rapid and sensitive in situ early warning systems for water toxicity monitoring is crucial. In this work, an entirely paper-based microbial fuel cell sensor utilizing freeze-dried bacteria is demonstrated as a portable and disposable water toxicity sensor. The bacterial cells were preinoculated on the anode reservoir of the device, and they were freeze-dried, making their on-site and on-demand applications possible. Upon rehydration of the bacteria with the water samples, current readings were obtained, and inhibition ratios (IRs) were calculated for different concentrations of formaldehyde as a model toxin. For 0.001, 0.01, and 0.02% of formaldehyde, IRs of 7.88, 16.08, and 23.14% were obtained, respectively. These IRs showed a very good linearity with the formaldehyde concentrations at R 2 = 0.995. Additionally, the shelf life of the freeze-dried microbial fuel cell sensor was investigated. Even after 14 days of storage in the desiccator, at 4, and at -20 °C, the performance outputs compared to the new device were all at 96%.

Enabling reversible redox reactions in electrochemical cells using protected LiAl intermetallics as lithium metal anodes.

Rechargeable electrochemical cells with metallic anodes are of increasing scientific and technological interest. The complex composition, poorly defined morphology, heterogeneous chemistry, and unpredictable mechanics of interphases formed spontaneously on the anodes are often examined but rarely controlled. Here, we couple computational studies with experimental analysis of well-defined LiAl electrodes in realistic electrochemical environments to design anodes and interphases of known composition. We compare phase behavior, Li binding energies, and activation energy barriers for adatom transport and study their effects on the electrochemical reversibility of battery cells. As an illustration of potential practical benefits of our findings, we create cells in which LiAl anodes protected by Langmuir-Blodgett MoS2 interphases are paired with 4.1 mAh cm-2 LiNi0.8Co0.1Mn0.1O2 cathodes. These studies reveal that small- and larger-format (196 mAh, 294 Wh kg-1, and 513 Wh liter-1) cells based on protected LiAl anodes exhibit high reversibility and support stable Li migration during recharge of the cells.

Obtaining Thickness-Limited Electrospray Deposition for 3D Coating.

Electrospray processing utilizes the balance of electrostatic forces and surface tension within a charged spray to produce charged microdroplets with a narrow dispersion in size. In electrospray deposition, each droplet carries a small quantity of suspended material to a target substrate. Past electrospray deposition results fall into two major categories: (1) continuous spray of films onto conducting substrates and (2) spray of isolated droplets onto insulating substrates. A crossover regime, or a self-limited spray, has only been limitedly observed in the spray of insulating materials onto conductive substrates. In such sprays, a limiting thickness emerges, where the accumulation of charge repels further spray. In this study, we examined the parametric spray of several glassy polymers to both categorize past electrospray deposition results and uncover the critical parameters for thickness-limited sprays. The key parameters for determining the limiting thickness were (1) field strength and (2) spray temperature, related to (i) the necessary repulsive field and (ii) the ability for the deposited materials to swell in the carrier solvent vapor and redistribute charge. These control mechanisms can be applied to the uniform or controllably-varied microscale coating of complex three-dimensional objects.

Quadriplegia caused by an epidural abscess occurring at the same level of cervical destructive spondyloarthropathy: a case report.

BACKGROUND: Destructive spondyloarthropathy (DSA) is one of the major complications in patients undergoing long-term hemodialysis. To the best of our knowledge, an epidural abscess occurring at the level of preexisting cervical DSA has not been well described in the literature. We report a unique case of quadriplegia caused by an epidural abscess occurring at the same level of preexisting cervical DSA. CASE PRESENTATION: A 49-year-old woman was transferred to our emergency department with 5 days of sepsis, drowsy mental status, and quadriplegia below the C5 level. The patient had a medical history of hemodialysis for 10 years. Magnetic resonance imaging showed spinal cord compression by an epidural abscess at the level of preexisting cervical DSA. Blood culture revealed methicillin-sensitive Staphylococcus aureus. Infection of the arteriovenous (AV) shunt was considered as the primary focus of sepsis and pyogenic spondylitis. We performed an emergent open door laminoplasty and the vascular team debrided the infected AV shunt site. Approximately 8 months after surgery, the patient was able to perform activities of daily living somewhat independently. CONCLUSIONS: Emergent surgical decompression and intensive medical care led to successful recovery from a septic and quadriplegic state in this patient. When diagnosing a patient who has undergone long-term hemodialysis presenting with neurologic deficits, the possibility of infectious spondylitis at the same level as DSA should be considered.