A Unique Case of Rapidly Progressive Glomerulonephritis in a Patient With Anti-neutrophil Cytoplasmic Antibody (ANCA)-Positive Vasculitis Presenting With Ocular and Cardiac Manifestations.

Anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitides (AAVs) can be divided into three distinct clinical entities. Of the three subgroups, granulomatosis with polyangiitis (GPA) is the most common AAV. We present a 33-year-old Hispanic male with no past medical history who presented to the ER with acute-onset pleuritic chest pain and dyspnea.

Drug-Induced Systemic Lupus Erythematosus: A Rare Presentation of Hydralazine-Induced Lupus.

Systemic lupus erythematosus (SLE) is a chronic autoimmune disorder characterized by the production of autoantibodies directed against nuclear and cytoplasmic antigens. SLE can be induced by various medications, such as hydralazine, procainamide, isoniazid, methyldopa, chlorpromazine, quinidine, and minocycline. Hydralazine-induced lupus syndrome was first reported in 1953, and only occurs in 5-10% of patients taking hydralazine.

High energy density picoliter-scale zinc-air microbatteries for colloidal robotics.

The recent interest in microscopic autonomous systems, including microrobots, colloidal state machines, and smart dust, has created a need for microscale energy storage and harvesting. However, macroscopic materials for energy storage have noted incompatibilities with microfabrication techniques, creating substantial challenges to realizing microscale energy systems. Here, we photolithographically patterned a microscale zinc/platinum/SU-8 system to generate the highest energy density microbattery at the picoliter (10 liter) scale.

Observation and Isochoric Thermodynamic Analysis of Partially Water-Filled 1.32 and 1.45 nm Diameter Carbon Nanotubes.

Recent measurements of fluids under extreme confinement, including water within narrow carbon nanotubes, exhibit marked deviations from continuum theoretical descriptions. In this work, we generate precise carbon nanotube replicates that are filled with water, closed from external mass transfer, and studied over a wide temperature range by Raman spectroscopy. We study segments that are empty, partially filled, and completely filled with condensed water from -80 to 120 °C.

Discretized hexagonal boron nitride quantum emitters and their chemical interconversion.

Quantum emitters in two-dimensional hexagonal boron nitride (hBN) are of significant interest because of their unique photophysical properties, such as single-photon emission at room temperature, and promising applications in quantum computing and communications. The photoemission from hBN defects covers a wide range of emission energies but identifying and modulating the properties of specific emitters remain challenging due to uncontrolled formation of hBN defects. In this study, more than 2000 spectra are collected consisting of single, isolated zero-phonon lines (ZPLs) between 1.

Management and referral patterns for new-onset chronic cough in primary care patients.

The diagnosis and management of chronic cough in primary care is challenging despite it being one of the most common chronic conditions. Clinical characterization of patients with new-onset chronic cough in the primary care setting. This was a retrospective study of adult patients (ages ≥ 18 years) with at least three visits with primary care providers (PCP) for new-onset cough, with at least 8 weeks between the first and third visits, within a tertiary-care center and affiliated clinics between January 1, 2010, and January 1, 2019 ( = 174).

Gas Separations using Nanoporous Atomically Thin Membranes: Recent Theoretical, Simulation, and Experimental Advances.

Porous graphene and other atomically thin 2D materials are regarded as highly promising membrane materials for high-performance gas separations due to their atomic thickness, large-scale synthesizability, excellent mechanical strength, and chemical stability. When these atomically thin materials contain a high areal density of gas-sieving nanoscale pores, they can exhibit both high gas permeances and high selectivities, which is beneficial for reducing the cost of gas-separation processes. Here, recent modeling and experimental advances in nanoporous atomically thin membranes for gas separations is discussed.

Direct Chemical Vapor Deposition Synthesis of Porous Single-Layer Graphene Membranes with High Gas Permeances and Selectivities.

Single-layer graphene containing molecular-sized in-plane pores is regarded as a promising membrane material for high-performance gas separations due to its atomic thickness and low gas transport resistance. However, typical etching-based pore generation methods cannot decouple pore nucleation and pore growth, resulting in a trade-off between high areal pore density and high selectivity. In contrast, intrinsic pores in graphene formed during chemical vapor deposition are not created by etching.

The Anterior Cruciate Ligament Can Become Hypertrophied in Response to Mechanical Loading: A Magnetic Resonance Imaging Study in Elite Athletes.

Background: Evidence, mainly from animal models, suggests that exercise during periods of pubertal growth can produce a hypertrophied anterior cruciate ligament (ACL) and improve its mechanical properties. In humans, the only evidence of ACL hypertrophy comes from a small cross-sectional study of elite weight lifters and control participants; that study had methodological weaknesses and, thus, more evidence is needed.

Purpose: To investigate bilateral differences in the ACL cross-sectional area (CSA) for evidence of unilateral hypertrophy in athletes who have habitually loaded 1 leg more than the other.

Atomically Precise Control of Carbon Insertion into hBN Monolayer Point Vacancies using a Focused Electron Beam Guide.

Precise controlled filling of point vacancies in hBN with carbon atoms is demonstrated using a focused electron beam method, which guides mobile C atoms into the desired defect site. Optimization of the technique enables the insertion of a single C atom into a selected monovacancy, and preferential defect filling with sub-2 nm accuracy. Increasing the C insertion process leads to thicker 3D C nanodots seeded at the hBN point vacancy site.

Diameter Dependence of Water Filling in Lithographically Segmented Isolated Carbon Nanotubes.

Although the structure and properties of water under conditions of extreme confinement are fundamentally important for a variety of applications, they remain poorly understood, especially for dimensions less than 2 nm. This problem is confounded by the difficulty in controlling surface roughness and dimensionality in fabricated nanochannels, contributing to a dearth of experimental platforms capable of carrying out the necessary precision measurements. In this work, we utilize an experimental platform based on the interior of lithographically segmented, isolated single-walled carbon nanotubes to study water under extreme nanoscale confinement.

Surgery Residents' Experiences With Seriously-Ill and Dying Patients: An Opportunity to Improve Palliative and End-of-Life Care.

Objective: To describe how and when surgery residents provided primary palliative care and engaged specialty palliative care services.

Design: Phase I consisted of a previously validated survey instrument supplemented with additional questions. We then conducted semistructured interviews with a subset of the survey respondents (Phase II).

Enhancing Lithium Insertion with Electrostatic Nanoconfinement in a Lithography Patterned Precision Cell.

The rapidly growing demand for portable electronics, electric vehicles, and grid storage drives the pursuit of high-performance electrical energy storage (EES). A key strategy for improving EES performance is exploiting nanostructured electrodes that present nanoconfined environments of adjacent electrolytes, with the goal to decrease ion diffusion paths and increase active surface areas. However, fundamental gaps persist in understanding the interface-governed electrochemistry in such nanoconfined geometries, in part because of the imprecise and variable dimension control.

A nanofluidic ion regulation membrane with aligned cellulose nanofibers.

The advancement of nanofluidic applications will require the identification of materials with high-conductivity nanoscale channels that can be readily obtained at massive scale. Inspired by the transpiration in mesostructured trees, we report a nanofluidic membrane consisting of densely packed cellulose nanofibers directly derived from wood. Numerous nanochannels are produced among an expansive array of one-dimensional cellulose nanofibers.

Preserved Analgesia With Reduction in Opioids Through the Use of an Acute Pain Protocol in Enhanced Recovery After Surgery for Open Hepatectomy.

Background: Enhanced recovery after surgery (ERAS) pathways are designed to restore baseline physiology, mitigate surgical stressors, and hasten recovery. Paramount to this approach is optimal pain control through multimodal analgesia and limiting reliance on opioid-based medications. Recent studies have fostered growing controversy surrounding the use of epidural analgesia in the ERAS setting, especially for higher-risk procedures.

Hypertension Risk Subsequent to Gestational Dysglycemia Is Modified by Race/Ethnicity.

Gestational diabetes mellitus is associated with an increased risk of type 2 diabetes mellitus and hypertension. Additionally, gestational dysglycemia has been associated with an increased risk of type 2 diabetes mellitus but not yet associated with hypertension subsequent to pregnancy in long-term follow-up. Therefore, we set out to examine this relationship as well as the role of race/ethnicity in modifying this relationship.

Direct Observation of Charge Inversion in Divalent Nanofluidic Devices.

Solid-state nanofluidic devices have proven to be ideal systems for studying the physics of ionic transport at the nanometer length scale. When the geometrical confining size of fluids approaches the ionic Debye screening length, new transport phenomena occur, such as surface mediated transport and permselectivity. Prior work has explored these effects extensively in monovalent systems (e.

Voltage gated ion and molecule transport in engineered nanochannels: theory, fabrication and applications.

Nanochannels remain at the focus of growing scientific and technological interest. The nanometer scale of the structure allows the discovery of a new range of phenomena that has not been possible in traditional microchannels, among which a direct field effect control over the charges in nanochannels is very attractive for various applications, since it offers a unique opportunity to integrate wet ionics with dry electronics seamlessly. This review will focus on the voltage gated ionic and molecular transport in engineered gated nanochannels.

Skeletal muscle metastases: a three-part study of a not-so-rare entity.

Objective: Our purposes were to explore the epidemiology of metastases to skeletal muscle and their detection on fused positron emission tomography and computed tomography.

Materials And Methods: We evaluated the epidemiology of skeletal muscle metastases in the literature and among cases from our hospital and studied the prevalence and appearance of skeletal muscle metastases among 433 patients undergoing fused positron emission tomography and computed tomography for non-small-cell lung cancer.

Results: We found 264 cases of skeletal muscle metastases in 151 articles.