Efficacy Of Conversion Research Articles

Is conversion to duodenal switch after Roux-en-Y gastric bypass safe? Short-term outcomes review.

Weight regain after Roux-en-Y gastric bypass (RYGB) can be seen in approximately 20% of patients. Surgical management options include revision of RYGB and conversion to duodenal switch (DS). Using recently included revisional surgery variables in the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP) database, we compared the safety and efficacy of RYGB revision versus conversion to DS. An analysis of the 2020 MBSAQIP Participant Use Data File (PUF) revealed 1421 patients who underwent revision of RYGB (n = 1255) or conversion from RYGB to DS (n = 166) for inadequate weight loss or weight regain. Patient characteristics, preoperative body mass index (BMI), operating room (OR) time, and 30-day complications were compared between groups. When compared with the revision RYGB group, the DS group had higher mean BMI (47.5 vs 42.7, p < 0.001) and longer operative time (209.1 vs 133.4min, p < 0.001). DS had higher rates of any complication compared to revision RYGB (22.3 vs 5.58%, p < 0.001). DS had higher 30-day readmission rates (16.3 vs 5.50%, p < 0.001), reoperation within 30days (9.04 vs 2.87%, p < 0.001), venous thromboembolism (VTE) (3.01 vs 0.08%, p < 0.001), intensive care unit (ICU) admission (8.43 vs 0.72%, p < 0.001), anastomotic leak (7.83 vs 0.40%, p < 0.001), surgical site occurrence (SSO) (11.5 vs 2.71%, p < 0.001), and death (0.60 vs 0%, p < 0.001). This short-term data suggests that conversion of RYGB to DS is associated with higher rates of postoperative complications when compared with revision of RYGB. Given the complexity of the procedure, it is best performed by experienced surgeons with careful consideration given to appropriate patient selection and only after extensive patient counseling on associated risks and complications.

Single-Stage Conversion of External Fixation into Internal Fixation for Compound Fractures in War-Wounded Patients: A Cohort Study in Iraq

Background: War-induced. Compound fractures cause considerable damage to the limbs, affecting mobility and quality of life; surgeons consider managing compound fractures to be a difficulty. Although multi-stage conversion from external to internal fixation is still common, multiple studies worldwide are promoting single-stage conversion. Objective: To assess the efficacy and safety of a single-stage conversion from external to internal fixation using the functional results of many Iraqi war wounded patients who were initially treated with external fixation. Methods: A retrospective cohort study analyzed the data of 40 war-wounded patients (39 males and 1 female) ranging in age from 18 to 50 years. All patients came with war-related complex fractures, which were stabilized and referred for external fixation. Following a single-stage conversion to internal fixation, the patients were followed up to assess the functional outcomes of this approach using Ketenjian's functional criteria. Results: A study of 40 patients (45 limbs), mostly male (97.8%), demonstrated a statistically significant link between non-union and time to convert from external to internal fixation. However, fracture type, Gustilo categorization, fixation method, and complication rates had no significant impact on Ketenjian's score results. Conclusions: The single-staged external to internal fixation conversion is regarded as a safe and reliable procedure with good overall functional outcomes; it could be performed by experienced surgeons instead of two-staged conversions, taking into account the patient's general health and the state of the local soft tissue.

Free‐Standing, Multifunctional Thermoelectric and Acoustic Absorbing Nanocomposite Foams

AbstractThermoelectric materials are potential energy harvesting technologies that enable direct, clean conversion between thermal and electrical energy. The efficacy of thermoelectric energy conversion is influenced by the electrical conductivity, thermal conductivity, and Seebeck coefficient. Flexibility, manufacturability, and cost‐effectiveness are also important factors. Polymeric nanocomposites offer advantages in these respects. However, the development of conductive‐polymer thermoelectric materials is limited to an in‐plane architecture, which does not resemble common real‐world scenarios. Moreover, existing works have low thermoelectric properties or rely on additives for performance improvement. In this work, a free‐standing thermoelectric nanocomposite foam is fabricated via the integration of thermally activated microspheres. Due to the microstructure, a thermal conductivity as low as 0.03 W m−1 K−1 is achieved, which is lower than reported for aerogels fabricated via freeze‐drying methods. Additionally, the nanocomposite foam can reach a maximum electrical conductivity of 1.13 S cm−1, power factor of 0.12 µW m−1 K−2, and thermoelectric figure of merit of 3.0 × 10−4. The study also evaluated the compressive stiffness and demonstrated the potential for sound absorption. With the unique combination of the thermoelectric, sound absorption, and mechanical behavior, these nanocomposite foams would offer versatile solutions to address the next generation energy harvesting and acoustic absorption applications.

Efficient high-power 1.9 µm picosecond Raman laser in H2-filled hollow-core fiber without generation of rotational lines

In this paper, an efficient high-power 1.9 µm picosecond Raman laser through pure vibrational stimulated Raman scattering (SRS) in H2-filled hollow-core fiber (HCF) is demonstrated. The maximum Raman conversion efficiency of 34 % and the Raman power of 7.3 W (36.5 µJ) is achieved within a 130 cm length of our in-house fabricated fiber. By controlling the H2 pressure, the high-order Stokes and rotational Stokes/anti-Stokes will not be generated, thereby enhancing the efficacy of the 1st Stokes conversion. In addition, the vibrational anti-Stokes are produced inevitably, which can be explained by the phase-matching of higher-order modes. Our results show SRS in H2-filled HCF to be a promising method for generating high-power 1.9 µm picosecond pulses, which are valuable in spectroscopy, defense, and efficient nonlinear conversion.

Loewner Theory for Stochastic Neuron Model

The nonlinear response of the dynamics of the stochastic neuronal activity based on the leaky integrate-and-fire model was reformulated using the Loewner theory. We observed that the signal-to-noise ratio (SNR), which is an indicator of stochastic resonance (SR), and fluctuation-dissipation relation (FDR) for the neuronal dynamics were newly obtained in the theoretical framework of the Loewner evolution. Particularly, we focus on the role of the Loewner entropy [Formula: see text], defined as the entropy of the Loewner driving force, while showing the efficacy of Loewner time conversion to theorize the nonlinear characteristic of the neuronal dynamics. The present results indicate a possible approach to the novel formulation of biophysical models.

Results of sleeve gastrectomy conversion to Roux-en-Y gastric bypass on gastroesophageal reflux disease symptoms and proton pump inhibitors use evolution over time

BackgroundAlthough sleeve gastrectomy (SG) is associated with excellent results in the short term, it has been shown that it is plagued by weight regain and new onset or worsening of gastroesophageal reflux disease (GERD). These 2 clinical conditions are currently the 2 most frequent indications for revisional surgery. To date, only a few studies have focused exclusively on GERD. In a selected series of patients complaining of GERD symptoms after SG as a main complaint, we analyzed the efficacy of conversion to Roux-en-Y gastric bypass (RYGB), with a standardized surgical technique. MethodsThis is a retrospective study including all consecutive cases of SG to RYGB conversion for GERD not controlled by medical treatment. We excluded all patients undergoing conversion for weight regain without GERD. Quality of life and GERD symptoms were evaluated at outpatient’s clinic visits before and after surgery with 2 standardized questionnaires (Gastroesophageal Reflux Disease Questionnaire and Simplified Form 6). ResultsThis study showed that 70% of patients had complete resolution of GERD symptoms and 60% had completely discontinued proton pump inhibitors (PPIs). The conversion to RYGB resulted in a significant decrease in the rate of patients presenting daily symptoms of GERD and use of PPIs (10% and 16.6%, respectively; P < .019) and a dramatic increase in those without symptoms and no need for PPIs (70% and 60%, respectively; P < .001). ConclusionConversion to RYGB is a good option for GERD complications after SG providing a high rate of symptom remission and PPI discontinuation. Conversion to RYGB in the setting of GERD complications after SG improves postoperative outcomes decreasing GERD symptoms and improving quality of life.

Recent Progress of Ion-Modified TiO2 for Enhanced Photocatalytic Hydrogen Production.

Harnessing solar energy to produce hydrogen through semiconductor-mediated photocatalytic water splitting is a promising avenue to address the challenges of energy scarcity and environmental degradation. Ever since Fujishima and Honda's groundbreaking work in photocatalytic water splitting, titanium dioxide (TiO2) has garnered significant interest as a semiconductor photocatalyst, prized for its non-toxicity, affordability, superior photocatalytic activity, and robust chemical stability. Nonetheless, the efficacy of solar energy conversion is hampered by TiO2's wide bandgap and the swift recombination of photogenerated carriers. In pursuit of enhancing TiO2's photocatalytic prowess, a panoply of modification techniques has been explored over recent years. This work provides an extensive review of the strategies employed to augment TiO2's performance in photocatalytic hydrogen production, with a special emphasis on foreign dopant incorporation. Firstly, we delve into metal doping as a key tactic to boost TiO2's capacity for efficient hydrogen generation via water splitting. We elaborate on the premise that metal doping introduces discrete energy states within TiO2's bandgap, thereby elevating its visible light photocatalytic activity. Following that, we evaluate the role of metal nanoparticles in modifying TiO2, hailed as one of the most effective strategies. Metal nanoparticles, serving as both photosensitizers and co-catalysts, display a pronounced affinity for visible light absorption and enhance the segregation and conveyance of photogenerated charge carriers, leading to remarkable photocatalytic outcomes. Furthermore, we consolidate perspectives on the nonmetal doping of TiO2, which tailors the material to harness visible light more efficiently and bolsters the separation and transfer of photogenerated carriers. The incorporation of various anions is summarized for their potential to propel TiO2's photocatalytic capabilities. This review aspires to compile contemporary insights on ion-doped TiO2, propelling the efficacy of photocatalytic hydrogen evolution and anticipating forthcoming advancements. Our work aims to furnish an informative scaffold for crafting advanced TiO2-based photocatalysts tailored for water-splitting applications.

Enhanced Open-Circuit Voltage Subject to Harmonic Excitations in Piezoelectric Energy Harvesters Using Hybrid Optimization Algorithm

In this manuscript, a hybrid method is proposed to attain the piezo-electric energy harvesters (PEHs) with an improved conversion of energy effectiveness or open-circuit voltage. The proposed method is the joint execution of Pelican Optimization Algorithm (POA) and Dwarf Mongoose Optimizer (DMO) named as POA-DMO technique. The primary goal of the planned POA's design is to simulate pelicans’ typical hunting activity. By topologically improving piezo-electric distribution through the thickness of materials, such as piezo-electric energy harvester plates are based on the harmonic excitations and open-circuit-voltage of PEHs is increased. The efficacy of the energy conversion and the open-circuit-voltage are taken into account as the design goals. For the two taken into consideration design objectives, the arrangement of the piezo-electric material in the thickness direction is topologically optimal. In order to produce more electricity, the piezoelectric materials are positioned in the regions of increased stress/strain and high energy conversion efficiency. To acquire more electric power while maintaining a constant electric resistance, the distribution of piezo-electric materials is calibrated to determine the frequency of external stimulation frequency in order to realize a high open-circuit voltage. The proposed method performance is done in MATLAB and it is compared with existing approaches.

Conversion of sleeve gastrectomy to Roux-en-Y gastric bypass: impact on reflux and weight loss

BackgroundSleeve gastrectomy (SG) is the most commonly performed weight loss operation, and its 2 most common complications are postoperative reflux and weight recurrence. There is limited evidence to guide decision-making in treating these conditions. ObjectivesTo determine the efficacy of conversion of SG to Roux-en-Y gastric bypass (RYGB) for GERD management and weight loss. SettingForty-one hospitals in Michigan. MethodsWe conducted a retrospective cohort study examining patients who underwent conversion of SG to RYGB from 2014 to 2022. The primary outcomes were changes in GERD-HRQL scores, anti-reflux medication use, and weight from baseline to 1 year after conversion. Secondary outcomes included 30-day postoperative complications and resource utilization. ResultsAmong 2133 patients undergoing conversion, 279 (13%) patients had baseline and 1-year GERD-HRQL survey data and anti-reflux medication data. GERD-HRQL scores decreased significantly from 24.6 to 6.6 (P < .01). Among these, 207 patients (74%) required anti-reflux medication at baseline, with only 76 patients (27%) requiring anti-reflux medication at 1 year postoperatively (P < .01). Of the 380 patients (18%) with weight loss data, mean weight decreased by 68.4lbs, with a 24.3% decline in total body weight and 51.5% decline in excess body weight. In terms of 30-day complications, 308 (14%) patients experienced any complication and 89 (4%) experienced a serious complication, but there were no leaks, perforations, or deaths. Three-hundred and fifty-five (17%) patients presented to the emergency department and 64 (3%) patients underwent reoperation. ConclusionsThis study represents the largest reported experience with conversion from SG to RYGB. We found that conversion to RYGB is associated with significant improvement in GERD symptoms, reduction in anti-reflux medication use, and significant weight loss and is therefore an effective treatment for GERD and weight regain after SG. However, the risks and benefits of conversion surgery should be carefully considered, especially in patients with significant comorbidity burden.

Solar based Smart Sanitizer Dispenser System with Internet of Things (IoT) Technology

In response to the growing demand for efficient and sustainable hygiene solutions, this project introduces a Solar-Powered Smart Sanitizer Dispenser System leveraging IoT technology. The system aims to address the need for touchless and accessible hand sanitization in various environments, including public spaces, healthcare facilities, and commercial establishments. By integrating solar power as the primary energy source, the system offers autonomy and eco-friendliness, reducing dependency on conventional electricity grids and minimizing environmental impact. The core components of the system include a smart dispenser unit equipped with sensors for detecting hand proximity, a reservoir for storing sanitizer solution, and a microcontroller unit responsible for data processing and IoT connectivity. Through the IoT interface, users can remotely monitor sanitizer levels, receive real-time usage statistics, and manage dispenser settings, enhancing operational efficiency and maintenance. Furthermore, the incorporation of solar panels ensures continuous operation even in off-grid locations, making the system suitable for deployment in remote or outdoor settings where access to electricity may be limited. Maximizing the efficacy of solar power conversion and extending operational uptime.

Lung CT harmonization of paired reconstruction kernel images using generative adversarial networks.

The kernel used in CT image reconstruction is an important factor that determines the texture of the CT image. Consistency of reconstruction kernel choice is important for quantitative CT-based assessment as kernel differences can lead to substantial shifts in measurements unrelated to underlying anatomical structures. In this study, we investigate kernel harmonization in a multi-vendor low-dose CT lung cancer screening cohort and evaluate our approach's validity in quantitative CT-based assessments. Using the National Lung Screening Trial, we identified CT scan pairs of the same sessions with one reconstructed from a soft tissue kernel and one from a hard kernel. In total, 1000 pairs of five different paired kernel types (200 each) were identified. We adopt the pix2pix architecture to train models for kernel conversion. Each model was trained on 100 pairs and evaluated on 100 withheld pairs. A total of 10 models were implemented. We evaluated the efficacy of kernel conversion based on image similarity metrics including root mean squared error (RMSE), peak signal-to-noise ratio (PSNR), and structural similarity index measure (SSIM) as well as the capability of the models to reduce measurement shifts in quantitative emphysema and body composition measurements. Additionally, we study the reproducibility of standard radiomic features for all kernel pairs before and after harmonization. Our approach effectively converts CT images from one kernel to another in all paired kernel types, as indicated by the reduction in RMSE (p<0.05) and an increase in the PSNR (p<0.05) and SSIM (p<0.05) for both directions of conversion for all pair types. In addition, there is an increase in the agreement for percent emphysema, skeletal muscle area, and subcutaneous adipose tissue (SAT) area for both directions of conversion. Furthermore, radiomic features were reproducible when compared with the ground truth features. Kernel conversion using deep learning reduces measurement variation in percent emphysema, muscle area, and SAT area.

A PV MPPT control method based on async-PSO and INC algorithm under shading condition

For the time being, solar energy has received considerable attention and development on account of its distinct advantages, such as rich reserves and no geographical restrictions. Nevertheless, in practical applications, the photovoltaic module is easily affected by external environments, which gives rise to a decrease in photovoltaic power. The maximum power point tracking (MPPT) technology for PV power system is an effective method to elevate the efficacy of photovoltaic electricity conversion. The frequently used control methods include the perturb and observe (P&amp;O) algorithm and the incremental conductance (INC) method, and so forth; these methods vary tremendously in terms of the required parameters, algorithm complexity, tracking speed, tracking accuracy, hardware requirements etc. This work puts forth a MPPT control method on the basis of Async-PSO and INC algorithm to achieve a better performance in the MPPT. To reflect the change of light amplitude and temperature in a day, the temperature varies from 25℃ to 60℃ and irradiance from 450W/m2 to 900W/m2 . An extensively used mono-crystalline silicon PV module with 240W was considered as the research object to compare the capability of the recommended MPPT control method. MATLAB/Simulink software was adopted to model and simulate the algorithm. Aside from that, comprehensive comparisons were made with other MPPT methods to test and verify the recommended algorithm has significantly improved the tracking speed and accuracy at the maximum power point with smaller oscillations under various conditions.

Conversion from twice-daily everolimus to once-daily sirolimus in long-term stable liver transplant recipients

BackgroundAfter organ transplantation, strategies for simplifying the therapeutic regimen may improve adherence and prevent acute organ rejection and/or late graft loss. The present study aimed to evaluate the safety and efficacy of conversion from everolimus (EVR) twice daily to sirolimus (SIR) once daily in a large cohort of liver transplantation (LT) patients. MethodsWe included 108 LT patients with at least 12 months of post-transplant follow-up and no rejection episodes in the last year. Conversion was based on a 1:1 ratio (but eventually adapted to available formulations of SIR). ResultsThe median age at the time of conversion was 68.9 years (range: 26.1–83.6); 75.0% were men. The main indications for mTOR inhibitor use were renal failure (38.9%) and/or a history of malignancy (37.0%). Median conversion time after LT was 14.8 years (range: 2.3–31.5). The median dose of EVR and SIR (initially) was 1.50 mg/day (range: 0.5–4.5). The mean follow-up after conversion was 15.8±4.4 months. Median serum EVR/SIR trough levels before/after conversion were 3.85 ng/mL vs. 6.32 ng/mL (p < 0.05), i.e. a 1:1.64 ratio. At the end of follow-up after conversion, the median dose of SIR was 1.25 mg/day (range: 0.5–3.5), and the mean serum SIR trough level was 5.23 ng/mL; 9 patients (8.3%) had returned to EVR, because of side effects (mainly digestive), that resolved thereafter. No biopsy-proven acute rejection episode was observed. Finally, 87.1% of patients considered the conversion beneficial and the cost was reduced by 50.3%. ConclusionThe results of our study indicate that conversion from once-daily EVR to once-daily SIR in stable LT patients is safe, but needs dose adaptations and careful monitoring.

Pricing decisions of online and offline dual-channel supply chains considering data resource mining

Data resources, a fundamental component in the digital economy, play a vital role for businesses aiming to establish a lasting competitive edge. A company's data resources can uniquely influence the decisions surrounding products and services within the supply chain. The integrated dual-channel supply chain (DCSC) involves direct online channels utilized by manufacturing service providers alongside offline channels, such as physical retail stores, managed by sales service integrators. The DCSC is capable of performing second-stage data mining services in accordance with the sold products and customer services after the product sales are completed. Subsequently, data resource mining can be achieved through a cross-channel approach. As such, considering the exploration of cross-channel data resources, this study strives to formulate a structure for a dual-channel closed-loop supply chain. Furthermore, utilizing concepts from the Stackelberg and Nash equilibrium game theories, it delves into the analysis of pricing decisions and profit allocation. This examination encompasses distinct closed-loop supply chain configurations, viewed through the lenses of both centralized and decentralized decision-making approaches. In addition, the effects of cross-channel data mining and channel consumption preferences on supply chain decisions are analyzed, and the analysis is conducted in combination with numerical examples. As evidenced by the findings in this investigation, cross-channel data resource mining, consumer channel preference, and the data mining value conversion rate can prominently affect the formulation of pricing strategies and the distribution of profits in closed-loop supply chains. The potential value of data resources can lead to the generation of “external incentives” following the strategy of data resource mining. Furthermore, the data resource mining strategy is promising in stimulating the growth of the product and service markets. Finally, the overall profit of the supply chain is increased with the increase in the efficiency of data resource conversion. Enhancements in the efficacy of data resource conversion correspondingly lead to heightened overall profits within the supply chain.

Impact of solid-fluid interfacial layer and nanoparticle diameter on Maxwell nanofluid flow subjected to variable thermal conductivity and uniform magnetic field

The utilization of Maxwell fluid with nanoparticle suspension exhibits promising prospects in enhancing the efficacy of energy conversion and storage mechanisms. They have the potential to be utilized in sophisticated cooling systems for power generation facilities, thereby augmenting the overall energy efficacy. Keeping this in mind, the current research examines the Maxwell nanofluid flow over a rotating disk with the impact of a heat source/sink. The present study centers on the examination of flow characteristics in the existence of a uniform magnetic field. The conversion of governing equations into ordinary differential equations is achieved using appropriate similarity variables. To derive the Nusselt number (Nu) and skin friction (SF) model related to the flow and temperature parameters, the suggested back-propagation artificial neural networking (ANN) technique is used. The Runge-Kutta-Fehlberg fourth-fifth order (RKF-45) method is used to solve the reduced equations and produce the necessary data to create the Nu and SF model. Both the Nu and SF models require 1000 data for training the network, respectively. Graphs are utilized to communicate numerical outcomes. The results concluded that the upsurge in magnetic parameter drops the velocity profile but advances the heat transport. Rise in the thermal conductivity parameter, increases the heat transport.

Impact of Catalyst Morphology on the Adsorption and Electrocatalytic Hydrogenation of Benzaldehyde

Biomass represents an untapped resource for achieving a circular carbon economy. Current processes for converting biomass are limited to centralized processing facilities. Electrochemical approaches are inherently modular and enable decentralized upgrading of pyrolysis oil to value-added chemicals and fuels (products). A primary component of the aqueous phase of such feedstocks are carbonyl functionalities, where benzaldehyde (BZ) represents a model compound. Selective reduction of BZ to benzyl alcohol (BnOH) can be used to understand the catalytic upgrading of pyrolysis oil to value-added products. Electrocatalytic hydrogenation (ECH) of BZ can be carried out at mild temperatures and pressure with the hydrogen required for BZ reduction coming from the protons in the solution. However, these protons can also combine in the hydrogen evolution reaction (HER) in a competitive process. Among the noble and base metals studied in the literature, palladium (Pd) is very active and has demonstrated a high faradaic efficiency (FE) for ECH of BZ relative to HER. Palladium also forms a thermodynamically stable hydride under these conditions. However, prior work has shown that BZ inhibits the formation of palladium hydride under reaction conditions, whereas the presence of weaker adsorbing organics does not. Together, these observations raise interesting questions whether ECH occurs via a proton coupled electron transfer (PCET) pathway or via addition of H from the catalyst surface directly (Langmuir-Hinshelwood, LH pathway). The specific aims of this work investigate the effect of catalyst morphology on the surface coverage of intermediates like H and adsorbed BZ, the relative rates of PCET and LH pathways, and their competition with HER and hydride formation. For this, we investigate high surface area Pd nanoparticle electrocatalysts and a gel network (Pd Gel) of them rich with grain boundaries and strain via cyclic voltammetry. Adsorption isotherms on these Pd catalysts show changes in hydride formation and the relative affinity of H and BZ on the Pd surface. We further study the reaction rate orders and FE as a function of applied potential to better understand the contributions of PCET and LH pathways. These findings point to catalyst morphology as a further handle to manipulate activity and FE for ECH of BZ. Furthermore, these findings will enhance the mechanistic understanding of BZ ECH kinetics and will contribute to improving the overall efficacy of biomass conversion to biofuels.

(Invited) Understanding Photoelectrocatalysis on Epitaxial Oxide Surfaces

The intermittent nature of renewable energy sources requires a clean, scalable means of converting and storing energy. One Earth abundant storage option is water electrolysis, storing energy in the bonds of O2 and H2. Photoelectrochemical (PEC) cells based on semiconductor/liquid interfaces can convert sunlight to chemical fuels without external circuitry, such as “splitting” water into O2 and H2 upon illumination. The efficacy of conversion depends in part on the location of the semiconductor band edges, dictating absorption, and also the rectifying properties of semiconductor–electrolyte junctions, which drives the separation of electron–hole pairs.We will present studies of model oxide La(1-x)SrxFeO3 photoelectrodes grown by molecular beam epitaxy (MBE) and pulsed laser deposition (PLD) that display a known crystallographic orientation, surface area, path for charge transport, and strain. Aliovalent doping can tune the transition metal redox properties as well as the material band gap and conductivity, resulting in a rich phase space of possible water-oxidation photoanodes. Comparing the photooxidation of a fast redox couple to the slugging water oxidation reaction demonstrates the potential of electronic states that must be filled prior to oxygen evolution. Measurements of the surface speciation in a humid environment demonstrate that Sr incorporation also promotes hydroxylation, suggesting that water oxidation proceeds through the oxidation of FeIII-OH states, which is facilitated by Sr incorporation and results in an increased photovoltage. Surface-sensitive measurement of the valence band and unoccupied states (via O K-edge X-ray absorption spectroscopy) under humid conditions further support this picture. This fundamental insight builds understanding necessary for the design of active, earth-abundant photocatalysts that can be integrated into PEC devices for efficient conversion of solar energy into chemical fuels.

Safety and Efficacy of Conversion to Once-Daily Tacrolimus from Twice-Daily Tacrolimus in Pediatric Liver Transplant Recipients

BackgroundNonadherence to immunosuppression is the most common cause of late acute rejection in pediatric liver transplant (LT) recipients. A prolonged-release once-daily tacrolimus formulation was developed to improve adherence and long-term allograft survival. MethodsWe screened 179 pediatric LT recipients who converted from twice-daily tacrolimus (TD-TAC) to once-daily tacrolimus (OD-TAC) between February 2011 and September 2019. ResultsOne hundred seventy-nine recipients converted to OD-TAC and were followed for 18 months. 152 OD-TAC-converted recipients (84.9%) experienced uneventful follow-up, while 21 recipients showed LFT elevation. Four recipients had biopsy-proven acute rejection within six months of conversion, all of which were successfully treated with steroid pulse. 166 recipients (92.7%) remain on OD-TAC and 13 (7.3%) were switched back to TD-TAC. The mean tacrolimus trough level significantly decreased three months following conversion (3.14 ± 1.9 ng/mL) compared with pre-conversion levels (3.69 ± 1.98 ng/mL). Mean tacrolimus trough levels remained unchanged from 3 months to 12 months following conversion. Percent coefficient of variation of tacrolimus trough levels decreased significantly from 32.5 ± 16.4 ng/mL to 27.5 ± 15.6 ng/mL after conversion to OD-TAC, reflecting a decrease in variation of tacrolimus trough levels following conversion. ConclusionsConversion to OD-TAC in pediatric LT recipients with stable graft function is safe and effective. Level of evidenceLevel IV.

New Perspectives in Cytomegalovirus After Transplant: The Role of Immunosuppressant Management.

New Perspectives in Cytomegalovirus After Transplant: The Role of Immunosuppressant Management.

Early efficacy of individual regimens containing bedaquiline in patients with drug resistant tuberculosis

Objective: To evaluate early efficacy of sputum conversion within 6 months of individual regimens containing bedaquiline in patients with drug resistant tuberculosis. Methods: We conducted a retrospective study among patients with drug resistant tuberculosis who were receiving individual regimens containing bedaquiline. The primary outcome was sputum conversion of both smear and culture within 6 months of treatment. We used medical records of drug resistant tuberculosis patients from January 2020 to December 2021. The study was conducted at Dr. Soetomo Hospital, Indonesia from August to October 2022. Results: In this study, 44 eligible drug resistant tuberculosis patients were initiated on regimens containing bedaquiline. There were 52.3% males and the median age was 45.5 years. The rates of previous treatment (70.5%) and lung cavity (36.4%) were high. The most common companion drugs included clofazimine, cycloserine, levofloxacin, and linezolid. Sputum smear and culture conversion was seen in 79.4% and 82.1% at the 2nd month, respectively. More than 97% patients had smear and culture conversion at the end of 6 months. Conclusions: Among drug resistant tuberculosis patients, individual regimens containing bedaquiline were associated with high rates of smear and culture conversion at the end of 6 months. Early efficacy of regimens containing bedaquiline can be used to predict cure rate at the end of treatment.