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Ni-rich layered cathodes suffer detrimental structural changes due to irreversible phase transformation (IPT). Precisely surface structural reconstruction through foreign element doping is a potential method to alleviate IPT propagation. The structure of surface reconstructed layer is greatly determined by the foreign element content and species. Herein, small doses of Ti and Al were co-substituted in LiNi0.92Co0.08O2 to synergistically regulate the surface reductive Ni distribution, consequently constructing thin rock salt phase at the particle surface. This homogeneous rock salt phase combined with the strong Ti-O and Al-O bonds generated a reversible H2-H3 phase transition and further eliminated IPT propagation. Moreover, the suppressed IPT propagation converted the two-phase (H2 and H3) coexistence to a quasi-single-phase transition. This eliminated the strong internal strains caused by a significant lattice mismatch. The Ti and Al co-substituted LiNi0.92Co0.08O2 exhibited outstanding capacity retention and excellent structural stability. Similar improvements were observed with W or Zr and Al cosubstitution in Ni-rich layered cathodes. This study proposes a universal method for comprehensive improvement of structural stability based on the synergistic effect of dual-element cosubstitution in Ni-rich layered oxide cathodes, which is being explored for production of high-cycle-stability lithium-ion batteries.Some bacteria uniquely produce "bacterial polyynes", which possess a conjugated C≡C bond starting with a terminal alkyne, and use them as chemical weapons against hosts and competitors. KI-20227 Pseudomonas protegens Cab57, a biocontrol agent against plant pathogens, has an orphan biosynthetic gene cluster for bacterial polyynes (named protegenins). In this study, the isolation, structure elucidation, and biological characterization of protegenins A-D are reported. The structures of protegenins A-D determined by spectroscopic and chemical techniques were octadecanoic acid derivatives possessing an ene-tetrayne, ene-triyne-ene, or ene-triyne moiety. The protegenins exhibited weak to strong antioomycete activity against Pythium ultimum OPU774. The deletion of proA, a protegenin biosynthetic gene, resulted in the reduction of the antioomycete activity of P. protegens. The Gac/Rsm system, a quorum sensing-like system of Pseudomonas bacteria, regulated the production of protegenins. The production profile of protegenins was dependent on the culturing conditions, suggesting a control mechanism for protegenin production selectivity. P. protegens suppressed the damping-off of cucumber seedlings caused by P. ultimum, and this protective effect was reduced in the proA-deletion mutant. Altogether, protegenins are a new class of bacterial polyynes which contribute to the antioomycete and plant-protective effects of P. protegens.

Obstructive sleep apnea (OSA) is often associated with clinical, psychological and neuropsychological comorbidities such as Mild Cognitive Impairment (MCI). This study evaluated changes in clinical, psychosocial, Health Related Quality of Life (HRQoL) and neuropsychological profile in OSA subjects after ventilatory therapy, making comparison with normative data. The aim of the study was to verify the suitability of the HRQoL and neuropsychological screening tests in detecting variations in OSA subjects.

At baseline, 32 OSA subjects underwent the following assessment EuroQol (EQ-5D-3L) and EQ VAS, Hospital Anxiety and Depression Scale (HADS), Montreal Cognitive Assessment (MoCA) and Frontal Assessment Battery (FAB). After the ventilatory titration, 31 OSA subjects repeated the EQ VAS, MoCA and FAB assessment.

The analyzed subjects (77% male, 58.97±10.06 years old and 47.34±26.67 AHI [ev*hr

]) showed low emotive distress, a lower perception of HRQoL than normative data and 35.48% of them exhibited executive deficits, too. MCI was detected in 3.2% and 48.4% of subjects after normative Italian and international correction, respectively. Subsequently the ventilatory therapy and the rehabilitative interdisciplinary treatment, subjects improved in EQ VAS (68.23±18.73 vs. 87.13±10.80, P=0.0001), FAB scores (15,30±2.03 vs. 16,65±1,40, P=0.007) and MoCA memory subtest scores (2.16±1.34 vs. 3.06±1.63, P=0.008).

Ventilatory therapy provided during a rehabilitative and interdisciplinary program increased subjects' HRQoL, executive functions and verbal memory.

Ventilatory therapy provided during a rehabilitative and interdisciplinary program increased subjects' HRQoL, executive functions and verbal memory.

Gonadotropin-releasing hormone agonist (GnRHa) has been the mainstay of central precocious puberty (CPP) treatment for decades, although there have been few reports comparing the efficacy between 1-month and 3-month depot GnRHa formulations. This study aimed to investigate the short-term efficacy of 1-month and 3-month depot GnRHa in girls with CPP.

Overall, 150 girls with CPP were included from a retrospective review of their medical records. Subjects in group 1 (n=105) were treated with 1-month depot GnRHa for ≥12 months and those in group 2 (n=45) with 1-month depot for 6 months and subsequent 3-month depot GnRHa for ≥6 months. Anthropometric and biochemical data were compared between groups at three time points (0, 6, and 12 months after GnRHa treatment).

Demographic and clinical characteristics showed no difference between groups at baseline and 6 months after GnRHa treatment. After 12 months of GnRHa treatment, patients in both groups showed no difference in bone age (BA), chronological age (CA), BA-CA difference, height standard deviation score (SDS) for CA and BA, and body mass index SDS for CA and BA. The sexual maturity rate of the breast was prepubertal at 12 months in all subjects. GnRH-stimulated luteinizing hormone (LH) levels were suppressed during GnRHa treatment in both groups at 6 and 12 months, although LH levels in group 2 were higher than those in group 1.

Treatment with a 3-month depot GnRHa in CPP showed comparable short-term efficacy to the 1-month depot for anthropometric parameters and pubertal suppression.

Treatment with a 3-month depot GnRHa in CPP showed comparable short-term efficacy to the 1-month depot for anthropometric parameters and pubertal suppression.Differential diagnosis of hypercalcemia in children includes hyperthyroidism, infection, inflammatory processes, malignant tumors. Immobilization-induced hypercalcemia is rare in healthy individuals; it can occur in adolescent males, especially after a fracture. Immobility caused increased skeletal calcium release and hypercalcemia, and this condition is also known as resorptive hypercalcemia. We present here a 10-year-old adolescent girl with advanced heart failure who underwent HeartMate 3 (HM3) left ventricular assist device (LVAD) implantation. She had symtomps abdominal pain, vomiting, and constipation on the 5th month of hospitalization. She subsequently developed immobilization-induced symptomatic hypercalcemia (serum calcium, 12.1 mg/dL; corrected calcium 12.8 mg/dL; parathormone (PTH), 1.9 pg/mL; calcium/creatinine ratio in spot urine, 1.21). Hypercalcemia is uncommon in children with advanced heart failure (HF). The bisphosphonate therapy was initiated because our patient did not respond to hydration and furosemide treatment, and she had abdominal pain, vomiting, and constipation. The patient's complaints were resolved on the second day after administrating bisphosphonate and hypercalcemia did not recur.

The gold standard for assessing pubertal activation is the gonadotropin-releasing hormone (GnRH) stimulation test (GnRHST), which is invasive, time-consuming and inconvenient. This study evaluated whether a single random measurement of urinary luteinizing hormone (LH) concentration could substitute for the GnRHST in diagnosing and monitoring central precocious puberty (CPP) in girls.

Fifty-five girls with breast buds before 8 years of age were assessed by both the GnRHST and urinary gonadotropin assays. Based on GnRHST results, 29 girls were assigned to the CPP group (peak LH ≥ 5 IU/L) and 26 to the premature thelarche (PT) group (peak LH < 5 IU/L). Auxological data and urine and serum samples were collected at baseline and after treatment with GnRH agonist for 12 and 24 weeks.

Although auxological data did not differ between the two groups, the levels of insulin-like growth factor-1, basal LH and follicle stimulating hormone (FSH), estradiol, peak LH, urinary LH, and peak LH/FSH and urinary LH/FSH ratios were higher in the CPP than in the PT group. Pearson's correlation analysis showed a positive correlation between urinary and serum LH concentration (r = 0.660, P < 0.001). Receiver-operating characteristic curve analyses showed that urinary LH concentration 0.725 IU/L was a cutoff significantly reflecting positivity on the GnRHST. Urinary LH and FSH concentrations declined significantly during GnRH agonist treatment.

A single, random measurement of urinary gonadotropin concentration may be reliable for the initial screening and monitoring of CPP in girls.

A single, random measurement of urinary gonadotropin concentration may be reliable for the initial screening and monitoring of CPP in girls.Myhre syndrome (MS) is a rare autosomal dominant disorder characterized by short stature, intellectual disability, skeletal anomalies, restricted joint mobility, distinctive facial dysmorphism, and deafness. Early diagnosis of MS is difficult because its features progress and become noticeable at school age. Recently, the SMAD4 gene was identified as the major gene responsible for MS. Herein, we report the first Korean case of MS after identification of a SMAD4 mutation by clinical exome sequencing. The patient was born as small for gestational age and she had typical clinical features of MS, including short stature, characteristic facial appearance, developmental delay, and selective mutism. She was diagnosed with central precocious puberty. Because of her precocious puberty and short stature, we subsequently administered combined recombinant human growth hormone and gonadotropin-releasing hormone agonist treatments, which resulted in improved height. While there have been 79 reported cases worldwide, to our knowledge, this is the first case of genetically confirmed MS in Korea.

This study aimed to evaluate the time interval to menarche after gonadotropin-releasing hormone agonist (GnRHa) treatment in females with central precocious puberty (CPP) and identify factors contributing to timing of menarche.

We retrospectively reviewed medical records of 39 females with CPP who reached menarche after GnRHa treatment (leuprolide or histrelin). CPP diagnostic criteria were breast development <8 years, pubertal luteinizing hormone and/or estradiol concentrations, and bone age advancement. Indications to treat are advanced bone age and psychosocial concerns. Descriptive summaries were reported as frequency and proportion for categorical variables and mean and standard deviation for continuous measures. Linear regression models were performed to evaluate the association between clinical factors with the time interval to menarche.

Mean age was 9.4±1.6 years at treatment onset and treatment duration was 2.2±1.4 years. Menarche occurred at 12.6±1.1 years, which was 1.04±0.5 years after treatment discontinuation.

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