Directly converting sunlight into hydrogen fuels using particulate photocatalysts represents a sustainable route for clean energy supply. Organic semiconductors have emerged as attractive candidates but always suffer from optical and exciton recombination losses with large exciton “dead zone” inside the bulk material, severely limiting the catalytic performance. Herein, we demonstrate a facile strategy that combines a scalable flash nanoprecipitation (FNP) method with hydrophilic soluble polymers (PC-PEG5 and PS-PEG5) to prepare highly efficient nanosized photocatalysts without using surfactants. Significantly, a 70-fold enhancement of hydrogen evolution rate (HER) is achieved for nanosized PC-PEG5, and the FNP-processed PS-PEG5 shows a peak HER rate of up to 37.2 mmol h-1  g-1 under full-spectrum sunlight irradiation, which is among the highest results for polymer photocatalysts. A scaling-up production of nanocatalyst is demonstrated with the continuously operational FNP.

Patients with stageIIC malignant melanoma are recommended to undergo cross-sectional imaging for initial staging. PET/CT is superior to other methods regarding its diagnostic accuracy of the tumor spread in stageIII. So far there is no meaningful data on the nationwide availability, usage and cost recovery of this imaging technique.

Questionnaires on the healthcare situation in 2018 were sent to all German dermatology clinics and PET/CT centers in March and April 2019.

61.2% of the dermatology clinics (71/115) and 48.2% of the PET/CT centers (77/160) took part in the survey. A total of 22,645 patients with malignant melanoma were seen in these clinics in 2018. 16.8% of the patients with stageIIC melanoma received a PET/CT for primary staging. The costs of this examination were covered for all statutory and privately insured patients in 40% and 68% of dermatology clinics (20/50 and 34/50), respectively. 68.0% (34/50) of all dermatology clinics reported relevant changes of treatment according to PET/CT findings. Long examination periods by the health insurance companies and the time required to submit the application were the most common reasons for dermatology clinics to reject a request for PET/CT. Relevant incidental findings were reported in 90.2% (47/51) of all PET/CT centers.

There are clear differences in the nationwide availability and cost coverage of PET/CT in primary staging for stageIIC melanoma. For these reasons, a two-tiered healthcare system may be assumed.

There are clear differences in the nationwide availability and cost coverage of PET/CT in primary staging for stage IIC melanoma. For these reasons, a two-tiered healthcare system may be assumed.

The aim of this study was to evaluate the efficacy of lurasidone in acute schizophrenia in Japan and other countries.

Subjects (aged 18-74 years) diagnosed with schizophrenia were randomized to lurasidone 40 mg/day or placebo. The primary efficacy endpoint was change from baseline on the Positive and Negative Syndrome Scale (PANSS) total score at Week 6. Secondary efficacy assessments included the Clinical Global Impression-Severity Scale (CGI-S). Safety endpoints included adverse events, and laboratory and electrocardiogram parameters.

A total of 483 subjects were randomized to lurasidone or placebo; 107 subjects were from Japan. Mean changes from baseline at Week 6 endpoint in PANSS total scores were -19.3 in the lurasidone group and -12.7 in the placebo group (treatment difference P < 0.001, effect size=0.41). Changes from baseline for Week 6 CGI-S scores were -1.0 for lurasidone and -0.7 for placebo (treatment difference P < 0.001, effect size=0.41). All-cause discontinuation during the 6-week, double-blind period was 19.4% for lurasidone and 25.4% for placebo, and discontinuation rates due to adverse event were 5.7% for lurasidone and 6.4% for placebo. The following common treatment-emergent adverse events occurred in more than 2% on lurasidone and at a rate at least twice that of the placebo group akathisia (4.0%), dizziness (2.8%), somnolence (2.8%), abdominal discomfort (2.0%) and asthenia (2.0%). No significant changes in bodyweight or metabolic parameters were observed.

Lurasidone 40 mg once daily dosing demonstrated efficacy in a patient population with acute schizophrenia, including subjects from Japan, and was generally safe and well-tolerated.

Lurasidone 40 mg once daily dosing demonstrated efficacy in a patient population with acute schizophrenia, including subjects from Japan, and was generally safe and well-tolerated.

Family caregivers play an important role for patients admitted to the intensive care unit (ICU), and delirium is a common clinical syndrome. Abexinostat order Little is known about the experiences of family caregivers when a relative is a patient with delirium, especially for caregivers in Asian cultures.

To understand the experience of family caregivers with a family member as a patient with delirium in the ICU in Taiwan.

A descriptive qualitative study with in-depth face-to-face semi-structured interviews.

Interviews were conducted with 20 family caregivers of 20 patients with delirium in the ICU of a hospital in northern Taiwan.

The core theme describing the phenomenon of family caregivers of a patient with delirium was “Sailing in a sea of perplexity,” which described family caregivers’ uncertainty of navigating the ICU and providing support for a relative. Three subthemes described the core theme (a) perplexity of the ICU environment, (b) perplexity of making decisions, and (c) perplexity of Chinese cultural con communication between staff and caregivers. Hospitals can also provide information on their websites, including treatment of delirium and visitation hours. Information access could be enhanced by developing a smartphone app linked to a QR code that families can scan to obtain information, which would be useful during restricted visitation.

Acute stroke treatment in mobile stroke units (MSU) is feasible and reduces time-to-treatment, but the optimal staffing model is unknown. We wanted to explore if integrating thrombolysis of acute ischemic stroke (AIS) in an anesthesiologist-based emergency medical services (EMS) reduces time-to-treatment and is safe.

A nonrandomized, prospective, controlled intervention study.

age ≥18years, nonpregnant, stroke symptoms with onset ≤4h. The MSU staffing is inspired by the Norwegian Helicopter Emergency Medical Services crew with an anesthesiologist, a paramedic-nurse and a paramedic. Controls were included by conventional ambulances in the same catchment area. Primary outcome was onset-to-treatment time. Secondary outcomes were alarm-to-treatment time, thrombolytic rate and functional outcome. Safety outcomes were symptomatic intracranial hemorrhage and mortality.

We included 440 patients. MSU median (IQR) onset-to-treatment time was 101 (71-155) minutes versus 118 (90-176) minutes in controls, p=0.007.