We reveal a unique mechanism by which pure water can be dissociated to form free radicals without requiring catalysts, electrolytes, or electrode contact by means of high-frequency nanometer-amplitude electromechanical surface vibrations in the form of surface acoustic waves (SAWs) generated on a piezoelectric substrate. The physical undulations associated with these mechanical waves, in concert with the evanescent electric field arising from the piezoelectric coupling, constitute half-wavelength "nanoelectrochemical cells" in which liquid is trapped within the SAW potential minima with vertical dimensions defined by the wave amplitude (∼10 nm), thereby forming highly confined polarized regions with intense electric field strengths that enable the breakdown of water. The ions and free radicals that are generated rapidly electromigrate under the high field intensity in addition to being convectively transported away from the cells by the bulk liquid recirculation generated by the acoustic excitation, thereby overcoming mass transport limitations that lead to ion recombination.
This paper proposes recommendations for probiotics in pediatric gastrointestinal diseases in the Asia-Pacific region. Evidence-based recommendations and randomized controlled trials in the region are included. Cultural aspects, health management issues and economic factors were also considered. Final recommendations were approved by utilizing a modified Delphi process and applying the Likert scale in an electronic voting process. Bacillus clausii was recommended as an adjunct treatment with oral rehydration solution for acute viral diarrhea. B. clausii may also be considered for prevention of antibiotic-associated diarrhea, Clostridium difficile-induced diarrhea, and as adjunct treatment of Helicobacter pylori. There is insufficient evidence for recommendations in other conditions. Despite a diversity of epidemiological, socioeconomical and health system conditions, similar recommendations currently apply to most Asia-Pacific countries. Ideally, these need to be validated with local randomized-controlled trials.