Regulating Phase Separation Kinetics for High-Efficiency and Mechanically Robust All-Polymer Solar Cells

All-polymer solar cells (all-PSCs) possess excellent operation stability and mechanical robustness than other types of organic solar cells, thereby attracting considerable attention for wearable flexible electron devices. However, the power conversion efficiencies (PCEs) of all-PSCs are still lagging behind those of small-molecule-acceptor-based systems owing to the limitation of photoactive materials and unsatisfactory blend morphology. In this work, a novel terpolymer, denoted as PBDB-TFCl (poly4,8-bis(5-(2-ethylhexyl)-4-fluorothiophen-2-yl)benzo[1,2-b:4,5-b″]dithiophene-1,3-bis(2-ethylhexyl)-5,7-di(thiophen-2-yl)-4H,8H-benzo[1,2-c:4,5-c″]dithiophene-4,8-dione-4,8-bis(4-chloro-5-(2-ethylhexyl)thiophen-2-yl)benzo[1,2-b:4,5-b']dithiophene), is used as an electron donor coupled with a ternary strategy to optimize the performance of all-PSCs. The addition of PBDB-TCl unit deepens the highest occupied molecular orbital energy level, reducing voltage losses. Moreover, the introduction of the guest donor (D18-Cl) effectively regulates the phase-transition kinetics of PBDB-TFCl:D18-Cl:PY-IT during the film formation, leading to ideal size of aggregations and enhanced crystallinity. PBDB-TFCl:D18-Cl:PY-IT devices exhibit a PCE of 18.6% (certified as 18.3%), judged as the highest value so far obtained with all-PSCs. Besides, based on the ternary active layer, the manufactured 36 cm2 flexible modules exhibit a PCE of 15.1%. Meanwhile, the ternary PSCs exhibit superior photostability and mechanical stability. In summary, the proposed strategy, based on molecular design and the ternary strategy, allows optimization of the all-polymer blend morphology and improvement of the photovoltaic performance for stable large-scale flexible PSCs.

Low-Cost Fully Non-fused Ring Acceptor Enables Efficient Organic Photovoltaic Modules for Multi-Scene Applications

Organic photovoltaic (OPV) cells, with highly tunable light-response ranges, offer significant potential for use in driving low-power consumption off-grid electronics in multi-scenarios. However, development of photoactive layer materials that can meet simultaneously the requirements of diverse irradiation conditions is a still challenging task. Herein, a low-cost fully non-fused acceptor (denoted as GS60) featuring well-matched absorption spectra with solar, scattered light and artificial light radiation was designed and synthesized. Systematic characterizations revealed that GS60 possessed outstanding photoelectron properties and ideal morphology, which resulted in reduced voltage loss and suppressed charge recombination. By blending with a non-fused ring polymer PTVT-T, the as-obtained GS60 based OPV cells achieved a good power conversion efficiency (PCE) of 14.1 %, a high value for the cells based on non-fused ring bulk heterojunction. Besides, manufactured large-area OPV modules based on PTVT-T:GS60 yielded PCEs of 11.2 %, 11.8 %, 12.1 %, 23.1 %, and 20.3 % under irradiation of AM 1.5G, natural light of cloudy weather, natural light in shadow, laser and indoor, respectively. The PTVT-T:GS60 devices exhibited considerable potential in terms of improving photostability and reducing material cost. Overall, this work provides novel insight into the molecular design of low-cost non-fused ring acceptors, and extended potential of medium band gap acceptors based OPV cells used in various application scenarios.

Organic laser power converter for efficient wireless micro power transfer

Wireless power transfer with collimated power transmission and efficient conversion provides an alternative charging mode for off-grid and portable micro-power electronics. However, charging micro-power electronics with low photon flux can be challenging for current laser power converters. Here we show laser power converters with organic photovoltaic cells with good performance for application in laser wireless power transfer. The laser selection strategy is established and the upper limit of efficiency is proposed. The organic laser power converters exhibit a 36.2% efficiency at a 660 nm laser with a photon flux of 9.5 mW cm-2 and achieve wireless micro power transfer with an output of 0.5 W on a 2 meter scale. This work shows the good performance of organic photovoltaic cells in constructing organic laser power converters and provides a potential solution for the wireless power transfer of micro-power electronics.

Tandem organic solar cells with 20.6% efficiency enabled by reduced voltage losses

Large voltage losses are the main obstacle for achieving high efficiency in organic solar cells (OSCs). Here we construct ternary OSCs by introducing an asymmetric small molecule acceptor AITC into PBDB-TCl : BTP-eC9 system and demonstrate the effectiveness in simultaneously decreasing energy disorder and non-radiative voltage losses. It is found that the introduction of AITC can modify domain size and increase the degree of crystallinity, which enhances open-circuit voltage and power conversion efficiency (19.1%, certified as 18.9%). Inspiringly, an output efficiency of 20.6% of the constructed tandem OSCs based on PBDB-TCl : AITC : BTP-eC9 ternary active layer output a recorded efficiency of 20.6% (certified as 20.3%), which is the highest value in OSCs field to date. This work demonstrates that decreasing the voltage losses by ternary strategy and constructing of tandem architecture are effective approaches towards improving photovoltaic performance.

Enhancing Photon Utilization Efficiency for High-Performance Organic Photovoltaic Cells via Regulating Phase-Transition Kinetics

Efficient photon utilization is key to achieving high-performance organic photovoltaic (OPV) cells. In this study, a multiscale fibril network morphology in a PBQx-TCl:PBDB-TF:eC9-2Cl-based system is constructed by regulating donor and acceptor phase-transition kinetics. The distinctive phase-transition process and crystal size are systematically investigated. PBQx-TCl and eC9-2Cl form fibril structures with diameters of ≈25 nm in ternary films. Additionally, fine fibrils assembled by PBDB-TF are uniformly distributed over the fibril networks of PBQx-TCl and eC9-2Cl. The ideal multiscale fibril network morphology enables the ternary system to achieve superior charge transfer and transport processes compared to binary systems; these improvements promote enhanced photon utilization efficiency. Finally, a high power conversion efficiency of 19.51% in a single-junction OPV cell is achieved. The external quantum efficiency of the optimized ternary cell exceeds 85% over a wide range of 500-800 nm. A tandem OPV cell is also fabricated to increase solar photon absorption. The tandem cell has an excellent PCE of more than 20%. This study provides guidance for constructing an ideal multiscale fibril network morphology and improving the photon utilization efficiency of OPV cells.

Binary Organic Solar Cells with 19.2% Efficiency Enabled by Solid Additive

Morphology optimization is critical for achieving high efficiency and stable bulk-heterojunction (BHJ) organic solar cells (OSCs). Herein, the use of 3,5-dichlorobromobenzene (DCBB) with high volatility and low cost to manipulate evolution of the BHJ morphology and improve the operability and photostability of OSCs is proposed. Systematic simulations reveal the charge distribution of DCBB and its non-covalent interaction with the active layer materials. The addition of DCBB can effectively tune the aggregation of PBQx-TF:eC9-2Cl during film formation, resulting in a favorable phase separation and a reinforced molecular packing. As a result, a power conversion efficiency of 19.2% (certified as 19.0% by the National Institute of Metrology) for DCBB-processed PBQx-TF:eC9-2Cl-based OSCs, which is the highest reported value for binary OSCs, is obtained. Importantly, the DCBB-processed devices exhibit superior photostability and have thus considerable application potential in the printing of large-area devices, demonstrating outstanding universality in various BHJ systems. The study provides a facile approach to control the BHJ morphology and enhances the photovoltaic performance of OSCs.

A Medium-Bandgap Nonfullerene Acceptor Enabling Organic Photovoltaic Cells with 30% Efficiency under Indoor Artificial Light

The correlation between molecular structure and photovoltaic performance is lagging for constructing high-performance indoor organic photovoltaic (OPV) cells. Herein, this relationship is investigated in depth by employing two medium-bandgap nonfullerene acceptors (NFAs). The newly synthesized NFA of FTCCBr exhibits a similar bandgap and molecular energy level, but a much stronger dipole moment and larger average electrostatic potential (ESP) compared with ITCC. After blending with the polymer donor PB2, the PB2:ITCC and PB2:FTCCBr blends exhibit favorable bulk-heterojunction morphologies and the same driving force, but the PB2:FTCCBr blend exhibits a large ESP difference. In OPV cells, the PB2:ITCC-based device produces a power conversion efficiency (PCE) of 11.0%, whereas the PB2:FTCCBr-based device gives an excellent PCE of 14.8% with an open-circuit voltage (V_OC ) of 1.05 V, which is the highest value among OPV cells with V_OC values above 1.0 V. When both acceptor-based devices work under a 1000 lux of 3000 K light-emitting diode, the PB2:ITCC-based 1 cm² device yields a good PCE of 25.4%; in contrast, the PB2:FTCCBr-based 1 cm² device outputs a record PCE of 30.2%. These results suggest that a large ESP offset in photovoltaic materials is important for achieving high-performance OPV cells.

A New Polymer Donor Enables Binary All-Polymer Organic Photovoltaic Cells with 18% Efficiency and Excellent Mechanical Robustness

The development of polymerized small-molecule acceptors has boosted the power conversion efficiencies (PCEs) of all-polymer organic photovoltaic (OPV) cells to 17%. However, the polymer donors suitable for all-polymer OPV cells are still lacking, restricting the further improvement of their PCEs. Herein, a new polymer donor named PQM-Cl is designed and its photovoltaic performance is explored. The negative electrostatic potential and low average local ionization energy distribution of the PQM-Cl surface enable efficient charge generation and transfer process. When blending with a well-used polymer acceptor, PY-IT, the PQM-Cl-based devices deliver an impressive PCE of 18.0% with a superior fill factor of 80.7%, both of which are the highest values for all-polymer OPV cells. The relevant measurements demonstrate that PQM-Cl-based films possess excellent mechanical and flexible properties. As such, PQM-Cl-based flexible photovoltaic cells are fabricated and an excellent PCE of 16.5% with high mechanical stability is displayed. These results demonstrate that PQM-Cl is a potential candidate for all-polymer OPV cells and provide insights into the design of polymer donors for high-efficient all-polymer OPV cells.

A High-Performance Nonfused Wide-Bandgap Acceptor for Versatile Photovoltaic Applications

Wide-bandgap (WBG) nonfullerene acceptors (NFAs) with nonfused conjugated structures play a critical role in organic photovoltaic (OPV) cells. Here, NFAs named GS-OEH, GS-OC6, and GS-ISO, with optical bandgaps larger than 1.70 eV, are synthesized without using the fused ring structures. Compared with GS-OEH and GS-OC6, GS-ISO exhibits much stronger crystallinity, leading to a smaller energetic disorder and a larger exciton diffusion coefficient. GS-ISO also possesses a higher electroluminescence external quantum efficiency of 1.0 × 10^-2 . The OPV cell based on PBDB-TF:GS-ISO demonstrates a power conversion efficiency (PCE) of 11.62% under the standard one sun illumination. Besides, the PBDB-TF:GS-ISO-based cell with effective area of 1.0 cm²  exhibits a PCE of 28.37% under 2700 K illumination of 500 lux. A tandem OPV cell using PBDB-TF:GS-ISO as the front subcell shows an outstanding efficiency of 19.10%. Importantly, the GS-ISO-based OPV cell exhibits promising stability under the continuous illumination of simulated sunlight. This study indicates that the molecular design strategy demonstrated in this work has great superiority in developing nonfused NFAs and also that GS-ISO is a promising WBG acceptor for versatile photovoltaic applications.

A Universal Nonhalogenated Polymer Donor for High-Performance Organic Photovoltaic Cells

Nonhalogenated polymers have great potential in the commercialization of organic photovoltaic (OPV) cells due to their advantage in low-cost preparation. However, non-halogenated polymers usually have high highest occupied molecular orbital (HOMO) energy levels and inferior self-aggregation properties in solution, thus resulting in low power conversion efficiencies (PCEs). Herein, two nonhalogenated polymers, PB1 and PB2, are prepared. When the polymers are used to fabricate OPV cells with BTP-eC9, the PB1-based device only gives a PCE of 5.3%, while the PB2-based device shows an outstanding PCE of 17.7%. After the introduction of PBDB-TF as the third component, the PB2:PBDB-TF:BTP-eC9-based device with an optimal weight ratio of 0.5:0.5:1 achieves a PCE up to 18.4%. More importantly, PB2 exhibits good compatibility with various nonfullerene acceptors to achieve better PCEs than those of classical polymer (PBDB-T and PBDB-TF)-based devices. When PB2 is combined with a wide-bandgap electron acceptor (F-BTA3), this device shows excellent PCE of 27.1% and 24.6% for 1 and 10 cm² devices, respectively, under light intensity of 1000 lux light-emitting diode illumination. These results provide new insight in the rational design of novel nonhalogenated polymer donors for further development of low-cost materials and broadening the application of OPV cells.

Effects of high temperatures on poor mental health outcomes: a systematic review and meta-analysis

Background

In the context of warming temperature and increased prevalence of mental disorders, a growing body of literature suggests the adverse effects of high temperatures on mental health. However, no study has quantitatively summarised the evidence. This study therefore systematically reviews the epidemiological evidence and summarises the quantitative effects of high temperatures on mental health outcomes, including mortality and morbidity.

Methods

A systematic search of peer-reviewed epidemiological studies in five databases that linked high temperatures and mental health was conducted on literature published till November 2020. A range of mental health conditions were defined using ICD-10 classifications. We included studies that examined the quantitative association between temperatures and mental health mortality or morbidity (i.e. hospital admissions, emergency presentations) in the general population. Random-effects models were used to summarise the percentage changes in mental health outcomes per 1 °C temperature increase.

Results

The keyword search yielded 4560 citations from which 34 studies were included in the meta-analysis. For 1 °C increase in temperature, the risk of mental health-related mortality and morbidity increased by 2.2% (95%CI: 1.5-2.9%) and 0.9% (95%CI: 0.7-1.5%). The greatest risk was associated with mortality attributed to substance-related mental disorders (4.6%; 95%CI: 0-10.1%), and organic mental disorders (3.3%; 95%CI: 2-4.6%). A 1 °C temperature rise was also associated with a statistically significant increase in morbidity such as mood disorders, organic mental disorders, and schizophrenia. Higher risk was evident for elderly and populations living in tropical and subtropical climate zones.

Conclusions

Our results suggest that exposure to high temperatures increases the risk of poor mental health outcomes. These risks will likely increase with a warming climate.

Key messages

High temperatures are associated with poor mental health outcomes, including mortality and morbidity. The findings reinforce the need for preventive intervention to protect vulnerable populations.

Heatwave-related morbidity in Australia: Effect modification by Individual and Area-level factors

Background

Heatwaves are associated with increases in mortality, emergency department visits, and hospital admissions. However, evidence regarding heatwave impacts on general practice (GP) visits is limited. The objectives of this study were to quantify the impact of heatwaves on GP visits in Australia and identify the individual and area-level factors that modify the heatwave-GP visits association.

Methods

Warm-season (October-March) GP visits data (2011-2016) were obtained from the Australian Bureau of Statistics. Using a case-crossover approach we assessed the effect of heatwaves (defined using Excess Heat Factor) on GP visits at the Statistical Area Level 2 (SA2) spatial unit (reflecting suburbs), as well as effect modification by individual and area-level factors. Results are reported as percent increase in GP visits during severe/extreme heatwaves compared with non-heatwaves.

Results

Nationally, GP visits increased by 4% (95%CI: 3-4%) during severe/extreme heatwaves. But impacts varied with the highest effect observed in Canberra (16.4%; 95%CI:15.4-17.4%), Adelaide (14.9%; 95%CI: 14.3-15.4%), and regional Victoria (13.5%; 95%CI: 13-14%). A gradient of impact was found within locations, for example, vulnerable SA2s nationally were featured by a higher proportion of populations with no air-conditioning, low income, limited English proficiency, living alone, and a prevalence of diabetes and circulatory diseases. Individual-level factors included those: living alone, with limited English proficiency, with diabetes, hypertension and using anti-coagulants and diuretic medications.

Conclusions

Heatwaves increase GP visits in Australia, with impacts varied between locations and populations, affecting certain areas and individuals disproportionately. Our results using an individual and area-level linked data suggest that local area and individual vulnerabilities should be incorporated when developing place-based interventions combating heatwave-health impacts.

Key messages

Heatwaves increase GP visits in Australia, but with spatial variability across and within locations. Individual and area-level factors contribute to heatwave-vulnerability.

18.5% Efficiency Organic Solar Cells with a Hybrid Planar/Bulk Heterojunction

The donor:acceptor heterojunction has proved as the most successful approach to split strongly bound excitons in organic solar cells (OSCs). Establishing an ideal architecture with selective carrier transport and suppressed recombination is of great importance to improve the photovoltaic efficiency while remains a challenge. Herein, via tailoring a hybrid planar/bulk structure, highly efficient OSCs with reduced energy losses (E_loss s) are fabricated. A p-type benzodithiophene-thiophene alternating polymer and an n-type naphthalene imide are inserted on both sides of a mixed donor:acceptor active layer to construct the hybrid heterojunction, respectively. The tailored structure with the donor near the anode and the acceptor near the cathode is beneficial for obtaining enhanced charge transport, extraction, and suppressed charge recombination. As a result, the photovoltaic characterizations suggest a reduced nonradiative E_loss by 25 meV, and the best OSC records a high efficiency of 18.5% (certified as 18.2%). This study highlights that precisely regulating the structure of donor:acceptor heterojunction has the potential to further improve the efficiencies of OSCs.

Single-Junction Organic Photovoltaic Cell with 19% Efficiency

Improving power conversion efficiency (PCE) is important for broadening the applications of organic photovoltaic (OPV) cells. Here, a maximum PCE of 19.0% (certified value of 18.7%) is achieved in single-junction OPV cells by combining material design with a ternary blending strategy. An active layer comprising a new wide-bandgap polymer donor named PBQx-TF and a new low-bandgap non-fullerene acceptor (NFA) named eC9-2Cl is rationally designed. With optimized light utilization, the resulting binary cell exhibits a good PCE of 17.7%. An NFA F-BTA3 is then added to the active layer as a third component to simultaneously improve the photovoltaic parameters. The improved light unitization, cascaded energy level alignment, and enhanced intermolecular packing result in open-circuit voltage of 0.879 V, short-circuit current density of 26.7 mA cm^-2 , and fill factor of 0.809. This study demonstrates that further improvement of PCEs of high-performance OPV cells requires fine tuning of the electronic structures and morphologies of the active layers.

Suppressing Energetic Disorder Enables Efficient Indoor Organic Photovoltaic Cells With a PTV Derivative

Indoor organic photovoltaics (IOPVs) cells have attracted considerable attention in the past few years. Herein, two PTV-derivatives, PTVT-V and PTVT-T, were used as donor materials to fabricate IOPV cells with ITCC as the acceptor. The preferred orientation of the crystals changed from edge-on to face-on after replacing the ethylene in the backbones of PTVT-V by the thiophene in that of PTVT-T. Besides, it was found that, the energetic disorder of the PTVT-T:ITCC based system is 58 meV, which is much lower than that of PTVT-V:ITCC-based system (70 meV). The lower energetic disorder in PTVT-T:ITCC leads to an efficient charge transfer, charge transport, and thus the weak charge recombination. As a result, a PCE of 9.60% under AM 1.5 G and a PCE of 24.27% under 1,000 lux (LED 2,700 K) with a low non-radiative energy loss of 0.210 eV were obtained based on PTVT-T:ITCC blend. The results indicate that to improve the PTV-derivatives photovoltaic properties by suppressing the energetic disorder is a promising way to realize low-cost IOPV cells.

Molecular design revitalizes the low-cost PTV-polymer for highly efficient organic solar cells

Developing photovoltaic materials with simple chemical structures and easy synthesis still remains a major challenge in the industrialization process of organic solar cells (OSCs). Herein, an ester substituted poly(thiophene vinylene) derivative, PTVT-T, was designed and synthesized in very few steps by adopting commercially available raw materials. The ester groups on the thiophene units enable PTVT-T to have a planar and stable conformation. Moreover, PTVT-T presents a wide absorption band and strong aggregation effect in solution, which are the key characteristics needed to realize high performance in non-fullerene-acceptor (NFA)-based OSCs. We then prepared OSCs by blending PTVT-T with three representative fullerene- and NF-based acceptors, PC₇₁BM, IT-4F and BTP-eC9. It was found that PTVT-T can work well with all the acceptors, showing great potential to match new emerging NFAs. Particularly, a remarkable power conversion efficiency of 16.20% is achieved in a PTVT-T:BTP-eC9-based device, which is the highest value among the counterparts based on PTV derivatives. This work demonstrates that PTVT-T shows great potential for the future commercialization of OSCs.

Effect of the Energy Offset on the Charge Dynamics in Nonfullerene Organic Solar Cells

The energy offset, considered as the driving force for charge transfer between organic molecules, has significant effects on both charge separation and charge recombination in organic solar cells. Herein, we designed material systems with gradually shifting energy offsets, including both positive and negative values. Time-resolved spectroscopy was used to monitor the charge dynamics within the bulk heterojunction. It is striking to find that there is still charge transfer and charge generation when the energy offset reached -0.10 eV (ultraviolet photoelectron spectroscopy data). This work not only indicates the feasibility of the free carrier generation and the following charge separation under the condition of a negative offset but also elucidates the relationship between the charge transfer and the energy offset in the case of polymer chlorination.

Heatwave-related Mortality in Australia: Who's impacted the most?

Background

The impacts of heatwaves on the risk of mortality have been well-documented worldwide. However, impacts are not equally spread across the population with certain subgroups and locations affected more than others, warranting local evidence to guide and improve prevention and adaptation strategies. The objectives of this study were to identify the person and area-level socio-demographic, health, and environmental factors that modify the heatwave-mortality association in Australia.

Methods

Warm-season (October-March) mortality (2007-2017) were obtained from the Australian Bureau of Statistics. Heatwaves were defined using Excess Heat Factor, a normalised metric of heatwave severity. A time-stratified case-crossover design was used to model heatwave-mortality associations at the Statistical Areas 2 (SA2) spatial unit. Effect modification by person and area-level factors was assessed using interaction terms.

Results

Nationally, mortality increased by 2% (Relative Risk-RR 1.02; 95%CI: 1.01-1.03) during heatwaves with 1418 excess deaths (95%CI: 723-2113). But impacts varied with the highest effect observed in Adelaide (RR 1.08; 95%CI: 1.04-1.12) and Regional Tasmania (RR 1.11; 95%CI: 1.04-1.18). A gradient of impact was found within locations, for example, vulnerable SA2s in Adelaide were featured by a higher proportion of people in rental housing, inaccessibilities (vehicle and internet), low vegetation, newer houses, and a prevalence of respiratory and psychological diseases. Person-level factors included those: renting privately, with a low English-speaking ability, with chronic health conditions (diabetes, asthma/chronic obstructive pulmonary diseases) and using antidepressants, anxiolytics and sedative medications.

Conclusions

Our results, leveraging person and area-level linked data, highlight the need to consider contextual and individual risk factors and the importance of developing place-based targeted interventions to reduce heatwave health impacts.

Key messages

Heatwaves increase mortality in Australia. Heatwave-vulnerability is determined by individual and community-level factors.

Organic photovoltaic cell with 17% efficiency and superior processability

The development of organic photoactive materials, especially the newly emerging non-fullerene electron acceptors (NFAs), has enabled rapid progress in organic photovoltaic (OPV) cells in recent years. Although the power conversion efficiencies (PCEs) of the top-performance OPV cells have surpassed 16%, the devices are usually fabricated via a spin-coating method and are not suitable for large-area production. Here, we demonstrate that the fine-modification of the flexible side chains of NFAs can yield 17% PCE for OPV cells. More crucially, as the optimal NFA has a suitable solubility and thus a desirable morphology, the high efficiencies of spin-coated devices can be maintained when using scalable blade-coating processing technology. Our results suggest that optimization of the chemical structures of the OPV materials can improve device performance. This has great significance in larger-area production technologies that provide important scientific insights for the commercialization of OPV cells.

Incidence Trends of Lip, Oral Cavity, and Pharyngeal Cancers: Global Burden of Disease 1990–2017

The worldwide incidence trends of the lip, oral cavity, and pharyngeal cancers (LOCPs) need to be updated. This study aims to examine the temporal incidence trends of LOCPs from 1990 to 2017, using the latest Global Burden of Disease (GBD) study data to explore sex, age, and regional differences. GBD incidence data for LOCPs were driven by population cancer registries and were estimated from mortality data. Age-standardized incidence rates (ASIRs) were directly extracted from the 2017 GBD database to calculate the estimated annual percentage change (EAPC) over the study period. Incidence trends are mapped and compared separately by sex (females vs. males), age groups (15–49, 50–69, and 70+ y), regions (21 geographical and 5 sociodemographic regions), and countries. Among 678,900 incident cases of LOCPs notified in 2017, more than half were lip and oral cavity cancers. From 1990 to 2017, the estimated global incidence for nasopharyngeal cancers decreased dramatically (EAPC = −1.52; 95% confidence interval [CI], –1.70 to −1.34), while the incidence for lip and oral cavity cancers (EAPC = 0.26; 95% CI, 0.16–0.37) and other pharyngeal cancers (EAPC = 0.62; 95% CI, 0.54–0.71) increased. Higher ASIRs were observed among males than females across all age groups. However, females had larger EAPC variation when compared to males. Population groups aged 15 to 49 y presented the lowest ASIRs, with larger values of EAPC than those aged 50 to 69 and 70+ y. While high-income countries had higher ASIRs with little EAPC variation, ASIRs varied across low/middle-income regions with larger EAPC variations. South Asia and East Asia had the highest ASIRs and EAPC for lip and oral cavity cancers, respectively. In conclusion, the global incidence of LOCPs has increased among females, those aged 15 to 49 y, and people from low/middle-income countries over the study period, excepting nasopharyngeal cancers, which had a decreasing worldwide trend.

Morphology Control Enables Efficient Ternary Organic Solar Cells

Ternary organic solar cells are promising alternatives to the binary counterpart due to their potential in achieving high performance. Although a growing number of ternary organic solar cells are recently reported, less effort is devoted to morphology control. Here, ternary organic solar cells are fabricated using a wide-bandgap polymer PBT1-C as the donor, a crystalline fused-ring electron acceptor ITIC-2Cl, and an amorphous fullerene derivative indene-C₆₀ bisadduct (ICBA) as the acceptor. It is found that ICBA can disturb π-π interactions of the crystalline ITIC-2Cl molecules in ternary blends and then help to form more uniform morphology. As a result, incorporation of 20% ICBA in the PBT1-C:ITIC-2Cl blend enables efficient charge dissociation, negligible bimolecular recombination, and balanced charge carrier mobilities. An impressive power conversion efficiency (PCE) of 13.4%, with a high fill factor (FF) of 76.8%, is eventually achieved, which represents one of the highest PCEs reported so far for organic solar cells. The results manifest that the adoption of amorphous fullerene acceptor is an effective approach to optimizing the ternary blend morphology and thereby increases the solar cell performance.

The challenges of implementing an integrated One Health surveillance system in Australia

As 75 per cent of emerging infectious diseases are of animal origin, a One Health approach that integrates the health of humans, animals and the environment could provide an earlier opportunity for zoonotic disease detection and prevention. In Australia, human, animal and ecological health are managed by separate sectors with limited communication. This study aims to explore how professionals in these fields perceive a One Health approach to zoonotic disease surveillance, aiming to identify the challenges to the implementation of an integrated system in Australia. Using a qualitative research method, ten semistructured interviews were conducted with academic experts to gain insight into the possibility of developing an integrated surveillance system in Australia. A thematic analysis of the data was undertaken. Findings showed the absence of a clear definition and subsequent vision for the future of One Health act as a barrier to interdisciplinary collaboration, and that siloed approaches by different sectors restrict the ability for professionals to work collaboratively across disciplines. An understanding of disease transmission was considered by participants to be a necessary requirement for a successful One Health approach. Finally, participants considered political will an essential requirement for the integration of surveillance systems. This study demonstrates that for a One Health approach to be implemented in an Australian setting, those working in the fields of human, animal and ecological health must agree on several aspects. The establishment of a formal governance body with representatives from each sector could assist in overcoming long‐standing barriers of privacy and distrust. Further, developing interdisciplinary training in One Health concepts for medical, environmental and veterinary students may encourage cross‐disciplinary collaboration. Finally, demonstrating to policymakers the economic benefit of improved and timely detection of zoonoses may help in facilitating a structured One Health approach to disease surveillance in Australia.

Improving the Compatibility of Donor Polymers in Efficient Ternary Organic Solar Cells via Post-Additive Soaking Treatment

In dual-donor ternary organic solar cells, the compatibility between the donor polymers plays important roles to control the conformational change and govern the photophysical behavior in the blend films. Here, we apply a post-additive soaking (PAS) approach to reconstruct the morphology in a ternary organic photovoltaic BHJ of PTB7-Th: PCDTBT: PC₇₁BM. The PAS-treated device has a maximum power conversion efficiency (PCE) of about 8.7% in this ternary system. From the analyses of GIWAXS and GISAXS, the superior device performance is attributed to the favorable nanomorphology with optimum crystallinity of PTB7-Th and good intermixing of PCDTBT with PTB7-Th:PC₇₁BM, leading to improved charge transport in the vertical direction. AFM and TRPL measurements clearly demonstrate PAS-treated film envisages a homogeneous distribution of smaller PC₇₁BM aggregates to facilitate the exciton dissociation and carrier extraction at the interface. The increased PCE ascribed to not only the enhancement of absorption and nonradiative Förster resonance energy transfer (FRET) between two donors (PCDTBT and PTB7-Th) but also the formation of a bicontinuous interpenetrating network of PC₇₁BM.

Experts' Perceptions on China's Capacity to Manage Emerging and Re-emerging Zoonotic Diseases in an Era of Climate Change

Zoonotic diseases transmitted by arthropods and rodents are a major public health concern in China. However, interventions in recent decades have helped lower the incidence of several diseases despite the country's large, frequently mobile population and socio-economic challenges. Increasing globalization, rapid urbanization and a warming climate now add to the complexity of disease control and prevention and could challenge China's capacity to respond to threats of emerging and re-emerging zoonoses. To investigate this notion, face-to-face interviews were conducted with 30 infectious disease experts in four cities in China. The case study diseases under discussion were malaria, dengue fever and haemorrhagic fever with renal syndrome, all of which may be influenced by changing meteorological conditions. Data were analysed using standard qualitative techniques. The study participants viewed the current disease prevention and control system favourably and were optimistic about China's capacity to manage climate-sensitive diseases in the future. Several recommendations emerged from the data including the need to improve health literacy in the population regarding the transmission of infectious diseases and raising awareness of the health impacts of climate change amongst policymakers and health professionals. Participants thought that research capacity could be strengthened and human resources issues for front-line staff should be addressed. It was considered important that authorities are well prepared in advance for outbreaks such as dengue fever in populous subtropical areas, and a prompt and coordinated response is required when outbreaks occur. Furthermore, health professionals need to remain skilled in the identification of diseases for which incidence is declining, so that re-emerging or emerging trends can be rapidly identified. Recommendations such as these may be useful in formulating adaptation plans and capacity building for the future control and prevention of climate-sensitive zoonotic diseases in China and neighbouring countries.

The effects of air pollution on asthma hospital admissions in Adelaide, South Australia, 2003-2013: time-series and case-crossover analyses

BACKGROUND

Air pollution can have adverse health effects on asthma sufferers, but the effects vary with geographic, environmental and population characteristics. There has been no long time-series study in Australia to quantify the effects of environmental factors including pollen on asthma hospitalizations.

OBJECTIVES

This study aimed to assess the seasonal impact of air pollutants and aeroallergens on the risk of asthma hospital admissions for adults and children in Adelaide, South Australia.

METHODS

Data on hospital admissions, meteorological conditions, air quality and pollen counts for the period 2003-2013 were sourced. Time-series analysis and case-crossover analysis were used to assess the short-term effects of air pollution on asthma hospitalizations. For the time-series analysis, generalized log-linear quasi-Poisson and negative binomial regressions were used to assess the relationships, controlling for seasonality and long-term trends using flexible spline functions. For the case-crossover analysis, conditional logistic regression was used to compute the effect estimates with time-stratified referent selection strategies.

RESULTS

A total of 36,024 asthma admissions were considered. Findings indicated that the largest effects on asthma admissions related to PM_2.5 , NO₂ , PM₁₀ and pollen were found in the cool season for children (0-17 years), with the 5-day cumulative effects of 30.2% (95% CI: 13.4-49.6%), 12.5% (95% CI: 6.6-18.7%), 8.3% (95% CI: 2.5-14.4%) and 4.2% (95% CI: 2.2-6.1%) increases in risk of asthma hospital admissions per 10 unit increments, respectively. The largest effect for ozone was found in the warm season for children with the 5-day cumulative effect of an 11.7% (95% CI: 5.8-17.9%) increase in risk of asthma hospital admissions per 10 ppb increment in ozone level.

CONCLUSION

Findings suggest that children are more vulnerable and the associations between exposure to air pollutants and asthma hospitalizations tended to be stronger in the cool season compared to the warm season, with the exception of ozone. This study has important public health implications and provides valuable evidence for the development of policies for asthma management.

Meat Science and Muscle Biology Symposium: stem cell niche and postnatal muscle growth

Stem cell niche plays a critical role in regulating the behavior and function of adult stem cells that underlie tissue growth, maintenance, and regeneration. In the skeletal muscle, stem cells, called satellite cells, contribute to postnatal muscle growth and hypertrophy, and thus, meat production in agricultural animals. Satellite cells are located adjacent to mature muscle fibers underneath a sheath of basal lamina. Microenvironmental signals from extracellular matrix mediated by the basal lamina and from the host myofiber both impinge on satellite cells to regulate their activity. Furthermore, several types of muscle interstitial cells, including intramuscular preadipocytes and connective tissue fibroblasts, have recently been shown to interact with satellite cells and actively regulate the growth and regeneration of postnatal skeletal muscles. From this regard, interstitial adipogenic cells are not only important for marbling and meat quality, but also represent an additional cellular component of the satellite cell niche. At the molecular level, these interstitial cells may interact with satellite cells through cell surface ligands, such as delta-like 1 homolog (Dlk1) protein whose overexpression is thought to be responsible for muscle hypertrophy in callipyge sheep. In fact, extracellular Dlk1 protein has been shown to promote the myogenic differentiation of satellite cells. Understanding the cellular and molecular mechanisms within the stem cell niche that regulate satellite cell differentiation and maintain muscle homeostasis may lead to promising approaches to optimizing muscle growth and composition, thus improving meat production and quality.

Internet use and risk behaviours: an online survey of visitors to three gay websites in China

OBJECTIVES

To describe the risk behaviours of visitors to gay websites and to explore the role of the internet in the HIV transmission among the Chinese men who have sex with men (MSM).

METHODS

Between May and August 2006, visitors of three Chinese gay websites were invited to complete an online questionnaire about the use of the internet and risk sexual behaviours.

RESULTS

The median age of the online sample was 25 years old (range 18 to 64). Over three-quarters (77.6%) had an education of college or higher. Less than 44% of the online sample reported little or no risk for HIV transmission. These men had either had no anal intercourse (28.0%) or had always used a condom for anal intercourse (15.8%). Although only about half of the participants reported that their main purpose of visiting the gay websites was to look for sexual partners, most participants (86.1%) had used the internet to seek partners. Compared with men seeking sexual partners only on the internet, men seeking partners both in traditional gay venues and on the internet were older, less likely to be students and more likely to have unprotected anal intercourse, more than six sexual partners in the past 6 months and commercial sex behaviours.

CONCLUSION

The users of the gay websites are relatively young and well educated, and highly vulnerable to HIV/AIDS, given their low prevalence of consistent condom use and multiple-risk sexual behaviours. Effective intervention programmes should be implemented and strengthened in China, especially for those who seek sexual partners both on the internet and in traditional gay venues.

Weather: driving force behind the transmission of severe acute respiratory syndrome in China?

BACKGROUND

The association between weather and severe acute respiratory syndrome (SARS) transmission in Beijing and Hong Kong in the 2003 epidemic was studied to examine the effect of weather on SARS transmission.

METHODS

Pearson's correlation analyses and negative binomial regression analyses were used to quantify the correlations between the daily newly reported number of SARS cases and weather variables, using daily disease notification data and meteorological data from the two locations.

RESULTS

The results indicate that there were inverse association between the number of daily cases and maximum and/or minimum temperatures whereas air pressure was found to be positively associated with SARS transmission.

CONCLUSION

The study suggests that weather might be a contributory factor in the 2003 SARS epidemic, in particular in the transmission among the community members.

Advantages and challenges of using census and multiplier methods to estimate the number of female sex workers in a Chinese city

Using census and multiplier methods to estimate the size of the population of female sex workers (FSWs) in a small city in western China, this study compared the advantages and challenges of the two methods. It was estimated that there were about 1,500 FSWs within the urban area using the census method, which was significantly lower than that estimated by the multiplier method (2,500). Each method has advantages and limitations, and could be applied to different situations. The census method is less time and resource consuming in smaller regions and has a tendency to underestimate, and therefore, the result can be viewed as a low limit. It is useful in a local setting, for example, when estimations are needed for planning HIV/AIDS prevention programmes in a single city. Using existing information or resources, multiplier method could be used to produce estimates for a large geographic area or at a national level.

Are humans infected by Hantaviruses in Australia?

Hantavirus antibody-positive rodents have been found across Australia although, to date, there are no reports of infections in humans. This could be due to misdiagnosis clinically and/or inadequate laboratory technique/skills. There are close trading ties between Australia and Asian countries as well as our geographical neighbours where both human and rodent infections are found, so importation is a continuing threat. We consider that further sero-epidemiological surveys are warranted among rodents (especially those captured from ports in Australia), in patients from renal and respiratory wards of hospitals, and in residents and employees close to harbours using more specific and sensitive laboratory techniques than have been available in the past.

The prevalence of HCV antibody in South Australian prisoners

OBJECTIVES

The study was aimed at identifying the hepatitis C virus (HCV)-antibody status of prisoners incarcerated in South Australia in order to develop an HCV prevalence estimate for the whole prison system.

METHODS

The health records of persons incarcerated within eight prisons (accommodating approximately 93% of the jurisdiction's adult incarcerated population) were audited for evidence of HCV infection, age, sex, Indigenous status (Australian Aboriginal or Torres Strait Islander) and date of entry to prison. These data were analysed using both univariate and multivariate techniques.

RESULTS

Among 1347 prisoners (1254 males and 93 females), 30.2% were HCV-antibody positive. After excluding those with no history of testing, HCV-antibody prevalence rose to 41.3% (males 39.8%, females 66.1%). HCV-antibody positivity was significantly associated with age, sex and Indigenous status in both univariate and multivariate analyses.

CONCLUSIONS

Consistent with the literature, the prevalence of HCV infection in the SA prison system appears to be extremely high. This study suggests that HCV prevention efforts in prison settings should be considered as an important priority.

Occupational blood and body fluid exposure in an Australian teaching hospital

To examine work-related blood and body fluid exposure (BBFE) among health-care workers (HCWs), to explore potential risk factors and to provide policy suggestions, a 6-year retrospective study of all reported BBFE among HCWs (1998-2003) was conducted in a 430-bed teaching hospital in Australia. Results showed that BBFE reporting was consistent throughout the study period, with medical staff experiencing the highest rate of sharps injury (10.4%). Hollow-bore needles were implicated in 51.7% of all percutaneous injuries. Most incidents occurred during sharps use (40.4%) or after use but before disposal (27.1%). Nursing staff experienced 68.5% of reported mucocutaneous exposure. Many such exposures occurred in the absence of any protective attire (61.1%). This study indicated that emphasis on work practice, attire, disposal systems and education strategies, as well as the use of safety sharps should be employed to reduce work-related injuries among HCWs in Australia.

Trends in mortality rates for infectious and parasitic diseases in Australia: 1907-1997

AIMS

To characterize long-term mortality trends for infectious and parasitic diseases in Australia during the twentieth century, explore influencing factors and provide suggestions to health policy-makers.

METHODS

A descriptive study was conducted. Deaths due to communicable diseases from 1907 to 1997 were tallied, according to the International Classification of Diseases version 9 (ICD-9). Trends in infectious disease mortality in overall population and in the 0-4 years age group were examined and standardized by sex. Death rates were also studied for: (i) diarrhoea/enteritis, (ii) pneumonia and all respiratory diseases and (iii) tuberculosis.

RESULTS

There has been a substantial decline in -mortality from communicable diseases over the study period. The death rate dropped from 258.9 per 100,000 population in 1907 to 7.2 per 100,000 population in 1997. Six phases of the decline were observed.

CONCLUSIONS

A combination of improved living conditions and access to readily available treatments over the twentieth century played an important role in the reduction of infectious disease mortality in Australia.

Climate variability and Ross River virus transmission

OBJECTIVES

(1) To examine the feasibility to link climate data with monthly incidence of Ross River virus (RRv). (2) To assess the impact of climate variability on the RRv transmission.

DESIGN

An ecological time series analysis was performed on the data collected between 1985 to 1996 in Queensland, Australia.

METHODS

Information on the notified RRv cases was obtained from the Queensland Department of Health. Climate and population data were supplied by the Australian Bureau of Meteorology and the Australian Bureau of Statistics, respectively. Spearman's rank correlation analyses were performed to examine the relation between climate variability and the monthly incidence of notified RRv infections. The autoregressive integrated moving average (ARIMA) model was used to perform a time series analysis. As maximum and minimum temperatures were highly correlated with each other (r(s)=0.75), two separate models were developed.

RESULTS

For the eight major cities in Queensland, the climate-RRv correlation coefficients were in the range of 0.12 to 0.52 for maximum and minimum temperatures, -0.10 to 0.46 for rainfall, and 0.11 to 0.52 for relative humidity and high tide. For the whole State, rainfall (partial regression coefficient: 0.017 (95% confidence intervals 0.009 to 0.025) in Model I and 0.018 (0.010 to 0.026) in Model II), and high tidal level (0.030 (0.006 to 0.054) in Model I and 0.029 (0.005 to 0.053) in Model II) seemed to have played significant parts in the transmission of RRv in Queensland. Maximum temperature was also marginally significantly associated with the incidence of RRv infection.

CONCLUSION

Rainfall, temperature, and tidal levels may be important environmental determinants in the transmission cycles of RRv disease.

Geographic variation of notified Ross River virus infections in Queensland, Australia, 1985-1996

The spatial and temporal variations of Ross River virus infections reported in Queensland, Australia, between 1985 and 1996 were studied by using the Geographic Information System. The notified cases of Ross River virus infection came from 489 localities between 1985 and 1988, 805 between 1989 and 1992, and 1,157 between 1993 and 1996 (chi2(df = 2) = 680.9; P < 0.001). There was a marked increase in the number of localities where the cases were reported by 65 percent for the period of 1989-1992 and 137 percent for 1993-1996, compared with that for 1985-1988. The geographic distribution of the notified Ross River virus cases has expanded in Queensland over recent years. As Ross River virus disease has impacted considerably on tourism and industry, as well as on residents of affected areas, more research is required to explore the causes of the geographic expansion of the notified Ross River virus infections.

Family self-medication and antibiotics abuse for children and juveniles in a Chinese city

To identify the determinants of self-medication and antibiotics abuse by parents treating their children aged between 2 and 18 over the previous year, an investigation was conducted in Hefei City, China in April, 1995. A total of 1596 students from a kindergarten, a primary school and a high school were included in the study, and 1459 completed questionnaires were collected (the response rate: 91.4%). The results showed the rate of parental self-medication for their children in the sample was 59.4%. It increased with children's age; about 51% of children had received parental self-medication on six or more occasions during the 1-year period and 32.8% on four to five occasions; there were associations between parental self-prescribers and sources of medicine and severity of disease. The rate of antibiotics abuse was 35.7%. Logistic regression analysis showed that there were significant associations between self-medication and payment of the mother's medical fees by employers, severity of diseases as well as the mother's educational level.