Dynamic Reversible Full-Color Piezochromic Fluorogens Featuring Through-Space Charge-Transfer Thermally Activated Delayed Fluorescence and their Application as X-Ray Imaging Scintillators

Thermally activated delayed fluorescence (TADF) emitters featuring through-space charge transfer (TSCT) can be excellent candidates for piezochromic luminescent (PCL) materials due to their structural dynamics. Spatial donor-acceptor (D-A) stacking arrangements enable the modulation of inter- and intramolecular D-A interactions, as well as spatial charge transfer states, under varying pressure conditions. Herein, we demonstrate an effective approach toward dynamic reversible full-color PCL materials with TSCT-TADF characteristics. Their single crystals exhibit a full-color-gamut PCL process spanning a range of 170 nm. Moreover, the TSCT-TADF-PCL emitters display a unity photoluminescence quantum yield, and show promising application in X-ray scintillator imaging.

Synonymous mutations in TLR2 and TLR9 genes decrease COPD susceptibility in the Chinese Han population

INTRODUCTION

Previous studies have found associations between polymorphisms in some candidate genes and chronic obstructive pulmonary disease (COPD) risk. However, the association between TLR2 and TLR9 polymorphisms and COPD risk remains uncertain.

METHODS

Four variants (rs352140, rs3804099, rs3804100, and rs5743705) of the TLR2 and TLR9 genes in 540 COPD patients and 507 healthy controls were genotyped using the Agena MassARRAY system. Odds ratio (OR) and 95% confidence interval (CI) were calculated to assess the association of TLR2 and TLR9 polymorphisms with COPD risk by logistic regression analysis.

RESULTS

TLR9-rs352140, TLR2-rs3804100, and TLR2-rs5743705 were related to a lower risk of COPD among Chinese people and the significance still existed after Bonferroni correction. Additionally, rs3804099, rs3804100, and rs352140 were found to be associated with COPD development in different subgroups (males, age ≤ 68 years, smokers, BMI < 24 kg/m2, and acute exacerbation).

CONCLUSIONS

Our findings indicated that TLR9 and TLR2 polymorphisms had protective effects on the development of COPD among Chinese people.

Vertebral fracture severity assessment on anteroposterior radiographs with a new semi-quantitative technique

We developed a new tool to assess the severity of osteoporotic vertebral fracture using radiographs of the spine. Our technique can be used in patient care by helping to stratify patients with osteoporotic vertebral fractures into appropriate treatment pathways. It can also be used for research purposes.

PURPOSE

The aim of our study was to propose a semi-quantitative (SQ) grading scheme for osteoporotic vertebral fracture (OVF) on anteroposterior (AP) radiographs.

METHODS

On AP radiographs, the vertebrae are divided into right and left halves, which are graded (A) vertical rectangle, (B) square, (C) traverse rectangle, and (D) trapezoid; whole vertebrae are graded (E) transverse band or (F) bow-tie. Type A and B were compared with normal and Genant SQ grade 1 OVF, Type C and D with grade 2 OVF, and Type E and F with grade 3 OVF. Spine AP radiographs and lateral radiographs of 50 females were assessed by AP radiographs SQ grading. After training, an experienced board-certified radiologist and a radiology trainee assessed the 50 AP radiographs.

RESULTS

The height-to-width ratio of the half vertebrae varied 1.32-1.48. On lateral radiographs, 84 vertebrae of the 50 patients had OVFs (38 grade 1, 24 grade 2, and 22 grade 3). On AP radiographs, the radiologist correctly assigned 84.2%, 91.7%, and 77.2% and the trainee correctly assigned 68.4%, 79.2%, and 81.8% of grade 1, 2, and 3 OVFs, respectively. Compared with lateral radiographs, the radiologist had a weighted Kappa of 0.944 including normal vertebrae and 0.883 not including normal vertebrae, while the corresponding Kappa values for the trainee were 0.891 and 0.830, respectively.

CONCLUSION

We propose a new semi-quantitative grading system for vertebral fracture severity assessment on AP spine radiographs.

Through-Space Charge-Transfer Organogold(III) Complexes Enable High-Performance X-ray Scintillation and Imaging

Organic scintillators have recently attracted growing attention for X-ray detection in industrial and medical applications. However, these materials still face critical obstacles of low attenuation efficiency and/or inefficient triplet exciton utilization. Here we developed a new category of organogold(III) complexes, Tp-Au-1 and Tp-Au-2, through adopting a through-space interaction motif to realize high X-ray attenuation efficiency and efficient harvesting of triplet excitons for emission. Thanks to the efficient through-space charge transfer process, this panel of complexes achieved higher photoluminescence quantum yield and shorter radiative lifetimes compared with the through-bond reference complexes. Inspiringly, these organogold(III) complexes exhibited polarity-dependent emission origins: thermally activated delayed fluorescence and/or phosphorescence. Under X-ray irradiation, Tp-Au-2 manifested intense radioluminescence together with a record-high scintillation light yield of 77,600 photons MeV-1 for organic scintillators. The resulting scintillator screens demonstrated high-quality X-ray imaging with >16.0 line pairs mm-1 spatial resolution, outstripping most organic and inorganic scintillators. This finding provides a feasible strategy for the design of superior organic X-ray scintillators.

Constructing Ultra-Shallow Near-Edge States for Efficient and Stable Perovskite Solar Cells

Electronic band structure engineering of metal-halide perovskites (MHP) lies at the core of fundamental materials research and photovoltaic applications. However, reconfiguring the band structures in MHP for optimized electronic properties remains challenging. This article reports a generic strategy for constructing near-edge states to improve carrier properties, leading to enhanced device performances. The near-edge states are designed around the valence band edge using theoretical prediction and constructed through tailored material engineering. These states are experimentally revealed with activation energies of around 23 milli-electron volts by temperature-dependent time-resolved spectroscopy. Such small activation energies enable prolonged carrier lifetime with efficient carrier transition dynamics and low non-radiative recombination losses, as corroborated by the millisecond lifetimes of microwave conductivity. By constructing near-edge states in positive-intrinsic-negative inverted cells, a champion efficiency of 25.4% (25.0% certified) for a 0.07-cm2 cell and 23.6% (22.7% certified) for a 1-cm2 cell is achieved. The most stable encapsulated cell retains 90% of its initial efficiency after 1100 h of maximum power point tracking under one sun illumination (100 mW cm-2) at 65 °C in ambient air.

[A retrospective cohort study on the correlation between early energy management and bronchopulmonary dysplasia in premature infants]

Objective: To investigate the correlation between early energy supplement and bronchopulmonary dysplasia (BPD) in very preterm and very low birth weight infants. Methods: A retrospective cohort study design was used. A total of 939 preterm infants who were admitted to the Department of Neonatology of the West China Second Hospital of Sichuan University within 24 h after birth from January 2019 to December 2021 were enrolled in the study. They were born with a gestational age of <32 weeks and (or) a birth weight of <1 500 g. Of them, 250 preterm infants who developed BPD were enrolled in the BPD group, and each of them was matched to a preterm infant who did not develop BPD (matched for gestational age and birth weight) in the order of priority after calculating propensity score. Their total energy, enteral energy, parenteral energy, total fluid intake and energy per unit of fluid per week were collected within the first 2 weeks of life. The independent sample t-test or Mann Whitney U test was used for continuous variables, and the χ2 test for between-group comparisons of categorical variables. Univariate and multivariate Logistic regression analyses were used to explore the association between total energy and total fluid and BPD incidence, respectively. The dose-response relationship between parenteral energy and BPD was investigated by a generalized additive model, and the threshold effect of parenteral energy on BPD used a two-piecewise linear regression model. Results: The gestational age was (28.4±1.9) weeks in the BPD group and (29.5±1.3) weeks in the control group; the birth weight was (1 107±258) g in the BPD group and (1 324±261) g in the control group; and there were 140 males (56.0%) and 131 males (52.4%) in each group, respectively. An increase in energy per unit of fluid in the second week of life was associated with a reduced risk of BPD (OR=0.32, 95%CI 0.12-0.84, P=0.021), and an increase in total energy in the second week of life was also associated with a reduced risk of BPD, with total energy of >418-502 kJ/(kg·d) was significantly lower than when total energy was ≤334 kJ/(kg·d) (OR=0.15, 95%CI 0.03-0.85, P=0.033). There was no association between the average total fluid intake and BPD incidence (both P>0.05) in the first and second week. The increase in the proportion of parenteral energy to total energy in the second week of life was associated with an increased incidence of BPD (OR=8.45, 95%CI 2.14-33.32, P=0.003); specifically, the risk of BPD significantly increased when the parenteral energy was ≥305 kJ/(kg·d) (OR=1.02, 95%CI 1.01-1.03, P=0.003). Conclusions: Maintaining a high total energy supply in the early postnatal period in preterm infants may reduce the risk of BPD, but continued reliance on high parenteral energy to meet total energy requirements increases the risk of BPD, so enteral feeds should be initiated as early as possible and maximized as tolerated.

Precursor Engineering of Solution-Processed Sb2 S3 Solar Cells

Antimony-based chalcogenides have emerged as promising candidates for next-generation thin film photovoltaics. Particularly, binary Sb2 S3 thin films have exhibited great potential for optoelectronic applications, due to the facile and low-cost fabrication, simple composition, decent charge transport and superior stability. However, most of the reported efficient Sb2 S3 solar cells are realized based on chemical bath deposition and hydrothermal methods, which require large amount of solution and are normally very time-consuming. In this work, Ag ions are introduced within the Sb2 S3 sol-gel precursors, and effectively modulated the crystallization and charge transport properties of Sb2 S3 . The crystallinity of the Sb2 S3 crystal grains are enhanced and the charge carrier mobility is increased, which resulted improved charge collection efficiency and reduced charge recombination losses, reflected by the greatly improved fill factor and open-circuit voltage of the Ag incorporated Sb2 S3 solar cells. The champion devices reached a record high power conversion efficiency of 7.73% (with antireflection coating), which is comparable with the best photovoltaic performance of Sb2 S3 solar cells achieved based on chemical bath deposition and hydrothermal techniques, and pave the great avenue for next-generation solution-processed photovoltaics.

Tumorigenesis of basal muscle invasive bladder cancer was mediated by PTEN protein degradation resulting from SNHG1 upregulation

BACKGROUND

Phosphatase and tensin homolog deleted on chromosome ten (PTEN) serves as a powerful tumor suppressor, and has been found to be downregulated in human bladder cancer (BC) tissues. Despite this observation, the mechanisms contributing to PTEN's downregulation have remained elusive.

METHODS

We established targeted genes' knockdown or overexpressed cell lines to explore the mechanism how it drove the malignant transformation of urothelial cells or promoted anchorageindependent growth of human basal muscle invasive BC (BMIBC) cells. The mice model was used to validate the conclusion in vivo. The important findings were also extended to human studies.

RESULTS

In this study, we discovered that mice exposed to N-butyl-N-(4-hydroxybu-tyl)nitrosamine (BBN), a specific bladder chemical carcinogen, exhibited primary BMIBC accompanied by a pronounced reduction in PTEN protein expression in vivo. Utilizing a lncRNA deep sequencing high-throughput platform, along with gain- and loss-of-function analyses, we identified small nucleolar RNA host gene 1 (SNHG1) as a critical lncRNA that might drive the formation of primary BMIBCs in BBN-treated mice. Cell culture results further demonstrated that BBN exposure significantly induced SNHG1 in normal human bladder urothelial cell UROtsa. Notably, the ectopic expression of SNHG1 alone was sufficient to induce malignant transformation in human urothelial cells, while SNHG1 knockdown effectively inhibited anchorage-independent growth of human BMIBCs. Our detailed investigation revealed that SNHG1 overexpression led to PTEN protein degradation through its direct interaction with HUR. This interaction reduced HUR binding to ubiquitin-specific peptidase 8 (USP8) mRNA, causing degradation of USP8 mRNA and a subsequent decrease in USP8 protein expression. The downregulation of USP8, in turn, increased PTEN polyubiquitination and degradation, culminating in cell malignant transformation and BMIBC anchorageindependent growth. In vivo studies confirmed the downregulation of PTEN and USP8, as well as their positive correlations in both BBN-treated mouse bladder urothelium and tumor tissues of bladder cancer in nude mice.

CONCLUSIONS

Our findings, for the first time, demonstrate that overexpressed SNHG1 competes with USP8 for binding to HUR. This competition attenuates USP8 mRNA stability and protein expression, leading to PTEN protein degradation, consequently, this process drives urothelial cell malignant transformation and fosters BMIBC growth and primary BMIBC formation.

Association between high-resolution magnetic resonance vessel wall imaging characteristics and recurrent stroke in patients with intracranial atherosclerotic steno-occlusive disease: A prospective multicenter study

BACKGROUND

High-resolution magnetic resonance vessel wall imaging (HRMR-VWI) is a promising technique for identifying intracranial vulnerable plaques beyond lumen narrowing. However, the association between HRMR-VWI characteristics and recurrent stroke remains uncertain.

AIMS

This study aimed to investigate the association between HRMR-VWI characteristics and recurrent ipsilateral stroke in patients with symptomatic intracranial atherosclerotic steno-occlusive disease (ICAS).

METHODS

This multicenter, observational study recruited first-ever acute ischemic stroke patients attributed to ICAS (>50% stenosis or occlusion) within 7 days after onset. Participants were assessed by multiparametric magnetic resonance imaging (MRI) including diffusion-weighted imaging, three-dimension time-of-flight magnetic resonance angiography, and three-dimensional T1-weighted HRMR-VWI. The patients were recommended to receive best medical therapy and were systematically followed up for 12 months. The association between HRMR-VWI characteristics and the time to recurrent ipsilateral stroke was investigated by univariable and multivariable analysis.

RESULTS

Two hundred and fifty-five consecutive patients were enrolled from 15 centers. The cumulative 12 month ipsilateral recurrence incidence was 4.1% (95% confidence interval (CI): 1.6-6.6%). Patients with recurrent ipsilateral stroke exhibited higher rates of intraplaque hemorrhage (IPH) (30.0% vs 6.5%) and eccentric plaque (90.0% vs 48.2%), and lower occurrence of occlusive thrombus (10.0% vs 23.7%). Plaque length (5.69 ± 2.21 mm vs 6.67 ± 4.16 mm), plaque burden (78.40 ± 7.37% vs 78.22 ± 8.32%), degree of stenosis (60.25 ± 18.95% vs 67.50% ± 22.09%) and remodeling index (1.07 ± 0.27 vs 1.03 ± 0.35) on HRMR-VWI did not differ between patients with and without recurrent ipsilateral stroke. In the multivariable Cox regression analysis, IPH (hazard ratio: 6.64, 95% CI: 1.23-35.8, p = 0.028) was significantly associated with recurrent ipsilateral stroke after adjustment.Conclusions:Our results suggest intraplaque hemorrhage (IPH) is significantly associated with recurrent ipsilateral stroke and has potential value in the selection of patients for aggressive treatment strategies.

DATA ACCESS STATEMENT

Data from this study are available and can be accessed upon request.

AAV-mediated delivery of a Sleeping Beauty transposon and an mRNA-encoded transposase for the engineering of therapeutic immune cells

Engineering cells for adoptive therapy requires overcoming limitations in cell viability and, in the efficiency of transgene delivery, the duration of transgene expression and the stability of genomic integration. Here we report a gene-delivery system consisting of a Sleeping Beauty (SB) transposase encoded into a messenger RNA delivered by an adeno-associated virus (AAV) encoding an SB transposon that includes the desired transgene, for mediating the permanent integration of the transgene. Compared with lentiviral vectors and with the electroporation of plasmids of transposon DNA or minicircle DNA, the gene-delivery system, which we named MAJESTIC (for 'mRNA AAV-SB joint engineering of stable therapeutic immune cells'), offers prolonged transgene expression, as well as higher transgene expression, therapeutic-cell yield and cell viability. MAJESTIC can deliver chimeric antigen receptors (CARs) into T cells (which we show lead to strong anti-tumour activity in vivo) and also transduce natural killer cells, myeloid cells and induced pluripotent stem cells with bi-specific CARs, kill-switch CARs and synthetic T-cell receptors.

Surgical treatment of nasopharyngeal cancer - a consensus recommendation from two Chinese associations

BACKGROUND

Surgical treatment is playing an increasingly important role in the management of nasopharyngeal carcinoma (NPC). This consensus focuses on the indications for optimal surgery, and surgical methods in the whole process of treatment for NPC to provide a useful reference to assist these difficult clinical decisions.

METHODOLOGY

A thorough review of available literature on NPC and surgery was conducted by the Association for the prevention and treatment of nasopharyngeal carcinoma in China, international exchange and promotion Association for medicine and healthcare, and the Committee on nasopharyngeal cancer of Guangdong provincial anticancer association. A set of questions and a preliminary draft guideline was circulated to a panel of 1096 experienced specialists on this disease for voting on controversial areas and comments. A refined second proposal, based on a summary of the initial voting and different opinions expressed, was recirculated to the experts in two authoritative medical science and technology academic groups in the prevention and treatment of NPC in China for review and reconsideration.

RESULTS

The initial round of questions showed variations in clinical practice even among similar specialists, reflecting the lack of high-quality supporting data and resulting difficulties in formulating clinical decisions. Through exchange of comments and iterative revisions, recommendations with high-to-moderate agreement were formulated on general treatment strategies and details of surgery, including indications and surgical approaches.

CONCLUSION

By standardizing the surgical indications and practice, we hope not only to improve the surgical outcomes, but also to highlight the key directions of future clinical research in the surgical management of NPC.

Peritumoural MRI radiomics signature of brain metastases can predict epidermal growth factor receptor mutation status in lung adenocarcinoma

AIM

To investigate whether magnetic resonance imaging (MRI) radiomics features of brain metastases (BMs) can predict epidermal growth factor receptor (EGFR) mutation status in lung adenocarcinoma.

MATERIALS AND METHODS

Between June 2014 and December 2022, 58 histopathologically confirmed lung adenocarcinoma patients (27 with EGFR wild-type, 31 with EGFR mutation) who underwent gadobenate dimeglumine-enhanced brain MRI were recruited retrospectively. A total of 123 metastatic brain lesions were allocated randomly into the training cohort (n=86) and test cohort (n=37) at a ratio of 7:3. Radiomics models based on multi-sequence MRI images in different regions such as volume of interest (VOI)enhancing tumour, VOIwholetumour, VOIperitumour 1mm, VOIperitumour 3mm, and VOIperitumour 5mm were built. The optimal radiomics model was integrated into the clinical or radiological indicators to construct a fusion model through multivariable logistic regression analysis.

RESULTS

The optimal radiomics model based on the VOIperitumour 1mm, a combination of nine features selected from the fluid-attenuated inversion recovery (FLAIR) sequence, yielded areas under the curves (AUCs) of >0.75 in the training and test cohorts. The prediction of the fusion model with integration of clinical factors (age) and radiomics score (the optimal radiomics model) was not better than that of the optimal radiomics model alone in the test cohort (AUC: 0.808 and 0.785, respectively, p=0.525).

CONCLUSION

The FLAIR radiomics model based on VOIperitumour 1mm as an effective biomarker helps predict EGFR mutation status in lung adenocarcinoma patients with BMs and then assists clinicians in selecting optimal treatment strategies.

Genome scale CRISPR screens identify actin capping proteins as key modulators of therapeutic responses to radiation and immunotherapy

Radiotherapy (RT), is a fundamental treatment for malignant tumors and is used in over half of cancer patients. As radiation can promote anti-tumor immune effects, a promising therapeutic strategy is to combine radiation with immune checkpoint inhibitors (ICIs). However, the genetic determinants that impact therapeutic response in the context of combination therapy with radiation and ICI have not been systematically investigated. To unbiasedly identify the tumor intrinsic genetic factors governing such responses, we perform a set of genome-scale CRISPR screens in melanoma cells for cancer survival in response to low-dose genotoxic radiation treatment, in the context of CD8 T cell co-culture and with anti-PD1 checkpoint blockade antibody. Two actin capping proteins, Capza3 and Capg, emerge as top hits that upon inactivation promote the survival of melanoma cells in such settings. Capza3 and Capg knockouts (KOs) in mouse and human cancer cells display persistent DNA damage due to impaired homology directed repair (HDR); along with increased radiation, chemotherapy, and DNA repair inhibitor sensitivity. However, when cancer cells with these genes inactivated were exposed to sublethal radiation, inactivation of such actin capping protein promotes activation of the STING pathway, induction of inhibitory CEACAM1 ligand expression and resistance to CD8 T cell killing. Patient cancer genomics analysis reveals an increased mutational burden in patients with inactivating mutations in CAPG and/or CAPZA3, at levels comparable to other HDR associated genes. There is also a positive correlation between CAPG expression and activation of immune related pathways and CD8 T cell tumor infiltration. Our results unveil the critical roles of actin binding proteins for efficient HDR within cancer cells and demonstrate a previously unrecognized regulatory mechanism of therapeutic response to radiation and immunotherapy.

Enhanced Photoluminescence Quantum Yield of Metal Halide Perovskite Microcrystals for Multiple Optoelectronic Applications

Recently, metal 1halide perovskites have shown compelling optoelectronic properties for both light-emitting devices and scintillation of ionizing radiation. However, conventional lead-based metal halide perovskites are still suffering from poor material stability and relatively low X-ray light yield. This work reports cadmium-based all-inorganic metal halides and systematically investigates the influence of the metal ion incorporation on the optoelectronic properties. This work introduces the bi-metal ion incorporation strategy and successfully enhances the photoluminescence quantum yield (98.9%), improves thermal stability, and extends the photoluminescence spectra, which show great potential for white light emission. In addition, the photoluminescent decay is also modulated with single metal ion incorporation, the charge carrier lifetime is successfully reduced to less than 1 µs, and the high luminescent efficiency and X-ray light yield (41 000 photons MeV-1 ) are maintained. Then, these fast scintillators are demonstrated for high-speed light communication and sensitive X-ray detection and imaging.

Hole Transport Layer-Free Low-Bandgap Perovskite Solar Cells for Efficient All-Perovskite Tandems

Low-bandgap (LBG, Eg  ≈1.25 eV) tin-lead (Sn-Pb) perovskite solar cells (PSCs) play critical roles in constructing efficient all-perovskite tandem solar cells (TSCs) that can surpass the efficiency limit of single-junction solar cells. However, the traditional poly(3,4-ethylenedioxythiophene):poly(styrenesulfonate) (PEDOT:PSS) hole transport layer (HTL) in LBG PSCs usually restricts device efficiency and stability. Here, a strategy of employing 2-aminoethanesulfonic acid (i.e., taurine) as the interface bridge to fabricate efficient HTL-free LBG PSCs with improved optoelectronic properties of the perovskite absorbers at the buried contacts is reported. Taurine-modified ITO substrate has lower optical losses, better energy level alignment, and higher charge transfer capability than PEDOT:PSS HTL, leading to significantly improved open-circuit voltage (VOC ) and short-circuit current density of corresponding devices. The best-performing LBG PSC with a power conversion efficiency (PCE) of 22.50% and an impressive VOC of 0.911 V is realized, enabling all-perovskite TSCs with an efficiency of 26.03%. The taurine-based HTL-free TSCs have highly increased stability, retaining more than 90% and 80% of their initial PCEs after constant operation under 1-sun illumination for 600 h and under 55 °C thermal stress for 950 h, respectively. This work provides a facile strategy for fabricating efficient and stable perovskite devices with a simplified HTL-free architecture.

Advances in polysaccharides for probiotic delivery: Properties, methods, and applications

Probiotics are essential to improve the health of the host, whereas maintaining the viability of probiotics in harsh environments remains a challenge. Polysaccharides have non-toxicity, excellent biocompatibility, and outstanding biodegradability, which can protect probiotics by forming a physical barrier and show a promising prospect for probiotic delivery. In this review, we summarize polysaccharides commonly used for probiotic microencapsulation and introduce the microencapsulation technologies, including extrusion, emulsion, spray drying, freeze drying, and electrohydrodynamics. We discuss strategies for better protection of probiotics and introduce the applications of polysaccharides-encapsulated probiotics in functional food, oral formulation, and animal feed. Finally, we propose the challenges of polysaccharides-based delivery systems in industrial production and application. This review will help provide insight into the advances and challenges of polysaccharides in probiotic delivery.

Adaptive Radiotherapy Guided by PET/CT in Patients with Locally Advanced Non-Small Cell Lung Cancer: A Phase II Randomized Study

PURPOSE/OBJECTIVE(S)

The aim of this study was to determine whether adaptive radiotherapy guided by functional imaging with flourine-18 fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) can improve local tumor control in patients with locally advanced non-small cell lung cancer (LA-NSCLC).

MATERIALS/METHODS

This was a phase II randomized study comparing the efficacy and safety between PET-guided adaptive radiotherapy and conventional radiotherapy. The primary end point was 2-year local-regional tumor control (LRTC) rate. Secondary end points included local-regional progression-free survival (LR-PFS), progression-free survival (PFS), overall survival (OS), and radiation-related toxicities.

RESULTS

Between November 2012 and June 2017, 72 patients were 1:1 randomized to adaptive and conventional arms. The 2- and 5-year LRTC rates were 63.2% and 58.0% versus 43.0% and 37.6% (P = 0.035) in the adaptive and conventional arms, respectively. The median LR-PFS (14.3 versus 12.0 months; P = 0.010) and PFS (12.8 versus 8.9 months; P = 0.034) were significantly longer in the adaptive arm than in the conventional arm. The median OS was 36.3 months in the adaptive arm and 28.8 months in the conventional arm (P = 0.266). The esophageal volume of receiving ≥60 Gy (V60) in the adaptive arm was lower than that in the conventional arm (P = 0.011), while the V30 for the heart in the adaptive arm was lower than that in the conventional arm (P = 0.077). Other radiological metrological parameters of tumor, organs at risk, and the incidence of ≥grade 2 radiation-related toxicities were not significantly different between the 2 arms.

CONCLUSION

Compared with conventional radiotherapy, PET-guided adaptive radiotherapy significantly improved the 2-year LRTC rate, LR-PFS, and PFS without increased risks of radiation-related toxicities in patients with LA-NSCLC.

Does Dual Anti-HER2 Therapy Increase Early Cardiac Toxicity in Comparison with Trastuzumab Alone in Breast Cancer Patients Receiving Adjuvant Radiotherapy? A Multicenter Retrospective Study

PURPOSE/OBJECTIVE(S)

Adjuvant trastuzumab in combination with RT has proved its safety in terms of cardiac events. Dual anti-HER2 therapy with pertuzumab is currently standard adjuvant therapy in N+ and high-risk N0 early breast cancer (BC) patients. Our study aims to find if it increases early cardiac toxicity compared with trastuzumab alone in BC patients receiving adjuvant radiotherapy.

MATERIALS/METHODS

Operable BC patients who received adjuvant radiotherapy (RT) and trastuzumab with or without pertuzumab between January 2017 and September 2020 in 7 Chinese centers were retrospectively reviewed. The cardiac examination included ultrasonography, electrocardiogram (ECG), NT-proBNP, and cTnI before RT and during follow-up. The cardiac event was any new-onset symptomatic heart disease or abnormality in the cardiac examination after RT.

RESULTS

In total, 711 patients with a median age of 52 years were included, of whom 567 (79.7%) patients were treated with trastuzumab-only and 144 (20.3%) patients received dual anti-HER2 therapy. Adjuvant RT was given concurrently in 140/144 (97.2%) of dual anti-HER2 therapy and 562/567 (99.1%) of trastuzumab alone, respectively. With a median follow-up of 11 months, no patients developed symptomatic heart diseases. Among patients with normal baseline, 17 (2.4%), 86 (12.1%), 18 (2.5%) and 14 (7.3%) developed new-onset diastolic dysfunction, left ventricular ejection fraction (LVEF) decline, abnormal ECG, and abnormal NT-proBNP, respectively. No significant difference was found between the trastuzumab-only and dual anti-HER2 cohort in the incidence of all kinds of new-onset cardiac events (all p > 0.1). Multivariate analysis showed that left-sided (vs right-sided) RT significantly increased the risk of ECG abnormality (HR = 2.32, 95% CI 1.62-3.32, p<0.001). Increased age was an independent risk factor for diastolic dysfunction (HR = 1.1, 95% CI 1.02-1.18, p = 0.0098). Dosimetric analysis showed that patients who developed any cardiac events had increased mean heart dose (397.67±251.08 vs 344.87±236.75 cGy, p = 0.032). A significant increase in risk of cardiac events was found in patients with mean heart dose > 450 cGy (HR = 1.55, 95% CI 1.17-2.05, p = 0.0024), V5 > 26% (HR = 1.51, 95% CI 1.09-2.09, p = 0.013), and V30 > 5.5% (HR = 1.49, 95% CI 1.09-2.04, p = 0.0117), respectively. Further analysis was done in the subgroup of patients treated with left-sided RT, internal mammary nodes RT, or anthracyclines, no difference in risk of cardiac events was found between trastuzumab alone and dual anti-HER2 therapy in concurrent with RT (all p > 0.05).

CONCLUSION

Compared with trastuzumab-only, dual anti-HER2 therapy does not increase early cardiac toxicity in combination with adjuvant RT in BC patients. Cardiac radiation exposure remains the primary risk factor associated with early cardiac toxicity.

Visualization of Thromboinflammation by 18F-DPA-714 PET in a Stroke Patient

ABSTRACT

A 44-year-old man who presented with progressive right limb weakness was diagnosed with ischemic stroke. He was referred for 18F-DPA-714 PET/CT for evaluation of the disease. 18F-DPA-714 PET/CT showed increased uptake of the intracranial thrombus. This DPA-714-avid thrombus highly suggested the involvement of immune cells in the extension of the clot resulting in neurological deterioration. This present case suggested that 18F-DPA-714 PET might be a promising tracer in visualizing thromboinflammation in vivo.

30 Gy vs. 45 Gy Consolidative Thoracic Radiation (cTRT) for Extensive Stage Small Cell Lung Cancer (ES-SCLC): A Multicenter, Randomized, Phase 3 Trial

PURPOSE/OBJECTIVE(S)

Consolidative thoracic radiotherapy (cTRT) showed potential benefit to extensive stage small cell lung cancer (ES-SCLC). However, the optimum dose of cTRT is unknown. The purpose of this randomized trial was to compare the effect of 45 Gy in 15 fractions with 30 Gy in 10 fractions cTRT in ES-SCLC.

MATERIALS/METHODS

This phase III, randomized trial was conducted in 12 public hospitals in China. Eligible patients with pathologically confirmed ES-SCLC who responded to 4-6 cycles of etoposide plus cisplatin (EP) or carboplatin (EC) chemotherapy were randomized 1:1 to receive either 30 Gy in 10 fractions or 45 Gy in 15 fractions cTRT. The primary outcome was 2-year overall survival (OS). Secondary outcomes included 2-year progression-free survival (PFS), 2-year local control (LC) and radiation treatment related toxicity. The primary objective was to detect an OS improvement in 45 Gy cTRT group at 2 years from 13% to 26% assuming a two-sided a = 0.05 and power of 85%, with a planned sample size of 186 patients. This trial was registered with Clinical Trials.gov, number NCT02675088.

RESULTS

Between January 15, 2016, and September 20, 2022, 90 patients were randomly assigned either 30 Gy in 10 fractions (n = 50) or 45 Gy in 15 fractions (n = 40) cTRT group. Recruitment to the trial closed early due to slow accrual since first-line chemoimmunotherapy has become the new standard of care for ES-SCLC. The median age of patients was 58 years, 87.8% were male, 76.7% had a smoking history, 95.6% received IMRT, and 58.9% received prophylactic cranial irradiation. At a median follow-up of 39.9 months (IQR 27.2-59.2), there was no significant difference in the 2-year OS between the 45 Gy group and the 30 Gy group, at 43.4% (95% CI 29.3%-64.3%) and 40.0% (95% CI 27.9%-59.1%), respectively (log-rank p = 0.62; HR 1.13 [95% CI 0.69-1.84]). The 2-year PFS was 12.1% (95% CI 4.3%-33.8%) in the 45 Gy group and 9.0% (95% CI 3.2%-25.2%) in the 30 Gy group (log-rank p = 0.25, HR 0.76(95% CI [0.478-1.22]). There were also no significant differences in locoregional recurrence free survival (log-rank p = 0.75; HR 0.888 [95% CI 0.423-1.863]) and distant metastasis free survival (log-rank p = 0.95; HR 1.015 [95% CI 0.624-1.651]) between two groups. No grade 5 toxicity was observed in both groups. Patients treated with higher cTRT dose presented with increased incidence of grade 3+ radiation pneumonitis (10% vs 2%) and hematological toxicity (20% vs 12.5%).

CONCLUSION

This randomized trial did not find a higher probability of survival improvement in patients with ES-SCLC receiving cTRT of 45 Gy in 15 fractions compared with 30 Gy in 10 fractions. In contrast, there was an increase in toxicity, especially radiation pneumonitis. Additional randomized studies investigating the role of cTRT in ES-SCLC after a response to chemoimmunotherapy are warranted.

Quality Assurance of Protocol Compliance in a Multicenter Randomized Trial Investigating the Role of Hypofractionated Comprehensive Reginal Nodal Irradiation in Node-Positive Breast Cancer (HARVEST)

PURPOSE/OBJECTIVE(S)

The HARVEST trial (NCT03829553) is a phase III, multicenter, randomized clinical trial to explore efficacy and safety of hypofractionated irradiation (HFI) involving regional nodal irradiation (RNI, including internal mammary nodes, IMN) in N+ breast cancer patients treated with mastectomy or breast conserving surgery (BCS). Current study aims to analyze the dosimetric quality assurance so as to evaluate the compliance to the trial protocol.

MATERIALS/METHODS

Eligible patients were randomly assigned (1:1) to receive conventional fractionated irradiation (CFI: 50 Gy/25Fx) or HFI (40.05 Gy/15Fx), which is delivered to ipsilateral chest wall or whole breast (CW/WB) with tumor bed boost (HFI: 10.68 Gy/4Fx; CFI: 10 Gy/5Fx) and comprehensive RNI (supra/infraclavicular nodes and IMN in each patient, lower axilla if indicated) by using IMRT technique. The plan quality was evaluated based on dose distribution, dose volume histogram (DVH) and field parameters. The target coverage, including planning target volume of CW/WB (PTV1) and tumor bed (PTV2) and doses of the organs at risk (OARs) were evaluated. The LQ model was used to convert doses of OARs in HFI group using α/β = 3 Gy (EQD23) for comparison.

RESULTS

Between Feb 21, 2019 and Feb 14, 2022, 801 patients were enrolled at 8 centers with 401 and 400 in CFI and HFI group, respectively. There were 182 patients received BCS and 387 patients were with more than three positive lymph nodes. In the CFI group, the D90 and V45 of PTV1 reached the prescribed dose in 70.6% and 96.0% of the patients, respectively. In the HFI group, the D90 and V36 of PTV1 reached the prescribed dose in 87.8% and 95.5% of the patients, respectively. When the tumor bed was irradiated, the D90 of PTV2 reached the prescribed dose in 95.6% in the CFI group and 100% in the HFI group, respectively. The mean D90 of PTV1 and PTV2 were 50.09±0.65 Gy and 60.63±0.91 Gy in CFI group while 40.11±0.56 Gy and 50.79±2.03 Gy in HFI group. For OARs constraints, protocol compliance was all above 95% (heart: 95.3%; ipsilateral lung: 95.5%; contralateral lung: 97.1%; humeral head: 98.2% and spinal cord: 100%) with no significant difference between CFI and HFI groups. For patients with left-sided breast cancer, the Dmean of the heart was 5.10±1.75 Gy vs. 4.59±1.86 Gy (EQD23) in CFI and HFI groups (p = 0.51), respectively. No significant differences in Dmean of the heart (1.45±0.71 Gy vs. 1.33±0.77 Gy (EQD23), p = 0.40) was found either between two groups in right-sided patients. The differences were significant in the Dmean of the ipsilateral lung (13.37±1.99 Gy vs. 11.17±3.50 Gy (EQD23), p<0.01), contralateral lung (0.88±0.73 Gy vs. 0.74±0.61 Gy (EQD23), p<0.01) and the ipsilateral humeral head (15.27±7.62 Gy vs. 13.05±6.19 Gy (EQD23), p<0.01) and the Dmax of spinal cord (21.40±8.82 Gy vs. 19.47±7.99 Gy (EQD23), p = 0.05) between CFI and HFI groups.

CONCLUSION

A high degree of compliance with protocol dose constraints was found for treatment plans in the HARVEST trial and doses to the most of OARs decreased in HFI group.

Strong Magnetically-Responsive Circularly Polarized Phosphorescence and X-Ray Scintillation in Ultrarobust Mn(II)-Organic Helical Chains

Over recent years, Mn(II)-organic materials showing circularly polarized luminescence (CPL) have attracted great interest because of their eco-friendliness, cheapness, and room temperature phosphorescence. Using the helicity design strategy, herein, chiral Mn(II)-organic helical polymers are constructed featuring long-lived circularly polarized phosphorescence with exceptionally high glum and ΦPL magnitudes of 0.021% and 89%, respectively, while remaining ultrarobust toward humidity, temperature, and X-rays. Equally important, it is disclosed for the first time that the magnetic field has a remarkably high negative effect on CPL for Mn(II) materials, suppressing the CPL signal by 4.2-times atB ⃗ $\vec{B}$  = 1.6 T. Using the designed materials, UV-pumped CPL light-emitting diodes are fabricated, demonstrating enhanced optical selectivity under right- and left-handed polarization conditions. On top of all this, the reported materials display bright triboluminescence and excellent X-ray scintillation activity with a perfectly linear X-ray dose rate response up to 174 µGyair  s-1 . Overall, these observations significantly contribute to the CPL phenomenon for multi-spin compounds and promote the design of highly efficient and stable Mn(II)-based CPL emitters.

Neutron Irradiation Effects on Boron Nitride-Based Ceramics for Use in X-ray Detection

X-ray detectors based on conventional semiconductors with large atomic numbers are suffering from the poor stability under a high dose rate of ionizing irradiation. In this work, we demonstrate that a wide band gap ceramic-boron nitride with small atomic numbers could be used for sensitive X-ray detection. Boron nitride samples showed excellent resistance to ionizing radiation, which have been systematically studied with the neutron- and electron-aging experiments. Then, we fully analyzed the influence of these aging effects on the fundamental properties of boron nitride. Interestingly, we found that the boron nitride samples could maintain relatively good charge transport properties even after large dose of neutron irradiation. The fabricated X-ray detectors showed decent performance metrics, and the neutron-aged boron nitride even showed improved operational stability under continuous X-ray irradiation, suggesting the great potential for real applications.

Flexible all-organic photodetectors via universal water-assisted transfer printing

Transfer printing of small-molecular organic semiconductors often faces challenges due to surface adhesion mismatch. Here, we developed a sacrificing-layer-assisted transfer printing technique for the deposition of small-molecular thin films. High-boiling-point ethylene glycol (EG) was doped in aqueous solution poly(3,4-ethylenedioxythiophene) polystyrene sulfonate (PEDOT:PSS) as the sacrificing layer to manipulate residual water in film, which allowed chlorobenzene solution to spontaneously spread and form uniform film. The residual water guaranteed film delamination from the stamp, allowing for its transfer onto various substrates and seeding layers. As a proof of concept, laterally conductive organic photodetectors using recyclable EG-PEDOT:PSS electrodes and a small-molecular active layer were consecutively fabricated via transfer printing in ambient air. The resulting device exhibited a high on/off ratio of 711 and a fast rise time of 0.5 ms. Notably, the polymer electrode and the bulk heterojunction demonstrated unique repairability and recyclability.

Charge-Carrier Dynamics of Evaporated Bismuth-Based Chalcogenide Thin Films Probed with Time-Resolved Microwave Conductivity

Chalcogenide-based semiconductors are emerging as a set of highly promising candidates for optoelectronic devices, owing to their low toxicity, cost-effectiveness, exceptional stability, and tunable optoelectronic properties. Nonetheless, the limited understanding of charge recombination mechanisms and trap states of these materials is impeding their further development. To fill this gap, we conducted a comprehensive study of bismuth-based chalcogenide thin films and systematically investigated the influence of post-treatments via time-resolved microwave conductivity and temperature-dependent photoluminescence. The key finding in this work is that post-treatment with Bi could effectively enhance the crystallinity and charge-carrier mobility. However, the carrier density also increased significantly after the Bi treatment. On the contrary, post-treatment of evaporated Bi₂S₃ thin films with sulfur could effectively increase the carrier lifetime and mobility by passivating the trap states on the grain boundaries, which is also consistent with the enhanced radiative recombination efficiency.

Improved Carrier Management via a Multifunctional Modifier for High-Quality Low-Bandgap Sn-Pb Perovskites and Efficient All-Perovskite Tandem Solar Cells

All-perovskite tandem solar cells (TSCs) hold great promise in terms of ultrahigh efficiency, low manufacturing cost, and flexibility, stepping forward to the next-generation photovoltaics. However, their further development is hampered by the relatively low performance of low-bandgap (LBG) tin (Sn)-lead (Pb) perovskite solar cells (PSCs). Improving the carrier management, including suppressing trap-assisted non-radiative recombination and promoting carrier transfer, is of great significance to enhance the performance of Sn-Pb PSCs. Herein, a carrier management strategy is reported for using cysteine hydrochloride (CysHCl) simultaneously as a bulky passivator and a surface anchoring agent for Sn-Pb perovskite. CysHCl processing effectively reduces trap density and suppresses non-radiative recombination, enabling the growth of high-quality Sn-Pb perovskite with greatly improved carrier diffusion length of >8 µm. Furthermore, the electron transfer at the perovskite/C₆₀ interface is accelerated due to the formation of surface dipoles and favorable energy band bending. As a result, these advances enable the demonstration of champion efficiency of 22.15% for CysHCl-processed LBG Sn-Pb PSCs with remarkable enhancement in both open-circuit voltage and fill factor. When paired with a wide-bandgap (WBG) perovskite subcell, a certified 25.7%-efficient all-perovskite monolithic tandem device is further demonstrated.

Additive-Enhanced Crystallization of Inorganic Perovskite Single Crystals for High-Sensitivity X-Ray Detection

Inorganic cesium lead halide perovskite single crystals are particularly intriguing to ionizing radiation detection by virtue of their material stability and high attenuation coefficients. However, the growth of high-quality inorganic perovskite single crystals remains challenging, mainly due to the limited solubility. In this work, an additive-enhanced crystallization method is proposed for cesium lead perovskites. The additive can remarkably increase the solubility of cesium bromide in dimethyl sulfoxide (DMSO) forming a balanced stoichiometric precursor solution, which prevents the formation of impurity phases. In addition, the additives would react with DMSO generating glyoxylic acid (GLA) via nucleophilic substitution and Kornblum oxidation reactions. The GLA can form stable PbBr₂ -DMSO-GLA complexes, which enables better crystallinity, uniformity and much longer carrier lifetimes for the grown single crystals. The X-ray detectors using the additive-enhanced crystals exhibit an ultra-high sensitivity of 3.0 × 10⁴  µC Gy_air ^-1 cm^-2 which is more than two orders of magnitude higher than that for the control devices.

Seismic magnitude clustering is prevalent in field and laboratory catalogs

Clustering of earthquake magnitudes is still actively debated, compared to well-established spatial and temporal clustering. Magnitude clustering is not currently implemented in earthquake forecasting but would be important if larger magnitude events are more likely to be followed by similar sized events. Here we show statistically significant magnitude clustering present in many different field and laboratory catalogs at a wide range of spatial scales (mm to 1000 km). It is universal in field catalogs across fault types and tectonic/induced settings, while laboratory results are unaffected by loading protocol or rock types and show temporal stability. The absence of clustering can be imposed by a global tensile stress, although clustering still occurs when isolating to triggered event pairs or spatial patches where shear stress dominates. Magnitude clustering is most prominent at short time and distance scales and modeling indicates >20% repeating magnitudes in some cases, implying it can help to narrow physical mechanisms for seismogenesis.

Perturbomics of tumor-infiltrating NK cells

Natural killer (NK) cells are an innate immune cell type that serves at the first level of defense against pathogens and cancer. NK cells have clinical potential, however, multiple current limitations exist that naturally hinder the successful implementation of NK cell therapy against cancer, including their effector function, persistence, and tumor infiltration. To unbiasedly reveal the functional genetic landscape underlying critical NK cell characteristics against cancer, we perform perturbomics mapping of tumor infiltrating NK cells by joint in vivo AAV-CRISPR screens and single cell sequencing. We establish a strategy with AAV-SleepingBeauty(SB)- CRISPR screening leveraging a custom high-density sgRNA library targeting cell surface genes, and perform four independent in vivo tumor infiltration screens in mouse models of melanoma, breast cancer, pancreatic cancer, and glioblastoma. In parallel, we characterize single-cell transcriptomic landscapes of tumor-infiltrating NK cells, which identifies previously unexplored sub-populations of NK cells with distinct expression profiles, a shift from immature to mature NK (mNK) cells in the tumor microenvironment (TME), and decreased expression of mature marker genes in mNK cells. CALHM2, a calcium homeostasis modulator that emerges from both screen and single cell analyses, shows both in vitro and in vivo efficacy enhancement when perturbed in chimeric antigen receptor (CAR)-NK cells. Differential gene expression analysis reveals that CALHM2 knockout reshapes cytokine production, cell adhesion, and signaling pathways in CAR- NKs. These data directly and systematically map out endogenous factors that naturally limit NK cell function in the TME to offer a broad range of cellular genetic checkpoints as candidates for future engineering to enhance NK cell-based immunotherapies.

Therapeutic immune cell engineering with an mRNA : AAV- Sleeping Beauty composite system

Adoptive cell therapy has shown clinical success in patients with hematological malignancies. Immune cell engineering is critical for production, research, and development of cell therapy; however, current approaches for generation of therapeutic immune cells face various limitations. Here, we establish a composite gene delivery system for the highly efficient engineering of therapeutic immune cells. This system, termed MAJESTIC ( m RNA A AV-Sleeping-Beauty J oint E ngineering of S table T herapeutic I mmune C ells), combines the merits of mRNA, AAV vector, and transposon into one composite system. In MAJESTIC, the transient mRNA component encodes a transposase that mediates permanent genomic integration of the Sleeping Beauty (SB) transposon, which carries the gene-of-interest and is embedded within the AAV vector. This system can transduce diverse immune cell types with low cellular toxicity and achieve highly efficient and stable therapeutic cargo delivery. Compared with conventional gene delivery systems, such as lentiviral vector, DNA transposon plasmid, or minicircle electroporation, MAJESTIC shows higher cell viability, chimeric antigen receptor (CAR) transgene expression, therapeutic cell yield, as well as prolonged transgene expression. CAR-T cells generated by MAJESTIC are functional and have strong anti-tumor activity in vivo . This system also demonstrates versatility for engineering different cell therapy constructs such as canonical CAR, bi-specific CAR, kill switch CAR, and synthetic TCR; and for CAR delivery into various immune cells, including T cells, natural killer cells, myeloid cells, and induced pluripotent stem cells.

Manipulation of the Buried Interface for Robust Formamidinium-based Sn-Pb Perovskite Solar Cells with NiOx Hole-Transport Layers

Low band gap tin-lead perovskite solar cells (Sn-Pb PSCs) are expected to achieve higher efficiencies than Pb-PSCs and regarded as key components of tandem PSCs. However, the realization of high efficiency is challenged by the instability of Sn²⁺ and the imperfections at the charge transfer interfaces. Here, we demonstrate an efficient ideal band gap formamidinium (FA)-based Sn-Pb (FAPb_0.5 Sn_0.5 I₃ ) PSC, by manipulating the buried NiO_x /perovskite interface with 4-hydroxyphenethyl ammonium halide (OH-PEAX, X=Cl^- , Br^- , or I^- ) interlayer, which exhibits fascinating functions of reducing the surface defects of the NiO_x hole transport layer (HTL), enhancing the perovskite film quality, and improving both the energy level matching and physical contact at the interface. The effects of different halide anions have been elaborated and a 20.53 % efficiency is obtained with OH-PEABr, which is the highest one for FA-based Sn-Pb PSCs using NiO_x HTLs. Moreover, the device stability is also boosted.

RAMIHM generates fully human monoclonal antibodies by rapid mRNA immunization of humanized mice and BCR-seq

As a clinical vaccine, lipid nanoparticle (LNP) mRNA has demonstrated potent and broad antibody responses, leading to speculation about its potential for antibody discovery. Here, we developed RAMIHM, a highly efficient strategy for developing fully human monoclonal antibodies that employs rapid mRNA immunization of humanized mice followed by single B cell sequencing (scBCR-seq). We immunized humanized transgenic mice with RAMIHM and generated 15 top-ranked clones from peripheral blood, plasma B, and memory B cell populations, demonstrating a high rate of antigen-specificity (93.3%). Two Omicron-specific neutralizing antibodies with high potency and one broad-spectrum neutralizing antibody were discovered. Furthermore, we extended the application of RAMIHM to cancer immunotherapy targets, including a single transmembrane protein CD22 and a multi-transmembrane G protein-coupled receptor target, GPRC5D, which is difficult for traditional protein immunization methods. RAMIHM-scBCR-seq is a broadly applicable platform for the rapid and efficient development of fully human monoclonal antibodies against an assortment of targets.

The Association between Dietary Protein Diversity and Protein Patterns with Frailty in Older Chinese Adults: A Population-Based Cohort Study

OBJECTIVES

Frailty is a pervasive condition among older people worldwide. Despite the association between higher protein intake and lower frailty risk has been well documented, older individuals encounter barriers to enhancing their protein consumption due to reduced appetite and impaired digestive capacity. This study aims to delve into the potential correlation between dietary protein diversity, protein patterns, and the risk of frailty among older Chinese individuals.

DESIGN

Prospective cohort study.

SETTING

Community-based.

PARTICIPANTS

2,216 participants aged 65 and above and not frail at the baseline were recruited from the Chinese Longitudinal Healthy Longevity Survey (CLHLS) dataset spanning from 2014 to 2018.

MEASUREMENTS

Dietary protein diversity was evaluated utilizing a protein diversity score (PDS), calculated based on the results of a food frequency questionnaire. Dietary protein patterns were identified by employing principal component analysis (PCA). Frailty was ascertained using a 40-item frailty index (FI) where FI > 0.21 indicated frailty. Logistic analysis was employed to investigate the association between dietary variables and frailty.

RESULTS

541 participants were identified as frail after a 4-year follow-up. After adjusting for confounders, each 1-unit increase in PDS was linked to a 10% decrease in frailty risk. Compared to individuals with PDS ≤ 1, those with PDS scores of 2-3, 4-5, and 6 had lower risks of frailty, with OR (95% CI) of 0.78 (0.58-1.06), 0.58 (0.38-0.87), 0.42 (0.20-0.81), respectively (P trend = 0.038). Individuals who consistently maintained high PDS demonstrated a lower frailty risk in contrast to those who maintained low PDS (OR = 0.60, 95% CI, 0.41-0.87). Additionally, the "meat-fish" pattern exhibited a protective association with frailty, with OR Q4 versus Q1 (95% CI) of 0.54 (0.40-0.74), P trend < 0.001.

CONCLUSION

Maintaining a variety of dietary protein sources and following a "meat-fish" protein pattern might decrease the likelihood of frailty among the older Chinese population.

Interfacial Engineering of High-Performance, Solution-Processed Sb2S3 Phototransistors

Antimony sulfide, as a binary chalcogenide, has attracted great attention in the field of optoelectronics in recent years, particularly in photovoltaics, because of its striking merits such as earth elements abundance, excellent stability, chemical versatility, and solution processability. With the rapid development of fabrication techniques and device engineering, the device performance of Sb₂S₃ solar cells has experienced an unprecedented success. However, photodetectors based on Sb₂S₃ were barely reported, especially based on the transistor configuration. In this work, we prepared high quality Sb₂S₃ thin films via a sol-gel method, and Sb₂S₃ thin films were deposited on zinc-tin oxide based field-effect transistors. Furthermore, an additional electron transport layer was inserted between the Sb₂S₃ layers and the zinc-tin oxide channels and archived high-performance phototransistors with proper interfacial engineering. The optimized devices exhibited extremely high photosensitivity (10⁶), low dark current (∼10 pA) and noise (∼11 fA Hz^-1/2), high detectivity (1 × 10¹³ Jones), and superior device stability, indicating great potential for next generation solution-processed photodetectors.

Pressure-Induced Indirect-Direct Bandgap Transition of CsPbBr3 Single Crystal and Its Effect on Photoluminescence Quantum Yield

Despite extensive study, the bandgap characteristics of lead halide perovskites are not well understood. Usually, these materials are considered as direct bandgap semiconductors, while their photoluminescence quantum yield (PLQY) is very low in the solid state or single crystal (SC) state. Some researchers have noted a weak indirect bandgap below the direct bandgap transition in these perovskites. Herein, application of pressure to a CsPbBr3 SC and first-principles calculations reveal that the nature of the bandgap becomes more direct at a relatively low pressure due to decreased dynamic Rashba splitting. This effect results in a dramatic PLQY improvement, improved more than 90 times, which overturns the traditional concept that the PLQY of lead halide perovskite SC cannot exceed 10%. Application of higher pressure transformed the CsPbBr3 SC into a pure indirect bandgap phase, which can be maintained at near-ambient pressure. It is thus proved that lead halide perovskites can induce a phase transition between direct and indirect bandgaps. In addition, distinct piezochromism is observed for a perovskite SC for the first time. This work provides a novel framework to understand the optoelectronic properties of these important materials.

Fluorinated Interlayer Modulation of NiOx-Based Inverted Perovskite Solar Cells

p-Type inorganic nickel oxide (NiOx) exhibits high transparency, tunable-optoelectronic properties, and a work function (W_F) that is potentially suitable for hole extraction in inverted perovskite solar cells (PSCs). However, NiOx films possess surface defects that lead to high interfacial recombination and an energy offset with the ionization potential of the perovskite. Herein, we show that fluorinated 3-(2,3,4,5,6-pentafluorophenyl)propan-1-aminium iodide (FPAI) can be used to modify the electronic properties of the NiOx anode interlayer. The FPAI modification led to good perovskite crystal growth and films with reduced surface defects. The FPAI modification also increased the W_F of NiOx and improved charge extraction. These improvements led to an increased V_oc value compared with control devices without FPAI modification, 1.05 V versus 1.00 V, and a higher short-circuit current and larger fill factor. As a result, the best PSCs with FPAI-modified NiOx had a power conversion efficiency of 19.3%. Finally, the PSCs with the FPAI-modified NiOx layer were found to have improved stability.

[A prospective cohort study on refractive status of schoolchildren in Huangzhong District, Xining City, Qinghai Province]

Objective: To determine the characteristics and progress of the visual acuity and refractive state of schoolchildren in Huangzhong District, Xining City, Qinghai Province in China. Methods: Cohort study. Department of Ophthalmology, Beijing Children's Hospital carried out a cohort study by collecting the visual acuity and refractive state of Grade 1-5 schoolchildren among 16 primary schools in Huangzhong District, Xining City, Qinghai Province in September 2020 and July 2021. Cycloplegic retinoscopy with eye drop which contained tropicamide (0.5%) and phenylephrine hydrochloride (0.5%) was performed in children with low vision(<1.0). Myopia was defined as the spherical equivalent (SE) ≤-0.5 D after cycloplegic retinoscopy. Measurement data was analyzed by t-test and enumeration data was analyzed by χ² test. Multiple linear regression was used to analyze the influencing factors. Results: The 2 489 individuals with repeated tests in two years were included in the follow-up study, among whom the prevalence of myopia was 26.24%(653/2 489) in 2020, while 32.94% (820/2 489)respectively in 2021. The incidence of myopia in one school year from grades 1 to 5 was 11.19%(47/420), 5.44%(21/386), 6.39%(25/391), 11.52%(44/382) and 11.67%(30/257). The average SE of children in all grades in 2021 increased negatively from the previous year (Grade 1 to Grade 5 increased respectively: 0.40 D, 0.69 D, 0.62 D, 0.52 D and 0.37 D). Conclusions: The prevalence of myopia among schoolchildren in Huangzhong District, Xining City, Qinghai Province was relatively high. There were two peaks of myopia incidence in the first, fourth and fifth grades. Female, age, and the baseline of SE were the related influencing factors for myopia progression.

Optoelectronic Modulation of Silver Antimony Sulfide Thin Films for Photodetection

Silver antimony sulfide, as a ternary chalcogenide, has attracted great attention in the field of optoelectronics in recent years. In particular, it has appealing properties, such as excellent stability, solution processability, and versatile composition tunability. Benefiting from the recent development of processing techniques, AgSbS₂ has emerged as a promising candidate for next-generation, thin-film photovoltaics. On the contrary, AgSbS₂-based photodetectors have been barely reported. In this work, we systematically investigated the composition engineering of silver antimony sulfide compounds with a precursor route. Their optoelectronic properties were fully characterized, and the composition was optimized for photodetection. High-performance phototransistors were first reported based on field-effect thin film transistors with interfacial modification. The obtained AgSbS₂ phototransistors exhibited relatively high photosensitivity, low dark current and noise, superior device stability, and excellent detectivity covering the whole range from ultraviolet to near-infrared, highlighting the great potential for next-generation photodetection.

Multiplexed LNP-mRNA vaccination against pathogenic coronavirus species

Although COVID-19 vaccines have been developed, multiple pathogenic coronavirus species exist, urging on development of multispecies coronavirus vaccines. Here we develop prototype lipid nanoparticle (LNP)-mRNA vaccine candidates against SARS-CoV-2 Delta, SARS-CoV, and MERS-CoV, and we test how multiplexing LNP-mRNAs can induce effective immune responses in animal models. Triplex and duplex LNP-mRNA vaccinations induce antigen-specific antibody responses against SARS-CoV-2, SARS-CoV, and MERS-CoV. Single-cell RNA sequencing profiles the global systemic immune repertoires and respective transcriptome signatures of vaccinated animals, revealing a systemic increase in activated B cells and differential gene expression across major adaptive immune cells. Sequential vaccination shows potent antibody responses against all three species, significantly stronger than simultaneous vaccination in mixture. These data demonstrate the feasibility, antibody responses, and single-cell immune profiles of multispecies coronavirus vaccination. The direct comparison between simultaneous and sequential vaccination offers insights into optimization of vaccination schedules to provide broad and potent antibody immunity against three major pathogenic coronavirus species.

[Outcomes at discharge of preterm infants born <34 weeks' gestation]

Objective: To investigate the incidence and trend of short-term outcomes among preterm infants born <34 weeks' gestation. Methods: A secondary analysis of data from the standardized database established by a multicenter cluster-randomized controlled study "reduction of infection in neonatal intensive care units (NICU) using the evidence-based practice for improving quality (REIN-EPIQ) study". This study was conducted in 25 tertiary NICU. A total of 27 192 infants with gestational age <34 weeks at birth and admitted to NICU within the first 7 days of life from May 2015 to April 2018 were enrolled. Infants with severe congenital malformation were excluded. Descriptive analyses were used to describe the mortality and major morbidities of preterm infants by gestational age groups and different admission year groups. Cochran-Armitage test and Jonckheere-Terpstra test were used to analyze the trend of incidences of mortality and morbidities in 3 study-years. Multiple Logistic regression model was constructed to analyze the differences of outcomes in 3 study-years adjusting for confounders. Results: A total of 27 192 preterm infants were enrolled with gestational age of (31.3±2.0) weeks at birth and weight of (1 617±415) g at birth. Overall, 9.5% (2 594/27 192) of infants were discharged against medical advice, and the overall mortality rate was 10.7% (2 907/27 192). Mortality for infants who received complete care was 4.7% (1 147/24 598), and mortality or any major morbidity was 26.2% (6 452/24 598). The incidences of moderate to severe bronchopulmonary dysplasia, sepsis, severe intraventricular hemorrhage or periventricular leukomalacia, proven necrotizing enterocolitis, and severe retinopathy of prematurity were 16.0% (4 342/27 192), 11.9% (3 225/27 192), 6.8% (1 641/24 206), 3.6% (939/25 762) and 1.5% (214/13 868), respectively. There was a decreasing of the overall mortality (P<0.001) during the 3 years. Also, the incidences for sepsis and severe retinopathy of prematurity both decreased (both P<0.001). However, there were no significant differences in the major morbidity in preterm infants who received complete care during the 3-year study period (P=0.230). After adjusting for confounders, infants admitted during the third study year showed significantly lower risk of overall mortality (adjust OR=0.62, 95%CI 0.55-0.69, P<0.001), mortality or major morbidity, moderate to severe bronchopulmonary dysplasia, sepsis and severe retinopathy of prematurity, compared to those admitted in the first study year (all P<0.05). Conclusions: From 2015 to 2018, the mortality and major morbidities among preterm infants in Chinese NICU decreased, but there is still space for further efforts. Further targeted quality improvement is needed to improve the overall outcome of preterm infants.

Scintillation light detection in the 6-m drift-length ProtoDUNE Dual Phase liquid argon TPC

DUNE is a dual-site experiment for long-baseline neutrino oscillation studies, neutrino astrophysics and nucleon decay searches. ProtoDUNE Dual Phase (DP) is a 6  ×  6  ×  6 m 3 liquid argon time-projection-chamber (LArTPC) that recorded cosmic-muon data at the CERN Neutrino Platform in 2019-2020 as a prototype of the DUNE Far Detector. Charged particles propagating through the LArTPC produce ionization and scintillation light. The scintillation light signal in these detectors can provide the trigger for non-beam events. In addition, it adds precise timing capabilities and improves the calorimetry measurements. In ProtoDUNE-DP, scintillation and electroluminescence light produced by cosmic muons in the LArTPC is collected by photomultiplier tubes placed up to 7 m away from the ionizing track. In this paper, the ProtoDUNE-DP photon detection system performance is evaluated with a particular focus on the different wavelength shifters, such as PEN and TPB, and the use of Xe-doped LAr, considering its future use in giant LArTPCs. The scintillation light production and propagation processes are analyzed and a comparison of simulation to data is performed, improving understanding of the liquid argon properties.

Thick-junction perovskite X-ray detectors: processing and optoelectronic considerations

Metal halide perovskites have attracted increasing attention due to their strong stopping power, defect tolerance, large mobility lifetime product, tunable bandgap and simple single-crystal growth via low-cost solution processes, particularly for ionizing radiation detection. Over the past few years, semiconductor-type X-ray detectors based on a variety of perovskites have been developed, showing impressive progress in achieving high sensitivity and low detection limits. In this study, based on the requirement of material properties for high-performance X-ray detectors, we review various materials used for direct detection and summarize the processing techniques and optoelectronic considerations of thick-junction perovskite X-ray detectors. This review also highlights the key challenges facing perovskite X-ray detectors towards real applications and discusses the opportunities, which are promising to explore and may require more research activities.

Engineering the Non-Radiative Recombination of Mixed-Halide Perovskites with Optimal Bandgap for Indoor Photovoltaics

Indoor photovoltaics have attracted increasing attention, since they can provide sustainable energy through the recycling of photon energy from household dim lighting. However, solar cells exhibiting high performance under sunlight may not perform well under indoor light conditions, mainly due to the mismatch of the irradiance spectrum. In particular, most of the indoor light sources emit visible photons with negligible near-infrared irradiance. According to the detailed balance theory, the optimal bandgap for indoor photovoltaics should be relatively larger, considering the trade-off between photocurrent and photovoltage losses. In this work, a systematic comparison of the theoretical limits of the conventional and indoor photovoltaics is presented. Then the non-radiative recombination losses are reduced by a synergetic treatment with Pb(SCN)₂ and PEABr, resulting relatively high open circuit voltage of 1.29 V and power conversion efficiency of 17.32% under 1 sun illumination. Furthermore, the devices are fully characterized under weak indoor light (1000 lux, 4000 K LED) achieving a high efficiency of 37.18%, which is promising for real applications.