Solution-Processable Large-Area Black Phosphorus/Reduced Graphene Oxide Schottky Junction for High-Temperature Broadband Photodetectors

2D materials-based broadband photodetectors have extensive applications in security monitoring and remote sensing fields, especially in supersonic aircraft that require reliable performance under extreme high-temperature conditions. However, the integration of large-area heterostructures with 2D materials often involves high-temperature deposition methods, and also limited options and size of substrates. Herein, a liquid-phase spin-coating method is presented based on the interface engineering to prepare larger-area Van der Waals heterojunctions of black phosphorus (BP)/reduced graphene oxide (RGO) films at room temperature on arbitrary substrates of any required size. Importantly, this method avoids the common requirement of high-temperature, and prevents the curling or stacking in 2D materials during the liquid-phase film formation. The BP/RGO films-based devices exhibit a wide spectral photo-response, ranging from the visible of 532 nm to infrared range of 2200 nm. Additionally, due to Van der Waals interface of Schottky junction, the array devices provide infrared detection at temperatures up to 400 K, with an outstanding photoresponsivity (R) of 12 A W-1 and a specific detectivity (D*) of ≈2.4 × 109 Jones. This work offers an efficient approach to fabricate large-area 2D Schottky junction films by solution-coating for high-temperature infrared photodetectors.

All-Covalent Organic Framework Nanofilms Assembled Lithium-Ion Capacitor to Solve the Imbalanced Charge Storage Kinetics

Free-standing covalent organic framework (COFs) nanofilms exhibit a remarkable ability to rapidly intercalate/de-intercalate Li+ in lithium-ion batteries, while simultaneously exposing affluent active sites in supercapacitors. The development of these nanofilms offers a promising solution to address the persistent challenge of imbalanced charge storage kinetics between battery-type anode and capacitor-type cathode in lithium-ion capacitors (LICs). Herein, for the first time, custom-made COFBTMB-TP and COFTAPB-BPY nanofilms are synthesized as the anode and cathode, respectively, for an all-COF nanofilm-structured LIC. The COFBTMB-TP nanofilm with strong electronegative-CF3 groups enables tuning the partial electron cloud density for Li+ migration to ensure the rapid anode kinetic process. The thickness-regulated cathodic COFTAPB-BPY nanofilm can fit the anodic COF nanofilm in the capacity. Due to the aligned 1D channel, 2D aromatic skeleton and accessible active sites of COF nanofilms, the whole COFTAPB-BPY//COFBTMB-TP LIC demonstrates a high energy density of 318 mWh cm-3 at a high-power density of 6 W cm-3, excellent rate capability, good cycle stability with the capacity retention rate of 77% after 5000-cycle. The COFTAPB-BPY//COFBTMB-TP LIC represents a new benchmark for currently reported film-type LICs and even film-type supercapacitors. After being comprehensively explored via ex situ XPS, 7Li solid-state NMR analyses, and DFT calculation, it is found that the COFBTMB-TP nanofilm facilitates the reversible conversion of semi-ionic to ionic C-F bonds during lithium storage. COFBTMB-TP exhibits a strong interaction with Li+ due to the C-F, C=O, and C-N bonds, facilitating Li+ desolation and absorption from the electrolyte. This work addresses the challenge of imbalanced charge storage kinetics and capacity between the anode and cathode and also pave the way for future miniaturized and wearable LIC devices.

Longitudinal evaluation of cervical length and shear wave elastography in women with spontaneous preterm birth

OBJECTIVES

To compare longitudinal changes in cervical length (CL) and mean cervical shear wave elastography (CSWE) scores between women with singleton and twin pregnancies who experience spontaneous preterm birth (sPTB) and those who have term births (TB).

METHODS

This was a prospective longitudinal study of 1264 unselected women with singleton (n=1143) and twin (n=121) pregnancy attending a dedicated research clinic for screening of sPTB at 4 timepoints during pregnancy including 11-15+6 (visit 1), 16-20+6 (visit 2), 21-24+6 (visit 3) and 28-32+6 (visit 4) weeks of gestation. At each visit, a transvaginal ultrasound scan was conducted to measure the CL and the CSWE scores from six regions of interest (ROI) (inner, middle, and external parts of anterior and posterior lips) in the cervix. The mean of CSWE scores from the six ROIs were calculated for data analysis. Log10 transformation was applied to make the data Gaussian prior to statistical analysis. A multilevel mixed-effects analysis was performed to compare CL and CSWE longitudinally between sPTB and TB groups.

RESULTS

A total of 57 (4.99%) singleton pregnancies and 33 (27.27%) twin pregnancies were complicated with sPTB. Women with sPTB had shorter CL across gestation when controlling for history of cervical surgery, number of fetuses, gestational age at cervical assessment (GA), and the interaction between GA and sPTB. CL in the sPTB group was significantly lower than that of the TB group at 21-24+6 weeks (p=0.039) and 28-32+6 weeks (p<0.001). Twin pregnancies had significantly longer CL throughout pregnancy, compared to singleton pregnancies (coefficient=0.01864, p<0.001). Furthermore, after adjusting for maternal age, weight, height, body mass index (BMI), and GA, CSWE scores in sPTB group were significantly lower in the sPTB group across gestation, compared to the TB group (1.28265 vs 1.32832; p=0.013). However, in the individual visit analysis, CSWE scores in the sPTB group were significantly lower than that of the TB group only at 11-15+6 weeks (p=0.013). There was no difference in CSWE scores between singleton and twin pregnancies throughout pregnancy (coefficient=-0.00128, p=0.937).

CONCLUSION

Women with sPTB have shorter CL and softer cervix across gestation when compared to those with TB. In the individual visit analysis, the reduction in CL in the sPTB group occurs from late second trimester onwards, while the reduction in cervical stiffness in the sPTB group is observed primarily in the first trimester. Additionally, our study has found that CL is significantly shorter in singleton pregnancies compared to twin pregnancies, while cervical stiffness does not differ between the two types of pregnancy. Our findings indicate that the cervix tends to undergo a softening process prior to shortening in the sPTB cases This article is protected by copyright. All rights reserved.

Resolidified Chalcogen-Assisted Growth of Bilayer Semiconductors with Controlled Stacking Orders

Bilayer semiconductors have attracted much attention due to their stacking-order-dependent properties. However, as both 3R- and 2H-stacking are energetically stable at high temperatures, most of the high-temperature grown bilayer materials have random 3R- or 2H-stacking orders, leading to non-uniformity in optical and electrical properties. Here, a chemical vapor deposition method is developed to grow bilayer semiconductors with controlled stacking order by modulating the resolidified chalcogen precursors supply kinetics. Taking tungsten disulfide (WS2 ) as an example, pure 3R-stacking (100%) and 2H-stacking dominated (87.6%) bilayer WS2 are grown by using this method and both show high structural and optical quality and good uniformity. Importantly, the bilayer 3R-stacking WS2 shows higher field effect mobility than 2H-stacking samples, due to the difference in stacking order-dependent surface potentials. This method is universal for growing other bilayer semiconductors with controlled stacking orders including molybdenum disulfide and tungsten diselenide, paving the way to exploit stacking-order-dependent properties of these family of emerging bilayer materials.

[Standardized nomenclature of oral microorganisms in Chinese: the 2023 update]

Oral microbial community, as an important part of human microbial community, is closely related to oral and general health. Oral microbiological research has become the forefront of international microbiological research. Standardized and unified nomenclature for oral microorganisms in Chinese is of great significance to support the development of oral medicine research. Standardized translation of microbial names is the basis for writing canonical and authoritative professional textbooks and reference books, which helps students to accurately acquire the characteristics and classifications of oral microbes. Unified translation of oral microorganisms is also conducive to academic communication and cooperation, and plays an important role in oral health education and science popularization, which enables oral microbiology knowledge to be accurately disseminated to the public. Therefore, in order to standardize the words in scientific research, funding application, publications, academic exchanges and science popularization within the field of oral medicine, we have fully discussed and revised the Chinese names of oral microorganisms in 2017 edition and ones of newly discovered oral microbes, finally reaching a consensus to form the 2023 edition of Chinese names of oral microorganisms.

Efficacy of Postoperative Radiotherapy for Patients with New N2 Descriptors of Subclassification in Completely Resected Non-Small Cell Lung Cancer: A Real-World Study

PURPOSE/OBJECTIVE(S)

Patients with N2 non-small cell lung cancer (NSCLC) were heterogeneous groups and required further stratification. The International Society for the Study of Lung Cancer (IASLC) added new descriptors of three sub-stages for stage N2 NSCLC: N2 at a single station without N1 involvement (N2a1), N2 at a single station with N1 involvement (N2a2), and N2 at multiple stations (N2b). This study aimed to investigate the efficacy of postoperative radiotherapy (PORT) for patients with these N2 descriptors.

MATERIALS/METHODS

Patients with histologically confirmed NSCLC after complete resection and divided into PORT group and non-PORT group. The primary endpoint was DFS. The second endpoints were overall survival (OS) and locoregional recurrence-free survival (LRFS). Propensity-score matching (PSM) of baseline characteristics between the PORT and non-PORT groups was used for validation.

RESULTS

Totally 1832 patients were enrolled, including 308 N2a1 patients, 682 N2a2 patients, and 842 N2b patients. The median follow-up time was 50.1 months. The survival outcomes of the PORT and non-PORT groups before PSM were shown in Table 1. For patients with N2a1, PORT could not improve the DFS (median DFS of the PORT group and the non-PORT group: not reached vs. 46.8 months, P = 0.41), OS (P = 0.85), or LRFS (P = 0.32), which were consistent with the multivariate analysis and data after the PSM. For patients with N2a2, PORT significantly improved the DFS (median DFS 29.7 vs. 22.2 months, P = 0.02), OS (P = 0.03), and LRFS (P = 0.01). The multivariate analysis and data after the PSM confirmed the benefits in DFS and LRFS, but no benefit was observed in OS (multivariate analysis: HR 0.79, P = 0.18; median OS after PSM: 103.7 vs. 63.1 months, P = 0.34). For patients with N2b, PORT could not improve the DFS (median DFS 20.6 vs. 21.2 months, P = 0.39) but significantly improved the OS (P<0.001) and LRFS (P<0.001). However, the multivariate analysis showed that PORT significantly improved DFS (HR 0.81, P = 0.03), consistent with the data after the PSM (median DFS 20.6 and 17.6 months, P = 0.04).

CONCLUSION

PORT significantly improved the DFS and LRFS in patients with N2a2 and significantly improved the DFS, LRFS, and OS in patients with N2b. Patients with N2a1 could not benefit from PORT.

Chemoradiotherapy Combined with Nab-Paclitaxel plus Cisplatin in Patients with Locally Advanced Borderline Resectable or Unresectable Esophageal Squamous Cell Carcinoma: A Phase I/II Study

PURPOSE/OBJECTIVE(S)

To evaluate the efficacy and safety of nanoparticle albumin-bound paclitaxel (nab-PTX) plus cisplatin as the regimen of conversional chemoradiotherapy (cCRT) in locally advanced borderline resectable or unresectable esophageal squamous cell carcinoma (ESCC).

MATERIALS/METHODS

Patients with locally advanced ESCC (cT3-4, Nany, M0-1, M1 was limited to lymph node metastasis in the supraclavicular area) were enrolled. All the patients received the cCRT of nab-PTX plus cisplatin. After the cCRT, those resectable patients received esophagectomy; those unresectable patients continued to receive the definitive chemoradiotherapy (dCRT). The locoregional control (LRC), overall survival (OS), progression-free survival (PFS), distant metastasis free survival (DMFS), pathological complete response (pCR), R0 resection rate and adverse events (AEs) were calculated.

RESULTS

A total of 45 patients with ESCC treated from October 2019 to May 2021 were finally included. The median follow-up time was 30.3 months. The LRC, OS, EFS, DMFS at 1and 2 years were 81.5%, 86.6%, 64.3%, 73.2% and 72.4%, 68.8%, 44.8%, 52.7% respectively. 21 patients (46.7%) received conversional chemoradiotherapy plus surgery (cCRT+S). The pCR rate and R0 resection rate were 47.6% and 84.0%. The LRC rate at 1 and 2 years were 95.0%, 87.1% in cCRT+S patients and 69.3%, 58.7% in dCRT patients respectively (HR, 5.14; 95% CI, 1.10-23.94; P = 0.021). The OS rate at 1 and 2 years were 95.2% and 84.2% in resectable patients compared to 78.8% and 54.4% in unresectable patients (HR, 3.41; 95% CI, 1.10-10.61; P = 0.024). The toxicities during chemoradiotherapy were tolerated, the most common grade 3-4 toxicities were radiation esophagitis (15.6%).

CONCLUSION

Nab-PTX plus cisplatin were effective and safe as the regimen of conversional chemoradiotherapy of ESCC. The patients receiving conversional chemoradiotherapy plus surgery (cCRT+S) were prone to have a better survival.

[Deep learning-based dose prediction in radiotherapy planning for head and neck cancer]

OBJECTIVE

To propose an deep learning-based algorithm for automatic prediction of dose distribution in radiotherapy planning for head and neck cancer.

METHODS

We propose a novel beam dose decomposition learning (BDDL) method designed on a cascade network. The delivery matter of beam through the planning target volume (PTV) was fitted with the pre-defined beam angles, which served as an input to the convolution neural network (CNN). The output of the network was decomposed into multiple sub-fractions of dose distribution along the beam directions to carry out a complex task by performing multiple simpler sub-tasks, thus allowing the model more focused on extracting the local features. The subfractions of dose distribution map were merged into a distribution map using the proposed multi-voting mechanism. We also introduced dose distribution features of the regions-of-interest (ROIs) and boundary map as the loss function during the training phase to serve as constraining factors of the network when extracting features of the ROIs and areas of dose boundary. Public datasets of radiotherapy planning for head and neck cancer were used for obtaining the accuracy of dose distribution of the BDDL method and for implementing the ablation study of the proposed method.

RESULTS

The BDDL method achieved a Dose score of 2.166 and a DVH score of 1.178 (P < 0.05), demonstrating its superior prediction accuracy to that of current state-ofthe-art (SOTA) methods. Compared with the C3D method, which was in the first place in OpenKBP-2020 Challenge, the BDDL method improved the Dose score and DVH score by 26.3% and 30%, respectively. The results of the ablation study also demonstrated the effectiveness of each key component of the BDDL method.

CONCLUSION

The BDDL method utilizes the prior knowledge of the delivery matter of beam and dose distribution in the ROIs to establish a dose prediction model. Compared with the existing methods, the proposed method is interpretable and reliable and can be potentially applied in clinical radiotherapy.

Multiple Helicenes Defected by Heteroatoms and Heptagons with Narrow Emissions and Superior Photoluminescence Quantum Yields

The incorporation of heteroatoms and/or heptagons as the defects into helicenes expands the variety of chiroptical materials with novel properties. However, it is still challenging to construct novel boron-doped heptagon-containing helicenes with high photoluminescence quantum yields (PLQYs) and narrow full-width-at-half-maximum (FWHM) values. We report an efficient and scalable synthesis of a quadruple helicene 4Cz-NBN with two nitrogen-boron-nitrogen (NBN) units and a double helicene 4Cz-NBN-P1 bearing two NBN-doped heptagons, the latter could be formed via a two-fold Scholl reaction of the former. The helicenes 4Cz-NBN and 4Cz-NBN-P1 exhibit excellent PLQYs up to 99% and 65% with narrow FWHM of 24 nm and 22 nm, respectively. The emission wavelengths are tunable via stepwise titration experiments of 4Cz-NBN-P1 toward fluoride, enabling distinguished circularly polarized luminescence (CPL) from green, orange (4Cz-NBN-P1-F1) to yellow (trans/cis-4Cz-NBN-P1-F2) with near-unity PLQYs and broader circular dichroism (CD) ranges. The five structures of the aforementioned four helicenes were confirmed by single crystal X-ray diffraction analysis. This work provides a novel design strategy for construction of non-benzenoid multiple helicenes exhibiting narrow emissions with superior PLQYs.

[General anesthesia versus deep sedation for dental treatment in children: comparison of parental acceptance, oral health-related quality of life, and treatment efficacy]

OBJECTIVE

To compare the parental acceptance of dental treatment under general anesthesia and deep sedation in children and assess the changes in postoperative oral health-related quality of life and treatment efficacy.

METHODS

The parents of 131 children undergoing dental treatment in the Department of Stomatology of Sichuan Provincial People's Hospital from January, 2022 to June, 2022 were surveyed using a questionnaire of children's advanced oral behavior management, and 83 children receiving general anesthesia or deep sedation for dental treatment between January, 2018 and December, 2021 were also investigated for changes in quality of life after the treatment using a questionnaire. The treatment efficacy was assessed at the 1-year follow-up visit in 149 children who received dental treatment under general anesthesia or deep sedation during the same period.

RESULTS

The survey of perantal acceptance showed that 62.6% of the parents preferred deep sedation, 29.01% preferred general anesthesia, and 8.4% preferred compulsory treatment. Dental treatments under general anesthesia and deep sedation both significantly improved oral health-related quality of life of the children. While dental surgeries under general anesthesia resulted in the most significant improvement of pain symptoms, deep sedation was associated with both obvious relief of the children's pain symptoms and reduction of the parents' pressure level. No significant difference was found in the efficacy of treatments under general anesthesia and deep sedation at the 1-year follow-up.

CONCLUSION

Dental treatment in children under deep sedation has the highest parental acceptance, followed by treatment under general anesthesia, and the acceptance of compulsory treatment is the lowest. The treatments under general anesthesia and deep sedation significantly improve the quality of life of the children and their parents and both have good treatment efficacy.

Large-Area Black Phosphorus/PtSe2 Schottky Junction for High Operating Temperature Broadband Photodetectors

High operating temperature (HOT) broadband photodetectors are urgently necessary for extreme condition applications in infrared-guided missiles, infrared night vision, fire safety imaging, and space exploration sensing. However, conventional photodetectors show dramatic carrier mobility decreases and carrier losses with low photoresponsivity at HOT due to the increased carrier scattering in channels at high temperatures. Herein, the HOT broadband photodetectors from room temperature to 470 K are developed for the first time by large-area black phosphorus (BP)/PtSe₂ films device arrays via a depletion-enhanced photocarrier dynamics strategy. Attributed to the 2D Schottky junction at BP/PtSe₂ interface and resulting in full depleted working channels, the BP/PtSe₂ photodetector arrays exhibit high tolerance to carrier mobility decrease during the increasing operating temperature in a wide wavelength range from 532 to 2200 nm. Thus, the photodetector shows a state-of-the-art operating temperature at 470 K with the photo-responsivity (R) and specific detectivity (D*) of 25 A W^-1 and 6.4 × 10¹¹ Jones under 1850 nm illumination, respectively. Moreover, BP/PtSe₂ photodetector arrays show high-uniformity photo-response in a large area. This work provides new strategies for high-performance broadband photodetector arrays with HOT by Schottky junction of large-area BP/PtSe₂ films.

A multifunctional integrated carbon nanotubes/polyphenylene sulfide composite: preparation, properties and applications

Although great progress has been achieved in polyphenylene sulfide (PPS) composites by the use of carbon nanotubes (CNTs), the development of cost-efficient, well dispersive and multifunctional integrated PPS composites has yet to be achieved because of the strong solvent resistance of PPS. In this work, a CNTs-PPS/PVA composite material has been prepared by mucus dispersion-annealing, which employed polyvinyl alcohol (PVA) to disperse PPS particles and CNTs at room temperature. Dispersion and scanning electron microscopy observations revealed that PVA mucus can uniformly suspend and disperse micron-sized PPS particles, promoting the interpenetration of the micro-nano scale between PPS and CNTs. During the annealing process, PPS particles deformed and then crosslinked with CNTs and PVA to form a CNTs-PPS/PVA composite. The as-prepared CNTs-PPS/PVA composite possesses outstanding versatility, including excellent heat stability with resistant temperatures up to 350 °C, corrosion resistance against strong acids and alkalis for up to 30 days, and distinguished electrical conductivity with 2941 S m^-1. Besides, a well-dispersed CNTs-PPS/PVA suspension could be used to 3D print microcircuits. Hence, such multifunctional integrated composites will be highly promising in the future of new materials. This research also develops a simple and meaningful method to construct composites for solvent resistant polymers.

Observation of Monoenergetic Electrons from Two-Pulse Ionization Injection in Quasilinear Laser Wakefields

The generation of low emittance electron beams from laser-driven wakefields is crucial for the development of compact x-ray sources. Here, we show new results for the injection and acceleration of quasimonoenergetic electron beams in low amplitude wakefields experimentally and using simulations. This is achieved by using two laser pulses decoupling the wakefield generation from the electron trapping via ionization injection. The injection duration, which affects the beam charge and energy spread, is found to be tunable by adjusting the relative pulse delay. By changing the polarization of the injector pulse, reducing the ionization volume, the electron spectra of the accelerated electron bunches are improved.

Bending Resistance Covalent Organic Framework Superlattice: "Nano-Hourglass"-Induced Charge Accumulation for Flexible In-Plane Micro-Supercapacitors

Covalent organic framework (COF) film with highly exposed active sites is considered as the promising flexible self-supported electrode for in-plane micro-supercapacitor (MSC). Superlattice configuration assembled alternately by different nanofilms based on van der Waals force can integrate the advantages of each isolated layer to exhibit unexpected performances as MSC film electrodes, which may be a novel option to ensure energy output. Herein, a mesoporous free-standing A-COF nanofilm (pore size is 3.9 nm, averaged thickness is 4.1 nm) with imine bond linkage and a microporous B-COF nanofilm (pore size is 1.5 nm, averaged thickness is 9.3 nm) with β-keto-enamine-linkages are prepared, and for the first time, we assembly the two lattice matching films into sandwich-type superlattices via layer-by-layer transfer, in which ABA-COF superlattice stacking into a "nano-hourglass" steric configuration that can accelerate the dynamic charge transportation/accumulation and promote the sufficient redox reactions to energy storage. The fabricated flexible MSC-ABA-COF exhibits the highest intrinsic CV of 927.9 F cm-3 at 10 mV s-1 than reported two-dimensional alloy, graphite-like carbon and undoped COF-based MSC devices so far, and shows a bending-resistant energy density of 63.2 mWh cm-3 even after high-angle and repeat arbitrary bending from 0 to 180°. This work provides a feasible way to meet the demand for future miniaturization and wearable electronics.

[FUT8 modulates galectin-3 expression to regulate TGF-β1-mediated fibrosis of lung fibroblasts]

OBJECTIVE

To investigate the regulatory role of α-1, 6-fucosyltransferase (FUT8) in TGF-β1-induced proliferation, migration and fibrosis of human embryonic lung fibroblasts (MRC-5 cells) and explore the underlying molecular mechanism.

METHODS

C57/BL6 mice were randomized into 4 groups for treatment with saline (control group), bleomycin, bleomycin+sh-NC or bleomycin+sh-FUT8, and pulmonary fibrosis was observed using Masson staining.MRC-5 cells were transfected with si-NC, FUT8 siRNA (si-FUT8), or both si-FUT8 and a galectin-3(Gal-3) overexpression plasmid (pcDNA3.1-Gal) prior to TGF-β1 treatment, and the changes in cell proliferation and migration were assessed using CCK-8 assay, BrdU assay, and wound healing assay; the changes in the expression levels of α-SMA, collagen I (COLIA1) and extracellular matrix fibronectin (FN) were detected with real-time quantitative PCR (RT-qPCR) and Western blotting.The interaction of FUT8 and Gal-3 was tested using coimmunoprecipitation (Co-IP) assay, and the effect of FUT8 silencing on Gal-3 and FAK/Akt signaling pathways was analyzed.

RESULTS

FUT8 knockdown significantly reduced bleomycin-induced extracellular collagen deposition in the lung tissues of the mice.Silencing FUT8 obviously inhibited cell proliferation (P < 0.05) and migration mediated by TGF-β1.FUT8 knockdown down-regulated the mRNA and protein levels of α-SMA, COLIA1 and FN (P < 0.05) in the cells.Coimmunoprecipitation analysis showed that FUT8 interacted with Gal-3.Silencing FUT8 significantly down-regulated Gal-3 expression and inhibited the activation of the FAK/Akt signaling pathway (P < 0.05).Overexpression of Gal-3 obviously reversed the effects of FUT8 silencing on cell proliferation, migration and fibrosis (P < 0.05).

CONCLUSION

FUT8 regulates TGF-β1-induced proliferation, migration and fibrosis of MRC-5 cells by modulating Gal-3 expression, in which the FAK/Akt pathway may play a role.

Prediction of spontaneous preterm birth and preterm prelabor rupture of membranes using maternal factors, obstetric history and biomarkers of placental function at 11-13 weeks

OBJECTIVES

To determine whether first-trimester biomarkers of placental function can be used to screen for spontaneous preterm birth (sPTB), and to develop prediction models using maternal factors, obstetric history and biomarkers of placental function at 11-13 weeks for the calculation of patient-specific risk for sPTB.

METHODS

This was a retrospective secondary analysis of data derived from a prospective cohort study on first-trimester screening for pre-eclampsia in singleton pregnancies attending for routine Down syndrome screening at 11 + 0 to 13 + 6 weeks' gestation at a tertiary obstetric unit between December 2016 and September 2019. A split-sample internal validation method was used to explore and develop prediction models for all sPTB at < 37 weeks and for PTB at < 37 weeks after preterm prelabor rupture of membranes (PPROM) using maternal risk factors, uterine artery Doppler indices, serum placental growth factor (PlGF), pregnancy-associated plasma protein-A (PAPP-A) and β-human chorionic gonadotropin (β-hCG). Screening performance was assessed using receiver-operating-characteristics (ROC)-curve analysis, with calculation of the areas under the ROC curves (AUCs).

RESULTS

A total of 9298 singleton pregnancies were included in this study. sPTB at < 37 weeks occurred in 362 (3.89%) cases, including 231 (2.48%) cases of PPROM. sPTB at < 34 weeks occurred in 87 (0.94%) cases, including 39 (0.42%) cases of PPROM. Identified maternal risk factors for sPTB at < 37 weeks included chronic hypertension, conception using in-vitro fertilization and history of PTB. Maternal risk factors for PPROM at < 37 weeks included conception using in-vitro fertilization and history of PTB. Median PlGF multiples of the median (MoM) and PAPP-A MoM were significantly reduced in women with sPTB at < 37 weeks, as well as in those who had PPROM, compared to those who delivered at term. Screening by a combination of maternal risk factors, PAPP-A and PlGF achieved better performance in predicting sPTB at < 37 weeks (AUC, 0.630 vs 0.555; detection rate (DR), 24.8% vs 16.6% at a false-positive rate (FPR) of 10%; P ≤ 0.0001) and PPROM at < 37 weeks (AUC, 0.643 vs 0.558; DR, 28.1% vs 17.0% at a FPR of 10%; P ≤ 0.0001) than using maternal risk factors alone. Both models were successfully applied to the internal validation dataset, with AUCs of 0.628 and 0.650, respectively.

CONCLUSIONS

We demonstrated that low levels of maternal serum PAPP-A and PlGF in the first trimester are associated with increased risks of sPTB and PPROM at < 37 weeks. However, further research is needed to identify additional biomarkers to improve the screening performance of the combined model that includes maternal risk factors, PAPP-A and PlGF before clinical application. © 2022 International Society of Ultrasound in Obstetrics and Gynecology.

Modulating the Band Structure of Metal Coordinated Salen COFs and an In Situ Constructed Charge Transfer Heterostructure for Electrocatalysis Hydrogen Evolution

A series of crystalline, stable Metal (Metal = Zn, Cu, Ni, Co, Fe, and Mn)-Salen covalent organic framework (COF)_EDA complex are prepared to continuously tune the band structure of Metal-Salen COF_EDA , with the purpose of optimizing the free energy intermediate species during the hydrogen evolution reaction (HER) process. The conductive macromolecular poly(3,4-ethylenedioxythiophene) (PEDOT) is subsequently integrated into the one-dimensional (1D) channel arrays of Metal-Salen COF_EDA to form heterostructure PEDOT@Metal-Salen COF_EDA via the in situ solid-state polymerization method. Among the Metal-Salen COF_EDA and PEDOT@Metal-Salen COF_EDA complexes, the optimized PEDOT@Mn-Salen COF_EDA displays prominent electrochemical activity with an overpotential of 150 mV and a Tafel slope of 43 mV dec^-1 . The experimental results and density of states data show that the continuous energy band structure modulation in Metal-Salen COF_EDA has the ability to make the metal d-orbital interact better with the s-orbital of H, which is conducive to electron transport in the HER process. Moreover, the calculated charge density difference indicates that the heterostructures composed of PEDOT and Metal-Salen COF_EDA induce an intramolecular charge transfer and construct highly active interfacial sites.

Ionization states for the multipetawatt laser-QED regime

A paradigm shift in the physics of laser-plasma interactions is approaching with the commissioning of multipetawatt laser facilities worldwide. Radiation reaction processes will result in the onset of electron-positron pair cascades and, with that, the absorption and partitioning of the incident laser energy, as well as the energy transport throughout the irradiated targets. To accurately quantify these effects, one must know the focused intensity on target in situ. In this work, a way of measuring the focused intensity on target is proposed based upon the ionization of xenon gas at low ambient pressure. The field ionization rates from two works [Phys. Rev. A 59, 569 (1999)1050-294710.1103/PhysRevA.59.569 and Phys. Rev. A 98, 043407 (2018)2469-992610.1103/PhysRevA.98.043407], where the latter rate has been derived using quantum mechanics, have been implemented in the particle-in-cell code SMILEI [Comput. Phys. Commun. 222, 351 (2018)0010-465510.1016/j.cpc.2017.09.024]. A series of one- and two-dimensional simulations are compared and shown to reproduce the charge states without presenting visible differences when increasing the simulation dimensionality. They provide a way to accurately verify the intensity on target using in situ measurements.

[Study on the dynamic changes of oral microbiota in type 2 diabetes patients with periodontitis after initial periodontal therapy]

Objectives: To clarify the effect of initial periodontal therapy on the dynamic changes of oral (saliva, dorsal tongue and subgingival plaque) microbiota in periodontitis patients with or without type 2 diabetes mellitus (T2DM). Methods: A total of 14 patients with chronic periodontitis (CP group) and 14 CP patients with T2DM (CP-T2DM group) were included from Department of Periodontology, School and Hospital of Stomatology,Cheeloo College of Medicine, Shandong University. The microbial samples were collected from saliva, dorsal tongue and subgingival plaque of first molars at baseline, 1.5 and 3 months after initial periodontal therapy, and were detected by 16S rRNA (V3-V4 region) gene sequencing. The sequencing data were analyzed to obtain microbial distribution and community structure information. The same professional periodontist evaluated the periodontal status of patients according to periodontitis detection indices before and after initial periodontal therapy. Meanwhile, patients' blood samples were collected and related metabolic indices were evaluated. Results: After initial periodontal therapy, the glycosylated hemoglobin levels [(7.46±1.69)%] in CP-T2DM group were significantly improved than that at baseline [(7.65±1.34)%] (t=0.52,P=0.610). The probing depth of the sampling sites [CP group: (2.94±0.46) mm, CP-T2DM group: (2.95±0.35) mm] and bleeding index (CP group: 1.91±0.42, CP-T2DM group: 1.67±0.49) at 3 months after treatment were significantly decreased than the probing depth [CP group: (3.99±0.77) mm, CP-T2DM group: (3.80±0.76) mm] (F=25.61, P<0.001; F=17.63, P<0.001) and bleeding index (CP group: 3.03±0.52, CP-T2DM group: 2.54±0.65) (F=28.43, P<0.001; F=20.21, P<0.001) at baseline. The flora analysis showed that the α and β diversity indices of the same sites in the CP and CP-T2DM groups did not change significantly before and after the initial therapy, but the bacterial abundance at each site changed. There were commonalities and differences in the microbial composition of each site in the CP and CP-T2DM groups. Among them, the relative abundance of Proteobacteria in saliva and dorsal tongue samples of the two groups after treatment was basically consistent with the change trend in the subgingival plaque microbes. In the subgingival plaque of the CP group, the relative abundance of Proteobacteria showed a gradual increase with the prolongation of initial periodontal therapy; while in the CP-T2DM group, it showed a trend of first increase and then decrease. Syntrophy, Dethiosulfate, Methanobacteriaceae and TG5 in CP and CP-T2DM groups were all significantly dominant bacteria in subgingival plaque at baseline (P<0.05). Moreover, in the CP-T2DM group Spirochetes also showed a significant advantage. At 1.5 months after treatment, Rhizobacteria, Alcaligenes, Comamomons, Delftia, Blautella, etc. were dominant in subgingival plaque (P<0.05). Firmicutes, Clostridia/Clostridiales, Enterococci and Ruminococci showed significant differences at 3 months (P<0.05). Conclusions: Plaques in saliva and tongue dorsal could reflect the effects of initial periodontal therapy on the dynamic changes of microorganisms to a certain extent. CP and CP-T2DM patients had differences in microbial composition and responses to initial periodontal therapy.

POS0393 ASSOCIATION BETWEEN GENETICALLY PREDICTED EXPRESSION OF TPMT AND AZATHIOPRINE ADVERSE EVENTS IN PATIENTS WITH INFLAMMATORY CONDITIONS

Background

Azathioprine is a widely used immunosuppressant for the treatment of inflammatory conditions such as systemic lupus erythematosus (SLE), systemic vasculitis, dermatomyositis, and inflammatory bowel disease. However, its use is often limited by myelotoxicity. Variants in the gene encoding thiopurine-S-methyltransferase (TPMT), an enzyme in the metabolic pathway of azathioprine, increase the risk for myelotoxicity1. We know little about the relationship between the genetically predicted expression of TPMT and side effects of azathioprine.

Objectives

To examine whether genetically predicted expression of TPMT in liver tissue is associated with azathioprine adverse effects.

Methods

We assembled a retrospective cohort of new users taking azathioprine for inflammatory conditions at a tertiary care center. We performed genotyping with Illumina Infinium Expanded Multi-Ethnic Genotyping Array plus custom content data, and we then used Michigan Imputation servers for genetic imputation and PrediXcan models trained with GTEx/Genotype-Tissue Expression Project version 8 data to impute TPMT expression in liver tissue. We prespecified nine groups of phecodes (comprised of ICD9 and ICD10 codes) corresponding to known adverse effects of azathioprine. We then tested the association between the predicted expression of TPMT and these adverse events; for outcomes significant in the Wilcoxon ranksum tests (p<0.05), each case was reviewed in clinical records for confirmation. Finally, we grouped the predicted expression of TPMT in liver tissue into tertiles and conducted logistic regressions to assess the associations between predicted expression and side effects. We conducted a sensitivity analysis restricted to patients with EHR-reported White race.

Results

The cohort included 1034 patients (Table 1). Phecodes for 3 side effects—leukopenia (n=29), skin cancer (n=13), and rash (n=52)—were identified as associated with predicted TPMT expression in liver tissue. Of these, cases of side effects attributed to azathioprine were validated by chart review: leukopenia (96.6%; n=28), skin cancer (92.3%; n=12), and rash (9.6%; n=5) and used for analysis. When assessed by tertile of predicted TPMT expression, patients in the highest tertile had lower odds of having leukopenia (OR=0.35, 95%CI: 0.12-0.98, p=0.045) and a trend towards higher odds for skin cancer, but the number of cases was small (OR=3.56, 95%CI: 0.73-17.27, p=0.115). Confirmed cases of rash attributed to azathioprine were too few for meaningful analysis. We found similar results when restricted to patients with reported White race.

Table 1.

Characteristics of patients by TPMT expression

Lowest TertileMiddle TertileHighest TertileN=345N=345N=344Female sex, n (%)228 (66.1)244 (70.7)238 (69.2)EHR-reported White race, n (%)306 (88.7)293 (84.9)290 (84.3)Age, median [IQR]42 [29-58]43 [30-55]46 [30-56]Indication, n (%)Systemic lupus erythematosus38 (11.0)42 (12.2)38 (11.0)Inflammatory bowel disease191 (55.3)185 (53.6)190 (55.2)Other connective tissue disorder/autoimmune92 (26.7)96 (27.8)100 (29.1)Other24 (7.0)22 (6.4)16 (4.7)Verified leukopenia attributed to azathioprine, n (%)14 (4.1)9 (2.6)5 (1.5)Verified skin cancer attributed to azathioprine, n (%)2 (0.6)3 (0.9)7 (2.0)Verified rash attributed to azathioprine, n (%)2 (0.6)3 (0.9)0 (0)

Conclusion

This analysis suggests that PrediXcan may be useful for examining the association between gene expression and side effects of medications. Moreover, this approach successfully identified leukopenia as a side effect associated with predicted TPMT expression.

Acknowledgements

None to declare.

Disclosure of Interests

None declared.

POS1444 FLT1 AND EPHB2 ARE NOVEL GENETIC MARKERS ASSOCIATED WITH PANCREATITIS IN PATIENTS TAKING AZATHIOPRINE FOR IMMUNE-MEDIATED CONDITIONS: INTEGRATING GENOME- AND TRANSCRIPTOME-WIDE ASSOCIATION STUDIES

Background

Azathioprine (AZA) is a thiopurine immunosuppressant medication used to treat a variety of immune-mediated diseases. Unfortunately, its use is limited by adverse effects. Pancreatitis, a potentially severe, life-threatening side effect is independent of dose and necessitates AZA discontinuation given the high risk of recurrent pancreatitis with continued use or re-challenge. The mechanisms driving pancreatitis are unclear. While classic thiopurine-induced acute pancreatitis (TIAP) has been associated with HLA haplotypes, most patients taking AZA and presenting with pancreatitis do not fulfill the stringent criteria for TIAP.

Objectives

To identify genetic risk factors for pancreatitis in patients taking azathioprine for immune-mediated conditions.

Methods

Using a biobank linked to electronic health records (EHR) from a tertiary center, we identified new users of AZA. Patients were excluded if the primary indication for AZA was organ transplant or if there was a history of pancreatitis prior to AZA use. The analysis was restricted to patients with EHR-reported race as White due to insufficient case counts for the non-White group. We then identified patients with amylase or lipase values that exceeded twice the upper limit of normal (“>2x ULN”) or with ICD-9/ICD-10 codes for acute pancreatitis. Each record was manually reviewed to confirm the timing of AZA use in relation to laboratory derangements or ICD coding, as well as to further classify patients into three increasingly strict, but not exclusive categories: 1) pancreatic injury (amylase or lipase >2x ULN); 2) acute pancreatitis1, or 3) TIAP2. We completed genotyping with Illumina Infinium Expanded Multi-Ethnic Genotyping Array plus custom content data, employed Michigan Imputation servers for genetic imputation, and used PrediXcan (GTEx v8) to impute gene expression. We then conducted genome-wide association and transcriptome-wide association studies (GWAS, TWAS). Acknowledging the relatively small overall cohort, and possible imbalance of cases vs controls, we used the Firth logistic regression method, which is a penalized likelihood-based method.

Results

We studied 2127 AZA users (35.4% male; mean 44.5+/-17.2 years). The median AZA dose was 100mg/day (IQR: 50-125mg/day). Rheumatologic conditions (56.9%) and inflammatory bowel disease (40.4%) comprised the most common primary indications for AZA. Pancreatic injury, pancreatitis, and TIAP were diagnosed in 42 (2.0%), 16 (0.8%), and 9 (0.4%) patients, respectively. GWAS identified several significantly associated genes, many with overlapping TWAS findings in the pancreas and liver (Figure 1). From these, the two protein-encoding genes Fms Related Receptor Tyrosine Kinase-1 (FLT1) and Ephrin type-B receptor-2 (EPHB2) overlapped in two or more pancreatitis phenotypes in the TWAS and GWAS, respectively. EPHB2 was associated with a 8.6-fold (P=1.84 x 10-8) and a 31.4-fold (P=2.87x 10-8) higher likelihood of pancreatic injury and TIAP, respectively.

Figure 1.

Conclusion

FLT1—a gene that encodes a receptor tyrosine kinase and is a member of the vascular endothelial growth factor receptor (VEGFR) family—and EPHB2—a gene that encodes a member of the Eph receptor family, which is the largest subgroup of the receptor tyrosine kinase family—are novel genetic markers associated with pancreatitis in patients taking AZA. VEGF can potentiate inflammation and the pancreas microenvironment is known to promote VEGF expression, which has been linked to pancreatic cancer development; anti-VEGF treatments have been investigated both for mitigating inflammation and also anti-pancreatic cancer treatment. Future studies validating our findings in AZA-induced pancreatitis are warranted.

References

[1]Crockett et al. Gastroenterology (2018). 154(4):1096-1101.

[2]Heap et al. Nature Genetics (2014). 46:1131-1134

Disclosure of Interests

Shailja Shah Consultant of: ad hoc consultant for Phathom pharmaceuticals, Tyler Reese: None declared, Jacy Zanussi: None declared, Alyson Dickson: None declared, Laura Daniel: None declared, Ran Tao: None declared, Tyne Miller-Fleming: None declared, Peter Straub: None declared, Adriana Hung: None declared, Puran Nepal: None declared, Wei-Qi Wei: None declared, Elizabeth Phillips: None declared, Nancy Cox: None declared, Charles M. Stein: None declared, QiPeng Feng: None declared, Cecilia P. Chung: None declared

Methods for extremely sparse-angle proton tomography

Proton radiography is a widely fielded diagnostic used to measure magnetic structures in plasma. The deflection of protons with multi-MeV kinetic energy by the magnetic fields is used to infer their path-integrated field strength. Here the use of tomographic methods is proposed for the first time to lift the degeneracy inherent in these path-integrated measurements, allowing full reconstruction of spatially resolved magnetic field structures in three dimensions. Two techniques are proposed which improve the performance of tomographic reconstruction algorithms in cases with severely limited numbers of available probe beams, as is the case in laser-plasma interaction experiments where the probes are created by short, high-power laser pulse irradiation of secondary foil targets. A new configuration allowing production of more proton beams from a single short laser pulse is also presented and proposed for use in tandem with these analytical advancements.

[Clinical significance of the deep learning algorithm based on contrast-enhanced CT in the differential diagnosis of gastric gastrointestinal stromal tumors with a diameter ≤ 5 cm]

Objective: Contrast-enhanced CT is an important method of preoperative diagnosis and evaluation for the malignant potential of gastric submucosal tumor (SMT). It has a high diagnostic accuracy rate in differentiating gastric gastrointestinal stromal tumor (GIST) with a diameter greater than 5 cm from gastric benign SMT. This study aimed to use deep learning algorithms to establish a diagnosis model (GISTNet) based on contrast-enhanced CT and evaluate its diagnostic value in distinguishing gastric GIST with a diameter ≤ 5 cm and other gastric SMT before surgery. Methods: A diagnostic test study was carried out. Clinicopathological data of 181 patients undergoing resection with postoperative pathological diagnosis of gastric SMT with a diameter ≤ 5 cm at Department of Gastrointestinal Surgery of Renji Hospital from September 2016 to April 2021 were retrospectively collected. After excluding 13 patients without preoperative CT or with poor CT imaging quality, a total of 168 patients were enrolled in this study, of whom, 107 were GIST while 61 were benign SMT (non-GIST), including 27 leiomyomas, 24 schwannomas, 6 heterotopic pancreas and 4 lipomas. Inclusion criteria were as follows: (1) gastric SMT was diagnosed by contrast-enhanced CT before surgery; (2) preoperative gastroscopic examination and biopsy showed no abnormal cells; (3) complete clinical and pathological data. Exclusion criteria were as follows: (1) patients received anti-tumor therapy before surgery; (2) without preoperative CT or with poor CT imaging quality due to any reason; (3) except GIST, other gastric malignant tumors were pathologically diagnosed after surgery. Based on the hold-out method, 148 patients were randomly selected as the training set and 20 patients as the test set of the GISTNet diagnosis model. After the GISTNet model was established, 5 indicators were used for evaluation in the test set, including sensitivity, specificity, positive predictive value, negative predictive value and the area under the receiver operating curve (AUC). Then GISTNet diagnosis model was compared with the GIST-risk scoring model based on traditional CT features. Besides, in order to compare the accuracy of the GISTNet diagnosis model and the imaging doctors in the diagnosis of gastric SMT imaging, 3 radiologists with 3, 9 and 19 years of work experience, respectively, blinded to clinical and pathological information, tested and judged the samples. The accuracy rate between the three doctors and the GISTNet model was compared. Results: The GISTNet model yielded an AUC of 0.900 (95% CI: 0.827-0.973) in the test set. When the threshold value was 0.345, the sensitivity specificity, positive and negative predictive values of the GISTNet diagnosis model was 100%, 67%, 75% and 100%, respectively. The accuracy rate of the GISTNet diagnosis model was better than that of the GIST-risk model and the manual readings from two radiologists with 3 years and 9 years of work experience (83% vs. 75%, 60%, 65%), and was close to the manual reading of the radiologist with 19 years of work experience (83% vs. 80%). Conclusion: The deep learning algorithm based on contrast-enhanced CT has favorable and reliable diagnostic accuracy in distinguishing gastric GIST with a diameter ≤ 5 cm and other gastric SMT before operation.

Ultrasensitive Photodetectors Promoted by Interfacial Charge Transfer from Layered Perovskites to Chemical Vapor Deposition-Grown MoS2

Heterostructures for charge-carrier manipulation have laid the foundation of modern optoelectronic devices, such as photovoltaics and photodetectors. High-performance heterostructure devices usually impose stringent requirements on the material quality to sustain efficient carrier transport and charge transfer, thus leading to sophisticated fabrication processes. Here, a simple yet efficient strategy is proposed to develop ultrasensitive photodetectors based on heterostructures of chemical vapor deposition-grown MoS₂ and polycrystalline-layered perovskites. The layered perovskites possess pure crystallographic orientation with conductive edges in contact with MoS₂ , which gives rise to efficient light absorption, exciton diffusion, and interfacial charge transfer. In dark state, the mismatch of work functions of two materials facilitates low dark currents by the depletion of electrons in MoS₂ . Under light irradiation, efficient exciton diffusion and interfacial charge transfer are realized in the heterostructures with type-II band alignment, which produces drifting electrons in MoS₂ and leaves trapped holes in layered perovskites. The photodetectors present suppress noises and boost photocurrents, yielding a champion device with a responsivity of 2.5 × 10⁴  A W^-1 , and a specific detectivity of 4.1 × 10¹⁴  Jones. The results demonstrate a scalable approach for the integration of high-performance devices with high tolerance to defects.

Mechanism of MIR-210 mediated NF-κB pathway on cardiac ischemia-reperfusion injury

In this study, MicroRNA-210 (miR-210), which was previously proved to be a potential immunomodulator in various disease, attenuated mouse myocardium ischemia/reperfusion (I/R) injury. miR-210 was increased in cardiomyocytes exposed to hypoxia/reoxygenation (H/R). The expression of IL-6 and TNF-α in both serum and supernatant were reduced in miR-210 mimics groups. Mice were randomly divided into four groups, which were pre-treated with saline (sham and ischemia/reperfusion group), miR-210 mimics and miR-210 inhibitor treatments. Three days later, the mouse IR model was established by ischemia for 30 min, followed by reperfusion for 3 h. Myocardium and plasma were harvested and assessed. The myocardium histopathological changes were reduced in miR-210 mimics groups, and serum levels of Creatine kinase isoenzyme (CK-MB) and Lactate dehydrogenase (LDH) were significantly decreased compared with I/R groups. The protein expression of proinflammatory factor interleukin (IL)-1β and IL-6 were suppressed by the up-regulation of miR-210. The expression of miR-210 was negatively correlated with the expression of nuclear factor kappa-light-chain-enhancer of activated B cells (NF-κB). In conclusion, our study indicates that miR-210 protects heart from myocardium I/R injury via suppressing NF-κB signal pathway.

High cyclic tensile stress disrupts the extracellular matrix in human chondrocyte by F-actin cytoskeletal polymerization and reactive oxygen species production

This study aims to explore the mechanism of cyclic tensile stress (CTS) on human chondrocytes (CHs) relating to the reactive oxygen species (ROS) generation and extracellular matrix (ECM) stability in vitro. A well-established CTS model with 5%, 10%, or 20% elongation was performed for CHs stretching. After CTS, the cell viability, total ROS level, main ECM components, matrix metalloproteinase (MMP), tissue inhibitor of metalloproteinase (TIMP), F-actin density, and some anti-oxidative enzymes were analyzed. Additionally, the antioxidant N-acetylcysteine (NAC) and cytochalasin D were used to suppress the ROS production and F-actin polymerization when the CHs underwent CTS, respectively. The treatment of 20% elongation-CST significantly decreased the CH viability and the expressions of collagen II, aggrecan, anti-oxidative enzymes and TIMP3/4, however, it increased the ROS accumulation, F-actin polymerization, and the expression of collagen I and MMP3/13. In contrast, the application of NAC and cytochalasin D could partly rescue the CHs from the injury caused by the high CTS. Therefore, high CTS disrupts the ECM by remodeling the F-actin cytoskeleton and promoting ROS production. Cytochalasin D and NAC are effective in rejecting F-actin cytoskeleton polymerization, and ROS accumulation through a potential synergetic process, which alleviates the ECM injury caused by High CTS.

Application of artificial intelligence in diagnosis of osteoporosis using medical images: a systematic review and meta-analysis

Artificial intelligence (AI) is a potentially reliable assistant in the diagnosis of osteoporosis. This meta-analysis aims to assess the diagnostic accuracy of the AI-based systems using medical images. We searched PubMed and Web of Science from inception to June 15, 2020, for eligible articles that applied AI approaches to diagnosing osteoporosis using medical images. Quality and bias of the included studies were evaluated with the Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) tool. The main outcome was the sensitivity and specificity of the performance of the AI-based systems. The data analysis utilized the R Foundation packages of "meta" for univariate analysis and Stata for bivariate analysis. Random effects model was utilized. Seven studies with 3186 patients were included in the meta-analysis. The overall risk of bias of the included studies was assessed as low. The pooled sensitivity was 0.96 (95% CI 0.93-1.00), and the pooled specificity was 0.95 (95% CI 0.91-0.99). However, high heterogeneity was found in this meta-analysis. The results supported that the AI-based systems had good accuracy in diagnosing osteoporosis. However, the high risk of bias in patient selection and high heterogeneity in the meta-analysis made the conclusion less convincing. The application of AI-based systems in osteoporosis diagnosis needs to be further confirmed by more prospective studies in multi-centers including more random samples from complete patient types.

[Establishment of a 3D ultrasound imaging system based on pulse-triggered image acquisition]

OBJECTIVE

To establish a 3D ultrasound imaging system based on pulse-triggered image acquisition using the linear probe on the Verasonics^TM vantage 128 platform and evaluate its performance in scanning standard phantom and human carotid artery.

OBJECTIVE

The 3D ultrasound imaging system included 3 modules for probe motion control, image acquisition and storage, and 3D image reconstruction and display. To improve the precision of image acquisition, we used fixed frequency pulses to control the external trigger function combined with mechanical scanning. Voxel-based 3D reconstruction was used for image reconstruction and display. The user interface was designed to allow direct operations of the platform. We carried out scanning tests of standard ultrasound phantom and human carotid artery to evaluate the performance of this imaging system.

OBJECTIVE

We successfully constructed a 3D ultrasound imaging system based on pulse-triggered image acquisition. The results of standard phantom and human carotid scanning tests showed that each module of the system was fully functional. The self-designed user interface of this ultrasound imaging system allowed full control of the system functions for original image acquisition, 3D image reconstruction, and display of cross-sections in 3 different views.

OBJECTIVE

This 3D ultrasound imaging system achieves high-quality 3D ultrasound imaging and provides the basis for further study and clinical application of 3D ultrasound imaging.

Tongxin formula protects H9c2 cardiomyocytes from cobalt chloride-induced hypoxic injury via inhibition of apoptosis

In this study, the effect of the Tongxin formula (TXF) on the apoptosis of H9c2 cardiomyocytes induced by cobalt chloride (CoCl₂) was investigated, and the potential mechanism was explored. A hypoxic injury model of H9c2 cardiomyocytes was established using CoCl₂. The cell viability was measured using a Cell Counting Kit-8 assay. The lactate dehydrogenase (LDH) release and caspase-3 activity were measured using spectrophotometry. The apoptosis was measured via Annexin V-FITC/PI staining and flow cytometry. The changes in the mitochondrial membrane potential were examined using immunofluorescence microscopy following the loading of JC-1 probes. The expressions of apoptosis-related proteins and key proteins in the phosphatidylinositol 3-kinase/protein kinase B (PI3K/Akt) pathway were examined via immunoblotting. The different TXF concentrations studied significantly improved the percentage of viability of cardiomyocytes with hypoxic injury, and the LDH release, apoptotic rate, caspase-3 activity, and levels of cleaved caspase-3 protein were reduced in the injured cells. Additionally, the TXF group had increased mitochondrial membrane potential, upregulated expression of Bcl-2 and p-Akt proteins, and significantly reduced expression of cleaved caspase-3 protein in the cells with hypoxic injury. Moreover, in the TXF group, the treatment significantly reduced the BAX protein expression, but the difference was not statistically significant compared with the CoCl2 group. In this study, TXF regulated the expression of apoptosis-related proteins, inhibited apoptosis, increased the mitochondrial membrane potential, and alleviated damage to the mitochondrial membrane, thereby protecting the cardiomyocytes from hypoxic injury. The underlying mechanism could be related to activation of the PI3K/Akt signaling pathway and upregulation of the Bcl-2 protein.

The clinical value of the combined detection of sEGFR, CA125 and HE4 for epithelial ovarian cancer diagnosis

OBJECTIVE

This study aims to investigate the clinical value of combined detection of serum soluble epidermal growth factor receptor (sEGFR), cancer antigen 125 (CA125), and human epididymis protein 4 (HE4) in the diagnosis of epithelial ovarian cancer (EOC).

PATIENTS AND METHODS

From December 2017 to October 2018, the serum samples were obtained from the Affiliated Hospital of Xuzhou Medical University, with 30 patients as EOC group, 30 patients with benign ovarian neoplasms as benign group, and 17 healthy subjects as healthy group. Besides, among 30 EOC patients, 9 serum samples were obtained from pre-operative and post-operative EOC patients. The levels of serum sEGFR were detected by enzyme-linked immunosorbent assay (ELISA), while CA125 and HE4 were detected by enhanced chemiluminescence immunoassay (ECLIA). The diagnostic value was evaluated by receiver operating characteristic (ROC) curve analysis.

RESULTS

The levels of serum sEGFR, CA125, and HE4 in EOC group were significantly higher than those in benign group (p<0.05) and healthy group (p<0.05). When using a single tumor marker, the CA125 shows the highest sensitivity (93.30%) and HE4 shows the highest specificity (97.87%). The specificity of combined detection of serum sEGFR, CA125, and HE4 was 100%, which was significantly higher than that using a single tumor marker. The area under the ROC curve (AUC) of combined detection of serum sEGFR, CA125, and HE4 (0.965) was much higher than that of the single detection and higher than that of combined detection of CA125 and HE4 (0.940). Moreover, the level of serum sEGFR in post-operative EOC group was significantly lower than that in the corresponding pre-operative EOC group (p<0.05).

CONCLUSIONS

Our study shows that combined detection of serum sEGFR, CA125, and HE4 increases the specificity and efficiency in EOC diagnosis, indicating that sEGFR could be a potential biomarker for the diagnosis and prognosis of EOC.

[The effect of episiotomy on pelvic floor muscle function within six months after first childbirth through electromyography and questionnaires assessment]

Objective: To compare the impact of mediolateral episiotomy on pelvic floor muscle (PFM) function through surface electromyography (sEMG) and quality of life questionnaire assessment. Methods: From January 2018 to June 2019, 1 250 eligible primiparous women were enrolled in Beijing Hospital and the First People's Hospital of Yunnan Province. Participants were divided into episiotomy group (n=676)and non-episiotomy group (n=574). Both groups underwent clinical pelvic examination, sEMG assessment, and quality of life (QOL) questionnaire assessment at two fixed time points: 6-8 weeks, 6 months after vaginal delivery. Follow-up of sEMG amplitudes and their correlation with QOL questionnaire scores were evaluated. Results: Among the women delivered with episiotomy, the peak amplitude of phasic contraction (PPC) was (17.7±5.3) μV at 6-8 weeks after childbirth and (29.6±8.7) μV at 6 months after childbirth. The mean amplitude of tonic contraction (MTC) was (14.8±7.4) μV and (22.2±8.9) μV, respectively. In the non-episiotomy group, PPC was (20.0±7.9) μV and (35.4±10.7) μV at 6-8 weeks and 6 months, and MTC was (17.8±9.0) μV and (27.5±8.9) μV, respectively. Compared with EMG amplitudes at 6-8 weeks, both PPC and MTC significantly improved at 6 months in both groups (all P<0.01). Moreover, episiotomy was related with significantly lower PPC and MTC at both fixed checkups. Besides, both IIQ-7 and PFIQ-7 questionnaire scores improved at 6 months compared with those at 6-8 weeks in both groups (all P<0.001). There was consistently significant difference in QOL scores between episiotomy and non-episiotomy group at two checkups (all P<0.05). A negative correlation was observed between PFM contractile amplitudes and QOL scores at both time points after childbirth (all P<0.05), and the correlation weakened with time. Conclusion: Episiotomy has a negative impact on the postpartum PFM contractile function within 6 months after childbirth. The negative correlation between the sEMG and QOL scores indicates that sEMG is a candidate assessment for PFM function follow-up after childbirth.

Electrochemical Delamination of Ultralarge Few-Layer Black Phosphorus with a Hydrogen-Free Intercalation Mechanism

Due to strong interlayer interaction and ease of oxidation issues of black phosphorus (BP), the domain size of artificial synthesized few-layer black phosphorus (FL-BP) crystals is often below 10 µm, which extremely limits its further applications in large-area thin-film devices and integrated circuits. Herein, a hydrogen-free electrochemical delamination strategy through weak Lewis acid intercalation enabled exfoliation is developed to produce ultralarge FL-BP single-crystalline domains with high quality. The interaction between the weak Lewis acid tetra-n-butylammonium acetate (CH₃ COOTBA) and P atoms promotes the average domain size of FL-BP crystal up to 77.6 ± 15.0 µm and the largest domain size is found to be as large as 119 µm. The presence of H⁺ and H₂ O is found to sharply decrease the size of as-exfoliated FL-BP flakes. The electronic transport measurements show that the delaminated FL-BP crystals exhibit a high hole mobility of 76 cm² V^-1 s^-1 and an on/off ratio of 10³ at 298 K. A broadband photoresponse from 532 to 1850 nm with ultrahigh responsivity is achieved. This work provides a scalable, simple, and low-cost approach for large-area BP films that meet industrial requirements for nanodevices applications.

Caprin1 targeted by circular circ_0000885 in the tumor progression of osteosarcoma

Since this article has been suspected of research misconduct and the corresponding authors did not respond to our request to prove originality of data and figures, "Caprin1 targeted by circular circ_0000885 in the tumor progression of osteosarcoma, by X.-Y. Liu, M. Li, B. Dong, Q. Feng, published in Eur Rev Med Pharmacol Sci 2020; 24 (9): 4665-4670-DOI: 10.26355/eurrev_202005_21152-PMID: 32432729" has been withdrawn. The Publisher apologizes for any inconvenience this may cause. https://www.europeanreview.org/article/21152.

Use of contrast-enhanced ultrasound in evaluating the efficacy and application value of microwave ablation for adenomyosis

Aim

This study aims to assess the use of contrast-enhanced ultrasonography (CEUS) and dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) in the evaluation of percutaneous microwave ablation (PMWA) of localized adenomyosis.

Materials and Methods

Sixty-six patients with single-onset adenomyosis who underwent PMWA at the Liaocheng Tumor Hospital of Shandong Province from January 2013 to February 2019 were enrolled. Venous CEUS and DCE-MRI examinations were performed before and 1-2 days after the surgery. The ablation rates calculated by CEUS and DCE-MRI were compared and analyzed for accuracy.

Results

After microwave ablation (MWA), CEUS showed that the volume and ablation rate of the ablated zone were 52.03 ± 28.39 cm3 and 90.90% ±6.61%, respectively. By DCE-MRI, the ablation volume and ablation rate of adenomyosis were 52.20 ± 28.65 cm3 and 90.88% ±6.32%, respectively. Dysmenorrhea was significantly relieved within 3 months of the operation, and nonmenstrual hemoglobin levels were significantly improved at 3 and 6 months after the operation (P < 0.05). All 66 cases of adenomyosis were treated using PMWA. Postoperatively, 17 patients reported a change in vaginal fluid; however, no special treatment was required as this disappeared 2-11 days after surgery.

Conclusions

CEUS can accurately evaluate the ablation rate of localized adenomyosis treated with MWA, which is consistent with DCE-MRI. It is convenient and easy to perform ablation of adenomyomas, with incomplete ablation and angiography, and is a method worthy of clinical promotion.