An n-Type Conjugated Polymer with Low Crystallinity for High-Performance Organic Thermoelectrics

Conjugated polymers (CPs) with low crystallinity are promising candidates for application in organic thermoelectrics (OTEs), particularly in flexible devices, because the disordered structures of these CPs can effectively accommodate dopants and ensure robust resistance to bending. However, n-doped CPs usually exhibit poor thermoelectric performance, which hinders the development of high-performance thermoelectric generators. Herein, we report an n-type CP (ThDPP-CNBTz) comprising two acceptor units: a thiophene-flanked diketopyrrolopyrrole and a cyano-functionalized benzothiadiazole. ThDPP-CNBTz shows a low LUMO energy level of below -4.20 eV and features low crystallinity, enabling high doping efficiency. Moreover, the dual-acceptor design enhances polaron delocalization, resulting in good thermoelectric performance. After n-doping, ThDPP-CNBTz exhibits an average electrical conductivity (σ) of 50.6 S cm-1 and a maximum power factor (PF) of 126.8 μW m-1 K-2, which is among the highest values reported for solution-processed n-type CPs to date. Additionally, a solution-processed flexible OTE device based on doped ThDPP-CNBTz exhibits a maximum PF of 70 μW m-1 K-2; the flexible device also shows remarkable resistance to bending strain, with only a marginal change in σ after 600 bending cycles. The findings presented in this work will advance the development of n-type CPs for OTE devices, and flexible devices in particular.

Universal Design and Efficient Synthesis for High Ambipolar Mobility Emissive Conjugated Polymers

High ambipolar mobility emissive conjugated polymers (HAME-CPs) are perfect candidates for organic optoelectronic devices, such as polymer light emitting transistors. However, due to intrinsic trade-off relationship between high ambipolar mobility and strong solid-state luminescence, the development of HAME-CPs suffers from high structural and synthetic complexity. Herein, a universal design principle and simple synthetic approach for HAME-CPs are developed. A series of simple non-fused polymers composed of charge transfer units, π bridges and emissive units are synthesized via a two-step microwave assisted C-H arylation and direct arylation polymerization protocol with high total yields up to 61 %. The synthetic protocol is verified valid among 7 monomers and 8 polymers. Most importantly, all 8 conjugated polymers have strong solid-state emission with high photoluminescence quantum yields up to 24 %. Furthermore, 4 polymers exhibit high ambipolar field effect mobility up to 10-2 cm2 V-1 s-1, and can be used in multifunctional optoelectronic devices. This work opens a new avenue for developing HAME-CPs by efficient synthesis and rational design.

Aligned Conjugated Polymer Nanofiber Networks in an Elastomer Matrix for High-Performance Printed Stretchable Electronics

Conjugated polymer films are promising in wearable X-ray detection. However, achieving optimal film microstructure possessing good electrical and detection performance under large deformation via scalable printing remains challenging. Herein, we report bar-coated high-performance stretchable films based on a conjugated polymer P(TDPP-Se) and elastomer SEBS blend by optimizing the solution-processing conditions. The moderate preaggregation in solution and prolonged growth dynamics from a solvent mixture with limited dissolving capacity is critical to forming aligned P(TDPP-Se) chains/crystalline nanofibers in the SEBS phase with enhanced π-π stacking for charge transport and stress dissipation. The film shows a large elongation at break of >400% and high mobilities of 5.29 cm2 V-1 s-1 at 0% strain and 1.66 cm2 V-1 s-1 over 500 stretch-release cycles at 50% strain, enabling good X-ray imaging with a high sensitivity of 1501.52 μC Gyair-1 cm-2. Our work provides a morphology control strategy toward high-performance conjugated polymer film-based stretchable electronics.

Thienoisoindigo-Based Conjugated Polymers Synthesized by Direct Arylation Polycondensation

A series of thienoisoindigo (TIG)-based conjugated polymers (CPs) with high molecular weights are synthesized by direct arylation polycondensation (DArP) by using TIG derivatives as CBr monomer and multi-halogenated thiophene derivatives, i.e., (E)-1,2-bis(3,4-difluorothien-2-yl)ethene (4FTVT), (E)-1,2-bis(3,4-dichlorothien-2-yl)ethene (4ClTVT), 3,3',4,4'-tetrafluoro-2,2'-bithiophene (4FBT), and 3,3',4,4'-tetrachloro-2,2'-bithiophene (4ClBT), as CH monomers. Density functional theory (DFT) calculations reveal the high selectivity between α-CH bonds in 4FTVT, 4ClTVT, 4FBT, and 4ClBT and β-CH bonds in TIG CBr monomer. All four resulting CPs exhibit low optical bandgaps of ca. 1.20 eV and ambipolar transport characteristics with both electron and hole mobility above 0.1 cm2  V-1  s-1 as elaborated with organic thin-film transistors (OTFTs). The polymer TIG-4FTVT delivers the best device performance. With this polymer, n-channel OTFTs with electron mobility up to 1.67 cm2  V-1  s-1 and p-channel OTFTs with hole mobility up to 0.62 cm2  V-1  s-1 are fabricated by modifying source/drain electrodes with polyethylenimine ethoxylated (PEIE) and MoO3 , respectively, to selectively inject electrons and holes.

Conjugated Polymers from Direct Arylation Polycondensation of 3,4-Difluorothiophene-Substituted Aryls: Synthesis and Properties

3,4-Difluorothiophene-substituted aryls, i.e., 1,4-bis(3,4-difluorothiophen-2-yl)-benzene (Ph-2FTh), 1,4-bis(3,4-difluorothiophen-2-yl)-2,5-difluorobenzene (2FPh-2FTh), and 4,7-bis(3,4-difluorothiophen-2-yl)-2,1,3-benzothiadiazole (BTz-2FTh), are synthesized as C─H monomers for the synthesis of conjugated polymers (CPs) via direct arylation polycondensation (DArP) with diketopyrrolopyrrole (DPP) and isoindigo (IID) derivatives as C─Br monomers. The Gibbs free energies of activation for direct arylation (ΔG298 K , kcal mol-1 ) for α─C─H bonds of thiophene moieties as calculated by density functional theory (DFT) are 14.3, 16.5, and 16.4 kcal mol-1 for Ph-2FTh, 2FPh-2FTh and BTz-2FTh, respectively, meaning that inserting an electron-deficient unit in 3,3',4,4'-tetrafluoro-2,2'-bithiophene (4FBT, ΔG298K : 14.6 kcal mol-1 ) may cause a reactivity decrease of the C─H monomers. Photophysical and semiconducting properties of the resulting six CPs (i.e., DPP-Ph, DPP-2FPh, DPP-BTz, 2FIID-Ph, 2FIID-2FPh, and 2FIID-BTz) are characterized in detail. DPP-based CPs show ambipolar transport properties while IID-based ones exhibited n-type behavior owing to the deeper frontier molecular orbital energy levels of IID-based CPs. With source/drain electrodes modified with polyethylenimine ethoxylated, n-channel organic thin-film transistors with maximum electron mobility of 0.40, 0.54, 0.29, 0.05, 0.16, and 0.01 cm2 V-1 s-1 for DPP-Ph, DPP-2FPh, DPP-BTz, 2FIID-Ph, 2FIID-2FPh, and 2FIID-BTz, respectively, are fabricated. DPP-2FPh exhibits the best device performance due to the good film morphology and the highest intermolecular packing order.

Retina-inspired organic neuromorphic vision sensor with polarity modulation for decoding light information

The neuromorphic vision sensor (NeuVS), which is based on organic field-effect transistors (OFETs), uses polar functional groups (PFGs) in polymer dielectrics as interfacial units to control charge carriers. However, the mechanism of modulating charge transport on basis of PFGs in devices is unclear. Here, the carboxyl group is introduced into polymer dielectrics in this study, and it can induce the charge transfer process at the semiconductor/dielectric interfaces for effective carrier transport, giving rise to the best device mobility up to 20 cm2 V-1 s-1 at a low operating voltage of -1 V. Furthermore, the polarity modulation effect could further increase the optical figures of merit in NeuVS devices by at least an order of magnitude more than the devices using carboxyl group-free polymer dielectrics. Additionally, devices containing carboxyl groups improved image sensing for light information decoding with 52 grayscale signals and memory capabilities at an incredibly low power consumption of 1.25 fJ/spike. Our findings provide insight into the production of high-performance polymer dielectrics for NeuVS devices.

Self-Doped n-Type Quinoidal Compounds with Good Air Stability and High Electrical Conductivity for Organic Electronics

Air stable n-type conductive molecules with high electrical conductivities and excellent device performance have important applications in organic electronics, but their synthesis remains challenging. Herein, we report three self-doped n-type conductive molecules, designated QnNs, with a closed-shell quinoidal backbone and alkyl amino chains of different lengths. The QnNs are self-doped by intermolecular electron transfer from the amino groups to the quinoidal backbone. This process is ascertained unambiguously by experiments and theoretical calculations. The use of a quinoidal structure effectively improves the self-doping level, and thus increases the electrical conductivity of self-doped n-type conductive molecules achieved by a closed-shell structure from<10-4  S cm-1 to>0.03 S cm-1 . Furthermore, the closed-shell quinoidal structure results in good air stability of the QnNs, with half-lives>73 days; and Q4N shows an electrical conductivity of 0.019 S cm-1 even after exposure to air for 120 days. When applying Q6N as the cathode interlayer in organic solar cells (OSCs), an outstanding power conversion efficiency of up to 18.2 % was obtained, which represents one the best results in binary OSCs.

B-Cell-Derived TGF-β1 Inhibits Osteogenesis and Contributes to Bone Loss in Periodontitis

B cells play a vital role in the elimination of periodontal pathogens, the regulation of the immune response, and the induction of tissue destruction. However, the role of B cells in the dysfunction of mesenchymal stem cell (MSC) differentiation to osteoblasts in periodontitis (PD) has been poorly studied. Here we show that the frequency of CD45^-CD105⁺CD73⁺ MSCs in inflamed periodontal tissues is significantly decreased in patients with PD compared with that of healthy controls. CD19⁺ B cells dominate the infiltrated immune cells in periodontal tissues of patients with PD. Besides, B-cell depletion therapy reduces the alveolar bone loss in a ligature-induced murine PD model. B cells from PD mice express a high level of TGF-β1 and inhibit osteoblast differentiation by upregulating p-Smad2/3 expression and downregulating Runx2 expression. The inhibitory effect of PD B cells on osteoblast differentiation is reduced by TGF-β1 neutralization or Smad2/3 inhibitor. Importantly, B-cell-specific knockout of TGF-β1 in PD mice significantly increases the number of CD45^-CD105⁺Sca1⁺ MSCs, ALP-positive osteoblast activity, and alveolar bone volume but decreases TRAP-positive osteoclast activity compared with that from control littermates. Lastly, CD19⁺CD27⁺CD38^- memory B cells dominate the B-cell infiltrates in periodontal tissues from both patients with PD and patients with PD after initial periodontal therapy. Memory B cells in periodontal tissues of patients with PD express a high level of TGF-β1 and inhibit MSC differentiation to osteoblasts. Thus, TGF-β1 produced by B cells may contribute to alveolar bone loss in periodontitis, in part, by suppressing osteoblast activity.

Tetrachromatic vision-inspired neuromorphic sensors with ultraweak ultraviolet detection

Sensing and recognizing invisible ultraviolet (UV) light is vital for exploiting advanced artificial visual perception system. However, due to the uncertainty of the natural environment, the UV signal is very hard to be detected and perceived. Here, inspired by the tetrachromatic visual system, we report a controllable UV-ultrasensitive neuromorphic vision sensor (NeuVS) that uses organic phototransistors (OPTs) as the working unit to integrate sensing, memory and processing functions. Benefiting from asymmetric molecular structure and unique UV absorption of the active layer, the as fabricated UV-ultrasensitive NeuVS can detect 370 nm UV-light with the illumination intensity as low as 31 nW cm^-2, exhibiting one of the best optical figures of merit in UV-sensitive neuromorphic vision sensors. Furthermore, the NeuVS array exbibits good image sensing and memorization capability due to its ultrasensitive optical detection and large density of charge trapping states. In addition, the wavelength-selective response and multi-level optical memory properties are utilized to construct an artificial neural network for extract and identify the invisible UV information. The NeuVS array can perform static and dynamic image recognition from the original color image by filtering red, green and blue noise, and significantly improve the recognition accuracy from 46 to 90%.

Convergent Synthesis of the Precursors to Thiophene-Based Quinoids

A convergent (outside-to-center) route was adopted to synthesize the precursors of quinoidal compounds in high yields of 85-93%. With subsequent rearrangement/dehydroxylation and oxidation, a series of thiophene-based quinoids with indandione or oxindole terminal groups were successfully synthesized. This strategy shows good compatibility with versatile central and terminal units, leading to quinoidal compounds with tunable properties.

A High-Performance n-Type Thermoelectric Polymer from C-H/C-H Oxidative Direct Arylation Polycondensation

n-Type conjugated polymers (CPs) are crucial in the applications of organic electronics. Direct coupling of electron-deficient C-H monomer via selective C-H activation, namely C-H/C-H oxidative direct arylation polycondensation (Oxi-DArP), is an ideal approach toward such CPs. Herein, Oxi-DArP is firstly adopted to synthesize a high-performance n-type CP using a newly developed monomer, i.e., 3,6-di(thiazol-5-yl)-diketopyrrolopyrrole (Tz-5-DPP). Tz-5-DPP based homopolymer PTz-5-DPP with a molecular weight of 22 kDa has been synthesized via Oxi-DArP. After n-doping, PTz-5-DPP films exhibited electric conductivity values up to 8 S cm-1 and power factors (PFs) up to 106 μW m-1 K-2. Notably, this PF value is the highest for n-type polymer thermoelectric materials to date. The Oxi-DArP synthesis and the excellent n-type performance of the polymer makes this work an important step toward the straightforward and sustainable preparation of high-performance n-type polymer semiconductors.

Isomerically Pure Oxindole-Terminated Quinoids for n-Type Organic Thin-Film Transistors Enabled by the Chlorination of Quinoidal Core

Quinoidal compounds have great potential utility as high-performance organic semiconducting materials because of their rigid planar structures and extended π-conjugation. However, the existence of E and Z isomers adversely affects the charge-transport properties of quinoidal compounds. In this study, three isomerically pure oxindole-terminated quinoids were developed by introducing chlorine atoms in the quinoidal core. The synthesized quinoids were confirmed to have a Z,Z configuration by means of ¹ H NMR spectroscopy, density functional theory calculations, and single-crystal X-ray analysis. Importantly, the strategy of chlorination allowed to maintain low-lying frontier molecular orbital energy levels and ensure favorable intermolecular packing. Consequently, all three quinoidal compounds showed n-type transport characteristics in organic thin-film transistors, with electron mobilities up to 0.35 cm²  V^-1  s^-1 , which is the highest value reported to date for oxindole-terminated quinoids. Our study can provide new guidelines for the design of isomerically pure quinoids with high electron mobilities.

Unraveling the Stretch-Induced Microstructural Evolution and Morphology-Stretchability Relationships of High-Performance Ternary Organic Photovoltaic Blends

The stretchability and stretch-induced structural evolution of organic solar cells (OSCs) are pivotal for their collapsible, portable, and wearable applications, and they are mainly affected by the complex morphology of active layers. Herein, a highly ductile conjugated polymer P(NDI2OD-T2) is incorporated into the active layers of high-efficiency OSCs based on nonfullerene small molecule acceptors to simultaneously investigate the morphological, mechanical, and photovoltaic properties and structural evolution under stretching of ternary blend films with various acceptor contents. The structural robustness of the blend films is indicated by their stretch-induced structural evolution, which is monitored in real-time by a combination of in situ wide/small angle X-ray scattering. It is found that adding the soft P(NDI2OD-T2) can enhance the stretchability and structural robustness of ternary blend films by more entangled chains and tie chains to dissipate strain. Furthermore, the stretchability of the ternary blends can be superbly predicted by a 3D equivalent box model. This work provides instructive insight and guidance for designing stretchable electronics and predicting the stretchability of multicomponent blends.

Polyurethane-Based Stretchable Semiconductor Nanofilms with High Intrinsic Recovery Similar to Conventional Elastomers

Polymer semiconductors with large elastic recovery (ER) under high strain in thin film state are highly desirable for stretchable electronics. Here we report a type of stretchable semiconductor PU(DPP)x, by copolymerization of oligodiketopyrrolopyrrole-based conjugated block and hydrogenated polybutadiene flexible block via urethane linkage for intermolecular hydrogen bonding. By regulating block ratio, PU(DPP)35 with 35 wt % conjugated block exhibits high intrinsic ER > 80% under 175% strain (ε) in pseudo free-standing thin film state, comparable with commercial elastomers, and crack onset strain (COS) > 300% along with maximum hole mobility of 0.19 cm2 V-1 s-1 in organic thin film transistors to bring it to the best performing block copolymer-type stretchable semiconductors. Enhanced mobility is achieved using PU(DPP)35 as the binder for conjugated polymer PDPPT3. The 25 wt %-PDPPT3 blend displays mobility up to 1.28 cm2 V-1 s-1 along with COS ∼120%, and 10 wt %-PDPPT3 blend exhibits ER of 78% at ε = 150%, COS of ∼230%, modulus of 36.5 MPa, maximum mobility of 0.62 cm2 V-1 s-1 and no obvious degradation of mobility at ε = 150% after 100 cycles of strain. Moreover, the structural similarity enables the blend film uniform and stable microstructure against mechanical and thermal deformation. Notably, PU(DPP)35 and the blend are characterized by high mechanical performance similar to that of commercial elastomers in thin film state, and demonstrate their potential for high performance stretchable electronics.

AB0171 TOWARDS A BETTER IMPLEMENTATION OF TREAT-TO-TARGET STRATEGY IN RHEUMATOID ARTHRITIS: A COMPARISON OF TWO REAL-WORLD COHORTS

Background

Treat-to-target (T2T) strategy has been the core of rheumatoid arthritis (RA) management for over a decade, however implemented distinctly varied in real practices.

Objectives

We tried to investigate the differences in disease activity and target achievement of two cohorts with different T2T implementations.

Methods

We used data of the CENTRA (Collaboratively intENsive Treat-to-target in RA) and TARRA (Treat-to-TARget in RA) cohorts. The CENTRA is a RA cohort prospectively follow-up by a fixed team with tight control, while the TARRA is a longitudinal observational cohort follow-up by a rheumatologist with casual control. Patients from two cohorts were matched 1:3 by propensity score matching (PSM). The primary outcome was simplified disease activity index (SDAI) at 1-year follow-up.

Results

102 patients from the CENTRA cohort and 271 patients from the TARRA cohort were included. Both groups were comparable in terms of age, gender, disease course, and seropositivity. At the end of 1 year follow-up, the SDAI of patients in the CENTRA cohort was significantly lower than that of patients in the TARRA cohort (2.1 vs 3.4, p＜0.001). The follow-up interval of patients in the CENTRA cohort was significantly shorter than that in the TARRA cohort when patients have not achieved remission (3.1 vs. 3.3 months, p=0.019).

Conclusion

RA patients may benefit more from a tight control T2T strategy with closer follow-up and appropriate education compared with a casual T2T strategy.

Disclosure of Interests

None declared

POS0599 IMPACT OF TREAT-TO-TARGET THERAPY ON BONE MINERAL DENSITY LOSS IN PATIENTS WITH RHEUMATOID ARTHRITIS: A PROSPECTIVE COHORT STUDY

Background

Osteoporosis is a common comorbidity of rheumatoid arthritis (RA). Although RA disease activity has been demonstrated to be associated with bone loss in previous studies, most of them were cross-sectional studies and not in the context of treat-to-target (T2T) strategies.

Objectives

To evaluate the association of disease activity with bone mineral density (BMD) changes in the context of T2T strategies in a prospective RA cohort.

Methods

RA patients were enrolled from a prospective CENTRA cohort of Peking University First Hospital. BMD was repeated at baseline, 1-year and then every other year. Time-adjusted mean disease activity scores were adopted to reflect the overall disease activity during follow-up. The influence of univariable associations between predictors and BMD was investigated using linear regression.

Results

A total of 268 patients were included in our analysis. Their mean age was 50 (12.9) years old. At enrollment, the mean (SD) DAS28-ESR was 3.70 (1.17), and the median (IQR) CDAI and SDIA was 10 (14.45) and 10.30 (16.53), respectively. Osteoporosis at lumbar spine was observed in 23.1% patients and 9.3% at femoral neck at enrollment. Older age, higher SDAI score and lower BMI were found to be associated with osteoporosis at baseline. Reevaluations of BMD at 1 year was applied in 144 patients. Mean decreases of BMDs were 1.75 % at the lumbar spine and 1.40 % at femoral neck at 1 year form baseline, respectively. Patients who achieved remission had less yearly bone loss at lumbar spine (p=0.036). Female gender was identified as a risk factor in the multiple linear regression analyses, and lower disease activity and bisphosphonates were protective factors of continuous bone loss.

Conclusion

Disease activity is associated with bone loss in RA patients in the context of T2T strategies, and those who achieved remission had less yearly bone loss.

Disclosure of Interests

None declared

POS0315 DIAGNOSTIC PERFORMANCE OF CASPAR CRITERIA FOR PSORIATIC ARTHRITIS WITH OR WITHOUT INTEGRATION OF ULTRASOUND

Background

Although the CASPAR criteria in the diagnosis of psoriatic arthritis (PsA) have been validated, CASPAR based on physical examination (PE) is not “gold standard”. The ultrasound (US) could improve the diagnostic accuracy as compared to clinical examination alone.

Objectives

To evaluate the diagnostic performance of CASPAR criteria for psoriatic arthritis (PsA) with or without integration of ultrasound (US).

Methods

The patients with hint of PsA were enrolled. Tender and swollen joint counts, presents of enthesitis and dactylitis were collected by physical examination (PE). US was performed to evaluate peripheral joints, entheses and tendons. The additional value of US to CASPAR criteria were analysed.

Results

326 consecutive patients were enrolled, with 164 PsA and 162 non-PsA. Significantly higher frequencies of tenosynovitis and enthesitis on US and new bone formation on X-ray were found in PsA than non-PsA patients (56.7% vs. 13.0%; 62.2% vs. 14.2%; 62.2% vs. 8.0%, p<0.01 for all). Logistic regression analysis showed that dactylitis (OR=12.0, p<0.01), family history of PsO/PsA (OR=3.1, p<0.05), nail involvement (OR=3.5, p=0.01), new bone formation (OR=14.8, p<0.01) and tenosynovitis on US (OR=21.3, p<0.01), enthesitis on US (OR=21.7, p<0.01) were independent risk factors for PsA. Adding US tenosynovitis and/or enthesitis to CASPAR criteria showed better performance by improving the specificity (91.4% vs. 67.9%) and meanwhile keeping sensitivity (92.1% vs. 96.3%). When replacing hand X-ray by US in CASPAR criteria, the sensitivity and specificity were comparable to CASPAR criteria adding with US. The diagnostic accuracy was 82.2% for CASPAR criteria based on PE, 91.7% for CASPAR integrated with US, and 91.4% for CASPAR with US to replace X-ray.

Conclusion

CASPAR criteria based on US improve the diagnosis utility of PsA than CASPAR criteria based on PE. US assessment is valuable in the diagnosis of PsA.

References

[1]Fiorenza A, Bonitta G, Gerratana E, et al. Assessment of enthesis in patients with psoriatic arthritis and fibromyalgia using clinical examination and ultrasound. Clinical and experimental rheumatology 2020;38 Suppl 123:31-9.

[2]Zabotti A, Bandinelli F, Batticciotto A, et al. Musculoskeletal ultrasonography for psoriatic arthritis and psoriasis patients: a systematic literature review. Rheumatology (Oxford) 2017;56:1518-32.

Figure 1.

ROC curves for adding US or substituting X-ray by US in CASPAR criteria. Receiver operating characteristic (ROC) curve illustrates the diagnosis performance of CASPAR criteria adding US or substituting X-ray by US in CASPAR criteria and CASPAR criteria based on PE alone. The area under the curve of the ROC curve (AUC) was 0.929 (95%CI 0.897, 0.961) (p<0.01) for adding US to CASPAR criteria. AUC was 0.908 (95%CI 0.876, 0.940) (p<0.01) for CASPAR criteria based on PE. And AUC was 0.916 (95%CI 0.880, 0.951) (p<0.01) for substituting X-ray by US in CASPAR criteria. CASPAR: ClASsification criteria for Psoriatic ARthritis; PE: physical examination; US: ultrasound.

Disclosure of Interests

None declared

Semiconducting Polymer Nanoparticles with Intramolecular Motion-Induced Photothermy for Tumor Phototheranostics and Tooth Root Canal Therapy

Much effort is devoted to develop agents with superior photoacoustic/photothermal properties for improved disease diagnosis and treatment. Herein, a new fused two isoindigo (DIID)-based semiconducting conjugated polymer (named PBDT-DIID) is rationally designed and synthesized with a strong near-infrared absorption band ranging from 700 to 1000 nm. Water-dispersing nanoparticles (NPs) of PBDT-DIID are prepared with good biocompatibility and a rather high photothermal conversion efficiency (70.6%), as the active excited-state intramolecular twist around the central double bonds in DIID permits most of the absorbed excitation energy flow to heat deactivation pathway through internal conversion. The photoacoustic signal can be further magnified by incorporation of polylactide (PLA) in the NP core to confine the generated heat of PBDT-DIID within NPs. The resultant doped NPs show excellent performance in photoacoustic imaging-guided photothermal therapy in an orthotopic 4T1 breast tumor-bearing mouse model. It is also found that the photothermal effect of the PBDT-DIID NPs is safe and quite efficacious to highly improve the root canal treatment outcome by heating the 1% NaClO solution inside the root canal upon 808 nm laser irradiation in a human extracted tooth root canal infection model.

Iodine-125 brachytherapy for the treatment of central mucoepidermoid carcinoma of the jaw in a pre-teen

Central mucoepidermoid carcinoma (MEC) of the jaw is a rare malignant neoplasm, even rarer in teenagers. Radical surgical resection, such as en bloc resection or segmental resection, is the main treatment for MEC of the jaw. This surgical treatment results in a loss of integrity of the jaw. The successful application of iodine-125 brachytherapy for the treatment of intraosseous MEC of the mandible in an 11-year-old girl is reported here. No local recurrence or distant metastasis was observed during 6 years of follow-up. The integrity of the mandible was preserved and the development of the mandible was not significantly affected. Iodine-125 brachytherapy is a potential alternative treatment for central mucoepidermoid carcinoma of the jaw, especially in teenagers, and may preserve the continuity and function of the jaw.

Unraveling the Molar Mass Dependence of Shearing-Induced Aggregation Structure of a High-Mobility Polymer Semiconductor

Aggregation-structure formation of conjugated polymers is a fundamental problem in the field of organic electronics and remains poorly understood. Herein, the molar mass dependence of the aggregation structure of a high-mobility conjugated copolymer (TDPP-Se) comprising thiophene-flanked diketopyrrolopyrrole and selenophene is thoroughly shown. Five batches of TDPP-Se are prepared with the number-average molecular weights (M_n ) varied greatly from 21 to 135 kg mol^-1 . Small-angle neutron scattering and transmission electron microscopy are combined to probe the solution structure of these polymers, consistently using a deuterated solvent. All the polymers adopt 1D rod-like aggregation structures and the radius of the 1D rods is not sensitive to the M_n , while the length increases monotonically with M_n . By utilizing the ordered packing of the aggregated structure in solution, a highly aligned and ordered film is prepared and, thereafter, a reliable hole mobility of 13.8 cm² V^-1 s^-1 is realized in organic thin-film transistors with the moderate M_n batch via bar coating. The hole mobility is among the highest values reported for diketopyrrolopyrrole-based polymers. This work paves the way to visualize the real aggregated structure of polymer semiconductors in solution and sheds light on the microstructure control of high-performance electronic devices.

[Analysis of molecular and clinical characteristics of carbapenem-resistant hypervirulent Klebsiella pneumoniae in the intensive care unit]

To investigate the carbapenemases distribution of carbapenem-resistant Klebsiella pneumoniae (CRKP) in the intensive care unit, and the clinical characteristics between carbapenem-resistant hypervirulent Klebsiella pneumoniae (CR-hvKP) and carbapenem-resistant non-hypervirulent Klebsiella pneumoniae (CR-non-hvKP) were compared. A total of 53 non-repetitive CRKP strains isolated from 49 patients in the intensive care unit of the Second Affiliated Hospital of Xi'an Jiaotong University from May 2020 to March 2021 were retrospectively studied. The carbapenemase inhibitor enhancement test was used for screening carbapenemase-producing strains, and the string test was carried out to screen the hypermucoviscosity phenotype. Using PCR to detect five main carbapenemase genes (bla_KPC-2, bla_NDM, bla_IMP , bla_VIM and bla_OXA-48-like), common serotype (K1 and K2) and virulence gene (rmpA and iutA). Treated the strains with both rmpA and iutA genes as hypervirulent Klebsiella pneumonia (hvKP), and the whole genome sequencing of CR-hvKP was completed. At the same time, the clinical data of 49 patients were sorted out, and the differences in clinical characteristics of CR-hvKP and CR-non-hvKP infected patients were compared using the independent sample t test, Mann-Whitney U test, chi-square test or Fisher's exact probability test. CRKP isolated from the intensive care unit were extensively drug resistance and still had a good sensitivity to polymyxin B and tigecycline. Producing carbapenemases were the main resistance mechanism of CRKP (52/53, 98.1%). Of the 53 CRKP strains, except for 1strain that did not detect carbapenemase, at least one carbapenemase resistance gene was detected in the remaining 52 CRKP strains, of which 45 strains carried an enzyme, including 36 bla_KPC-2 (36/53, 67.9%), 8 bla_NDM (8/53, 15.1%), 1 bla_IMP (1/53, 1.9%), and 7 strains carried with both bla_KPC-2 and bla_NDM (7/53, 13.2%). String test and virulence gene showed that 7 CR-hvKP strains (13.2%) were detected in 53 CRKP strains, and two of which were hypermucoviscosity phenotype. Sequencing results revealed that CR-hvKP were mainly ST11 type. Almost all patients with CR-hvKP infection were over 60 years old (7/7), with invasive treatment (7/7), pulmonary infection with hypermucoviscosity phenotype (2/7) and high mortality (5/7); and the percentage of neutrophils in patients with CR-hvKP infection (86.44±4.70) % was higher than those patients with CR-non-hvKP infection (78.90±19.15) %, the difference was statistically significant (t=-2.225, P=0.032). The CR-hvKP strains in the intensive care unit mainly produced KPC-2 enzyme, with K2 capsular serotype and ST11 type. It is necessary to strengthen the monitoring and control of the CR-hvKP strain to prevent the co-evolution of drug-resistant and hypervirulent strains.

[The standardized diagnosis and treatment of rheumatoid arthritis]

Rheumatoid arthritis (RA) is an autoimmune disease characterized by synovial inflammation of the joints with high risk of disability. In recent years, remarkable progress has been made towards the diagnosis and treatment of RA, and the international RA guidelines have been also kept updated. Nevertheless, there are many challenges in China, especially inadequate number of rheumatologists and insufficient experience in the diagnosis and treatment of RA. Therefore, Chinese Rheumatology Association drafted the standardized diagnosis and treatment of RA based on the available evidence, so as to improve the management of RA patients in China.

P3HT-Based Organic Solar Cells with a Photoresponse to 1000 nm Enabled by Narrow Band Gap Nonfullerene Acceptors with High HOMO Levels

Three narrow band gap (NBG) acceptors, namely, TTDTC-0F, TTDTC-2F, and TTDTC-4F, were synthesized by introducing a strong electron-donating unit as the central core. The enhanced intramolecular charge transfer endows the three acceptors with high-lying highest occupied molecular orbitals (HOMOs) of ∼-5.20 eV and ultranarrow band gaps (∼1.25 eV). When blended with poly(3-hexylthiophene) (P3HT), all organic solar cells (OSCs) exhibited a broad photoresponse from 300 to ∼1000 nm. Among them, P3HT:TTDTC-4F-based devices achieved the highest efficiency of 7.81% with a prominent J_sc exceeding 22 mA·cm^-2. This study demonstrates that the conjugated molecules with high HOMOs can also function as acceptor materials for P3HT-based OSCs, which opens a window to increase PCEs of P3HT-based OSCs in the future to the level of the devices based on the current state-of-the-art polymer donor materials.

Thermoplastic Elastomer Tunes Phase Structure and Promotes Stretchability of High-Efficiency Organic Solar Cells

Top-performance organic solar cells (OSCs) consisting of conjugated polymer donors and nonfullerene small molecule acceptors (NF-SMAs) deliver rapid increases in efficiencies. Nevertheless, many of the polymer donors exhibit high stiffness and small molecule acceptors are very brittle, which limit their applications in wearable devices. Here, a simple and effective strategy is reported to improve the stretchability and reduce the stiffness of high-efficiency polymer:NF-SMA blends and simultaneously maintain the high efficiency by incorporating a low-cost commercial thermoplastic elastomer, polystyrene-block-poly(ethylene-ran-butylene)-block-polystyrene (SEBS). The microstructure, mechanical properties, and photovoltaic performance of PM6:N3 with varied SEBS contents and the molecular weight dependence of SEBS on microstructure and mechanical properties are thoroughly characterized. This strategy for mechanical performance improvement exhibits excellent applicability in some other OSC blend systems, e.g., PBQx-TF:eC9-2Cl and PBDB-T:ITIC. More crucially, the elastic modulus of such complex ternary blends can be nicely predicted by a mechanical model. Therefore, incorporating thermoplastic elastomers is a widely applicable and cost-effective strategy to improve mechanical properties of nonfullerene OSCs and beyond.

A poorly soluble organic electrode material for high energy density lithium primary batteries based on a multi-electron reduction

Here we report an organic cathode material with poor solubility for lithium primary batteries, i.e. indeno[3,2-b]fluorene-6,12-dione. Each carbonyl group experiences a four-electron reduction to a methylene group, resulting in a high energy density of 1392 W h kg^-1, which is among the best results for organic electrode materials.

High-yield and sustainable synthesis of quinoidal compounds assisted by keto-enol tautomerism

The classical synthesis of quinoids, which involves Takahashi coupling and subsequent oxidation, often gives only low to medium yields. Herein, we disclose the keto–enol-tautomerism-assisted spontaneous air oxidation of the coupling products to quinoids. This allows for the synthesis of various indandione-terminated quinoids in high isolated yields (85–95%). The origin of the high yield and the mechanism of the spontaneous air oxidation were ascertained by experiments and theoretical calculations. All the quinoidal compounds displayed unipolar n-type transport behavior, and single crystal field-effect transistors based on the micro-wires of a representative quinoid delivered an electron mobility of up to 0.53 cm² V⁻¹ s⁻¹, showing the potential of this type of quinoid as an organic semiconductor.

Facilitated by the highly efficient Pd-catalyzed coupling and keto–enol-tautomerism-assisted spontaneous air oxidation, various indandione-terminated quinoidal compounds have been synthesized in isolated yields up to 95%.

AB0280 THE INFLUENCE OF TARGET THERAPY AS WELL AS GLUCOCORTICOIDS TAPERING ON DISEASE FLARE IN SYSTEMIC LUPUS ERYTHEMATOSUS: RESULTS FROM A PROSPECTIVE CHINESE COHORT

Background:

Treat-to-target in systemic lupus erythematosus (SLE) has been proposed for 7 years and several recommendations were developed [1]. In these recommendations, prevention of flares should be a realistic target. Meanwhile, ‘remission’ or ‘low disease activity’ was recommended as the treatment target and minimizing glucocorticoids (GC) dose or withdrawal if possible was suggested in the maintenance treatment. However, would target therapy and GC tapering/withdrawal influence disease flare?

Objectives:

To investigate the frequency and determinants of disease flare, especially the influence of target therapy as well as GC tapering on flare in Chinese lupus patients.

Methods:

The baseline and follow-up data of all consecutive patients in a prospective longitudinal lupus cohort from January 2017 to June 2020 were collected. The lupus low disease activity state (LLDAS) was defined as in Golder et al., 2019[2]. The criteria for remission were from DORIS definitions [3]. Flare was assessed using the SELENA-SLEDAI flare index [4].

Results:

We enrolled 185 patients with disease duration at recruitment of 2.3 (0.8–7.7) years. During the 26.2 (12.5-34.5) months of follow-up, 73 (39.5%) patients experienced 95 flares, including 70 mild/moderate and 25 severe flares. The incidence of flare per patient-year was 0.27. Kaplan-Meier analyses showed that compared with those who never achieved LLDAS or DORIS, the patients who achieved the target at least once had a higher flare free survival rate; meanwhile, the patients with prednisone withdrawn had significantly lower flare free rate compared with those with small dose of GC maintained (≤7.5mg/d) (Figure 1A), but among the patients with different prednisone maintain doses (7.5~5mg, 5~2.5mg, and ≤2.5mg) there was not significant difference (Figure 1B). Cox regression analysis showed that younger age at disease onset and lower Complement 3 (C3) level at recruitment were independent risk factors for flare and achieving LLDAS or DORIS ≥50% of visits was independent protective factor (Table 1).

Conclusion:

In this Chinese prospective SLE cohort, age at disease onset, C3 level at recruitment and therapeutic target achieving influenced disease flare independently and significantly. GC tapering in appropriate patients and with appropriate pace did not increase the flare rate, but prednisone withdrawal may induce more disease exacerbation, which needs to be confirmed by large prospective studies.

References:

[1]Van Vollenhoven R F, et al. Treat-to-target in systemic lupus erythematosus: recommendations from an international task force. Ann Rheum Dis, 2014. 73(6): 958-967

[2]Golder, V., et al. Lupus low disease activity state as a treatment endpoint for systemic lupus erythematosus: a prospective validation study. The Lancet Rheumatology, 2019. 1(2): p. e95-e102.

[3]van Vollenhoven R, et al. A framework for remission in SLE: consensus findings from a large international task force on definitions of remission in SLE (DORIS). Ann Rheum Dis. 2017. 76(3): 554–561.

[4]Petri M, et al. Classification and definition of major flares in SLE clinical trials. Lupus. 1999. 8(8): 685-691.

Table 1.

Determinants of disease flare by multivariate Cox regression analyses

Model 1(LLDAS) ΔModel 2(RONT) ΔModel 3(Complete RONT) ΔHR95%CIP valueHR95%CIP valueHR95%CIP valueAge at disease onset (years)†0.970.95-0.990.0040.970.95-0.990.0030.970.95-0.990.003Anti-dsDNA positive at recruitment1.340.82-2.180.2171.120.68-1.850.6491.190.73-1.960.486C3 (mg/L) at recruitment0.9980.997-0.9990.0040.9980.997-0.9990.0070.9980.997-1.0000.010Minimum prednisone dose during follow- up (mg/d)0.980.90-1.080.7161.010.94-1.080.7471.040.97-1.110.243Therapeutic target achieved≥50% of observationsΔ0.600.39-0.940.0010.540.34-0.870.0110.680.51-0.920.011

Δ In the three hazard models, the different target achievement status were included respectively.

RONT: Clinical remission on treatment; Complete RONT: Complete remission on treatment.

Disclosure of Interests:

None declared

[Association between parental education level and left ventricular hypertrophy in childhood]

Objective: To examine the relationship between parental education level and left ventricular hypertrophy (LVH) in children. Methods: The data comes from the baseline survey of the Huantai Childhood Cardiovascular Health Cohort Study (HCCH) conducted in Huantai County, Zibo City, Shandong Province. A convenient cluster sampling method was used to select a primary school in Huantai County, Zibo City, Shandong Province as a survey point. A cross-sectional survey was conducted from November 2017 to January 2018. A total of 1 316 children aged 6-11 years with complete data were included. LVH was defined as left ventricular mass index ≥ sex-and age-specific 90th percentile values of this population. Education levels of both parents were divided into junior high school or lower, high school, university or higher, respectively. Logistic regression models were used to analyze the association between parental education level and LVH in children. Results: The age of 1 316 participants was (8.9±1.5) years old. Among them, there were 703 boys (53.4%).After adjusting for gender, age, intake of vegetables and fruits, intake of carbonated drinks, physical activity, sleep time, screen time, overweight or obesity, and occasional hypertension, the logistic regression model results show that compared with those children whose parents' education level is junior high school or below, paternal or maternal education level of college or higher was associated with odds of LVH (father: OR=0.53, 95%CI: 0.33-0.87; mother: OR=0.52, 95%CI: 0.32-0.87; father/mother: OR=0.54,95%CI: 0.32-0.91). Conclusion: Parental education level is inversely associated with LVH in childhood. The probability of LVH in childhood decreases with the increase of parental education levels.

Fluorination Enables Tunable Molecular Interaction and Photovoltaic Performance in Non-Fullerene Solar Cells Based on Ester-Substituted Polythiophene

Owing to the advantages of low synthetic cost and high scalability of synthesis, polythiophene and its derivatives (PTs) have been of interest in the community of organic photovoltaics (OPVs). Nevertheless, the typical efficiency of PT based photovoltaic devices reported so far is much lower than those of the prevailing push-pull type conjugated polymer donors. Recent studies have underscored that the excessively low miscibility between PT and nonfullerene acceptor is the major reason accounting for the unfavorable active layer morphology and the inferior performance of OPVs based on a well-known PT, namely PDCBT-Cl and a non-halogenated nonfullerene acceptor IDIC. How to manipulate the miscibility between PT and acceptor molecule is important for further improving the device efficiency of this class of potentially low-cost blend systems. In this study, we introduced different numbers of F atoms to the end groups of IDIC to tune the intermolecular interaction of the hypo-miscible blend system (PDCBT-Cl:IDIC). Based on calorimetric, microscopic, and scattering characterizations, a clear relationship between the number of F atoms, miscibility, and device performance was established. With the increased number of F atoms in IDIC, the resulting acceptors exhibited enhanced miscibility with PDCBT-Cl, and the domain sizes of the blend films were reduced substantially. As a result, distinctively different photovoltaic performances were achieved for these blend systems. This study demonstrates that varying the number of F atoms in the acceptors is a feasible way to manipulate the molecular interaction and the film morphology toward high-performance polythiophene:nonfullerene based OPVs.

Direct Arylation Polycondensation toward Water/Alcohol-Soluble Conjugated Polymers: Influence of Side Chain Functional Groups

Direct arylation of 2,7-dibromofluorene with n-octyl, 6-diethoxylphosphorylhexyl, 6-(N,N-diethylamino)hexyl or 6-bromohexyl side chains and 1,2,4,5-tetrafluorobenzene (TFB) were conducted to investigate the effect of side chain functional groups on the coupling, and the resulting TFB-substituted fluorene derivatives were used as C-H monomers for the synthesis of water/alcohol soluble conjugated polymers (WSCPs) by direct arylation polycondensation (DArP). The direct arylation and DArP of the monomers carrying phosphonate and amino groups went on smoothly in typical DArP conditions, that is, Pd(OAc)₂/P^tBu₂Me-HBF₄/base/DMAc and Pd₂(dba)₃·CHCl₃/P(o-MeOPh)₃/pivalic acid/base/THF, and high molecular weight polymers with these groups were successfully synthesized. However, for fluorene-monomers with bromohexyl side chains, the target products could not be obtained from the above conditions but could be prepared in the absence of carboxylic acid additives in low polar solvents. With the above DArP-made polymers as cathode interfacial layers, high performance organic solar cells (OSCs) were successfully fabricated.

[The mechanism of hyperbaric oxygen regulating HMGB1 in the prevention and treatment of encephalopathy after acute CO poisoning]

Objective: To study the expression of high mobility group protein 1 (HMGB1) in the brain of rats after hyperbaric oxygen (HBO) treatment of acute carbon monoxide poisoning (DEACMP) , and to explore the mechanism of HBO in the prevention and treatment of DEACMP pathological process by regulating HMGB1. Methods: 108 SD rats were randomly divided into control group (NC group) and co group (CO group) . HBO treatment group (HBO group) , 48 rats in each group. Co group and HBO group were used to establish CO poisoning model, HBO group were treated with hyperbaric oxygen once a day. Water maze test was used to detect and analyze the memory retention ability of three groups of rats in 3 d, 7 d, 14 d. ELISA was used to detect the plasma concentration of HMGB1、IL-6、TNF-α in three groups of rats on the 1 d, 3 d, 7 d, 14 d, 21 d Concentration. Western blotting was used to detect the expression of HMGB1 and Caspase-3 in the brain of the three groups on the 1 d, 3 d, 7 d, 14 d, 21 d. TUNEL staining was used to detect the apoptosis of hippocampal neurons in the three groups. Results: Compared with NC group, the average escape latency of rats in CO group and HBO group was significantly prolonged, and the activity time of platform quadrant in CO group was significantly shortened on 14 d and 21 d (P<0.05) ; compared with CO group, the average escape latency of HBO group on 7 d, 14 d and 21 d was significantly shortened (P<0.05) . Compared with NC group, plasma HMGB1 in CO group and HBO group were significantly increased (P<0.05) ; after 3 days, HBO group was significantly lower than co group, the difference was statistically significant (P<0.05) . The levels of IL-6 and TNF-α in HBO group and co group increased rapidly and then decreased gradually. The increased levels of IL-6 and TNF-α in HBO group were significantly lower than those in CO group (P<0.05) . Compared with NC group, the expression of HMGB1 and Caspase-3 in CO group was significantly increased on 3 d, 7 d and 14 d (P<0.05) ; the expression of HMGB1 and Caspase-3 in HBO group was significantly increased on 3 d, 7 d, 14 d and 21 d (P<0.05) ; compared with CO group, the expression of HMGB1 and Caspase-3 in HBO group decreased significantly on 3 d, 7 d, 14 d and 21 d (P<0.05) . The apoptotic index of nerve cells in CO group began to increase at 3 days, which was significantly different from that of NC group (P<0.05) , and the difference was still statistically significant on 21 d (P<0.05) ; the apoptotic index of nerve cells in HBO group was slightly increased, but there was no significant difference compared with NC group (P>0.05) , and the apoptotic index of 3 d, 7 d, 14 d and 21 d in HBO group was significantly lower than that in CO group (P<0.05) . Conclusion: acute CO poisoning can induce the release of HMGB1 and a variety of inflammatory factors. HMGB1 can promote the apoptosis of nerve cells after acute CO poisoning by up regulating the expression of caspase-3 protein, and participate in the pathological process of DEACMP. HBO can down regulate the expression of HMGB1, IL-6, TNF-α and caspase-3 protein, inhibit the apoptosis of nerve cells, and play a protective role on nerve cells.