Efficacy and safety of intrathecal pemetrexed for TKI-failed leptomeningeal metastases from EGFR+ NSCLC: an expanded, single-arm, phase II clinical trial

BACKGROUND

This study aimed to evaluate the efficacy and safety of intrathecal pemetrexed (IP) for treating patients with leptomeningeal metastases (LM) from non-small-cell lung cancer (NSCLC) who progressed from epidermal growth factor receptor (EGFR)-tyrosine kinase inhibitor (TKI) treatment in an expanded, prospective, single-arm, phase II clinical study (ChiCTR1800016615).

PATIENTS AND METHODS

Patients with confirmed NSCLC-LM who progressed from TKI received IP (50 mg, day 1/day 5 for 1 week, then every 3 weeks for four cycles, and then once monthly) until disease progression or intolerance. Objectives were to assess overall survival (OS), response rate, and safety. Measurable lesions were assessed by investigator according to RECIST version 1.1. LM were assessed according to the Response Assessment in Neuro-Oncology (RANO) criteria.

RESULTS

The study included 132 patients; 68% were female and median age was 52 years (31-74 years). The median OS was 12 months (95% confidence interval 10.4-13.6 months), RANO-assessed response rate was 80.3% (106/132), and the most common adverse event was myelosuppression (n = 42; 31.8%), which reversed after symptomatic treatment. The results of subgroup analysis showed that absence of brain parenchymal metastasis, good Eastern Cooperative Oncology Group score, good response to IP treatment, negative cytology after treatment, and patients without neck/back pain/difficult defecation had longer survival. Gender, age, previous intrathecal methotrexate/cytarabine, and whole-brain radiotherapy had no significant influence on OS.

CONCLUSIONS

This study further showed that IP is an effective and safe treatment method for the EGFR-TKI-failed NSCLC-LM, and should be recommended for these patients in clinical practice and guidelines.

Effect of solid-electrolyte pellet density on failure of solid-state batteries

Despite the potentially higher energy density and improved safety of solid-state batteries (SSBs) relative to Li-ion batteries, failure due to Li-filament penetration of the solid electrolyte and subsequent short circuit remains a critical issue. Herein, we show that Li-filament growth is suppressed in solid-electrolyte pellets with a relative density beyond ~95%. Below this threshold value, however, the battery shorts more easily as the density increases due to faster Li-filament growth within the percolating pores in the pellet. The microstructural properties (e.g., pore size, connectivity, porosity, and tortuosity) of [Formula: see text] with various relative densities are quantified using focused ion beam-scanning electron microscopy tomography and permeability tests. Furthermore, modeling results provide details on the Li-filament growth inside pores ranging from 0.2 to 2 μm in size. Our findings improve the understanding of the failure modes of SSBs and provide guidelines for the design of dendrite-free SSBs.

Ultrasensitive Photothermal Switching with Resonant Silicon Metasurfaces at Visible Bands

Dynamic access to quasi-bound states in the continuum (q-BICs) offers a highly desired platform for silicon-based active nanophotonic applications, while the prevailing tuning approaches by free carrier injections via an all-optical stimulus are yet limited to THz and infrared ranges and are less effective in visible bands. In this work, we present the realization of active manipulations on q-BICs for nanoscale optical switching in the visible by introducing a local index perturbation through a photothermal mechanism. The sharp q-BIC resonance exhibits an ultrasensitive susceptibility to the complex index perturbation, which can be flexibly fulfilled by optical heating of silicon. Consequently, a mild pump intensity of 1 MW/cm2 can yield a modification of the imaginary part of the refractive index of less than 0.05, which effectively suppresses the sharp q-BIC resonances and renders an active modulation depth of reflectance exceeding 80%. Our research might open up an enabling platform for ultrasensitive dynamic nanophotonic devices.

[Percutaneous hollow screw internal fixation combined with cementoplasty in treatment of periacetabular metastasis]

Objective

To explore the percutaneous hollow screw internal fixation combined with cementoplasty in the treatment of periacetabular metastasis.

Methods

A retrospective study was performed on 16 patients with periacetabular metastasis who were treated with percutaneous hollow screw internal fixation combined with cementoplasty between May 2020 and May 2021. There were 9 males and 7 females. The age ranged from 40 to 73 years, with an average of 53.6 years. The tumor involved around the acetabulum, and 6 cases were located on the left and 10 cases on the right. Operation time, frequency of fluoroscopy, bed rest time, and complications were recorded. Before operation, and at 1 weeks, 3 months after operation, the visual analogue scale (VAS) score was used to evaluate the pain degree, the short-form 36 health survey scale (SF-36) score was used to evaluate the quality of life. At 3 months after operation, the Musculoskeletal Tumor Society (MSTS) scoring system was used to evaluate the functional recovery of patients. During follow-up, the loosening of internal fixator and bone cement leakage were observed by X-ray film.

Results

All patients were performed operation successfully. The operation time ranged from 57 to 82 minutes, with an average of 70.4 minutes. The frequency of intraoperative fluoroscopy was 16-34 times, with an average of 23.1 times. After operation, 1 case of incision hematoma and 1 case of scrotal edema occurred. All patients felt the pain relieved after operation. The patients started walking at 1-3 days after operation, with an average of 1.4 days. All patients were followed up 6-12 months (mean 9.7 months). The VAS and SF-36 scores significantly improved after operation when compared with the preoperative scores, and the scores at 3 months after operation were significant better than those at 1 week after operation ( P<0.05). At 3 months after operation, the MSTS score ranged from 9 to 27, with an average of 19.8. Among them, 3 cases were excellent (18.75%), 8 cases were good (50%), 3 cases were fair (18.75%), and 2 cases were poor (12.5%). The excellent and good rate was 68.75%. And 11 patients returned to normal walking, 3 had mild claudication, and 2 had obvious claudication. Radiological examination showed that there were 2 cases of bone cement leakage after operation, and there was no internal fixator loosening or displacement.

Conclusion

Percutaneous hollow screw internal fixation combined with cementoplasty can effectively relieve pain and improve the quality of life of patients with periacetabular metastasis.

Effect of local chemical order on the irradiation-induced defect evolution in CrCoNi medium-entropy alloy

High- (and medium-) entropy alloys have emerged as potentially suitable structural materials for nuclear applications, particularly as they appear to show promising irradiation resistance. Recent studies have provided evidence of the presence of local chemical order (LCO) as a salient feature of these complex concentrated solid-solution alloys. However, the influence of such LCO on their irradiation response has remained uncertain thus far. In this work, we combine ion irradiation experiments with large-scale atomistic simulations to reveal that the presence of chemical short-range order, developed as an early stage of LCO, slows down the formation and evolution of point defects in the equiatomic medium-entropy alloy CrCoNi during irradiation. In particular, the irradiation-induced vacancies and interstitials exhibit a smaller difference in their mobility, arising from a stronger effect of LCO in localizing interstitial diffusion. This effect promotes their recombination as the LCO serves to tune the migration energy barriers of these point defects, thereby delaying the initiation of damage. These findings imply that local chemical ordering may provide a variable in the design space to enhance the resistance of multi-principal element alloys to irradiation damage.

[Clinical and endoscopic characteristics of adult celiac disease]

Objective: The study aimed to analyze the clinical and endoscopic characteristics of adult celiac disease (CD) to provide a scientific basis for more effective CD diagnosis and treatment. Methods: In this cross-sectional study, the clinical and endoscopic data of 96 adult CD patients treated in the Department of Gastroenterology of the People's Hospital of Xinjiang Uygur Autonomous Region from March 2016 to December 2021 were retrospectively collected and analyzed. Results: A total of 96 CD patients were diagnosed, including 33 men and 63 women. The average age was 47±14 years (range, 18-81 years). The disease occurred mainly in the age group of 31-60 years. The median course of the disease was 2.0 (0.2-40.0) years. There were 41 (42.7%) classical and 55 (57.3%) non-classical CD patients. All patients with classical CD showed chronic diarrhea, often accompanied by abdominal pain (46.3%, 19/41), abdominal distension (17.1%, 7/41), anemia (65.9%, 27/41), and chronic fatigue (48.8%, 20/41). The main manifestations of non-classical CD were chronic abdominal pain (58.2%, 32/55), abdominal distension (32.7%, 18/55), anemia (40.0%, 22/55), and osteopenia/osteoporosis (38.2%, 21/55). Compared with non-classical CD, anemia developed more frequently in classical CD, and the difference was statistically significant (P = 0.012). The incidence of complications in CD patients was 36.5% (35/96), and the main complications were thyroid disease (19.8%, 19/96), connective tissue disease (6.2%, 6/96), and kidney disease (6.2%, 6/96). There was no significant difference between classical and non-classical CD (P>0.05). The frequency of endoscopic manifestations in CD patients was 84.4% (81/96). Duodenal bulb endoscopy showed nodular changes (72.9%, 70/96), grooved changes (10.4%, 10/96), and focal villous atrophy (9.4%, 9/96). The main manifestations of descending endoscopy were the decrease, flattening, or disappearance of duodenal folds (43.8%, 42/96), scallop-like changes (38.5%, 37/96), and nodular changes (34.4%, 33/96). Conclusions: Adult CD patients are mostly female. CD occurred mainly in the age group of 31-60 years. The clinical manifestations were mainly those of non-classical CD. Some patients often had other autoimmune diseases. Patients with characteristic endoscopic manifestations should be warned about the possibility of developing CD. Clinicians should strengthen the understanding of CD and reduce the related rates of missed diagnosis.

Observation of localized magnetic plasmon skyrmions

Optical skyrmions have recently been constructed by tailoring vectorial near-field distributions through the interference of multiple surface plasmon polaritons, offering promising features for advanced information processing, transport and storage. Here, we provide experimental demonstration of electromagnetic skyrmions based on magnetic localized spoof plasmons (LSP) showing large topological robustness against continuous deformations, without stringent external interference conditions. By directly measuring the spatial profile of all three vectorial magnetic fields, we reveal multiple π-twist target skyrmion configurations mapped to multi-resonant near-equidistant LSP eigenmodes. The real-space skyrmion topology is robust against deformations of the meta-structure, demonstrating flexible skyrmionic textures for arbitrary shapes. The observed magnetic LSP skyrmions pave the way to ultra-compact and robust plasmonic devices, such as flexible sensors, wearable electronics and ultra-compact antennas.

A novel approach on designing ultrahigh burnup metallic TWR fuels: Upsetting the current technological limits

ABSTRACT

The grand challenge of "net-zero carbon" emission calls for technological breakthroughs in energy production. The traveling wave reactor (TWR) is designed to provide economical and safe nuclear power and solve imminent problems, including limited uranium resources and radiotoxicity burdens from back-end fuel reprocessing/disposal. However, qualification of fuels and materials for TWR remains challenging and it sets an "end of the road" mark on the route of R&D of this technology. In this article, a novel approach is proposed to maneuver reactor operations and utilize high-temperature transients to mitigate the challenges raised by envisioned TWR service environment. Annular U-50Zr fuel and oxidation dispersion strengthened (ODS) steels are proposed to be used instead of the current U-10Zr and HT-9 ferritic/martensitic steels. In addition, irradiation-accelerated transport of Mn and Cr to the cladding surface to form a protective oxide layer as a self-repairing mechanism was discovered and is believed capable of mitigating long-term corrosion. This work represents an attempt to disruptively overcome current technological limits in the TWR fuels.

IMPACT STATEMENT

After the Fukushima accident in 2011, the entire nuclear industry calls for a major technological breakthrough that addresses the following three fundamental issues: (1) Reducing spent nuclear fuel reprocessing demands, (2) reducing the probability of a severe accident, and (3) reducing the energy production cost per kilowatt-hour. An inherently safe and ultralong life fast neutron reactor fuel form can be such one stone that kills the three birds. In light of the recent development findings on U-50Zr fuels, we hereby propose a disruptive, conceptual metallic fuel design that can serve the following purposes at the same time: (1) Reaching ultrahigh burnup of above 40% FIMA, (2) possessing strong inherent safety features, and (3) extending current limits on fast neutron irradiation dose to be far beyond 200 dpa. We believe that this technology will be able to bring about revolutionary changes to the nuclear industry by significantly lowering the operational costs as well as improving the reactor system safety to a large extent.

SUPPLEMENTARY INFORMATION

The online version contains supplementary material available at 10.1557/s43577-022-00420-4.

Planar chiral metasurfaces with maximal and tunable chiroptical response driven by bound states in the continuum

Optical metasurfaces with high quality factors (Q-factors) of chiral resonances can boost substantially light-matter interaction for various applications of chiral response in ultrathin, active, and nonlinear metadevices. However, current approaches lack the flexibility to enhance and tune the chirality and Q-factor simultaneously. Here, we suggest a design of chiral metasurface supporting bound state in the continuum (BIC) and demonstrate experimentally chiroptical responses with ultra-high Q-factors and near-perfect circular dichroism (CD = 0.93) at optical frequencies. We employ the symmetry-reduced meta-atoms with high birefringence supporting winding elliptical eigenstate polarizations with opposite helicity. It provides a convenient way for achieving the maximal planar chirality tuned by either breaking in-plane structure symmetry or changing illumination angle. Beyond linear CD, we also achieved strong near-field enhancement CD and near-unitary nonlinear CD in the same planar chiral metasurface design with circular eigen-polarization. Sharply resonant chirality realized in planar metasurfaces promises various practical applications including chiral lasers and chiral nonlinear filters.

Here, the authors employ the physics of chiral bound states in the continuum and suggest planar chiral metasurfaces with simultaneous ultrahigh quality factor and near-perfect circular dichroism in both linear regime and nonlinear regime.

AB0390 COST-EFFECTIVENESS OF IGURATIMOD IN PATIENTS WITH RHEUMATOID ARTHRITIS (RA) BY USING A CLAIMS-BASED ALGORITHM: RETROSPECTIVE ANALYSIS OF REAL‑WORLD DATA

Background

Iguratimod (IGU), as one of the conventional synthetic disease-modifying antirheumatic drugs (csDMARDs), has been approved by National Medical Products Administration (NMPA) to treat Rheumatoid arthritis (RA).

Objectives

This study aimed to compare the cost-effectiveness of well-established RA therapies using a claims-based algorithm in RA patients.

Methods

An electronic medical record (EMR) database from Zhujiang Hospital was utilized to estimate the cost-effectiveness of medication for RA patients, including IGU with MTX, biological DMARDs (bDMARDs) with MTX, and MTX alone for more than 6 months from 2014 to 2020. Patients who were deemed effective must meet all the following criteria according to the algorithm, high adherence; no bDMARDs or IGU switch or addition; no prescription of new csDMARDs; no increase in dose or frequency of index drug; no new use of chronic glucocorticoids or increase in glucocorticoid dose; and no more than one glucocorticoid injection. Average cost was calculated by summing total cost of effective treatment and dividing by number of patients achieving efficacy in each group.

Results

A total of 263 patients were included in the analysis. Based on a claims-based algorithm, the effective rate was 27.1 % (26/96) for IGU with MTX group, 11.2% (7/62) for bDMARDs with MTX group, and 13.3% (14/105) for MTX alone group, respectively. Average cost of effective treatment was $833.46 for IGU with MTX therapy, $2554.57 for bDMARDs with MTX therapy, and $171.48 for MTX alone (Table 1).

Table 1.

Effectiveness and Cost per Effectively Treated Patient with RA

CriteriaAll patients (n=263)IGU with MTX group(n=96)bDMARDs with MTX group (n=62)MTX (n=105)Effectiveness:no. of patients (%)a47(17.87%)26 (27.1%)7 (11.2/%)14 (13.3%)Cost of all RA-related medication per effectively treated patient(SD)$892.75(911.57)$833.46 (252.67)$2554.5 (1273.13)$171.4 (110.33)Average cost of all RA medications postindex (excluding biologic DMARDs) per patient (SD)b$146.38(114.60)$148.81 (123.12)$86.90 (74.53)$171.4 (110.33)Average cost of only biologicDMARDs postindex per patient (SD)b$746.38(926.35)$684.27(188.67)$2468.67(1285.91)/

a χ2showed significant difference in percentage effectiveness for the original algorithm (p<0.05).

bMedication cost was 2020 U.S. dollars.

Conclusion

IGU with MTX therapy was revealed to be both effective and modestly priced, which seemed to be a cost-effective strategy for RA therapy and warranted further cost-effectiveness investigation.

References

[1](2018) [2018 Chinese guideline for the diagnosis and treatment of rheumatoid arthritis]. Zhonghua Nei Ke Za Zhi 57 (4), 242-251. https://doi.org/10.3760/cma.j.issn.0578-1426.2018.04.004

[2]Hitchon, C. A., & El-Gabalawy, H. S. (2011). The synovium in rheumatoid arthritis. The open rheumatology journal, 5, 107–114. https://doi.org/10.2174/1874312901105010107

[3]Smolen, J. S., Landewé, R., Bijlsma, J., Burmester, G. R., Dougados, M., Kerschbaumer, A., McInnes, I. B., Sepriano, A., van Vollenhoven, R. F., de Wit, M., Aletaha, D., Aringer, M., Askling, J., Balsa, A., Boers, M., den Broeder, A. A., Buch, M. H., Buttgereit, F., Caporali, R., Cardiel, M. H., … van der Heijde, D. (2020). EULAR recommendations for the management of rheumatoid arthritis with synthetic and biological disease-modifying antirheumatic drugs: 2019 update. Annals of the rheumatic diseases, 79(6), 685–699. https://doi.org/10.1136/annrheumdis-2019-216655

[4]Fraenkel, L., Bathon, J. M., England, B. R., St Clair, E. W., Arayssi, T., Carandang, K., Deane, K. D., Genovese, M., Huston, K. K., Kerr, G., Kremer, J., Nakamura, M. C., Russell, L. A., Singh, J. A., Smith, B. J., Sparks, J. A., Venkatachalam, S., Weinblatt, M. E., Al-Gibbawi, M., Baker, J. F., … Akl, E. A. (2021). 2021 American College of Rheumatology Guideline for the Treatment of Rheumatoid Arthritis. Arthritis care & research, 73(7), 924–939. https://doi.org/10.1002/acr.24596

Disclosure of Interests

None declared

Spin-Holstein Models in Trapped-Ion Systems

In this work, we highlight how trapped-ion quantum systems can be used to study generalized Holstein models, and benchmark expensive numerical calculations. We study a particular spin-Holstein model that can be implemented with arrays of ions confined by individual microtraps, and that is closely related to the Holstein model of condensed matter physics, used to describe electron-phonon interactions. In contrast to earlier proposals, we focus on simulating many-electron systems and inspect the competition between charge-density wave order, fermion pairing, and phase separation. In our numerical study, we employ a combination of complementary approaches, based on non-Gaussian variational ansatz states and matrix product states, respectively. We demonstrate that this hybrid approach outperforms standard density-matrix renormalization group calculations.

Investigating the association between COVID-19 vaccination and care home outbreak frequency and duration

OBJECTIVES

At the end of 2020, many countries commenced a vaccination programme against SARS-CoV-2. Public health authorities aim to prevent and interrupt outbreaks of infectious disease in social care settings. We aimed to investigate the association between the introduction of the vaccination programme and the frequency and duration of COVID-19 outbreaks in Northern Ireland (NI).

STUDY DESIGN

We undertook an ecological study using routinely available national data.

METHODS

We used Poisson regression to measure the relationship between the number of RT-PCR confirmed COVID-19 outbreaks in care homes, and as a measure of community COVID-19 prevalence, the Office for National Statistics COVID-19 Infection Survey estimated the number of people testing positive for COVID-19 in NI. We estimated the change in this relationship and estimated the expected number of care home outbreaks in the absence of the vaccination programme. A Cox proportional hazards model estimated the hazard ratio of a confirmed COVID-19 care home outbreak closure.

RESULTS

Care home outbreaks reduced by two-thirds compared to expected following the introduction of the vaccination programme, from a projected 1625 COVID-19 outbreaks (95% prediction interval 1553-1694) between 7 December 2020 and 28 October 2021 to an observed 501. We estimated an adjusted hazard ratio of 2.53 of the outbreak closure assuming a 21-day lag for immunity.

CONCLUSIONS

These findings describe the association of the vaccination with a reduction in outbreak frequency and duration across NI care homes. This indicates probable reduced harm and disruption from COVID-19 in social care settings following vaccination. Future research using individual level data from care home residents will be needed to investigate the effectiveness of the vaccines and the duration of their effects.

Pharmacokinetics of HupA-PLGA-NPs of different sizes in the mouse blood and brain determined by LC-MS/MS

OBJECTIVE

Huperzine A, which was extracted from a Chinese herb, is a reversible and selective inhibitor of acetylcholinesterase (AChE), which is used as an anti-Alzheimer's drug that exerts evident pretreatment effects against exposure to organophosphate chemical warfare agents or pesticides. The aims of this study were to establish an LC-MS/MS method for the detection of HupA in biological samples and to investigate the pharmacokinetics of HupA polylactic-co-glycolic acid nanoparticles (HupA-PLGA-NPs) with different diameters in mice.

MATERIALS AND METHODS

The proposed LC-MS/MS method was established by optimizing the MS conditions and validating the specificity, linear range, lower limit, precision, accuracy, matrix effects, absolute recovery, and sample stability of the method. ICR mice were divided into three treatment groups: the HupA control group, the 46.4-nm HupA-PLGA-NP group and the 208.5-nm HupA-PLGA-NP group. All the mice in the three groups were administered 0.5 mg/kg HupA via the tail vein. The pharmacokinetic parameters in plasma and the brain were detected by LC-MS/MS. Pharmacokinetic parameters were analyzed using PKS pharmacokinetic software, and the relative bioavailability and brain-targeted drug targeting efficiency (DTE) were also calculated.

RESULTS

The distributions of HupA-PLGA-NP groups showed marked changes compared with that of HupA in mice in vivo, and the particle size of nanodrugs exerted a significant effect on the pharmacokinetic parameters in mice. The half-life (T1/2) values in plasma of the 46.4- and 208.5-nm HupA-PLGA-NPs were 1.53- and 1.96-fold longer than that of the HupA at the same dose. The bioavailabilities of the two nanoparticles were 1.93- and 2.19-fold higher than that of HupA, respectively. In the brain, the Tmax values of the two HupA-PLGA-NPs of different sizes was 1.25 h, which was clearly longer than that of HupA (0.5 h), and the corresponding T1/2 values were 12.53 h and 8.47 h, which were 1.82- and 1.23-fold higher than that of HupA (6.89 h). In addition, the brain targeting index of the 46.40-nm HupA-PLGA-NPs was 1.48, which revealed an evident brain-targeting effect.

CONCLUSIONS

The LC-MS/MS method has the advantages of good specificity, high sensitivity and needing a low sample amount and is economical and particularly suitable for determining the drug content in plasma and brain samples. The NP size is associated with the distribution patterns of nanodrugs. Therefore, a particular NP size can be selected to maximize the pharmacodynamics effects and control the toxicity of nanodrugs.

Vectorial Compound Metapixels for Arbitrary Nonorthogonal Polarization Steganography

Malus' law regulating the intensity of light when passed through a polarizer, forms the solid basis for image steganography based on orthogonal polarizations of light to convey hidden information without adverse perceptions, which underpins important practices in information encryptions, anti-counterfeitings, and security labels. Unfortunately, the restriction to orthogonal states being taken for granted in the common perceptions fails to advance cryptoinformation to upgraded levels of security. By introducing a vectorial compound metapixel design, arbitrary nonorthogonal polarization multiplexing of independent grayscale images with high fidelity and strong concealment is demonstrated. The Jones matrix treatment of compound metapixels consisting of double atoms with tailored in-plane orientation sum and difference allows point-by-point configuring of both the amplitude and polarization rotations of the output beam in an analytical and linear form. With this, both multiplexing two continuous grayscale images in arbitrary nonorthogonal polarization angles and concealing grayscale image on another in an arbitrary disclosure angle window are experimentally demonstrated in the visible TiO₂ metasurface platform. The methods shed new light on multifarious metaoptics by harnessing the new degree of freedom and unlock the full potential of metasurface polarization optics.

[Clinical characteristics and related factors of human respiratory syncytial viruses infection in premature infants within 2 years after birth in Shenzhen Children's Hospital]

Objective: To analyze the clinical characteristics and factors associated with human respiratory syncytial virus (HRSV) infection in preterm infants within the first 2 years of life. Methods: Children with respiratory tract infections admitted to Shenzhen Children's Hospital during the 3-year period from January 2016 to December 2018 who were <2 years old and whose gestational age at birth was <37 weeks were selected, and those who met the diagnostic criteria for RSV infection were categorized as the positive case group, and those who had no detectable influenza virus, parainfluenza virus and adenovirus antigens were categorized as the negative group. The clinical characteristics of the case group were retrospectively analyzed. A multivariable logistic regression model was used to analyze the associated factors. Results: A total of 1, 483 children were included, of whom 149 (10.1%) were HRSV positive (case group) and 447 (30.1%) were in the negative group (control group). In the case group, there were 88 (59.1%) male and 61 (40.1%) female children; 127 children (85.2%) in the mild-to-moderate disease group and 22 children (14.8%) in the severe disease group. The number of cases in the severe disease group was greater than that in the mild-to-moderate disease group [(17 cases, 77.3%) than (59 cases, 46.5%)], with statistical significance (P=0.010). A total of 117 cases (78.5%) had onset from February to July. Multivariable analysis showed that males [OR (95%CI) of 0.105 (0.013-0.112)], age at month [0.045 (0.036-0.112)], congenital heart disease [0.388 (0.206-0.940)] and bronchopulmonary dysplasia [0.622 (0.484-0.927)] were positively associated with HRSV infection in preterm infants. Conclusion: The high prevalence of HRSV infection in preterm infants in Shenzhen is from February to July each year, and male children are more common. Young age, congenital heart disease and bronchopulmonary dysplasia are all independent risk factors for HRSV infection in preterm infants.

Optimization of the electron beam dump for a GeV-class laser electron accelerator

The advances of laser-driven electron acceleration offer the promise of great reductions in the size of high-energy electron accelerator facilities. Accordingly, it is desirable to design compact radiation shielding for such facilities. A key component of radiation shielding is the high-energy electron beam dump. In an effort to optimize the electron beam dump design, different material combinations have been simulated with the FLUKA Monte Carlo code in the range of 1-40 GeV. The studied beam dump configurations consist of alternating layers of high-Z material (lead or iron) and low-Z material (high-density concrete or borated polyethylene) in either three-layer or five-layer structures. The designs of various beam dump configuration have been compared and it has been found that the iron and concrete stacking in a three-layer structure with a thick iron layer results in the lowest dose at 1, 10, and 40 GeV. The performance of the beam dump exhibits a strong dependence on the selected materials, the stacking method, the beam dump thickness, as well as the electron energy. This parametric study provides general insights that can be used for compact shielding design of future electron accelerator facilities.

Comparative study of two contrast agents for intraoperative identification of sentinel lymph nodes in patients with early breast cancer

Background

The use of contrast-enhanced ultrasound (CEUS) to locate sentinel lymph nodes (SLNs) in breast cancer has been studied more and more in recent years. This prospective study aimed to compare periareolar injection of two different contrast agents, SonoVue^® (SNV) and Sonazoid^® (SNZ), followed by CEUS to identify SLNs in breast cancer patients with clinically negative nodes.

Methods

A total of 205 patients with T1-2N0M0 breast cancer were divided into the SNV group and SNZ group. All were administered a periareolar injection of SNV or SNZ and underwent US to identify contrast-enhanced SLNs. Each contrast-enhanced SLN underwent a biopsy with blue dye and examined again by CEUS in vitro.

Results

In all cases, contrast-enhanced lymphatic vessels were clearly visualized using US soon after the periareolar injection of SNZ, and the SLNs were easily identified. The SLN identification rates were 75.27% (210/279) for SNV and 93.58% (102/109) for SNZ. Although the accuracy of detecting SLN metastasis was slightly different between the two groups, there was no statistically significant difference between those groups (P=0.615). Moreover, it was possible to identify SLNs in vitro in the SNZ group, and these could be compared with the lymph nodes (LNs) located using SNZ during the preoperative stage and with blue dye during the procedure. This helped in determining the resection requirements.

Conclusions

When comparing the subdermal use of SNV and SNZ, no significant differences in the number of detected SLNs and the diagnosis of metastatic LNs were observed. Because SLNs can be detected for a longer time in living tissues with SNZ, this contrast agent may provide more intraoperative information for complete resection of all preoperative localization of SLN.

Application of VR image recognition and digital twins in artistic gymnastics courses

Because rhythmic gymnastics requires a combination of human movements and hand-held instruments, it is difficult to teach and requires high movement standards. Therefore, the actual course teaching is difficult. In order to improve the teaching efficiency of rhythmic gymnastics courses, based on VR image recognition technology and digital twins, this paper combines the actual teaching needs of rhythmic gymnastics to build a corresponding auxiliary teaching system. The sports database designed in this article mainly has three kinds of sports: difficulty movements, connecting movements and equipment movements. It is different from the traditional method in that each movement and the device-related connection movement correspond to a difficulty movement of the same length and close coordination, and the connection movement plays a role in smoothly connecting the two difficulty movements. In addition, the performance of the auxiliary teaching system constructed in this paper is studied through system experiments. The research results show that this system is feasible.

A distinctive release profile of vancomycin and tobramycin from a new and injectable polymeric dicalcium phosphate dehydrate cement (P-DCPD)

A novel injectable polymeric dicalcium phosphate dehydrate (P-DCPD) cement was developed with superior mechanical strength and excellent cohesion. The purpose of this study was to assess the in vitro performance of P-DCPD loaded with vancomycin (VAN-P), tobramycin (TOB-P) and combination of both (VAN/TOB-P) (10%, w/w). There is a distinctive release profile between VAN and TOB. VAN-P showed decreased initial burst (<30% within 3 d) and sustained VAN release (76% in 28 d). In the presence of TOB (VAN/TOB-P), >90% of VAN was released within 3 d (p < 0.05). Slow and limited TOB release was observed both in TOB-P (<5%) and in TOB/VAN-P (<1%) over 28 d. Zone of inhibition (ZOI) of Staphylococcus aureus growth showed that eluents collected from VAN-P had stronger and longer ZOI (28 d) than that from TOB-P (14 d, p < 0.05). Direct contact of VAN-P, TOB-P and VAN/TOB-P cements displayed persistent and strong ZOI for >3 weeks. Interestingly, the cement residues (28 d after drug release) still maintained strong ZOI ability. P-DCPD with or without antibiotics loading were nontoxic and had no inferior impacts on the growth of osteoblastic MC3T3 cells. VAN-P and TOB-P were injectable. No significant influence on setting time was observed in both VAN-P (11.7 ± 1.9 min) and VAN/TOB-P (10.8 ± 1.5 min) as compared to control (12.2 ± 2.6 min). We propose that a distinctive release profile of VAN and TOB observed is mainly due to different distribution pattern of VAN and TOB within P-DCPD matrix. A limited release of TOB might be due to the incorporation of TOB inside the crystalline lattice of P-DCPD crystals. Our data supported that the bactericidal efficacy of antibiotics-loaded P-DCPD is not only depend on the amount and velocity of antibiotics released, but also probably more on the direct contact of attached bacteria on the degrading cement surface.

π-phase modulated monolayer supercritical lens

The emerging monolayer transition metal dichalcogenides have provided an unprecedented material platform for miniaturized opto-electronic devices with integrated functionalities. Although excitonic light–matter interactions associated with their direct bandgaps have received tremendous research efforts, wavefront engineering is less appreciated due to the suppressed phase accumulation effects resulting from the vanishingly small thicknesses. By introducing loss-assisted singular phase behaviour near the critical coupling point, we demonstrate that integration of monolayer MoS₂ on a planar ZnO/Si substrate, approaching the physical thickness limit of the material, enables a π phase jump. Moreover, highly dispersive extinctions of MoS₂ further empowers broadband phase regulation and enables binary phase-modulated supercritical lenses manifesting constant sub-diffraction-limited focal spots of 0.7 Airy units (AU) from the blue to yellow wavelength range. Our demonstrations downscaling optical elements to atomic thicknesses open new routes for ultra-compact opto-electronic systems harnessing two-dimensional semiconductor platforms with integrated functionalities.

Here the authors report binary phase supercritical lenses by patterning monolayer TMD materials. Through placement of atomic thin 2D TMD with sufficient absorption, a spot of critical coupling is created to facilitate a π phase jump and subdiffraction focusing over bandwidth of 150 nm in visible range.

First-dose ChAdOx1 and BNT162b2 COVID-19 vaccines and thrombocytopenic, thromboembolic and hemorrhagic events in Scotland

Reports of ChAdOx1 vaccine-associated thrombocytopenia and vascular adverse events have led to some countries restricting its use. Using a national prospective cohort, we estimated associations between exposure to first-dose ChAdOx1 or BNT162b2 vaccination and hematological and vascular adverse events using a nested incident-matched case-control study and a confirmatory self-controlled case series (SCCS) analysis. An association was found between ChAdOx1 vaccination and idiopathic thrombocytopenic purpura (ITP) (0-27 d after vaccination; adjusted rate ratio (aRR) = 5.77, 95% confidence interval (CI), 2.41-13.83), with an estimated incidence of 1.13 (0.62-1.63) cases per 100,000 doses. An SCCS analysis confirmed that this was unlikely due to bias (RR = 1.98 (1.29-3.02)). There was also an increased risk for arterial thromboembolic events (aRR = 1.22, 1.12-1.34) 0-27 d after vaccination, with an SCCS RR of 0.97 (0.93-1.02). For hemorrhagic events 0-27 d after vaccination, the aRR was 1.48 (1.12-1.96), with an SCCS RR of 0.95 (0.82-1.11). A first dose of ChAdOx1 was found to be associated with small increased risks of ITP, with suggestive evidence of an increased risk of arterial thromboembolic and hemorrhagic events. The attenuation of effect found in the SCCS analysis means that there is the potential for overestimation of the reported results, which might indicate the presence of some residual confounding or confounding by indication. Public health authorities should inform their jurisdictions of these relatively small increased risks associated with ChAdOx1. No positive associations were seen between BNT162b2 and thrombocytopenic, thromboembolic and hemorrhagic events.

Promises and Challenges of Next-Generation "Beyond Li-ion" Batteries for Electric Vehicles and Grid Decarbonization

The tremendous improvement in performance and cost of lithium-ion batteries (LIBs) have made them the technology of choice for electrical energy storage. While established battery chemistries and cell architectures for Li-ion batteries achieve good power and energy density, LIBs are unlikely to meet all the performance, cost, and scaling targets required for energy storage, in particular, in large-scale applications such as electrified transportation and grids. The demand to further reduce cost and/or increase energy density, as well as the growing concern related to natural resource needs for Li-ion have accelerated the investigation of so-called "beyond Li-ion" technologies. In this review, we will discuss the recent achievements, challenges, and opportunities of four important "beyond Li-ion" technologies: Na-ion batteries, K-ion batteries, all-solid-state batteries, and multivalent batteries. The fundamental science behind the challenges, and potential solutions toward the goals of a low-cost and/or high-energy-density future, are discussed in detail for each technology. While it is unlikely that any given new technology will fully replace Li-ion in the near future, "beyond Li-ion" technologies should be thought of as opportunities for energy storage to grow into mid/large-scale applications.

Full-visible transmissive metagratings with large angle/wavelength/polarization tolerance

Metagratings have been shown to form an agile and efficient platform for extreme wavefront manipulation, going beyond the limitations of gradient metasurfaces. Here, we present all-dielectric transmissive metagratings with high diffraction efficiencies using simple rectangular inclusions with neither high index nor high aspect ratio requirement. We further experimentally demonstrate continuous phase encoding of a hologram based on such transmissive metagratings through displacement modulation of CMOS-compatible silicon nitride nanobars in the full visible range, manifesting broadband and wide-angle high diffraction efficiencies for both polarizations. Featured with extreme angle/wavelength/polarization tolerance and alleviated structural complexity for both design and fabrication, our demonstration unlocks the full potential of metagrating-based wavefront manipulation for a variety of practical applications.

The interplay between thermodynamics and kinetics in the solid-state synthesis of layered oxides

In the synthesis of inorganic materials, reactions often yield non-equilibrium kinetic byproducts instead of the thermodynamic equilibrium phase. Understanding the competition between thermodynamics and kinetics is a fundamental step towards the rational synthesis of target materials. Here, we use in situ synchrotron X-ray diffraction to investigate the multistage crystallization pathways of the important two-layer (P2) sodium oxides Na_0.67MO₂ (M = Co, Mn). We observe a series of fast non-equilibrium phase transformations through metastable three-layer O3, O3' and P3 phases before formation of the equilibrium two-layer P2 polymorph. We present a theoretical framework to rationalize the observed phase progression, demonstrating that even though P2 is the equilibrium phase, compositionally unconstrained reactions between powder precursors favour the formation of non-equilibrium three-layered intermediates. These insights can guide the choice of precursors and parameters employed in the solid-state synthesis of ceramic materials, and constitutes a step forward in unravelling the complex interplay between thermodynamics and kinetics during materials synthesis.

Can elevated concentrations of ALT and AST predict the risk of 'recurrence' of COVID-19?

'Recurrence' of coronavirus disease 2019 (COVID-19) has triggered numerous discussions of scholars at home and abroad. A total of 44 recurrent cases of COVID-19 and 32 control cases admitted from 11 February to 29 March 2020 to Guanggu Campus of Tongji Hospital affiliated to Tongji Medical College Huazhong University of Science and Technology were enrolled in this study. All the 44 recurrent cases were classified as mild to moderate when the patients were admitted for the second time. The gender and mean age in both cases (recurrent and control) were similar. At least one concomitant disease was observed in 52.27% recurrent cases and 34.38% control cases. The most prevalent comorbidity among them was hypertension. Fever and cough being the most prevalent clinical symptoms in both cases. On comparing both the cases, recurrent cases had markedly elevated concentrations of alanine aminotransferase (ALT) (P = 0.020) and aspartate aminotransferase (AST) (P = 0.007). Moreover, subgroup analysis showed mild to moderate abnormal concentrations of ALT and AST in recurrent cases. The elevated concentrations of ALT and AST may be recognised as predictive markers for the risk of 'recurrence' of COVID-19, which may provide insights into the prevention and control of COVID-19 in the future.

LINC00707 promotes cell proliferation and invasion of colorectal cancer via miR-206/FMNL2 axis

OBJECTIVE

Long non-coding RNAs (lncRNAs) have been verified to participate in the regulation of colorectal cancer (CRC). However, the role of LINC00707 in CRC still remains unknown. Here, we aim to study the role of LINC00707 in CRC.

PATIENTS AND METHODS

LINC00707 expression in 97 pairs of CRC tissues and adjacent normal tissues was determined by the quantitative Real Time-Polymerase Chain Reaction (qRT-PCR). LINC00707 overexpression or knockdown in SW620 or HCT116 cells was achieved by lentivirus transfection. The proliferation and cell circle progression of established cells were detected by cell counting kit-8 (CCK-8) assay and flow cytometry, respectively. Cell invasion and migration abilities were studied by transwell assay. Dual-luciferase assay and Western blot was used to verify the underlying mechanism of LINC00707 in CRC. Nude mice were obtained to identify the in vivo function of LINC00707 in CRC.

RESULTS

LINC00707 was significantly over-expressed in CRC tissues and cell lines. Up-regulation of LINC00707 promoted cell proliferation, cell cycle progression, invasion, and migration of SW620 cells. Conversely, down-regulation of LINC00707 reduced cell growth and metastasis of HCT116 cells. MiR-206 was verified as a direct target of LINC00707, and its function was inhibited by LINC00707. FMNL2 was a target for miR-206 in CRC cells. Meanwhile, LINC00707 promoted tumor growth of CRC in vivo.

CONCLUSIONS

LINC00707 was up-regulated in CRC tissues and cells, which promoted cell proliferation and metastasis via sponging miR-206 to increase FMNL2 expression. This might provide a novel target for the biological treatment of CRC.

Proton irradiation of graphene: insights from atomistic modeling

Various types of topological defects are produced during proton irradiation, which are crucial in functionalizing graphene, but the mechanisms of the defect generation process and the structure change are still elusive. Herein, we investigated the graphene defect generation probabilities and defect structures under proton irradiation using both ab initio and classical molecular dynamics simulations. As the proton energy increases from 0.1 keV to 100 keV, defect structures transition from single vacancy and Frenkel pairs to a rich variety of topological defects with the possibility of ejecting multiple atoms. We show that, relatively good agreement on defect generation probabilities can be reached between the two simulation approaches at a proton energy of 1 and 10 keV. However, at 0.1 keV, the single vacancy generation probability differs significantly in two methods due to the difference in the energy required to form single vacancy. Using the classical molecular dynamics simulation, we also studied the evolution of different types of defects and the dependence of their probabilities of occurrence on the proton energy and incident angle. The correlation between the impact positions and defect types allows for the convoluted relationship between the defect probabilities, geometric parameters, and proton energy to be elucidated. We show that the proton energy and incident angle can be used to effectively tune the generation probabilities of different types of defects. Our results provide insights into the controlled defect engineering through ion irradiation, which will be useful for the development of functionalized graphene and graphene electronics.

P2769Racial differences in outcomes among acute pulmonary embolism patients: a nationwide analysis

Background

Limited data is available regarding racial disparities in patients admitted for acute pulmonary embolism.

Purpose

We aimed to examine the impact of racial differences on outcomes in patients admitted for acute pulmonary embolism.

Methods

We used the Nationwide Inpatient Sample, which represents 20% of community hospital discharges in the US, to identify adult patients who were discharged with the primary diagnosis of acute pulmonary embolism in 2016 with ICD-10 codes. Logistic regression analysis and linear regression analysis were used to compare patients with different races. Outcomes were focused on in-hospital mortality, total cost, length of stay and disposition, adjusting gender, age, Charlson comorbid index and socioeconomic variables.

Results

In 2016, 35,526 patients were admitted with a primary diagnosis of acute pulmonary embolism. White patients were more likely to be older and with higher income. After adjusting for the above variables, white patients had lower total cost of hospitalization (p<0.0001), shorter length of stay (p<0.0001), lower in-hospital mortality (adjusted odds ratio = 0.79, p=0.001), and more likely to be discharged to rehabilitation facilities compared to being discharged home.

Outcomes in white vs non-white patients

Conclusion

Among acute pulmonary embolism hospitalizations, white patients generally had better outcomes despite being older in age, and were more likely to be transferred to rehabilitation facilities after discharge.

Extraordinary Radiation Hardness of Atomically Thin MoS2

We demonstrate that atomically thin layered two-dimensional (2D) semiconductors are promising candidates for space electronics owing to their inherent and extraordinary resilience to radiation damage from energetic heavy charged particles. In particular, we found that ultrathin MoS₂ nanosheets can easily withstand proton and helium irradiation with fluences as high as ∼10¹⁶ and ∼10¹⁵ ions/cm², respectively, corresponding to hundreds or thousands of years of unshielded exposure to radiation in space. While radiation effects on 2D material-based field effect transistors have been reported in the recent past, none of these studies could isolate the impact of irradiation on standalone ultrathin 2D layers. By adopting a unique experimental approach that exploits the van der Waals epitaxy of 2D materials, we were able to differentiate the effects of radiation on the 2D semiconducting channel from that of the underlying dielectric substrate, semiconductor/substrate interface, and metal/semiconductor contact interface, revealing the ultimate potential of these 2D materials. Furthermore, we used a statistical approach to evaluate the effect of radiation damage on critical device and material parameters, including threshold voltage, subthreshold slope, and carrier mobility. The statistical approach lends additional credence to the general conclusions drawn from this study, overcoming a common drawback of methods applied in this area of research. Our findings do not only offer exciting prospects for the operation of modern electronics in space, but may also benefit electronics applications in high-altitude flights, military aircraft, satellites, nuclear reactors, particle accelerators, and other high-radiation environments. Additionally, they highlight the importance of evaluating the impact of damage to the substrate and surrounding materials on electrical characteristics during future radiation studies of 2D materials.

Hidden structural and chemical order controls lithium transport in cation-disordered oxides for rechargeable batteries

Structure plays a vital role in determining materials properties. In lithium ion cathode materials, the crystal structure defines the dimensionality and connectivity of interstitial sites, thus determining lithium ion diffusion kinetics. In most conventional cathode materials that are well-ordered, the average structure as seen in diffraction dictates the lithium ion diffusion pathways. Here, we show that this is not the case in a class of recently discovered high-capacity lithium-excess rocksalts. An average structure picture is no longer satisfactory to understand the performance of such disordered materials. Cation short-range order, hidden in diffraction, is not only ubiquitous in these long-range disordered materials, but fully controls the local and macroscopic environments for lithium ion transport. Our discovery identifies a crucial property that has previously been overlooked and provides guidelines for designing and engineering cation-disordered cathode materials.

Facile metagrating holograms with broadband and extreme angle tolerance

The emerging meta-holograms rely on arrays of intractable meta-atoms with various geometries and sizes for customized phase profiles that can precisely modulate the phase of a wavefront at an optimal incident angle for given wavelengths. The stringent and band-limited angle tolerance remains a fundamental obstacle for their practical application, in addition to high fabrication precision demands. Utilizing a different design principle, we determined that facile metagrating holograms based on extraordinary optical diffraction can allow the molding of arbitrary wavefronts with extreme angle tolerances (near-grazing incidence) in the visible-near-infrared regime. By modulating the displacements between uniformly sized meta-atoms rather than the geometrical parameters, the metagratings produce a robust detour phase profile that is irrespective of the wavelength or incident angle. The demonstration of high-fidelity meta-holograms and in-site polarization multiplexing significantly simplifies the metasurface design and lowers the fabrication demand, thereby opening new routes for flat optics with high performances and improved practicality.

[Effects of Personality and Psychological Acceptance on Medical Workers' Occupational Stress]

Objective: To assess psychological acceptance and occupational stress of medical staff, analyze the relationship among personality, psychological acceptance and occupational stress and discuss the direct or indirect effects of personality to occupational stress. Methods: Eysenck Personality Questionnaire (EPQ-RSC) , Acceptance and Action Questionnaire-II (AAQ-Ⅱ) and Revised Occupational Stress Inventory (OSI-R) were administered to 749 medical staff. Results: The level of occupational stress of medical staff was high, the score of PSY was 26.8±7.13 and the score of PHS was 24.3±6.50. Personality and psychological acceptance can predict occupational stress. Psychological acceptance was a protective factor of occupational stress. Medical staff with personality of introversion, neuroticism and psychoticism suffered higher occupational stress. Personality have both direct and indirect effects on occupational stress. Neuroticism have the strongest effect on occupational stress with effect size of 0.496 (psychological stress) and 0.431 (physical strain) . Conclusion: Medical staff have heavier occupational stress. There is a significant correlation between personality and occupational stress. Measures depending on personality should be taken to deal with this situation.

Reversible Mn2+/Mn4+ double redox in lithium-excess cathode materials

There is an urgent need for low-cost, resource-friendly, high-energy-density cathode materials for lithium-ion batteries to satisfy the rapidly increasing need for electrical energy storage. To replace the nickel and cobalt, which are limited resources and are associated with safety problems, in current lithium-ion batteries, high-capacity cathodes based on manganese would be particularly desirable owing to the low cost and high abundance of the metal, and the intrinsic stability of the Mn⁴⁺ oxidation state. Here we present a strategy of combining high-valent cations and the partial substitution of fluorine for oxygen in a disordered-rocksalt structure to incorporate the reversible Mn²⁺/Mn⁴⁺ double redox couple into lithium-excess cathode materials. The lithium-rich cathodes thus produced have high capacity and energy density. The use of the Mn²⁺/Mn⁴⁺ redox reduces oxygen redox activity, thereby stabilizing the materials, and opens up new opportunities for the design of high-performance manganese-rich cathodes for advanced lithium-ion batteries.

High magnesium mobility in ternary spinel chalcogenides

Magnesium batteries appear a viable alternative to overcome the safety and energy density limitations faced by current lithium-ion technology. The development of a competitive magnesium battery is plagued by the existing notion of poor magnesium mobility in solids. Here we demonstrate by using ab initio calculations, nuclear magnetic resonance, and impedance spectroscopy measurements that substantial magnesium ion mobility can indeed be achieved in close-packed frameworks (~ 0.01–0.1 mS cm^–1 at 298 K), specifically in the magnesium scandium selenide spinel. Our theoretical predictions also indicate that high magnesium ion mobility is possible in other chalcogenide spinels, opening the door for the realization of other magnesium solid ionic conductors and the eventual development of an all-solid-state magnesium battery.

Low magnesium mobility in solids represents a significant obstacle to the development of Mg intercalation batteries. Here the authors show that substantial magnesium ion mobility can be achieved in close-packed ternary selenide spinel materials.

Mitigating oxygen loss to improve the cycling performance of high capacity cation-disordered cathode materials

Recent progress in the understanding of percolation theory points to cation-disordered lithium-excess transition metal oxides as high-capacity lithium-ion cathode materials. Nevertheless, the oxygen redox processes required for these materials to deliver high capacity can trigger oxygen loss, which leads to the formation of resistive surface layers on the cathode particles. We demonstrate here that, somewhat surprisingly, fluorine can be incorporated into the bulk of disordered lithium nickel titanium molybdenum oxides using a standard solid-state method to increase the nickel content, and that this compositional modification is very effective in reducing oxygen loss, improving energy density, average voltage, and rate performance. We argue that the valence reduction on the anion site, offered by fluorine incorporation, opens up significant opportunities for the design of high-capacity cation-disordered cathode materials.The performance of lithium-excess cation-disordered oxides as cathode materials relies on the extent to which the oxygen loss during cycling is mitigated. Here, the authors show that incorporating fluorine is an effective strategy which substantially improves the cycling stability of such a material.

Investigation of Potassium Storage in Layered P3-Type K0.5 MnO2 Cathode

Novel and low-cost batteries are of considerable interest for application in large-scale energy storage systems, for which the cost per cycle becomes critical. Here, this study proposes K_0.5 MnO₂ as a potential cathode material for K-ion batteries as an alternative to Li technology. K_0.5 MnO₂ has a P3-type layered structure and delivers a reversible specific capacity of ≈100 mAh g^-1 with good capacity retention. In situ X-ray diffraction analysis reveals that the material undergoes a reversible phase transition upon K extraction and insertion. In addition, first-principles calculations indicate that this phase transition is driven by the relative phase stability of different oxygen stackings with respect to the K content.

The signaling axis of microRNA-31/interleukin-25 regulates Th1/Th17-mediated inflammation response in colitis

Interleukin-25 (IL-25) is an important regulatory cytokine that has a key role on mucosal immune tolerance during inflammation response. However, the molecular mechanism that regulates the colonic IL-25 expression in Crohn's disease (CD) remains unclear. In this study, IL-25 level was proved to decrease in 2,4,6-trinitrobenzene sulfonic acid (TNBS)-induced colitis mice and IL-10 knockout (KO) spontaneous colitis mice. An inverse correlation between IL-25 and miR-31 was discovered in the colons from model mice and CD patients. Furthermore, target validation analysis demonstrated that miR-31 directly regulated IL-25 expression by binding to its messenger RNA 3'-untranslated region. Changing colonic miR-31 level in the colitis mice could affect the mucosal IL-12/23-mediated Th1/Th17 pathway and lead to either amelioration or aggravation of colonic inflammation. In addition, the therapeutic effects of anti-miR-31 in TNBS-induced colitis were abolished by colonic treatment with IL-25 antibody or colonic down-expression of IL-25. Our findings demonstrated that IL-25 could be a crucial anti-inflammatory cytokine in TNBS-induced colitis and the signaling of miR-31 targeting IL-25 might be a possible mechanism that regulates IL-12/23-mediated Th1/Th17 inflammatory responses during colonic inflammation process. Restoring colonic IL-25 expression and blocking Th1/Th17 responses via intracolonic administration of miR-31 inhibitor may represent a promising approach for CD treatment.

[Mediating effect of mental elasticity on occupational stress and depression in female nurses]

Objective: To investigate the interaction between mental elasticityand occupational stress and depressionin female nurses and the mediating effect of mental elasticity, as well as the functioning way of mental elasticity in occupational stress-depression. Methods: From August to October, 2015, cluster sampling was used to select 122 female nurses in a county-level medical institution as study subjects. The Connor-Davidson Resilience Scale (CD-RISC) , Occupational Stress Inventory-Revised Edition (OSI-R) , and Self-Rating Depression Scale (SDS) were used to collect the data on mental elasticity, occupational stress, and depression and analyze their correlation and mediating effect. Results: The 122 female nurses had a mean mental elasticity score of 62.4±15.1, which was significantly lower than the Chinese norm (65.4±13.9) (P<0.05) ; the mean depression score was 41.0±7.7, which was significantly higher than the Chinese norm (33.5±8.6) (P<0.01) , and the incidence rate of depression of 52.5%. Mental elasticity was negatively correlated with occupational stress and depression (r=-0.559 and -0.559, both P<0.01) . Occupational stress and the two subscales mental stress reaction and physical stress reaction were positively correlated with depression (r=0.774, 0.734, and 0.725, all P<0.01) . After adjustment for confounding factors, occupational stress had a positive predictive effect on depression (β=0.744, P<0.01) , and mental elasticity had a negative predictive effect on depression (β=-0.221, P<0.01) . The analysis of mediating effect showed a significant direct effect of occupational stress on depression and a significant mediating effect of mental elasticity (a=-0.527, b=-0.227, c=0.744, c'=0.627; all P<0.01) , and the mediating effect of mental elasticity accounted for 16.08% of the total effect. Conclusion: As a partial mediating variable, mental elasticity has an indirect effect on the relationship between occupational stress and depression and can alleviate the adverse effect of occupational stress and reduce the development of depression.

Electroplating lithium transition metal oxides

Materials synthesis often provides opportunities for innovation. We demonstrate a general low-temperature (260°C) molten salt electrodeposition approach to directly electroplate the important lithium-ion (Li-ion) battery cathode materials LiCoO₂, LiMn₂O₄, and Al-doped LiCoO₂. The crystallinities and electrochemical capacities of the electroplated oxides are comparable to those of the powders synthesized at much higher temperatures (700° to 1000°C). This new growth method significantly broadens the scope of battery form factors and functionalities, enabling a variety of highly desirable battery properties, including high energy, high power, and unprecedented electrode flexibility.

Nonlinear Transition from Mitigation to Suppression of the Edge Localized Mode with Resonant Magnetic Perturbations in the EAST Tokamak

Evidence of a nonlinear transition from mitigation to suppression of the edge localized mode (ELM) by using resonant magnetic perturbations (RMPs) in the EAST tokamak is presented. This is the first demonstration of ELM suppression with RMPs in slowly rotating plasmas with dominant radio-frequency wave heating. Changes of edge magnetic topology after the transition are indicated by a gradual phase shift in the plasma response field from a linear magneto hydro dynamics modeling result to a vacuum one and a sudden increase of three-dimensional particle flux to the divertor. The transition threshold depends on the spectrum of RMPs and plasma rotation as well as perturbation amplitude. This means that edge topological changes resulting from nonlinear plasma response plays a key role in the suppression of ELM with RMPs.

Active fiber-based retroreflector providing phase-retracing anti-parallel laser beams for precision spectroscopy

We present an active fiber-based retroreflector providing high quality phase-retracing anti-parallel Gaussian laser beams for precision spectroscopy of Doppler sensitive transitions. Our design is well-suited for a number of applications where implementing optical cavities is technically challenging and corner cubes fail to match the demanded requirements, most importantly retracing wavefronts and preservation of the laser polarization. To illustrate the performance of the system, we use it for spectroscopy of the 2S-4P transition in atomic hydrogen and demonstrate an average suppression of the first order Doppler shift to 4 parts in 10⁶ of the full collinear shift. This high degree of cancellation combined with our cryogenic source of hydrogen atoms in the metastable 2S state is sufficient to enable determinations of the Rydberg constant and the proton charge radius with competitive uncertainties. Advantages over the usual Doppler cancellation based on corner cube type retroreflectors are discussed as well as an alternative method using a high finesse cavity.

Multichannel Exchange-Scattering Spin Polarimetry

Electron spin plays important roles in determining the physical and chemical properties of matter. However, measurements of electron spin are of poor quality, impeding the development of material sciences, because the spin polarimeter has a low efficiency. Here, we show an imaging-type exchange-scattering spin polarimeter with 6786 channels and an 8.5×10^{-3} single channel efficiency. As a demonstration, the fine spin structure of the electronic states in bismuth (111) is investigated, for which strong Rashba-type spin splitting behavior is seen in both the bulk and surface states. This improvement paves the way to study novel spin related phenomena with unprecedented accuracy.