Exceptional Stability against Water, UV Light, and Heat for CsPbBr3@Pb-MOF Composites

All-inorganic lead halide perovskite nanocrystals (NCs) have been widely applied in optoelectronic devices owing to their excellent photoluminescence (PL) properties. However, poor stability upon exposure to water, UV light or heat strongly limits their practical application. Herein, CsPbBr3@Pb-MOF composites with exceptional stability against water, UV light, and heat are synthesized by ultrasonic processing the precursors of lead-based MOF (Pb-MOF), oleylammonium bromide (OAmBr) and cesium oleate (Cs-OA) solutions at room temperature. Pb-MOF can not only provide the lead source for the in situ growth of CsPbBr3 NCs, but also the protective layer of perovskites NCs. The formed CsPbBr3@Pb-MOF composites show a considerable PL quantum yield (PLQY) of 67.8%, and can maintain 90% of the initial PL intensity when immersed in water for 2 months. In addition, the outstanding PL stability against UV light and heat is demonstrated with CsPbBr3 NCs synthesized by the conventional method as a comparison. Finally, a green (light-emitting diode) LED is fabricated using green-emitting CsPbBr3@Pb-MOF composites and exhibits excellent stability without packaging when immersed in water for 30 days. This study provides a practical approach to improve the stability in aqueous phase, which may pave the way for future applications for various optoelectronic devices.

Measurements of All-Particle Energy Spectrum and Mean Logarithmic Mass of Cosmic Rays from 0.3 to 30 PeV with LHAASO-KM2A

We present the measurements of all-particle energy spectrum and mean logarithmic mass of cosmic rays in the energy range of 0.3-30 PeV using data collected from LHAASO-KM2A between September 2021 and December 2022, which is based on a nearly composition-independent energy reconstruction method, achieving unprecedented accuracy. Our analysis reveals the position of the knee at 3.67±0.05±0.15  PeV. Below the knee, the spectral index is found to be -2.7413±0.0004±0.0050, while above the knee, it is -3.128±0.005±0.027, with the sharpness of the transition measured with a statistical error of 2%. The mean logarithmic mass of cosmic rays is almost heavier than helium in the whole measured energy range. It decreases from 1.7 at 0.3 PeV to 1.3 at 3 PeV, representing a 24% decline following a power law with an index of -0.1200±0.0003±0.0341. This is equivalent to an increase in abundance of light components. Above the knee, the mean logarithmic mass exhibits a power law trend towards heavier components, which is reversal to the behavior observed in the all-particle energy spectrum. Additionally, the knee position and the change in power-law index are approximately the same. These findings suggest that the knee observed in the all-particle spectrum corresponds to the knee of the light component, rather than the medium-heavy components.

Underwater dynamic polarization imaging without dependence on the background region

Active-polarization imaging holds significant promise for achieving clear underwater vision. However, only static targets were considered in previous studies, and a background region was required for image restoration. To address these issues, this study proposes an underwater dynamic polarization imaging method based on image pyramid decomposition and reconstruction. During the decomposition process, the polarized image is downsampled to generate an image pyramid. Subsequently, the spatial distribution of the polarization characteristics of the backscattered light is reconstructed by upsampling, which recovered the clear scene. The proposed method avoids dependence on the background region and is suitable for moving targets with varying polarization properties. The experimental results demonstrate effective elimination of backscattered light while sufficiently preserving the target details. In particular, for dynamic targets, processing times that fulfill practical requirements and yield superior recovery effects are simultaneously obtained.

Characterizing amyloid protein conformation with a multi-resonant metasurface based biosensor in the infrared window

Misfolding of amyloid protein will cause neurodegeneration and trigger conformational disease. The lack of an effective detection approach is a brake on unveiling the mechanism of protein misfolding. We theoretically proposed a novel metasurface-based biosensor for characterizing the protein's conformation. The coupling complementary split ring resonator (cSRR) was engineered to manipulate incident waves in the near-infrared (NIR) and mid-infrared (MIR) windows at the same sensing surface. The cSRRs had the advantages of intensifying the electric field and sharpening the resonance profile, resulting in a highly qualified biosensing performance. In the NIR window, the biolayer's refractive index and thickness change were detected by the dual-wavelength, which resolved into an optogeometrical parameter of the amyloid biolayer. In the MIR window, the resonant wave specifically triggered the rotation-vibration transition of amyloid protein molecules with different conformations, which was shown as the unique Amide I and II bands in the fingerprint spectrum. Thus, our proposed biosensor presented sensitive detection of biolayer and specific identification of constituent molecules. It is helpful to interpret the protein's misfolding behavior on the molecular level by associating the biolayer's structure and the constituent molecule's conformational change.

Sorption behaviour of neptunium in marine and fresh water bottom sediments in Far East area of Russia (Lake Khanka and Amur Bay)

The concentration and sorption behavior of 237Np on the bottom sediments of water bodies in the Far East region of Russia (Lake Khanka and Peter the Great Bay) were studied for the first time. The 237Np concentrations vary from 1.06 × 10-6 to 4.43 × 10-5 mBq g-1 in the bottom sediments of Lake Khanka and from 1.05 × 10-4 to 2.52 × 10-3 mBq g-1 for Amur Bay. The experiment on the adsorption of Np on marine and lake sediment showed that it is sorbed through complexation with silicates (albite, leucite). The Np sorption isotherm on marine sediments is described by the Langmuir equation; the distribution coefficients (Kd) of Np vary from 57 to 588 mL g-1. For lake sediments, the isotherm is described by the Henry equation; the Kd value reaches 935 mL g-1.

Sub-diffraction limited nanogroove fabrication of 30 nm features on diamond films using 800 nm femtosecond laser irradiation

By controlling the 800 nm fs laser energy and applying an isopropyl alcohol environment, controlled sub-diffraction limited lithography with a characteristic structure of approximately 30 nm was achieved on the surface of diamond films, and diamond gratings with a period of 200 nm were fabricated. The fabrication of single grooves with a feature size of 30 nm demonstrates the potential for patterning periodic or nonperiodic structures, and the fabrication of 200 nm periodic grating structures demonstrates the ability of the technique to withstand laser proximity effects. This enhances the technology of diamond film nanofabrication and broadens its potential applications in areas such as optoelectronics and biology.

Energy transfer enhanced photoluminescence of 2D/3D CsPbBr3 hybrid assemblies

Energy transfer has been proven to be an effective method to optimize optoelectronic conversion efficiency by improving light absorption and mitigating nonradiative losses. We prepared 2D/3D CsPbBr3 hybrid assemblies at different reaction temperatures using the hot injection method and found that the photoluminescence quantum yields (PLQYs) of these hybrids were greatly enhanced from 53.4% to 72.57% compared with 3D nanocrystals (NCs). Femtosecond transient absorption measurements were used to study the PLQY enhancement mechanisms, and it was found that the hot carrier lifetime improved from 0.36 to 1.88 ps for 2D/3D CsPbBr3 hybrid assemblies owing to the energy transfer from 2D nanoplates to 3D NCs. The energy transfer benefits the excited carrier accumulation and prolonged hot carrier lifetime in 3D NCs in hybrid assemblies, as well as PLQY enhancement in materials.

Remnant cholesterol is associated with hip BMD and low bone mass in young and middle-aged men: a cross-sectional study

PURPOSE

Remnant cholesterol (RC) is a contributor to cardiovascular diseases, obesity, diabetes, and metabolic syndrome. However, the specific relationship between RC and bone metabolism remains unexplored. Therefore, we aimed to investigate the relationships of RC with hip bone mineral density (BMD) and the risk of low bone mass.

METHODS

Physical examination data was collected from men aged < 60 years as part of the Kailuan Study between 2014 and 2018. The characteristics of the participants were compared between RC quartile groups. A generalized linear regression model was used to evaluate the relationship between RC and hip BMD and a logistic regression model was used to calculate odds ratios (ORs) and 95% confidence intervals (CIs) for low bone mass. Additional analyses were performed after stratification by body mass index (BMI) (≥ or < 24 kg/m2). Sensitivity analyses were performed by excluding individuals who were taking lipid-lowering therapy or had cancer, cardiovascular diseases, or diabetes.

RESULTS

Data from a total of 7,053 participants were included in the analysis. After adjustment for confounding factors, RC negatively correlated with hip BMD (β =  - 0.0079, 95% CI: - 0.0133, - 0.0025). The risk of low bone mass increased from the lowest to the highest RC quartile, with ORs of 1 (reference), 1.09 (95% CI: (0.82, 1.44), 1.35 (95%CI: 1.02, 1.77), and 1.43 (95% CI: 1.09, 1.89) for Q1, Q2, Q3, and Q4, respectively (P for trend = 0.004) in the fully adjusted model. Compared to RC < 0.80 mmol/l group, the risk of low bone mass increased 39% in RC ≥ 0.80 mmol/l group (P < 0.001). The correlation between RC and hip BMD was stronger in participants with BMI ≥ 24 kg/m2 group (β =  - 0.0159, 95% CI: - 0.0289, - 0.0029). The results of sensitivity analyses were consistent with the main results.

CONCLUSION

We have identified a negative correlation between serum RC and hip BMD, and a higher RC concentration was found to be associated with a greater risk of low bone mass in young and middle-aged men.

A novel twin-grasper assisted mucosal inverted closure technique for closing large artificial gastric mucosal defects

BACKGROUND

Large artificial gastric mucosal defects are always left unclosed for natural healing due to technique difficulties in closure. This study aims to evaluate the feasibility and safety of a new Twin-grasper Assisted Mucosal Inverted Closure (TAMIC) technique in closing large artificial gastric mucosal defects.

METHODS

Endoscopic submucosal dissection (ESD) was performed in fifteen pigs to create large gastric mucosal defects. The mucosal defects were then either left unclosed or closed with metallic clips using TAMIC technique. Successful closure rate and the wound outcomes were assessed.

RESULTS

Two mucosal defects with size of about 4.0 cm were left unclosed and healed two months after surgery. Thirteen large gastric mucosal defects were created by ESD with a medium size of 5.9 cm and were successfully closed with the TAMIC technique (100%), even in a mucosal defect with a width up to 8.5 cm. The mean closure time was 59.0 min. Wounds in eight stomachs remained completely closed 1 week after surgery (61.5%), while closure in the other five stomachs had partial wound dehiscence (38.5%). Four weeks later, all the closed defects healed well and 61.5% of the wounds still remained completely closed during healing. There was no delayed perforation or bleeding after surgery. In addition, there was less granulation in the submucosal layer of the closed wound sites than those under natural healing.

CONCLUSIONS

The present study suggests that TAMIC is feasible and safe in closing large artificial gastric mucosal defects and could improve mucosal recovery compared to natural healing process.

The effect of previous orbital decompression on outcomes of rectus muscle recession surgery in patients with thyroid ophthalmopathy

PURPOSE

To evaluate the effect of previous orbital decompression on outcomes of rectus muscle recession surgery in patients with thyroid-associated ophthalmopathy.

METHODS

This retrospective study enrolled 55 eyes of 33 patients treated in our hospital for restrictive strabismus caused by thyroid-associated ophthalmopathy. We performed muscle recession for the obviously restricted extraocular muscles, with 6 weeks of follow-up. Surgical outcomes were compared between the orbital decompression group (DG, n=15) and non-orbital decompression group (NDG, n=18).

RESULTS

A total of 33 patients with Graves' ophthalmopathy who underwent rectus muscle recession surgery were included. Of these, 15 patients had undergone orbital decompression prior to strabismus surgery, and 18 had not. The two groups did not differ in terms of the preoperative horizontal or vertical ocular deviation, degree of restriction of eye movement, degree of diplopia, or mean number of muscles that underwent surgery (P>0.05). There was no significant difference in the preoperative horizontal or vertical ocular deviation, level of eye movement restriction, degree of diplopia and the success rate of the surgery (P>0.05).

CONCLUSION

Rectus muscle recession surgery in patients with thyroid-associated ophthalmopathy during the quiescent period could improve the ocular deviation and diplopia, and orbital decompression performed before strabismus surgery had no significant effect on surgical technique or outcomes of rectus muscle recession surgery.

Development and Validation of Serum Markers as Noninvasive Diagnostic Methods for Achalasia

INTRODUCTION

Currently, the diagnosis of achalasia mainly relies on invasive or radioactive examinations. This study aimed to develop a noninvasive diagnostic method for achalasia based on specific serum markers.

METHODS

Serum levels of profilin-1, galectin-10, immunoglobulin heavy variable 3-9, vasodilator-stimulated phosphoprotein, and transgelin-2 were measured in patients with achalasia and controls by enzyme-linked immunosorbent assay. The diagnostic values and thresholds were determined by the receiver operating characteristic curve analysis. Then, patients with dysphagia were prospectively enrolled to validate the ability of these molecules for achalasia diagnosing.

RESULTS

A total of 142 patients with achalasia and 50 nonachalasia controls (healthy volunteers and patients with reflux esophagitis) were retrospectively included. The serum levels of profilin-1, galectin-10, and transgelin-2 in patients with achalasia were significantly higher than those in healthy volunteers and patients with reflux esophagitis ( P all < 0.001). Profilin-1, galectin-10, and transgelin-2 were of good performance in diagnosing achalasia, with optimal thresholds of 2,171.2, 33.9, and 1,630.6 pg/mL, respectively. Second, 40 patients with dysphagia were prospectively enrolled to the validation of achalasia. For profilin-1, the positive predictive value, negative predictive value, sensitivity, and specificity were 100.0%, 64.5%, 45.0%, and 100.0%, respectively. The figures for transgelin-2 were 65.5%, 90.9%, 95.0%, and 50.0%. When both increased, the positive predictive value reached to 100.0%. When both indexes were normal, the negative predictive value was 100.0%.

DISCUSSION

Profilin-1 and transgelin-2 were promising biomarkers for achalasia diagnosis and performed better in combination. Further multicenter studies are necessary to verify their application as preliminary screening tools for achalasia.

[Quality of blood smear examinations for malaria parasites in Chenzhou City after malaria elimination]

OBJECTIVE

To analyze the quality of blood smear examinations for malaria parasites in Chenzhou City, so as to provide insights into sustainable consolidation of malaria elimination achievements.

METHODS

All positive blood smears from fever patients were irregularly sampled from each county (district) of Chenzhou City from 2018 to 2022 and reexamined, and no less than 3% negative blood smears were reexamined. The preparation, dyeing, cleanliness and microscopic examination results of blood smear were reexamined, and the quality of blood smear reexaminations was assessed using a descriptive statistical method.

RESULTS

A total of 13 625 fever patients received blood smear examinations for malaria parasites in Chenzhou City from 2018 to 2022, of which 21 were positive and 13 604 were negative; 687 blood samples were reviewed, and the percentage of negative blood smear reexaminations was 4.90% (666/13 604), with a 63.51% rate of qualified negative blood smears preparation, a 67.87% rate of qualified dyeing and a 76.13% rate of qualified cleanliness, and no missing diagnosis found. There were 21 positive blood smears reexamined, and the proportions of qualified blood smears preparation, dyeing and cleanliness were all 85.71%, with 2 smears mistaking Plasmodium species (9.52%). The percentage of qualified negative blood smears preparation was 51.41% in 2022, which reduced by 31.61% in relative to that (75.17%) in 2019 (χ2 = 9.033, P < 0.05), and the percentage of qualified negative blood smears dyeing was 60.19% in 2022, which reduced by 28.82% in relative to that (84.56%) in 2019 (χ2 = 19.498, P < 0.05), while the percentage of qualified negative blood smears cleanliness was 62.96% in 2022, which reduced by 28.93% in relative to that (88.59%) in 2019 (χ2 = 23.826, P < 0.001). In addition, there were no significant differences in the proportion of qualified negative blood smears preparation (χ2 = 0.260, P > 0.05) or dyeing (χ2 = 1.094, P > 0.05) among the three years, while a significant difference was detected in the percentage of qualified negative blood smears cleanliness (χ2 = 12.175, P < 0.05).

CONCLUSIONS

No missing diagnosis was seen in blood smear examinations for malaria parasites among fever patients in Chenzhou City after malaria elimination; however, there were reductions in proportions of qualified blood smears preparation, dyeing and cleanliness. Quality control of blood smear examinations is recommended to be reinforced in key regions of Chenzhou City.

Two-component polymer sorting to obtain high-purity s-SWCNTs for all-carbon photodetectors

The advancement of carbon-based electronics is reliant on the development of semiconducting carbon nanotubes with high purity and yield. We developed a new extraction strategy to efficiently sort SWCNTs with superior yields and purity. The approach uses two polymers, poly[N-(1-octylnonyl)-9H-carbazol-2,7-diyl](PCz) and poly(9,9-n-dihexyl-2,7-fluorene-alt-9-phenyl-3,6-carbazole)(PDFP), and two sonication processes to eliminate surface polymer contamination. PCz selectively wraps large-diameter s-SWCNTs, with PDFP added as an enhancing molecule to increase sorting efficiency at 4-fold compared to the efficiency of only PCz alone sorting. The purity of the sorted s-SWCNTs was confirmed to be above 99 % using absorption and Raman spectra. Field-effect transistors and photodetectors made from the sorted s-SWCNTs exhibited excellent semiconductor properties and broad-spectrum detection, with good long-term stability. Furthermore, a photodetector using large-tube diameter s-SWCNTs achieved broad-spectrum detection, which the photoresponsivity is 0.35 mA/W and the detectivity is 4.7×106 Jones. The s-SWCNTs/graphene heterojunction photodetector achieved a photoresponsivity of 3 mA/W and a detectivity of 6.3×106 Jones. This new strategy provides a promising approach to obtain high-purity and high-yield s-SWCNTs for carbon-based photodetectors.

Measurement of Ultra-High-Energy Diffuse Gamma-Ray Emission of the Galactic Plane from 10 TeV to 1 PeV with LHAASO-KM2A

The diffuse Galactic γ-ray emission, mainly produced via interactions between cosmic rays and the interstellar medium and/or radiation field, is a very important probe of the distribution, propagation, and interaction of cosmic rays in the Milky Way. In this Letter, we report the measurements of diffuse γ rays from the Galactic plane between 10 TeV and 1 PeV energies, with the square kilometer array of the Large High Altitude Air Shower Observatory (LHAASO). Diffuse emissions from the inner (15°10  TeV). The energy spectrum in the inner Galaxy regions can be described by a power-law function with an index of -2.99±0.04, which is different from the curved spectrum as expected from hadronic interactions between locally measured cosmic rays and the line-of-sight integrated gas content. Furthermore, the measured flux is higher by a factor of ∼3 than the prediction. A similar spectrum with an index of -2.99±0.07 is found in the outer Galaxy region, and the absolute flux for 10≲E≲60  TeV is again higher than the prediction for hadronic cosmic ray interactions. The latitude distributions of the diffuse emission are consistent with the gas distribution, while the longitude distributions show clear deviation from the gas distribution. The LHAASO measurements imply that either additional emission sources exist or cosmic ray intensities have spatial variations.

Visualization of Hot Carrier Dynamics in a Single CsPbBr3 Perovskite Microplate Using Femtosecond Kerr-Gated Wide-Field Fluorescence Spectroscopy

Lead halide perovskites (LHPs) have excellent semiconductor properties. They have been used in many applications such as solar cells. Recently, the hot carrier dynamics in this type of material have received much attention as they are useful for enhancing the performance of optoelectrical devices fabricated from it. Here, we study the ultrafast hot carrier dynamics of a single CsPbBr3 microplate using femtosecond Kerr-gated wide-field fluorescence spectroscopy. The transient photoluminescence spectra have been measured under a variety of excitation fluences. The temporal evolution of bandgap renormalization and the competition between hot carrier cooling and the recovery of the renormalized bandgap are clearly revealed.

Timing of Postoperative Radiation Therapy for Early-Stage Endometrial Carcinoma: A 20-Year Single-Center Retrospective Cohort Experience in China

PURPOSE/OBJECTIVE(S)

To investigate the appropriate timing of radiotherapy (RT) after hysterectomy for women with early-stage endometrial carcinoma (EC).

MATERIALS/METHODS

Between 1999 and 2020, 1080 patients with I and II endometrial cancer received postoperative RT at our hospital. All patients underwent hysterectomy followed by RT. The optimal cut-off values for the surgery-RT interval (SRI) based on overall survival (OS) were determined using the R software. The disease-free survival (DFS), OS, locoregional recurrence free survival (LRFS), and distant metastasis free survival (DMFS) rates were estimated using the Kaplan-Meier method. Multivariate analyses were performed using Cox proportional hazards regression.

RESULTS

Median follow-up time was 52 months. Median SRI were 46 days. The optimal cut-off value for the surgery-RT interval (SRI) based on overall survival (OS) is 40 days. The group initiated RT within 40 days following surgery has higher OS (P = 0.004), higher LRFS (P = 0.002) and higher DMFS (P = 0.039). An SRI of ≤ 40 days was independently associated with higher OS (HR 0.454, 95% CI:0.261-0.788), higher LRFS (HR 0.487, 95% CI:0.304-0.779), and higher DMFS (HR 0.643, 95% CI:0.421-0.982) than SRI of >40 days. However, SRI had no significant effect on DFS.

CONCLUSION

The surgery-RT interval affects the patients' survival endpoints. Based on this analysis, the timing of the initiation of RT after hysterectomy is crucial for patients with early-stage endometrial carcinoma (EC). The postoperative radiation therapy for endometrial cancer should be initiated within 40 days following surgery.

Risk Stratification of Postoperative Adjuvant Therapy for Endometrial Cancer (POAT-ENDORISK) Based on Bayesian Network Model: A Development and Validation Study

PURPOSE/OBJECTIVE(S)

To establish a Bayesian network (BN) model for postoperative adjuvant treatment of early endometrial carcinoma (EC) patients.

MATERIALS/METHODS

We retrospectively analyzed the data of 1280 early EC patients treated by multiple institutions in China from 1999 to 2017. All patients received primary hysterectomy/bilateral salpingo-oophorectomy and adjuvant radiotherapy. The FIGO 2009 stage of all patients is stage I and stage II EC, and the median age is 57 years old. All patients are grouped according to the ESMO-ESGO-ESTRO risk stratification. The clinicopathologic factors, treatment-related factors, local regional recurrence, distant metastasis and cancer-specific survival rate (CSS) of all patients were reviewed. We divide the original data set into training set and Validation set according to the ratio of 7:3. The training of the Bayesian network model is completed on Netica, and the test of the model effect is finally completed on the test set.

RESULTS

After variable screening, a total of 14 characteristic variables entered the final model. A total of 896 patients were used for the development of BN model, and 384 patients were used for the validation of BN model. The results of the model showed that the factors directly related to CSS were locoregional failure (LRF), radiotherapy mode, distant metastasis (DM). Factors directly related to DM were chemotherapy, LRF, CSS. The factors directly related to LRF were risk stratification, preoperative serum CA125 and preoperative HB. The accuracy, sensibility, specificity, micro-f1, micro-f1, weighted-f1 and AUC of BN model in predicting DM and CSS were better than XGBoost model.

CONCLUSION

In this study, we integrated almost all clinical pathology and treatment information related to postoperative adjuvant treatment of early EC patients and established a BN model for personalized clinical decision-making of postoperative adjuvant treatment of early EC patients. The results showed the complex correlation among the variables, and the overall prediction ability and visualization effect of BN model was significantly better than XGBoost model. Prospective research is needed before clinical implementation.

Comparison of Molecular and Clinicopathologic-Based Classifications and the Transition of Adjuvant Treatment Mode for Early-Stage Endometrial Cancer

PURPOSE/OBJECTIVE(S)

Due to the division in classification strategies based on different molecular and clinicopathologic guidelines, the current emergence of multiple molecular typing methods greatly challenges the traditional classification-guided hierarchical treatment model.

MATERIALS/METHODS

The early-stage ECs who underwent a total hysterectomy and comprehensive molecular analyses were analyzed consecutively between May 2021 and December 2022. All enrolled patients were performed with immunohistochemistry for lymph-vascular space invasion (LVSI), p53, and mismatch repair (MMR) proteins, NGS-panel Sanger sequencing for POLE exonuclease domain, and TP53. The Proactive Molecular Risk Classifier for Endometrial Cancer (ProMisE) classifier and the ESGO/ESTRO/ESP guidelines with and without molecular character were respectively employed to reclassify the enrolled patients. Categorical variables of the risk-group shift were compared by Pearson's χ2 or two-sided Fisher's exact test.

RESULTS

A total of 81 early-stage ECs patients were enrolled. Molecular analyses identified four subgroups across the 81 ECs: 9 (11%) POLE mut, 22 (27.1%) MMRd, 38 (46.9%) NSMP, and 12 (14.8%) p53 abn. Compared with ESGO/ESTRO/ESP 2016 classifier, 26 (32.1%) and 23 (28.4%) patients in ESGO/ESTRO/ESP 2020 cohort with and without molecular classification, respectively, were risk-group downshifted (p>0.05). Ten (12.3%) patients were upshifted in ESGO/ESTRO/ESP 2020 molecular classification comparing to clinical classifier. Remarkably, two patients demonstrated discordance between the ProMisE and TCGA classifiers since the different sequences of classification strategies. On the other hand, 48 of 81 patients received adjuvant radiotherapy, and 12 patients received external beam radiation therapy (EBRT). According to the final molecular test, eight of 12 were classified into low and intermediate risk.

CONCLUSION

The treatment of endometrial cancer is in a period of transition from the clinicopathologic-based model to the era of molecular precision. Discordance between different classifiers and overtreatment remain in clinical practice. Therefore, we should be cautious about using molecular typing to guide adjuvant treatment decisions until it is finally validated in prospective trials.

Dose DIBH Really Reduce the Subclinical Cardiac Acute Injury? Analysis of Clinical Real World from Our Institute

PURPOSE/OBJECTIVE(S)

The study is aim to investigate whether Deep-inspirational breath-hold (DIBH), compared with free breathing (FB), could provide a short-term cardiac benefit in patients with early left breast cancer after breast-conserving surgery combined whole breast radiotherapy.

MATERIALS/METHODS

A total of 78 patients with early stage left breast cancer treated with radiotherapy between 2021-2022 after breast-conserving surgery were enrolled. Among them, 32 cases were treated with DIBH technique and 46 cases were treated with free breathing. Patients with previous cardiac disease such as coronary artery disease were excluded. We performed myocardial enzymes, ECG, and ECHO in all patients within 2 weeks before, during, and 6 months after radiotherapy. The results of the two groups were compared using nonparametric tests and chi-square tests, and P < 0.05 indicated statistical significance. Where subclinical acute cardiac injury was defined as new above-normal myocardial enzymes and/or electrocardiographic ST-T or T-wave changes and/or ECHO abnormalities after the start of radiotherapy.

RESULTS

The median follow-up of patients was 6 months and the mean age of patients was 52.3 years for FB and 44.9 years for DIBH. There were no significant differences in staging, molecular subtype, chemotherapy and endocrine therapy history. The proportion of subclinical acute cardiac injury was smaller in the DIBH group compared to the FB group (DIBH = 31/46 and FB = 28/32, p = 0.042). The most sensitive of the subclinical acute cardiac injury events were detected by myocardial enzymes rising, with cTnI (p = 0.034) and NT-proBNP (p = 0.023) appearing significantly lower in the DIBH patients during radiotherapy. The difference of cTnI between 2 groups at 6 months after radiotherapy became non-significant. In contrast, CK-MB was higher in DIBH compared with FB only 6 months after radiotherapy (p = 0.006). The differences in ECG and ECHO were not significant between the two groups.

CONCLUSION

After breast-conserving surgery combined with radiotherapy for left early breast cancer, DIBH compared to FB reduces the proportion of acute subclinical cardiac injury that occurs with the most sensitive changes in myocardial enzymes. Subsequent studies will explore the relationship between the short-term subclinical injury and irradiated dose, as well as long term cardiac injury.

Lymphocyte Count Kinetics and the Effect of Different Radiotherapy Techniques on Radiation-Induced Lymphopenia in Patients with Breast Cancer Receiving Hypofractionated Postmastectomy Radiotherapy

PURPOSE/OBJECTIVE(S)

Radiation-induced lymphopenia (RIL) is associated with poor prognosis in solid tumors. This study aimed to describe the lymphocyte kinetics in patients with breast cancer receiving hypofractionated postmastectomy radiotherapy (RT) and to investigate the association of different RT techniques with RIL.

MATERIALS/METHODS

We assessed 607 patients who received hypofractionated postmastectomy RT for breast cancer in our prospective clinical database from 8 hospitals. All patients received irradiation to the chest wall and supraclavicular fossa. RT techniques included integrated RT with the photon-based intensity modulated techniques to irradiate all target volumes (integrated RT) and a hybrid approach combining photon irradiation to supraclavicular nodes and electron irradiation to the chest wall (hybrid RT). Peripheral lymphocyte counts (PLC) were tested prior to RT (baseline), weekly during RT, at 1, 2 weeks, 3, 6 months after RT, and then every 6 months. Grade 3+ RIL was defined as PLC nadir during RT of <0.5 ×103/ml. Mean PLC was compared by the t test. Univariate, multivariate, and propensity score matching (PSM) analyses were used to evaluate the effect of different RT techniques on grade 3+ RIL.

RESULTS

During RT, 121 (19.9%) of patients had grade 3+ RIL. The PLC started to recover at 1 week and reached baseline levels 1 year after RT. A greater proportion of the patients treated with the integrated RT (90/269, 33.5%) developed grade 3+ PLC compared with those receiving hybrid RT (31/338, 9.2%, P < 0.001). After conducting PSM, multivariate analyses showed lower baseline PLC (HR = 0.15, P<0.001) and RT technique (the integrated RT vs. hybrid RT, HR = 4.76, P<0.001) were independent risk factors for grade 3+ RIL. The PLC in patients receiving the integrated RT after RT were higher than that in those receiving hybrid RT (p<0.05).

CONCLUSION

RT technique affect the risk of and recovery from RIL, which may impact survival. Choosing appropriate RT technique to minimize RIL might be considered to benefit their outcomes.

Dose-Volume Predictors for Radiation Esophagitis in Breast Cancer Patients Undergoing Hypofractionated Regional Nodal Radiotherapy

PURPOSE/OBJECTIVE(S)

Radiation esophagitis (RE) is often overlooked in breast cancer radiotherapy. This study aimed to assess the incidence and dose-volume predictors of RE in breast cancer patients undergoing hypofractionated regional nodal irradiation (RNI).

MATERIALS/METHODS

Eligible patients were included who received intensity-modulated radiotherapy (RT) at the chest wall, the supraclavicular/infraclavicular fossa, level II axilla, and/or the internal mammary chain after mastectomy. The prescribed dose was 43.5 Gy in 15 fractions. The dose constraint for the esophagus was maximum dose <48 Gy. RE was evaluated weekly during RT and at 1 and 2 weeks, followed by 3 and 6 months after RT, and was graded according to the Common Toxicity Criteria for Adverse Events v3.0. The esophagus was contoured from the lower border level of the cricoid cartilage to the lower margin of the aortic arch. Esophageal total volume, mean dose (Dmean), maximum dose (Dmax), and the relative and absolute volumes receiving at least 5-45 Gy by 5 Gy increments (RV5-RV45 and AV5-AV45) were evaluated. Univariable and multivariable logistics regression analyses were performed to determine risk factors for RE, and receiver operating characteristic curves were obtained to identify the thresholds of esophageal dosimetric parameters.

RESULTS

In total, 298 patients were included between May 8, 2020 and January 5, 2022 (minimum post-RT follow-up: 6 months). A total of 153 (51.3%) patients had left-sided breast cancer and 145 (48.7%) patients received internal mammary nodal irradiation (IMNI). Grade 2 and 3 RE incidence was 40.9% (122/298) and 0.3% (1/298), respectively. No grade 4 or 5 RE was observed. All RE cases resolved within 1 month after RT, and the median duration of RE was 3 weeks (range, 1-5). Based on univariable analyses, tumor laterality (p < .001), IMNI (p = .056) and esophageal Dmean, Dmax, RV10-RV40, and AV10-AV40 were risk factors of ≥grade 2 RE. Esophageal RV10-RV40 and AV35-AV40 were significantly associated with the risk of ≥grade 2 RE after adjusting for tumor laterality and IMNI. Based on multivariable analyses, RV25 and AV35 were optimum dose-volume predictors for ≥grade 2 RE at thresholds 20% for RV25 (35.9% vs. 60.9%, p = .04) and 0.27 mL for AV35 (31.0% vs. 54.6%, p = .04).

CONCLUSION

RE is common in breast cancer patients undergoing hypofractionated RNI. With the same esophageal contouring standard, maintaining the upper esophageal V25 at <20% and V35 at <0.27 mL may decrease the risk of RE and improve the quality of life of patients.

Quality Assurance in a Phase III, Multicenter, Randomized Trial of POstmastectomy radioThErapy in Node posiTive Breast Cancer with or without Internal mAmmary nodaL Irradiation (POTENTIAL): A Planning Dummy Run

PURPOSE/OBJECTIVE(S)

To report the planning dummy run results of the POstmastectomy radioThErapy in Node posiTive breast cancer with or without Internal mAmmary nodaL irradiation (POTENTIAL) trial-a multicenter, randomized, phase 3 trial-to evaluate postmastectomy radiotherapy, with or without internal mammary nodal irradiation, for patients with high-risk breast cancer.

MATERIALS/METHODS

All participating institutions were provided the contours of the dummy run case, and they generated radiotherapy (RT) plans per protocol guidelines. The plans were reviewed and feedback were provided by the quality assurance team, after which the institutions resubmitted revised plans. The information on beams arrangement, skin flash, inhomogeneity corrections, and protocol compliance was assessed both in the primary and final submission.

RESULTS

Theplans from 26 institutions were included in the analysis. A number of major deviations were found in the primary submission, such as less strict constraint on organs at risk (OARs) V5Gy, and no application of chest wall skin flash. The protocol compliance rates of the dose coverage for the planning target volume of the chest wall (PTVcw), PTV of supra/infraclavicular fossa plus axilla levels I, II, III (PTVsc+ax), and PTV of the IMN region (PTVim) were all significantly improved in the final submission compared with those in the primary submission, which were 96.2% vs. 69.2%, 100% vs. 76.9%, and 88.4% vs. 53.8, respectively. For OARs, the protocol compliance rates of heart Dmean, left anterior descending coronary artery V40Gy, ipsilateral lung V5Gy, and stomach V5Gy were significantly improved.

CONCLUSION

All major deviations were corrected and protocol compliance was significantly improved and of high level in the final submission. Moreover, the variations were reduced. Therefore, a planning dummy run was essential to guarantee good RT plan quality and inter-institutional consistency for multicenter trials.

Mismatch Repair Status is an Effective Prognostic Factor for Early-Stage Endometrial Carcinoma

PURPOSE/OBJECTIVE(S)

This study is to evaluate the impact of mismatch repair (MMR) status on prognosis among patients with stage I to II (FIGO 2009) endometrial carcinoma (EC) treated with hysterectomy and adjuvant RT.

MATERIALS/METHODS

Between Oct. 2017 and Dec. 2020, patients with stage I to II (FIGO 2009) EC who had undergone hysterectomy followed by adjuvant RT in our institution were retrospectively reviewed. Clinical characteristics were compared between patients with proficient and deficient mismatch repair (pMMR and dMMR) using Pearson Chi-Square test for categorical variables. Kaplan-Meier method and log-rank test were used to compared overall survival (OS), disease-free survival (DFS), local-regional recurrence free survival (LRFS) and distant metastasis free survival (DMFS). Statistically significant difference was set as p<0.05.

RESULTS

Totally 276 stage I to II EC patients with known MMR status were included in this study. Among them, 211 patients were classified as pMMR while 65 patients were classified as dMMR. When compared to pMMR, patients with dMMR were more likely to have grade 3 and non-endometrioid type(37.8% vs. 20.8%, p = 0.014), lympho-vascular invasion (36.7% vs. 16.3%, p = 0.000), young age (<60) (28.6% vs. 17.2%, p = 0.027), HIR to HR classification(30.9% vs. 16.1%, p = 0.004). Of all the 276 patients, the median follow-up time was 31 months. Two-year DMFS was superior for pMMR compared to dMMR patients (96.3% vs. 95.0%, p = 0.048). Two-year DFS tended to be better for pMMR than dMMR patients with survival curves not crossed over each other (93.0% vs. 86.8%, p = 0.074). Two-year OS (98.9% vs. 98.4%, p = 0.716) and LRFS (96.3% vs. 95.0%, p = 0.815) were not different between pMMR/dMMR patients. For HIR to HR group, we reached the similar conclusion while for LR to IR group, survival statistics were not different between pMMR/dMMR patients. As to failure pattern, dMMR were more likely to have distant failure while local and regional failure were not different between the two groups.

CONCLUSION

For stage I to II EC, patients with dMMR have poorer DMFS and DFS compared to pMMR patients especially in HIR to HR risk classification. The combination of MMR status and other clinical and pathological factors may establish a new prognostic model and form a new risk stratification system.

Postoperative Radiotherapy to Abdominal and Pelvic Lymphatic Drainage Area for Stage III Epithelial Ovarian Cancer: A Sharp Tool to Prolong Disease-Free Survival Time

PURPOSE/OBJECTIVE(S)

For patients with stage III epithelial ovarian cancer, there are limited studies on the effects of postoperative adjuvant radiotherapy (RT) after standard cytoreductive surgery (CRS) and full treatment of first-line adjuvant chemotherapy (CT). The aims of our study were to assess the therapeutic efficacy and toxicity of our special postoperative radiotherapy to abdominal and pelvic lymphatic drainage area for stage III epithelial ovarian cancer patients.

MATERIALS/METHODS

We retrospectively collected patients with stage III epithelial ovarian cancer after CRS and full-course adjuvant chemotherapy. The CT+RT group patients were treated with intensity modulated radiotherapy (IMRT) to abdominal and pelvic lymphatic drainage area (which has been shown to be an alternative to whole abdominal radiotherapy (WART) both on the basis of clinical result and dosimetric verification from our prior study). The CT group data was obtained from the PUMCH's electronic medical record analytical database between 2010 and 2020. A propensity score matching analysis was performed 1:2 between CT+RT group and CT group.

RESULTS

A total of 132 patients with median follow-up of 73.9 months (9.1-137.7 months) were included (44 and 88 for the CT+RT and CT groups, retrospectively). The baseline characteristics of age, histology, level of CA12-5, surgical staging, residual tumor, courses of adjuvant CT, and courses to reduce CA12-5 to normal were all balanced. The median disease-free survival (DFS) time, 5-year overall survival (OS), and local recurrence free survival (LRFS) of CT+RT group and CT group were 100.0 months versus 25.9 months (p = 0.020), 69.2% versus 49.9% (p = 0.002), 85.9% versus 50.5% (p = 0.020), respectively. Distant metastasis was still the primary reason (57.6%), and local failure rate was 42.3%, the local recurrence rate was significantly lower in CT+RT group, compared with CT group (13.6% versus 45.5%, p = 0.016). In terms of toxicity, CT+RT group mainly presented with acute hematological toxicities, with no statistically significant difference with CT group when compared with grade III intestinal adverse effects (3/44 versus 6/88, p = 0.480).

CONCLUSION

This report demonstrates that long-term disease-free survival could be achieved in stage III epithelial ovarian cancer patients treated with IMRT preventive radiation to abdominal and pelvic lymphatic area. Compared with CT group, DFS and OS were significantly prolonged and adverse effects were acceptable.

Fabrication of a flexible stretchable hydrogel-based antenna using a femtosecond laser for miniaturization

We demonstrated a new method of fabricating a stretchable antenna by injecting liquid metal (LM) into a femtosecond-laser-ablated embedded hydrogel microchannel, and realized miniaturization of a stretchable dipole antenna based on hydrogel substrate. Firstly, symmetrical microchannels with two equal and linear branches were formed by a femtosecond laser in the middle of a hydrogel substrate, and then were filled with LM by use of a syringe needle. Using this method, a stretchable LM-dipole antenna with each dimension of  24 mm × 0.6 mm × 0.2 mm separated by a 2-mm gap, was formed in the middle of a 70 mm × 12 mm × 7 mm hydrogel slab. Since the polyacrylamide (PAAm) hydrogel contained ∼ 95 wt % deionized water with a high permittivity of 79 in the 0.5 GHz - 1.5 GHz range, the hydrogel used to prepare the flexible antenna can be considered as distilled water boxes. Experiments and simulations showed that a 5-cm-long LM-dipole embedded in hydrogel resonated at approximately 927.5 MHz with an S11 value of about - 12.6 dB and omnidirectional radiation direction. Benefiting from the high permittivity of the hydrogel, the dipole length was downsized by about half compared with conventional polymer substrates at the same resonant frequency. By varying the applied strain from 0 to 48%, the resonant frequency of the hydrogel/LM dipole antenna can be tuned from 770.3 MHz to 927.0 MHz. This method provides a simple and scalable technique for the design and preparation of LM-pattern microstructures in hydrogels, and has potential applications in hydrogel-based soft electronic device.

Application of a fiber Bragg grating temperature sensing method based on support vector regression optimized by a genetic algorithm for the decreasing external ambient temperature case

We studied the application of the fiber Bragg grating (FBG) temperature sensing method based on support vector regression optimized by a genetic algorithm (GA-SVR) for constant and decreasing external ambient temperature cases by simulation. The external ambient temperature could be retrieved from both the transient FBG wavelength and its corresponding change rate using GA-SVR, before the FBG temperature sensor reached the thermal equilibrium state with the external ambient temperature. FBG wavelengths and their corresponding change rates in the cases of FBG sensor temperatures higher and lower than the external ambient temperature were studied and used to construct the training data set. We found that there exist singularity points in the curves of the wavelength change rate when the FBG sensor temperature is higher than the external ambient temperature in some cases, which is different from the case where the FBG sensor temperature is lower than the external ambient temperature. Its application for sensing the constant and decreasing external ambient temperature in real time was demonstrated with an accuracy of 0.32°C in those two cases. It also indicates that for real applications of this temperature sensing method where the external ambient temperature varies randomly, the FBG sensor temperature changes rather than the external ambient temperature changes play the dominant role. What is more, the demodulation time was decreased to 0.002 s, which is approximately 0.05‱ of the time constant of the FBG temperature sensor. In other words, this method makes it possible to realize the external ambient temperature determination using a time smaller than the time constant of the FBG sensor. The high sensing accuracy and fast demodulation speed are crucial for future high-performance real-time FBG temperature sensing.

Twin-grasper assisted mucosal inverted closure achieves complete healing of large perforations after gastric endoscopic full-thickness resection

OBJECTIVES

This study aimed to demonstrate the feasibility and safety of a novel twin-grasper assisted mucosal inverted closure (TAMIC) technique for large perforations after gastric endoscopic full-thickness resection (EFTR) in a porcine model.

METHODS

Iatrogenic large perforations of the stomach were created and closed by an experienced endoscopist using the TAMIC technique in 12 pigs. Repeat gastroscopy was performed in 4 weeks after surgery to examine the wound sites and then the animals were killed. The primary outcomes were the successful TAMIC closure rate and the complete healing rate. Secondary end points included procedure time of TAMIC, complete inverted healing rate, delayed bleeding rate, and postsurgery perforation. Histologies of the wounds were analyzed by hematoxylin-eosin, Masson trichrome, and immunohistochemistry staining.

RESULTS

The median size of the defects was 3.5 (range 2.5-4.5) cm. TAMIC was successfully performed in all the 12 pigs. Complete healing was achieved in 11 pigs 4 weeks after operation as one pig died postsurgery due to severe pneumonia. The median procedure time for TAMIC was 39 (range 23-81) min. The complete inverted healing rate was 45.5% (5/11). No delayed bleeding or postsurgery perforation was observed. Histologic analyses showed that both the epithelium and muscularis mucosae layers were appropriately connected under inverted healing.

CONCLUSIONS

Twin-grasper assisted mucosal inverted closure is feasible and safe for closure of large perforations after gastric EFTR and could be a propagable and promising technique for clinical practice.

Ultrafast Dynamics of Extraordinary Optical Transmission through Two-Slit Plasmonic Antenna

We have theoretically investigated the spatial-temporal dynamics of extraordinary optical transmission (EOT) through a two-slit plasmonic antenna under femtosecond laser dual-beam irradiation. The dynamic interference of the crossed femtosecond laser dual-beam with the transiently excited surface plasmon polariton waves are proposed to characterize the particular spatial-temporal evolutions of EOT. It is revealed that the dynamic EOT can be flexibly switched with tunable symmetry through the respective slit of a two-slit plasmonic antenna by manipulating the phase correlation of the crossed femtosecond laser dual-beam. This is explained as tunable interference dynamics by phase control of surface plasmon polariton waves, allowing the dynamic modulation of EOT at optimized oblique incidences of dual-beams. Furthermore, we have obtained the unobserved traits of symmetry-broken transient spectra of EOT from the respective up- and down-slit of the antenna under crossed femtosecond laser dual-beam irradiation. This study can provide fundamental insights into the ultrafast dynamics of EOT in two-slit plasmonic antennas, which can be helpful to advance a wide range of applications, such as ultrafast plasmonic switch, ultrahigh resolution imaging, the transient amplification of non-linear effects, etc.

Ligand Engineering in Tin-Based Perovskite Solar Cells

Perovskite solar cells (PSCs) have attracted aggressive attention in the photovoltaic field in light of the rapid increasing power conversion efficiency. However, their large-scale application and commercialization are limited by the toxicity issue of lead (Pb). Among all the lead-free perovskites, tin (Sn)-based perovskites have shown potential due to their low toxicity, ideal bandgap structure, high carrier mobility, and long hot carrier lifetime. Great progress of Sn-based PSCs has been realized in recent years, and the certified efficiency has now reached over 14%. Nevertheless, this record still falls far behind the theoretical calculations. This is likely due to the uncontrolled nucleation states and pronounced Sn (IV) vacancies. With insights into the methodologies resolving both issues, ligand engineering-assisted perovskite film fabrication dictates the state-of-the-art Sn-based PSCs. Herein, we summarize the role of ligand engineering during each state of film fabrication, ranging from the starting precursors to the ending fabricated bulks. The incorporation of ligands to suppress Sn2+ oxidation, passivate bulk defects, optimize crystal orientation, and improve stability is discussed, respectively. Finally, the remained challenges and perspectives toward advancing the performance of Sn-based PSCs are presented. We expect this review can draw a clear roadmap to facilitate Sn-based PSCs via ligand engineering.

Underwater active polarization descattering based on a single polarized image

Active polarization imaging techniques have tremendous potential for a variety of underwater applications. However, multiple polarization images as input are necessary for almost all methods, thereby limiting the range of applicable scenarios. In this paper, via taking full advantage of the polarization feature of target reflective light, the cross-polarized backscatter image is reconstructed via introducing an exponential function for the first time, only based on mapping relations of co-polarized image. Compared with rotating the polarizer, the result performs a more uniform and continuous distribution of grayscale. Furthermore, the relationship of degree of polarization (DOP) between the whole scene and backscattered light is established. This leads to an accurate estimation of backscattered noise and high-contrast restored images. Besides, single-input greatly simplifies the experimental process and upgrades efficiency. Experimental results demonstrate the advancement of the proposed method for objects with high polarization under various turbidities.

The molecular pathogenesis of achalasia: a paired lower esophageal sphincter muscle and serum 4D label-free proteomic study

Background

Achalasia is a primary esophageal motility disorder with potential molecular pathogenesis remaining uncertain. This study aimed to identify the differentially expressed proteins and potential pathways among achalasia subtypes and controls to further reveal the molecular pathogenesis of achalasia.

Methods

Paired lower esophageal sphincter (LES) muscle and serum samples from 24 achalasia patients were collected. We also collected 10 normal serum samples from healthy controls and 10 normal LES muscle samples from esophageal cancer patients. The 4D label-free proteomic analysis was performed to identify the potential proteins and pathways involved in achalasia.

Results

Analysis of Similarities showed distinct proteomic patterns of serum and muscle samples between achalasia patients and controls (both P < 0.05). Functional enrichment analysis suggested that these differentially expressed proteins were immunity-, infection-, inflammation-, and neurodegeneration-associated. The mfuzz analysis in LES specimens showed that proteins involved in the extracellular matrix-receptor interaction increased sequentially between the control group, type III, type II, and type I achalasia. Only 26 proteins altered in the same directions in serum and muscle samples.

Conclusions

This first 4D label-free proteomic study of achalasia indicated that there were specific protein alterations in both the serum and muscle of achalasia, involving immunity, inflammation, infection, and neurodegeneration pathways. Distinct protein clusters between types I, II, and III revealed the potential molecular pathways associated with different disease stages. Analysis of proteins changed in both muscle and serum samples highlighted the importance of further studies on LES muscle and revealed potential autoantibodies.

A tera-electron volt afterglow from a narrow jet in an extremely bright gamma-ray burst

Some gamma-ray bursts (GRBs) have a tera-electron volt (TeV) afterglow, but the early onset of this has not been observed. We report observations with the Large High Altitude Air Shower Observatory of the bright GRB 221009A, which serendipitously occurred within the instrument field of view. More than 64,000 photons >0.2 TeV were detected within the first 3000 seconds. The TeV flux began several minutes after the GRB trigger, then rose to a peak about 10 seconds later. This was followed by a decay phase, which became more rapid ~650 seconds after the peak. We interpret the emission using a model of a relativistic jet with half-opening angle ~0.8°. This is consistent with the core of a structured jet and could explain the high isotropic energy of this GRB.

High-efficiency dual-layer grating coupler for vertical fiber-chip coupling in two polarizations

Efficient coupling between optical fibers and high-index-contrast silicon waveguides is essential for the development of integrated nanophotonics. Herein, a high-efficiency dual-layer grating coupler is demonstrated for vertical polarization-diversity fiber-chip coupling. The two waveguide layers are orthogonally distributed and designed for y- and x-polarized L P 01 fiber modes, respectively. Each layer consists of two 1D stacked gratings, allowing for both perfectly vertical coupling and high coupling directionality. The gratings are optimized using the particle swarm algorithm with a preset varying trend of parameters to thin out the optimization variables. The interlayer thickness is determined to ensure efficient coupling of both polarizations. The optimized results exhibit record highs of 92% (-0.38d B) and 85% (-0.72d B) 3D finite-difference time-domain simulation efficiencies for y and x polarizations, respectively. The polarization-dependent loss (PDL) is below 2 dB in a 160 nm spectral bandwidth with cross talk between the two polarizations less than -24d B. Fabrication imperfections are also investigated. Dimensional offsets of ±10n m in etching width and ±8 nm in lateral shift are tolerated for a 1 dB loss penalty. The proposed structure offers an ultimate solution for polarization diversity coupling schemes in silicon photonics with high directionality, low PDL, and a possibility to vertically couple.

Recent Progress and Perspective of an Evolving Carbon Family From 0D to 3D: Synthesis, Biomedical Applications, and Potential Challenges

A variety of imaging techniques are available for detecting biological processes with sufficient penetration depth and temporal resolution. However, inflammation, cardiovascular, and cancer-related disorders might be difficult to diagnose with typical bioimaging methods because of the lack of resolution in the imaging of deep tissues. Therefore, nanomaterials are the most promising candidate to overcome this hurdle. This review is on the utilization of carbon-based nanomaterials (CNMs), ranging from zero-dimension (0D) to three-dimension (3D), in the development of fluorescence (FL) imaging, photoacoustic imaging (PAI), and biosensing for the early detection of cancer. Nanoengineered CNMs, such as graphene, carbon nanotubes (CNTs), and functional carbon quantum dots (QDs), are being further studied for multimodal biometrics and targeted therapy. CNMs have many advantages over conventional dyes in FL sensing and imaging, including clear emission spectra, long photostability, low cost, and high FL intensity. Nanoprobe production, mechanical illustrations, and diagnostic therapeutic applications are the key areas of focus. The bioimaging technique has facilitated a greater understanding of the biochemical events underlying multiple disease etiologies, consequently facilitating disease diagnosis, evaluation of therapeutic efficacy, and drug development. This review may lead to the development of interdisciplinary research in bioimaging and sensing as well as possible future concerns for researchers and medical physicians.

A Review of Smart Superwetting Surfaces Based on Shape-Memory Micro/Nanostructures

Bioinspired smart superwetting surfaces with special wettability have aroused great attention from fundamental research to technological applications including self-cleaning, oil-water separation, anti-icing/corrosion/fogging, drag reduction, cell engineering, liquid manipulation, and so on. However, most of the reported smart superwetting surfaces switch their wettability by reversibly changing surface chemistry rather than surface microstructure. Compared with surface chemistry, the regulation of surface microstructure is more difficult and can bring novel functions to the surfaces. As a kind of stimulus-responsive material, shape-memory polymer (SMP) has become an excellent candidate for preparing smart superwetting surfaces owing to its unique shape transformation property. This review systematically summarizes the recent progress of smart superwetting SMP surfaces including fabrication methods, smart superwetting phenomena, and related application fields. The smart superwettabilities, such as superhydrophobicity/superomniphobicity with tunable adhesion, reversible switching between superhydrophobicity and superhydrophilicity, switchable isotropic/anisotropic wetting, slippery surface with tunable wettability, and underwater superaerophobicity/superoleophobicity with tunable adhesion, can be obtained on SMP micro/nanostructures by regulating the surface morphology. Finally, the challenges and future prospects of smart superwetting SMP surfaces are discussed.

Favorable outcome in advanced pheochromocytoma and paraganglioma after hypofractionated intensity modulated radiotherapy

PURPOSE

The purpose of this study was to review outcomes of patients with advanced/metastatic pheochromocytoma/paraganglioma (PPGL) treated at our institution with Intensity-modulated radiotherapy (IMRT), describe the treatment outcomes, and determine predictors.

METHODS

A retrospective study on patients with advanced/metastatic PPGL who received IMRT at Peking Union Medical College Hospital between 2014 and 2019. A total of 14 patients with 17 lesions were included in this study. Ultra-hypofractionated radiation therapy was used for 7 lesions in 5 patients, while hypofractionated radiation therapy was used for 8 lesions in 7 patients. 2 patients got conventional fractionated radiotherapy. Patients who received external beam radiation therapy were given a median total radiation dose of 74.4/130 Gy (BED10/3) in a median of 13 fractions.

RESULTS

OS at 2 years was 78% for all patients. For lesions evaluated by RECIST response, at least stable disease of the target lesion was achieved in 94% and distant progression in 28.5%, with an average time to progression of 5.2 months. Patients with locally advanced primary tumors or recurred in situ (n = 8) achieved 100% local control, and none of them got recurrence or distant metastasis after radiotherapy at last follow-up (median 29 months). Of patients with catecholamine-related syndromes (n = 12), 91% of symptomatic lesions improved following radiation therapy and a more than 50% decline in catecholamines.

CONCLUSIONS

We have found hypofractionated IMRT effective as an additional therapy for patients with advanced primary tumors or recurrence in situ and not amenable to complete surgical resection.

Influence mechanism of the particle size on underwater active polarization imaging of reflective targets

Underwater active polarization imaging is a promising imaging method, however, it is ineffective in some scenarios. In this work, the influence of the particle size from isotropic (Rayleigh regime) to forward-scattering on polarization imaging is investigated by both Monte Carlo simulation and quantitative experiments. The results show the non-monotonic law of imaging contrast with the particle size of scatterers. Furthermore, through polarization-tracking program, the polarization evolution of backscattered light and target diffuse light are detailed quantitatively with Poincaré sphere. The findings indicate that the noise light's polarization and intensity scattering field change significantly with the particle size. Based on this, the influence mechanism of the particle size on underwater active polarization imaging of reflective targets is revealed for the first time. Moreover, the adapted principle of scatterer particle scale is also provided for different polarization imaging methods.

Recurrent syncope in an 84-year-old man

An 84-year-old man with hypertension and type 2 diabetes presented with recurrent transient loss of consciousness within 2 hours after dinner at home. Physical examination, electrocardiogram, and laboratory studies were unremarkable except hypotension. Blood pressures were measured in different postures and within 2 hours after meal, but neither orthostatic hypotension nor postprandial hypotension was detected. Further, history taking revealed that the patient was tube-fed with a fluid food pump with an inappropriate rapid infusion rate of 1500 mL per minute at home. He was eventually diagnosed as having syncope due to postprandial hypotension, which was caused by the inappropriate way of tube feeding. The family was educated about appropriate way of tube-feeding and the patient did not develop any episode of syncope during a two-year follow-up. This case highlights the importance of careful history taking in the diagnostic evaluation of syncope and the increased risk of syncope due to postprandial hypotension in the elderly.

Ultra-high-temperature sensing using fiber grating sensor and demodulation method based on support vector regression optimized by a genetic algorithm

We propose an ultra-high-temperature sensing method using a fiber Bragg grating (FBG) and demodulation technique based on support vector regression optimized by a genetic algorithm (GA-SVR). A type-I FBG inscribed by a femtosecond laser in a silica fiber was packaged with a tube and used as a temperature sensor. The external ambient temperature was retrieved from the transient FBG wavelength and its increase rate in reaching thermal equilibrium of the FBG with the external environment using GA-SVR. The temperature sensing in the range of 400 to 1000 °C was realized with an accuracy of 4.8 °C. The highest sensing temperature exceeded the FBG resisting temperature of 700 °C. The demodulation time was decreased to approximately 15 s, only 3.14% of the FBG sensor time constant. The proposed method could realize the external ambient temperature determination before the FBG temperature reached the thermal equilibrium state, which enables to attain a demodulation time shorter than the time constant of the FBG sensor and a sensing temperature higher than the FBG resisting temperature. This method could be potentially applied in temperature inspection of combustion and other fields.

Single-chirality of single-walled carbon nanotubes (SWCNTs) through chromatography and its potential biological applications

Gel chromatography is used to separate single-chirality and selective-diameter SWCNTs. We also explore the use of photothermal therapy and biosensor applications based on single-chirality, selected-diameter, and unique geometric shape.

Constraints on Heavy Decaying Dark Matter from 570 Days of LHAASO Observations

The kilometer square array (KM2A) of the large high altitude air shower observatory (LHAASO) aims at surveying the northern γ-ray sky at energies above 10 TeV with unprecedented sensitivity. γ-ray observations have long been one of the most powerful tools for dark matter searches, as, e.g., high-energy γ rays could be produced by the decays of heavy dark matter particles. In this Letter, we present the first dark matter analysis with LHAASO-KM2A, using the first 340 days of data from 1/2-KM2A and 230 days of data from 3/4-KM2A. Several regions of interest are used to search for a signal and account for the residual cosmic-ray background after γ/hadron separation. We find no excess of dark matter signals, and thus place some of the strongest γ-ray constraints on the lifetime of heavy dark matter particles with mass between 10^{5} and 10^{9}  GeV. Our results with LHAASO are robust, and have important implications for dark matter interpretations of the diffuse astrophysical high-energy neutrino emission.

Rapid Fabrication of Wavelength-Scale Micropores on Metal by Femtosecond MHz Burst Bessel Beam Ablation

The preparation of the wavelength-scale micropores on metallic surfaces is limited by the high opacity of metal. At present, most micropores reported in the literature are more than 20 µm in diameter, which is not only large in size, but renders them inefficient for processing so that it is difficult to meet the needs of some special fields, such as aerospace, biotechnology, and so on. In this paper, the rapid laser fabrications of the wavelength-scale micropores on various metallic surfaces are achieved through femtosecond MHz burst Bessel beam ablation. Taking advantage of the long-depth focal field of the Bessel beam, high-density micropores with a diameter of 1.3 µm and a depth of 10.5 µm are prepared on metal by MHz burst accumulation; in addition, the rapid fabrication of 2000 micropores can be achieved in 1 s. The guidelines and experimental results illustrate that the formations of the wavelength-scale porous structures are the result of the co-action of the laser-induced periodic surface structure (LIPSS) effect and Bessel beam interference. Porous metal can be used to store lubricant and form a lubricating layer on the metallic surface, thus endowing the metal resistance to various liquids' adhesion. The microporous formation process on metal provides a new physical insight for the rapid preparation of wavelength-scale metallic micropores, and promotes the application of porous metal in the fields of catalysis, gas adsorption, structural templates, and bio-transportation fields.

Protein conformation characterization via a silicon resonator-based optical sensor based on the combination of wavelength interrogation and dual polarization detection

Protein conformational abnormality causes cell malfunction. Conformational change of amyloid protein causes neuron malfunction, which renders "protein conformational disease" Alzheimer's disease. Dual polarization interferometry enables to provide one-dimensional structure of a protein biolayer via deconvolution of interference patterns, which in turn is interpreted as the protein molecule conformation. However, it is still challenging to avoid interference patterns becoming faint and obscure sometimes. Resonance wavelength response to the biolayer structure can achieve a very low detection limit due to inherent high Q factor of an optical resonator. Here, we introduce the concept of combining dual polarization detection with wavelength interrogation via a simple and compact resonator-based optical biosensor. Biolayer were probed by the wave of dual polarization and its opto-geometrical parameters were resolved into resonance wavelength shift. Because protein molecule with distinct conformation produced a biolayer with unique thickness and mass density. Amyloid proteins in monomeric and dimeric morphology were respectively characterized. This concept enables protein conformation characterization in an easy and direct paradigm and provides a desirable sensing performance due to sensitive resonance response in the form of the sharp resonance profile occurring in a nonoverlapping spectrum.

Visibility enhancement of underwater images based on polarization common-mode rejection of a highly polarized target signal

Underwater active polarization imaging is promising due to its effect of significantly descattering. Polarization-difference is commonly used to filter out backscattered noise. However, the polarization common-mode rejection of target signal has rarely been utilized. In this paper, via taking full advantage of this feature of Stokes vectors S₂ which ably avoids interference from target light, the spatial variation of the degree of polarization of backscattered light is accurately estimated, and the whole scene intensity distribution of background is reconstructed by Gaussian surface fitting based on least square. Meanwhile, the underwater image quality measure is applied as optimization feedback, through iterative computations, not only sufficiently suppresses backscattered noise but also better highlights the details of the target. Experimental results demonstrate the effectiveness of the proposed method for highly polarized target in strongly scattering water.

Ultrafast Charge Carrier Dynamics in InP/ZnSe/ZnS Core/Shell/Shell Quantum Dots

The excellent performance of InP/ZnSe/ZnS core/shell/shell quantum dots (CSS-QDs) in light-emitting diodes benefits from the introduction of a ZnSe midshell. Understanding the changes of ultrafast carrier dynamics caused by the ZnSe midshell is important for their optoelectronic applications. Herein, we have compared the ultrafast carrier dynamics in CSS-QDs and InP/ZnS core/shell QDs (CS-QDs) using femtosecond transient absorption spectroscopy. The results show that the ZnSe midshell intensifies the electron delocalization and prolongs the in-band relaxation time of electrons from 238 fs to 350 fs, and that of holes from hundreds of femtoseconds to 1.6 ps. We also found that the trapping time caused by deep defects increased from 25.6 ps to 76 ps, and there were significantly reduced defect emissions in CSS-QDs. Moreover, the ZnSe midshell leads to a significantly increased density of higher-energy hole states above the valence band-edge, which may reduce the probability of Auger recombination caused by the positive trion. This work enhances our understanding of the excellent performance of the CSS-QDs applied to light-emitting diodes, and is likely to be helpful for the further optimization and design of optoelectronic devices based on the CSS-QDs.

Clinical outcomes of asymptomatic low-grade esophagitis: results from a multicenter Chinese cohort

Background

Asymptomatic low-grade (Los Angeles Classification Grades A and B) esophagitis is common in clinical practice with unclear clinical outcomes. This study aimed to explore the clinical outcomes of asymptomatic low-grade esophagitis.

Methods

This was a multicenter cohort study conducted by three academic hospitals in China. Asymptomatic low-grade esophagitis patients between January 2015 and December 2019 were included. Mucosal healing condition 1 year after initial diagnosis, symptom outcomes, and proton-pump inhibitor (PPI) use within 1 year after initial diagnosis were studied and compared.

Results

A total of 248 asymptomatic low-grade esophagitis patients were included. Esophagitis disappeared in 76.2% of patients 1 year after initial diagnosis. In terms of symptom outcomes, 89.9% of patients did not present gastroesophageal reflux disease (GERD) symptoms within 1 year after initial diagnosis. No significant difference was found in the proportion of patients who presented GERD symptoms and in the proportion of patients with persistent esophagitis between the PPI group and the non-PPI group (all P > 0.05). Patients with initial Grade B esophagitis were more likely to present follow-up GERD symptoms (16.0% vs 7.5%, P = 0.041) and had more severe follow-up esophagitis than those with Grade A (P < 0.001). Patients with follow-up GERD symptoms were more likely to have persistent esophagitis than those without.

Conclusions

This study demonstrated that asymptomatic low-grade esophagitis had relatively benign clinical outcomes. Patients with initial Grade B esophagitis and patients with follow-up GERD symptoms were more likely to be those who are in genuine need of further follow-up and treatments.

Ultrafast Electron Transfer in InP/ZnSe/ZnS Quantum Dots for Photocatalytic Hydrogen Evolution

InP/ZnS core/shell quantum dots have shown extraordinary application potential in photocatalysis. In this work, we demonstrated by ultrafast spectroscopy that the electron transfer ability of InP/ZnSe/ZnS core/shell/shell quantum dots was better than that of InP/ZnS quantum dots, because the introduction of ZnSe midshell resulted in improved passivation and greater exciton delocalization. The temperature-dependent PL spectra indicate that the exciton-phonon coupling strength and exciton binding energy of InP/ZnSe/ZnS quantum dots are smaller than those of InP/ZnS quantum dots. Further photocatalytic hydrogen evolution testing revealed that the photocatalytic activity of InP/ZnSe/ZnS quantum dots was significantly higher than that of InP/ZnS quantum dots, and InP/ZnSe/ZnS quantum dots even demonstrated improved stability. This research deepened our understanding of carrier dynamics and charge separation of InP/ZnSe/ZnS quantum dots, especially highlighting the application potential of InP/ZnSe/ZnS quantum dots in photocatalytic hydrogen evolution.