Biomass Solid-State Electrolyte with Abundant Ion and Water Channels for Flexible Zinc-Air Batteries

Flexible zinc-air batteries are the leading candidates as the next-generation power source for flexible/wearable electronics. However, constructing safe and high-performance solid-state electrolytes (SSEs) with intrinsic hydroxide ion (OH-) conduction remains a fundamental challenge. Herein, by adopting the natural and robust cellulose nanofibers (CNFs) as building blocks, the biomass SSEs with penetrating ion and water channels are constructed by knitting the OH--conductive CNFs and water-retentive CNFs together via an energy-efficient tape casting. Benefiting from the abundant ion and water channels with interconnected hydrated OH- wires for fast OH- conduction under a nanoconfined environment, the biomass SSEs reveal the high water-uptake, impressive OH- conductivity of 175 mS cm-1 and mechanical robustness simultaneously, which overcomes the commonly existed dilemma between ion conductivity and mechanical property. Remarkably, the flexible zinc-air batteries assemble with biomass SSEs deliver an exceptional cycle lifespan of 310 h and power density of 126 mW cm-2. The design methodology for water and ion channels opens a new avenue to design high-performance SSEs for batteries.

Hyperselective neurectomy in the treatment of elbow and wrist spasticity: an anatomical study and incision design

OBJECTIVE

Hyperselective neurectomy is used to treat spastic arm paralysis. The aim of the study was to analyze the nerve branching patterns of elbow and wrist flexors/pronator to inform hyperselective neurectomy approached.

METHODS

Eighteen upper extremities of fresh cadaver specimen were dissected. The number of motor branches from the musculocutaneous nerve to biceps brachii and brachialis, median nerve to pronator teres, flexor carpi radialis and ulnar nerve to flexor carpi ulnaris were counted. The origin site of each primary motor branch was documented.

RESULTS

Either biceps or brachialis was innervated by one or two primary motor branches. Pronator teres was innervated by one to three motor trunks and the pattern for flexor carpi radialis was a common trunk with other branches. The origin of the biceps and brachialis nerve trunk was located approximately 30% to 60% of the length of the arm. The median nerve branched to pronator teres and flexor carpi radialis at the region about 34mm (SD 18.8mm) above and 50mm (SD 14.9mm) below the medial epicondyle. Flexor carpi ulnaris was innervated by one to three motor trunks and the mean distance from the medial epicondyle to the origin of flexor carpi ulnaris nerve on ulnar nerve was 18.7 mm (SD 6.5mm).

CONCLUSION

Primary motor branches to elbow flexors, wrist flexors and pronators were various, while the regions of their origins were relatively settled. It was recommended the incisions be designed according to the location of the primary motor trunks.

Feasibility study of the multishot gradient-echo planar imaging sequence in non-enhanced and free-breathing whole-heart magnetic resonance coronary angiography

AIM

To investigate the feasibility of non-enhanced and free-breathing whole-heart magnetic resonance coronary angiography (MRCA) using multishot gradient-echo planar imaging (MSG-EPI).

MATERIALS AND METHODS

In total, 29 healthy volunteers were recruited for free-breathing whole-heart MRCA acquisition using the MSG-EPI sequence and fast gradient echo (GRE) sequence. After the examination, the actual scanning times, signal-to-noise ratio (SNR), and contrast-to-noise ratio (CNR) of the left main (LM) coronary artery, subjective quality scores for each segment, and evaluable length of the coronary artery were recorded and statistically analysed.

RESULTS

There was no significant difference between the SNRLM of the MSG-EPI sequence and fast GRE sequence (p=0.130), but the CNRLM of the MSG-EPI sequence was higher (p=0.001). The subjective quality score of the mid- and distal left anterior descending branch as well as the distal circumflex branch of the coronary artery in the MSG-EPI sequence was higher than that in the fast GRE sequence (p=0.003, 0.001, and 0.003, respectively). The evaluable length of the left anterior descending branch and the circumflex branch was better using the MSG-EPI sequence than that of the fast GRE sequence (p=0.015 and < 0.001, respectively). Moreover, the scanning time of the MSG-EPI sequence was 54.5% less than that of the fast GRE sequence (p<0.001).

CONCLUSION

The MSG-EPI sequence improves the subjective and objective image quality of MRCA as well as reduces the scanning time.

Conformal Engineering of Both Electrodes Toward High-Performance Flexible Quasi-Solid-State Zn-Ion Micro-Supercapacitors

The severe Zn-dendrite growth and insufficient carbon-based cathode performance are two critical issues that hinder the practical applications of flexible Zn-ion micro-ssupercapacitors (FZCs). Herein, a self-adaptive electrode design concept of the synchronous improvement on both the cathode and anode is proposed to enhance the overall performance of FZCs. Polypyrrole doped with anti-expansion graphene oxide and acrylamide (PPy/GO-AM) on the cathode side can exhibit remarkable electrochemical performance, including decent capacitance and cycling stability, as well as exceptional mechanical properties. Meanwhile, a robust protective polymeric layer containing reduced graphene oxide and polyacrylamide is self-assembled onto the Zn surface (rGO/PAM@Zn) at the anode side, by which the "tip effect" of Zn small protuberance can be effectively alleviated, the Zn-ion distribution homogenized, and dendrite growth restricted. Benefiting from these advantages, the FZCs deliver an excellent specific capacitance of 125 mF cm-2 (125 F cm-3) at 1 mA cm-2, along with a maximum energy density of 44.4 µWh cm-2, and outstanding long-term durability with 90.3% capacitance remained after 5000 cycles. This conformal electrode design strategy is believed to enlighten the practical design of high-performance in-plane flexible Zn-based electrochemical energy storage devices (EESDs) by simultaneously tackling the challenges faced by Zn anodes and capacitance-type cathodes.

Expression of macrophage activation‑specific factors in hyperplastic scar tissue during hyperplasia phase by antibody array blotting membrane assay and its clinical significance

The expression of macrophage activation-specific factors in hyperplastic scar (HS) tissues during hyperplasia phase was detected by antibody array imprinted membrane method and the role of macrophage activation in the natural evolution of HS was explored. A total of 83 patients with HS admitted to the Affiliated Hospital of Beihua University (Jilin, China) between February 2021 and July 2021 were enrolled. The clinical data of the patients were retrospectively analyzed. These patients were divided into the hyperplasia HS group (n=26) and the decline HS group (the HS tissues ceased to grow and were in regression periods; n=57) according to the time of scar formation and clinical characteristics. The HS tissues were collected from patients in both groups. The contents of IL-12, IL-10, VEGF and basic fibroblast growth factor (bFGF) were detected by antibody array imprinted membrane method and the contents of IL-12, IL-10, VEGF and bFGF in tissues with various groups of tissues and clinical features were compared. The connection between macrophage activation-specific factors with VEGF and bFGF was analyzed using Pearson correlation analysis. The contents of IL-10 (9.48±1.06), VEGF (24.15±2.64) and bFGF (37.48±2.56) were much lower and IL-12 levels (16.45±0.85) were strongly higher in hyperplasia HS group compared with those in the decline HS group (14.56±1.26 for IL-10, 27.85±2.63 for VEGF, 43.15±3.16 for bFGF and 10.46±0.75 for IL-12, P<0.001). In the hyperplasia HS group, the contents of IL-10, VEGF and bFGF were obviously higher and the IL-12 levels were markedly lower in patients with age ≥30 years, protuberance height <2 mm, soft flexibility, low hyperemia degree and no concomitant symptoms than those in the patients with age <30 years, protuberance height ≥2 mm, hard flexibility, high hyperemia degree and concomitant symptoms (P<0.001). Pearson correlation analysis showed that IL-12 was negatively correlated with VEGF and bFGF (r=-0.328, 0.600, P<0.01). IL-10 was positively correlated with VEGF and bFGF (r=0.486, 0.684, respectively, P<0.001). In conclusion, macrophage activation-specific factors were abnormally expressed in hyperplasia HS, mainly M1 macrophages, accompanied by severe inflammatory reaction. The transformation of M1 macrophage into M2 macrophage usually occurred during the declining HS phase, which accelerated scar formation by promoting the formation of fibroblasts and angiogenesis. Detection of macrophage activation-specific factors may contribute to evaluate the clinical stage of HS.

Polysulfide regulation by defect-modulated Ta3N5-x electrocatalyst toward superior room-temperature sodium-sulfur batteries

Resolving low sulfur reaction activity and severe polysulfide dissolution remains challenging in metal-sulfur batteries. Motivated by a theoretical prediction, herein, we strategically propose nitrogen-vacancy tantalum nitride (Ta3N5-x) impregnated inside the interconnected nanopores of nitrogen-decorated carbon matrix as a new electrocatalyst for regulating sulfur redox reactions in room-temperature sodium-sulfur batteries. Through a pore-constriction mechanism, the nitrogen vacancies are controllably constructed during the nucleation of Ta3N5-x. The defect manipulation on the local environment enables well-regulated Ta 5d-orbital energy level, not only modulating band structure toward enhanced intrinsic conductivity of Ta-based materials, but also promoting polysulfide stabilization and achieving bifunctional catalytic capability toward completely reversible polysulfide conversion. Moreover, the interconnected continuous Ta3N5-x-in-pore structure facilitates electron and sodium-ion transport and accommodates volume expansion of sulfur species while suppressing their shuttle behavior. Due to these attributes, the as-developed Ta3N5-x-based electrode achieves superior rate capability of 730 mAh g-1 at 3.35 A g-1, long-term cycling stability over 2000 cycles, and high areal capacity over 6 mAh cm-2 under high sulfur loading of 6.2 mg cm-2. This work not only presents a new sulfur electrocatalyst candidate for metal-sulfur batteries, but also sheds light on the controllable material design of defect structure in hopes of inspiring new ideas and directions for future research.

Diagnostic value of MRI in traumatic triangular fibrocartilage complex injuries: a retrospective study

BACKGROUND

Triangular fibrocartilage complex (TFCC) injuries commonly manifest as ulnar-sided wrist pain and can be associated with distal radioulnar joint (DRUJ) instability and subsequent wrist functional decline. This study aimed to assess the diagnostic value of MRI compared to wrist arthroscopy in identifying traumatic TFCC injuries and to determine the distribution of different TFCC injury subtypes in a normal clinical setting.

METHODS

The data of 193 patients who underwent both preoperative wrist MRI and wrist arthroscopy were retrospectively reviewed. The analysis focused on the proportion of subtypes and the diagnostic value of MRI in traumatic TFCC injuries, utilizing Palmer's and Atzei's classification with wrist arthroscopy considered as the gold standard.

RESULTS

The most prevalent subtype of TFCC injuries were peripheral injuries (Palmer 1B, 67.9%), followed by combined injuries (Palmer 1 A + 1B, 14%; Palmer 1B + 1D, 8.3%). Compared with wrist arthroscopy, the diagnostic sensitivity, specificity, negative predictive value (NPV), and Kappa value of MRI was as follows: traumatic TFCC tears 0.99 (95% CI: 0.97-1), 0.90 (0.78-0.96), 0.97 (0.87-1), and 0.93; styloid lamina tears 0.93 (0.88-0.96), 0.53 (0.30-0.75), 0.47 (0.26-0.69), and 0.44; and foveal lamina tears 0.85 (0.74-0.92), 0.38 (0.29-0.49), 0.79 (0.65-0.89), and 0.21.

CONCLUSIONS

The diagnostic value of MRI in traumatic TFCC injuries has been confirmed to be almost perfect using Palmer's classification. In more detailed classification of TFCC injuries, such as pc-TFCC tears classified by Atzei's classification, the diagnostic accuracy of MRI remains lower compared to wrist arthroscopy. Radiological associated injuries may offer additional diagnostic value in cases with diagnostic uncertainty.

Active-Passive Joint Acoustic Emission Monitoring Test Considering the Heterogeneity of Concrete

The heterogeneity of concrete is a major challenge for acoustic emission monitoring. A method of active-passive joint acoustic emission monitoring considering the heterogeneity of concrete is presented herein, and the time-frequency-space multi-parameter response characteristics of active and passive acoustic emission signals were studied in relation to the damage evolution of concrete. This method provides an idea of evaluating the damage state of concrete more actively and quantitatively than traditional methods. The results show that the microscopic damage model of concrete based on the acoustic emission penetrating wave velocity and amplitude is in agreement with the damage process of concrete. The standard deviation of the wave velocity up to 1000 m/s and the change rate of the amplitude up to -0.66 can be adopted as two signs that the load of concrete reached 70% of the ultimate load. The time-of-arrival localization based on variable velocity was used to correct the acoustic emission localization results, and the localization accuracy was increased by 44.74%. The damage process of concrete undergoes diverse changes; that is, the distribution of damage changes from heterogeneous to homogeneous and then back to heterogeneous. Hence, it is necessary for researchers to consider the heterogeneity of concrete when using acoustic emission monitoring. The active-passive joint acoustic emission monitoring is an effective method.

The predictive value of baseline symptom score and the peripheral CD4CD8 double-positive T cells in patients with AECOPD

BACKGROUND

Accurate prediction of acute exacerbation helps select patients with chronic obstructive pulmonary disease (COPD) for individualized therapy. The potential of lymphocyte subsets to function as clinical predictive factors for acute exacerbations of chronic obstructive pulmonary disease (AECOPD) remains uncertain.

METHODS

In this single-center prospective cohort study with a 2-year follow-up, 137 patients aged 51 to 79 with AECOPD were enrolled. We examined the prognostic indicators of AECOPD by analyzing lymphocyte subsets and baseline symptom score. Furthermore, a predictive model was constructed to anticipate the occurrence of respiratory failure in patients experiencing AECOPD.

RESULTS

The COPD Assessment Test (CAT) score combined with home oxygen therapy and CD4+CD8+ T cells% to predict respiratory failure in AECOPD patients were the best (the area under the curves [AUC] = 0.77, 95% CI: 0.70-0.86, P < 0.0001, sensitivity: 60.4%, specificity: 86.8%). The nomogram model, the C index, calibration plot, decision curve analysis, and clinical impact curve all indicate the model's good predictive performance. The observed decrease in the proportions of CD4+CD8+ T cells appears to be correlated with more unfavorable outcomes.

CONCLUSIONS

The nomogram model, developed to forecast respiratory failure in patients with AECOPD, utilizing variables such as home oxygen therapy, CAT score, and CD4+CD8+ T cells%, demonstrated a high level of practicality in clinical settings. CD4+CD8+ T cells serve as a reliable and readily accessible predictor of AECOPD, exhibiting greater stability compared to other indices. It is less susceptible to subjective influences from patients or physicians. This model facilitated personalized estimations, enabling healthcare professionals to make informed decisions regarding preventive interventions.

On-top plasty combined with modified Bilhaut-Cloquet procedure for reconstructing complicated radial polydactyly

PURPOSE

To present a surgical technique of combining the on-top plasty with modified Bilhaut-Cloquet procedure for reconstructing a rare type of complicated radial polydactyly and evaluate the outcomes.

METHODS

Fourteen complicated radial polydactyly in 13 patients were corrected by combining the on-top plasty with modified Bilhaut-Cloquet procedure. Osteotomies were performed as required, and the acral part of the ulnar thumb was transposed onto the proximal part of the radial thumb. The distal parts of the two thumbs were isolated as neurovascular pedicled composite tissue flaps, including part of the distal phalanx and nail bed, and were attached together in an extra-articular way. The tendons were rebalanced, and the nail bed was reconstructed. Objective and subjective outcomes were assessed.

RESULTS

The average follow-up time was 32.4 months (6-60 months). All reconstructed thumbs were rated as good in appearance and function. The mean Vancouver Scar Scale score was 1.3 (range 1-2) and the mean Wang-Gao score of the reconstructed thumbnail was 9.4 (range 8-11). The Tada score for the function of the reconstructed thumb was 5.5 (range 5-6). The main active range of motion (ROM) of the interphalangeal joint (IPJ) was 2.1-38.9°. All parents were satisfied with the outcomes.

CONCLUSIONS

Because of the diverse manifestations of thumb polydactyly, individualized surgical treatment is recommended, and careful preoperative planning should be made with the principle of combining the best parts of the two thumbs. By combining an on-top plasty with modified Bilhaut-Cloquet procedure, a satisfactory result can be achieved for treating complicated radial polydactyly.

Reconstruction of Type IIIB Thumb Hypoplasia Using a Vascularized Hemi-Metatarsal Composite Tissue Flap

BACKGROUND

The aim of this study was to determine the clinical outcomes of vascularized hemi-metatarsal composite tissue transfer for the reconstruction of type IIIB hypoplastic thumbs.

METHODS

Twenty-eight patients with type IIIB hypoplastic thumbs treated with vascularized hemi-metatarsal composite tissue transfer were included in this retrospective study with a mean follow-up of 2.4 years. Preoperative digital subtraction angiography was performed to examine the vessel variance. Clinical measures included grip and pinch strength, scar status, and Kapandji thumb opposition score. Subjective Pediatric Outcomes Data Collection Instrument scores and parent satisfaction were also evaluated.

RESULTS

Radial arteries were hypoplastic in 82.1% of the cases, and the common palmar digital artery was chosen as the recipient vessel for the tissue transfer. There was no neurovascular complication. The only donor-site complication was a metatarsal fracture that healed with casting. Key pinch and tripod pinch were 29.5% and 45.8% of the normal side, respectively. The mean grip strength was 51.7% of the unaffected side. The mean Kapandji score was 6. The Pediatric Outcomes Data Collection Instrument scores were high for global function; upper extremity function; transfer; and basic mobility, happiness, and comfort. The Vancouver Scar Scale showed an average score of 2.1. All parents were satisfied with the clinical outcomes.

CONCLUSION

Vascularized hemi-metatarsal composite tissue transfer for type IIIB thumb hypoplasia can provide improved subjective outcomes and is a feasible method for the attainment of a five-digit hand.

CLINICAL QUESTION/LEVEL OF EVIDENCE

Therapeutic, IV.

Prevalence of and prognosis for poor immunological recovery by virally suppressed and aged HIV-infected patients

Background

Antiretroviral therapy (ART) prolongs lifespan and decreases mortality of HIV infected patients. However, many patients do not achieve optimal immune reconstitution. The influence of non-optimal immune recovery on non-AIDS related diseases is not well defined in aged HIV-infected patients receiving ART.

Methods

A retrospective study was conducted at Tianjin Second People's Hospital, China to evaluate the association of an inadequate immunological response and non-AIDS diseases in HIV infected patients ≥60 years of age and virally suppressed for at least 2 years by ART.

Results

The study included patients (n = 666) who initiated ART between August 2009 and December 2020. The prevalence of patients with an inadequate immunological response was 29.6%. The percentage of non-AIDS diseases such as hypertension, cardiovascular disease (CVD), diabetes, tumor, and chronic kidney disease (CKD) was 32.9, 9.9, 31, 4.1, and 13%, respectively. In addition to baseline CD4+ T cell counts, CVD and tumor were associated with poor immune reconstitution in aged Chinese HIV-1 infected patients. The adjusted odds ratios (95% confidence interval) were AOR 2.45 (95% CI: 1.22-4.93) and 3.06 (95% CI: 1.09-8.56, p = 0.03). Inadequate immunological response was associated with greater mortality (AOR: 2.83, 95% CI: 1.42-5.67, p = 0.003) in this cohort.

Conclusion

These results tend to demonstrate appropriate drug selection at ART initiation and prevention of non-AIDS complications during ART decreased mortality of and an inadequate immunological response in aged HIV infected patients.

Accelerated Multi-step Sulfur Redox Reactions in Lithium-Sulfur Batteries Enabled by Dual Defects in Metal-Organic Framework-based Catalysts

The sluggish sulfur redox kinetics and shuttle effect of lithium polysulfides (LiPSs) are recognized as the main obstacles to the practical applications of the lithium-sulfur (Li-S) batteries. Accelerated conversion by catalysis can mitigate these issues, leading to enhanced Li-S performance. However, a catalyst with single active site cannot simultaneously accelerate multiple LiPSs conversion. Herein, we developed a novel dual-defect (missing linker and missing cluster defects) metal-organic framework (MOF) as a new type of catalyst to achieve synergistic catalysis for the multi-step conversion reaction of LiPSs. Electrochemical tests and first-principle density functional theory (DFT) calculations revealed that different defects can realize targeted acceleration of stepwise reaction kinetics for LiPSs. Specifically, the missing linker defects can selectively accelerate the conversion of S8 →Li2 S4 , while the missing cluster defects can catalyze the reaction of Li2 S4 →Li2 S, so as to effectively inhibit the shuttle effect. Hence, the Li-S battery with an electrolyte to sulfur (E/S) ratio of 8.9 mL g-1 delivers a capacity of 1087 mAh g-1 at 0.2 C after 100 cycles. Even at high sulfur loading of 12.9 mg cm-2 and E/S=3.9 mL g-1 , an areal capacity of 10.4 mAh cm-2 for 45 cycles can still be obtained.

An Analysis of Patients Treated with Stereotactic Body Radiotherapy for Metastatic Urinary Tract Tumors to Identify Predictors of Response

PURPOSE/OBJECTIVE(S)

To identify selection criteria linked to outcomes in patients treated with stereotactic body radiotherapy (SBRT) for metastatic tumors of the urinary tract (UT).

MATERIALS/METHODS

Single institution retrospective analysis of SBRT treated patients for oligometastatic/progressive UT tumors from 2006-2022. Charts were queried for M1 status at diagnosis or during disease course, treatment details (surgery, SBRT, systemic therapy), metabolic status (diabetes [DM], BMI) and outcomes. A linear quadratic formula was used to calculate the biologically effective dose (BED) using an α/β of 10 for tumor. Descriptive statistics portrayed the cohort, and analyses were done at patient and site level. Time-to-event analyses, including overall survival (OS) and progression-free survival (PFS) from SBRT, were assessed by the Kaplan-Meier method. Cox regression was used for univariable (UVA) and multivariable analyses (MVA) to identify predictors of outcomes.

RESULTS

A total of 35 patients were treated at 44 metastatic sites, including: bone (25%), node (36.4%), lung (20.5%), soft tissue (13.6%) and liver (4.5%). Most were male (74.3%) with a median age of 70 (range: 51-89), without DM (60%) having a median BMI of 29.8, and ECOG <2 (97.1%) at time of SBRT. Six (17.1%) patients were M1 at diagnosis. Of the 29 non-M1 patients, 86.2% received definitive local therapy (LT), 58.6% had at least T3/N+ disease, 75.8% received systemic therapy with a median of 2 agents (range: 1-6) prior to SBRT. Sixteen (45.7%) received immunotherapy (IO) with most receiving this before (75%) and after (56.2%) SBRT. Six patients had positive PD-L1 status (n = 10). The median RT dose, fractionation and BED was 40 Gy (range: 14-46), 5 fractions, and 72 (range: 28-132), respectively. At a median follow-up of 34.8, the median OS was 18.4 m (range: 9.3-27.4) with a 2-year OS of 35.9%. At patient level, 62.8% recurred after SBRT. The median PFS after SBRT was 5.3 m (range: 1.8-8.7) with a 2-yr PFS of 29.3%. Patient-level PFS was improved with LT (6.7 vs 1.4 m; p = 0.001) and DM (NR vs 2.9 m; p = 0.015), whereas improved OS was related with LT (18.9 vs 6.6 m; p = 0.03), DM (p = 0.04), ECOG (p = 0.004), and no relapse after SBRT (NR vs 9.8 m; p <0.001). Exposure to < 3 systemic agents prior to SBRT portended better PFS (6.7 vs 2.6 m; p = 0.04) without any impact by IO. At site level, 20.4% of sites had local relapse with 4 being the first event. Site was related with PFS (p = 0.009) with order of increased relapse risk being liver > bone > soft tissue > node > lung. No dosimetric feature was related with recurrence risk. On MVA, both DM (p = 0.02) and LT (p = 0.002) were predictive for PFS. Only recurrence after SBRT predicted for OS on MVA (HR: 6.7, 95% CI: 1.4-31; p = 0.014). In the IO subset, median PFS was 5.3 m and OS was 9.4 m, with no difference seen with IO-SBRT sequence or PDL1 status.

CONCLUSION

Optimized selection criteria for metastasis-directed therapy in patients with UT tumors is unclear, notably with IO. Future studies may benefit by assessing circulating tumor markers prior to SBRT.

High-Dose Rate Brachytherapy Alone for Treatment of Unfavorable Intermediate Risk Prostate Cancer: A Propensity-Score Matched Analysis

PURPOSE/OBJECTIVE(S)

To demonstrate the feasibility of high-dose rate brachytherapy (HDR BT) as monotherapy for unfavorable intermediate risk (UIR) prostate cancer by comparing survival outcomes of HDR BT alone against external beam radiation therapy (EBRT) + HDR BT boost, +/- androgen deprivation therapy (ADT) using propensity-score matched (PSM) data.

MATERIALS/METHODS

This retrospective study queried two data registries collecting patient data from 1991 to present. 633 patients with UIR prostate cancer treated with HDR BT alone, HDR BT+EBRT or HDR+EBRT+ADT were included. HDR BT patients received 42-45Gy/6 fractions (fx) or 27 Gy/2 fx. For HDR BT+EBRT, the HDR dose was 20-24 Gy/2 fx, 24 Gy/4 fx, or 15 Gy/1 fx. EBRT patients received 45 Gy/25 fx to the prostate +/- pelvic nodes. GU/GI toxicities were graded according to the Common Terminology Criteria for Adverse Events (CTCAE) v5.0. Time-to-event analyses were carried out to evaluate the relationship between treatments and five primary endpoints of interest: freedom from biochemical recurrence (FFBC), freedom from distant metastasis (FFDM), freedom from local failure (FFLF), cancer specific survival (CSS), and overall survival (OS) at 5 years. PSM was performed with one-to-n matching. Logistic regression was used to estimate the respective propensity scores. The five potential confounders identified were T-stage, Gleason score, pre-treatment PSA, age, and percent positive cores. Balance was checked using the standardized mean difference of covariates. Univariate and multivariate analyses were conducted on the matched data. Toxicity analysis was performed via association between a change in pre- and post-treatment GU/GI toxicity status and the treatment group, as well as incidence of post-treatment severe GI/GU toxicity (grade 3 or higher) and the treatment group.

RESULTS

Univariate analysis with Kaplan-Meier method and log rank test comparison between the three cohorts demonstrated no significant difference in all survival outcomes FFBC, FFDM, FFLF, CSS, OS (p = 0.15, 0.19, 0.29, 0.57, 0.28, respectively). Multivariate analysis with Cox proportional hazard regression showed no differences in HR for FFBC and OS (p = 0.95, 0.11) with addition of EBRT, or with EBRT+ADT (p = 0.17, 0.24); no fit was obtainable for FFDM, CSS, FFLF. Toxicities between the three cohorts were not significantly different when comparing post-treatment and baseline GI/GU symptoms (p = 0.53/1). No Grade 2 or 3 GI toxicities were identified, while 8%/1% HDR patients, 10%/1% HDR+EBRT patients, and 12%/2% HDR+EBRT+ADT patients experienced Grade 2/3 GU toxicities. The incidence of grade 3 or higher GU toxicities between the three groups was not significantly different (p = 0.91).

CONCLUSION

This propensity-score matched study demonstrates the feasibility of HDR BT alone for effective treatment of UIR prostate cancer when compared to HDR+EBRT or HDR+EBRT+ADT, while potentially minimizing the added toxicities of EBRT and the undesirable side effect profile of ADT.

Enabling Future Closed-Loop Recycling of Spent Lithium-Ion Batteries: Direct Cathode Regeneration

The rapid proliferation of electric vehicles equipped with lithium-ion batteries (LIBs) presents serious waste management challenges and environmental hazards for recyclers after scrap. Closed-loop recycling contributes to the sustainable development of batteries and plays an important role in mitigating raw material shortages and supply chain risks. Herein, current direct cathode regeneration methods for industrialized recycling are outlined and evaluated. Different regeneration methods for spent cathode materials are summarized, which provide a new perspective for realizing closed-loop recycling of LIBs. A reference recycling route for retrofitting existing cathode production lines is proposed and minimizes the costs. In addition to promoting the industrialization of direct cathode recycling, the environmental, economic, and political benefits of battery recycling are also highlighted.

Bridging Trans-Scale Electrode Engineering for Mass CO2 Electrolysis

Electrochemical CO2 upgrade offers an artificial route for carbon recycling and neutralization, while its widespread implementation relies heavily on the simultaneous enhancement of mass transfer and reaction kinetics to achieve industrial conversion rates. Nevertheless, such a multiscale challenge calls for trans-scale electrode engineering. Herein, three scales are highlighted to disclose the key factors of CO2 electrolysis, including triple-phase boundaries, reaction microenvironment, and catalytic surface coordination. Furthermore, the advanced types of electrolyzers with various electrode design strategies are surveyed and compared to guide the system architectures for continuous conversion. We further offer an outlook on challenges and opportunities for the grand-scale application of CO2 electrolysis. Hence, this comprehensive Perspective bridges the gaps between electrode research and CO2 electrolysis practices. It contributes to facilitating the mixed reaction and mass transfer process, ultimately enabling the on-site recycling of CO2 emissions from industrial plants and achieving net negative emissions.

Enhanced electrical properties of microcellular polymer nanocomposites via nanocarbon geometrical alteration: a comparison of graphene nanoribbons and their parent multiwalled carbon nanotubes

Geometric factors of nanofillers considerably govern the properties of conductive polymer composites (CPCs). This study provides insights into how geometrical alteration through nanotube-to-nanoribbon conversion affects the electrical properties of solid and microcellular CPCs. In this regard, polyvinylidene fluoride (PVDF)-based nanocomposites are synthesized using both the parent multi-walled carbon nanotube (MWCNT) and its chemically unzipped product, i.e., graphene nanoribbons (GNRs). Theoretical and experimental results show that GNR-based composites exhibit 1-4 orders greater conductivities than MWCNT-based composites at the same filler loading because of the larger number of filler-filler junctions as well as the significantly greater contact areas. On the other hand, the conductivities of MWCNT-based and GNR-based composites are significantly increased by 230 times and 121 times, respectively, through microcellular foaming. The effective rearrangements of rigid MWCNTs and flexible GNRs (having 4 and 5 orders less bending stiffness) for network formation during cellular growth are compared. The GNR-based composites also exhibit a superior dielectric permittivity (e.g., 2.6 times larger real permittivity at a representative frequency of 10³ Hz and a nanofiller loading of 4.2 vol%) compared to their MWCNT-based counterparts. This study demonstrates how the modification of the carbon fillers and the polymer matrix can dramatically enhance EMI shielding.

Anode-free sodium metal batteries as rising stars for lithium-ion alternatives

With the impact of the COVID-19 lockdown, global supply chain crisis, and Russo-Ukrainian war, an energy-intensive society with sustainable, secure, affordable, and recyclable rechargeable batteries is increasingly out of reach. As demand soars, recent prototypes have shown that anode-free configurations, especially anode-free sodium metal batteries, offer realistic alternatives that are better than lithium-ion batteries in terms of energy density, cost, carbon footprint, and sustainability. This Perspective explores the current state of research on improving the performance of anode-free Na metal batteries from five key fields, as well as the impact on upstream industries compared to commercial batteries.

Detection of Sleeve Grouting Compactness Based on Acoustic Emission Technology

Sleeve grouting compactness has a significant effect on the mechanical properties of rebar connections. However, a detection method for the grouting compactness inside the sleeve is still lacking. Therefore, the aim of this paper is to propose a new acoustic emission (AE) detection technology for horizontal defects and vertical defects in sleeves with different grout compactness. The basic waveform characteristic of the AE signal is analyzed. The results show that the count of acoustic emission signals decreases with the increase of grouting compactness, and the reduction rate of vertical defects is larger than that of horizontal defects. The acoustic emission waveform is further processed through wavelet packet decomposition. It is found that with the increase of grouting compactness, the composition of approximately 125-187.5 kHz in the signal is accelerated to approximately 62.5-125 kHz. The grouting compactness index is constructed by wavelet packet energy ratio. With the increase of grouting compactness, the compactness index decreases exponentially, indicating that the presence of defects can greatly reduce the attenuation of elastic wave energy. The compactness index is highly consistent with the size of defects and has little relationship with the distribution of grout materials. Experiments show that the proposed method is effective when grout defects reach a certain degree and provides a new method for sleeve grouting compactness detection.

Single Zinc Atom Aggregates: Synergetic Interaction to Boost Fast Polysulfide Conversion in Lithium-Sulfur Batteries

Single-atom catalysts (SACs) pave new possibilities to improve the utilization efficiency of sulfur electrodes arising from polysulfide shuttle effects and sluggish kinetics due to their excellent applicability in atomic-scale reaction mechanisms and structure-activity relationships. Herein, nitrogen (N)-anchored SACs on the highly ordered N-doped carbon nanotube arrays are reported as the sulfur host for fast redox conversion in lithium-sulfur (Li-S) batteries. The cube structure of the aligned carbon nanotubes can promote the rapid mass transfer under high sulfur loadings, and abundant single-atom active sites further accelerate the conversion of lithium polysulfides (LiPSs). The synergistic enhancement effect induced by adjacent single atoms with interatomic distances <1 nm further accelerates the rapid multi-step reaction of sulfur at high sulfur loadings. As a result, the obtained Li-S batteries exhibit outstanding cycle stability with a high areal capacity of 5.6 mAh cm^-2 after 100 cycles under a high sulfur loading of 7.2 mg cm^-2 (electrolyte to sulfur ratio is ≈3.7 mL g^-1 ). Even assembled into a pouch cell, it still delivers a high capacity of 953.4 mAh g^-1 after 100 cycles at 0.1 C, contributing to the development of the practically viable Li-S batteries.

Regulation of Outer Solvation Shell Toward Superior Low-Temperature Aqueous Zinc-Ion Batteries

Aqueous Zn-ion batteries are well regarded among a next-generation energy-storage technology due to their low cost and high safety. However, the unstable stripping/plating process leading to severe dendrite growth under high current density and low temperature impede their practical application. Herein, it is demonstrated that the addition of 2-propanol can regulate the outer solvation shell structure of Zn²⁺ by replacing water molecules to establish a "eutectic solvation shell", which provides strong affinity with the Zn (101) crystalline plane and fast desolvation kinetics during the plating process, rendering homogeneous Zn deposition without dendrite formation. As a result, the Zn anode exhibits promising cycle stability over 500 h under an elevated current density of 15 mA cm^-2 and high depth of discharge of 51.2%. Furthermore, remarkable electrochemical performance is achieved in a 150 mAh Zn|V₂ O₅ pouch cell over 1000 cycles at low temperature of -20 °C. This work not only offers a new strategy to achieve excellent performance of aqueous Zn-ion batteries under harsh conditions, but also reveals electrolyte structure designs that can be applied in related energy storage and conversion fields.

Advanced Material Engineering to Tailor Nucleation and Growth towards Uniform Deposition for Anode-Less Lithium Metal Batteries

Anode-less lithium metal batteries (ALMBs), whether employing liquid or solid electrolytes, have significant advantages such as lowered costs and increased energy density over lithium metal batteries (LMBs). Among many issues, dendrite growth and non-uniform plating which results in poor coulombic efficiency are the key issues that viciously decrease the longevity of the ALMBs. As a result, lowering the nucleation barrier and facilitating lithium growth towards uniform plating is even more critical in ALMBs. While extensive reviews have focused to describe strategies to achieve high performance in LMBs and ALMBs, this review focuses on strategies designed to directly facilitate nucleation and growth of dendrite-free ALMBs. The review begins with a discussion of the primary components of ALMBs, followed by a brief theoretical analysis of the nucleation and growth mechanism for ALMBs. The review then emphasizes key examples for each strategy in order to highlight the mechanisms and rationale that facilitate lithium plating. By comparing the structure and mechanisms of key materials, the review discusses their benefits and drawbacks. Finally, major trends and key findings are summarized, as well as an outlook on the scientific and economic gaps in ALMBs.

Dual-Scale Integration Design of Sn-ZnO Catalyst toward Efficient and Stable CO2 Electroreduction

Electrochemical CO₂ reduction to CO is a potential sustainable strategy for alleviating CO₂ emission and producing valuable fuels. In the quest to resolve its current problems of low-energy efficiency and insufficient durability, a dual-scale design strategy is proposed by implanting a non-noble active Sn-ZnO heterointerface inside the nanopores of high-surface-area carbon nanospheres (Sn-ZnO@HC). The metal d-bandwidth tuning of Sn and ZnO alters the extent of substrate-molecule orbital mixing, facilitating the breaking of the *COOH intermediate and the yield of CO. Furthermore, the confinement effect of tailored nanopores results in a beneficial pH distribution in the local environment around the Sn-ZnO nanoparticles and protects them against leaching and aggregating. Through integrating electronic and nanopore-scale control, Sn-ZnO@HC achieves a quite low potential of -0.53 V vs reversible hydrogen electrode (RHE) with 91% Faradaic efficiency for CO and an ultralong stability of 240 h. This work provides proof of concept for the multiscale design of electrocatalysts.

Effect of Interphase Properties on Isothermal and Non-isothermal Crystallization Behavior of Poly(lactic acid)/Acetylated Starch Blends

The effect of interphase properties on the crystallization behavior of blends of poly(lactic acid) (PLA)/acetylated starch (AS) with different degrees of substitution (DSs) was investigated. Under isothermal crystallization conditions, the rate of crystallization was higher for PLA/DS0.5 and lower for PLA/DS1.5 and PLA/DS2.5 when compared to PLA. In contrast, non-isothermal crystallization behavior indicated a slower rate of crystallization of PLA/DS0.5 and a faster rate of crystallization of PLA/DS1.5 and PLA/DS2.5 compared to PLA at the highest cooling rate (5 °C/min). The potential relationship between crystallization behavior and interphase properties and interphase thickness and formation of rigid amorphous fraction in the interphase, was investigated. The formation of a rigid amorphous fraction in PLA/DS1.5 and a thick interphase in PLA/DS2.5 prevented the formation of crystals on the dispersed phase and interrupted the crystallization under isothermal conditions. Hydrogen bonding in the PLA/DS1.5 blend and hydrophobic interactions in the PLA/DS2.5 blend may facilitate the crystallization at high cooling rates under non-isothermal conditions. Small-angle X-ray scattering analysis revealed the presence of a smaller lamellar structure in PLA/AS blends. The largest amorphous phase among blends was observed for the PLA/DS1.5 blend, which can be attributed to the hydrogen bonding in the interphase region of this blend.

Emerging Trends in Sustainable CO2 -Management Materials

With the rising level of atmospheric CO₂ worsening climate change, a promising global movement toward carbon neutrality is forming. Sustainable CO₂ management based on carbon capture and utilization (CCU) has garnered considerable interest due to its critical role in resolving emission-control and energy-supply challenges. Here, a comprehensive review is presented that summarizes the state-of-the-art progress in developing promising materials for sustainable CO₂ management in terms of not only capture, catalytic conversion (thermochemistry, electrochemistry, photochemistry, and possible combinations), and direct utilization, but also emerging integrated capture and in situ conversion as well as artificial-intelligence-driven smart material study. In particular, insights that span multiple scopes of material research are offered, ranging from mechanistic comprehension of reactions, rational design and precise manipulation of key materials (e.g., carbon nanomaterials, metal-organic frameworks, covalent organic frameworks, zeolites, ionic liquids), to industrial implementation. This review concludes with a summary and new perspectives, especially from multiple aspects of society, which summarizes major difficulties and future potential for implementing advanced materials and technologies in sustainable CO₂ management. This work may serve as a guideline and road map for developing CCU material systems, benefiting both scientists and engineers working in this growing and potentially game-changing area.

The petrosal artery and its variations: a comprehensive review and anatomical study with application to skull base surgery and neurointerventional procedures

BACKGROUND

The petrosal artery supplies several structures at the skull base and is often the focus of various neurointerventional procedures. Therefore, knowledge of its anatomy and variations is important to surgeons and interventionalists.

MATERIALS AND METHODS

Twenty latex injected cadaveric heads (40 sides) underwent microsurgical dissection of the petrosal artery. Documentation of the course of the artery and its branches were made. Measurements of the petrosal artery's length and diameter were performed using microcallipers.

RESULTS

A petrosal artery was identified on all sides. The mean length and diameter of the artery within the middle cranial fossa was 2.4 cm and 0.38 mm, respectively. Branches included the following: dural, ganglionic, V3 branches, branches extending through the foramen ovale, branches directly to the greater petrosal and lesser petrosal nerves, branches to the floor of the hiatus of the greater and lesser petrosal nerves, branch to the arcuate eminence, and superior tympanic artery. No statistically significant differences were noted between male and female specimens, but right-sided petrosal arteries were in general, larger in diameter than left sides.

CONCLUSIONS

A thorough anatomical knowledge of the petrosal artery and to its relationship to the facial nerve and other neurovascular structures is necessary to facilitate effective endovascular treatment and to preclude facial nerve complications.

Effect of Interface Transition Zone and Coarse Aggregate on Microscopic Diffusion Behavior of Chloride Ion

Concrete is a multiphase composite material composed of coarse aggregate, cement mortar, and interface transition zone (ITZ). It is of great significance to study the effect of ITZ and coarse aggregate on chloride microscopic diffusion behavior for predicting the service life of reinforced concrete (RC) structures. By introducing the random distribution function, a random coarse aggregate model considering the randomness of the thickness of the ITZ was established. Furthermore, a two-dimensional (2D) chloride ion diffusion mesoscopic model was developed by specifying different diffusion properties for different phase materials of concrete. Moreover, the effects of coarse aggregate rate, ITZ thickness, and ITZ diffusion property on chloride ion diffusion behavior were investigated in this paper. The research showed that the aggregate has hindrance and agglomeration action on chloride ion diffusion. Although the volume content of the ITZ was very small, less than 0.2% of the total volume of concrete, the effect of the ITZ on the chloride diffusion in concrete cannot be ignored. More importantly, the mechanism of promoting chloride diffusion in the ITZ was revealed through the chloride diffusion trajectory. The research revealed the transmission mechanism of chloride ions in the meso-structure of concrete and provides theoretical support for the design of RC structures in coastal areas.

Hierarchically Nanostructured Solid-State Electrolyte for Flexible Rechargeable Zinc-Air Batteries

The construction of safe and environmentally-benign solid-state electrolytes (SSEs) with intrinsic hydroxide ion-conduction for flexible zinc-air batteries is highly desirable yet extremely challenging. Herein, hierarchically nanostructured CCNF-PDIL SSEs with reinforced concrete architecture are constructed by nanoconfined polymerization of dual-cation ionic liquid (PDIL, concrete) within a robust three-dimensional porous cationic cellulose nanofiber matrix (CCNF, reinforcing steel), where plenty of penetrating ion-conductive channels are formed and undergo dynamic self-rearrangement under different hydrated levels. The CCNF-PDIL SSEs synchronously exhibit good flexibility, mechanical robustness, superhigh ion conductivity of 286.5 mS cm^-1 , and decent water uptake. The resultant flexible solid-state zinc-air batteries deliver a high-power density of 135 mW cm^-2 , a specific capacity of 775 mAh g^-1 and an ultralong cycling stability with continuous operation of 240 hours for 720 cycles, far outperforming those of the state-of-the-art solid-state batteries. The marriage of biomaterials with the diversity of ionic liquids creates enormous opportunities to construct advanced SSEs for solid-state batteries.

Quasi-Covalently Coupled Ni-Cu Atomic Pair for Synergistic Electroreduction of CO2

Developing highly active, selective, and stable electrocatalysts for the carbon dioxide reduction reaction (CO₂RR) is crucial to establish a CO₂ conversion system for industrial implementation and, therefore, to realize an artificially closed carbon loop. This can only be achieved through the rational material design based upon the knowledge of the operational active site at the molecular scale. Enlightened by theoretical screening, herein, we for the first time manipulate a novel Ni-Cu atomic pair configuration toward improved CO₂RR performance. Systematic characterizations and theoretical modeling reveal that the secondary Cu metal incorporation positively shifts the Ni 3d orbital energy to the Fermi level and thus accelerates the rate-determining step, *COOH formation. In addition, the intrinsic inactivity of Cu toward the competing hydrogen evolution reaction causes a considerable reaction barrier for water dissociation on the Ni-Cu moiety. Due to these attributes, the as-developed Ni/Cu-N-C catalyst exhibits excellent catalytic activity and selectivity, with a record-high turnover frequency of 20,695 h^-1 at -0.6 V (vs RHE) and a maximum Faradaic efficiency of 97.7% for CO production. Furthermore, the dynamic structure evolution monitored by operando X-ray absorption fine-structure spectroscopy unveils the interaction between the Ni center and CO₂ molecules and the synergistic effect of the Ni-Cu atomic pair on CO₂RR activity.

Greatly Enhanced Electromagnetic Interference Shielding Effectiveness and Mechanical Properties of Polyaniline-Grafted Ti3C2Tx MXene-PVDF Composites

Nowadays, evolutions in wireless telecommunication industries, such as the emergence of complex 5G technology, occur together with massive development in portable electronics and wireless systems. This positive progress has come at the expense of significant electromagnetic interference (EMI) pollution, which requires the development of highly efficient shielding materials with low EM reflection. The manipulation of MXene surface functional groups and, subsequently, incorporation into engineered polymer matrices provide mechanisms to improve the electromechanical performance of conductive polymer composites (CPCs) and create a safe EM environment. Herein, Ti₃C₂T_x MXene nanoflakes were first synthesized and then, taking advantage of their abundant surface functional groups, polyaniline (PA) nanofibers were grafted onto the MXene surface via oxidant-free oxidative polymerization at two different MXene to monomer ratios. The electrical conductivity, EMI shielding effectiveness (SE), and mechanical properties of poly (vinylidene fluoride) (PVDF)-based CPCs at different nanomaterial loadings were then thoroughly investigated. A very low percolation threshold of 1.8 vol % and outstanding electrical conductivities of 0.23, 0.195, and 0.17 S/cm were obtained at 6.9 vol % loading for PVDF-MXene, PVDF-MX₂AN₁, and PVDF-MX₁AN₁, respectively. Compared to the pristine MXene composite, surface modification significantly enhanced the EMI SE of the PVDF-MX₂AN₁ and PVDF-MX₁AN₁ composites by 19.6 and 32.7%, respectively. The remarkable EMI SE enhancement of the modified nanoflakes was attributed to (i) the intercalation of PA nanofibers between MXene layers, resulting in better nanoflake exfoliation, (ii) a large amount of dipole and interfacial polarization dissipation by constructing capacitor-like structures between nanoflakes and polymer chains, and (iii) augmented EMI attenuation via conducting PA nanofibers. The surface modification of the MXene nanoflakes also enhanced the interfacial interactions between PVDF chains and nanoflakes, which resulted in an improved Young's modulus of the PVDF matrix by about 67 and 46% at 6.9 vol % loading for PVDF-MX₂AN₁ and PVDF-MX₁AN₁ composites, respectively.

Load-Bearing Radioulnar Distances to Evaluate an Unstable Distal Radioulnar Joint in Patients With Triangular Fibrocartilage Complex Tears

PURPOSE

Tears of the proximal component of the triangular fibrocartilage complex (pc-TFCC) lead to instability in the distal radioulnar joint. The aim of this study was to measure the load-bearing radioulnar distances (RaUls) and to evaluate its diagnostic suitability in patients with pc-TFCC tears.

METHODS

We retrospectively assessed and compared the lateral wrist radiographs of 61 adult patients with arthroscopically confirmed tears of pc-TFCC with those of a control group of 64 healthy participants. The RaUl was measured on lateral radiographs, and the difference in RaUl (D-value) between load-bearing and nonloading conditions was calculated in the 2 groups. Receiver operator characteristic curves were plotted to determine the diagnostic accuracy and optimal cutoff-score of load-bearing RaUl and RaUl D-value. The diagnostic performance was verified in a validation sample of patients (30 wrists) with pc-TFCC tears and a control group of healthy individuals (30 wrists).

RESULTS

In the training sample, load-bearing RaUls of the affected wrists were higher than the same side of the controls (12.0 mm vs 7.1 mm). The TFCC-injury group showed a significantly higher RaUl D-value than the control group (8.5 mm vs 3.4 mm). Using a receiver operator characteristic curve, the cutoff value of load-bearing RaUl was 10 mm (sensitivity = 97.6%, specificity = 85.7%) and that of RaUl D-value was 6.5 mm (sensitivity = 90.2%, specificity = 78.5%). The areas under the curve of load-bearing RaUl and RaUl D-value were 0.96 and 0.88, respectively. In the test sample, the sensitivity, specificity, and accuracy of RaUl were 0.93, 0.70, and 0.82 and those of RaUl D-value were 0.77, 0.83, and 0.80 respectively.

CONCLUSIONS

Load-bearing RaUl measurement is a simple method to diagnose an unstable distal radioulnar joint in patients with TFCC injury. The load bearing RaUl of >10 mm or RaUl D-value of >6.5 mm can be used to differentiate TFCC injuries and showed acceptable accuracy.

TYPE OF STUDY/LEVEL OF EVIDENCE

Diagnostic II.

Bioinspired Tough Solid-State Electrolyte for Flexible Ultralong-Life Zinc-Air Battery

Manufacturing advanced solid-state electrolytes (SSEs) for flexible rechargeable batteries becomes increasingly important but remains grand challenge. The sophisticated structure of robust animal dermis and good water-retention of plant cell in nature grant germane inspirations for designing high-performance SSEs. Herein, tough bioinspired SSEs with intrinsic hydroxide ion (OH^- ) conduction are constructed by in situ formation of OH^- conductive ionomer network within a hollow-polymeric-microcapsule-decorated hydrogel polymer network. By virtue of the bioinspired design and dynamic dual-penetrating network structure, the bioinspired SSEs simultaneously obtain mechanical robustness with 1800% stretchability, good water uptake of 107 g g^-1 and water retention, and superhigh ion conductivity of 215 mS cm^-1 . The nanostructure of bioinspired SSE and related ion-conduction mechanism are revealed and visualized by molecular dynamics simulation, where plenty of compact and superfast ion-transport channels are constructed, contributing to superhigh ion conductivity. As a result, the flexible solid-state zinc-air batteries assembled with bioinspired SSEs witness high power density of 148 mW cm^-2 , specific capacity of 758 mAh g^-1 and ultralong cycling stability of 320 h as well as outstanding flexibility. The bioinspired methodology and deep insight of ion-conduction mechanism will shed light on the design of advanced SSEs for flexible energy conversion and storage systems.

2D Materials for All-Solid-State Lithium Batteries

Although one of the most mature battery technologies, lithium-ion batteries still have many aspects that have not reached the desired requirements, such as energy density, current density, safety, environmental compatibility, and price. To solve these problems, all-solid-state lithium batteries (ASSLB) based on lithium metal anodes with high energy density and safety have been proposed and become a research hotpot in recent years. Due to the advanced electrochemical properties of 2D materials (2DM), they have been applied to mitigate some of the current problems of ASSLBs, such as high interface impedance and low electrolyte ionic conductivity. In this work, the background and fabrication method of 2DMs are reviewed initially. The improvement strategies of 2DMs are categorized based on their application in the three main components of ASSLBs: The anode, cathode, and electrolyte. Finally, to elucidate the mechanisms of 2DMs in ASSLBs, the role of in situ characterization, synchrotron X-ray techniques, and other advanced characterization are discussed.

Quantifying Contact Patterns: Development and Characteristics of the British Columbia COVID-19 Population Mixing Patterns Survey

Purpose

Several non-pharmaceutical interventions such as physical distancing, self-isolation, a stay-at-home order, hand washing, and schools and businesses closures were implemented in British Columbia (BC) following the first lab-tested case of COVID-19 on January 26, 2020. These interventions were aimed at minimizing in-person contacts that could potentially lead to new COVID-19 infections. The BC COVID-19 Population Mixing Patterns survey (BC-Mix) was established as a surveillance system to measure behaviour and contact patterns in BC over time to inform the timing of the easing/re-imposition of control measures. We describe the BC-Mix survey design and the demographic characteristics of respondents.

Methods & Materials

The ongoing repeated online survey was launched in September 2020. Participants are recruited through a variety of social media platforms including Instagram, Facebook, YouTube, and community group mailing lists. A follow up survey is sent to participants two to four weeks after completing the first iteration. Survey responses are weighted to BC's population by age, sex, geography, and ethnicity to obtain generalizable estimates. A survey completion rate of at least 33% AND a valid response for the sex questionnaire item AND a valid response for age questionnaire item were required for inclusion in weighting and further analysis. Additional indices such as material and social deprivation index, and residential instability are generated using census and location data.

Results

As of June 14, 2021, over 58,000 residents of BC had participated in the survey of which 31,007 survey responses were eligible for analysis. Of the eligible participants, about 60% provided consent for monthly follow up and about 26% provided their personal health numbers for linkage with other healthcare utilization databases. Approximately 51% were females 39% were 55 years or older, 63% identified as white or not a visible minority and 48% had at least a university degree.

Conclusion

The pandemic response is best informed by surveillance systems capable of timely assessment of behaviour patterns. BC-Mix survey respondents represented a large cohort of British Columbians providing near real-time information on behavioural and contact patterns in BC. Data from the BC-Mix survey continues to inform provincial COVID-19-related control measures.

Linker-Compensated Metal-Organic Framework with Electron Delocalized Metal Sites for Bifunctional Oxygen Electrocatalysis

Metal-organic frameworks with tailorable coordination chemistry are propitious for regulating catalytic performance and deciphering genuine mechanisms. Herein, a linker compensation strategy is proposed to alter the intermediate adsorption free energy on the Co-Fe zeolitic imidazolate framework (CFZ). This grants zinc-air battery superior high current density capability with a small discharge-charge voltage gap of 0.88 V at 35 mA cm^-2 and an hourly fading rate of less than 0.01% for over 500 h. Systematic characterization and theoretical modeling reveal that the performance elevation is closely correlated with the compensation of CFZ unsaturated metal nodes by S-bridging heterogeneous linkers, which exhibit electron-withdrawing characteristic that drives the delocalization of d-orbital electrons. These rearrangements of electronic structures establish a favorable adsorption/desorption pathway for key intermediates (OH*) and a stable coordination environment in bifunctional oxygen electrocatalysis.

Thin Film Polyamide Nanocomposite Membrane Decorated by Polyphenol-Assisted Ti3C2Tx MXene Nanosheets for Reverse Osmosis

Transition-metal carbides (MXenes), multifunctional 2D materials, have caught the interest of researchers in the fabrication of high-performance nanocomposite membranes. However, several issues regarding MXenes still remain unresolved, including low ambient stability; facile restacking and agglomeration; and poor compatibility and processability. To address the aforementioned challenges, we proposed a facile, green, and cost-efficient approach for coating a stable layer of plant-derived polyphenol tannic acid (TA) on the surface of MXene (Ti₃C₂T_x) nanosheets. Then, high-performance reverse osmosis polyamide thin film nanocomposite (RO-PA-TFN) membranes were fabricated by the incorporation of modified MXene (Ti₃C₂T_x-TA) nanosheets in the polyamide selective layer through interfacial polymerization. The strong negative charge and hydrophilic multifunctional properties of TA not only boosted the chemical compatibility between Ti₃C₂T_x MXene nanosheets and the polyamide matrix to overcome the formation of nonselective voids but also generated a tight network with selective interfacial pathways for efficient monovalent salt rejection and water permeation. In comparison to the neat thin film composite membrane, the optimum TFN (Ti₃C₂T_x-TA) membrane with a loading of 0.008 wt % nanofiller revealed a 1.4-fold enhancement in water permeability, a well-maintained high NaCl rejection rate of 96% in a dead-end process, and enhanced anti-fouling tendency. This research offers a facile way for the development of modified MXene nanosheets to be successfully integrated into the polyamide-selective layer to improve the performance and fouling resistance of TFN membranes.

Application of pulmonary rehabilitation in patients with pulmonary embolism (Review)

As a common clinical emergency, pulmonary embolism (PE) is the third most fatal cardiovascular disease worldwide. Although current sophisticated medical technology has considerably improved the prognosis of patients with PE, they remain at risk of developing long-term complications such as post-PE syndrome. Pulmonary rehabilitation is of great value for patients with chronic lung diseases since it can improve their quality of life while also relieving clinical symptoms. Rehabilitation therapy has been demonstrated to improve recovery and prognosis of patients with PE. Due to short implementation time and the small number of studies, its effectiveness and safety in PE warrant further investigation. The present review focused on elucidating PE pathogenesis, post-PE syndrome and the clinical application of pulmonary rehabilitation in patients with PE.

Hierarchically Porous Ti3C2 MXene with Tunable Active Edges and Unsaturated Coordination Bonds for Superior Lithium-Sulfur Batteries

Lithium-sulfur (Li-S) batteries hold great promise for next-generation electronics owing to their high theoretical energy density, low cost, and eco-friendliness. Nevertheless, the practical implementation of Li-S batteries is hindered by the shuttle effect and sluggish reaction kinetics of polysulfides. Herein, the spray drying and chemical etching strategies are implemented to fabricate hierarchically porous MXene microspheres as a multifunctional sulfur electrocatalyst. The interconnected skeleton offers uniform sulfur distribution and prevents the restacking of MXene sheets, while the abundant edges endow the nanosheet-like Ti₃C₂ with rich active sites and regulated a d-band center of Ti atoms, leading to strong lithium polysulfide (LiPS) adsorption. The unsaturated Ti on edge sites can further act as multifunctional sites for chemically anchoring LiPS and lowering Li-ion migration barriers, accelerating LiPS conversion. Owing to these structural advantages, excellent cycling and rate performances of the sulfur cathode can be obtained, even under a raised sulfur loading and lean electrolyte content.

The Impact of Mental Health Stigma and Ageism on Students’ Intention to Work with Older Adults: A Mixed Methods Design

Approximately 20% of older adults have a mental or neurological disorder which can cause significant disability. With a growing older adult population, there is a need for providers receiving specialized training in aging to provide quality care. However, there continues to be shortages of students seeking careers in geriatrics and especially in working with older individuals with mental health (MH) concerns. The present study explored the relationship between MH stigma, ageism and intention to work with older adults among undergraduate students. Undergraduate students (N=188) completed a battery of questionnaires including intention to work with older adults, positive and negative attitude towards older adults, and open-ended questions exploring MH stigma views. Regression results indicated that MH stigma, positive, and negative attitudes significantly predicted intention to work with older adults, (F(3, 182) = 8.51, p = .000). Examination of the coefficients revealed that positive attitudes significantly predicted intention to work with older adults (t=4.38, p=.000), and MH stigma demonstrated a trend towards significance (t=1.90, p=.059). Open-ended responses were analyzed using qualitative description methods which revealed themes consistent with negative and positive stereotypes, MH problems going undetected, and need for additional support in recognizing and treating MH conditions among older adults. Positive attitudes are an important predictor in students’ intention to work with older adults, and MH stigma may be an important factor to explore further. Qualitative themes also describe how MH concerns are an important area to focus on among older adults, although there continues to be evidence of aging stereotypes.

Ageism and Undergraduate Attitudes towards Older Adults during COVID-19

The COVID-19 pandemic has shed light on the far reaches of ageism in our society. The current study sought to better understand ageist beliefs in Canadian undergraduate students during the pandemic. As part of a larger survey on ageism, we conducted a thematic analysis on open-ended responses to the following questions: 1) “Has your relationship with older adults in your life changed as a result of the COVID-19 pandemic?” and 2) “Have you noticed that attitudes or opinions towards older adults in your community have changed as a result of the COVID-19 pandemic?” Students felt that older adults should be treated differently during the pandemic because they are seen as “high risk” or “vulnerable.” Furthermore, students felt that they needed to be more cautious around older adults because older adults need to be taken care of. Students expressed fear about transmitting the virus to older adults in their lives so chose to isolate from grandparents or avoid older adults in the community in an effort to keep them safe. Finally, examples of negative and positive ageism were present in responses. Negative ageism was seen in comments about how older adults were going to die anyway, the assumption that older adults need more help, and the belief that older adults should be staying home during the pandemic. Positive ageism was present where students realized the importance of their relationships with the older adults in their lives. Results are discussed using the framework of implicit and explicit ageism.