A Dual-Functional MXene-Based Bioanode for Wearable Self-Charging Biosupercapacitors

As a reliable energy-supply platform for wearable electronics, biosupercapacitors combine the characteristics of biofuel cells and supercapacitors to harvest and store the energy from human's sweat. However, the bulky preparation process and deep embedding of enzyme active sites in bioelectrodes usually limit the energy-harvesting process, retarding the practical power-supply sceneries especially during the complicated in vivo motion. Herein, a MXene/single-walled carbon nanotube/lactate oxidase hierarchical structure as the dual-functional bioanode is designed, which can not only provide a superior 3D catalytic microenvironment for enzyme accommodation to harvest energy from sweat, but also offers sufficient capacitance to store energy via the electrical double-layer capacitor. A wearable biosupercapacitor is fabricated in the "island-bridge" structure with a composite bioanode, active carbon/Pt cathode, polyacrylamide hydrogel substrate, and liquid metal conductor. The device exhibits an open-circuit voltage of 0.48 V and the high power density of 220.9 µW cm-2 at 0.5 mA cm-2 . The compact conformal adhesion with skin is successfully maintained under stretching/bending conditions. After repeatedly stretching the devices, there is no significant power attenuation in pulsed output. The unique bioelectrode structure and attractive energy harvesting/storing properties demonstrate the promising potential of this biosupercapacitor as a micro self-powered platform of wearable electronics.

Microenvironment Regulation Strategies Facilitating High-Efficiency CO2 Electrolysis in a Zero-Gap Bipolar Membrane Electrolyzer

In alkaline and neutral zero-gap CO2 electrolyzers, the carbon utilization efficiency of the electrocatalytic CO2 reduction to CO is less than 50% because of inherently homogeneous reactions. Utilization of the bipolar membrane (BPM) electrolyzer can effectively suppress (bi)carbonate formation and parasitic CO2 losses; however, an excessive concentration of H+ in the catalyst layer (CL) significantly hinders the activity and selectivity for CO2 reduction. Here, we report a microenvironment regulation strategy that controls the CL thickness and ionomer content to regulate local CO2 transport and the local pH within the CL. We report 80% faradaic efficiency of CO at a current density of 400 mA/cm2 without the use of a buffering layer, exceeding that of state-of-the-art catalysts with a buffering layer. A carbon utilization efficiency of 63.6% at 400 mA/cm2 is also obtained. This study demonstrates the significance of regulating the microenvironment of the CL in a BPM system.

Droplet transportation on photosensitive lubricant-impregnated slippery surfaces in response to the light induced Marangoni effect and asymmetrical wetting ridges

Flexible control of droplet transportation is crucial in various applications but is constrained by liquid-solid friction. The development of biomimetic lubricant-impregnated slippery surfaces provides a new solution for flexible manipulation of droplet transportation. Herein, a light strategy is reported for flexibly controlling droplet transportation on photosensitive lubricant-impregnated slippery surfaces. Owing to the localized heating effect of a focused laser beam via photothermal conversion, the resultant thermal Marangoni flow and horizontal component of the surface tension associated with the asymmetric wetting ridges are together responsible for actuating droplet transportation. It is found that the asymmetry of the wetting ridge is dominated by the thickness of the infused oil layer, which directly affects the droplet transportation. The feasibility of this light strategy is also demonstrated by uphill movement, droplet coalescence, and chemical reaction. This study provides a new design for potential applications in open droplet microfluidics, analytical chemistry, diagnosis, etc.

Neratinib + fulvestrant + trastuzumab for HR-positive, HER2-negative, HER2-mutant metastatic breast cancer: outcomes and biomarker analysis from the SUMMIT trial

BACKGROUND

HER2 mutations are targetable alterations in patients with hormone receptor-positive (HR+) metastatic breast cancer (MBC). In the SUMMIT basket study, patients with HER2-mutant MBC received neratinib monotherapy, neratinib + fulvestrant, or neratinib + fulvestrant + trastuzumab (N + F + T). We report results from 71 patients with HR+, HER2-mutant MBC, including 21 (seven in each arm) from a randomized substudy of fulvestrant versus fulvestrant + trastuzumab (F + T) versus N + F + T.

PATIENTS AND METHODS

Patients with HR+ HER2-negative MBC with activating HER2 mutation(s) and prior cyclin-dependent kinase 4/6 inhibitor (CDK4/6i) therapy received N + F + T (oral neratinib 240 mg/day with loperamide prophylaxis, intramuscular fulvestrant 500 mg on days 1, 15, and 29 of cycle 1 then q4w, intravenous trastuzumab 8 mg/kg then 6 mg/kg q3w) or F + T or fulvestrant alone. Those whose disease progressed on F + T or fulvestrant could cross-over to N + F + T. Efficacy endpoints included investigator-assessed objective response rate (ORR), clinical benefit rate (RECIST v1.1), duration of response, and progression-free survival (PFS). Plasma and/or formalin-fixed paraffin-embedded tissue samples were collected at baseline; plasma was collected during and at end of treatment. Extracted DNA was analyzed by next-generation sequencing.

RESULTS

ORR for 57 N + F + T-treated patients was 39% [95% confidence interval (CI) 26% to 52%); median PFS was 8.3 months (95% CI 6.0-15.1 months). No responses occurred in fulvestrant- or F + T-treated patients; responses in patients crossing over to N + F + T supported the requirement for neratinib in the triplet. Responses were observed in patients with ductal and lobular histology, 1 or ≥1 HER2 mutations, and co-occurring HER3 mutations. Longitudinal circulating tumor DNA sequencing revealed acquisition of additional HER2 alterations, and mutations in genes including PIK3CA, enabling further precision targeting and possible re-response.

CONCLUSIONS

The benefit of N + F + T for HR+ HER2-mutant MBC after progression on CDK4/6is is clinically meaningful and, based on this study, N + F + T has been included in the National Comprehensive Cancer Network treatment guidelines. SUMMIT has improved our understanding of the translational implications of targeting HER2 mutations with neratinib-based therapy.

Light-manipulated binary droplet transport on a high-energy surface

Flexible and precise manipulation of droplet transport is of significance for scientific and engineering applications, but real-time and on-demand droplet manipulation remains a challenge. Herein, we report a strategy using light for the outstanding manipulation of binary droplet motion on a high-energy surface and reveal the underlying mechanism. Upon irradiation to a substrate by a focused light beam, the substrate can provide a localized heating source via photothermal conversion, and a binary droplet can be flexibly transported on a high-energy surface with free contact-line pinning, exhibiting light-propelled droplet transport. We theoretically showed that the surface tension gradient across the droplet interface resulting from the localized photothermal effect is responsible for actuating droplet transport. Remarkably, the high reconfigurability and flexibility of light allowed for binary droplet transport with dynamically tunable velocity and direction as well as arbitrary trajectory assisted by 2D channels on a high-energy surface. Complex droplet transportation, controllable droplet coalescence, and anti-gravity motion were realized. The promising applicability of this light-fueled droplet platform was also demonstrated by directional transport of biosample droplets containing DNA molecules and cells, as well as successional microreactions.

Multifunctional MOF-Derived Au, Co-Doped Porous Carbon Electrode for a Wearable Sweat Energy Harvesting-Storage Hybrid System

As an efficient alternative for harnessing the energy from human's biofluid, a wearable energy harvesting-storage hybrid supercapacitor-biofuel cell (SC-BFC) microfluidic system is established with one multifunctional electrode. The electrode integrates metal-organic framework (MOF) derived carbon nanoarrays with embedded Au, Co nanoparticles on a flexible substrate, and is used for the symmetric supercapacitor as well as the enzyme nanocarriers of the biofuel cell. The electrochemical performance of the proposed electrode is evaluated, and the corresponding working mechanism is studied in depth according to the cyclic voltammetry and density functional theory calculation. The multiplexed microfluidic system is designed to pump and store natural sweat to maintain the continuous biofuel supply in the hybrid SC-BFC system. The biofuel cell module harvests electricity from lactate in sweat, and the symmetric supercapacitor module accommodates the bioelectricity for subsequent utilization. A numerical model is developed to validate the normal operation in poor and rich sweat under variable situations for the microfluidic system. One single SC-BFC unit can be self-charged to ≈0.8 V with superior mechanical durability in on-body testing, as well as energy and power values of 7.2 mJ and 80.3 µW, respectively. It illustrates the promising scenery of energy harvesting-storage hybrid microfluidic system.

Light Fueled High-Throughput Binary Droplet Splitting and Transport on High-Energy Substrate

High-throughput droplet splitting and controllable transport of generated microdroplets on open surfaces are crucial in a broad spectrum of applications. Herein, a light strategy for controlling high-throughput splitting of binary droplets and transport of generated microdroplets on a high-energy substrate endowed by a localized photothermal effect is reported. Strong Marangoni flow as a result of the surface tension gradient and limited inward flow at the droplet bottom as a result of the significant viscous effect are together responsible for binary droplet splitting. The temperature gradients across the generated microdroplets established at the core heating zone are responsible for their transport away from the laser-acted zone. Remarkably, assisted by hydrophobic stripes on a high-energy substrate, high-throughput binary droplet splitting and controllable transport of generated microdroplets can be realized. Successful applications in biosample droplets and parallelized microreactions highlight the promising potential of this light strategy in open droplet microfluidics, biological assays and diagnosis, etc.

Microstructure Design Strategy for Molecularly Dispersed Cobalt Phthalocyanine and Efficient Mass Transport in CO2 Electroreduction

Cobalt phthalocyanine (CoPc) has attracted particular interest owing to its excellent activity during the electrochemical CO₂ conversion to CO. However, the efficient utilization of CoPc at industrially relevant current densities is still a challenge owing to its nonconductive property, agglomeration, and unfavorable conductive substrate design. Here, a microstructure design strategy for dispersing CoPc molecules on a carbon substrate for efficient CO₂ transport during CO₂ electrolysis is proposed and demonstrated. The highly dispersed CoPc is loaded on a macroporous hollow nanocarbon sheet to act as the catalyst (CoPc/CS). The unique interconnected and macroporous structure of the carbon sheet forms a large specific surface area to anchor CoPc with high dispersion and simultaneously boosts the mass transport of reactants in the catalyst layer, significantly improving the electrochemical performance. By employing a zero-gap flow cell, the designed catalyst can mediate CO₂ to CO with a high full-cell energy efficiency of 57% at 200 mA cm^-2 .

Gas diffusion TiO2 photoanode for photocatalytic fuel cell towards simultaneous VOCs degradation and electricity generation

In this work, a photocatalytic fuel cell (PFC) with a gas diffusion TiO₂ photoanode is proposed to directly convert chemical energy contained in volatile organic compounds into electricity by using solar energy. The gas diffusion TiO₂ photoanode is prepared by coating TiO₂ nanoparticles onto Ti mesh, whose intrinsic porous structure allows for gaseous pollutants to directly transfer inside the photoanode and thereby enhances mass transport. The feasibility of the developed gas diffusion photoanode is demonstrated by degrading toluene as a model gaseous pollutant. It is shown that the newly-developed PFC yields better electricity generation and toluene removal efficiency due to the enhanced mass transport of toluene and the eliminated interference of gas bubbles. The short-circuit current density and maximum power density of the PFC with a gas diffusion TiO₂ photoanode (0.1 mA/cm² and 0.02 mW/cm²) are about 3.3 times and 4 times as those of the bubbling PFC (0.03 mA/cm² and 0.005 mW/cm²), respectively. Both the discharging performance and toluene removal efficiency increase with increasing the light intensity and electrolyte concentration, while there exists an optimal gas flow rate leading to the best performance. The present work provides an innovative strategy for clean processing of volatile organic compounds while recycling the contained chemical energy.

Causal relationship between Type 1 diabetes and osteoporosis and fracture occurrence: a two-sample Mendelian randomization analysis

We used two-sample Mendelian Randomization to reveal causal estimates of type 1 diabetes and bone. Type 1 diabetes was found to be a risk factor for bone metabolic health, although there was no clear evidence to support a genetic association between type 1 diabetes and osteoporosis and fracture risk.

INTRODUCTION

Based on the random assignment of gametes at conception, Mendelian randomization (MR) analysis simulates randomized controlled trials in an observational setting. Therefore, we used MR to assess the association causality of type 1 diabetes (T1D) with fractures and osteoporosis.

METHODS

From a genome-wide association meta-analysis, independent single nucleotide polymorphisms closely associated with T1D were selected as instrumental variables. Data on fracture and osteoporosis were obtained from the FinnGen Consortium. We performed a two-sample MR analysis, using inverse-variance weighted (IVW) as the primary analysis method, to assess possible causal associations between T1D and bone risk. The results were verified by MR-Egger regression and median weighted method (WME). MR-PRESSO and MR-Egger intercepts were used to evaluate the horizontal pleiotropy of instrumental variables, and the Q-test and "leave-one-out" methods were used to test the heterogeneity of MR results.

RESULTS

IVW (OR=1.040, 95% CI=0.974-1.109, P=0.238), MR-Egger regression (OR=1.077, 95% CI=0.921-1.260, P=0.372) and WME (OR=1.021, 95% CI=0.935-1.114, P=0.643) all showed that there was no causal relationship between T1D and osteoporosis, but the direction was consistent. The indicative significance of IVW results in T1D and forearm fractures (OR=1.062, 95% CI=1.010-1.117, P=0.020), but the results are not robust enough. There was no causal effect in femur, lumbar and pelvis, or shoulder and upper arm fractures.

CONCLUSIONS

After MR analysis, although T1D may be a risk factor for bone health, we do not have sufficient evidence to support a causal effect of T1D on osteoporosis and fractures at a genetically predicted level. More cases need to be included for analysis.

Light-Controlled Particle Enrichment Patterns in Droplets

Precision manipulation of particle-enrichment patterns in droplets is challenging but important in biochemical analysis and clinical diagnosis. Herein, a light strategy for precisely manipulating particle enrichment patterns is reported. Focused laser irradiation to the droplet induces a Marangoni flow owing to a localized photothermal effect, which carries in-droplet particles and concentrates them at the laser-spot-acted region. Owing to high flexibility of light, multiple particle-enriched sites are formed in a droplet, and the concentrated particles can be transported and reconstructed on demand. In addition to the island-like enrichment pattern, this optical particle manipulation strategy enables the formation of various particle-enriched patterns, such as the line-shape and circle-shape patterns. Further, light directly acts on the working fluid instead of target particles, considerably weakening dependence on particle properties. For particles whose density is similar to that of the working fluid, a portion of particles can still be concentrated. It is also found that only a small portion of submicron particles can be concentrated, while nanoparticles are hardly concentrated by this light strategy. Moreover, high reconfigurability of light enables in-parallel high-throughput operations, which is demonstrated using two laser beams to form two particle enrichment sites in a droplet simultaneously. Finally, this light strategy is also demonstrated by concentrating cells and nucleic acid molecules. This work paves the way for the applications of optofluidics in cell sorting, point-of-care analysis, and drug screening.

Micro-object manipulation by decanol liquid lenses

The flexible and precise manipulation of droplets on an air-liquid interface with complex functions remains challenging. Herein, we propose a smart strategy for excellently manipulating target droplets by decanol liquid lenses. A moveable surface tension gradient field generated by decanol liquid lenses is responsible for realizing various functions of transportation, launching and splitting of target droplets. With such fascinating features, directional long-distance transportation and on-demand droplet coalescence are enabled. Moreover, paw-like liquid lenses are constructed, which realizes a complex process, including collection, capture, transportation and release of target droplets. Remarkably, this strategy can also be applied to manipulate particles and liquid marbles other than droplets, eliminating the limitation of object properties. This work offers a smart strategy for manipulating micro-objects, which shows great potential in applications such as lab-on-a-chip, diagnostics, analytical chemistry and bioengineering, etc.

Light-Fueled Submarine-Like Droplet

Flexibly and precisely manipulating 3D droplet transportation is a fundamental challenge for broad implications in diagnostics, drug delivery, bioengineering, etc. Herein, a light method is developed for manipulating a droplet to make it behave like a submarine. This light method enables flexible 3D transportation, stable suspension, and floating of a droplet, which can be freely altered. It is demonstrated that the localized photothermal effect induced thermocapillary flow in the water droplet/oil phase is responsible for energizing and manipulating the droplet. With such remarkable motility, the light-fueled submarine-like droplet successfully realizes various functions such as the acid-base detection, particle capture and transportation, and target crystal collection, dissolution and transportation. It is demonstrated that the light-fueled submarine-like droplet shows promising perspective for long-sought precise droplet manipulation in various applications.

Light Controlled 3D Crystal Morphology for Droplet Evaporative Crystallization on Photosensitive Hydrophobic Substrate

Controlling crystal morphology is crucial in analytical chemistry and smart materials synthesis, etc. However, flexible manipulation of 3D crystal morphology still remains challenging. Herein, we present a novel and facile light strategy for droplet evaporative crystallization to manipulate macroscopic crystal morphology on photosensitive hydrophobic substrate possessing photothermal conversion property. We demonstrate that the spherical coronal shell and alms bowl-like crystal skeletons can be achieved on smooth photosensitive hydrophobic substrate, depending on the salt concentration. Rough photosensitive hydrophobic substrate further creates a bubble-assisted light strategy, by which a cylindrical shell-like crystal skeleton with a directionally controllable cavity is achieved. Amazingly, the proper additive endows droplet evaporative crystallization to form a closed crystal skeleton with the solution wrapped inside. The present study provides new ideas for designing a novel optical droplet microfluidic platform for controlling crystal morphology.

Light Droplet Levitation in Relation to Interface Morphology and Liquid Property

Light droplet levitation is an elegant technique allowing for contact-less manipulation in a wall-free environment. However, direct generation of light levitated droplets remains limited by small-curvature interface and underlying mechanism remains unclear. Here we report that small-curvature interface limitation encountered in liquid water is overcome by using liquids with extremely small saturated vapor pressure, which allows for direct generation of light levitated droplets above large-curvature interface. It is demonstrated that the interface morphology and extremely small saturated vapor pressure of liquids together contribute to creation of the gravity-lift and evaporation-condensation balances, enabling droplet levitation even above large-curvature interface. We also propose a levitation number Lv to judge whether droplets can be directly levitated above a curved interface or not, which successfully predicts the occurrence of light droplet levitation. When Lv falls in the range of 2.25 × 10^-4 ∼ 6 × 10^-3, tiny condensed droplets can be stably levitated above the gas-liquid interface no matter interface morphology and liquid type. The study deepens the understanding of the underlying mechanism for generating light levitated droplets.

Spontaneous Imbibition in Paper-Based Microfluidic Devices: Experiments and Numerical Simulations

Microfluidic paper-based analytical devices (μPADs) have quickly been an excellent choice for point-of-care diagnostic platforms ever since they appeared. Because capillary force is the main driving force for the transport of analytes in μPADs, low spontaneous imbibition rates may limit the detection sensitivity. Therefore, quantitative understanding of internal spontaneous capillary flow progress is requisite for designing sensitive and accurate μPADs. In this work, experimental and numerical studies have been performed to investigate the capillary flow in a typical filter paper. We use light-transmitting imaging technology to study wetting saturation changes in the paper. Our experimental results show an obvious transition of a saturated wetting front into an unsaturated wetting front as the imbibition proceeds. We find that the single-phase Darcy model considerably overestimates the temporal wetting penetration depths. Alternatively, we use the Richards equation together with the two-phase flow material properties that are obtained from the image-based pore-network modeling of the filter paper. Moreover, we have considered a dynamic term in the capillary pressure due to strong wetting dynamics in spontaneous imbibition. As a result, the numerical predictions of spontaneous imbibition in the paper are significantly improved. Our studies provide insights into the development of a quantitative spontaneous imbibition model for μPADs applications.

Synergetic Photo-Thermo Catalytic Hydrogen Production by Carbon Materials

Photo-thermo catalytic hydrogen production represents one of the most promising routes for channeling solar energy but typically suffers from high reaction temperatures. In this work, we develop photo-thermo catalytic hydrogen production at low temperatures by cost-effective, nonplasmonic, and metal-free nitrogen-doped carbon materials (CNO_1-x). We demonstrate that due to the photothermal conversion of CNO_1-x, carrier generation is improved and electron migration is enhanced to suppress the recombination of electron-hole pairs, both of which promote hydrogen production by photocatalysis, while generated hydrogen radicals facilitate the regeneration of active sites for hydrogen production by thermocatalysis. Such synergy greatly promotes photo-thermo catalytic hydrogen production at low temperatures. These results demonstrate the great promise of photo-thermo catalytic hydrogen production over carbon materials at low temperatures.

[Cell heterogeneity of laryngeal carcinoma and evolution trajectory of epithelial cells]

Objective: To analyze the classification and functions of cell subsets in laryngeal carcinoma and metastatic lymph nodes, and to explore the evolution trajectory of epithelial cells to tumor cells. Methods: Single-cell RNA sequencing was performed on 5 cases of laryngeal cancer, matched metastatic lymph nodes and 3 normal tissues. Patients were admitted to Ningbo Medical Center Lihuili Hospital from October 22, 2019 to December 16, all patients were male, aged 53-70 years old. Cell subsets of the above-mentioned tissues were analyzed by the Seurat, and the biological functions of cell subpopulation were investigated by functional enrichment analysis. Malignant epithelial cells were identified using copy number variation (CNV). The evolutionary trajectory of epithelial cells to cancer cells was analyzed by cell trajectory analysis, and cancerous transitional cells were identified. The highly expressed genes in transitional cells were analyzed by the FindAllMarker of the Seurat and verified by immunohistochemistry. Results: A total of 66 969 high-quality cells were obtained in 9 major clusters: epithelial cells, T cells, B cells, fibroblasts, endothelial cells, myeloid cells, mast cells, plasmacytoid dendritic cells and nerve cells. The first 5 cell clusters were divided into 8, 6, 4, 3 and 2 subgroups, respectively. Four epithelial cell subsets (C0, C1, C2 and C5) were derived from tumor tissues and metastatic lymph nodes, and had high levels of CNV and tumor cell content. Cell trajectory analysis showed that the evolution trajectory of epithelial cells was from normal epithelial subpopulation C4 to early cancerous cell population C0, which differentiated into three major malignant cell subsets C1, C3, and C5. Epithelial cell C0 may represent the transitional cell population of carcinogenesis, and were enriched in biological processes such as epithelial-mesenchymal transformation and angiogenesis. C0 highly expressed sulforaphane (SFN) which may be related to the occurrence and development of cancer. Immunohistochemistry confirmed that SFN was highly expressed in tumor tissues and metastatic lymph nodes compared with paracancerous tissues. Conclusion: Single-cell sequencing may be used to elucidate the diversity of cells and functions in laryngeal carcinoma tissues and metastatic lymph nodes, and cell population C0 plays a key role in the evolution of cells.

Upper Limit of Light-Levitated Droplet Motion

The light-enabled droplet levitation shows promising potential in applications in biotechnology, clinical medicine, and nanomaterials. In particular, light-levitated droplets have good followability with a moving laser beam, resulting in flexibility in manipulating their motion. However, it is still unclear whether there exists an upper limit to the light-levitated droplet motion with a moving laser beam. Therefore, the motion of light-levitated droplets above the free interface is studied to determine the upper limit of motions of the droplets with a moving laser beam. We demonstrate that an inefficient interface temperature response because of a very high moving speed of the laser beam and the resultant small upward vertical component of vapor flow are responsible for the existence of an upper-limit velocity. Above the upper limit, the light-levitated droplets are unable to stably move with the laser beam and finally disappear. By contrast, the droplets can stably move with the laser beam in a wide range at or below this upper limit. In addition, an almost linear relationship between the upper-limit velocity of the light-levitated droplets and the input laser power is presented. The findings of the present study are informative for the implementation of this light levitation technology.

Light fueled mixing in open surface droplet microfluidics for rapid probe preparation

In this study, a contactless, flexible, and interference-free light fueled method has been developed to enhance the mixing between the ssDNA and dynabeads in a droplet, which enables rapid probe preparation for promoting the probe technology based on open surface droplet microfluidics. In this light fueled method, the use of the photothermal effect of a focused infrared laser can easily create non-uniform temperature distribution and accordingly the surface tension gradient over the interface as a result of the localized heating effect, which thereby initiates the Marangoni flow in a droplet. Experimental results confirm that the light-induced Marangoni flow greatly enhances the mixing, ensuring rapid and efficient binding between the ssDNA and dynabeads. Moreover, the mixing intensity and degree can be simply tuned by controlling the laser intensity and laser heating time. The light fueled rapid mixing method developed in the present study paves the way for rapid bio-chemical detection.

Pan-Asian adapted ESMO Clinical Practice Guidelines for the diagnosis, treatment and follow-up of patients with renal cell carcinoma

The most recent version of the European Society for Medical Oncology (ESMO) Clinical Practice Guidelines for the diagnosis, treatment and follow-up of renal cell carcinoma was published in 2019 with an update planned for 2021. It was therefore decided by both the ESMO and the Singapore Society of Oncology (SSO) to convene a special, virtual guidelines meeting in May 2021 to adapt the ESMO 2019 guidelines to take into account the ethnic differences associated with the treatment of renal cell carcinomas in Asian patients. These guidelines represent the consensus opinions reached by experts in the treatment of patients with renal cell carcinoma representing the oncological societies of China (CSCO), India (ISMPO), Japan (JSMO), Korea (KSMO), Malaysia (MOS), Singapore (SSO) and Taiwan (TOS). The voting was based on scientific evidence and was independent of the current treatment practices and drug access restrictions in the different Asian countries. The latter were discussed when appropriate.

Controllable light-induced droplet evaporative crystallization

Droplet evaporative crystallization is one of the practical tools for clinical diagnosis, environmental monitoring, and pharmaceutical synthesis. Herein, we proposed a controllable and flexible light strategy to manipulate the droplet evaporative crystallization, in which the photothermal effect of a focused infrared laser actuated intense evaporation to attain the droplet evaporative crystallization. Due to the localized heating effect, not only the droplet evaporative crystallization could be promoted, but also the resultant Marangoni-flow enabled the crystals to be concentrated, exhibiting excellent controllability. Besides, a relationship between the crystallization starting time and the solution concentration/laser power was achieved, which benefited the manipulation of the droplet evaporative crystallization. The light strategy proposed in the present study possesses promising potential for future applications.

[A new classification of intrahepatic cholangiocarcinoma based on actual anatomy:a series of 135 cases]

Objective: To explore the feasibility and clinical value of a new classification for resectable intrahepatic cholangiocarcinoma (IHCC) according to the actual anatomy. Methods: The data of 135 patients with IHCC who were admitted to the Department of Hepatopancreatobiliary Surgery,Second Affiliated Hospital of Zhejiang University School of Medicine from November 2011 to November 2020 after discussion by a multidisciplinary team and planned to undergo radical resection were analyzed retrospectively. There were 77 males and 58 females,with a median age of 61 years (range:26 to 86 years),of which 38 cases had vascular invasion. This new classification was carried out independently by two hepatobiliary surgeons. First,a preliminary classification was made based on the location of the tumor,and then the final classification was based on vascular invasion. All patients were followed up by telephone,and the follow-up was as of November 2020. Survival time is defined as the time after surgery to follow-up or death. Log-rank test was used to compare patients' median recurrence-free survival and overall survival time. The Cox proportional hazard model was used to analyze the prognosis factors of the overall survival time of patients with IHCC. Results: Among the 135 patients,129 underwent R0 resection and 6 underwent R1 resection. According to the actual anatomy,28 cases (20.7%) belonged to segmental type, 43 cases (31.9%) belonged to branch type, 64 cases (47.4%). The median survival time of all patients was 35.2 months(95%CI:21.3 to 70.5 months),the 1-year cumulative survival rate was 75.1%,the 3-year cumulative survival rate was 45.8%,and the 5-year cumulative survival rate was 39.0%. After grouping according to the classification,the median survival time of segmental patients was 36.9 months (more than 50% of patients reached the median survival time),and the median survival time of branched patients was 33.8 months (95%CI:16.8 to 38.5);The median survival time of lobe patients was 25.0 months (95%CI:13.6 to 58.7). The result of Log-rank test between groups indicated that the median survival time of patients with segmental type was better than that of patients with branch and lobe type(HR=2.03,95%CI:1.24 to 3.64,P=0.006);There was no significant difference in survival time between patients with branch type and lobe type (P=0.685). The results of the multivariate analysis of the Cox risk ratio model suggested that the actual anatomical location classification (HR=2.32,95%CI:1.10 to 4.92,P=0.028) and the postoperative lymph node metastasis rate (HR=2.06,95%CI:1.24 to 3.45,P=0.005) were independent factors related to survival after radical resection of IHCC patients. Conclusion: It is simple and convenient to classify resectable IHCC by actual anatomy,which can be used to preliminarily judge the prognosis of patients and provide a feasible classification scheme for the clinic.

P–389 The relationship between serum hormone profiles and missed abortion in humans

Study question

Are circulating profiles of metabolic-related hormones also associated with the missed abortion (MA) in humans?

Summary answer

Serum levels of fatty acid-binding protein–4 (FABP4) and fibroblast growth factor 21 (FGF21) are positively associated with MA.

What is known already

A cluster of endocrine hormones, including FABP4, FGF21, adiponectin, lipocalin–2 (LCN2), exhibit pleiotropic effects on regulating systematic metabolism. Serum levels of them are associated with gestational obesity and diabetes and affect pregnancy outcomes, however, the relationship between their circulating profiles and MA is under-investigated.

Study design, size, duration

78 patients with MA and 86 healthy pregnant subjects matching on maternal age and body mass index (BMI) were nested from a prospective cohort in the Chinese population.

Participants/materials, setting, methods

Fasting serum samples from all participants were collected to test their serum levels of FGF21, FABP4, adiponectin, and LCN2 by enzyme-linked immunosorbent assay method (ELISA).

Main results and the role of chance

There were no significant differences in circulating profiles of adiponectin and LCN2 between MA patients and healthy pregnant subjects. By contrast, circulating levels of FGF21 and FABP4 were significantly and independently elevated in patients with MA relative to control cases even after adjusting confounding factors (for FGF21: MA: 28.96 ± 2.17 ng/ml; HP: 19.18 ± 1.12 ng/ml, P < 0.001, for FABP4: MA: 152.50 ± 9.31 pg/ml; HP: 90.86 ± 4.14 pg/ml, P < 0.001). Linear regression analysis showed, FGF21 raised every 10 pg/ml contributed to a 24% (95% CI: 15% - 34%) increase in the risk of MA, whereas the OR of FABP4 for the risk of MA was 1.052 (95% CI: 1.022 –1.088). Furthermore, using serum FGF21 level or FABP4 levels discriminated MA from healthy controls with an area under the operating characteristic’s curve (AUROC) of 0.81 (95% CI 0.76–0.92) and 0.70 (95% CI 0.62 - 0.78), respectively.

Limitations, reasons for caution

The study is limited by the sample size. In addition, our results were based-on Chinese population, whether it could be observed in other ethics group remain to be investigated. Meanwhile, the cause-effect relationship between increased serum FGF21 level and MA remains to be explored.

Wider implications of the findings: Our data would suggest that serum levels of FGF21 and FABP4 are associated with MA. Moreover, circulating FGF21 levels may serve as a potential diagnostic biomarker for the recognition of M.

Trial registration number

IRB Ref. No.: KY201913

Light-Fueled Beating Coffee-Ring Deposition for Droplet Evaporative Crystallization

Condensed deposition favors biochemical analysis, bioassays, and clinical diagnosis, but the existing strategies may suffer from low resolution, inaccurate control, cross-contamination, or miscellaneous apparatus. Herein, we propose a noncontact light strategy to enable the condensed deposition for droplet evaporative crystallization, in which the photothermal effect of a focused infrared laser is employed to induce intense evaporation. Due to the localized heating effect, not only can the droplet evaporative crystallization on the hydrophobic substrate be promoted, but also the resultant intensified Marangoni flow enables the movement of the early-formed crystals, preventing the pinning of the triple-phase contact line. Synergy of the Marangoni flow and nonuniform evaporation makes the solutes tend to accumulate near the focused light beam region, which facilitates the condensed deposition. More importantly, this light strategy not only enables condensed deposition on the hydrophobic surface with low hysteresis, but also works successfully on the hydrophilic substrate with high hysteresis via adjusting input laser power. It is demonstrated that the light strategy proposed in the present study has great potential for relevant applications.

Uncertainty quantification patterns for multiscale models

Uncertainty quantification (UQ) is a key component when using computational models that involve uncertainties, e.g. in decision-making scenarios. In this work, we present uncertainty quantification patterns (UQPs) that are designed to support the analysis of uncertainty in coupled multi-scale and multi-domain applications. UQPs provide the basic building blocks to create tailored UQ for multiscale models. The UQPs are implemented as generic templates, which can then be customized and aggregated to create a dedicated UQ procedure for multiscale applications. We present the implementation of the UQPs with multiscale coupling toolkit Multiscale Coupling Library and Environment 3. Potential speed-up for UQPs has been derived as well. As a proof of concept, two examples of multiscale applications using UQPs are presented. This article is part of the theme issue 'Reliability and reproducibility in computational science: implementing verification, validation and uncertainty quantification in silico'.

A high power density paper-based zinc-air battery with a hollow channel structure

In light of the surging research interest in disposable electronics, great demands have been imposed on compact power sources. Herein, a paper-based zinc-air battery that takes advantage of a hollow channel structure is reported. Unlike conventional paper-based metal-air batteries and fuel cells that tightly immobilize the electrode on the paper channel, a hollow channel layer containing potassium hydroxide solution electrolyte is sandwiched between the electrodes and paper channel layer. This novel zinc-air battery is capable of delivering a peak power density of 102 mW cm-2, surpassing state-of-the-art paper-based power sources. The superior power density originates from the boosted electrochemically active surface area of the cathode, which enhances the oxygen reduction reaction kinetics.