Tuning Electrocatalytic Activities of Dealloyed Nanoporous Catalysts by Macroscopic Strain Engineering

It is technically challenging to quantitatively apply strains to tune catalysis because most heterogeneous catalysts are nanoparticles, and lattice strains can only be applied indirectly via core-shell structures or crystal defects. Herein, we report quantitative relations between macroscopic strains and hydrogen evolution reaction (HER) activities of dealloyed nanoporous gold (NPG) by directly applying macroscopic strains upon bulk NPG. It was found that macroscopic compressive strains lead to a decrease, while macroscopic tensile strains improve the HER activity of NPG, which is in line with the d-band center model. The overpotential and onset potential of HER display approximately a linear relation with applied macroscopic strains, revealing an ∼2.9 meV decrease of the binding energy per 0.1% lattice strains from compressive to tensile. The methodology with the high strain sensitivity of electrocatalysis, developed in this study, paves a new way to investigate the insights of strain-dependent electrocatalysis with high precision.

Dual Redox Reaction Sites for Pseudocapacitance Based on Ti and -P Functional Groups of Ti3C2PBrx MXene

MXenes have extensive applications due to their different properties determined by intrinsic structures and various functional groups. Exploring different functional groups of MXenes leads to improved performance or potential applications. In this work, we prepared new Ti3C2PBrx (x=0.4-0.6) MXene with phosphorus functional groups (-P) through a two-step gas-phase reaction. The acquisition of -P is achieved by replacing bromine functional groups (-Br) of Ti3C2Br2 in the phosphorus vapor. After -Br is replaced with -P, Ti3C2PBrx MXene shows an improved areal capacitance (360 mF cm-2) at 20 mV s-1 compared with Ti3C2Br2 MXene (102 mF cm-2). At a current density of 5 mA cm-2 after 10000 cycles, the capacitance retention of Ti3C2PBrx MXene has not decreased. The pseudocapacitive enhancement mechanism has been discovered based on the dual redox sites of the functional groups -P and Ti.

Microstructural, Micromechanical Atlas of the Temporomandibular Joint Disc

The temporomandibular joint (TMJ) disc is mainly composed of collagen, with its arrangement responding to efficient stress distribution. However, microstructural and micromechanical transformations of the TMJ disc under resting, functional, and pathological conditions remain unclear. To address this, our study presents a high-resolution microstructural and mechanical atlas of the porcine TMJ disc. First, the naive microstructure and mechanical properties were investigated in porcine TMJ discs (resting and functional conditions). Subsequently, the perforation and tear models (pathological conditions) were compared. Following this, a rabbit model of anterior disc displacement (abnormal stress) was studied. Results show diverse microstructures and mechanical properties at the nanometer to micrometer scale. In the functional state, gradual unfolding of the crimping cycle in secondary and tertiary structures leads to D-cycle prolongation in the primary structure, causing tissue failure. Pathological conditions lead to stress concentration near the injury site due to collagen interfibrillar traffic patterns, resulting in earlier damage manifestation. Additionally, the abnormal stress model shows collagen damage initiating at the primary structure and extending to the superstructure over time. These findings highlight collagen's various roles in different pathophysiological states. Our study offers valuable insights into TMJ disc function and dysfunction, aiding the development of diagnostic and therapeutic strategies for TMJ disorders, as well as providing guidance for the design of structural biomimetic materials.

A Smart Bacteria-Capture-Killing Vector for Effectively Treating Osteomyelitis Through Synergy Under Microwave Therapy

Osteomyelitis caused by deep tissue infections is difficult to cure through phototherapy due to the poor penetration depth of the light. Herein, Cu/C/Fe3O4-COOH nanorod composites (Cu/C/Fe3O4-COOH) with nanoscale tip convex structures are successfully fabricated as a microwave-responsive smart bacteria-capture-killing vector. Cu/C/Fe3O4-COOH exhibited excellent magnetic targeting and bacteria-capturing ability due to its magnetism and high selectivity affinity to the amino groups on the surface of Staphylococcus aureus (S. aureus). Under microwave irradiation, Cu/C/Fe3O4-COOH efficiently treated S. aureus-infected osteomyelitis through the synergistic effects of microwave thermal therapy, microwave dynamic therapy, and copper ion therapy. It is calculated the electric field intensity in various regions of Cu/C/Fe3O4-COOH under microwave irradiation, demonstrating that it obtained the highest electric field intensity on the surface of copper nanoparticles of Cu/C/Fe3O4-COOH due to its high-curvature tips and metallic properties. This led to copper nanoparticles attracted more charged particles compared with other areas in Cu/C/Fe3O4-COOH. These charges are easier to escape from the high curvature surface of Cu/C/Fe3O4-COOH, and captured by adsorbed oxygen, resulting in the generation of reactive oxygen species. The Cu/C/Fe3O4-COOH designed in this study is expected to provide insight into the treatment of deep tissue infections under the irradiation of microwave.

A revisit of drugs and potential therapeutic targets against non-alcoholic fatty liver disease: learning from clinical trials

PURPOSE

Non-alcoholic fatty liver disease (NAFLD) is the most common liver disease, with a worldwide prevalence of 25%. Although numerous clinical trials have been conducted over the last few decades, an effective treatment has not been approved yet. Extensive research has accumulated a large amount of data and experience; however, the vast number of clinical trials and new therapeutic targets for NAFLD make it impossible to keep abreast of the relevant information. Therefore, a systematic analysis of the existing trials is necessary.

METHODS

Here, we reviewed clinical trials on NAFLD registered in the mandated federal database, ClinicalTrials.gov, to generate a detailed overview of the trials related to drugs and therapeutic targets for NAFLD treatment. Following screening for pertinence to therapy, a total of 440 entries were identified that included active trials as well as those that have already been completed, suspended, terminated, or withdrawn.

RESULTS

We summarize and systematically analyze the state, drug development pipeline, and discovery of treatment targets for NAFLD. We consider possible factors that may affect clinical outcomes. Furthermore, we discussed these results to explore the mechanisms responsible for clinical outcomes.

CONCLUSION

We summarised the landscape of current clinical trials and suggested the directions for future NAFLD therapy to assist internal medicine specialists in treating the whole clinical spectrum of this highly prevalent liver disease.

Natural Extracts for Antibacterial Applications

Bacteria-induced epidemics and infectious diseases are seriously threatening the health of people around the world. In addition, antibiotic therapy has been inducing increasingly more serious bacterial resistance, which makes it urgent to develop new treatment strategies to combat bacteria, including multidrug-resistant bacteria. Natural extracts displaying antibacterial activity and good biocompatibility have attracted much attention due to greater concerns about the safety of synthetic chemicals and emerging drug resistance. These antibacterial components can be isolated and utilized as antimicrobials, as well as transformed, combined, or wrapped with other substances by using modern assistive technologies to fight bacteria synergistically. This review summarizes recent advances in natural extracts from three kinds of sources-plants, animals, and microorganisms-for antibacterial applications. This work discusses the corresponding antibacterial mechanisms and the future development of natural extracts in antibacterial fields.

[Analysis and prediction of disease burden of cirrhosis and other chronic liver diseases due to alcohol use in China from 1990 to 2030]

Objective: To comprehensively understand the disease burden of liver cirrhosis and other chronic liver diseases caused by alcohol use in China from 1990 to 2019, as well as to predict the trends in disease burden from 2020 to 2030. Methods: The analysis utilized data from the Global Burden of Disease study in 2019 (GBD2019). Key indicators such as incidence rate, mortality rate, disability-adjusted life years (DALY), years of life lost due to premature mortality, and years lived with disability were selected to describe the disease burden of alcohol-related liver cirrhosis and other chronic liver diseases in China from 1990 to 2019. The estimated annual percentage change (EAPC) was used to depict the temporal trends in disease burden. Furthermore, a Bayesian age-period-cohort (BAPC) model was constructed using R software to predict the age-standardized incidence rate (ASIR) and age-standardized mortality rate (ASMR) of alcohol-related liver cirrhosis and other chronic liver diseases in China from 2020 to 2030. Results: From 1990 to 2019, the incidence of alcohol-related liver cirrhosis and other chronic liver diseases in China showed an upward trend, with an EAPC of 0.31% (95%CI: 0.10%-0.52%). However, the DALY declined, with an EAPC of -2.81% (95%CI: -2.92% - -2.70%). The ASMR showed a downward trend, with an EAPC of -2.55% (95%CI: -2.66% - -2.45%). The highest incidence of cirrhosis of liver caused by alcohol and other chronic liver diseases was reported in the age group of 35-49 years, while the ASMR increased gradually with age, with a significant rise after the age of 30. The age-standardized DALY rate peaked between the ages of 55 and 64. The disease burden indicators for males were consistently higher than those for females during the same period. According to the predictions of the BAPC model, from 2020 to 2030, the ASIR for cirrhosis of liver caused by alcohol and other chronic liver diseases in the entire population of China was projected to increase from 3.45/100 000 in 2020 to 3.78/100 000 in 2030, a growth of 9.57%. Conversely, the ASMR was expected to decrease from 1.45/100 000 in 2020 to 1.24/100 000 in 2030, a reduction of 14.48%. Conclusions: The disease burden of cirrhosis of liver caused by alcohol and other chronic liver diseases remained serious in China, especially in men and the middle-aged to elderly population. There is a pressing need to prioritize attention and resources towards these groups. Despite the projected decrease in ASMR, the ASIR continued to rise and is expected to persist in its upward trend until 2030.

Electron Aggregation and Oxygen Fixation Reinforced Microwave Dynamic and Thermal Therapy for Effective Treatment of MRSA-Induced Osteomyelitis

Antibiotics are frequently used to clinically treat osteomyelitis caused by bacterial infections. However, extended antibiotic use may result in drug resistance, which can be life threatening. Here, a heterojunction comprising Fe2 O3 /Fe3 S4 magnetic composite is constructed to achieve short-term and efficient treat osteomyelitis caused by methicillin-resistant Staphylococcus aureus (MRSA). The Fe2 O3 /Fe3 S4 composite exhibits powerful microwave (MW) absorption properties, thereby effectively converting incident electromagnetic energy into thermal energy. Density functional theory calculations demonstrate that Fe2 O3 /Fe3 S4 possesses significant charge accumulation and oxygen-fixing capacity at the heterogeneous interface, which provides more active sites and oxygen sources for trapping electromagnetic hotspots. The finite element analysis indicates that Fe2 O3 /Fe3 S4 displays a larger electromagnetism field enhancement parameter than Fe2 O3 owing to a significant increase in electromagnetic hotspots. These hotspots contribute to charge differential accumulation and depletion motions at the interface, thereby augmenting the release of free electrons that subsequently combine with the oxygen adsorbed by Fe2 O3 /Fe3 S4 to generate reactive oxygen species (ROS) and heat. This research, which achieves extraordinary bacterial eradication through the synergistic effect of microwave thermal therapy (MWTT) and microwave dynamic therapy (MDT), presents a novel strategy for treating deep-tissue bacterial infections.

Development of terpenoid repellents against Aedes albopictus: a combined study of biological activity evaluation and computational modelling

To explore novel terpenoid repellents, 22 candidate terpenoid derivatives were synthesized and tested for their electroantennogram (EAG) responses and repellent activities against Aedes albopictus. The results from the EAG experiments revealed that 5-(2-hydroxypropan-2-yl)-2-methylcyclohex-2-en-1-yl formate (compound 1) induced distinct EAG responses in female Aedes albopictus. At concentrations of 0.1, 1, 10, 100, and 1000 mg/L, the EAG response values for compound 1 were 179.59, 183.99, 190.38, 193.80, and 196.66 mV, demonstrating comparable or superior effectiveness to DEET. Repellent activity analysis indicated significant repellent activity for compound 1, closest to the positive control DEET. The in silico assessment of the ADMET profile of compound 1 indicates that it successfully passed the ADMET evaluation. Molecular docking studies exhibited favourable binding of compound 1 to the active site of the odorant binding protein (OBP) of Aedes albopictus, involving hydrophobic forces and hydrogen bond interactions with residues in the OBP pocket. The QSAR model highlighted the influential role of hydrogen-bonding receptors, positively charged surface area of weighted atoms, polarity parameters of molecules, and maximum nuclear-nuclear repulsion force of carbon-carbon bonds on the relative EAG response values of the tested compounds. This study holds substantial significance for the advancement of new terpenoid repellents.

[Association between congenital hypothyroidism and in-hospital adverse outcomes in very low birth weight infants]

Objective: To investigate the association between congenital hypothyroidism (CH) and the adverse outcomes during hospitalization in very low birth weight infants (VLBWI). Methods: This prospective, multicenter observational cohort study was conducted based on the data from the Sino-northern Neonatal Network (SNN). Data of 5 818 VLBWI with birth weight <1 500 g and gestational age between 24-<37 weeks that were admitted to the 37 neonatal intensive care units from January 1st, 2019 to December 31st, 2022 were collected and analyzed. Thyroid function was first screened at 7 to 10 days after birth, followed by weekly tests within the first 4 weeks, and retested at 36 weeks of corrected gestational age or before discharge. The VLBWI were assigned to the CH group or non-CH group. Chi-square test, Fisher exact probability method, Wilcoxon rank sum test, univariate and multivariate Logistic regression were used to analyze the relationship between CH and poor prognosis during hospitalization in VLBWI. Results: A total of 5 818 eligible VLBWI were enrolled, with 2 982 (51.3%) males and the gestational age of 30 (29, 31) weeks. The incidence of CH was 5.5% (319 VLBWI). Among the CH group, only 121 VLBWI (37.9%) were diagnosed at the first screening. Univariate Logistic regression analysis showed that CH was associated with increased incidence of extrauterine growth retardation (EUGR) (OR=1.31(1.04-1.64), P<0.05) and retinopathy of prematurity (ROP) of stage Ⅲ and above (OR=1.74(1.11-2.75), P<0.05). However, multivariate Logistic regression analysis showed no significant correlation between CH and EUGR, moderate to severe bronchopulmonary dysplasia, grade Ⅲ to Ⅳ intraventricular hemorrhage, neonatal necrotizing enterocolitis in stage Ⅱ or above, and ROP in stage Ⅲ or above (OR=1.04 (0.81-1.33), 0.79 (0.54-1.15), 1.15 (0.58-2.26), 1.43 (0.81-2.53), 1.12 (0.70-1.80), all P>0.05). Conclusion: There is no significant correlation between CH and in-hospital adverse outcomes, possibly due to timely diagnosis and active replacement therapy.

Rapid and effective treatment of chronic osteomyelitis by conductive network-like MoS2/CNTs through multiple reflection and scattering enhanced synergistic therapy

Staphylococcus aureus (S. aureus)-infected chronic osteomyelitis (COM) is one of the most devastating infectious diseases with a high recurrence rate, often leading to amputation and even death. It is incurable by all the current strategies involving the clinical use of radical debridement and systemic intravenous antibiotics. Here, we reported on a microwave (MW)-assisted therapy for COM by constructing a heterojunction formed by flake nanoflower-shaped molybdenum disulfide (MoS2) and tubular carbon nanotubes (CNTs). This composite could achieve a combination of MW thermal therapy (MTT) and MW dynamic therapy (MDT) to accurately and rapidly treat COM with deep tissue infection. In vitro and in vivo experiments showed that MoS2/CNTs were effective in non-invasively treating S. aureus-induced COM due to the heat and reactive oxygen species (ROS) produced under MW irradiation. The mechanism of heat and ROS generation was explained by MW network vector analysis, density of states (DOS), oxygen adsorption energy, differential charge and finite element (FEM) under MW irradiation. Since the Fermi layer was mainly contributed by the Mo-4d and C-2P orbitals, MoS2/CNTs could store a large amount of charge and easily release more electrons. In addition, charge accumulation and dissipation motion were strong on the surface of and inside MoS2/CNTs because of electromagnetic hot spots, resulting in the spilling out of a great deal of high-energy electrons. Due to the low oxygen adsorption energy of MoS2/CNTs-O2, these high-energy electrons combined further with the adsorbed oxygen to produce ROS.

Effects of empagliflozin on progression of chronic kidney disease: a prespecified secondary analysis from the empa-kidney trial

BACKGROUND

Sodium-glucose co-transporter-2 (SGLT2) inhibitors reduce progression of chronic kidney disease and the risk of cardiovascular morbidity and mortality in a wide range of patients. However, their effects on kidney disease progression in some patients with chronic kidney disease are unclear because few clinical kidney outcomes occurred among such patients in the completed trials. In particular, some guidelines stratify their level of recommendation about who should be treated with SGLT2 inhibitors based on diabetes status and albuminuria. We aimed to assess the effects of empagliflozin on progression of chronic kidney disease both overall and among specific types of participants in the EMPA-KIDNEY trial.

METHODS

EMPA-KIDNEY, a randomised, controlled, phase 3 trial, was conducted at 241 centres in eight countries (Canada, China, Germany, Italy, Japan, Malaysia, the UK, and the USA), and included individuals aged 18 years or older with an estimated glomerular filtration rate (eGFR) of 20 to less than 45 mL/min per 1·73 m2, or with an eGFR of 45 to less than 90 mL/min per 1·73 m2 with a urinary albumin-to-creatinine ratio (uACR) of 200 mg/g or higher. We explored the effects of 10 mg oral empagliflozin once daily versus placebo on the annualised rate of change in estimated glomerular filtration rate (eGFR slope), a tertiary outcome. We studied the acute slope (from randomisation to 2 months) and chronic slope (from 2 months onwards) separately, using shared parameter models to estimate the latter. Analyses were done in all randomly assigned participants by intention to treat. EMPA-KIDNEY is registered at ClinicalTrials.gov, NCT03594110.

FINDINGS

Between May 15, 2019, and April 16, 2021, 6609 participants were randomly assigned and then followed up for a median of 2·0 years (IQR 1·5-2·4). Prespecified subgroups of eGFR included 2282 (34·5%) participants with an eGFR of less than 30 mL/min per 1·73 m2, 2928 (44·3%) with an eGFR of 30 to less than 45 mL/min per 1·73 m2, and 1399 (21·2%) with an eGFR 45 mL/min per 1·73 m2 or higher. Prespecified subgroups of uACR included 1328 (20·1%) with a uACR of less than 30 mg/g, 1864 (28·2%) with a uACR of 30 to 300 mg/g, and 3417 (51·7%) with a uACR of more than 300 mg/g. Overall, allocation to empagliflozin caused an acute 2·12 mL/min per 1·73 m2 (95% CI 1·83-2·41) reduction in eGFR, equivalent to a 6% (5-6) dip in the first 2 months. After this, it halved the chronic slope from -2·75 to -1·37 mL/min per 1·73 m2 per year (relative difference 50%, 95% CI 42-58). The absolute and relative benefits of empagliflozin on the magnitude of the chronic slope varied significantly depending on diabetes status and baseline levels of eGFR and uACR. In particular, the absolute difference in chronic slopes was lower in patients with lower baseline uACR, but because this group progressed more slowly than those with higher uACR, this translated to a larger relative difference in chronic slopes in this group (86% [36-136] reduction in the chronic slope among those with baseline uACR <30 mg/g compared with a 29% [19-38] reduction for those with baseline uACR ≥2000 mg/g; ptrend<0·0001).

INTERPRETATION

Empagliflozin slowed the rate of progression of chronic kidney disease among all types of participant in the EMPA-KIDNEY trial, including those with little albuminuria. Albuminuria alone should not be used to determine whether to treat with an SGLT2 inhibitor.

FUNDING

Boehringer Ingelheim and Eli Lilly.

Instant Protection Spray for Anti-Infection and Accelerated Healing of Empyrosis

Distinct from common injuries, deep burns often require a chronic recovery cycle for healing and long-term antibiotic treatment to prevent infection. The rise of drug-resistant bacteria has caused antibiotics to no longer be perfect, and continuous drug use can easily lead to repeated infection and even death. Inspired by wild animals that chew plants to prevent wound infection, probiotic extracts with a structure similar to the tailspike of phage are obtained from Lactobacillus casei and combined with different flavones to design a series of nonantibiotic bactericides. These novel antibacterial agents are combined with a rapid gelation spray with a novel cross-angle layout to form an instant protection spray (IPS) and provide a physical and anti-infectious barrier for burns within 30 s. This IPS is able to sterilize 100.00% and 96.14% of multidrug-resistant Staphylococcus aureus (MRSA) in vitro and in vivo, respectively. In addition, it is found to effectively reduce inflammation in MRSA-infected burns in rats and to promote tissue healing.

Impact of primary kidney disease on the effects of empagliflozin in patients with chronic kidney disease: secondary analyses of the EMPA-KIDNEY trial

BACKGROUND

The EMPA-KIDNEY trial showed that empagliflozin reduced the risk of the primary composite outcome of kidney disease progression or cardiovascular death in patients with chronic kidney disease mainly through slowing progression. We aimed to assess how effects of empagliflozin might differ by primary kidney disease across its broad population.

METHODS

EMPA-KIDNEY, a randomised, controlled, phase 3 trial, was conducted at 241 centres in eight countries (Canada, China, Germany, Italy, Japan, Malaysia, the UK, and the USA). Patients were eligible if their estimated glomerular filtration rate (eGFR) was 20 to less than 45 mL/min per 1·73 m2, or 45 to less than 90 mL/min per 1·73 m2 with a urinary albumin-to-creatinine ratio (uACR) of 200 mg/g or higher at screening. They were randomly assigned (1:1) to 10 mg oral empagliflozin once daily or matching placebo. Effects on kidney disease progression (defined as a sustained ≥40% eGFR decline from randomisation, end-stage kidney disease, a sustained eGFR below 10 mL/min per 1·73 m2, or death from kidney failure) were assessed using prespecified Cox models, and eGFR slope analyses used shared parameter models. Subgroup comparisons were performed by including relevant interaction terms in models. EMPA-KIDNEY is registered with ClinicalTrials.gov, NCT03594110.

FINDINGS

Between May 15, 2019, and April 16, 2021, 6609 participants were randomly assigned and followed up for a median of 2·0 years (IQR 1·5-2·4). Prespecified subgroupings by primary kidney disease included 2057 (31·1%) participants with diabetic kidney disease, 1669 (25·3%) with glomerular disease, 1445 (21·9%) with hypertensive or renovascular disease, and 1438 (21·8%) with other or unknown causes. Kidney disease progression occurred in 384 (11·6%) of 3304 patients in the empagliflozin group and 504 (15·2%) of 3305 patients in the placebo group (hazard ratio 0·71 [95% CI 0·62-0·81]), with no evidence that the relative effect size varied significantly by primary kidney disease (pheterogeneity=0·62). The between-group difference in chronic eGFR slopes (ie, from 2 months to final follow-up) was 1·37 mL/min per 1·73 m2 per year (95% CI 1·16-1·59), representing a 50% (42-58) reduction in the rate of chronic eGFR decline. This relative effect of empagliflozin on chronic eGFR slope was similar in analyses by different primary kidney diseases, including in explorations by type of glomerular disease and diabetes (p values for heterogeneity all >0·1).

INTERPRETATION

In a broad range of patients with chronic kidney disease at risk of progression, including a wide range of non-diabetic causes of chronic kidney disease, empagliflozin reduced risk of kidney disease progression. Relative effect sizes were broadly similar irrespective of the cause of primary kidney disease, suggesting that SGLT2 inhibitors should be part of a standard of care to minimise risk of kidney failure in chronic kidney disease.

FUNDING

Boehringer Ingelheim, Eli Lilly, and UK Medical Research Council.

Improved hydrogen evolution performance of Ni-based nanoporous catalyst with Mo and B co-addition

The exploration of efficient and stable noble-metal-free electrocatalysts for hydrogen evolution reaction (HER) is of great interest for the development of electrochemical hydrogen production technologies. Herein, nanoporous Ni-based catalyst with Mo and B co-addition (NiMoB) prepared by dealloying is reported as an efficient electrocatalysts for HER. The nanoporous NiMoB achieves an overpotential of 31 mV at 10 mA cm-2, along with exceptional catalytic stability in alkaline electrolyte. Density functional theory (DFT) calculations reveal that the incorporation of Mo and B can synergistically optimize the electronic structure and regulate the adsorption of HER intermediates on the Ni active site, thus accelerating the HER kinetics. This study provides a new perspective for the development of non-precious Ni-based catalysts towards efficient hydrogen energy conversion.

Metal Ion Coordination Improves Graphite Nitride Carbon Microwave Therapy in Antibacterial and Osteomyelitis Treatment

The ability to effectively treat deep bacterial infections while promoting osteogenesis is the biggest treatment demand for diseases such as osteomyelitis. Microwave therapy is widely studied due to its remarkable ability to penetrate deep tissue. This paper focuses on the development of a microwave-responsive system, namely, a zinc ion (Zn2+ ) doped graphite carbon nitride (CN) system (BZCN), achieved through two high-temperature burning processes. By subjecting composite materials to microwave irradiation, an impressive 99.81% eradication of Staphylococcus aureus is observed within 15 min. Moreover, this treatment enhances the growth of bone marrow stromal cells. The Zn2+ doping effectively alters the electronic structure of CN, resulting in the generation of a substantial number of free electrons on the material's surface. Under microwave stimulation, sodium ions collide and ionize with the free electrons generated by BZCN, generating a large amount of energy, which reacts with water and oxygen, producing reactive oxygen species. In addition, Zn2+ doping improves the conductivity of CN and increases the number of unsaturated electrons. Under microwave irradiation, polar molecules undergo movement and generate frictional heat. Finally, the released Zn2+ promotes macrophages to polarize toward the M2 phenotype, which is beneficial for tibial repair.

Hardware Implementation of Quantum Stabilizers in Superconducting Circuits

Stabilizer operations are at the heart of quantum error correction and are typically implemented in software-controlled entangling gates and measurements of groups of qubits. Alternatively, qubits can be designed so that the Hamiltonian corresponds directly to a stabilizer for protecting quantum information. We demonstrate such a hardware implementation of stabilizers in a superconducting circuit composed of chains of π-periodic Josephson elements. With local on-chip flux and charge biasing, we observe a progressive softening of the energy band dispersion with respect to flux as the number of frustrated plaquette elements is increased, in close agreement with our numerical modeling.

Predicting Prostate VMAT 3D Radiation Doses of Continuously Varying Organ Dose Trade-Offs Using a Conditional Variational Autoencoder

PURPOSE/OBJECTIVE(S)

Predicting 3D radiation doses from planning structures is a promising method of knowledge-based treatment planning. However, most models are designed to predict only one 3D dose distribution per patient, based on historical organ dose trade-offs. To allow customizable plan generation, in this study, we aim to show the feasibility of dose prediction in which the degrees of organ dose trade-off could be explicitly specified. Specifically, the bladder vs. rectum dose trade-off in prostate cancer was investigated.

MATERIALS/METHODS

In an IRB-approved study, we obtained imaging and structure contours for 167 patients with prostate cancer who received definitive radiotherapy. Training data was generated by automatically creating 3 different plans for each patient: while keeping target dose patterns constant, 1 base plan was generated with optimization objectives directly based on the output of a custom RapidPlan model prediction (S = 0), 1 plan with the goal to significantly lower bladder dose relative to the rectum (S = -1), and 1 plan with the goal to significantly lower rectum dose relative to the bladder (S = 1). This process was achieved by adjusting priority values during optimization. S is a scalar indicating the degree of bladder vs. rectum dose trade-off (higher S = higher dose to the bladder relative to the rectum). A conditional variational autoencoder (cVAE) was constructed as the generative model. Training, validation, and testing sets consist of 124, 10, and 33 patients, respectively. During training, the inputs to the model were 3D structure masks with voxel values modified based on S, and the output was the corresponding 3D dose. For model testing, we selected 7 equispaced values of S in the range [-1, +1] for each of the 33 test patients, generated the 3D doses for each S value (normalized to D2% = 110%), and calculated the differences of key dosimetric parameters (for S levels other than 0) compared to the predicted base plan (S = 0). The mean and standard deviations for these differences were reported.

RESULTS

The cVAE model converged after training for 800 epochs. As the value of S increased from -1 to +1, the target coverage remained similar, while the doses to the bladder and rectum increased and decreased, respectively, as expected (Table 1). This pattern was also confirmed by qualitative examination of dose-volume histograms for additional S values.

CONCLUSION

We demonstrated the feasibility of predicting 3D radiation dose distributions for prostate cancer where the degrees of organ dose trade-off could be explicitly specified.

Cost-Effectiveness of Short-Course Radiotherapy Based Total Neoadjuvant Therapy for Locally Advanced Rectal Cancer in China

PURPOSE/OBJECTIVE(S)

The phase III STELLAR (NCT02533271) trial demonstrated that four cycles of chemotherapy after short-course radiotherapy (SCRT-TNT) were not inferior to the standard care of long-course concurrent radiotherapy (LCRT) in patients with locally advanced rectal cancer (LARC). This study assessed the cost-effectiveness of SCRT-TNT versus LCRT in locally advanced rectal cancer in China on the basis of the STELLAR trial.

MATERIALS/METHODS

A Markov model was used to synthesize the healthcare costs and benefits of LARC patients based on results from the STELLAR trial. The model assumes that LARC who meet the inclusion criteria of the STELLAR trial experience four possible states: No Evidence of Disease (NED), locally recurrence, distant metastases, or any death from rectal cancer or other unrelated causes, where local recurrence continues to be classified as resectable and unresectable. The transition status period is 3 month, and 5 years is used to calculate direct medical costs and health benefits. The probabilities of states transition after SCRT-TNT or LCRT were derived from the results of the STELLAR trial and previous published article (Table.1). Costs were evaluated from the Chinese payer's perspective reported in early 2022 US dollars (US$1 = 6.78 Chinese Yuan). Sensitivity analyses were performed for key variables. Cost-effectiveness was evaluated using the incremental cost-effectiveness ratio and net monetary benefits. Effectiveness was defined as quality-adjusted life-years (QALYs). Willingness-to-pay (WTP) threshold was set at $43500/QALY. Data were collected from October 3, 2020, to September 20, 2021, and analyzed from November 15, 2020, to October 25, 2021.

RESULTS

During the 5-year horizon, for the base case scenario, SCRT-TNT incurred a lower total cost and higher QALYs compared with LCCRT. The total cost was $65767 and QALYs were 1.77 for SCRT-TNT; for LCCRT, the total cost was $72802 and QALYs were 1.64. This resulted in an ICER of -$ 55470.69 per QALY. Therefore, SCRT-TNT was a cost-saving and dominating treatment strategy compared with LCRT. Sensitivity analysis showed that ICERs were most sensitive to the parameters of distant metastases risk after treatment.

CONCLUSION

SCRT-TNT in locally advanced rectal cancer can be a cost-effective alternative to LCRT in China, and should be considered in appropriately selected patients.

Feasibility of Using Zero-Shot Learning in Transformer-Based Natural Language Processing Algorithm for Key Information Extraction from Head and Neck Tumor Board Notes

PURPOSE/OBJECTIVE(S)

Natural language processing (NLP) technology has the potential to automate information aggregation and summarization in oncology. One example is the automation of patient registry creation. In this work, we aim to show (1) the feasibility of using modern NLP algorithms to extract key information from tumor board notes, and (2) the impact of prompt engineering on the quality of the results.

MATERIALS/METHODS

In this IRB-approved study, we obtained the texts of head and neck tumor board notes for 306 unique patients. Five key pieces of information used to create a patient registry were predefined: age, gender, tumor histology, tumor stage, and primary location. The NLP algorithm used was a modified Text-To-Text Transfer Transformer (T5) model that was initially trained on the Colossal Clean Crawled Corpus (C4) dataset and subsequently fine-tuned on the Stanford Question Answering Dataset (SQuAD) to perform the downstream task of extractive question answering. The NLP model and trained weights were obtained from the Hugging Face platform. During inference, the entire body of the tumor board note and a related question were fed as inputs, and the model predicted a sequence of texts in response to the question. Two sets of questions of similar semantic meanings were used. Questions in prompt set #1 included "What is the gender?", "What is the age?", "What is the type of carcinoma in pathological diagnosis?", "What is the stage?", and "Where is the carcinoma located at?". Questions in prompt set #2 include "Is the patient male or female?", "How old is the patient?", "What kind of cancer?", "What is the cancer stage?", and "What is the tumor location?". Each model-predicted response was compared to the ground truth extracted from the tumor board notes. A response was classified as true if it is consistent with the ground truth, otherwise, it was deemed false. The response accuracy for each question was subsequently calculated.

RESULTS

The median number of words in each tumor board note was 448 (range, 219 - 1505). The accuracy of the NLP algorithm for each question from either set is reported in Table 1. Algorithm performance is higher for extracting objective information such as age, gender, and histology. In addition, it was found that questions of similar semantic meanings but with different wording can lead to significantly different results.

CONCLUSION

We demonstrated that a transformer-based extractive question-answering NLP algorithm can be successfully used for extracting information from head and neck tumor board notes with zero-shot learning. Furthermore, our results highlight the significance of prompt engineering for applying NLP for this task. Future work on finetuning these algorithms to oncology-specific texts can potentially enhance algorithm performance for more difficult tasks.

Interfacial and Defect Polarization Enhanced Microwave Noninvasive Therapy for Staphylococcus aureus-Infected Chronic Osteomyelitis

Chronic osteomyelitis (COM), is a long-term, constant, and intractable disease mostly induced by infection from the invasion of Staphylococcus aureus (S. aureus) into bone cells. Here, we describe a highly effective microwave (MW) therapeutic strategy for S. aureus-induced COM based on the in situ growth of interfacial oxygen vacancy-rich molybdenum disulfide (MoS2)/titanium carbide (Ti3C2Tx) MXene with oxygen-deficient titanium dioxide (TiO2-x) on Ti3C2Tx (labeled as HU-MoS2/Ti3C2Tx) by producing reactive oxygen species (ROS) and heat. HU-MoS2/Ti3C2Tx produced heat and ROS, which could effectively treat S. aureus-induced COM under MW irradiation. The underlying mechanism determined by density functional theory (DFT) and MW vector network analysis was that HU-MoS2/Ti3C2Tx formed a high-energy local electric field under MW irradiation, consequently generating more high-energy free electrons to pass and move across the interface at a high speed and accelerate by the heterointerface, which enhanced the charge accumulation on both sides of the interface. Moreover, these charges were captured by the oxygen species adsorbed at the HU-MoS2/Ti3C2Tx interface to produce ROS. MoS2 facilitated multiple reflections and scattering of electromagnetic waves as well as enhanced impedance matching. Ti3C2Tx enhanced the conduction loss of electromagnetic waves, while functional groups induced dipole polarization to enhance attenuation of MW.

Genetic Variations in TrkB.T1 Isoform and Their Association with Somatic and Psychological Symptoms in Individuals with IBS

Irritable bowel syndrome (IBS), a disorder of gut-brain interaction, is often comorbid with somatic pain and psychological disorders. Dysregulated signaling of brain-derived neurotrophic factor (BDNF) and its receptor, tropomyosin-related kinase B (TrkB), has been implicated in somatic-psychological symptoms in individuals with IBS. Thus, we investigated the association of 10 single nucleotide polymorphisms (SNPs) in the regulatory 3' untranslated region (UTR) of NTRK2 (TrkB) kinase domain-deficient truncated isoform (TrkB.T1) and the BDNF Val66Met SNP with somatic and psychological symptoms and quality of life in a U.S. cohort (IBS n=464; healthy controls n=156). We found that the homozygous recessive genotype (G/G) of rs2013566 in individuals with IBS is associated with worsened somatic symptoms, including headache, back pain, joint pain, muscle pain, and somatization as well as diminished sleep quality, energy level and overall quality of life. Validation using U.K. BioBank (UKBB) data confirmed the association of rs2013566 with increased likelihood of headache. Several SNPs (rs1627784, rs1624327, rs1147198) showed significant associations with muscle pain in our U.S. cohort. Notably, these SNPs are predominantly located in H3K4Me1-enriched regions, suggesting their enhancer and/or transcription regulation potential. Together, our findings suggest that genetic variation within the 3'UTR region of the TrkB.T1 isoform may contribute to comorbid conditions in individuals with IBS, resulting in a spectrum of somatic and psychological symptoms that may influence their quality of life. These findings advance our understanding of the genetic interaction between BDNF/TrkB pathways and somatic-psychological symptoms in IBS, highlighting the importance of further exploring this interaction for potential clinical applications.

[Near-infrared excited graphene oxide/silver nitrate/chitosan coating for improving antibacterial properties of titanium implants]

Objective

To design and construct a graphene oxide (GO)/silver nitrate (Ag3PO4)/chitosan (CS) composite coating for rapidly killing bacteria and preventing postoperative infection in implant surgery.

Methods

GO/Ag3PO4 composites were prepared by ion exchange method, and CS and GO/Ag3PO4 composites were deposited on medical titanium (Ti) sheets successively. The morphology, physical image, photothermal and photocatalytic ability, antibacterial ability, and adhesion to the matrix of the materials were characterized.

Results

The GO/Ag3PO4 composites were successfully prepared by ion exchange method and the heterogeneous structure of GO/Ag3PO4 was proved by morphology phase test. The heterogeneous structure formed by Ag3PO4 and GO reduced the band gap from 1.79 eV to 1.39 eV which could be excited by 808 nm near-infrared light. The photothermal and photocatalytic experiments proved that the GO/Ag3PO4/CS coating had excellent photothermal and photodynamic properties. In vitro antibacterial experiments showed that the antibacterial rate of the GO/Ag3PO4/CS composite coating against Staphylococcus aureus reached 99.81% after 20 minutes irradiation with 808 nm near-infrared light. At the same time, the composite coating had excellent light stability, which could provide stable and sustained antibacterial effect.

Conclusion

GO/Ag3PO4/CS coating can be excited by 808 nm near infrared light to produce reactive oxygen species, which has excellent antibacterial activity under light.

Lattice Strain Engineering of Ti3C2 Narrows Band Gap for Realizing Extraordinary Sonocatalytic Bacterial Killing

The rapid development of sonodynamic therapy (SDT) provides a promising strategy for treating deep-seated multidrug-resistant (MDR) bacterial infection. However, the extreme scarcity of biologically functional and highly efficient sonosensitizers severely limits the further clinical practice of SDT. Herein, the lattice-strain-rich Ti3C2 (LS-Ti3C2) with greatly improved sonosensitizing effect is one-step synthesized using Ti3C2 and meso-tetra(4-carboxyphenyl)porphine (TCPP) by the solvothermal method for realizing extraordinary SDT. The intervention of TCPP causes all the Ti-O chemical bonds and most of the Ti-F chemical bonds on the surface layer of Ti3C2 to break down. The amino groups of TCPP are then recombined with these exposed Ti atoms to perturb the order of the Ti atoms, resulting in displacement of the Ti atoms and final lattice structural distortion of Ti3C2. The inherent lattice strain narrows the band gap of Ti3C2, which mainly facilitates the electron-hole pair separation and electron transfer under ultrasound irradiation, thereby resulting in US-mediated reactive oxygen species (ROS) production and the subsequent robust bactericidal capability (99.77 ± 0.16%) against methicillin-resistant Staphylococcus aureus (MRSA). Overall, this research offers a perspective into the development of Ti-familial sonosensitizers toward SDT practice.

Ultrasmall Cortex Moutan Nanoclusters for the Therapy of Pneumonia and Colitis

Infectious pneumonia and colitis are hard to be treated due to tissue infection, mucosal immune disorders, and dysbacteriosis. Although conventional nanomaterials can eliminate infection, they also damage normal tissues and intestinal flora. Herein, this work reports bactericidal nanoclusters formed through self-assembly for efficient treatment of infectious pneumonia and enteritis. The ultrasmall (about 2.3 nm) cortex moutan nanoclusters (CMNCs) has excellent antibacterial, antiviral, and immune regulation activity. The formation of nanoclusters is analyzed from the molecular dynamics mainly through the binding between polyphenol structures through hydrogen bonding and ππ stacking interaction. CMNCs have enhanced tissue and mucus permeability ability compared with natural CM. CMNCs precisely targeted bacteria due to polyphenol-rich surface structure and inhibited broad spectrum of bacteria. Besides, they killed H1N1 virus mainly through the inhibition of the neuraminidase. These CMNCs are effective in treating infectious pneumonia and enteritis relative to natural CM. In addition, they can be used for adjuvant colitis treatment by protecting colonic epithelium and altering the composition of gut microbiota. Therefore, CMNCs showed excellent application and clinical translation prospects in the treatment of immune and infectious diseases.

Effect of Platelet-Rich Plasma Addition on the Chemical Properties and Biological Activity of Calcium Sulfate Hemihydrate Bone Cement

Currently, platelet-rich plasma (PRP) is an attractive additive for bone repair materials. PRP could enhance the osteoconductive and osteoinductive of bone cement, as well as modulate the degradation rate of calcium sulfate hemihydrate (CSH). The focus of this study was to investigate the effect of different PRP ratios (P1: 20 vol%, P2: 40 vol%, and P3: 60 vol%) on the chemical properties and biological activity of bone cement. The injectability and compressive strength of the experimental group were significantly higher than those of the control. On the other hand, the addition of PRP decreased the crystal size of CSH and prolonged the degradation time. More importantly, the cell proliferation of L929 and MC3T3-E1 cells was promoted. Furthermore, qRT-PCR, alizarin red staining, and western blot analyses showed that the expressions of osteocalcin (OCN) and Runt-related transcription factor 2 (Runx2) genes and β-catenin protein were up-regulated, and mineralization of extracellular matrix was enhanced. Overall, this study provided insight into how to improve the biological activity of bone cement through PRP incorporation.

Microwave-Excited, Antibacterial Core-Shell BaSO4/BaTi5O11@PPy Heterostructures for Rapid Treatment of S. aureus-Infected Osteomyelitis

Owing to its deep penetration capability, microwave (MW) therapy has emerged as a promising method to eradicate deep-seated acute bone infection diseases such as osteomyelitis. However, the MW thermal effect still needs to be enhanced to achieve rapid and efficient treatment of deep focal infected areas. In this work, the multi-interfacial core-shell structure barium sulfate/barium polytitanates@polypyrrole (BaSO₄/BaTi₅O₁₁@PPy) was prepared, which exhibited enhanced MW thermal response via the well-designed multi-interfacial structure. To be specific, BaSO₄/BaTi₅O₁₁@PPy achieved rapid temperature increases in a short period and efficient clearance of Staphylococcus aureus (S. aureus) infections under MW irradiation. After 15 min MW irradiation, the antibacterial efficacy of BaSO₄/BaTi₅O₁₁@PPy can reach up to 99.61 ± 0.22%. Their desirable thermal production capabilities originated from enhanced dielectric loss including multiple interfacial polarization and conductivity loss. Additionally, in vitro analysis illuminated that the underlying antimicrobial mechanism was attributed to the noticeable MW thermal effect and changes in energy metabolic pathways on bacterial membrane instigated by BaSO₄/BaTi₅O₁₁@PPy under MW irradiation. Considering remarkable antibacterial efficiency and acceptable biosafety, we envision that it has significant value in broadening the pool of desirable candidates to fight against S. aureus-infected osteomyelitis. STATEMENT OF SIGNIFICANCE: : The treatment of deep bacterial infection remains challenging due to the ineffectiveness of antibiotic treatment and the susceptibility to bacterial resistance. Microwave (MW) thermal therapy (MTT) is a promising approach with remarkable penetration to centrally heat up the infected area. This study proposes to utilize the core-shell structure BaSO₄/BaTi₅O₁₁@PPy as an MW absorber to achieve localized heating under MW radiation for MTT. In vitro experiments demonstrated that the disrupted bacterial membrane is primarily due to the localized high temperature and interrupted electron transfer chain. As a consequence, its antibacterial rate is as high as 99.61% under MW irradiation. It is shown that the BaSO₄/BaTi₅O₁₁@PPy is a promising candidate for eliminating bacterial infection in deep-seated tissues.

Superlattice Nanofilm on a Touchscreen for Photoexcited Bacteria and Virus Killing by Tuning Electronic Defects in the Heterointerface

Currently, the global COVID-19 pandemic has significantly increased the public attention toward the spread of pathogenic viruses and bacteria on various high-frequency touch surfaces. Developing a self-disinfecting coating on a touchscreen is an urgent and meaningful task. Superlattice materials are among the most promising photocatalysts owing to their efficient charge transfer in abundant heterointerfaces. However, excess electronic defects at the heterointerfaces result in the loss of substantial amounts of photogenerated charge carrier. In this study, a ZnOFe₂ O₃ superlattice nanofilm is designed via atomic layer deposition for photocatalytic bactericidal and virucidal touchscreen. Additionally, electronic defects in the superlattice heterointerface are engineered. Photogenerated electrons and holes will be rapidly separated and transferred into ZnO and Fe₂ O₃ across the heterointerfaces owing to the formation of ZnO, FeO, and ZnFe covalent bonds at the heterointerfaces, where ZnO and Fe₂ O₃ function as electronic donors and receptors, respectively. The high generation capacity of reactive oxygen species results in a high antibacterial and antiviral efficacy (>90%) even against drug-resistant bacteria and H1N1 viruses under simulated solar or low-power LED light irradiation. Meanwhile, this superlattice nanofilm on a touchscreen shows excellent light transmission (>90%), abrasion resistance (10⁶ times the round-trip friction), and biocompatibility.

Engineering Dynamic Defect of CeIII /CeIV -Based Metal-Organic Framework through Ultrasound-Triggered Au Electron Trapper for Sonodynamic Therapy of Osteomyelitis

Defect engineering is an important way to tune the catalytic properties of metal-organic framework (MOF), yet precise control of defects is difficult to achieve. Herein, a cerium-based MOF (CeTCPP) is decorated with Au nanoparticles. Under ultrasound irradiation, Au nanoparticles can precisely turn 1/3 of the pristine Ce³⁺ nodes into Ce⁴⁺ . With the stable existence of Ce⁴⁺ , the coordination of Ce nodes changed, causing the structural irregularity in CeTCPP-Au, so that the electron-hole recombination is obviously hindered, facilitating the generation of reactive oxygen species. Therefore, under 20 min of ultrasound irradiation, the CeTCPP-Au showed superior antibacterial efficacy of over 99% against Staphylococcus aureus and Escherichia coli with good biocompatibility, which is further used for effective therapy of osteomyelitis. Overall, this work provides a dynamic defect formation strategy of MOF through the electron trapping of Au nanoparticles, which also sheds light on sonodynamic therapy in curing deep-seated lesions.

Enhancing Microwave Dynamic Effects via Surface States of Ultrasmall 2D MOF Triggered by Interface Confinement for Antibiotics-Free Therapy

Microwave (MV)-trigged dynamic therapy based on MV-responsive materials is promising for treating deep infection diseases that cannot be effectively treated by antibiotics, like life-threatening osteomyelitis. Surface states of materials affect the generation of free charges under the excitation source with energy less than the band gap, consequently influencing the MV dynamic effects. Herein, an MV responsive system with interface confined 2D metal-organic framework (2D MOF) on oxidized carbon nanotube (CNT) is prepared, in which the ultrasmall Cu-based 2D MOF possesses sufficient surface/interface defects, endowing the system a large number of surface states. Under MV irradiation, the synthesized CNT-2D MOF not only efficiently absorbs and converts the microwave into heat for microwaveocaloric therapy (MCT) via enhanced hetero-interfacial polarization, but also generates excited electrons via surface state for microwave dynamic therapy (MDT). This biocompatible CNT-2D MOF exhibits highly effective broad-spectrum antimicrobial activity against seven pathogenic bacteria, including Gram-negative and Gram-positive pathogens, under 7 min MV irradiation. And this system is proven to efficiently eradicate Staphylococcus aureus infected rabbit tibia osteomyelitis. Significantly, MV-excited MCT and MDT of CNT-CuHHTP developed in this study makes a major step forward in antibiotic-free MV therapy in deep tissue bacterial infection diseases.

Synthesis and water splitting performance of FeCoNbS bifunctional electrocatalyst

Transition metal (TM) sulfides are promising catalysts for water splitting in alkaline media due to their high intrinsic activities and similar TM-S electronic structure with hydrogenase. In this work, the nanoporous FeCoNbS electrocatalyst with nanosheet morphology is synthesized through dealloying AlFeCoNb alloy followed by the steam sulphurization. The introduction of S element improves the electronic structure, further increases the active sites, regulates the mass transfer and enhances the intrinsic activity. The Nb introduction improves the electron transfer ability of the catalyst. The synergistic effect of Fe, Co and Nb improves the intrinsic activity of the active site. The FeCoNbS catalyst exhibits good catalytic performance for both hydrogen evolution reaction (HER) and oxygen evolution reaction (OER) in alkaline solution. The overpotentials at 10 mA cm^-2 of HER and OER are 83 and 241 mV, respectively. The Tafel slopes of HER and OER are 101.2 and 35.5 mV dec^-1, respectively. The FeCoNbS can serve as overall water splitting electrode with the decomposition voltage of 1.61 V at 10 mA cm^-2.

Interlayer Electrons Polarization of Asymmetric Metal Nanoclusters/g-C3 N4 for Enhanced Microwave Therapy of Pneumonia

Interlayer interactions in two dimensional (2D) materials promote catalytic performance but often depend on the transport of inter rather than intralayer electrons. In this study, it is found that asymmetric metal-nanocluster-doped 2D g-C₃ N₄ greatly enhances catalytic performance by inducing microwave excitation of interlayer electron delocalization, resulting in a polarization of interlaminar charge transport for microwave disinfection and pneumonia therapy. Asymmetric Fe and Cu nanocluster doping (DCN-FeCu) enables g-C₃ N₄ to generate interlayer electrons under microwave irradiation, leading to interlayer polarization processes and electron delocalization effects, thus enhancing the interlayer migration efficiency of electrons. It also improves impurity energy levels and leads to a decrease in work function, allowing DCN-FeCu to produce microwave carriers across the photoelectric potential barrier under low-energy microwave radiation (2.45 GHz). This asymmetric doping modulation produces layer number-dependent microwave electron excitations that are verified using multi-metal doping. Therefore, structurally modulated asymmetric doping of 2D materials with interfacial spatial effects can provide efficient microwave disinfection and pneumonia therapy.

Flexible free-standing antibacterial nanoporous Ag ribbon

The biomedical field has the potential to significantly benefit from the use of flexible free-standing Ag nanostructures due to their outstanding mechanical and antibacterial properties. However, the intricate process of synthesizing these nanostructures, as well as the potential toxicity of nanostructured Ag, pose significant challenges. This study used a facile etching method to synthesize the free-standing nanoporous Ag (NP-Ag) ribbons with a homogeneous and bicontinuous three-dimensional ligament structure. The free-standing NP-Ag ribbons demonstrated stable mechanical performance and excellent flexibility when subjected to various deformation states on artificial fingers. Additionally, the NP-Ag ribbons exhibited remarkable antibacterial capacity with rates of 99.81 ± 0.14% against Escherichia coli, 96.11 ± 1.49% against Staphylococcus aureus, and 95.37 ± 1.24% against methicillin-resistant Staphylococcus aureus. The antibacterial mechanism of NP-Ag is attributed to the rapid release of Ag ions (Ag⁺) in 24 h, causing damage to the bacterial membrane. Moreover, the in vivo results demonstrate that the NP-Ag ribbons provide rapid antibacterial efficacy and are biosafe due to the long-term stable Ag⁺ release of NP-Ag. The development of these free-standing flexible NP-Ag ribbons offers a new avenue for wearable antibacterial applications.

S-Cu-FC/CuS modified GO carboxymethyl cellulose hydrogel for enhanced photocatalytic sterilization through homo-heterojunction interface accelerated charge transfer

Charge transfer and separation play a critical role in the photocatalytic efficiency of photoresponsive materials and their subsequent applications. Herein, for the first time, we constructed a homo-heterostructured S-Cu-FC/CuS modified carboxymethyl cellulose (CMC) hydrogel doped with graphene oxide (GO) (S-Cu-FC/CuS/GO@CMC) through an in situ ionic complexation reaction, which exhibited enhanced photocatalytic performance under 808 nm near-infrared (NIR) light irradiation. On the one hand, photo-excited charges can rapidly transfer across the homo-heterojunction interface with copper atoms in S-Cu-FC/CuS as both donors and acceptors. On the other hand, the interface between GO and S-Cu-FC/CuS also favors the fast transfer of photogenerated charges. Hence, with the assistance of a photothermal effect, the enhanced photocatalytic performance of S-Cu-FC/CuS/GO endowed the hydrogel with robust sterilization ability for killing 99.5% S. aureus and 100.0% E. coli under 10 min NIR light irradiation. An in vivo test disclosed that this hydrogel could also accelerate the healing of bacteria-infected wounds.

Alloying-Triggered Phase Engineering of NiFe System via Laser-Assisted Al Incorporation for Full Water Splitting

It is challenging to design one non-noble material with balanced bifunctional performance for hydrogen evolution reaction (HER) and oxygen evolution reaction (OER) for commercial sustainability at a low cost since the different electrocatalytic mechanisms are not easily matchable for each other. Herein, a self-standing hybrid system Ni₁₈ Fe₁₂ Al₇₀ , consisting of Ni₂ Al₃ and Ni₃ Fe phases, was constructed by laser-assisted aluminum (Al) incorporation towards full water splitting. It was found that the incorporation of Al could effectively tune the morphologies, compositions and phases. The results indicate that Ni₁₈ Fe₁₂ Al₇₀ delivers an extremely low overpotential to trigger both HER (η₁₀₀ =188 mV) and OER (η₁₀₀ =345 mV) processes and maintains a stable overpotential for 100 h, comparable to state-of-the-art electrocatalysts. The synergistic effect of Ni₂ Al₃ and Ni₃ Fe alloys on the HER process is confirmed based on theoretical calculation.

Effect of Collagen-Reactive Functional Monomer on Etch-and-Rinse Adhesives

In this study, we evaluated a novel functional monomer (4-formylphenyl acrylate [FA]) that can specifically and covalently bind to the dentin collagen matrix as a potential alternative hydrophobic diluent-like monomer for improving the durability of dentin bonding. Experimental adhesives with different FA contents (0%, 10%, 20%, and 30%) were evaluated as partial substituents for the hydrophilic monomer 2-hydroxyethyl methacrylate, with the commercial adhesive One-Step (Bisco, Inc.) employed as the positive control. Their degree of conversion, viscosity, hydrophobicity, mechanical properties, and water absorption/solubility were measured as the comprehensive characterization. In situ zymographic assays were performed to determine the extent to which FA inhibits the endogenous hydrolytic activity of dentin. Finally, the bonding performances of the novel adhesives were evaluated with microtensile strength tests and scanning electron microscopy. The results showed that the incorporation of FA significantly improved the mobility of experimental adhesives attributable to the dilution property of FA. In contrast to the possible compromised rate of polymerization by hydroxyethyl methacrylate, FA exhibited typical characteristics of favorable copolymerization with polymerizable monomers in adhesives and improved the degree of conversion of experimental adhesives. The rigidity and hydrophobic properties of the phenyl framework of the FA molecule conferred superior mechanical properties and hydrolysis resistance to the novel experimental adhesives. An inhibitory effect on gelatinolytic activities within the hybrid layer was also observed in the in situ zymographic assays, even at a low FA concentration (10%). In conjunction with the significantly improved infiltration found via scanning electron microscopy, the experimental adhesives containing FA possessed significantly better-maintained microtensile strength, even after aging. Thus, the incorporation of this novel monomer endowed the experimental adhesives with multiple enhanced functionalities. These remarkable advantages highlight the suitability of the monomer for further applications in clinical practice.

Achieving Fast Charge Separation by Ferroelectric Ultrasonic Interfacial Engineering for Rapid Sonotherapy of Bacteria-Infected Osteomyelitis

Bacteria-infected osteomyelitis is life-threatening without effective therapeutic methods clinically. Here, a rapid and effective therapeutic strategy to treat osteomyelitis through ferroelectric polarization interfacial engineering of BiFeO₃ /MXene (Ti₃ C₂ ) triggered by ultrasound (US) is reported. Under US, the ferroelectric polarization induces the formation of the piezoelectric field. US cavitation effect induced sonoluminescence stimulates BiFeO₃ /Ti₃ C₂ to produce photogenerated carriers. With synergistic action of the polarization electric field and Schottky junction, BiFeO₃ /Ti₃ C₂ accelerates the separation of electrons and holes and simultaneously inhibits the backflow of electrons, thus improving the utilization of polarized charges and photogenerated charges and consequently enhancing the yield of reactive oxygen species under US. As a result, 99.87 ± 0.05% of Staphylococcus aureus are efficiently killed in 20 min with the assistance of ultrasonic heating. The theory of ferroelectric ultrasonic interfacial engineering is proposed, which brings new insight for developing ferroelectric ultrasonic responsive materials used for the diagnosis and therapy of deep tissue infection and other acoustoelectric devices.

Inflammation and Microbiota Regulation Potentiates Pneumonia Therapy by Biomimetic Bacteria and Macrophage Membrane Nanosystem

While conventional nanosystems can target infected lung tissue, they cannot achieve precise cellular targeting and enhanced therapy by modulating inflammation and microbiota for effective therapy. Here, we designed a nucleus-targeted nanosystem with adenosine triphosphate (ATP) and reactive oxygen species stimuli-response to treat pneumonia coinfected with bacteria and virus that is enhanced through inflammation and microbiota regulation. The nucleus-targeted biomimetic nanosystem was prepared through the combined bacteria-macrophage membrane and loaded hypericin and ATP-responsive dibenzyl oxalate (MMHP) subsequently. The MMHP despoiled the Mg²⁺ of intracellular cytoplasm in bacteria to achieve an effective bactericidal performance. Meanwhile, MMHP can target the cell nucleus and inhibit the H1N1 virus duplication by inhibiting the activity of nucleoprotein. MMHP possessed an immunomodulatory ability to reduce the inflammatory response and activate CD8⁺ T cells for assisted infection elimination. During the mice model, the MMHP effectively treated pneumonia coinfected with Staphylococcus aureus and H1N1 virus. Meanwhile, MMHP mediated the composition of gut microbiota to enhance the pneumonia therapy. Therefore, the dual stimuli-responsive MMHP possessed promising clinical translational potential to therapy infectious pneumonia.

Nb-Doped TiO2 with Outstanding Na/Mg-Ion Battery Performance

The group "beyond Li-ion" batteries (Na/Mg-ion batteries) have the advantages of abundant reserves and high theoretical specific capacity. However, the sluggish kinetics resulting from large ion radius (Na⁺) and polarity (Mg²⁺) seriously limit the battery performance. Herein, we prepared Nb-doped anatase TiO₂ with Ti vacancies (Nb-TiO₂) through a simple solvothermal and subsequent calcination process. The Nb doping widens the channels for metal ion diffusion, and the cationic vacancies can act as ion storage sites and improve the electrode conductivity. Thus, Nb-TiO₂ exhibits improved performance for rechargeable Na/Mg-ion batteries.

Modification and evaluation of diatrizoate sodium containing polymethyl methacrylate bone cement

Polymethyl methacrylate (PMMA) bone cement is now widely used in percutaneous vertebro plasty (PVP) and percutaneous kyphoplasty (PKP). However, studies showed that the radiopacifiers (zirconia, barium sulfate, etc.) added to PMMA will have a negative impact on its use, e.g. barium sulfate will weaken the mechanical properties of bone cement and lead to bone absorption and aseptic loosening. Iodine is an element existing in the human body and has good imaging performance. Iodine contrast agent has been used in clinic for many years and has abundant clinical data. Therefore, using iodine instead of barium sulfate may be a promising choice. In this paper, the effect of different content of diatrizoate sodium (DTA, C₁₁H₈I₃N₂NaO₄) on the properties of PMMA was studied and compared with the traditional PMMA bone cement containing 30 wt% barium sulfate. The mechanical properties, setting properties, radiopacity, and biocompatibility of bone cement were evaluated. The compressive strength of PMMA bone cement with 20 wt% DTA can reach 76.38 MPa. DTA released from bone cement up to 14 days accounted for only 2.3% of its dosage. The water contact angle was 62.3°. The contrast of bone cement on X-ray film was comparable to that of bone cement containing 30 wt% barium. The hemolysis rate was lower than 4%, and there was no obvious hemolysis. PMMA with 20 wt% DTA can maintain the relative growth rate of MC3T3-E1 and L929 cells above 80%. The results show that adding 20 wt% DTA into PMMA can obtain good radiopacity while maintaining its mechanical properties, setting properties, and biocompatibility. DTA can be used as a promising candidate material for PMMA bone cement radiopacifier.

Self-Driven Electron Transfer Biomimetic Enzymatic Catalysis of Bismuth-Doped PCN-222 MOF for Rapid Therapy of Bacteria-Infected Wounds

In this work, a biomimetic nanozyme catalyst with rapid and efficient self-bacteria-killing and wound-healing performances was synthesized. Through an in situ reduction reaction, a PCN-222 metal organic framework (MOF) was doped with bismuth nanoparticles (Bi NPs) to form Bi-PCN-222, an interfacial Schottky heterojunction biomimetic nanozyme catalyst, which can kill 99.9% of Staphylococcus aureus (S. aureus). The underlying mechanism was that Bi NP doping can endow Bi-PCN-222 MOF with self-driven charge transfer through the Schottky interface and the capability of oxidase-like and peroxidase-like activity, because a large number of free electrons can be captured by surrounding oxygen species to produce radical oxygen species (ROS). Furthermore, once bacteria contact Bi-PCN-222 in a physiological environment, its appropriate redox potential can trigger electron transfer through the electron transport pathway in bacterial membranes and then the interior of the bacteria, which disturbs the bacterial respiration process and subsequent metabolism. Additionally, Bi-PCN-222 can also accelerate tissue regeneration by upregulating fibroblast proliferation and angiogenesis genes (bFGF, VEGF, and HIF-1α), thereby promoting wound healing. This biomimetic enzyme-catalyzed strategy will bring enlightenment to the design of self-bacterial agents for efficient disinfection and tissue reconstruction simultaneously.

Association of Dental Caries with Muscle Mass, Muscle Strength, and Sarcopenia: A Community-Based Study

OBJECTIVES

Changes in the oral cavity can reflect other changes throughout the body. This study aimed to investigate the association of dental caries with muscle mass, muscle strength, and sarcopenia, and also to describe the microbial diversity, composition, and community structure of severe dental caries and sarcopenia.

DESIGN

Cross-sectional study based on a Chinese population aged from 50 to 85 years.

SETTING

Communities from Lanxi City, Zhejiang Province, China.

PARTICIPANTS

A total of 1,442 participants aged from 50 to 85 years from a general community (62.8% women; median age 61.0 [interquartile range: 55.0, 68.0]).

MEASUREMENTS

Dental caries was assessed by the decayed, missing, and filled teeth (DMFT) index. Sarcopenia was defined as the presence of both low muscle mass (assessed by dual-energy X-ray absorptiometry scanning) and low muscle strength (assessed by handgrip strength). Multivariate logistic regression models were used to analyze the association of dental caries with muscle mass, muscle strength, and sarcopenia. Fecal samples underwent 16S rRNA profiling to evaluate the diversity and composition of the gut microbiota in patients with severe dental caries and/or sarcopenia.

RESULTS

In the fully adjusted logistic models, dental caries was positively associated with low muscle strength (DMFT ≥ 7: OR, 1.61; 95% CI, 1.25-2.06), and sarcopenia (DMFT ≥ 7: OR, 1.51; 95% CI, 1.01-2.26), but not low muscle mass. Severe dental caries was positively associated with higher alpha-diversity indices (richness, chao1, and ACE, all p < 0.05) and associated with beta-diversity based on Bray-Curtis distance (p = 0.006). The severe dental caries group and the sarcopenia group overlapped with 11 depleted and 13 enriched genera.

CONCLUSION

Dental caries was positively associated with low muscle strength and sarcopenia but not muscle mass, and this association was more pronounced in male individuals. Significant differences were observed in gut microbiota composition both in severe dental caries and sarcopenia, and there was an overlap of the genera features. Future longitudinal studies are needed to clarify causal relationships.

Rapid Ferroelectric-Photoexcited Bacteria-Killing of Bi4Ti3O12/Ti3C2T x Nanofiber Membranes

In this study, an antibacterial nanofiber membrane [polyvinylidene fluoride/Bi₄Ti₃O₁₂/Ti₃C₂T _x (PVDF/BTO/Ti₃C₂T _x )] is fabricated using an electrostatic spinning process, in which the self-assembled BTO/Ti₃C₂T _x heterojunction is incorporated into the PVDF matrix. Benefiting from the internal electric field induced by the spontaneously ferroelectric polarization of BTO, the photoexcited electrons and holes are driven to move in the opposite direction inside BTO, and the electrons are transferred to Ti₃C₂T _x across the Schottky interface. Thus, directed charge separation and transfer are realized through the cooperation of the two components. The recombination of electron-hole pairs is maximumly inhibited, which notably improves the yield of reactive oxygen species by enhancing photocatalytic activity. Furthermore, the nanofiber membrane with an optimal doping ratio exhibits outstanding visible light absorption and photothermal conversion performance. Ultimately, photothermal effect and ferroelectric polarization enhanced photocatalysis endow the nanofiber membrane with the ability to kill 99.61% ± 0.28% Staphylococcus aureus and 99.71% ± 0.16% Escherichia coli under 20 min of light irradiation. This study brings new insights into the design of intelligent antibacterial textiles through a ferroelectric polarization strategy.

SUPPLEMENTARY INFORMATION

The online version contains supplementary material available at 10.1007/s42765-022-00234-8.

Interfacial Mo, W-Conjugated Polarization, and Oxygen Vacancies of MoO2/WO3 in Enhanced Microwave Therapy for MRSA-Induced Osteomyelitis

Deep tissue infection, such as osteomyelitis, caused by methicillin-resistant Staphylococcus aureus (MRSA) infection, poses a serious threat to public health and cannot be effectively treated by antibiotics. In this study, we report a microwave (MW)-responsive MoO₂/WO₃ heterojunction that can be utilized to effectively treat MRSA-infected osteomyelitis under MW irradiation because of the enhanced MW thermal effect and MW catalysis of the composite. The underlying mechanism is as follows: A myriad of oxygen vacancies forms on the surface of MoO₂ and WO₃ by deoxidization effect with hydrogen from the decomposition of sodium borohydride, which induces a mass of free electrons on the surface of the composite and consequently promotes a localized surface plasmon resonance effect (LSPR) under MW irradiation. Furthermore, the conjugation of Mo and W at the interface enhances the LSPR effect. Thus, the LSPR effect not only induces the formation of radical oxygen species, thereby enhancing MW catalysis, but also results in the formation of an interfacial electrical field, which strengthens dipole polarization through synergistic action with oxygen vacancies and contributes to better MW thermal effects. The characteristics of MoO₂/WO₃ prove to be promising for the treatment of deep-tissue infections under MW irradiation.

[Efficacy of dienogest versus gonadotropin-releasing hormone agonist combined with dienogest sequential therapy in the treatment of adenomyosis]

Objective: To investigate the efficacy and safety of dienogest (DNG) alone and gonadotropin-releasing hormone agonist (GnRH-a) combined with DNG sequential treatment to adenomyosis. Methods: The clinical data of 110 patients with adenomyosis attending the First Affiliated Hospital of Nanjing Medical University from December 2019 to March 2022 were retrospectively analyzed, including 40 patients treated with DNG (2 mg/day) alone (DNG group) and 70 patients treated with sequential DNG (2 mg/day) after 3-6 injections of GnRH-a (GnRH-a+DNG group). The clinical data before and after treatment were compared between the two groups. Results: (1) The dysmenorrhea visual analogue scale (VAS) scores, cancer antigen 125 (CA₁₂₅) and cancer antigen 19-9 (CA_19-9) levels at different time periods after treatment were significantly lower than before treatment in both groups (median before treatment: DNG group 70.0 mm, 68.55 kU/L, 22.45 kU/L respectively, GnRH-a+DNG group 80.0 mm, 151.50 kU/L, 20.44 kU/L respectively; all P<0.001). (2) The hemoglobin (Hb) levels of patients in both groups at different time periods after treatment were significantly higher than those before treatment (median: DNG group 102.00 g/L, GnRH-a+DNG group 94.00 g/L; all P<0.001). (3) Treatment with DNG alone did not have a significant effect on uterine volume in patients of DNG group (P>0.05), and uterine volume decreased significantly in the 15th-24th months of GnRH-a+DNG group compared with that before treatment (median: 167.76 vs 227.77 cm³; P<0.05). (4) There were no significant differences in hepatic and renal function and coagulation indexes between the two groups before and after treatment (all P>0.05), and no significant abnormal lesions were observed in breast tissue during the follow-up period. (5) The incidence of amenorrhea of GnRH-a+DNG group was higher than that of DNG group, and the incidences of irregular spotting bleeding and breakthrough hemorrhage were lower than those in DNG group. Conclusions: Whether DNG is used alone or in combination with GnRH-a in sequence, it could significantly relieve dysmenorrhea symptoms, improve the level of Hb, reduce the levels of CA₁₂₅ and CA_19-9 in patients with adenomyosis, with no adverse effects on coagulation and hepatic or renal function. GnRH-a sequential DNG therapy is superior to DNG alone in improving uterine bleeding patterns and controlling the growth of uterine volume in patients with adenomyosis.

Plastic bending in a semiconducting coordination polymer crystal enabled by delamination

Coordination polymers (CPs) are a class of crystalline solids that are considered brittle, due to the dominance of directional coordination bonding, which limits their utility in flexible electronics and wearable devices. Hence, engineering plasticity into functional CPs is of great importance. Here, we report plastic bending of a semiconducting CP crystal, Cu-Trz (Trz = 1,2,3-triazolate), that originates from delamination facilitated by the discrete bonding interactions along different crystallographic directions in the lattice. The coexistence of strong coordination bonds and weak supramolecular interactions, together with the unique molecular packing, are the structural features that enable the mechanical flexibility and anisotropic response. The spatially resolved analysis of short-range molecular forces reveals that the strong coordination bonds, and the adaptive C–H···π and Cu···Cu interactions, synergistically lead to the delamination of the local structures and consequently the associated mechanical bending. The proposed delamination mechanism offers a versatile tool for designing the plasticity of CPs and other molecular crystals.