Continuous Tunable Energy Band Tailoring Boosts Extending the Sensing of the Waveband Based on (InxGa1-x)2O3 Solar-Blind Photodetectors

Rising wide bandgap semiconductor gallium oxide (Ga2O3) displays huge potential in performing solar-blind photodetection, with constraint in narrow detection wavebands in nature, whereas bandgap modulation through the introduction of exotic atoms into Ga2O3 has an essential effect on the tunable performance of photodetectors and the detection waveband. Here, a novel method for the preparation of (InxGa1-x)2O3 alloy films is proposed, and the continuous tuning of the bandgap in the range of 3.70-4.99 eV is achieved by varying the In-doping content. Alloy-based metal-semiconductor-metal photodetectors were fabricated, achieving a peak responsivity between 254 and 295 nm, superior performance compared to Ga2O3 photodetectors, with a photo-to-dark current ratio as high as 106, and a better optical image-sensing capability. This study offers new insight for high-performance detection of full solar-blind waveband ultraviolet light.

Classification of breast edema on T2-weighted imaging for predicting sentinel lymph node metastasis and biological behavior in breast cancer

OBJECTIVE

To determine whether preoperative classification of breast edema on T2-weighted imaging (T2WI) is useful for predicting sentinel lymph node (SLN) metastasis and biological behavior in patients with early-stage breast cancer.

METHODS

This retrospective study involved 341 women with breast cancer who underwent breast MRI from January 2019 to March 2022. Breast edema was scored on a scale of 1-4 on T2WI (1, no edema; 2, peritumoral edema; 3, prepectoral edema; and 4, subcutaneous edema). A logistic regression model was employed for univariate and multivariate analyses. A clinicopathological model was established using independent influencing factors identified in the multivariate analyses, excluding breast edema score (BES). Subsequently, BES was incorporated into this model to establish a combined BES model. The AUC and Delong test were used to examine the additional predictive value of the BES.

RESULTS

Logistic regression analysis showed that breast edema was an independent risk factor for SLN metastasis. The combined BES model significantly improved the predictive performance of SLN metastasis compared with the clinicopathological model alone (AUC, 0.77 vs. 0.71; p=0.005). In addition, the BES was significantly positively correlated with the tumor diameter (p<0.001), histologic grade (p=0.001), Ki-67 index (p<0.001), and non-luminal subtypes (p<0.001).

CONCLUSION

The BES on T2WI is useful for predicting SLN metastasis. A higher grade of breast edema is associated with breast cancer aggressiveness and increases the probability of SLN metastasis.

First Measurement of η Meson Production in Neutrino Interactions on Argon with MicroBooNE

We present a measurement of η production from neutrino interactions on argon with the MicroBooNE detector. The modeling of resonant neutrino interactions on argon is a critical aspect of the neutrino oscillation physics program being carried out by the DUNE and Short Baseline Neutrino programs. η production in neutrino interactions provides a powerful new probe of resonant interactions, complementary to pion channels, and is particularly suited to the study of higher-order resonances beyond the Δ(1232). We measure a flux-integrated cross section for neutrino-induced η production on argon of 3.22±0.84(stat)±0.86(syst) 10^{-41}  cm^{2}/nucleon. By demonstrating the successful reconstruction of the two photons resulting from η production, this analysis enables a novel calibration technique for electromagnetic showers in GeV accelerator neutrino experiments.

Conjugated Phosphonic Acids Enable Robust Hole Transport Layers for Efficient and Intrinsically Stable Perovskite Solar Cells

High efficiency and long-term stability are the prerequisites for the commercialization of perovskite solar cells (PSCs). However, inadequate and non-uniform doping of hole transport layers (HTLs) still limits the efficiency improvements, while the intrinsic instability of HTLs caused by ion migration and accumulation is difficult to be addressed by external encapsulation. Here it is shown that the addition of a conjugated phosphonic acid (CPA) to the Spiro-OMeTAD benchmark HTL can greatly enhance the device efficiency and intrinsic stability. Featuring an optimal diprotic-acid structure, indolo(3,2-b)carbazole-5,11-diylbis(butane-4,1-diyl) bis(phosphonic acid) (BCZ) is developed to promote morphological uniformity and mitigate ion migration across both perovskite/HTL and HTL/Ag interfaces, leading to superior charge conductivity, reinforced ion immobilization, and remarkable film stability. The dramatically improved interfacial charge collection endows BCZ-based n-i-p PSCs with a champion power conversion efficiency of 24.51%. More encouragingly, the BCZ-based devices demonstrate remarkable stability under harsh environmental conditions by retaining 90% of initial efficiency after 3000 h in air storage. This work paves the way for further developing robust organic HTLs for optoelectronic devices.

[The accuracy and feasibility study of freehand pedicle screw insertion for subaxial cervical spine assisted with safe core-referred technique]

Objectives: To construct the "safe core" of the pedicle screw trajectory using CT imaging data of the subaxial cervical spine in adults, and to assess the accuracy and feasibility of the pedicle screw insertion assisted with the "safe core-referred technique" for subaxial cervical spine with a cadaver specimen study. Methods: This is an experimental study. From January 2015 to March 2020,60 adults' CT images data of the cervical spine were collected from the database of the First Affiliated Hospital of Gannan Medical University,and were imported into Mimics 20.0 software. Virtual cervical pedicle trajectory and safe core were constructed according to the self-designed "virtual construction method of pedicle in the subaxial cervical spine". The success rate of the construction and the spatial position data of the virtual safe core of was recorded,including the distance between the safe core and the tangent line of the upper and lower outer edge of Luschka's joint on coronal plane,and the distance between the safe core and the posterior edge of the vertebral body on sagittal plane.The 3.5 mm column was used to simulate the pedicle screw placement,using the safe core as the only hub in pedicle screw trajectory.The length of the anterior pedicle screw trajectory,the interval of the abductive angle of the pedicle screw in axial plane, and the projection area of the entry area on periapical radiograph was calculated.In addition,8 adult cervical cadaver specimens were collected for the pedicle screw insertion experiment.The left side group used the "safe core-referred technique" for pedicle screw insertion,while the right side group used the Abumi method for pedicle screw insertion.The accuracy of pedicle screw placement was verified by CT scan.The difference between the accuracy of subjective judgment based on X-ray monitoring of operator and the actual accuracy of pedicle screw insertion verified by CT scan was compared between the two groups.The chi-square test was used to compare the intergroup data. Results: The total success rate of the virtual construction method for the safe core of the subaxial cervical spine was 97.0% (291/300); The distance between the safe core and the tangent line of the upper and lower outer edge of Luschka's joint on coronal plane was (M(IQR)) 0.91 (0.98) mm (range: 0 to 1.85 mm);The distance between the safe core and the posterior wall on the sagittal plane of the vertebral body was (2.01±0.86) mm (range: 0.67 to 3.53 mm). The distance (anterior pedicle screw trajectory) from the posterior cortex to the central point of the safe core was (11.58±1.00)mm (range: 8.27 to 14.93 mm).The projection area of the entry point on the coronal plane was (36.18±11.67) mm2 (range: 13.38 to 83.11 mm2). Pedicle screw insertion experiment in cervical cadaver specimen showed the rate of intraoperative correction of the pedicle screw trajectory was 7.5% (3/40) in the experimental group and 12.5% (5/40) in the control group (χ2=0.139,P=0.709). The operator 's correct rate of subjective judgment on CT in the stage of pedicle screw trajectory preparation was 100% (40/40) in the experimental group and 82.5% (33/40) in the control group, the difference was statistically significant (χ2=5.638,P=0.018). The actual correct rate of CT verification in the stage of pedicle screw insertion was 100% (40/40) in the experimental group and 90.0% (36/40) in the control group, the difference was statistically significant (χ2=2.368,P=0.124); The operator 's correct rate of subjective judgment in the stage of pedicle screw insertion completion was 100% (83/83) in the experimental group and 92.9% (79/85) in the control group (χ2=4.199,P=0.040). Conclusions: The virtual safe-core of subaxial cervical spine can be use as a reliable anatomical fluoroscopy landmark for freehand pedicle screw insertion."Safe core-referred technique" can improve the accuracy rate of the operator's subjective judgment on the intraoperative fluoroscopy monitoring,and hence improve the accuracy of freehand pedicle screw insertion technology for subaxial cervical spine. And it still needs to be further verified in clinical practice.

Search for Heavy Neutral Leptons in Electron-Positron and Neutral-Pion Final States with the MicroBooNE Detector

We present the first search for heavy neutral leptons (HNLs) decaying into νe^{+}e^{-} or νπ^{0} final states in a liquid-argon time projection chamber using data collected with the MicroBooNE detector. The data were recorded synchronously with the NuMI neutrino beam from Fermilab's main injector corresponding to a total exposure of 7.01×10^{20} protons on target. We set upper limits at the 90% confidence level on the mixing parameter |U_{μ4}|^{2} in the mass ranges 10≤m_{HNL}≤150  MeV for the νe^{+}e^{-} channel and 150≤m_{HNL}≤245  MeV for the νπ^{0} channel, assuming |U_{e4}|^{2}=|U_{τ4}|^{2}=0. These limits represent the most stringent constraints in the mass range 35 Collapse

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Affiliation(s)

P Abratenko Tufts University, Medford, Massachusetts 02155, USA
O Alterkait Tufts University, Medford, Massachusetts 02155, USA
D Andrade Aldana Illinois Institute of Technology (IIT), Chicago, Illinois 60616, USA
L Arellano The University of Manchester, Manchester M13 9PL, United Kingdom
J Asaadi University of Texas, Arlington, Texas 76019, USA
A Ashkenazi Tel Aviv University, Tel Aviv, Israel, 69978
S Balasubramanian Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
B Baller Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
G Barr University of Oxford, Oxford OX1 3RH, United Kingdom
D Barrow University of Oxford, Oxford OX1 3RH, United Kingdom
J Barrow Massachusetts Institute of Technology (MIT), Cambridge, Massachusetts 02139, USA Tel Aviv University, Tel Aviv, Israel, 69978
V Basque Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
O Benevides Rodrigues Illinois Institute of Technology (IIT), Chicago, Illinois 60616, USA
S Berkman Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA Michigan State University, East Lansing, Michigan 48824, USA
A Bhanderi The University of Manchester, Manchester M13 9PL, United Kingdom
A Bhat University of Chicago, Chicago, Illinois 60637, USA
M Bhattacharya Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
M Bishai Brookhaven National Laboratory (BNL), Upton, New York 11973, USA
A Blake Lancaster University, Lancaster LA1 4YW, United Kingdom
B Bogart University of Michigan, Ann Arbor, Michigan 48109, USA
T Bolton Kansas State University (KSU), Manhattan, Kansas 66506, USA
J Y Book Harvard University, Cambridge, Massachusetts 02138, USA
M B Brunetti University of Warwick, Coventry CV4 7AL, United Kingdom
L Camilleri Columbia University, New York, New York 10027, USA
Y Cao The University of Manchester, Manchester M13 9PL, United Kingdom
D Caratelli University of California, Santa Barbara, California 93106, USA
F Cavanna Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
G Cerati Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
A Chappell University of Warwick, Coventry CV4 7AL, United Kingdom
Y Chen SLAC National Accelerator Laboratory, Menlo Park, California 94025, USA
J M Conrad Massachusetts Institute of Technology (MIT), Cambridge, Massachusetts 02139, USA
M Convery SLAC National Accelerator Laboratory, Menlo Park, California 94025, USA
L Cooper-Troendle University of Pittsburgh, Pittsburgh, Pennsylvania 15260, USA
J I Crespo-Anadón Centro de Investigaciones Energéticas, Medioambientales y Tecnológicas (CIEMAT), Madrid E-28040, Spain
R Cross University of Warwick, Coventry CV4 7AL, United Kingdom
M Del Tutto Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
S R Dennis University of Cambridge, Cambridge CB3 0HE, United Kingdom
P Detje University of Cambridge, Cambridge CB3 0HE, United Kingdom
A Devitt Lancaster University, Lancaster LA1 4YW, United Kingdom
R Diurba Universität Bern, Bern CH-3012, Switzerland
Z Djurcic Argonne National Laboratory (ANL), Lemont, Illinois 60439, USA
R Dorrill Illinois Institute of Technology (IIT), Chicago, Illinois 60616, USA
K Duffy University of Oxford, Oxford OX1 3RH, United Kingdom
S Dytman University of Pittsburgh, Pittsburgh, Pennsylvania 15260, USA
B Eberly University of Southern Maine, Portland, Maine 04104, USA
P Englezos Rutgers University, Piscataway, New Jersey 08854, USA
A Ereditato University of Chicago, Chicago, Illinois 60637, USA Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
J J Evans The University of Manchester, Manchester M13 9PL, United Kingdom
R Fine Los Alamos National Laboratory (LANL), Los Alamos, New Mexico 87545, USA
O G Finnerud The University of Manchester, Manchester M13 9PL, United Kingdom
W Foreman Illinois Institute of Technology (IIT), Chicago, Illinois 60616, USA
B T Fleming University of Chicago, Chicago, Illinois 60637, USA
D Franco University of Chicago, Chicago, Illinois 60637, USA
A P Furmanski University of Minnesota, Minneapolis, Minnesota 55455, USA
F Gao University of California, Santa Barbara, California 93106, USA
D Garcia-Gamez Universidad de Granada, Granada E-18071, Spain
S Gardiner Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
G Ge Columbia University, New York, New York 10027, USA
S Gollapinni Los Alamos National Laboratory (LANL), Los Alamos, New Mexico 87545, USA
E Gramellini The University of Manchester, Manchester M13 9PL, United Kingdom
P Green University of Oxford, Oxford OX1 3RH, United Kingdom
H Greenlee Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
L Gu Lancaster University, Lancaster LA1 4YW, United Kingdom
W Gu Brookhaven National Laboratory (BNL), Upton, New York 11973, USA
R Guenette The University of Manchester, Manchester M13 9PL, United Kingdom
P Guzowski The University of Manchester, Manchester M13 9PL, United Kingdom
L Hagaman University of Chicago, Chicago, Illinois 60637, USA
O Hen Massachusetts Institute of Technology (MIT), Cambridge, Massachusetts 02139, USA
C Hilgenberg University of Minnesota, Minneapolis, Minnesota 55455, USA
G A Horton-Smith Kansas State University (KSU), Manhattan, Kansas 66506, USA
Z Imani Tufts University, Medford, Massachusetts 02155, USA
B Irwin University of Minnesota, Minneapolis, Minnesota 55455, USA
M Ismail University of Pittsburgh, Pittsburgh, Pennsylvania 15260, USA
C James Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
X Ji Nankai University, Nankai District, Tianjin 300071, China
J H Jo Brookhaven National Laboratory (BNL), Upton, New York 11973, USA
R A Johnson University of Cincinnati, Cincinnati, Ohio 45221, USA
Y-J Jwa Columbia University, New York, New York 10027, USA
D Kalra Columbia University, New York, New York 10027, USA
N Kamp Massachusetts Institute of Technology (MIT), Cambridge, Massachusetts 02139, USA
G Karagiorgi Columbia University, New York, New York 10027, USA
W Ketchum Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
M Kirby Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
T Kobilarcik Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
I Kreslo Universität Bern, Bern CH-3012, Switzerland
M B Leibovitch University of California, Santa Barbara, California 93106, USA
I Lepetic Rutgers University, Piscataway, New Jersey 08854, USA
J-Y Li University of Edinburgh, Edinburgh EH9 3FD, United Kingdom
K Li Wright Laboratory, Department of Physics, Yale University, New Haven, Connecticut 06520, USA
Y Li Brookhaven National Laboratory (BNL), Upton, New York 11973, USA
K Lin Rutgers University, Piscataway, New Jersey 08854, USA
B R Littlejohn Illinois Institute of Technology (IIT), Chicago, Illinois 60616, USA
H Liu Brookhaven National Laboratory (BNL), Upton, New York 11973, USA
W C Louis Los Alamos National Laboratory (LANL), Los Alamos, New Mexico 87545, USA
X Luo University of California, Santa Barbara, California 93106, USA
C Mariani Center for Neutrino Physics, Virginia Tech, Blacksburg, Viriginia 24061, USA
D Marsden The University of Manchester, Manchester M13 9PL, United Kingdom
J Marshall University of Warwick, Coventry CV4 7AL, United Kingdom
N Martinez Kansas State University (KSU), Manhattan, Kansas 66506, USA
D A Martinez Caicedo South Dakota School of Mines and Technology (SDSMT), Rapid City, South Dakota 57701, USA
S Martynenko Brookhaven National Laboratory (BNL), Upton, New York 11973, USA
A Mastbaum Rutgers University, Piscataway, New Jersey 08854, USA
I Mawby University of Warwick, Coventry CV4 7AL, United Kingdom
N McConkey University College London, London WC1E 6BT, United Kingdom
V Meddage Kansas State University (KSU), Manhattan, Kansas 66506, USA
J Micallef Massachusetts Institute of Technology (MIT), Cambridge, Massachusetts 02139, USA Tufts University, Medford, Massachusetts 02155, USA
K Miller University of Chicago, Chicago, Illinois 60637, USA
A Mogan Colorado State University, Fort Collins, Colorado 80523, USA
T Mohayai Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA Indiana University, Bloomington, Indiana 47405, USA
M Mooney Colorado State University, Fort Collins, Colorado 80523, USA
A F Moor University of Cambridge, Cambridge CB3 0HE, United Kingdom
C D Moore Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
L Mora Lepin The University of Manchester, Manchester M13 9PL, United Kingdom
M M Moudgalya The University of Manchester, Manchester M13 9PL, United Kingdom
S Mulleriababu Universität Bern, Bern CH-3012, Switzerland
D Naples University of Pittsburgh, Pittsburgh, Pennsylvania 15260, USA
A Navrer-Agasson The University of Manchester, Manchester M13 9PL, United Kingdom
N Nayak Brookhaven National Laboratory (BNL), Upton, New York 11973, USA
M Nebot-Guinot University of Edinburgh, Edinburgh EH9 3FD, United Kingdom
J Nowak Lancaster University, Lancaster LA1 4YW, United Kingdom
N Oza Columbia University, New York, New York 10027, USA
O Palamara Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
N Pallat University of Minnesota, Minneapolis, Minnesota 55455, USA
V Paolone University of Pittsburgh, Pittsburgh, Pennsylvania 15260, USA
A Papadopoulou Argonne National Laboratory (ANL), Lemont, Illinois 60439, USA
V Papavassiliou New Mexico State University (NMSU), Las Cruces, New Mexico 88003, USA
H B Parkinson University of Edinburgh, Edinburgh EH9 3FD, United Kingdom
S F Pate New Mexico State University (NMSU), Las Cruces, New Mexico 88003, USA
N Patel Lancaster University, Lancaster LA1 4YW, United Kingdom
Z Pavlovic Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
E Piasetzky Tel Aviv University, Tel Aviv, Israel, 69978
I Pophale Lancaster University, Lancaster LA1 4YW, United Kingdom
X Qian Brookhaven National Laboratory (BNL), Upton, New York 11973, USA
J L Raaf Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
V Radeka Brookhaven National Laboratory (BNL), Upton, New York 11973, USA
A Rafique Argonne National Laboratory (ANL), Lemont, Illinois 60439, USA
M Reggiani-Guzzo University of Edinburgh, Edinburgh EH9 3FD, United Kingdom The University of Manchester, Manchester M13 9PL, United Kingdom
L Ren New Mexico State University (NMSU), Las Cruces, New Mexico 88003, USA
L Rochester SLAC National Accelerator Laboratory, Menlo Park, California 94025, USA
J Rodriguez Rondon South Dakota School of Mines and Technology (SDSMT), Rapid City, South Dakota 57701, USA
M Rosenberg Tufts University, Medford, Massachusetts 02155, USA
M Ross-Lonergan Los Alamos National Laboratory (LANL), Los Alamos, New Mexico 87545, USA
C Rudolf von Rohr Universität Bern, Bern CH-3012, Switzerland
I Safa Columbia University, New York, New York 10027, USA
G Scanavini Wright Laboratory, Department of Physics, Yale University, New Haven, Connecticut 06520, USA
D W Schmitz University of Chicago, Chicago, Illinois 60637, USA
A Schukraft Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
W Seligman Columbia University, New York, New York 10027, USA
M H Shaevitz Columbia University, New York, New York 10027, USA
R Sharankova Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
J Shi University of Cambridge, Cambridge CB3 0HE, United Kingdom
E L Snider Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
M Soderberg Syracuse University, Syracuse, New York 13244, USA
S Söldner-Rembold The University of Manchester, Manchester M13 9PL, United Kingdom
J Spitz University of Michigan, Ann Arbor, Michigan 48109, USA
M Stancari Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
J St John Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
T Strauss Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
A M Szelc University of Edinburgh, Edinburgh EH9 3FD, United Kingdom
W Tang University of Tennessee, Knoxville, Tennessee 37996, USA
N Taniuchi University of Cambridge, Cambridge CB3 0HE, United Kingdom
K Terao SLAC National Accelerator Laboratory, Menlo Park, California 94025, USA
C Thorpe Lancaster University, Lancaster LA1 4YW, United Kingdom The University of Manchester, Manchester M13 9PL, United Kingdom
D Torbunov Brookhaven National Laboratory (BNL), Upton, New York 11973, USA
D Totani University of California, Santa Barbara, California 93106, USA
M Toups Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
Y-T Tsai SLAC National Accelerator Laboratory, Menlo Park, California 94025, USA
J Tyler Kansas State University (KSU), Manhattan, Kansas 66506, USA
M A Uchida University of Cambridge, Cambridge CB3 0HE, United Kingdom
T Usher SLAC National Accelerator Laboratory, Menlo Park, California 94025, USA
B Viren Brookhaven National Laboratory (BNL), Upton, New York 11973, USA
M Weber Universität Bern, Bern CH-3012, Switzerland
H Wei Louisiana State University, Baton Rouge, Louisiana 70803, USA
A J White University of Chicago, Chicago, Illinois 60637, USA
S Wolbers Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
T Wongjirad Tufts University, Medford, Massachusetts 02155, USA
M Wospakrik Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
K Wresilo University of Cambridge, Cambridge CB3 0HE, United Kingdom
W Wu University of Pittsburgh, Pittsburgh, Pennsylvania 15260, USA
E Yandel University of California, Santa Barbara, California 93106, USA
T Yang Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
L E Yates Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
H W Yu Brookhaven National Laboratory (BNL), Upton, New York 11973, USA
G P Zeller Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
J Zennamo Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
C Zhang Brookhaven National Laboratory (BNL), Upton, New York 11973, USA

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Pterostilbene in the treatment of inflammatory and oncological diseases

Pterostilbene (PTS), a naturally occurring analog of resveratrol (RSV), has garnered significant attention due to its potential therapeutic effects in treating inflammatory and oncological diseases. This comprehensive review elucidates the pharmacological properties, mechanisms of action, and therapeutic potential of PTS. Various studies indicate that PTS exhibits anti-inflammatory, antioxidant, and antitumour properties, potentially making it a promising candidate for clinical applications. Its influence on regulatory pathways like NF-κB and PI3K/Akt underscores its diverse strategies in addressing diseases. Additionally, PTS showcases a favorable pharmacokinetic profile with better oral bioavailability compared to other stilbenoids, thus enhancing its therapeutic potential. Given these findings, there is an increased interest in incorporating PTS into treatment regimens for inflammatory and cancer-related conditions. However, more extensive clinical trials are imperative to establish its safety and efficacy in diverse patient populations.

Association of radiotherapy for prostate cancer and second primary colorectal cancer: a US population-based analysis

BACKGROUND

Radiotherapy (RT) is a common treatment for prostate cancer, yet the risk of second primary colorectal cancer (SPCRC) in patients with prostate cancer undergoing RT has not been adequately studied.

METHODS

This study employed a population-based cohort design using the US Surveillance, Epidemiology, and End Results (SEER) database to identify individuals diagnosed between January 1975 and December 2015. The cumulative incidence of SPCRC was estimated using Fine-Gray competing risk regression. Poisson regression analysis was used to estimate the risk associated with RT. Survival outcomes of patients with SPCRC were evaluated using the Kaplan-Meier method.

RESULTS

A total of 287,607 patients diagnosed with prostate cancer were identified. The cumulative incidences were higher in patients who did not receive RT (2.00%) compared to those who underwent RT (2.47%) after 25 years. After adjustment for multiple variables, RT was associated with an increased risk of developing combined SPCRC (adjusted HR 1.590). Additionally, the overall survival was significantly lower in patients who developed colorectal cancer after receiving RT as compared to those who did not receive RT.

CONCLUSION

These findings underscore the need for diligent long-term monitoring and effective management strategies to detect SPCRC in patients treated with RT for prostate cancer.

Causal relationship between levels of myeloperoxidase and obstructive sleep apnea: a bidirectional two-sample Mendelian randomization study

Background

Several observational studies have investigated the association between myeloperoxidase (MPO) and obstructive sleep apnea (OSA). However, the nature of this relationship remains uncertain due to potential selection and confounding biases. To resolve this, we conducted a bidirectional two-sample Mendelian randomization (MR) study to scrutinize the causal relationship between MPO and OSA.

Methods

Instrumental variables (IVs) for OSA were sourced from the publicly available FinnGen dataset, encompassing 38,998 OSA cases and 336,659 controls. Data on MPO were sourced from a study of 21,758 individuals conducted by the European Bioinformatics Institute (EBI). The primary MR analysis utilized the inverse-variance weighted (IVW) method, with MR-Egger intercept and leave-one-out methods assessing pleiotropy and Cochran's Q test determining heterogeneity.

Results

The IVW analysis indicated a causal relationship between heightened MPO levels and an increased incidence of OSA. Individuals with elevated MPO levels manifested a higher propensity to develop OSA, exhibiting an odds ratio (OR) of 1.075 and a 95% confidence interval (CI) of 1.011-1.143 (p = 0.021). Conversely, the reciprocal analysis unveiled no significant association between OSA and heightened MPO levels (p = 0.643). No directional pleiotropy was identified through the MR-Egger intercept test (p > 0.05).

Conclusion

Our study provides evidence of an association between elevated MPO levels and an increased incidence of OSA. However, OSA does not necessarily lead to elevated MPO levels. When patients present with high MPO levels, screening for OSA may be advisable, considering their clinical characteristics.

A simple and convenient model combining multiparametric MRI and clinical features to predict tumour-infiltrating lymphocytes in breast cancer

AIM

To develop a simple and convenient method based on multiparametric magnetic resonance imaging (MRI) and clinical features to non-invasively predict tumour-infiltrating lymphocytes (TILs) in breast cancer (BC) and to explore the relationship between TIL levels and disease-free survival (DFS).

MATERIALS AND METHODS

A total of 172 BC patients were enrolled between November 2017 and June 2021 in this retrospective study. The patients were divided into high (≥10%) and low (<10%) TIL groups. Clinicopathological data were collected. MRI features were reviewed by two radiologists. Predictors associated with TILs were determined by using multivariable logistic regression analyses. Kaplan-Meier survival curves based on TIL levels were used to estimate DFS.

RESULTS

A total of 102 patients with low TILs and 70 patients with high TILs were included in the study. Tumour size (odds ratio [OR], 1.040; 95% confidence interval [CI]: 1.006, 1.075; p=0.020), apparent diffusion coefficient (ADC; OR, 1.003; 95% CI: 1.001, 1.005; p=0.015), clinical axillary lymph node status (CALNS; OR, 3.222; 95% CI: 1.372,7.568; p=0.007), and enhancement pattern (OR, 0.284; 95% CI: 0.143, 0.563; p<0.001) were independently associated with TIL levels. These features were used in the ALSE model (where A is ADC, L is CALNS, S is size, and E is enhancement pattern). High TILs were associated with better DFS (p=0.016).

CONCLUSION

The ALSE model derived from multiparametric MRI and clinical features could non-invasively predict TIL levels in BC, and high TILs were associated with longer DFS, especially in human epidermal growth factor receptor 2 (HER2)-positive BC and triple-negative BC (TNBC).

Tunable Ga2O3 solar-blind photosensing performance via thermal reorder engineering and energy-band modulation

As an ultra-wide bandgap semiconductor, gallium oxide (Ga2O3) has been extensively applied in solar-blind photodetectors owing to the absorbance cut-off wavelength of shorter than 280 nm, and the optimized technologies of detection performance is seriously essential for its further usages. Herein, a feasible thermal reorder engineering method was performed through annealing Ga2O3 films in vacuum, O2 and oxygen plasma atmospheres, realizing to tune solar-blind photosensing performance of Ga2O3 photodetectors. Thermal treatment, in fact a crystal reorder process, significantly suppressed the noise in Ga2O3-based photodetectors and enhanced the photo-sensitivity, with the dark current decreasing from 154.63 pA to 269 fA and photo-to-dark current ratio magically raising from 288 to 2.85×104. This achievement is dependent of energy-band modulation in Ga2O3 semiconductor, that is certified by first-principles calculation. Additionally, annealing in oxygen atmospheres notably reduces the concentration of oxygen vacancies in the surface of films, thereby improving the performance of the photodetectors; the oxygen vacancy is extremely concerned in oxide semiconductors in the view of physics of surface defects. In all, this work could display a promising guidance for modulating the performance of photodetectors based on wide bandgap oxide semiconductor, especially for hot Ga2O3 issue. .

[Diagnostic values of conventional tumor markers and their combination with chest CT for patients with stageⅠA lung cancer]

Objective: To investigate the diagnostic efficiency of conventional serum tumor markers and their combination with chest CT for stage ⅠA lung cancer. Methods: A total of 1 155 patients with stage ⅠA lung cancer and 200 patients with benign lung lesions (confirmed by surgery) treated at the Cancer Hospital, Chinese Academy of Medical Sciences from January 2016 to October 2020 were retrospectively enrolled in this study. Six conventional serum tumor markers [carcinoembryonic antigen (CEA), carbohydrate antigen 125 (CA125), squamous cell carcinoma associated antigen (SCCA), cytokeratin 19 fragment (CYFRA21-1), neuron-specific enolase (NSE), and gastrin-releasing peptide precursor (ProGRP)] and chest thin-slice CT were performed on all patients one month before surgery. Pathology was taken as the gold standard to analyze the difference of positivity rates of tumor markers between the lung cancer group and the benign group, the moderate/poor differentiation group and the well differentiation group, the adenocarcinoma group and the squamous cell carcinoma group, the lepidic and non-lepidic predominant adenocarcinoma groups, the solid nodule group and the subsolid nodule group based on thin-slice CT, and subgroups of ⅠA1 to ⅠA3 lung cancers. The diagnostic performance of tumor markers and tumor markers combined with chest CT was analyzed using the receiver operating characteristic curve. Results: The positivity rates of six serum tumor markers in the lung cancer group and the benign group were 2.32%-20.08% and 0-13.64%, respectively; only the SCCA positivity rate in the lung cancer group was higher than that in the benign group (10.81% and 0, P=0.022). There were no significant differences in the positivity rates of other serum tumor markers between the two groups (all P>0.05). The combined detection of six tumor markers showed that the positivity rate of the lung cancer group was higher than that of the benign group (40.93% and 18.18%, P=0.004), and the positivity rate of the adenocarcinoma group was lower than that of the squamous cell carcinoma group (35.66% and 47.41%, P=0.045). The positivity rates in the poorly differentiated group and moderately differentiated group were higher than that in the well differentiated group (46.48%, 43.75% and 22.73%, P=0.025). The positivity rate in the non-lepidic adenocarcinoma group was higher than that in lepidic adenocarcinoma group (39.51% and 21.74%, P=0.001). The positivity rate of subsolid nodules was lower than that of solid nodules (30.01% vs 58.71%, P=0.038), and the positivity rates of stageⅠA1, ⅠA2 and ⅠA3 lung cancers were 33.33%, 48.96% and 69.23%, respectively, showing an increasing trend (P=0.005). The sensitivity and specificity of the combined detection of six tumor markers in the diagnosis of stage ⅠA lung cancer were 74.00% and 56.30%, respectively, and the area under the curve (AUC) was 0.541. The sensitivity and specificity of the combined detection of six serum tumor markers with CT in the diagnosis of stage ⅠA lung cancer were 83.0% and 78.3%, respectively, and the AUC was 0.721. Conclusions: For stage ⅠA lung cancer, the positivity rates of commonly used clinical tumor markers are generally low. The combined detection of six markers can increase the positivity rate. The positivity rate of markers tends to be higher in poorly differentiated lung cancer, squamous cell carcinoma, or solid nodules. Tumor markers combined with thin-slice CT showed limited improvement in diagnostic efficiency for early lung cancer.

Multi-pixels gallium oxide UV detector array and optoelectronic applications

With the continuous advancement of deep-ultraviolet (DUV) communication and optoelectronic detection, research in this field has become a significant focal point in the scientific community. For more accurate information collection and transport, the photodetector array of many pixels is the key of the UV imaging and commnication systems, and its photoelectric performance seriously depends on semiconductor material and array layout. Gallium oxide (Ga2O3) is an emerging wide bandgap semicondutor material which has been widely used in DUV dectection. Therefore, this paper mainly focuses on Ga2O3semiconductor detector array which has gained widespread attention in the field of DUV technique, from the perspective of individual device to array and its optoelectonic integration, for reviewing and discussing the research progress in design, fabrication, and application of Ga2O3arrays in recent years. It includes the structure design and material selection of array units, units growth and array layout, response to solar blind light, the method of imaging and image recognition. Morever, the future development trend of the photodetector array has been analyzed and reflected, aiming to provide some useful suggestions for the optimizing array structure, improving patterned growth technology and material growth quality. As well as Ga2O3optoelectronic devices and their applications are discussed in view of device physics and photophysics in detector.

Azo-Linkage Redox Metal-Organic Framework Incorporating Carbon Nanotubes for High-Performance Aqueous Energy Storage

The design of well-defined hierarchical free-standing electrodes for robust high-performance energy storage is challenging. We report herein that azo-linkage redox metal-organic frameworks (MOFs) incorporate single-walled carbon nanotubes (CNTs) as flexible electrodes. The in situ-guided growth, crystallinity and morphology of UiO-66-NO2 MOFs were finely controlled in the presence of CNTs. The MOFs' covalent anchoring to CNTs and solvothermal grafting anthraquinone (AQ) pendants endow the hybrid (denoted as CNT@UiO-66-AQ) with greatly improved conductivity, charge storage pathways and electrochemical dynamics. The flexible CNT@UiO-66-AQ displays a highest areal specific capacitance of 302.3 mF cm-2 (at 1 mA cm-2) in -0.4~0.9 V potential window, together with 100% capacitance retention over 5000 cycles at 5 mA cm-2. Its assembled symmetrical supercapacitor (SSC) achieves a maximum energy density of 0.037 mWh cm-2 and a maximum power density of 10.4 mW cm-2, outperforming many MOFs-hybrids-based SSCs in the literature. Our work may open a new avenue for preparing azo-coupled redox MOFs hybrids with carbaneous substrates for high-performance robust aqueous energy storage.

Triple-negative breast cancer: predictive model of early recurrence based on MRI features

AIM

To develop an integrated model based on preoperative magnetic resonance imaging (MRI) features for predicting early recurrence in patients with triple-negative breast cancer (TNBC).

MATERIALS AND METHODS

Women with TNBC who underwent breast MRI and surgery between 2009 and 2019 were evaluated retrospectively. Two breast radiologists reviewed MRI images independently based on the Breast Imaging Reporting and Data System Lexicon (BI-RADS), and classified the breast oedema scores on T2-weighted imaging (WI) as no oedema, peritumoural oedema, prepectoral oedema, or subcutaneous oedema. The relationship between disease-free survival (DFS) and MRI features was analysed by Cox regression, and a nomogram model was generated based on the results.

RESULTS

150 patients with TNBC were included and divided into a training cohort (n=78) and validation cohort (n=72). MRI features including subcutaneous oedema and rim enhancement showed a tendency to worsen DFS in univariate analysis. Multivariate analysis showed that subcutaneous oedema (p=0.049, HR [95% confidence interval {CI} = 8.24 [1.01-67.52]) and rim enhancement (p=0.016, HR [95% CI] = 4.38 [1.32-14.54]) were independent predictors for DFS. In the nomogram, the areas under the curves (AUCs) of the training cohort was 0.808, and that of the validation cohort was 0.875.

CONCLUSION

The presence of subcutaneous oedema or rim enhancement on preoperative breast MRI was shown to be a good predictor of poor survival outcomes in patients with TNBC.

The Predictive Value of Circulating Exosomal PD-L1 in Cervical Cancer Immunotherapy

PURPOSE/OBJECTIVE(S)

Programmed death ligand 1 (PD-L1) expression was wildly used as a predictor of immune Check-Point Inhibitors (ICIs) efficiency. However, emerging results showed that PD-L1 was of great heterogeneity in sampling time and site. Recently, some studies found that exosomal PD-L1(ExoPD-L1) was related to ICIs response. In this study, we aimed to explore the predictive value of ExoPD-L1 in ICIs treatment of cervical cancer (CC) for the first time.

MATERIALS/METHODS

A total of 40 primarily diagnosed CC patients who accepted radical radiotherapy (RT) from March 2021 to October 2022 were included. The consecutive tumor sample were collected before and during RT. Another 37 advanced CC patients who accepted ICIs combination therapy from June 2020 to October 2022 were enrolled in this study. Blood samples were collected from each participant before and during treatment. Exosomes were derived by differential centrifugation, which was further identified by Western blot (WB) (CD9/TSG101/Calnexin), transmission electron microscope analysis and nanoparticle tracking analysis. ExoPD-L1 detection was conducted by enzyme-linked immuno-sorbent assay (ELISA). The knockout of PD-L1 was conducted via CRISPR/Cas9 assay and the overexpress of PD-L1 was conducted by lentiviral transfection. CD8+ T cells were extracted from murine spleen by CD8+ T Cell Isolation Kit. Immune cells and cytokines markers were detected by multicolor flow cytometry.

RESULTS

The consecutive detection of PD-L1 showed a dynamic change during RT. Compared with the level before RT, PD-L1 expression elevated in most patients (87.5%, 35/40) after RT. And the responders (n = 18) had elevated ExoPD-L1 level at the first two circles in the ICIs combination therapy (P<0.001). Whereas the level of pre-treatment ExoPD-L1 couldn't stratified clinical responders and non-responders (P = 0.181). The median follow-up time was 14.13 months. The mPFS in increased group vs. decreased group: not reach vs.11.02 months (P = 0.025, HR: 0.218, 0.052-0.913). Continuous blood sampling of mice models also found that effective therapeutic intervention could increase ExoPD-L1 in the early stage. The combination of exosome inhibitor GW4869 and anti-PD-1 further inhibited tumor growth. Mice were injected with external ExoPD-L1OE and ExoPD-L1KO. The results showed that ExoPD-L1OE suppressed body immunity and promoted tumor growth. The results of flow cytometry showed that ExoPD-L1OE inhibited CD8+ T cells from releasing interferon-and granzyme B. And ExoPD-L1OE also suppressed the CD8+ T cells proliferation in murine spleen. The coculture of CD8+ T cells and exosomes in vitro also confirmed the above conclusion.

CONCLUSION

Compared with unstable and impressionable tumoral PD-L1, ExoPD-L1 seems to be better predictor for the efficacy of immunotherapy in CC, which was with easy accessibility and continuation. Exosome PD-L1 played an immunosuppressive role by inhibiting the proliferation and functional factor release of CD8+ T cell.

Incidence and Risk Factors for Brain Metastases in Patients with Lung Cancer: A Systematic Review and Meta-Analysis

PURPOSE/OBJECTIVE(S)

Brain metastases (BM) are a very common metastatic site in lung cancer, but the exact rate of metastasis is still controversial. Risk factors for BM development are also largely lacking, hampering personalized treatment strategies. This study aimed to identify the incidence and possible risk factors for BM in lung cancer.

MATERIALS/METHODS

A systematic review, based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guide-lines, was conducted using PubMed, Medline databases and Cochrane Library databases from inception until February 2023. Two investigators independently searched and selected literature, included in randomized controlled trials and cohort studies. Heterogeneity was assessed using the χ2 test and the I2 statistic. Significant heterogeneity was indicated by P <0.05 in Cochrane Q tests and a ratio greater than 40% in I2 statistics. The review is registered on PROSPERO, number: CRD42022370173.

RESULTS

Forty-nine studies were included in the meta-analysis. The results showed that the incidence rate of BM in non-small cell lung cancer (NSCLC) was 0.24 (95% confidence interval [CI]: 0.23-0.25; I2 = 97.1%). The incidence rate in early NSCLC was 0.11 (95% CI: 0.10-0.13), locally advanced NSCLC was 0.32 (95% CI: 0.29-0.34), and advanced NSCLC was 0.37 (95% CI: 0.35-0.38). Lung adenocarcinoma was more prone to BM in NSCLC (risk ratio [RR] = 3.59, 95% CI: 1.97-6.54; P<0.001). The BM rate of NSCLC with EGFR mutation was also higher (hazard ratio [HR] = 1.49, 95% CI: 1.14-1.94; P = 0.004). Sex and smoking had no significant effect on the incidence of BM in NSCLC. Prophylactic Cranial Irradiation (PCI) could significantly reduce BM in NSCLC (HR = 0.36, 95% CI: 0.23-0.56; P<0.001), but chemotherapy had no obvious effect on decreasing the rate of BM (HR = 0.91, 95% CI: 0.54-1.54; P = 0.73). The incidence rate of BM in small cell lung cancer (SCLC) was 0.28 (95% CI: 0.27-0.30; I2 = 95.9%), and 0.23 (95% CI: 0.20-0.25) in the limited-stage SCLC. Older age (≥65) (HR = 0.70, 95% CI: 0.54-0.92; P = 0.01) were associated with less BM in SCLC. A higher T stage (≥T3) (HR = 1.72, 95% CI: 1.16-2.56; P = 0.007) was a significant risk factor for BM, while sex, smoking dose were not. PCI could also significantly decreased BM in SCLC (HR = 0.47, 95% CI: 0.38-0.58; P<0.001).

CONCLUSION

This study is the first meta-analysis of BM incidence rate in lung cancer, and further explores the factors affecting BM, providing some suggestions for clinical decision-making of BM prevention in patients with lung cancer.

First Double-Differential Measurement of Kinematic Imbalance in Neutrino Interactions with the MicroBooNE Detector

We report the first measurement of flux-integrated double-differential quasielasticlike neutrino-argon cross sections, which have been made using the Booster Neutrino Beam and the MicroBooNE detector at Fermi National Accelerator Laboratory. The data are presented as a function of kinematic imbalance variables which are sensitive to nuclear ground-state distributions and hadronic reinteraction processes. We find that the measured cross sections in different phase-space regions are sensitive to different nuclear effects. Therefore, they enable the impact of specific nuclear effects on the neutrino-nucleus interaction to be isolated more completely than was possible using previous single-differential cross section measurements. Our results provide precision data to help test and improve neutrino-nucleus interaction models. They further support ongoing neutrino-oscillation studies by establishing phase-space regions where precise reaction modeling has already been achieved.

Active metabolites and potential mechanisms of Notopterygium incisum against obstructive sleep apnea Syndrome (OSAS): network analysis and experimental assessment

Background: Notopterygium incisum K.C. Ting ex H.T. Chang, a synonym of Hansenia weberbaueriana (Fedde ex H. Wolff) Pimenov & Kljuykov, is an anti-inflammatory medicinal plant. Although abrnotopterol has been reported to be its primary active metabolite, the other metabolites and their mechanisms of action remain unclear. This study aims to investigate the potential mechanisms by which its active metabolites treat Obstructive Sleep Apnea Syndrome (OSAS) through network analysis and experimental assessment. Methods: The metabolites and potential targets of Notopterygium incisum were extracted from public databases. We searched for OSAS-related genes in the Genecards, OMIM, PharmGkb, TTD, and DrugBank databases. Cytoscape 3.9.0 was used to construct the drug-target-disease network and screen for hub genes. Human bronchial epithelial (HBE) cells were cultivated in normoxia and chronic intermittent hypoxia (CIH) medium for 24 h. Interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-α), and prostaglandin E2 (PGE2) were quantified using enzyme-linked immunosorbent assay (ELISA). Prostaglandin-endoperoxide synthase 2(PTGS2) mRNA was detected using RT-qPCR, while PTGS2 and nuclear factor-kappa B (NF-κB) proteins were identified using Western blot analysis. Co-Immunoprecipitation (CoIP) and Western blotting were utilized to evaluate the ubiquitination of PTGS2 in HBE cells. Results: Pterostilbene and notopterol, isolated from Notopterygium incisum, had potential therapeutic effects on OSAS. The PTGS2 and estrogen receptor alpha (ESR1) hub genes were associated with OSAS. The pathway enrichment analysis focuses on the NF-κB, apoptosis, and HIF-1A pathways. In response to CIH, pterostilbene and notopterol decreased IL-6, TNF-α, and PGE2 levels. The NF-κB pathway was activated by an increase in PTGS2 levels. Pterostilbene promoted proteasome-mediated ubiquitination of PTGS2 protein and reduced PTGS2 levels, inhibiting the NF-κB pathway. Conclusion: This study reveals the active metabolites of Notopterygium incisum and hub genes involved in treating OSAS, which provide a basis for the follow-up development and exploitation of the botanical drug.

Comprehensive Study on Ultra-Wide Band Gap La2O3/ε-Ga2O3 p-n Heterojunction Self-Powered Deep-UV Photodiodes for Flame Sensing

Solar-blind UV photodetectors have outstanding reliability and sensitivity in flame detection without interference from other signals and response quickly. Herein, we fabricated a solar-blind UV photodetector based on a La2O3/ε-Ga2O3 p-n heterojunction with a typical type-II band alignment. Benefiting from the photovoltaic effect formed by the space charge region across the junction interface, the photodetector exhibited a self-powered photocurrent of 1.4 nA at zero bias. Besides, this photodetector demonstrated excellent photo-to-dark current ratio of 2.68 × 104 under 254 nm UV light illumination and at a bias of 5 V, and a high specific detectivity of 2.31 × 1011 Jones and large responsivity of 1.67 mA/W were achieved. Importantly, the La2O3/ε-Ga2O3 heterojunction photodetector can rapidly respond to flames in milliseconds without any applied biases. Based on the performances described above, this novel La2O3/ε-Ga2O3 heterojunction is expected to be a candidate for future energy-efficient fire detection.

First Measurement of Quasielastic Λ Baryon Production in Muon Antineutrino Interactions in the MicroBooNE Detector

We present the first measurement of the cross section of Cabibbo-suppressed Λ baryon production, using data collected with the MicroBooNE detector when exposed to the neutrinos from the main injector beam at the Fermi National Accelerator Laboratory. The data analyzed correspond to 2.2×10^{20} protons on target running in neutrino mode, and 4.9×10^{20} protons on target running in anti-neutrino mode. An automated selection is combined with hand scanning, with the former identifying five candidate Λ production events when the signal was unblinded, consistent with the GENIE prediction of 5.3±1.1 events. Several scanners were employed, selecting between three and five events, compared with a prediction from a blinded Monte Carlo simulation study of 3.7±1.0 events. Restricting the phase space to only include Λ baryons that decay above MicroBooNE's detection thresholds, we obtain a flux averaged cross section of 2.0_{-1.7}^{+2.2}×10^{-40}  cm^{2}/Ar, where statistical and systematic uncertainties are combined.

[Metal artifact reduction and clinical verification in oral and maxillofacial region based on deep learning]

Objective: To construct a kind of neural network for eliminating the metal artifacts in CT images by training the generative adversarial networks (GAN) model, so as to provide reference for clinical practice. Methods: The CT data of patients treated in the Department of Radiology, West China Hospital of Stomatology, Sichuan University from January 2017 to June 2022 were collected. A total of 1 000 cases of artifact-free CT data and 620 cases of metal artifact CT data were obtained, including 5 types of metal restorative materials, namely, fillings, crowns, titanium plates and screws, orthodontic brackets and metal foreign bodies. Four hundred metal artifact CT data and 1 000 artifact-free CT data were utilized for simulation synthesis, and 1 000 pairs of simulated artifacts and metal images and simulated metal images (200 pairs of each type) were constructed. Under the condition that the data of the five metal artifacts were equal, the entire data set was randomly (computer random) divided into a training set (800 pairs) and a test set (200 pairs). The former was used to train the GAN model, and the latter was used to evaluate the performance of the GAN model. The test set was evaluated quantitatively and the quantitative indexes were root-mean-square error (RMSE) and structural similarity index measure (SSIM). The trained GAN model was employed to eliminate the metal artifacts from the CT data of the remaining 220 clinical cases of metal artifact CT data, and the elimination results were evaluated by two senior attending doctors using the modified LiKert scale. Results: The RMSE values for artifact elimination of fillings, crowns, titanium plates and screws, orthodontic brackets and metal foreign bodies in test set were 0.018±0.004, 0.023±0.007, 0.015±0.003, 0.019±0.004, 0.024±0.008, respectively (F=1.29, P=0.274). The SSIM values were 0.963±0.023, 0.961±0.023, 0.965±0.013, 0.958±0.022, 0.957±0.026, respectively (F=2.22, P=0.069). The intra-group correlation coefficient of 2 evaluators was 0.972. For 220 clinical cases, the overall score of the modified LiKert scale was (3.73±1.13), indicating a satisfactory performance. The scores of modified LiKert scale for fillings, crowns, titanium plates and screws, orthodontic brackets and metal foreign bodies were (3.68±1.13), (3.67±1.16), (3.97±1.03), (3.83±1.14), (3.33±1.12), respectively (F=1.44, P=0.145). Conclusions: The metal artifact reduction GAN model constructed in this study can effectively remove the interference of metal artifacts and improve the image quality.

Intravenous N-acetylcysteine in respiratory disease with abnormal mucus secretion

OBJECTIVE

Evidence for the mucolytic and expectorant efficacy of intravenous (IV) N-acetylcysteine (NAC) is limited. This study aimed to evaluate in a large, multicenter, randomized, controlled, subject, and rater-blinded study whether IV NAC is superior to placebo and non-inferior to ambroxol in improving sputum viscosity and expectoration difficulty.

PATIENTS AND METHODS

A total of 333 hospitalized subjects from 28 centers in China with respiratory disease (such as acute bronchitis, chronic bronchitis and exacerbations, emphysema, mucoviscidosis, and bronchiectasis) and abnormal mucus secretion were randomly allocated in a 1:1:1 ratio to receive NAC 600 mg, ambroxol hydrochloride 30 mg, or placebo as an IV infusion twice daily for 7 days. Mucolytic and expectorant efficacy was assessed by ordinal categorical 4-point scales and analyzed by stratified and modified Mann-Whitney U statistics.

RESULTS

NAC showed consistent and statistically significant superiority to placebo and non-inferiority to ambroxol in change from baseline to day 7 in both sputum viscosity scores [mean (SD) difference 0.24 (0.763), p<0.001 vs. placebo] and expectoration difficulty score [mean (SD) difference 0.29 (0.783), p=0.002 vs. placebo]. Safety findings confirm the good tolerability profile of IV NAC reported from previous small studies, and no new safety concerns were identified.

CONCLUSIONS

This is the first large, robust study of the efficacy of IV NAC in respiratory diseases with abnormal mucus secretion. It provides new evidence for IV NAC administration in this indication in clinical situations where the IV route is preferred.

Investigation and development of transient production process for porcine circovirus Type-2 (PCV2) capsid protein in HEK293F cells

Porcine circovirus type-2 capsid protein contains a major immunodominant epitope used as a subunit vaccine. Transient expression in mammalian cells is an efficient process for producing recombinant proteins. However, there is still a lack of research on the efficient production of virus capsid proteins in mammalian cells. Here we present a comprehensive study to investigate and optimize the production process of a model "difficult-to-express" virus capsid protein, PCV2 capsid protein in HEK293F transient expression system. The study evaluated the transient expression of PCV2 capsid protein in the mammalian cell line HEK293F and investigated the subcellular distribution by confocal microscopy. In addition, the RNA sequencing (RNA-seq) was used to detect the differential expression of genes after cells transfected with pEGFP-N1-Capsid or empty vectors. The analysis revealed that the PCV2 capsid gene affected a panel of differential genes of HEK293F cells involved in protein folding, stress response, and translation process, such as SHP90β, GRP78, HSP47, and eIF4A. An integrated strategy of protein engineering combined with VPA addition was applied to promote the expression of PCV2 capsid protein in HEK293F. Moreover, this study significantly increased the production of the engineered PCV2 capsid protein in HEK293F cells, reaching a yield of 8.7 mg/L. Conclusively, this study may provide deep insight for other "difficult-to-express" virus capsid proteins in the mammalian cell system.

Dynamic self-assembly of small molecules enables the spontaneous fabrication of hole conductors at perovskite/electrode interfaces for over 22% stable inverted perovskite solar cells

The bottom hole transport layers (HTLs) are of paramount importance in determining both the efficiency and stability of inverted perovskite solar cells (PSCs), however, their surface nature and properties strongly interfere with the upper perovskite crystallization kinetics and also influence interfacial carrier dynamics. In this work, we strategically develop a simple, facile and spontaneous fabrication method of the HTL at the perovskite/electrode interface by dynamic self-assembly (DSA) of small molecules during perovskite crystallization. Different from the traditional layer-by-layer approach, this DSA strategy involves a bilateral movement of self-assembled molecules (SAMs) from perovskite solution, realizing simultaneous fabrication of the HTL and perovskite surface passivation. We design a multifunctional molecule, (4-(7H-benzo[c]carbazol-7-yl)butyl)phosphonic acid (BCB-C4PA), for the DSA process, to optimize both self-assembly ability and interfacial energy alignment. Benefitting from this unconventional DSA approach and BCB-C4PA, a champion PCE of 22.2% is achieved along with remarkable long-term environmental stability for over 2750 h, which is among the highest reported efficiencies for SAM-based PSCs. This investigation provides a creative, unique and effective molecular approach for preparing reliable charge transport layers, opening up new avenues for the further development of efficient interfacial contacts for PSCs.

All-perovskite tandem 1 cm2 cells with improved interface quality

All-perovskite tandem solar cells (TSCs) promise high power conversion efficiency at a low cost^1-4. Rapid efficiency improvement in small-area (<0.1 cm²) TSCs has been primarily driven by advances in low-bandgap (~1.25 eV) perovskite bottom subcells^5-7. However, unsolved issues remain for wide-bandgap (WBG, >1.75 eV) perovskite top subcells⁸, which currently suffer from large voltage and fill factor (FF) losses, particularly for large-area (>1 cm²) TSCs. Here we develop a novel self-assembled monolayer (4-(7H-dibenzo[c,g]carbazol-7-yl)butyl)phosphonic acid (4PADCB) as a hole selective layer for WBG perovskite solar cells (PSCs), which facilitates subsequent growth of high-quality WBG perovskite over a large area with suppressed interfacial non-radiative recombination, enabling efficient hole extraction. Integrating 4PADCB in devices, we demonstrate a high open-circuit voltage (V_OC) of 1.31 V in a 1.77-eV PSC, corresponding to a record low V_OC-deficit of 0.46 V (with respect to the bandgap). With these WBG perovskite subcells, we report 27.0% (26.4% certified stabilized) monolithic all-perovskite TSCs with an aperture area of 1.044 cm². The certified tandem cell shows an outstanding combination of a high V_OC of 2.12 V and a FF of 82.6%. Our demonstration of the large-area TSCs with certified record efficiency is a key step toward upscaling all-perovskite tandem photovoltaic technology.

[The theory of unresponsive pulse by Wang Ji : The historical position of his Yun Qi Yi Lan]

Wang Ji (1463-1539) was a well-known doctor of the Xin An Medical School in the Ming Dynasty. He and his representative masterpiece Yun Qi Yi Lan are particularly important in the medical history of Yunqi, which refers to the principles of Air (Qi) regulation, influencing almost all life in nature. In terms of the theory "nonresponsive pulse matching the South and the North in the ten Stem years" (Nan Bei Zheng Bu Ying Mai), Wang Ji differentiated and analysed the changes of this theory after the Jin and Yuan Dynasties and traced it back to the classics the Inner canon of Huangdi (Huang Di Nei Jing), based on Su Wen Ru Shi Yun Qi Lun Ao, Huang Di Nei Jing and other relevant reference materials. This paper examined the evolution of the theory of unresponsive pulse in the ancient and modern literature. It was found that after the Song Dynasty, the theory of nonresponsive pulse in the South-North in the ten Stem years was developed into two main schools. One was represented by Cheng Wuji and Liu Wansu, followed with Zhang Jingyue, Li Yanshi, Yao Zhian, Lu Guanquan, Wu Qian, Huang Yuanyu, Xue Fuchen and Zhou Xuehai, who argued that the nonresponsive pulse was determined by the position of Shaoyin. Another was represented by Liu Wenshu, followed with Wang Ji, Li Zhongzi, Zhang Zhicong and Ren Yingqiu, who believed that Shaoyin always stands in the middle, Jueyin and Taiyin are always on the two sides of Shaoyin.

[The performance of digital chest radiographs in the detection and diagnosis of pulmonary nodules and the consistency among readers]

Objective: To investigate the detection and diagnostic efficacy of chest radiographs for ≤30 mm pulmonary nodules and the factors affecting them, and to compare the level of consistency among readers. Methods: A total of 43 patients with asymptomatic pulmonary nodules who consulted in Cancer Hospital, Chinese Academy of Medical Sciences from 2012 to 2014 and had chest CT and X-ray chest radiographs during the same period were retrospectively selected, and one nodule ≤30 mm was visible on chest CT images in the whole group (total 43 nodules in the whole group). One senior radiologist with more than 20 years of experience in imaging diagnosis reviewed CT images and recording the size, morphology, location, and density of nodules was selected retrospectively. Six radiologists with different levels of experience (2 residents, 2 attending physicians and 2 associate chief physicians independently reviewed the chest images and recorded the time of review, nodule detection, and diagnostic opinion. The CT imaging characteristics of detected and undetected nodules on X images were compared, and the factors affecting the detection of nodules on X-ray images were analyzed. Detection sensitivity and diagnosis accuracy rate of 6 radiologists were calculated, and the level of consistency among them was compared to analyze the influence of radiologists' seniority and reading time on the diagnosis results. Results: The number of nodules detected by all 6 radiologists was 17, with a sensitivity of detection of 39.5%(17/43). The number of nodules detected by ≥5, ≥4, ≥3, ≥2, and ≥1 physicians was 20, 21, 23, 25, and 28 nodules, respectively, with detection sensitivities of 46.5%, 48.8%, 53.5%, 58.1%, and 65.1%, respectively. Reasons for false-negative result of detection on X-ray images included the size, location, density, and morphology of the nodule. The sensitivity of detecting ≤30 mm, ≤20 mm, ≤15 mm, and ≤10 mm nodules was 46.5%-58.1%, 45.9%-54.1%, 36.0%-44.0%, and 36.4% for the 6 radiologists, respectively; the diagnosis accuracy rate was 19.0%-85.0%, 16.7%-6.5%, 18.2%-80.0%, and 0%-75.0%, respectively. The consistency of nodule detection among 6 doctors was good (Kappa value: 0.629-0.907) and the consistency of diagnostic results among them was moderate or poor (Kappa value: 0.350-0.653). The higher the radiologist's seniority, the shorter the time required to read the images. The reading time and the seniority of the radiologists had no significant influence on the detection and diagnosis results (P>0.05). Conclusions: The ability of radiographs to detect lung nodules ≤30 mm is limited, and the ability to determine the nature of the nodules is not sufficient, and the increase in reading time and seniority of the radiologists will not improve the diagnostic accuracy. X-ray film exam alone is not suitable for lung cancer diagnosis.

Recurrent syncope in an 84-year-old man

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

[A comparison of current guidelines for the management of intrahepatic cholangiocarcinoma worldwide]

Intrahepatic cholangiocarcinoma (ICC) is the second most common human liver malignancy and its incidence rate has been gradually increasing worldwide over the past decades. Surgical resection (R0 resection) is the preferred potentially curative treatment for ICC patients. However, due to its conceal clinical features and high invasiveness, most patients have lost the opportunity for surgical resection at the time of diagnosis. In recent years, with the rapid development of targeted therapy and immunotherapy, which is represented by immune checkpoint inhibitors, clinicians are expected to provide more effective treatment options for patients with mid-stage or advanced ICC. At present, there are still controversial opinions on different guidelines regarding preoperative biliary drainage, the extent of hepatectomy, the definition of R0 resection, the width of the resection margin, lymph node dissection, postoperative recurrence, adjuvant therapy, etc. In this review, 12 guidelines or expert consensus published worldwide from 2012 to 2022 (including 4 Chinese guidelines, 4 European guidelines, 2 American guidelines and 2 Japanese guidelines) were retrieved. Focusing on sorting and comparing the current views on clinical management of ICC in different guidelines, this review aims to provide reference information for ICC clinical management and decision-making.

[Efficiency and safety analysis of Plerixafor combined with granulocyte colony-stimulating factor on autologous hematopoietic stem cell mobilization in lymphoma]

Objective: To evaluate the advantages and safety of Plerixafor in combination with granulocyte colony-stimulating factor (G-CSF) in autologous hematopoietic stem cell mobilization of lymphoma. Methods: Lymphoma patients who received autologous hematopoietic stem cell mobilization with Plerixafor in combination with G-CSF or G-CSF alone were obtained. The clinical data, the success rate of stem cell collection, hematopoietic reconstitution, and treatment-related adverse reactions between the two groups were evaluated retrospectively. Results: A total of 184 lymphoma patients were included in this analysis, including 115 cases of diffuse large B-cell lymphoma (62.5%) , 16 cases of classical Hodgkin's lymphoma (8.7%) , 11 cases of follicular non-Hodgkin's lymphoma (6.0%) , 10 cases of angioimmunoblastic T-cell lymphoma (5.4%) , 6 cases of mantle cell lymphoma (3.3%) , and 6 cases of anaplastic large cell lymphoma (3.3%) , 6 cases of NK/T-cell lymphoma (3.3%) , 4 cases of Burkitt's lymphoma (2.2%) , 8 cases of other types of B-cell lymphoma (4.3%) , and 2 cases of other types of T-cell lymphoma (1.1%) ; 31 patients had received radiotherapy (16.8%) . The patients in the two groups were recruited with Plerixafor in combination with G-CSF or G-CSF alone. The baseline clinical characteristics of the two groups were basically similar. The patients in the Plerixafor in combination with the G-CSF mobilization group were older, and the number of recurrences and third-line chemotherapy was higher. 100 patients were mobilized with G-CSF alone. The success rate of the collection was 74.0% for one day and 89.0% for two days. 84 patients in the group of Plerixafor combined with G-CSF were recruited successfully with 85.7% for one day and 97.6% for two days. The success rate of mobilization in the group of Plerixafor combined with G-CSF was substantially higher than that in the group of G-CSF alone (P=0.023) . The median number of CD34(+) cells obtained in the mobilization group of Plerixafor combined with G-CSF was 3.9×10(6)/kg. The median number of CD34(+) cells obtained in the G-CSF Mobilization group alone was 3.2×10(6)/kg. The number of CD34(+) cells collected by Plerixafor combined with G-CSF was considerably higher than that in G-CSF alone (P=0.001) . The prevalent adverse reactions in the group of Plerixafor combined with G-CSF were grade 1-2 gastrointestinal reactions (31.2%) and local skin redness (2.4%) . Conclusion: The success rate of autologous hematopoietic stem cell mobilization in lymphoma patients treated with Plerixafor combined with G-CSF is significantly high. The success rate of collection and the absolute count of CD34(+) stem cells were substantially higher than those in the group treated with G-CSF alone. Even in older patients, second-line collection, recurrence, or multiple chemotherapies, the combined mobilization method also has a high success rate of mobilization.

Enhanced gain and detectivity of unipolar barrier solar blind avalanche photodetector via lattice and band engineering

Ga₂O₃-based solar blind avalanche photodetectors exhibit low voltage operation, optical filter-free and monolithic integration of photodetector arrays, and therefore they are promising to be an alternative to the bulky and fragile photomultiplier tubes for weak signal detection in deep-ultraviolet region. Here, by deliberate lattice and band engineering, we construct an n-Barrier-n unipolar barrier avalanche photodetector consisting of β-Ga₂O₃/MgO/Nb:SrTiO₃ heterostructure, in which the enlarged conduction band offsets fortify the reverse breakdown and suppress the dark current while the negligible valance band offsets faciliate minority carrier flow across the heterojunction. The developed devices exhibit record-high avalanche gain up to 5.9 × 10⁵ and detectivity of 2.33 × 10¹⁶ Jones among the reported wafer-scale grown Ga₂O₃-based photodetectors, which are even comparable to the commercial photomultiplier tubes. These findings provide insights into precise manipulation of band alignment in avalanche photodetectors, and also offer exciting opportunities for further developing high-performance Ga₂O₃-based electronics and optoelectronics.

First Constraints on Light Sterile Neutrino Oscillations from Combined Appearance and Disappearance Searches with the MicroBooNE Detector

We present a search for eV-scale sterile neutrino oscillations in the MicroBooNE liquid argon detector, simultaneously considering all possible appearance and disappearance effects within the 3+1 active-to-sterile neutrino oscillation framework. We analyze the neutrino candidate events for the recent measurements of charged-current ν_{e} and ν_{μ} interactions in the MicroBooNE detector, using data corresponding to an exposure of 6.37×10^{20} protons on target from the Fermilab booster neutrino beam. We observe no evidence of light sterile neutrino oscillations and derive exclusion contours at the 95% confidence level in the plane of the mass-squared splitting Δm_{41}^{2} and the sterile neutrino mixing angles θ_{μe} and θ_{ee}, excluding part of the parameter space allowed by experimental anomalies. Cancellation of ν_{e} appearance and ν_{e} disappearance effects due to the full 3+1 treatment of the analysis leads to a degeneracy when determining the oscillation parameters, which is discussed in this Letter and will be addressed by future analyses.

Identification and validation of ferroptosis-related hub genes in obstructive sleep apnea syndrome

Background

By 2020, the prevalence of Obstructive Sleep Apnea Syndrome (OSAS) in the US has reached 26. 6-43.2% in men and 8.7-27.8% in women. OSAS promotes hypertension, diabetes, and tumor growth through unknown means. Chronic intermittent hypoxia (CIH), sleep fragmentation, and increased pleural pressure are central mechanisms of OSAS complications. CIH exacerbates ferroptosis, which is closely related to malignancies. The mechanism of ferroptosis in OSAS disease progression remains unknown.

Methods

OSAS-related datasets (GSE135917 and GSE38792) were obtained from the GEO. Differentially expressed genes (DEGs) were screened using the R software and intersected with the ferroptosis database (FerrDb V2) to get ferroptosis-related DEGs (f-DEGs). GO, DO, KEGG, and GSEA enrichment were performed, a PPI network was constructed and hub genes were screened. The TCGA database was used to obtain the thyroid cancer (THCA) gene expression profile, and hub genes were analyzed for differential and survival analysis. The mechanism was investigated using GSEA and immune infiltration. The hub genes were validated with RT-qPCR, IHC, and other datasets. Sprague-Dawley rats were randomly separated into normoxia and CIH groups. ROS, MDA, and GSH methods were used to detect CIH-induced ferroptosis and oxidative stress.

Results

GSEA revealed a statistically significant difference in ferroptosis in OSAS (FDR < 0.05). HIF1A, ATM, HSPA5, MAPK8, MAPK14, TLR4, and CREB1 were identified as hub genes among 3,144 DEGs and 74 f-DEGs. HIF1A and ATM were the only two validated genes. F-DEGs were mainly enriched in THCA. HIF1A overexpression in THCA promotes its development. HIF1A is associated with CD8 T cells and macrophages, which may affect the immunological milieu. The result found CIH increased ROS and MDA while lowering GSH indicating that it could cause ferroptosis. In OSAS patients, non-invasive ventilation did not affect HIF1A and ATM expression. Carvedilol, hydralazine, and caffeine may be important in the treatment of OSAS since they suppress HIF1A and ATM.

Conclusions

Our findings revealed that the genes HIF1A and ATM are highly expressed in OSAS, and can serve as biomarkers and targets for OSAS.

Predictive model for deep venous thrombosis caused by closed lower limb fracture after thromboprophylactic treatment

OBJECTIVE

Currently, there are still no convincing clinical models predicting closed lower extremity fracture-associated deep vein thrombosis in patients treated through thromboprophylactic methods. We aimed at using two retrospective cohorts to develop and externally verify a clinical prediction model for deep vein thrombosis in patients treated with anticoagulants after suffering closed lower extremity fractures.

PATIENTS AND METHODS

We evaluated the patients' pre- and post-operatively, to accurately determine the predictive power of the biomarkers and clinical risk factors. Two retrospective cohorts were used for the development and external verification of a pre-operative clinical prediction model (development: n = 2,253; verification: n = 833) and post-operative clinical prediction model (development: n = 1,422; verification: n = 449), respectively.

RESULTS

The C-indices were used to show the predicted incidence of objective thrombosis at the pre- and post-operative stage, which were then compared with the observed incidence of thrombosis in both cohorts. Biomarkers and clinical indicators were included in pre- and post-operative nomograms, which were adequately calibrated in both cohorts. The cross-validated C-indices of the pre- and post-operative clinical prediction models in the verification cohort were 0.706 (95% Cl, 0.67-0.74) and 0.875 (95% Cl, 0.84-0.91), respectively.

CONCLUSIONS

We present our findings of novel pre- and post-operative nomograms for the prediction of deep venous thrombosis in patients who received thromboprophylaxis after suffering closed lower extremity fractures.

[Prevalence and risk factors of coronary artery calcification on lung cancer screening with low-dose CT]

Objective: To investigate the prevalence and risk factors of coronary artery calcification (CAC) on lung cancer screening with low-dose computed tomography (LDCT). Methods: A total of 4 989 asymptomatic subjects (2 542 males and 2 447 females) who underwent LDCT lung cancer screening were recruited at Cancer Hospital, Chinese Academy of Medical Sciences from 2014 to 2017. The visual scoring method was used to assess coronary artery calcification score. χ(2) test or independent t-test was used to compare the difference of CAC positive rate among different groups. Multivariate logistic regression was used to analyze risk factors associated with CAC in the study. Results: Of the 4 989 asymptomatic subjects, CAC occurred in 1 018 cases. The positive rate was 20.4%, of which mild, moderate and severe calcification accounted for 86.3%, 11.4% and 2.3%, respectively. Gender, age, BMI, education level, occupation, smoking history, diabetes, hypertension and hyperlipidemia had statistically significant differences in CAC positive rates among groups. Multivariate logistic regression analysis showed that gender, age, diabetes, hypertension, hyperlipidemia and smoking history were risk factors for CAC. Age, diabetes, hypertension and smoking history were statistically significant risk factors between the mild and moderate CAC group. A total of 1 730 coronary arteries in 1 018 CAC positive cases had calcification, CAC positive rate of left anterior descending was the highest(51.3%); 568 cases (55.8%) were single vessel calcification, 450 cases (44.2%) were multiple vessel calcification. Conclusions: LDCT can be used for the 'one-stop' early detection of lung cancer and coronary atherosclerosis. Gender, age, diabetes, hypertension, hyperlipidemia and smoking are related risk factors for coronary atherosclerosis.

[Virtual reconstruction and clinical verification of maxillary defect based on deep learning]

Objective: To construct a virtual reconstruction method including midspan maxillary defects and provide clinical reference by training a generative adversarial network (GAN) model. Methods: The CT data of middle-aged Han patients with oral diseases who visited the Department of Radiology, West China Hospital of Stomatology, Sichuan University from June 2015 to June 2022 were collected, where the CT data of 100 healthy maxilla and 15 maxillary defects (5 simple unilateral defects, 5 unilateral defects involving zygomatic bone, 5 midspan defects) were selected. Mimics was used to create spherical phantom and simulate bone defects around the healthy maxillas, including simple unilateral defects, unilateral defects involving zygomatic bone and midspan defects. The original image was set as the correct reference for the reconstruction: artificial defects paired with the correct reference were divided into training set (n=70), validation set (n=20) and test set (n=10), where the first two were used to train the GAN model, and the test set was used to evaluate the GAN performance. Data from 15 clinical defects were imported into the trained GAN model for reconstruction, with mirroring and GAN-based virtual reconstruction for unilateral clinical defects, and only the latter method was adopted for midspan defects. The reconstruction results were divided into mirror reconstruction group (n=10), unilateral defect GAN reconstruction group (n=10) and midspan defect GAN reconstruction group (n=5). The test set, mirror reconstruction group, and unilateral defect GAN reconstruction group were quantitatively evaluated, whose quantitative indicators were Dice similarity coefficient (DSC) and 95% Hausdorff distance (HD95), and the group results were subjected to one-way ANOVA and Tukey test. The test set, mirror reconstruction group, unilateral defect GAN reconstruction group and midspan defect GAN reconstruction group were qualitatively scored, and Kruskal-Wallis test and Bonferroni correction were used for the total score of each group. Results: The total differences in the test set, mirror reconstruction group, unilateral defect GAN reconstruction group DCS (0.891±0.049, 0.721±0.047, 0.778±0.057, respectively) and HD95 [(3.58±1.51), (5.19±1.38), (4.51±1.10) mm, respectively] were statistically significant (F=28.08, P<0.001; F=3.62, P=0.041); among them, the test set DSC was significantly larger than the mirror reconstruction group (P<0.05), and the test set HD95 was significantly less than the mirror reconstruction group (P<0.05). Overall difference in qualitative total scores [8 (1), 6 (2), 6 (2), and 4 (2) points, respectively] in the test set, mirror reconstruction group, unilateral defect GAN reconstruction group, and midspan defect GAN reconstruction group were statistical significance (H=18.13, P<0.001); pairwise comparison showed that the total score of the test set was significantly higher than that of the mirror reconstruction group (P<0.05). Conclusions: The virtual reconstruction method based on GAN proposed in this study has better virtual reconstruction effect of unilateral defect than mirror technique, and can also realize virtual reconstruction of maxillary midspan defect.

Heart failure across the range of preserved ejection fraction in United States clinical practice

Introduction

Recent clinical trials of heart failure with preserved ejection fraction (HFpEF) have observed varying patient profiles by ejection fraction (EF), with attenuation of treatment benefits as EF increases. In routine clinical practice, the degree to which patients hospitalized for HF with EF≥60% may differ from those with lower EF is unknown.

Purpose

To compare patient characteristics, treatment patterns, and clinical outcomes across the range of EF among patients hospitalized for HFpEF.

Methods

Using the Humedica electronic medical records database between Jan 2010 and Dec 2020, patients hospitalized for a primary diagnosis of HF with EF&gt;40% and who were haemodynamically stable at admission, without concurrent acute coronary syndrome or end-stage renal disease, and treated with intravenous (IV) diuretic agents within 48 h of admission were identified. Patient characteristics, treatment patterns, and clinical outcomes were compared by EF ranges of 41–49%, 50–59%, and ≥60%.

Results

Of 47,026 patients hospitalized with HFpEF, 6,335 (13%) had EF 41–49%, 18,603 (40%) had EF 50–59%, and 22,088 (47%) had EF≥60%. Across all 3 groups, patients were similar with respect to age (median 77 years for each group), race (83–84% White, 12–13% Black), systolic blood pressure (137–138 mmHg at admission), and eGFR (63–64 mL/min/1.73 m2 at admission). With progressively higher EF group, the proportion of women increased (45% vs 54% vs 65%) and median NT-proBNP decreased (4,221 vs 2,945 vs 2,234 pg/mL). Patients with EF ≥60% had the lowest rates of coronary artery disease and atrial fibrillation, and the highest rates of chronic pulmonary disease (Figure 1, Panel A). Discharge medications were generally similar, with exception of less beta-blocker use and more calcium channel blocker use among those with EF ≥60% (Figure 1, Panel B). Discharge use of angiotensin receptor-neprilysin inhibitor and sodium glucose cotransporter-2 inhibitor therapies were each &lt;1% in all groups. Hospital length of stay (median 4 days for each group) and in-hospital mortality (1.1–1.3%) were similar across groups, but rates of in-hospital acute respiratory failure were higher among patients with EF ≥60% (27% vs 230-25% for lower EF groups). Rates of 30-day and 12-month post-discharge clinical events were high irrespective of EF, without meaningful differences between groups (Figure 2).

Conclusion

In a contemporary real-world population of US patients hospitalized for HF with EF &gt;40%, nearly half had an EF≥60%. While clinical profiles and discharge medications varied, post-discharge outcomes were similarly poor irrespective of EF. There remain important opportunities to improve the care and outcomes for patients with HF across the range of preserved ejection fraction.

Funding Acknowledgement

Type of funding sources: Private company. Main funding source(s): MyoKardia, Inc., a wholly owned subsidiary of Bristol Myers Squibb

Impact of weight loss on cardiac function: improvement in left ventricular global longitudinal strain following metabolic surgery

Introduction

Obesity leads to an increased risk of cardiovascular disease (CVD) morbidity and mortality and is associated with the metabolic risk factors such as hypertension, diabetes mellitus, hyperlipidemia [1]. Metabolic surgery has been proven to be the most effective long term weight management tool and has known benefits in CVD prevention [2]. Global longitudinal strain (GLS) is an effective quantitative measurement of left ventricular (LV) function that is also a powerful predictor of future CVD events and mortality [3]. The impact of metabolic surgery on LV structure and function is unknown.

Purpose

This study investigated the changes in cardiac structure and function after metabolic surgery, including GLS. To our knowledge there has not been a study investigating this relationship previously reported.

Methods

Consecutive patients undergoing metabolic surgery at our center between March 2005 and February 2019 were recruited. Patients with transthoracic echocardiographic imaging (TTE) pre and post metabolic surgery (May 2005 to January 2019) were included. Electronic medical records were searched to obtain demographic, surgical and clinical data. GLS was calculated with Velocity Vector Imaging (VVI, Siemens, v2.0, Pennsylvania, USA). Averaged GLS values were derived from 4 chamber, 2 chamber and 3 chamber calculations.

Results

398 patients with pre- and post-operative cardiac imaging were included. Please see Table 1 for the baseline demographics of our study population. The mean age was 60.0 years with 70% being female. There were significant rates of CVD risk factors such as: hypertension (76.4%), diabetes mellitus (58.8%) and hyperlipidemia (76.4%).

The clinical and echocardiographic changes noted post metabolic surgery are detailed in Table 2. Along with decreases in weight post operatively, there were significant improvements in the markers of CVD risk factors such as mean blood pressure (134/75 to 129/72 mmHg, p value &lt;0.001), mean gylcated hemoglobin levels (7.0 to 6.1%, p value &lt;0.001) and mean low density lipoprotein (LDL) levels (97.7 to 88.2 mg/dl, p value &lt;0.001).

There were a number of statistically significant positive changes in the left ventricular structure and function. The mean LV ejection fraction increased from 56.3% to 57.4% (p=0.008); left ventricular mass decreased from 238.2 g to 179.3 g (p value &lt;0.001), and both septal and posterior wall thicknesses decreased significantly (p value &lt;0.001). The LV mass indexed to body surface area (BSA) also decreased from 93.5 g/m2 to 83.1 g/m2.

The average global LV GLS was −15.7% pre-operatively, improving significantly to −17.9% post-operatively (p&lt;0.001).

Conclusion

Our study has shown for the first time the impact of metabolic surgery on ventricular structure and function, with reduction in LV mass and improvement in LV GLS. These novel findings lends further support to the cardiovascular benefits of metabolic surgery.

Funding Acknowledgement

Type of funding sources: None.

Multimodality imaging predictors of appropriate ICD shock and mortality in adults with cardiac sarcoidosis

Background

Identifying patients with cardiac sarcoidosis (CS) who are at increased risk of sudden cardiac death (SCD) is imperative. Current guideline recommendations for implantable cardioverter-defibrillator (ICD) implantation in patients with CS are based on small observational studies and have not been validated in contemporary cohorts using multimodality cardiac imaging.

Purpose

The aim of this study was to characterize a cohort of patients with tissue-proven cardiac sarcoidosis who underwent multimodality cardiac imaging and identify predictors of appropriate ICD shock and mortality.

Methods

We retrospectively identified subjects with a diagnosis of CS established by clinical/imaging criteria, and tissue biopsy (N=273) seen at our tertiary care center between 2001 and 2021. Clinical characteristics and outcomes were collected from electronic medical records. The primary endpoint of interest was a composite of appropriate ICD shock and all-cause mortality. Secondary endpoints were individual rates of appropriate ICD shock and all-cause mortality. Cox proportional hazard regression analysis was used to identify independent predictors of the outcomes.

Results

Mean age was 59±11 years and 40% were female. Isolated CS was found in 49 subjects (17.9%). The prevalence of traditional cardiovascular risk factors was low. Atrial fibrillation prevalence was high (41%). After a median follow-up of 7.9 years, the rate of appropriate ICD shock and all-cause mortality was 29% (N=79). The 5-year overall survival rate of 97.5%. Age, left ventricular ejection fraction (LVEF), and delayed gadolinium enhancement (DGE) in cardiac magnetic resonance (CMR) were independent predictors of the primary composite endpoint; LVEF and DGE in CMR were independent predictors of appropriate ICD-shock; and LVEF and baseline serum NT proBNP were independent predictors of overall mortality. An LVEF of 47% was identified as the optimal cutoff in predicting the primary composite endpoint. Presence of scar, inflammation or mismatch pattern in positron emission tomography were not significant predictors of the outcomes.

Conclusion

In this large cohort of subjects with CS, we found that the presence of DGE in CMR was the strongest independent predictor of the composite endpoint of appropriate ICD-shock and mortality and of appropriate ICD-shock individually; LVEF by echocardiogram was an independent predictor of the primary and secondary endpoints with an optimal LVEF cutoff for predicting the composite endpoint of 47%.

Funding Acknowledgement

Type of funding sources: None.

Evaluating the impact of Hartree-Fock exact exchange on the performance of global hybrid functionals for the vertical excited-state energies of fused-ring electron acceptors using TD-DFT

The acceptor-donor-acceptor structured fused-ring electron acceptors (FREAs) have piqued interest for organic solar cells. We herein employ time-dependent density functional theory to evaluate the effect of Hartree-Fock exact exchange (HFX) on the performance of 16 global hybrid functionals for computing the maximum absorption wavelengths (λ_ver-theo) and the vertical excitation energies (E_ver-theo) of 34 molecules. We customize the HFX ratio in the functionals used to perform an in-depth analysis of its impact on the E_ver-theo values. The computed λ_ver-theo values strictly follow an inverse proportionality to the HFX percentage. The performance of the methods with the same ratio of HFX is almost identical, such as B3LYP, B3PW91, and mPW3PBE containing 20% HFX. The performance enhances with a relatively higher HFX ratio of 21% in X3LYP, B971, B972, and 22% in B98 giving smaller deviations. APF and APFD containing 23% HFX provide the smallest deviations for all compounds, with a mean signed error limited to 0.02 eV and a mean absolute error (MAE) of 0.06 eV. The performance drops using M06 and M05 with comparatively higher HFX ratios providing MAE values of 0.07 eV and 0.1 eV, respectively. M06-2X with 54% HFX provides the largest MAE value of 0.35 eV. The lowest obtained MAE is 0.06 eV at 23 to 25% HFX in most of the functionals considered in this study, suggesting that these are the optimal values for the prediction of excitation energies of FREAs. It has also been found that global hybrids seem to be more efficient for larger-sized molecules with a smaller bandgap.