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Purpose: The incomplete resection of non-muscle invasive bladder cancer (NMIBC) augments the risk of disease recurrence. Imaging-guided surgery by molecular probes represents a pivotal strategy for mitigating postoperative recurrence. Traditional optical molecular probes, primarily composed of antibodies/peptides targeting tumour cells and fluorescent groups, are challenged by the high heterogeneity of NMIBC cells, leading to inadequate probe sensitivity. We have developed a collagen-adhesive probe (CA-P) to target the collagen within the tumour microenvironment, aiming to address the issue of insufficient imaging sensitivity., Methods: The distribution characteristics of collagen in animal bladder cancer models and human bladder cancer tissues were explored. The synthesis and properties of CA-P were validated. In animal models, the imaging performance of CA-P was tested and compared with our previously reported near-infrared probe PLSWT7-DMI. The clinical translational potential of CA-P was assessed using human ex vivo bladder tissues., Results: The distribution of collagen on the surface of tumour cells is distinct from its expression in normal urothelium. In vitro studies have demonstrated the ability of the CA-P to undergo a "sol-gel" transition upon interaction with collagen. In animal models and human ex vivo bladder specimens, CA-P exhibits superior imaging performance compared to PLSWT7-DMI. The sensitivity of this probe is 94.1%, with a specificity of 81%., Conclusion: CA-P demonstrates the capability to overcome tumour cell heterogeneity and enhance imaging sensitivity, exhibiting favorable imaging outcomes in preclinical models. These findings provide a theoretical basis for the application of CA-P in intraoperative navigation for NMIBC., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Mathematical modelling and simulation of gasification processes are increasingly used in the scientific field. This review explores the application of computational fluid dynamics (CFD) in modeling biomass gasification processes in downdraft gasifiers. It discusses the different types of gasification agents used, the composition of syngas, and key operational parameters influencing the process. The review then delves into the aspects of CFD modeling, focusing on the implementation of sub-models within ANSYS fluent software. The limitations of the existing literature are addressed, and strategies for enhancing downdraft gasifier performance are proposed to facilitate successful commercialization., Competing Interests: The authors declare no conflict of interest., (This journal is © The Royal Society of Chemistry.)

Humans can be exposed to multiple pollutants in the air and surface water. These environments are non-static, trans-boundary and correlated, creating a complex network, and significant challenges for research on environmental hazards, especially in real-world cancer research. This article reports on a large study (377 million people in 30 provinces of China) that evaluated the combined impact of air and surface water pollution on cancer. We formulate a spatial evaluation system and a common grading scale for co-pollution measurement, and validate assumptions that air and surface water environments are spatially connected and that cancers of different types tend to cluster in areas where these environments are poorer. We observe "dose-response" relationships in both the number of affected cancer types and the cancer incidence with an increase in degree of co-pollution. We estimate that 62,847 (7.4%) new cases of cancer registered in China in 2016 were attributable to air and surface water pollution, and the majority (69.7%) of these excess cases occurred in areas with the highest level of co-pollution. The findings clearly show that the environment cannot be considered as a set of separate entities. They also support the development of policies for cooperative environmental governance and disease prevention., (© 2024. The Author(s).)

Background: The Helicobacter pylori epidemic in China accounts for up to a third of gastric cancers worldwide. We aim to monitor the temporal and spatial dynamics of H. pylori infection in both adults and children across China., Materials and Methods: We developed a surveillance system consisting of a data collection component that harnessed survey reports in natural populations and an analysis component that accounted for the differences in survey time and location, population age structure, and H. pylori detection method. System outputs were estimates of the prevalence of H. pylori in adults and children (aged ≤ 14 years) presented at three hierarchical levels (regional, provincial, and prefectural)., Results: The overall prevalence of H. pylori infection declined sharply in adults (63.3%, 52.5%, 43.4%, and 38.7%) and less sharply in children (23.1%, 26.1%, 16.0%, and 15.7%) in 1983-1999, 2000-2009, 2010-2014, and 2015-2019, respectively. The changes were asynchronous across regions, with the most marked declines in the Northwest, the Hong Kong-Macao-Taiwan region, and the East. We estimated that 457.6 million adults and 44.5 million children have been infected with H. pylori, with cross-province disparities in prevalence ranging from 24.3% to 69.3% among adults and 2.9% to 46.3% among children. In general, the risk level of gastric cancer increased as the prevalence of H. pylori increased. The correlation was statistically significant for both adult men (Spearman coefficient of correlation: 0.393, p = 0.0146) and women (0.470, p = 0.0029)., Conclusions: The tracking system would be important for the continuous and stratified tracking of the Helicobacter pylori epidemic across China and can be used to furnish an evidence base for the formulation of tailored prevention strategies., (© 2024 John Wiley & Sons Ltd.)

Cation-doped cubic Li 7 La 3 Zr 2 O 12 is regarded as a promising solid electrolyte for safe and energy-dense solid-state lithium batteries. However, it suffers from the formation of Li 2 CO 3 and high electronic conductivity, which give rise to an unconformable Li/Li 7 La 3 Zr 2 O 12 interface and lithium dendrites. Herein, composite AlF 3 -Li 6.4 La 3 Zr 1.4 Ta 0.6 O 12 solid electrolytes were created based on thermal AlF 3 decomposition and F/O displacement reactions under a high-temperature sintering process. When the AlF 3 is thermally decomposed, it leaves Al 2 O 3 /AlF 3 meliorating the grain boundaries and F - ions partially displacing O 2- ions in the grains. Due to the higher electronegativity of F - in the grains and the grain-boundary modification, these AlF 3 -Li 6.4 La 3 Zr 1.4 Ta 0.6 O 12 deliver optimized electronic conduction and chemical stability against the formation of Li 2 CO 3 . The Li/AlF 3 -Li 6.4 La 3 Zr 1.4 Ta 0.6 O 12 /Li cell exhibits a low interfacial resistance of ∼16 Ω cm 2 and an ultrastable long-term cycling behavior for 800 h under a current density of 200 μA/cm 2 , leading to Li//LiCoO 2 solid-state batteries with good rate performance and cycling stability.

Herein, we develop a facile wet chemical method for the synthesis of Ag 2 Te powders at room temperature and flexible Ag 2 Te/nylon thermoelectric (TE) films are prepared by vacuum-assisted filtration of the synthesized Ag 2 Te powders and then hot pressing. Because of the good crystallinity of Ag 2 Te grains and continuous grain boundaries, an optimized film exhibits a power factor of 513 μW m -1 K -2 at 300 K, which stands among the highest values reported for Ag 2 Te-based films to date. In addition, the film also has good flexibility. A four-leg flexible TE device assembled with the film generates a power density of 5.46 W m -2 at a temperature gradient of 31.8 K. This work provides a facile and environmentally friendly method for preparing flexible Ag 2 Te films.

The significance of USP11 as a critical regulator in cancer has garnered substantial attention, primarily due to its catalytic activity as a deubiquitinating enzyme. Nonetheless, a thorough evaluation of USP11 across various cancer types in pan-cancer studies remains absent. Our analysis integrates data from a variety of sources, including five immunotherapy cohorts, thirty-three cohorts from The Cancer Genome Atlas (TCGA), and sixteen cohorts from the Gene Expression Omnibus (GEO), two of which involve single-cell transcriptomic data. Our findings indicate that aberrant USP11 expression is predictive of survival outcomes across various cancer types. The highest frequency of genomic alterations was observed in uterine corpus endometrial carcinoma (UCEC), with single-cell transcriptome analysis revealing significantly higher USP11 expression in plasmacytoid dendritic cells and mast cells. Notably, USP11 expression was associated with the infiltration levels of CD8 + T cells and natural killer (NK) activated cells. Additionally, in the skin cutaneous melanoma (SKCM) phs000452 cohort, patients with higher USP1 1 mRNA levels during immunotherapy experienced a significantly shorter median progression-free survival. USP11 emerges as a promising molecular biomarker with significant potential for predicting patient prognosis and immunoreactivity across various cancer types., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2024 The Authors. Published by Elsevier Ltd.)

Background: The current guidelines for managing screen-detected pulmonary nodules offer rule-based recommendations for immediate diagnostic work-up or follow-up at intervals of 3, 6, or 12 months. Customized visit plans are lacking., Purpose: To develop individualized screening schedules using reinforcement learning (RL) and evaluate the effectiveness of RL-based policy models., Methods: Using a nested case-control design, we retrospectively identified 308 patients with cancer who had positive screening results in at least two screening rounds in the National Lung Screening Trial. We established a control group that included cancer-free patients with nodules, matched (1:1) according to the year of cancer diagnosis. By generating 10,164 sequence decision episodes, we trained RL-based policy models, incorporating nodule diameter alone, combined with nodule appearance (attenuation and margin) and/or patient information (age, sex, smoking status, pack-years, and family history). We calculated rates of misdiagnosis, missed diagnosis, and delayed diagnosis, and compared the performance of RL-based policy models with rule-based follow-up protocols (National Comprehensive Cancer Network guideline; China Guideline for the Screening and Early Detection of Lung Cancer)., Results: We identified significant interactions between certain variables (e.g., nodule shape and patient smoking pack-years, beyond those considered in guideline protocols) and the selection of follow-up testing intervals, thereby impacting the quality of the decision sequence. In validation, one RL-based policy model achieved rates of 12.3% for misdiagnosis, 9.7% for missed diagnosis, and 11.7% for delayed diagnosis. Compared with the two rule-based protocols, the three best-performing RL-based policy models consistently demonstrated optimal performance for specific patient subgroups based on disease characteristics (benign or malignant), nodule phenotypes (size, shape, and attenuation), and individual attributes., Conclusions: This study highlights the potential of using an RL-based approach that is both clinically interpretable and performance-robust to develop personalized lung cancer screening schedules. Our findings present opportunities for enhancing the current cancer screening system., (© 2024 The Author(s). Cancer Medicine published by John Wiley & Sons Ltd.)

In this work, flexible Cu 2-x S films on nylon membranes are prepared by combining a simple hydrothermal synthesis and vacuum filtration followed by hot pressing. The films consist of Cu 2 S and Cu 1.96 S two phases with grain sizes from nano to submicron. Doping Se on the S site not only increases the Cu 1.96 S content in the Cu 2-x S to increase carrier concentration but also modifies electronic structure, thereby greatly improves the electrical properties of the Cu 2-x S. Specifically, an optimal composite film with a nominal composition of Cu 2-x S 0.98 Se 0.02 exhibits a high power factor of ~150.1 μW m -1 K -2 at 300 K, which increases by ~138% compared to that of the pristine Cu 2-x S film. Meanwhile, the composite film shows outstanding flexibility (~97.2% of the original electrical conductivity is maintained after 1500 bending cycles with a bending radius of 4 mm). A four-leg flexible thermoelectric (TE) generator assembled with the optimal film generates a maximum power of 329.6 nW (corresponding power density of 1.70 W m -2 ) at a temperature difference of 31.1 K. This work provides a simple route to the preparation of high TE performance Cu 2-x S-based films.

Background: To determine the predictive value of interstitial lung abnormalities (ILA) for epidermal growth factor receptor (EGFR) mutation status and assess the prognostic significance of EGFR and ILA in patients with non-small cell lung cancer (NSCLC)., Methods: We reviewed 797 consecutive patients with a histologically proven diagnosis of primary NSCLC from January 2013 to October 2018. Of these, 109 patients with NSCLC were found to have concomitant ILA. Multivariate logistic regression analysis was used to identify the significant clinical and computed tomography (CT) findings in predicting EGFR mutations. Cox proportional hazard models were used to identify significant prognostic factors., Results: EGFR mutations were identified in 22 of 109 tumors (20.2%). Multivariate analysis showed that the models incorporating clinical, tumor CT and ILA CT features yielded areas under the receiver operating characteristic curve (AUC) values of 0.749, 0.838, and 0.849, respectively. When combining the three models, the independent predictive factors for EGFR mutations were non-fibrotic ILA, female sex, and small tumor size, with an AUC value of 0.920 (95% confidence interval[CI]: 0.861-0.978, p < 0.001). In the multivariate Cox model, EGFR mutations (hazard ratio = 0.169, 95% CI = 0.042-0.675, p = 0.012; 692 days vs. 301 days) were independently associated with extended overall survival compared to the wild-type., Conclusion: Non-fibrotic ILA independently predicts the presence of EGFR mutations, and the presence of EGFR mutations rather than non-fibrotic ILA serves as an independent good prognostic factor for patients with NSCLC., (© 2024. The Author(s).)

Recent studies have shown that silver selenide is a promising thermoelectric material at room temperature. Herein, flexible films with a nominal composition of (Ag 1- x Cu x ) 2 Se are prepared by a simple and efficient one-pot method combined with vacuum-assisted filtration and hot pressing. The thermoelectric properties of the films are regulated by both cationic doping and a dual-phase strategy via a wet chemical method. As the x increases, not only Cu is doped into the Ag 2 Se, but different new phases (CuAgSe and/or CuSe 2 ) also appear. The (Ag 1- x Cu x ) 2 Se film with x = 0.02 composed of Cu-doped Ag 2 Se and CuAgSe shows a high PF of ∼2540 μW m -1 K -2 ( ZT ∼ 0.90) and outstanding flexibility at room temperature. The high thermoelectric properties of the film are due to the effect of Cu doping and the CuAgSe phase, including the increase in electrical conductivity caused by doping, the enhanced phonon scattering at the Ag 2 Se/CuAgSe interface, and the interaction between the energy filtering effect and the doping effect. In addition to the high output performance (PD max = 28.08 W m -2 , Δ T = 32.2 K), the flexible device assembled with the (Ag 0.98 Cu 0.02 ) 2 Se film also has potential applications as a temperature sensor.

With the advent of cancer immunotherapy, some special features including delayed treatment effect, cure rate, diminishing treatment effect and crossing survival are often observed in survival analysis. They violate the proportional hazard model assumption and pose a unique challenge for the conventional trial design and analysis strategies. Many methods like cure rate model have been developed based on mixture model to incorporate some of these features. In this work, we extend the mixture model to deal with multiple non-proportional patterns and develop its geometric average hazard ratio (gAHR) to quantify the treatment effect. We further derive a sample size and power formula based on the non-centrality parameter of the log-rank test and conduct a thorough analysis of the impact of each parameter on performance. Simulation studies showed a clear advantage of our new method over the proportional hazard based calculation across different non-proportional hazard scenarios. Moreover, the mixture modeling of two real trials demonstrates how to use the prior information on the survival distribution among patients with different biomarker and early efficacy results in practice. By comparison with a simulation-based design, the new method provided a more efficient way to compute the power and sample size with high accuracy of estimation. Overall, both theoretical derivation and empirical studies demonstrate the promise of the proposed method in powering future innovative trial designs., (© 2023 John Wiley & Sons Ltd.)

Treatment resistance and toxicities remain a risk following chimeric antigen receptor (CAR) T-cell therapy. Herein, we report pharmacokinetics, pharmacodynamics, and product and apheresis attributes associated with outcomes among patients with relapsed/refractory large B-cell lymphoma (LBCL) treated with axicabtagene ciloleucel (axi-cel) in ZUMA-7. Axi-cel peak expansion associated with clinical response and toxicity, but not response durability. In apheresis material and final product, a naive T-cell phenotype (CCR7+CD45RA+) expressing CD27 and CD28 associated with improved response durability, event-free survival, progression-free survival, and a lower number of prior therapies. This phenotype was not associated with high-grade cytokine release syndrome (CRS) or neurologic events. Higher baseline and postinfusion levels of serum inflammatory markers associated with differentiated/effector products, reduced efficacy, and increased CRS and neurologic events, thus suggesting targets for intervention. These data support better outcomes with earlier CAR T-cell intervention and may improve patient care by informing on predictive biomarkers and development of next-generation products., Significance: In ZUMA-7, the largest randomized CAR T-cell trial in LBCL, a naive T-cell product phenotype (CCR7+CD45RA+) expressing CD27 and CD28 associated with improved efficacy, decreased toxicity, and a lower number of prior therapies, supporting earlier intervention with CAR T-cell therapy. In addition, targets for improvement of therapeutic index are proposed. This article is featured in Selected Articles from This Issue, p. 4., (©2023 The Authors; Published by the American Association for Cancer Research.)

Background: Multimorbidity is common, particularly among elderly people. Restructuring health service systems to better manage this public health issue requires knowledge regarding disease prevalence and patterns. We quantified the epidemiology characteristics of multimorbidity among adults in China to inform policy-making and resource allocation., Methods: We searched 10 databases for studies (January 2000-October 2023) reporting primary epidemiological multimorbidity data for adults in China. We included observational studies; we excluded duplicate publications and studies investigating a single comorbidity pattern, focused on specific population categories, using medical insurance reimbursement data, and with unclear/incomplete data. We assessed risk of bias using the STROBE checklist and estimated heterogeneity among studies. The prevalence was pooled using the random-effects method and sample size as weight., Findings: Of 13,998 records retrieved, 67 studies (30 in English, 37 in Chinese) were included. The prevalence (95% confidence interval) of multimorbidity was 25.4% (15.1%, 35.7%) among Chinese adults. Among 42 studies reporting age-specific prevalence, multimorbidity prevalence increased rapidly with age: 3.3% (0%, 15.2%) for age 18-29 years, 5.9% (0%, 12.9%) for 30-44 years, 17.6% (6.1%, 29.1%) for 45-59 years, 32.4% (16.1%, 48.7%) for 60-69 years, 38.5% (23.6%, 53.4%) for 70-79 years, and 40.2% (20.8%, 59.6%) for age ≥ 80 years. Overall prevalence of multimorbidity has increased in recent years, with regional disparity. The most common patterns included hypertension with hearing impairment (10.4% [95% CI: 4.3%, 16.5%]), dyslipidemia (8.9% [4.1%, 13.6%]), and diabetes (8.7% [3.7%, 13.8%])., Conclusion: Multimorbidity was present nearly one in four Chinese adults, with hypertensive diseases and other comorbidities being the most-observed pattern; the prevalence increased rapidly with increased age. There is huge variation in the prevalence of multimorbidity across China. Coordinated, comprehensive strategies are urgently needed to control the ongoing impact of multimorbidity., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 The Authors. Published by Elsevier B.V. All rights reserved.)

Copper-sulfide-based materials have attracted noteworthy attention as thermoelectric materials due to rich elemental reserves, non-toxicity, low thermal conductivity, and adjustable electrical properties. However, research on the flexible thermoelectrics of copper sulfide has not yet been reported. In this work, we developed a facile method to prepare flexible Mn-doped Cu 2-x S films on nylon membranes. First, nano to submicron powders with nominal compositions of Cu 2-x Mn y S (y = 0, 0.01, 0.03, 0.05, 0.07) were synthesized by a hydrothermal method. Then, the powders were vacuum-filtrated on nylon membranes and finally hot-pressed. Phase composition and microstructure analysis revealed that the films contained both Cu 2 S and Cu 1.96 S, and the size of the grains was ~20-300 nm. By Mn doping, there was an increase in carrier concentration and mobility, and ultimately, the electrical properties of Cu 2-x S were improved. Eventually, the Cu 2-x Mn 0.05 S film showed a maximum power factor of 113.3 μW m -1 K -2 and good flexibility at room temperature. Moreover, an assembled four-leg flexible thermoelectric generator produced a maximum power of 249.48 nW (corresponding power density ~1.23 W m -2 ) at a temperature difference of 30.1 K, and had good potential for powering low-power-consumption wearable electronics.

Background: Numerous attempts have been made to identify risk factors for surgery complications, but few studies have identified accurate methods of predicting complex outcomes involving multiple complications., Methods: We performed a prospective cohort study of general surgical inpatients who attended 4 regionally representative hospitals in China from January to June 2015 and January to June 2016. The risk factors were identified using logistic regression. A Bayesian network model, consisting of directed arcs and nodes, was used to analyze the relationships between risk factors and complications. Probability ratios for complications for a given node state relative to the baseline probability were calculated to quantify the potential effects of risk factors on complications or of complications on other complications., Results: We recruited 19,223 participants and identified 21 nodes, representing 9 risk factors and 12 complications, and 55 direct relationships between these. Respiratory failure was at the center of the network, directly affected by 5 risk factors, and directly affected 7 complications. Cardiopulmonary resuscitation and sepsis or septic shock also directly affected death. The area under the receiver operating characteristic curve for the ability of the network to predict complications was >0.7. Notably, the probability of other severe complications or death significantly increased when a severe complication occurred. Most importantly, there was a 141-fold higher risk of death when cardiopulmonary resuscitation was required., Conclusion: We have created a Bayesian network that displays how risk factors affect complications and their interrelationships and permits the accurate prediction of complications and the creation of appropriate preventive guidelines., (Copyright © 2023. Published by Elsevier Inc.)

Flexible Ag 2 Se thermoelectric (TE) films are promising for wearable applications near room temperature (RT). Herein, a Ag 2 Se film on a nylon membrane with high TE performance was fabricated by a facile method. First, Ag 2 Se powders were prepared by a microwave-assisted synthesis method using Ag nanowires as a template. Second, the Ag 2 Se powders were deposited onto nylon via vacuum filtration followed by hot pressing. Through modulating the Ag/Se molar ratio for synthesizing the Ag 2 Se powders, an optimized Ag 2 Se film demonstrates a high power factor of 1577.1 μW m -1 K -2 and good flexibility at RT. The flexibility of the Ag 2 Se film is mainly attributed to the flexible nylon membrane. In addition, a six-leg flexible TE generator (f-TEG) fabricated with the optimized Ag 2 Se film exhibits a maximum power density of 18.4 W m -2 at a temperature difference of 29 K near RT. This work provides a new solution to prepare high-TE-performance flexible Ag 2 Se films for f-TEGs.

Herein, a flexible Ag 2 Se/Se composite film with a high power factor has been fabricated on a nylon membrane. The film has a high density and contains well-crystallized Ag 2 Se grains and embedded Se nanoinclusions, which exhibits not only excellent flexibility but also a comparably large room-temperature power factor and Seebeck coefficient of up to 2023 μW m -1 K -2 and -155 μV K -1 , respectively. The high Seebeck coefficient is ascribed to the energy-filtering effect as caused by the Se/Ag 2 Se heterointerface. The assembled flexible thermoelectric generator (4-leg) exhibits a maximum output power of 1135 nW and a power density of up to 16.4 W m -2 when the applied temperature difference is 30 K. This work offers a feasible method to design high-performance and low-cost flexible thermoelectric generators used for wearable electronics.

Complicated relationships exist in both occurrence and progression of surgical complications, which are difficult to account for using a separate quantitative method such as prediction or grading. Data of 51,030 surgical inpatients were collected from four academic/teaching hospitals in a prospective cohort study in China. The relationship between preoperative factors, 22 common complications, and death was analyzed. With input from 54 senior clinicians and following a Bayesian network approach, a complication grading, cluster-visualization, and prediction (GCP) system was designed to model pathways between grades of complication and preoperative risk factor clusters. In the GCP system, there were 11 nodes representing six grades of complication and five preoperative risk factor clusters, and 32 arcs representing a direct association. Several critical targets were pinpointed on the pathway. Malnourished status was a fundamental cause widely associated (7/32 arcs) with other risk factor clusters and complications. American Society of Anesthesiologists (ASA) score ⩾3 was directly dependent on all other risk factor clusters and influenced all severe complications. Grade III complications (mainly pneumonia) were directly dependent on 4/5 risk factor clusters and affected all other grades of complication. Irrespective of grade, complication occurrence was more likely to increase the risk of other grades of complication than risk factor clusters., (© 2023. Science China Press.)

Highly efficient and stable blue organic light-emitting diodes (OLEDs) cannot be easily obtained simultaneously. In particular, the efficiency roll-off as a reference index to evaluate the lifetime of deep-blue OLED at high luminescence is still severe. A novel molecule ( CzSiTrz ) connected with carbazole and triazine fragments by a nonconjugated silicon atom is designed. An intramolecular charge transfer emission and intermolecular exciplex luminescence in the aggregated state are obtained, resulting in a dual-channel intra/intermolecular exciplex ( DCIE ) emission with fast and efficient reverse intersystem crossing (RISC). Deep-blue OLED with Commission Internationale de l'Eclairage (CIE) coordinates of (0.157, 0.076) and a record-high external quantum efficiency (EQE) of 20.35% at high luminance (5000 cd m -2 ) is accomplished. Simple molecular synthesis and device fabrication of this strategy give a unique approach to realizing high-performance deep-blue electroluminescence.

As a vital parameter in living cells and tissues, the micro-environment is crucial for the living organisms. Significantly, organelles require proper micro-environment to achieve normal physiological processes, and the micro-environment in organelles can reflect the state of organelles in living cells. Moreover, some abnormal micro-environments in organelles are closely related to organelle dysfunction and disease development. So, visualizing and monitoring the variation of micro-environments in organelles is helpful for physiologists and pathologists to study the mechanisms of the relative diseases. Recently, a large variety of fluorescent probes was developed to study the micro-environments in living cells and tissues. However, the systematic and comprehensive reviews on the organelle micro-environment in living cells and tissues have rarely been published, which may hinder the research progress in the field of organic fluorescent probes. In this review, we will summarize the organic fluorescent probes for monitoring the microenvironment, such as viscosity, pH values, polarity, and temperature. Further, diverse organelles (mitochondria, lysosome, endoplasmic reticulum, cell membrane) about microenvironments will be displayed. In this process, the fluorescent probes about the "off-on" and ratiometric category (the diverse fluorescence emission) will be discussed. Moreover, the molecular designing, chemical synthesis, fluorescent mechanism, and the bio-applications of these organic fluorescent probes in cells and tissues will also be discussed. Significantly, the merits and defects of current microenvironment-sensitive probes are outlined and discussed, and the development tendency and challenges for this kind of probe are presented. In brief, this review mainly summarizes some typical examples and highlights the progress of organic fluorescent probes for monitoring micro-environments in living cells and tissues in recent research. We anticipate that this review will deepen the understanding of microenvironment in cells and tissues and facilitate the studies and development of physiology and pathology.

Solid state potassium (K) metal batteries are intriguing in grid-scale energy storage, benefiting from the low cost, safety, and high energy density. However, their practical applications are impeded by poor K/solid electrolyte (SE) interfacial contact and limited capacity caused by the low K self-diffusion coefficient, dendrite growth, and intrinsically low melting point/soft features of metallic K. Herein, a fused-modeling strategy using potassiophilic carbon allotropes molted with K is demonstrated that can enhance the electrochemical performance/stability of the system via promoting K diffusion kinetics (2.37 × 10 -8 cm 2 s -1 ), creating a low interfacial resistance (≈1.3 Ω cm 2 ), suppressing dendrite growth, and maintaining mechanical/thermal stability at 200 °C. A homogeneous/stable K stripping/plating is consequently implemented with a high current density of 2.8 mA cm -2 (at 25 °C) and a record-high areal capacity of 11.86 mAh cm -2 (at 0.2 mA cm -2 ). The enhanced K diffusion kinetics contribute to sustaining intimate interfacial contact, stabilizing the stripping/plating at high current densities. Full cells coupling ultrathin K-C composite anodes (≈50 µm) with Prussian blue cathodes and β/β″-Al 2 O 3 SEs deliver a high energy density of 389 Wh kg -1 with a retention of 94.4% after 150 cycles and fantastic performances at -20 to 120 °C., (© 2023 Wiley-VCH GmbH.)

Background and Objective: Postoperative complications confer an increased risk of reoperation, prolonged length of hospital stay, and increased mortality. Many studies have attempted to identify the complex associations among complications to preemptively interrupt their progression, but few studies have looked at complications as a whole to reveal and quantify their possible trajectories of progression. The main objective of this study was to construct and quantify the association network among multiple postoperative complications from a comprehensive perspective to elucidate the possible evolution trajectories., Methods: In this study, a Bayesian network model was proposed to analyze the associations among 15 complications. Prior evidence and score-based hill-climbing algorithms were used to build the structure. The severity of complications was graded according to their connection to death, with the association between them quantified using conditional probabilities. The data of surgical inpatients used in this study were collected from four regionally representative academic/teaching hospitals in a prospective cohort study in China., Results: In the network obtained, 15 nodes represented complications or death, and 35 arcs with arrows represented the directly dependent relationship between them. With three grades classified on that basis, the correlation coefficients of complications within grades increased with increased grade, ranging from -0.11 to -0.06, 0.16, and 0.21 to 0.4 in grade 1 to grade 3, respectively. Moreover, the probability of each complication in the network increased with the occurrence of any other complication, even mild complications. Most seriously, once cardiac arrest requiring cardiopulmonary resuscitation occurs, the probability of death will be up to 88.1%., Conclusions: The present evolving network can facilitate the identification of strong associations among specific complications and provides a basis for the development of targeted measures to prevent further deterioration in high-risk patients., Competing Interests: Declaration of Competing Interest The authors declare that they have no conflicts of interest., (Copyright © 2023. Published by Elsevier B.V.)

Background: China is experiencing a postpeak smoking epidemic with accelerating population ageing. Understanding the impacts of these factors on the future cancer burden has widespread implications., Methods: We developed predictive models to estimate smoking-related cancer deaths among men and women aged ≥35 years in China during 2020-2040. Data sources for model parameters included the United Nations World Population Prospects, China Death Surveillance Database, national adult tobacco surveys and the largest national survey of smoking and all causes of death to date. The main assumptions included stable sex-specific and age-specific cancer mortality rates and carcinogenic risks of smoking over time., Results: In a base-case scenario of continuing trends in current smoking prevalence (men: 57.4%-50.5%; women: 2.6%-2.1% during 2002-2018), the smoking-related cancer mortality rate with population ageing during 2020-2040 would rise by 44.0% (from 337.2/100 000 to 485.6/100 000) among men and 52.8% (from 157.3/100 000 to 240.4/100 000) among women; over 20 years, there would be 8.6 million excess deaths (0.5 million more considering former smoking), and a total of 117.3 million smoking-attributable years of life lost (110.3 million (94.0%) in men; 54.1 million (46.1%) in working-age (35-64 years) adults). An inflection point may occur in 2030 if smoking prevalence were reduced to 20% (Healthy China 2030 goal), and 1.4 million deaths would be averted relative to the base-case scenario if the trend were maintained through 2040., Conclusions: Coordinated efforts are urgently needed to curtail a rising tide of cancer deaths in China, with intensified tobacco control being key., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2023. No commercial re-use. See rights and permissions. Published by BMJ.)

Flexible thermoelectric (TE) generators have recently attracted increasing attention as they have the potential to power wearable devices using the temperature difference between the human body and the environment. Ag 2 S is recently reported to have plasticity near room temperature; however, it has very low electrical conductivity, leading to its poor TE property. Here, to improve the TE property, different amounts of Se (Se/Ag 2 S molar ratios being 0.4, 0.5, and 0.6) solid solution-substituted Ag 2 S films on a nylon membrane are prepared by combing wet-chemical synthesis, vacuum filtration, and hot-pressing. The film (Se/Ag 2 S molar ratio = 0.6) exhibits a better TE performance with a power factor of 477.4 ± 15.20 μW m -1 K -2 at room temperature, which is comparable to that of bulk Ag 2 S 1- x Se x . In addition, the film possesses excellent flexibility (only ∼5.4% decrease in electrical conductivity after 2000 times bending along a rod with a radius of 4 mm). The power density of a 6-leg TE generator assembled with the film is 6.6 W/m 2 under a temperature difference of 28.8 K. This work provides a facile new route to Ag 2 S-based TE films with low cost, high TE performance, and ultrahigh flexibility.

The digital economy is an important driving force for the high-quality development of the manufacturing industry. This paper uses 2013-2019 manufacturing panel data to empirically test the impact of digital economic growth on China's manufacturing export competitiveness. The results show that, first, the degree of integration of manufacturing and digital economy in the eastern region is higher than that in the central and western regions. Second, the development of the digital economy has indeed had a significant positive impact on the export competitiveness of China's manufacturing industry. Third, the digital economy has different impacts on the export competitiveness of manufacturing industries in different industries and regions. Based on the findings, some suggestions are made to further enhance the export competitiveness of China's manufacturing industry, such as paying attention to the development of digital infrastructure, optimizing the mode of integration of the manufacturing sector and the digital economy, and enhancing international collaboration in digital technology innovation.

Existing research has documented that public attitudes towards waste incineration plants are determined by various factors, such as risk perception, economic impacts, and social trust. However, the diversity in perceptions within communities hosting waste incineration plants is understudied. Adds to existing knowledge, the present paper employed the Q methodology to examine the perceptions of residents living in the vicinity of a waste incineration plant in Xuzhou, China. The results revealed four perspectives on residents' perceptions towards waste incineration plants: I do not trust them and feel besieged by risks; I trust local governments but I am unfairly treated; I attach this place a lot but I am unfairly treated; I possess knowledge of waste incineration and feel besieged by risks. Our data show that risk perception, trust perception, and political efficacy perception are underlying reasons for local acceptance of waste incineration plants. The diversified subjectivities we obtained supplement existing literature that quantitatively documents the influencing factors. These findings demonstrate that it is necessary to explicitly consider the deep-seated values and perspectives among hosting residents' for the siting of the waste incineration plant., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Huang, Zhang, Zhang and Wang.)

Background: Numerous observational studies have revealed an increased risk of death and complications with transfusion, but this observation has not been confirmed in randomized controlled trials (RCTs). The "transfusion kills patients" paradox persists in real-world observational studies despite application of analytic methods such as propensity-score matching. We propose a new design to address this long-term existing issue, which if left unresolved, will be deleterious to the healthy generation of evidence that supports optimized transfusion practice., Methods: In the new design, we stress three aspects for reconciling observational studies and RCTs on transfusion safety: (1) re-definition of the study population according to a stable hemoglobin range (gray zone of transfusion decision; 7.5-9.5 g/dL in this study); (2) selection of comparison groups according to a trigger value (last hemoglobin measurement before transfusion; nadir during hospital stay for control); (3) dealing with patient heterogeneity according to standardized mean difference (SMD) values. We applied the new design to hospitalized older patients (aged ≥60 years) undergoing general surgery at four academic/teaching hospitals. Four datasets were analyzed: a base population before (Base Match-) and after (Base Match+) propensity-score matching to simulate previous observational studies; a study population before (Study Match-) and after (Study Match+) propensity-score matching to demonstrate effects of our design., Results: Of 6141 older patients, 662 (10.78%) were transfused and showed high heterogeneity compared with those not receiving transfusion, particularly regarding preoperative hemoglobin (mean: 11.0 vs. 13.5 g/dL) and intraoperative bleeding (≥500 mL: 37.9% vs. 2.1%). Patient heterogeneity was reduced with the new design; SMD of the two variables was reduced from approximately 100% (Base Match-) to 0% (Study Match+). Transfusion was related to a higher risk of death and complications in Base Match- (odds ratio [OR], 95% confidence interval [CI]: 2.68, 1.86-3.86) and Base Match+ (2.24, 1.43-3.49), but not in Study Match- (0.77, 0.32-1.86) or Study Match+ (0.66, 0.23-1.89)., Conclusions: We show how choice of study population and analysis could affect real-world study findings. Our results following the new design are in accordance with relevant RCTs, highlighting its value in accelerating the pace of transfusion evidence generation and generalization., (© 2022. The Author(s).)

Purpose: To identify key biomarkers in the metastasis of uveal melanoma (UM). Methods: The microarray datasets GSE27831 and GSE22138 were downloaded from the Gene Expression Omnibus database. Differentially expressed genes (DEGs) were identified, and functional enrichment analyses were performed. A protein−protein interaction network was constructed, and four algorithms were performed to increase the reliability of hub genes. Biomarker analysis and metastasis-free survival analysis were performed to screen and verify prognostic hub genes. Results: A total of 138 DEGs were identified, consisting of 71 downregulated genes and 67 upregulated genes. Four genes (ROBO1, FMN1, FYN and FXR1) were selected as hub genes. Biomarker analysis and metastasis-free survival analysis showed that ROBO1, FMN1, FYN and FXR1 were factors affecting the metastasis and metastasis-free survival of UM (all p < 0.05). High expression of ROBO1 and low expression of FMN1 were associated with longer metastasis-free survival. Multivariable logistic regression and Cox analyses in GSE 27831 indicated that ROBO1 was an independent factor affecting metastasis and metastasis-free survival of UM (p = 0.010 and p = 0.009), while ROBO1 and FMN1 were independent factors affecting metastasis and metastasis-free survival of UM in GSE22138 (all p < 0.05). Conclusions: ROBO1, FMN1, FYN and FXR1 should be regarded as diagnostic biomarkers for the metastasis of UM, especially ROBO1 and FMN1. High expression of ROBO1 and low expression of FMN1 were associated with longer metastasis-free survival. This study may facilitate the understanding of the molecular mechanisms underlying the metastasis of UM.

Objective: To project future trajectories of the gastric cancer (GC) burden in China under different scenarios of GC prevention and identify strategies to improve affordability and cost-effectiveness., Design: Using a cohort of Chinese men and women born during 1951-1980, we assumed that different prevention strategies were conducted, including eradication of Helicobacter pylori (Hp) and endoscopy screening (one-time, annual, biennial, triennial or stratified according to personal risk). We performed a literature search to identify up-to-date data and populate a Markov model to project the number of new GC cases and deaths during 2021-2035, as well as resource requirements and quality-adjusted life-years (QALYs). We examined the impacts of general (among the whole population) and targeted (high-risk population) prevention., Results: During 2021-2035, 10.0 million new GC cases and 5.6 million GC deaths would occur, with 7.6%-35.5% and 6.9%-44.5%, respectively, being avoidable through various prevention strategies. Relative to the status quo, Hp eradication was a cost-saving strategy. General annual screening dominated other screening strategies, but cost more than CNY 70 000 per QALY gained (willingness-to-pay) compared with Hp eradication. Among endoscopy strategies, targeted screening resulted in 44%-49% lower cost per QALY gained over the status quo than general screening. Among high-risk population, tailoring the screening frequency according to personal risk could reduce endoscopy-related resources by 22% compared with biennial screening and by 55% compared with annual screening, CONCLUSION: Our findings provide important input for future decision-making and investment, highlighting the need and feasibility for China to include GC prevention in its national health plans., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2022. No commercial re-use. See rights and permissions. Published by BMJ.)

Axicabtagene ciloleucel (axi-cel) is an anti-CD19 chimeric antigen receptor (CAR) T cell therapy approved for relapsed/refractory large B cell lymphoma (LBCL) and has treatment with similar efficacy across conventional LBCL subtypes. Toward patient stratification, we assessed whether tumor immune contexture influenced clinical outcomes after axi-cel. We evaluated the tumor microenvironment (TME) of 135 pre-treatment and post-treatment tumor biopsies taken from 51 patients in the ZUMA-1 phase 2 trial. We uncovered dynamic patterns that occurred within 2 weeks after axi-cel. The biological associations among Immunoscore (quantification of tumor-infiltrating T cell density), Immunosign 21 (expression of pre-defined immune gene panel) and cell subsets were validated in three independent LBCL datasets. In the ZUMA-1 trial samples, clinical response and overall survival were associated with pre-treatment immune contexture as characterized by Immunoscore and Immunosign 21. Circulating CAR T cell levels were associated with post-treatment TME T cell exhaustion. TME enriched for chemokines (CCL5 and CCL22), γ-chain receptor cytokines (IL-15, IL-7 and IL-21) and interferon-regulated molecules were associated with T cell infiltration and markers of activity. Finally, high density of regulatory T cells in pre-treatment TME associated with reduced axi-cel-related neurologic toxicity. These findings advance the understanding of LBCL TME characteristics associated with clinical responses to anti-CD19 CAR T cell therapy and could foster biomarker development and treatment optimization for patients with LBCL., (© 2022. The Author(s).)

Background: Findings of observational studies investigating the impact of transfusions are at odds with those of randomised controlled trials, raising concern that observational studies may be inappropriate to inform transfusion decisions. We examined whether observational data could replicate evidence from randomised controlled trials on restrictive transfusion in cardiac and orthopaedic surgery, and be generalised to broader specialties as well as to a lower haemoglobin transfusion threshold (7 g/dL)., Material and Methods: A multicentre, prospective cohort study was performed at three representative regional hospitals in China between 2015 and 2016. Participants were surgical inpatients (≥18 years; hospital stay ≥24 h) in six specialties: cardiac, cerebral, vascular (CCV), and orthopaedic, general, thoracic (non-CCV). Patients with a stable haemoglobin (7-10 g/dL) constituted the primary analytic sample, while patients with ≥500 mL intra-operative bleeding were analysed separately to avoid haemoglobin instability. The association of transfusion with surgical outcomes (death, in-hospital complications) was evaluated., Results: The transfusion rate was 10.7% in 36,607 patients (mean age, 52.5±14.3 years; 52.3% female). After restriction, stratification, and propensity score matching to reduce patients' heterogeneity, transfusion was unrelated to death (CCV: odds ratio [OR]=0.74, 95% confidence interval [CI]: 0.16-3.39; non-CCV: OR 0.83, 95% CI: 0.36-1.94) and the composite complication (CCV: OR 1.31, 95% CI: 0.63-2.72; non-CCV: OR=1.24, 95% CI: 0.81-1.90). The results were consistent in subgroups (elderly, coronary heart disease, malignant tumour, severe illness) and applicable to patients with significant bleeding after restoration of a stable haemoglobin., Discussion: Transfusion at a stable haemoglobin concentration of 7-10 g/dL did not alter surgical outcomes. Our results show the feasibility of observational data to expand restrictive transfusion to broader specialties and a lower transfusion threshold in surgical practice.

Background: Radiomics-based image metrics are not used in the clinic despite the rapidly growing literature. We selected eight promising radiomic features and validated their value in decoding lung cancer heterogeneity., Methods: CT images of 236 lung cancer patients were obtained from three different institutes, whereupon radiomic features were extracted according to a standardized procedure. The predictive value for patient long-term prognosis and association with routinely used semantic, genetic (e.g., epidermal growth factor receptor (EGFR)), and histopathological cancer profiles were validated. Feature measurement reproducibility was assessed., Results: All eight selected features were robust across repeat scans (intraclass coefficient range: 0.81-0.99), and were associated with at least one of the cancer profiles: prognostic, semantic, genetic, and histopathological. For instance, "kurtosis" had a high predictive value of early death (AUC at first year: 0.70-0.75 in two independent cohorts), negative association with histopathological grade (Spearman's r: - 0.30), and altered expression levels regarding EGFR mutation and semantic characteristics (solid intensity, spiculated shape, juxtapleural location, and pleura tag; all p < 0.05). Combined as a radiomic score, the features had a higher area under curve for predicting 5-year survival (train: 0.855, test: 0.780, external validation: 0.760) than routine characteristics (0.733, 0.622, 0.613, respectively), and a better capability in patient death risk stratification (hazard ratio: 5.828, 95% confidence interval: 2.915-11.561) than histopathological staging and grading., Conclusions: We highlighted the clinical value of radiomic features. Following confirmation, these features may change the way in which we approach CT imaging and improve the individualized care of lung cancer patients., (© 2022. The Author(s).)

Background: Endothelial dysfunction is associated with two main complications of chimeric antigen receptor T (CAR-T) cell therapy, cytokine release syndrome (CRS) and immune effector cell-associated neurotoxicity syndrome (ICANS). This study evaluates the Endothelial Activation and Stress Index (EASIX) as a prognostic marker for high-grade CRS and ICANS in patients treated with CD19-directed CAR-T cells., Methods: In this retrospective study, a training cohort of 93 patients from the ZUMA-1 trial and a validation cohort of 121 patients from two independent centers (University Hospital Heidelberg, Charité University Medicine Berlin) were investigated. The primary objective was to assess the predictive capacity of EASIX measured immediately before the start of lymphodepletion (EASIX-pre) for the occurrence of grade ≥3 CRS and/or ICANS. To explore a possible endothelial link, serum levels of endothelial stress markers (angiopoietin-2, suppressor of tumorigenicity-2, soluble thrombomodulin, and interleukin-8) were determined before lymphodepletion and on day 7 after CART infusion in the validation cohort ( n = 47)., Results: The prognostic effect of EASIX-pre on grade ≥3 CRS and/or ICANS was significant in the training cohort [OR 2-fold increase 1.72 (1.26-2.46)] and validated in the independent cohort. An EASIX-pre cutoff >4.67 derived from the training cohort associated with a 4.3-fold increased odds ratio of severe CRS/ICANS in the independent cohort. Serum endothelial distress markers measured on day+7 correlated with EASIX-pre and associated with severe complications., Conclusions: EASIX-pre is a powerful predictor of severe CRS/ICANS after CD19-directed CART therapy and might be used as a basis for risk-adapted prevention strategies., Competing Interests: Authors MM and ZW were employed by the company Kite Pharma, Gilead. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.​, (Copyright © 2022 Korell, Penack, Mattie, Schreck, Benner, Krzykalla, Wang, Schmitt, Bullinger, Müller-Tidow, Dreger and Luft.)

MXene-based microsupercapacitors (MSCs) have promoted the development of on-chip energy storage for miniaturized and portable electronics due to the small size, high power density and integration density. However, restricted energy density and operating voltage invariably create obstacles to the practical application of MSCs. Here, we report a symmetric MXene-based on-chip MSC, achieving an ultrahigh energy density of 75 mWh cm -3 with high operating voltage of 1.2 V, which are almost the highest values among all reported symmetric MXene MSCs. The adjustment strategy of acetone on the viscosity and surface tension of MXene ink, along with the natural sedimentation strategy, can effectively prevent the orderly stacking of MXene sheets. Further, we developed an all-in-one Si-electronics with three series MSCs through laser-etching technology, obviously presenting high integration capacity and processing compatibility. Thus, this work will contribute to the development of high integration all-in-one electronics with high energy density MXene-based MSCs.

Objective: China is a developing country with urban-rural disparities and accelerating population aging. Therefore, quantifying the effects of population aging on the cancer mortality burden is urgently needed., Methods: Using data from China's death surveillance datasets (2004-2017), we decomposed and quantified the effects of population aging and factor variations on cancer mortality rates in urban and rural China during 2004-2017 through a decomposition method. R ratios were used to assess the extent of the mortality decreases attributable to factor variations offsetting the increases attributable to population aging for 4 aging-related cancers (lung, colorectal, esophageal, and stomach cancer)., Results: Overall, population aging has led to continued increases in cancer mortality rates in China during 2004-2017 (mortality rates attributable to population aging: 8.63/100,000 for urban men, 4.21/100,000 for urban women, 11.95/100,000 for rural men, and 5.66/100,000 for rural women). The 4 cancers displayed 3 patterns. The mortality rates from lung cancer in rural China and from colorectal cancer nationwide increased because of both population aging and factor variations. Population aging was primarily responsible for the growing mortality due to lung cancer in urban areas. However, for esophageal and stomach cancer, the effect of population aging was not dominant, thus resulting in decreases in mortality rates., Conclusions: Health resource allocation should prioritize areas or cancers more adversely affected by population aging. The burden of cancer will continue to increase in the future, because of rapid population aging, but can still be offset or even reversed with enhanced cancer control and prevention., Competing Interests: No potential conflicts of interest are disclosed., (Copyright © 2022 Cancer Biology & Medicine.)

In this work, we developed a facile method to fabricate low-cost, flexible, and high-thermoelectric-performance n-type Ag 2 Se 1- x S x @(Ag 2 S 1- y Se y /S) composite film on a nylon membrane. The composite film was prepared by first performing wet-chemical synthesis of the S-doped Ag 2 Se powder, then vacuum-assisted filtration of the powder on a nylon membrane, and finally hot-pressing. Transmission electron microscopy (TEM) observation and energy-dispersive system (EDS) analysis of the film revealed that the film had a porous network-like microstructure, in which Ag 2 Se 1- x S x sub-micron grains formed the skeleton and are coated by a ∼15 nm thick layer of S-rich Ag 2 S 1- y Se y nanograins mixed with an S amorphous phase. The film showed a power factor of ∼954.7 μW·m -1 ·K -2 at 300 K and superior flexibility (94.4% of the original electrical conductivity was preserved after bending 2000 times around a rod with a radius of 4 mm). Moreover, a six-leg flexible thermoelectric generator was assembled with the film and produced a maximum power of 6.67 μW (corresponding power density ∼14.8 W/m 2 ) at a temperature difference of 38.7 K. This work reveals a novel approach to explore high-performance and low-cost flexible thermoelectric devices suitable for room-temperature applications.

High power and good stability enable supercapacitors to work efficiently at high temperatures. However, the high-temperature-induced excessive ion transfer of the electrolyte would lead to severe self-discharge behavior, which has often been overlooked but can be highly detrimental. In this study, solid electrolytes consisting of poly(ethylene oxide) (PEO), bentonite clay, and ionic liquids (IL)-PEO-clay@[EMIM][BF 4 ] (PCE), PEO-clay@[BMIM][BF 4 ] (PCB), and PEO-clay@[HMIM][BF 4 ] (PCH) lead to dramatic decreases in self-discharge when used in all-solid-state supercapacitors at high temperature of 70 °C, which correlate with chain elongation (i. e., [EMIM + ]<[BMIM + ]<[HMIM + ]). Benefiting from both cation adsorption and high-temperature stabilization by bentonite clay, PCH-based supercapacitors (IL=[HMIM][BF 4 ]) deliver an extremely low self-discharge rate, with only a 30.7 % voltage drop over 10 h at 70 °C (44.5 % for 38 h), which is much lower than that of traditional liquid supercapacitors (63.7 % drop over 10 h at 70 °C). This improvement in high-temperature self-discharge behavior is found to be from the decrease in diffusion-controlled faradaic process. Based on the longer-chain [HMIM + ], soft-packaged supercapacitors exhibit a low self-discharge rate and work consistently at 70 °C. This chain-elongation strategy provides a new possibility for the suppression of self-discharge behavior in supercapacitors and further aids long-term energy storage by supercapacitors at high temperatures., (© 2021 Wiley-VCH GmbH.)

Printed electronics are expected to facilitate the widespread distributed wearable electronics in the era of the Internet of things. However, developing cheap and stable electrode inks remains a significant challenge in the printed electronics industry and academic community. Here, overcoming the weak hydrophilicity of polyaniline, a low-cost, easy-fabricating, and air-stable conducting polymer (CP) ink is devised through a facile assemble-disperse strategy delivering a high conductivity in the order of 10 -2 S cm -1 along with a remarkable specific capacitance of 386.9 F g -1 at 0.5 A g -1 (dehydrated state). The additive-free CP ink is directly employed to print wearable micro-supercapacitors (MSCs) via the spray-coating method, which deliver a high areal capacitance (96.6 mF cm -2 ) and volumetric capacitance (26.0 F cm -3 ), outperforming most state-of-the-art CP-based supercapacitors. This work paves a new approach for achieving scalable MSCs, thus rendering a cost-effective, environmentally friendly, and pervasive energy solution for next-generation distributed electronics., (© 2021 Wiley-VCH GmbH.)

Background: The timeliness of diagnostic testing after positive screening remains suboptimal because of limited evidence and methodology, leading to delayed diagnosis of lung cancer and over-examination. We propose a radiomics approach to assist with planning of the diagnostic testing interval in lung cancer screening., Methods: From an institute-based lung cancer screening cohort, we retrospectively selected 92 patients with pulmonary nodules with diameters ≥ 3 mm at baseline (61 confirmed as lung cancer by histopathology; 31 confirmed cancer-free). Four groups of region-of-interest-based radiomic features (n = 310) were extracted for quantitative characterization of the nodules, and eight features were proven to be predictive of cancer diagnosis, noise-robust, phenotype-related, and non-redundant. A radiomics biomarker was then built with the random survival forest method. The patients with nodules were divided into low-, middle- and high-risk subgroups by two biomarker cutoffs that optimized time-dependent sensitivity and specificity for decisions about diagnostic workup within 3 months and about repeat screening after 12 months, respectively. A radiomics-based follow-up schedule was then proposed. Its performance was visually assessed with a time-to-diagnosis plot and benchmarked against lung RADS and four other guideline protocols., Results: The radiomics biomarker had a high time-dependent area under the curve value (95% CI) for predicting lung cancer diagnosis within 12 months; training: 0.928 (0.844, 0.972), test: 0.888 (0.766, 0.975); the performance was robust in extensive cross-validations. The time-to-diagnosis distributions differed significantly between the three patient subgroups, p < 0.001: 96.2% of high-risk patients (n = 26) were diagnosed within 10 months after baseline screen, whereas 95.8% of low-risk patients (n = 24) remained cancer-free by the end of the study. Compared with the five existing protocols, the proposed follow-up schedule performed best at securing timely lung cancer diagnosis (delayed diagnosis rate: < 5%) and at sparing patients with cancer-free nodules from unnecessary repeat screenings and examinations (false recommendation rate: 0%)., Conclusions: Timely management of screening-detected pulmonary nodules can be substantially improved with a radiomics approach. This proof-of-concept study's results should be further validated in large programs.

Background: Cancer has become a global health problem, and assessments of cancer mortality are important for effective public health policy-making and adequate resource allocation. In this study, we aimed to predict the mortality rates and numbers of deaths related to four common cancers (lung, liver, stomach, and esophagus) in China from 2020 to 2030 and to estimate the corresponding cancer burden caused by population aging and tobacco smoking., Methods: Cancer mortality data (2004-2017) were extracted from China's death surveillance datasets, and China's population figures (2020-2030) were obtained from the United Nations population projections. Smoking prevalence data were retrieved from a World Health Organization global report, and relative risks of smoking and cancers were derived from large-scale Asian studies. We predicted the deaths related to the four major cancers and age-standardized mortality rates using joinpoint regression and linear regression models. The tobacco smoking-related burden of these four major cancers was estimated using the population attributable fraction., Results: Unlike lung cancer mortality which was predicted to continue to increase, the age-standardized mortality rates for digestive cancers (liver, stomach, and esophageal cancers) are predicted to decline over the next decade. The number of deaths caused by the four major cancers is predicted to increase from 1,490,304 in 2020 to 1,823,960 in 2030. The age-specific mortality rates of the four major cancers are predicted to increase with age after 40-45 years, peaking in the age groups of 80-84 and ≥85 years. In 2030, the combined number of deaths from the four examined cancers among adults aged ≥65 years is predicted to be 1,167,153, accounting for 64% of all deaths from these cancers. Tobacco smoking is predicted to contribute to nearly 29% of deaths from these cancers, corresponding to 527,577 deaths., Conclusions: The overall trend in the combined total mortality from four major cancers is predicted to decline over the next decade; however, the corresponding death toll is expected to surge, in the context of China's population aging and high smoking prevalence. These estimates provide data-driven evidence for China to implement effective cancer control measures in the future., (© 2021 The Authors. Cancer Communications published by John Wiley & Sons Australia, Ltd. on behalf of Sun Yat-sen University Cancer Center.)

Herein, we fabricated an Ag/Ag 2 Se composite film on a flexible nylon membrane with a high power factor and excellent flexibility. First, Ag nanoparticles and multiscale Ag 2 Se nanostructure composite powders were prepared by wet chemical synthesis using Se nanowires, silver nitrate, and l-ascorbic acid as raw materials, followed by vacuum-assisted filtration of the composite powders on a porous nylon membrane and then hot pressing. The optimized composite film shows a very high power factor of 1860.6 μW m -1 K -2 (with a corresponding electrical conductivity of 3958 S cm -1 ) at room temperature. The composite film retains 93.3% of the original electrical conductivity after 1000 bending cycles around a rod with a diameter of 8 mm. At a temperature difference of 27 K, an 8-leg thermoelectric prototype device assembled with the optimized composite film generates a maximum power of 7.14 μW with a corresponding power density of 8.74 W m -2 . This work provides a new strategy to synthesize flexible thermoelectric films with both a high power factor and high electrical conductivity.

High electrical conductivity and all-open microstructure characteristics intrinsically endow both graphene and MXenes with superior electrochemical energy storage capability. However, the above two-dimensional (2D) thicker electrodes (>20 μm) severely dilute their unique rapid electronic-ionic transferring characteristic, posing a paradox of high gravimetric and high volumetric capacitive properties due to massively excessive macropores or an unduly restacked issue. Herein, we elaborately construct novel monolithic NH 2 -graphene and Ti 3 C 2 T x MXene (NG@MX) composites through dual-functional induced self-assembly with the help of both covalent and hydrogen bonding interactions. Notably, much thicker monolithic NG@MX electrodes (>90 μm) fabricated by a conventional roll-coating method without any further compaction treatment can simultaneously deliver two times gravimetric (gra.) and volumetric (vol.) performance than those of pure graphene (in vol.) or MXene (in gra.) materials. Moreover, monolithic NG@MX-based supercapacitors can remarkably present two times energy density as that of graphene and four times as MXene, respectively. Such greatly enhanced electrochemical properties are closely related to the appropriate equilibrium of the volumetric density and the open structure, which can effectively guarantee the rapid transfer of both electrons and ions in the thick monolithic NG@MX electrodes. Undoubtedly, dual-functional chemical bonding-induced self-constructing NG@MX monoliths efficiently solve the long-existing gra. and vol. capacitive paradox of the thicker 2D materials used in supercapacitors, which will guide the design of high-performance capacitive materials and promote their practical application in electrochemical energy storage.

Studies on intercalation or substitution of atoms into layered two-dimensional (2D) materials are rapidly expanding and gaining significant consideration due to their importance in electronics, catalysts, batteries, sensors, etc. In this manuscript, we report a straightforward method to create sulphur (S) deficient molybdenum (Mo) sulfide (MoS 2- x ) structures and substitute them with zerovalent copper (Cu) atoms using a colloidal synthesis method. The synthesized materials were studied using several techniques to understand the proportion and position of copper atoms and the effect of copper functionalization. Specifically, the impact of change in the ratio of Cu : S and the hydrogen evolution reaction (HER) activity of the derived materials were evaluated. This technique paves the way for the synthesis of various functionalized 2D materials with a significant impact on their physical and chemical behavior making them potential candidates for catalysis and several other applications such as energy storage and the development of numerous functional devices., Competing Interests: There are no conflicts to declare., (This journal is © The Royal Society of Chemistry.)

Background: Having a senior surgeon present for high-risk patients is an important safety measure in emergency surgery, but 24-h consultant cover is not efficient. We aimed to develop a user-friendly toolbox (risk identification, outcome prediction and patient stratification) to support when to involve a senior surgeon., Materials and Methods: We included 11,901 general surgery patients (10.0% emergencies) in a multicenter prospective cohort in China (2015-2016). Patient information and surgeons' seniority were compared between emergency and elective surgery with the same procedure codes. Risk indicators common in these two surgical timings and specific to emergency surgery were identified, and their clinical importance was evaluated by a working group of 48 experienced surgeons. Predictive models for mortality and morbidity were built using logistic regression models. Stratification rules were created to balance patients' risk and surgeons' caseload with an Acute Call Team (ACT) model., Results: Emergency patients had significantly higher risks of mortality (3.6% vs 0.6%) and morbidity (7.8% vs 4.3%) than elective patients, but disproportionally fewer senior surgeons (59.9% vs 91.4%) were present. Using three risk indicators (American Society of Anesthesiologists score, age, blood urea nitrogen), C-statistic (95% CI) for prediction of emergency mortality was high [0.90 (0.84-0.96)]. It was less complex but equally accurate as two existing and validated models (0.86 [0.79-0.93] and 0.86 [0.77-0.95]). Using five indicators, C-statistic (95% CI) was moderate for prediction of overall morbidity [0.77 (0.72-0.83)], but high for severe morbidity [0.92 (0.88-0.97)]. Based on stratification rules of the ACT model, patient mortality and morbidity were 0.5% and 5.3% in the low-risk stratum (composing 64.6% of emergency caseload), and 15.9% and 29.0% in the very high-risk stratum (6.9% of caseload)., Conclusion: These findings show the practical feasibility of using a risk assessment tool to direct senior surgeons' involvement in emergency general surgery., (Copyright © 2020 IJS Publishing Group Ltd. Published by Elsevier Ltd. All rights reserved.)

Background: Omitting axillary lymph node dissection (ALND) is recommended for early-stage breast cancer patients with 1-2 sentinel lymph nodes (SLNs) macro-metastases and breast-conserving therapy. However, it is not safe for part of patients, so it is significant to find risk factors and develop a predictive model of non-SLNs metastases in breast cancer patients with 1-2 SLNs macro-metastases and breast-conserving therapy., Methods: This retrospective study enrolled 228 breast cancer patients with 1-2 SLNs macro-metastases who underwent ALND and breast-conserving surgery between Jan 2012 and Dec 2017 at Cancer Hospital Chinese Academy of Medical Sciences. Chi-square test and backward stepwise binary logistic regression were used to find factors that influenced non-SLN metastases, then a predictive model was formulated and obtained its area under the curve., Results: Tumor pathologic invasion size, number of positive SLNs and ALN status on imaging was associated with non-SLNs metastases. The predictive model was also formulated based on these three factors to assess and the area under the curve of model was 0.708., Conclusion: We developed a predictive model to assess the high-risk cohort of patients of non-SLNs metastases which can be an auxiliary tool for doctors., Competing Interests: Conflict of interest The authors declare that there is no conflict of interest., (Copyright© Iranian Public Health Association & Tehran University of Medical Sciences.)

Rich chemistry and surface functionalization provide MXenes enhanced electrochemical activity yet severely exacerbate their self-discharge behavior in supercapacitors. However, this self-discharge behavior and its related mechanism are still remaining issues. Herein, we propose a chemically interface-tailored regulation strategy to successfully unravel and efficiently alleviate the self-discharge behavior of Ti 3 C 2 T x MXene-based supercapacitors. As a result, Ti 3 C 2 T x MXenes with fewer F elements (∼0.65 atom %) show a positive self-discharge rate decline of ∼20% in comparison with MXenes with higher F elements (∼8.09 atom %). Such decline of the F elements can highly increase tight-bonding ions corresponding to an individual self-discharge process, naturally resulting in a dramatic 50% increase of the transition potential ( V T ). Therefore, the mixed self-discharge rate from both tight-bonding (contain fewer F elements) and loose-bonding ions (contain more F elements) is accordingly lowered. Through chemically interface-tailored engineering, the significantly changed average oxidation state and local coordination information on MXene affected the interaction of ion counterparts, which was evidently revealed by X-ray absorption fine structures. Theoretically, this greatly improved self-discharge performance was proven to be from higher adsorption energy between the interface of the electrode and the electrolyte by density functional theory. Therefore, this chemically interface-tailored regulation strategy can guide the design of high-performance MXene-based supercapacitors with low self-discharge behavior and will promote its wider commercial applications.

Background and Objective: Parathyroid carcinoma (PC) is a rare malignant neoplasm with a relatively poor prognosis. The loss of parafibromin expression or the presence of CDC73 mutation has been found to be remarkably associated with malignancy in parathyroid tumours. However, the prognostic role of them in PC has not yet been shown due to sampling limitations. We conducted a systematic review and meta-analysis based on individual patient data to clarify the performance of parafibromin immunohistochemical staining and CDC73 gene sequencing in predicting outcomes for patients PC., Methods: Published studies from PubMed/MEDLINE, EMBASE, Cochrane and Scopus Databases were searched using the terms 'parafibromin', 'CDC73', 'HRPT2' and 'parathyroid' to identify eligible studies. From the included studies, the survival data of patients with PC were extracted, and a Cox proportional hazards model was used to assess hazard ratio (HR) for disease-free survival (DFS) and overall survival (OS)., Results: A total of 193 patients from 9 studies were included in this survival analysis. Negative immunohistochemical staining of parafibromin was shown to be a risk factor for recurrence/metastasis (HR 2.73, P = .002) and death (HR 2.54, P = .004). Patient age ≥ 50 years was significantly related to lower OS (HR 2.37, P = .004) but not to DFS. CDC73 mutation was not statistically related to DFS or OS., Conclusions: Negative parafibromin staining indicated a higher risk of recurrence/metastasis and mortality. The immunohistochemical staining of parafibromin seems to be more promising in predicting outcomes for patients with PC than the sequencing of CDC73., (© 2020 John Wiley & Sons Ltd.)

Solid-state composite polymer electrolytes (CPEs) usually suffer from intrinsic low ionic conductivity and a solid-solid interface, badly inhibiting their widespread commercial application in all-solid-state Li-metal battery (ASSLMB) energy storage. Herein, a synergetic strategy using strong Lewis acid-base and weak hydrogen bonds was employed for self-assembly in situ construction of three-dimensional (3D) network-structured poly(ethylene oxide) (PEO) and SiO 2 CPEs (PEO@SiO 2 ). Ascribed to this synergistically rigid-flexible coupling dynamic strategy, a harmonious incorporation of monodispersed SiO 2 nanoparticles into PEO could remarkably reduce crystallinity of PEO, significantly enhancing the ionic conductivity (∼1.1 × 10 -4 S cm -1 at 30 °C) and dramatically facilitating solid electrolyte interface stabilization (electrochemical stability window > 4.8 V at 90 °C). Moreover, the PEO@SiO 2 -based ASSLMBs possess excellent rate capability over a wide temperature range (∼105 mA h g -1 under 2 C at 90 °C), high temperature cycling capacity (retaining 90 mA h g -1 after 100 cycles at 90 °C), and high specific capacity (146 mA h g -1 under 0.3 C at 90 °C). Unambiguously, these high ionic conductivity CPEs along with excellent flexibility and safety can be one of the most promising candidates for high-performance ASSLMBs, evidently revealing that this synergistically rigid-flexible coupling dynamic strategy will open up a way to exploit the novel high ionic conductivity solid-state electrolytes.