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Marginal zone lymphoma (MZL) includes extranodal (EMZL), splenic (SMZL), and nodal (NMZL) subtypes. Histological transformation (HT) to large B-cell lymphomas is well documented but with a large variability in published cumulative incidence rates. We report results from the Molecular Epidemiology Resource (MER) cohort for the cumulative incidence of HT (with death as competing risk) and associated risk factors and outcomes. We also conduct a meta-analysis of available studies on the cumulative incidence of HT. From 2002-2015, 529 patients with MZL were enrolled in the MER (69% EMZL, 16% SMZL, 15% NMZL). Ten-year overall survival (OS) from diagnosis was 66%. HT occurred in 21 patients, with 5-year and 10-year cumulative incidence of HT of 2.7% (95% confidence interval [CI] 0.02-0.05) and 3.6% (95%CI 0.02-0.06), respectively. HT was associated with an increased risk of death (subdistribution hazard ratio (HR)=3.95; 95%CI 2.06-7.55). Predictors of HT were ≥2 extranodal sites and MALT-IPI score ≥2. OS was 79% at 5 and 55% at 10 years after HT. Age at HT≥70 years was the only predictor of OS after HT (HR=3.57; 95%CI 1.34-9.48). In meta-analysis of 12 studies (6,161 patients), the 5- and 10-year cumulative incidence of HT across all subtypes were 5% (95%CI 0.05-0.06) and 8% (95%CI 0.07-0.09), respectively. Rates were lower in EMZL (3% and 5%) than in SMZL (7% and 13%) and NMZL (9% and 13%). While HT is relatively uncommon in the first decade after MZL diagnosis, it is associated with an inferior outcome and needs new approaches to prevention and management., (Copyright © 2024 American Society of Hematology.)

Introduction: Considering the notable advances made in the treatment of lymphoma, assessment of health-related quality of life (HRQoL) of lymphoma patients has become a critical aspect to consider both in clinical research and routine practice. However, there is paucity of information about lymphoma specific HRQoL profile at diagnosis., Patients and Methods: HRQoL at diagnosis was assessed for 3922 adult patients with newly diagnosed high-grade (HG) (n = 1994), low-grade (LG) (n = 1053) non-Hodgkin (NHL) and Hodgkin (HL) (n = 875) lymphomas included in REal world dAta in LYmphoma and Survival in Adults (REALYSA, NCT03869619), a prospective non-interventional multicentric cohort in France. Disease-specific HRQoL aspects were assessed with three validated EORTC questionnaires, namely, the QLQ-NHL-HG29, the QLQ-NHL-LG20 and the QLQ-HL27, for patients with NHL-HG, NHL-LG and HL, respectively., Results: We confirmed the high-level of completion of these questionnaires in REALYSA cohort, ranging from 84 % for QLQ-HG29 to 88 % for QLQ-HL27. The proportion of patients with impaired global health status was as follows: T-cell NHL, 67 %; diffuse large B-cell (DLBCL), 62 %; Burkitt, 61 %; HL, 53 %; marginal zone, 49 %; mantle cell, 48 %; follicular, 47 %. Multivariable regression analyses for DLBCL, follicular and HL showed that gender, performance status and B symptoms were independently associated with all HRQoL dimensions. However, a variable effect of age and stage were observed among these three subtypes., Conclusions: A comprehensive analysis was made describing the HRQoL profile of newly diagnosed patients with different types of lymphomas. Our data may help to enhance the interpretation of HRQoL results in future studies using the recently validated EORTC lymphoma specific questionnaires., Competing Interests: Declaration of Competing Interest AA had a consultancy or advisory role for Astrazeneca and Gilead/LKite, outside the submitted work. FB had received support for attending meeting from AbbVie. FE had a consultancy or advisory role for AbbVie, Incyte, Syros, Novartis and JAZZ Pharmaceuticals, outside the submitted work. LY had consulting fees from Abbvie, AstraZeneca, Beigene, BMS/Celgene, Gilead/Kite, Janssen, Roche, honoraria from Abbvie, AstraZeneca, Beigene, BMS/Celgene, Gilead/Kite, Janssen, Roche, and support for attending meeting and/or travel from Abbvie, Beigene, Janssen. AC had consulting fees from AMGEN. All other authors declare no conflict of interest., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Abstract: Use of surrogates as primary end points is commonplace in hematology/oncology clinical trials. As opposed to prognostic markers, surrogates are end points that can be measured early and yet can still capture the full effect of treatment, because it would be captured by the true outcome (eg, overall survival). We discuss the level of evidence of the most commonly used end points in hematology and share recommendations on how to apply and evaluate surrogate end points in research and clinical practice. Based on the statistical literature, this clinician-friendly review intends to build a bridge between clinicians and surrogacy specialists., (© 2024 American Society of Hematology. Published by Elsevier Inc. All rights are reserved, including those for text and data mining, AI training, and similar technologies.)

Background: Marginal zone lymphomas (MZL), comprised of three unique but related subtypes, lack a unifying prognostic score applicable to all the patients in need for systemic chemotherapy and/or immunotherapy., Methods: Patients from the prospective NF10 study (NCT02904577) with newly diagnosed MZL and receiving frontline systemic therapy at diagnosis or after observation were used to train a prognostic model. The primary endpoint was progression-free survival (PFS) from start of treatment. The model was externally validated in a pooled analysis of two independent cohorts from the University of Iowa and Mayo Clinic Molecular Epidemiology Resource and the University of Miami., Findings: We identified 501 eligible patients. After multivariable modeling, lactate dehydrogenase (LDH) above upper normal limit, hemoglobin <12 g/dL, absolute lymphocyte count <1 × 10 9 /L, platelets <100 × 10 9 /L, and MZL subtype (nodal or disseminated) were independently associated with inferior PFS. The proposed MZL International Prognostic index (MZL-IPI) combined these 5 factors, and we defined low (LRG, 0 factors, 27%), intermediate (IRG, 1-2 factors, 57%) and high (HRG, 3+ factors, 16%) risk groups with 5-y PFS of 85%, 66%, and 37%, respectively (c-Harrell = 0.64). Compared to the LRG, the IRG (Hazard Ratio [HR] = 2.30, 95% CI 1.39-3.80) and HRG (HR = 5.41, 95% CI 3.12-9.38) had inferior PFS. Applying the MZL-IPI to the pooled US cohort (N = 353), 94 (27%), 192 (54%), and 67 (19%) patients were classified as LRG, IRG, and HRG, respectively, and the model was validated for PFS (log-rank test p = 0.0018; c-Harrell = 0.578, 95% CI 0.54-0.62). The MZL-IPI was also prognostic for OS in both the training and the external validation sets., Interpretation: MZL-IPI is a new prognostic score for use in all patients with MZL considered for systemic treatment., Funding: The MER was supported by P50 CA97274 and U01 CA195568., Competing Interests: LA: Grants or contracts from any entity: My First AIRC grant n. 11,415 2012–2014; Investigator Grant AIRC (2018–2022); Honoraria: EUSA Pharma, Novartis. Participation on a Data Safety Monitoring Board or Advisory Board Roche, Janssen-Cilag, Verastem, Incyte, EUSA Pharma, Celgene/Bristol Myers Squibb, Kite/Gilead, ADC Therapeutics, Novartis; Support for attending meetings and/or travel: Roche. CB: Grants or contracts from any entity: INSERM, AvieSan ITMO Cancer, LYSA/ELI: Bertrand Coiffier Prize Institut Servier; Consulting fees: Currety; Support for attending meetings and/or travel: Mayo Clinic. JPA: Grants or contracts from any entity: Lymphoma Research Foundation, US Department of Defense; Payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing or educational events: ADC Therapeutics, Regeneron, Genentech. MM: Support for attending meetings and/or travel: Janssen. MJM: Grants or contracts from any entity: BMS, Roche, GenMab; Consulting fees: BMS; Participation on a Data Safety Monitoring Board or Advisory Board: AstraZeneca. CV: Payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing or educational events: Janssen, Lilly, Novartis, Gilead, Takeda, Kyowa-Kirin, Roche, Astra Zeneca, Beigene, Gentili. BKL: Grants or contracts from any entity: Roche/Genentech, Seattle Genetics, Genmab, AstraZeneca. OA: Payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing or educational events: Roche, Janssen, Beigene, Ely Lilli, Amgen, Sanofi. AP: Payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing or educational events: Roche, Msd, Pfizer, Sandoz, Takeda, Gilead, Bms, Janssen, Beigene; Participation on a Data Safety Monitoring Board or Advisory Board: Takeda, Roche. TMH: All support for the present manuscript (e.g., funding, provision of study materials, medical writing, article processing charges, etc.): Lymphoma SPORE NCI CA 97274; Participation on a Data Safety Monitoring Board or Advisory Board: Seagen, Eli Lilly & Co. LM: Other financial or non-financial interests: Scientific consultant for Sandoz spa, 2022–2023, free of fee. JRC: All support for the present manuscript (e.g., funding, provision of study materials, medical writing, article processing charges, etc.): National Cancer Institute, Grants P50 CA97274 and U01 CA195568 (to Mayo); Grants or contracts from any entity: BMS, Genentech, and Genmab; Participation on a Data Safety Monitoring Board or Advisory Board and SMC member: Protagonist Therapeutics. SL: Payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing or educational events: Roche, Novartis, Incyte, BMS, Kite, Regeneron, Abbvie, Genmab, Sobi, Beigene; Support for attending meetings and/or travel: Roche, Beigene, Regeneron. NF, MEN, VT, SF, SR, AT, RM, AK, RM, MD, EC, FR, ALF, MDT, MS, AJMF, CS, EP, SH, IMR, ISL: no COI., (© 2024 The Author(s).)

Abstract: Extranodal marginal zone lymphoma (EMZL) has a very indolent course, and the validation of surrogate markers could accelerate novel therapies. Although prognostic markers do exist, no surrogate markers have been validated in EMZL. We hypothesized that time to complete response within 24 months (TTCR24) and complete response (CR) at 24 months (CR24) could be valid surrogate markers of progression-free survival (PFS). The International Extranodal Lymphoma Study Group 19 phase 3 trial showed the advantage of double therapy (rituximab + chlorambucil) over single therapy (rituximab or chlorambucil) on PFS. We used 2 recently published single-trial approaches to assess whether TTCR24 and CR24 were good surrogate markers of 8-year PFS (8y-PFS). Among the 401 patients, 264 (66%) reached a CR in the first 24 months, of which 222 (84%) remained in CR at month 24. The cumulative incidence of CR over time was significantly higher in patients under double therapy (hazard ratio, 1.75; P < .001). The double therapy arm was associated with a higher CR24 rate, a shorter TTCR24, and a longer 8y-PFS. The estimated proportion of treatment effect on 8y-PFS explained by TTCR24 was 95% (95% confidence interval [CI], 0.27-1.87). CR24 was also a strong surrogate marker because it mediated 90% (95% CI, 0.51-2.22) of the treatment effect on PFS and its natural indirect effect was significant throughout the follow-up. We found that TTCR24 predicted 95% and that CR24 mediated 90% of the treatment effect on long-term PFS. Therefore, TTCR24 and CR24 could be used in clinical trials as informative and valid early indicators of treatment effect on PFS. This trial was registered at www.clinicaltrials.gov as #NCT00210353., (© 2024 American Society of Hematology. Published by Elsevier Inc. All rights are reserved, including those for text and data mining, AI training, and similar technologies.)

Since its launch in 2006, Twitter has become a commonly used platform for sharing medical information, especially in the field of oncology. However, its role and impact on young oncologists' education remain unclear. Moreover, COVID-19 and congress virtualization is likely to have modified Twitter use by the medical society.We conducted a national survey (27 questions) in France among medical oncology, hematology, and radiation therapy young doctors to help better understand the role played by Twitter on their medical education. One hundred eighty-three young oncologists participated in our survey. A majority does not use Twitter (72.1%), mostly to reduce their time spent on social media. Participants using Twitter (27.9%) often use it more than once a week, mostly by scrolling on their news feed. Interestingly, they rarely express their own opinion on Twitter: a majority of them (75.5%) tweet less than once a month while the rest of them mostly retweet others' tweets. They mainly follow English-speaking experts, scientific societies, and medical journals. Pharmaceutical laboratories' accounts are of less significance. Overall Twitter usage seems increasing since COVID-19 pandemic and the consequent digitalization of congresses. No statistical difference was observed between the baseline characteristics of Twitter users and non-users.This survey shows that Twitter is a relevant mean of continuous medical education used by around a third of French young oncologists, especially since COVID-19 pandemic and the virtualization of congresses. This media should be considered and evaluated for its educational advantages or potential biases., (© 2021. The Author(s).)

Marginal zone lymphoma (MZL) is a heterogeneous disease and has various end-point measures. Our aim was to describe the endpoints used in trials involving patients with MZL. We searched over the last 35 years via PubMed, The Cochrane Library, clinicaltrials.govandclinicaltrialsregister.eu for published and registered clinical trials using the keyword "marginalzone lymphoma." We excluded studies focusing on pediatric populations, cutaneous MZL and on use of allogenic stem cell transplant. Endpoints were reviewed as well as their influencing factors and their definitions. Among 1192 references Q7 dentified by initial screening, 309 references were included (111 published, 198 registered), with 213 (69%) phase 2, 65 (21%) phase 1/2 and 31 (10%) phase 3 trials. The majority were open-label (n¼295, 95%) non-randomized (n¼256, 83%) trials, concerned all subtypes of MZLs at once (n¼239, 77%), and were often merged with non-MZL patients (n¼232, 75%). Among phase 1/2 and 2 trials, Overall/complete response rate (ORR/CRR) (n¼196, 70.5%) and progression-free survival (PFS,n¼28, 10.1%) were the most used primary endpoints; in phase 3 trials PFS was the most used primary endpoint (n¼18, 58.1%; ORR/CRR n¼6, 19.4%, p<0.001). Overall, the most frequent secondary endpoints were overall survival (OS, n¼153, 50%), PFS (n¼142, 46%) and ORR/CRR (n¼116, 38%). Distribution was similar when considering trials with only patients with MZL. Endpoints definitions were inconsistent across published trials (up to 9 definitions per endpoint). Trials involving patients with MZL showed marked heterogeneity both in the choice and definitions of primary and secondary endpoints, thus hampering comparability between trials.

Supplemental Digital Content is available in the text., (Copyright © 2022 the Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the European Hematology Association.)

Gastric mucosa-associated lymphoid tissue (MALT) lymphoma is a rare disease which is often associated with Helicobacter pylori ( H. pylori ) infection. First-line treatment of stage IE and IIE localized gastric MALT lymphoma is based on the eradication of H. pylori . The presence of H. pylori resistance factors such as translocation t (11;18), peri-gastric lymph node involvement and the degree of tumor infiltration of the gastric wall; or lack of response to antibiotic therapy are two main indications to treat with definitive radiotherapy (RT). RT is an effective treatment in localized gastric MALT lymphoma. A moderate dose of 30 Gy allows a high cure rate while being well tolerated. After treatment, regular gastric endoscopic follow-up is necessary to detect a potential occurrence of gastric adenocarcinoma., Competing Interests: Conflict-of-interest statement: The authors have no conflict of interest related to the manuscript., (©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.)

As the impact of targeted next-generation sequencing (TNGS) on daily diagnosis has not been evaluated, we performed TNGS (46 genes) on lymphomas of unclear subtype following expert haematopathological review. The potential impact on patient care and modifications of final diagnosis were divided into major and minor changes according to the European Society of Medical Oncology (ESMO) guidelines. Among 229 patients [19 primary central nervous system lymphomas (PCNSL), 48 large B-cell lymphomas (LBCLs), 89 small BCLs (SBCLs), seven Hodgkin lymphomas (HL), 66 T-cell lymphomas], the overall concordance rate of histological and TNGS diagnosis was 89·5%. TNGS confirmed the histological diagnosis in 144 cases (62·9%), changed the diagnosis in 24 cases (10·5%) and did not help to clarify diagnosis in 61 cases (26·7%). Modifications to the final diagnosis had a clinical impact on patient care in 8·3% of cases. Diagnostic modifications occurred in all types of lymphoma except in PCNSL and HL; the modification rate was 14·6% in SBCL and 12·5% in LBCL. While comparing informative and uninformative cases, no differences were found in terms of DNA amplification, quality or depth of sequencing and biopsy type. The present study highlights that TNGS may directly contribute to a more accurate diagnosis in difficult-to-diagnose lymphomas, thus improving the clinical management in routine practice., (© 2021 British Society for Haematology and John Wiley & Sons Ltd.)

The question of the meaning of life arises as much for the young as for the old, as soon as they experience their finitude through some experience of death. To explore the issue in retrospect, let's look at death and suicide at different scales. If we were to compare suicide to one of the cell deaths, perhaps we would compare it to apoptosis as performed by the cell itself. At the animal level, survival follows the law of the strongest or the most intelligent. On an anthropological scale, civilizations survive in the illusion of their immortality. It is certain that suicide is a most intimate act and can, in this respect, be considered an act of freedom since it relieves the body's perception of any physical law, perception being abolished by death. The fascination for suicide is based on an intellectual exploration, a search for an absolute answer in opposition to all relativism, which paradoxically will take shape in annihilation. In times of pandemic and confinement, humanity experiences its finiteness. Confinement has re-installed a sense of loneliness in a society that lives on constant hyper-communication. In this text, the author demonstrates that suicide must be avoided because it is nonsense for both the individual and the community. Thus, living with disability as well as old age should be valued more highly, and public health policies against the causes leading to suicide should become state priorities. Finally, far from pathologizing suicide, the question of legally recognizing the right to (unassisted) suicide for those who commit it must be asked., (© 2020 Elsevier Masson SAS. All rights reserved.)

Multiple myeloma has extremely heterogeneous outcomes. Among prognostic factors, t(4;14) and del(17p) are rare oncogenic events associated with very poor prognosis. In an exploratory case-control study, we compared the combination of Busulfan-Melphalan or TBI-Melphalan with high dose Melphalan as a conditioning regimen in a series of 48 patients with del(17p) or t(4;14). These regimens were preceded by a Bortezomib-containing induction. Progression-free survival (PFS) was the primary endpoint whereas overall survival (OS) and complete response (CR) rate were the secondary endpoints. Twenty consecutive cases of high-risk myeloma received a reinforced conditioning regimen of Busulfan 0.8 mg/kg x4/j IV from day-6 to day-3 pre- graft (BuMel) or total body irradiation (TBI) 12 Gy (TbiMel), having received Melphalan 140 mg/m 2 at day-2 pre-graft. These cases were matched to 28 controls treated with Melphalan 200 mg/m 2 at day-2 (Mel200). After intensification ± consolidation, with a median follow-up of 6.3 years, the CR rate was higher in the BuMel/TbiMel group (65% vs 50%, P = .006). No differences were observed between both groups in terms of PFS and OS (P = .96). PFS in patients with a del(17p) mutation tended to be superior in the BuMel/TbiMel group. Our exploratory study shows that reinforcing the intensification regimen with Busulfan or TBI does not seem to improve the prognosis associated to t(4;14) and del(17p) abnormalities., (© 2020 John Wiley & Sons Ltd.)

Introduction: By threatening our lives, death becomes a medical as well as an institutional issue. To remedy the quest of sense, Man develops a culture amongst which the symbols will be the basis of rites. Recent studies have shown a high rate of burnout syndromes and suicide within the medical community. With a qualitative approach, we aimed to answer the following question: do doctor possess symbolic means of personal defence in front of the dissolvent action of death?, Methods: We built up a questionnaire from key points raised by anthropology and sociology of death. It was addressed to residents of Saint Louis Hospital (Paris, France) during winter 2016-2017., Results: Twenty comprehensive answers were obtained. Young physicians were between 25 and 33 years old (55% haematologists, 35% oncologists, others general practitioners & internal medicine physicians). We show that, to remedy the quest of sense in presence of death, young physicians reckon having repetitive gestures with corpses, thus elaborating the beginning of a personal rite. We also demonstrate the role of empathy and palliative medicine in diminishing the pain of seeing agony and death. Finally, we weave a tie between the lack of collective catharsis at hospital and the high rate of suicide and depressions within the medical community., Conclusion: In the West, we are out of effective symbolism due to the shift of rituals on less metaphysical symbols. This shift of symbolism also affects hospital which failed to develop or protect means to transcend death in a collective scale.

Breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) is a new provisional category in the 2016 World Health Organization (WHO) classification of lymphoid neoplasms, and its incidence is rising owing to increasing recognition of this complication of breast implant insertion. At a median of 10 years after implant insertion, the typical presenting features are sudden-onset breast swelling secondary to peri-implant effusion and less frequently mass-forming disease. Histologic features comprise pleomorphic cells expressing CD30 and negative anaplastic lymphoma kinase (ALK) receptor, similar to systemic and cutaneous ALK-negative anaplastic large cell lymphoma (ALCL). The effusion-only subtype is generally indolent and curable with surgery, unlike the more aggressive mass-forming disease, for which systemic therapy is advocated. High clinical suspicion and pertinent use of radiologic and pathology modalities are essential for timely and accurate diagnosis of BIA-ALCL. Contemporary imaging techniques including US, mammography, breast MRI, CT, and PET/CT are routinely used in breast disease and lymphomas; however, the unique behavior of BIA-ALCL presents significant diagnostic and radiologic interpretative challenges, with numerous nuanced imaging features being pertinent, and current lymphoma staging and response guidelines are not easily applicable to BIA-ALCL. The authors evaluate available evidence in this evolving field; detail key indications, strengths, and limitations of the panoply of radiologic techniques for BIA-ALCL; and propose multiparametric imaging paradigms for management of the peri-implant effusion and mass-forming or advanced disease subtypes, with the goal of accurate optimal patient care. The authors also predict a future model of multimodal assessment using novel imaging and molecular techniques and define key research directions. © RSNA, 2020.

Post-transplantation lymphoproliferative disease (PTLD) is a serious complication associated with Epstein-Barr virus (EBV) infection after hematopoietic stem cell transplantation (HSCT). Although anti-CD-20 therapy is now used as a preemptive strategy for EBV reactivation, PTLD still occurs in some patients. Here we analyzed outcomes and risk factors associated with PTLD transformation in 208 HSCT recipients who were diagnosed with EBV-DNAemia and received at least 1 course of rituximab. The median patient age was 42.52 years (range, 8.35 to 74.77 years), and the median duration of follow-up was 47.33 months (range, 3.18 to 126.20 months). The 2-year overall survival of the entire cohort was 62.8 (95% confidence interval [CI], 56.4 to 69.9), and the 2-year cumulative incidence function of PTLD was 6.3% (95% CI, 3.5% to 10.1%), for a median follow-up of patients diagnosed with PTLD of 37.85 months. Multivariable analysis identified 4 risk factors associated with PTLD: HSCT from an unrelated donor, recipient HLA-DRB1*11:01, fever at diagnosis of EBV infection, and donor-recipient sex-mismatched HSCT. The presence of more than 2 of these risk factors was associated with an increased risk of developing PTLD. This retrospective study identifies risk factors associated with PTLD in EBV-infected patients after HSCT and defines patient subgroups that may benefit from intensified preemptive strategies., (Copyright © 2019 American Society for Transplantation and Cellular Therapy. Published by Elsevier Inc. All rights reserved.)

We report the electrochemical anion storage properties of a group of molecular solids of polycyclic aromatic hydrocarbons (PAHs): coronene, perylene, and triphenylene. We discover an interesting trend of progressively lower potentials for these three molecular solids. Our DFT calculations reveal that the inserted PF 6 - anions preferably bind with the edge sites of the coronene molecules as opposed to being sandwiched between two coronene molecular planes. For smaller PAHs, the more edge sites in the solids may facilitate higher capacity values. However, small PAHs do face a greater challenge of dissolution in the nonaqueous electrolyte, which affects the cycling stability.

Through intense effort in recent years, knowledge of Na-ion batteries has been advanced significantly, pertaining to electrodes. Often, such progress has been accompanied by using a convenient choice of electrolyte or binder. Nevertheless, it has been witnessed that "external" factors to electrodes, such as electrolytes, solid electrolyte interphase, and binders, affect the functions of electrodes profoundly. And generally, certain types of electrodes favor some electrolytes or binders. With a rapidly increasing number of publications in the area, trends in terms of electrolytes and binders are possibly exploitable. Unfortunately, the field has yet to see a review article that devotes itself to these nonelectrode aspects of Na-ion batteries. Here, the gap is filled by conducting a comprehensive review of these nonelectrode external factors, especially by looking into their correlation with electrochemical properties, such as cycle life, and first cycle coulombic efficiency. Not only are the representative reports reviewed, but also quantitative analyses on the database that are constructed are provided. With such analyses, some new data-driven perspectives are postulated, which are of great value to the community., (© 2018 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.)

We report that crystalline 3,4,9,10-perylenetetracarboxylic dianhydride (PTCDA), an organic solid, is highly amenable to host divalent metal ions, i.e., Mg 2+ and Ca 2+ , in aqueous electrolytes, where the van der Waals structure is intrinsically superior in hosting charge-dense ions. We observe that the divalent nature of Mg 2+ causes unique squeezing deformation of the electrode structure, where it contracts and expands in different crystallographic directions when hosting the inserted Mg-ions. This phenomenon is revealed experimentally by ex situ X-ray diffraction and transmission electron microscopy, and is investigated theoretically by first-principles calculations. Interestingly, hosting one Mg 2+ ion requires the coordination from three PTCDA molecules in adjacent columns of stacked molecules, which rotates the columns, thus reducing the (011) spacing but increasing the (021) spacing. We demonstrate that a PTCDA Mg-ion electrode delivers a reversible capacity of 125 mA h g -1 , which may include a minor contribution of hydronium storage, a good rate capability by retaining 75 mA h g -1 at 500 mA g -1 (or 3.7 C), and a stable cycle life. We also report Ca 2+ storage in PTCDA, where a reversible capacity of over 80 mA h g -1 is delivered.

We demonstrate for the first time that hydronium ions can be reversibly stored in an electrode of crystalline 3,4,9,10-perylenetetracarboxylic dianhydride (PTCDA). PTCDA exhibits a capacity of 85 mAh g -1 at 1 A g -1 after an initial conditioning process. Ex situ X-ray diffraction revealed reversible and significant structure dilation upon reduction of PTCDA in an acidic electrolyte, which can only be ascribed to hydronium-ion intercalation. The lattice expansion upon hydronium storage was theoretically explored by first-principles density functional theory (DFT) calculations, which confirmed the hydronium storage in PTCDA., (© 2017 Wiley-VCH Verlag GmbH & Co. KGaA, Weinheim.)

The rate capability of hard carbon has long been underestimated in prior studies that used carbon/Na two-electrode half-cells. Through a three-electrode cell setup, we discover that it is the overpotential of the sodium counter electrode that drives the half-cells to the lower cutoff potential prematurely during hard carbon sodiation, particularly at high current rates, which prevents the hard carbon anode from being fully sodiated.

The intermittent nature of renewable energy sources, such as solar and wind, calls for sustainable electrical energy storage (EES) technologies for stationary applications. Li will be simply too rare for Li-ion batteries (LIBs) to be used for large-scale storage purposes. In contrast, Na-ion batteries (NIBs) are highly promising to meet the demand of grid-level storage because Na is truly earth abundant and ubiquitous around the globe. Furthermore, NIBs share a similar rocking-chair operation mechanism with LIBs, which potentially provides high reversibility and long cycling life. It would be most efficient to transfer knowledge learned on LIBs during the last three decades to the development of NIBs. Following this logic, rapid progress has been made in NIB cathode materials, where layered metal oxides and polyanionic compounds exhibit encouraging results. On the anode side, pure graphite as the standard anode for LIBs can only form NaC64 in NIBs if solvent co-intercalation does not occur due to the unfavorable thermodynamics. In fact, it was the utilization of a carbon anode in LIBs that enabled the commercial successes. Anodes of metal-ion batteries determine key characteristics, such as safety and cycling life; thus, it is indispensable to identify suitable anode materials for NIBs. In this Account, we review recent development on anode materials for NIBs. Due to the limited space, we will mainly discuss carbon-based and alloy-based anodes and highlight progress made in our groups in this field. We first present what is known about the failure mechanism of graphite anode in NIBs. We then go on to discuss studies on hard carbon anodes, alloy-type anodes, and organic anodes. Especially, the multiple functions of natural cellulose that is used as a low-cost carbon precursor for mass production and as a soft substrate for tin anodes are highlighted. The strategies of minimizing the surface area of carbon anodes for improving the first-cycle Coulombic efficiency are also outlined, where graphene oxide was employed as dehydration agent and 2,2,6,6-tetramethylpiperidine-1-oxyl (TEMPO) was used to unzip wood fiber. Furthermore, surface modification by atomic layer deposition technology is introduced, where we discover that a thin layer of Al2O3 can function to encapsulate Sn nanoparticles, leading to a much enhanced cycling performance. We also highlight recent work about the phosphorene/graphene anode, which outperformed other anodes in terms of capacity. The aromatic organic anode is also studied as anode with very high initial sodiation capacity. Furthermore, electrochemical intercalation of Na ions into reduced graphene oxide is applied for fabricating transparent conductors, demonstrating the great feasibility of Na ion intercalation for optical applications.

Na-ion batteries (NIBs) have attracted great attention for scalable electrical energy storage considering the abundance and wide availability of Na resources. However, it remains elusive whether carbon anodes can achieve the similar scale of successes in Na-ion batteries as in Li-ion batteries. Currently, much attention is focused on hard carbon while soft carbon is generally considered a poor choice. In this study, we discover that soft carbon can be a high-rate anode in NIBs if the preparation conditions are carefully chosen. Furthermore, we discover that the turbostratic lattice of soft carbon is electrochemically expandable, where d-spacing rises from 3.6 to 4.2 Å. Such a scale of lattice expansion only due to the Na-ion insertion was not known for carbon materials. It is further learned that portions of such lattice expansion are highly reversible, resulting in excellent cycling performance. Moreover, soft carbon delivers a good capacity at potentials above 0.2 V, which enables an intrinsically dendrite-free anode for NIBs.

Nongraphitizable carbon, also known as hard carbon, is considered one of the most promising anodes for the emerging Na-ion batteries. The current mechanistic understanding of Na-ion storage in hard carbon is based on the "card-house" model first raised in the early 2000s. This model describes that Na-ion insertion occurs first through intercalation between graphene sheets in turbostratic nanodomains, followed by Na filling of the pores in the carbon structure. We tried to test this model by tuning the sizes of turbostratic nanodomains but revealed a correlation between the structural defects and Na-ion storage. Based on our experimental data, we propose an alternative perspective for sodiation of hard carbon that consists of Na-ion storage at defect sites, by intercalation and last via pore-filling.

Na-ion batteries are emerging as one of the most promising energy storage technologies, particularly for grid-level applications. Among anode candidate materials, hard carbon is very attractive due to its high capacity and low cost. However, hard carbon anodes often suffer a low first-cycle Coulombic efficiency and fast capacity fading. In this study, we discover that doping graphene oxide into sucrose, the precursor for hard carbon, can effectively reduce the specific surface area of hard carbon to as low as 5.4 m(2)/g. We further reveal that such doping can effectively prevent foaming during caramelization of sucrose and extend the pyrolysis burnoff of sucrose caramel over a wider temperature range. The obtained low-surface-area hard carbon greatly improves the first-cycle Coulombic efficiency from 74% to 83% and delivers a very stable cyclic life with 95% of capacity retention after 200 cycles.

We demonstrate a novel synthetic route to fabricate a one-dimensional peapod-like Sb@C structure with disperse Sb submicron-particles encapsulated in carbon submicron-tubes. The synthetic route may well serve as a general methodology for fabricating carbon/metallic fine structures by thermally reducing their carbon-coated metal oxide composites.

The purpose of this research, led in the wake of years of pressure to reject paternalism, was to study whether controlled practice of nonverbal communication by doctors inheres a continued risk of paternalistic attitudes in oncology clinic interviews (chosen to illustrate the doctor-patient relationship). This study involved qualitative descriptive research based on interview observations and questionnaires and mobilized recognized theory borrowed from sociology and anthropology. We found that the legislative framework governing the doctor-patient relationship has simply shifted the paternalism issue from verbal communication over to a new area that doctors have not yet mastered and patients have not yet understood, i.e., nonverbal communication. This study shows that all the laws framing the doctor-patient relationship can be circumvented, and that by controlling nonverbal communication, the doctor can fall back into paternalism. The rejection of paternalism therefore needs to lead to an appropriate reading of the patient's story, which in ethical terms can only happen if hospital structures are made non-paternalizing by design, if doctors learn to understand the patient's different chronemic timeframe, and if doctors committedly engage in the Hippocratic Oath codified through the ethics of care.