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Overall survival of systemic lupus erythematosus (SLE) patients significantly increased in recent decades, however, the relative risk of mortality is still high. Long-term survival outcome of pediatric SLE remains unclear. This study aims to explore the long-term survival rate and its predictors in patients with systemic lupus erythematosus (SLE).A retrospective, hospital-based cohort study was performed between 2004 and 2018 in a tertiary referral medical center in Taiwan. Data on comorbidities, medications, and causes of admission were collected for risk factor analysis using time-dependent multivariate Cox proportional hazards models.A total of 2392 adults and 115 pediatric SLE patients were enrolled (female, n = 2157 and 95, respectively). The 10-year survival rates were 93.2%, 90.2%, 98.9%, and 100% in adult women, adult men, girls, and boys with SLE, respectively. The overall mortality rate was 2.09 case/100 patient-years (PY) for male SLE and 1.39 case/100 PY for female SLE patients. Male SLE patients did not have a statistically significantly higher mortality rate than female SLE patients in each age stratification. Infectious disease (n = 119), heart failure (n = 21), and cerebrovascular accident (n = 14) were the leading causes of death in adult SLE patients. Advanced age (hazard ratio [HR]: 1.04, 95% confidence interval [CI]: 1.03-1.05), treatment with mean dosage of systemic glucocorticoid equivalent to10 mg/d of prednisolone (HR: 1.71, 95% CI: 1.14-2.57), comorbidities with malignancy (HR: 1.94, 95% CI: 1.22-3.09), chronic kidney disease (HR: 1.86, 95% CI: 1.25-2.77), hypertension (HR: 1.42, 95% CI: 1.01-1.98), and admission due to bacterial pneumonia (HR: 1.92, 95% CI: 1.12-3.31) and sepsis (HR: 2.78, 95% CI: 1.51-5.13) were independent risk factors for mortality in SLE patients.SLE patients with advanced age, malignancy, chronic kidney disease, hypertension, treated with a higher average dosage of glucocorticoids, and admission due to bacterial pneumonia and sepsis have an increased risk of mortality.

Sol–gel-processed nickel oxide (NiOx) is a promising hole transport layer (HTL) for inverted perovskite solar cells (PSCs) because of its excellent carrier transport properties, low costs, and high stability. Annealing temperature plays a vital role in the sol–gel process as different temperatures can alter the physicochemical properties of the materials. In the present study, we investigated the effect of annealing temperature on NiOx thin films prepared through sol–gel processing from predominantly used precursors: (1) nickel acetate tetrahydrate (Ni-ac) and (2) nickel acetylacetonate (Ni-acac). X-ray diffraction and X-ray photoelectron spectroscopy results revealed that the crystallinity and stoichiometry of both NiOx thin films improve with an increase in annealing temperature, indicating the formation of a standard Ni–O octahedral in a cubic rock NiO structure. Higher annealing temperatures have been shown to improve film optical transparency and electrical conductivity due to the complete decomposition of precursors and improved crystallinity. The device characterization has shown both films can work as an effective HTL for PSCs and showed the best device performance for films annealed at 400 °C. It is believed that this study can provide a basic understanding and strategy for developing highly efficient NiOx HTL in PSCs.

Phthalates induce inflammation and are ubiquitously used in daily life. We aim to study the impact of di-(2-ethylhexyl) phthalate (DEHP) exposure on inflammation and osteoporosis in premenopausal and postmenopausal females.Female 8-week-old C57BL/6JNarl mice received an ovariectomy (OVX) or a sham operation and were fed with DEHP or vehicle by oral gavage for 4 or 8 weeks. Their femurs were isolated for micro-computed tomography, and their serum was collected for inflammatory cytokine assays. Correlations between urinary phthalate metabolites and the lumbar spine bone mineral density (BMD) in premenopausal and postmenopausal volunteers were performed.Among the OVX mice treated for 4 weeks, significant lower bone volume, bone volume/tissue volume, and trabecular number but significant higher trabecular bone pattern factor and structure model index were identified in the mice treated with DEHP than with vehicle. The OVX mice treated with DEHP for 4 weeks had significantly higher serum interleukin (IL)-1β, IL-10, IL-17A, interferon (IFN)-γ, tumor necrosis factor (TNF)-α, and Dickkopf-1 levels than those treated with vehicle. The sham mice treated with DEHP for 8 weeks showed an impaired femur trabecular microstructure and had significantly higher serum IL-1β, IL-6, IL-10, IL-17A, IFN-γ, and TNF-α than those treated with vehicle. DEHP metabolites were inversely correlated with the BMD of premenopausal women and the T-score of postmenopausal women.DEHP treatment in OVX and sham mice results in osteoporosis and impairs the microstructure of the femur trabecula through inflammation. Phthalate exposure negatively affects the bone mass in both premenopausal and postmenopausal women. Thus, long-term avoidance is suggested.

A tunable bandgap without doping is highly desirable for applications in optoelectronic devices. Herein, we develop a new method which can tune the bandgap without any doping. In the present research, the bandgap of Fe2O3 nanostructured films is simply tuned by changing the synthesis temperature. The Fe2O3 nanostructured films are synthesized on ITO/glass substrates at temperatures of 1100, 1150, 1200, and 1250 °C using the hot filament metal oxide vapor deposition (HFMOVD) and thermal oxidation techniques. The Fe2O3 nanostructured films contain two mixtures of Fe2+ and Fe3+ cations and two trigonal (α) and cubic (γ) phases. The increase of the Fe2+ cations and cubic (γ) phase with the elevated synthesis temperatures lifted the valence band edge, indicating a reduction in the bandgap. The linear bandgap reduction of 0.55 eV without any doping makes the Fe2O3 nanostructured films promising materials for applications in bandgap engineering, optoelectronic devices, and energy storage devices.

The real-world outcomes of golimumab (GLM) use have been rarely studied in Asian patients with rheumatoid arthritis (RA). This study assessed the real-world effectiveness and safety of GLM in a Taiwanese cohort.One hundred and eight GLM-treated RA patients were enrolled. Predictors of a good European League Against Rheumatism (EULAR) response at 24 months and drug retention were identified through multivariate analyses.After 24 months of GLM treatment, the mean Disease Activity Score using 28 joint counts with the erythrocyte sedimentation rate (DAS28-ESR) decreased from 6.7 to 3.1 (p0.001). Up to 58.9% of patients achieved a good EULAR response at 24 months. Multivariate logistic regression analysis revealed that after adjustment for other variables, a higher baseline C-reactive protein was an independent negative predictor of good EULAR responses (odds ratio, 0.82; 95% confidence interval [CI], 0.67-0.99; p = 0.043). During the mean follow-up period of 38.3 months, 15 (13.9%) patients discontinued GLM due to treatment failure. In multivariate analysis, high baseline ESR level, high DAS28-ESR, and the experience of biologic therapy were independent risk factors for GLM discontinuation (adjusted hazard ratio [HR], 1.03; 95% CI, 1.01-1.05; p = 0.003; adjusted HR, 2.93; 95% CI, 1.42-6.08; p = 0.004; and adjusted HR, 5.00; 95% CI, 1.75-14.26; p = 0.003, respectively). In receiver operator characteristic curve analysis, the optimal cutoff values of baseline ESR and DAS28-ESR for predicting drug survival were 52 mm/h (sensitivity: 60.0% and specificity: 77.4%) and 7.7 (sensitivity: 46.7% and specificity: 94.3%), respectively. During the follow-up period, 22 patients (20.4%) developed adverse events. The safety profile of GLM in this study was comparable with that in previous clinical trials.GLM was effective and safe for the real-life management of Taiwanese RA patients and showed a high retention rate in biologic-naive patients compared with biologic-experienced patients.

One-dimensional (1D) Magneli-phase W18O49 nanorods were synthesized on indium-tin-oxide thin-film coated glass substrates at 1350, 1400, 1450, 1500 and 1550 °C using the hot filament metal oxide vapor deposition technique. The 1D Magneli-phase W18O49 nanorods containing various mixtures of W5+ and W6+ cations all had a monoclinic crystal structure. Both the W5+ cations and the valence-band (VB) edges increased with elevated synthesis temperatures. The gain of the W5+ cations lifted the VB edges, implying a reduction in the bandgap (Eg). At a synthesis temperature of 1550 °C the VB edge was evidently 0.30 eV higher than that at 1350 °C, but at a synthesis temperature of 1550 °C the corresponding Eg was 0.3 eV smaller than that at 1350 °C. This shows that the Eg of the 1D Mageli-phase W18O49 nanorods can be tuned by simply controlling the synthesis temperature without any doping, giving the 1D Magneli-phase W18O49 nanorods good potential for application in bandgap engineering and optoelectronic nanodevices.

Aim To assess the real-world effectiveness and safety of rituximab (RTX) at 24 months in patients with established rheumatoid arthritis (RA) and to identify predictors of low disease activity/remission and a good European League Against Rheumatism (EULAR) response. Methods Seventy RTX-treated RA patients were enrolled. Predictors for low disease activity/remission and a good EULAR response at 24 months were identified by multivariate analyses. Results At 24 months, the mean Disease Activity Score of 28 joints-erythrocyte sedimentation rate (DAS28-ESR) decreased from 6.88 ± 0.85 at baseline to 3.47 ± 0.85. Twenty-nine patients (41.4%) reached low disease activity/remission, while all patients had a moderate/good EULAR response. After adjustment by multivariate analyses, we found concomitant methotrexate at a dosage >10 mg/week (odds ratio [OR] 5.17; 95% CI 1.34-19.93; P = 0.017) predicted low disease activity/remission, and baseline DAS28 ≤6.5 (OR 4.97; 95% CI 1.22-20.30; P = 0.026) predicted good EULAR response at 24 months. The most common adverse events were infusion-related (5.7%), and there was no incidence of malignancy or mortality during the treatment. Conclusions RTX was effective and safe in real-life management of RA patients with high disease activity. Patients taking concomitant methotrexate and with lower baseline DAS28-ESR were more likely to benefit from RTX.

Backgroud/AimOcular involvement in systemic lupus erythematosus (SLE) is often primarily recognised by ophthalmologists rather than internists. This study aims to investigate the incidence and risk factors for the occurrence of posterior ocular ischaemic events (OIE), including retinal vein occlusion (RVO), retinal artery occlusion (RAO) and ischaemic optic neuropathy (ION), in patients with SLE.MethodsA national database in Taiwan was used to identify 24 472 patients newly diagnosed with SLE and 244 720 age-matched and sex-matched controls between 1997 and 2012. New occurrences of OIE and confounding factors were recorded. The Kaplan-Meier method was used to compare the risk of OIE between the two groups. Fixed effect models were applied to evaluate the risk factors for OIE.ResultsThe mean age was 36.24±15.82 years and women accounted for 88.4%. Patients with SLE had significantly increased risk of overall OIE (HR 3.89, 95% CI 3.36 to 4.50, pConclusionsSLE increases the risk of developing OIE. Systemic comorbidities and higher dosage of steroid in patients with SLE are associated with severe ocular ischaemic complications.

A tunable bandgap without doping is highly desirable for applications in optoelectronic devices. Herein, we develop a new method which can tune the bandgap without any doping. In the present research, the bandgap of Fe

Combustion processed nickel oxide (NiOx) thin film is considered as an alternative to the sol-gel processed hole transport layer for perovskite solar cells (PSCs). In this paper, NiOx thin film was prepared by the solution–combustion process at 250 °C, a temperature lower than the actual reaction temperature. Furthermore, the properties of the NiOx hole transport layer (HTL) in PSCs were enhanced by the incorporation of zinc (Zn) in NiOx thin films. X-ray diffraction and X-ray photoelectron spectroscopy results revealed that the formation of NiOx was achieved at lower annealing temperature, which confirms the process of the combustion reaction. The electrical conductivity was greatly improved with Zn doping into the NiOx crystal lattice. Better photoluminescence (PL) quenching, and low PL lifetime decay were responsible for better charge separation in 5% Zn doped NiOx, which results in improved device performance of PSCs. The maximum power conversion efficiency of inverted PSCs made with pristine NiOx and 5% Zn-NiOx as the HTL was 13.62% and 14.87%, respectively. Both the devices exhibited better stability than the PEDOT:PSS (control) device in an ambient condition.

Immunoglobulin G4-related disease (IgG4-RD) is a recently recognized heterogeneous, subacute, and usually silent autoimmune disease involving many organs with protean manifestations. However, high IgG4 in serum is not necessarily indicating an IgG4-RD. The aims of this study were to investigate the clinical relevance of high serum IgG4 level in IgG4-RD or non IgG4-RD patients, and to see if IgG4-RD in Taiwan differs from that in other parts of the world.Eight hundred forty-five patients with high IgG4 were retrospectively reviewed from January 2002 to May 2020 in Taipei Veteran General Hospital. Two hundred sixty-seven patients fulfilled IgG4-RD criteria and were categorized into pancreato-hepato-biliary disease, retroperitoneal fibrosis and/or aortitis, head/neck-limited disease, classic Mikulicz syndrome with systemic involvement, CNS-limited disease, sclerosing vasculitis, skin-limited disease, and sensorineural hearing disease. These manifestations were correlated to smoking, atopy, hyper-IgE/eosinophilia, aging, malignancies, and hypocomplementemia. Five hundred seventy-eight patients were not fulfilling the criteria but were also analyzed for the prevalence of allergy, malignancy, connective tissue diseases, lung diseases, and infections.In IgG4-RD patients, 124 (46.4%) smoked. Top 4 clinical subtypes included Mikulicz syndrome with systemic involvement (33.3%), pancreato-hepatobiliary disease (31.4%), head/neck disease (19.4%), and retroperitoneal fibrosis/aortitis (12.7%). Top 4 co-morbid conditions included high serum IgE/eosinophilia (46.2%), hypocomplementemia (34%), malignancies (13.4%), and allergy (13.4%). Pancreato-biliary disease was associated with high IgE/eosinophilia (rSmoking may precipitate IgG4-RD. IgG4-RD with pancreato-hepatobiliary disease is closely related to allergy and neoplasm, and those with Mikulicz syndrome may result from atopy. Elderly IgG4-RD patients tend to develop CNS pathology parallel to advancing of age. The disease may probably be originated from an unknown mechanism that may sporadically evolve into malignancies.

To evaluate Pneumocystis jirovecii pneumonia (PJP) infection risk in patients with systemic lupus erythematosus (SLE) in Taiwan.We identified 24,367 patients with SLE from the National Health Insurance research database between 1997 and 2012 and compared the PJP incidence rates (IRs) with those in 243,670 age- and sex-matched non-SLE controls. PJP risk in the patients was evaluated using a Cox multivariate proportional hazards model.The SLE patients exhibited a significantly higher PJP risk than the controls, with an IR of 2.63 per 10,000 person-years and IR ratio of 27.65 (95% confidence interval 17.2-45.3; P 0.001). Male sex (hazard ratio [HR] 2.42, P 0.01), end-stage renal disease (ESRD; HR 1.74, P = 0.01), recent use of mycofenolate mofetil (MMF; HR 4.43, P 0.001), intravenous steroid pulse therapy (HR 108.73, P 0.001), and average oral dosage of7.5 mg/day prednisolone or equivalent treatment (HR 4.83, P 0.001) were associated with PJP in SLE, whereas hydroxychloroquine use reduced its risk (HR 0.51, P = 0.01). Of note, cyclophosphamide was not associated with PJP infection in the multivariate Cox proportional hazard model.Patients with SLE have a considerably high PJP risk. Cyclophosphamide does not increase PJP risk. Male sex, ESRD, MMF use, intravenous steroid pulse therapy, and oral prednisolone or equivalent treatment (7.5 mg/day) are risk factors for PJP, whereas hydroxychloroquine use reduces PJP risk.

Background Our aim was to characterize etiologic diagnoses obtained from bronchoalveolar lavage fluid (BALF) and blood specimens, and to identify risk factors for mortality in systemic lupus erythematosus (SLE) patients with pneumonia and respiratory failure. Methods We conducted a retrospective analysis of SLE patients with pneumonia and respiratory failure. Clinical characteristics, laboratory profiles, and microbiology in BALF and blood samples were evaluated. We performed univariable analyses to identify mortality risk factors. Results All 24 patients (F:M = 21:3, median age 46.5 years; disease duration 11 years) received mechanical ventilation (median duration: 11 days). Pathogens identified in BALF included Pneumocystis jiroveci (12 patients [50%]), cytomegalovirus (CMV, 7 patients [29.2%]), and bacteria (11 patients [45.8%]). Thirteen patients (54.2%) yielded pathogens in blood (CMV in 8 patients [33.3%] and Escherichia coli in 5 patients [20.8%]). Eight developed septic shock, and 9 died within 30 days. Univariable analysis identified thrombocytopenia (odds ratio [OR]: 8.0, 95% confidence interval [CI]: 1.23–52.25), bacteremia within 30 days before or after endotracheal intubation (OR: 8.0, 95% CI: 1.23–52.5), and P. jiroveci pneumonia (PJP, OR: 7.0, 95% CI: 1.04–46.95) as risk factors for 30-day mortality. Kaplan–Meier analysis confirmed an increased risk of 30-day mortality with thrombocytopenia and bacteremia. Conclusion There are high prevalence rates of PJP and CMV infections as evidenced by BALF analyses in SLE patients with pneumonia and respiratory failure. BALF analysis can facilitate rescue therapy per pathogen. Thrombocytopenia, bacteremia, and PJP in SLE patients can increase their 30-day mortality, so warrant early and aggressive treatments.

Objective.To evaluate the role of cytomegaloviral or Pneumocystis jiroveci pneumonia (CMV/PJP) in systemic lupus erythematosus (SLE) patients with pulmonary hemorrhage (PH).Methods.We retrospectively examined hospital records for 27 SLE patients with PH who received bronchoalveolar lavage fluid (BALF) analyses. Clinical profile and mortality rates were compared between groups with and without CMV/PJP. Risk factors for PH-related mortality were analyzed.Results.Among 27 SLE patients with PH, 15 had pathogens from BALF samples, and 8 had CMV/PJP. Although CMV/PJP was treated, the RR for 90- and 180-day mortality rates of SLE patients with CMV/PJP were higher than those without these infections (5.94, 95% CI 1.44–24.48; 7.13, 95% CI 1.81–28.06, respectively). Risk factors for 90- and 180-day mortality were presence of CMV/PJP (OR 14.2, 95% CI 1.83–109.9; OR 25.5, 95% CI 2.91–223.3, respectively) and use of pulse methylprednisolone for PH treatment (OR 12.0, 95% CI 1.48–97.2; OR 8.5, 95% CI 1.13–63.9, respectively). Factors increasing the 90-day mortality rate were duration of mechanical ventilation exceeding 14 days (OR 11.1, 95% CI 1.11–112.0) and use of aggressive immunosuppression close to PH onset (OR 7.56, 95% CI 1.09–52.4). Three of the 7 patients receiving aggressive immunosuppression died with the presence of CMV/PJP.Conclusion.Owing to the high prevalence of CMV/PJP and its association with mortality, routine BALF analysis is recommended for all suitable SLE patients with PH. Use of aggressive immunosuppression does not benefit SLE patients with opportunistic infections during PH attack.

The ideal form of a compact all-optical frequency conversion in a photonic circuit is a monolithical intracavity and resonant nonlinear fiber scheme. However, integrating nonlinear crystalline material that provides significant gain and realizes enhanced second-order nonlinearity (χ(2)) remains challenging to date. This challenge is due to the inherent conflict in achieving crystallization of nonlinear crystals in a rather unstable state, while attaining a sufficient thermal stability for glass fiber drawing. In addition, existing nano-fabrication techniques, such as the e-beam and focused ion beam, are not necessarily suitable for fabricating such large-scale three-dimensional metamaterials throughout the fiber. We therefore propose and demonstrate, for the first time, a new platform toward an enhanced χ(2), where a large-scale harmonic crystal (Si4+:γ-Al2O3) is monolithically integrated in a hybrid crystal–glass metamaterial fiber cavity. Through a comprehensive nano-scale investigation, along with nonlinear optical measurement, we confirmed a detailed growth mechanism for a non-centrosymmetric harmonic crystal directly derived from a centrosymmetric sapphire template. The key to this accomplishment lies in the development of a simple and scalable laser-based fiber drawing that involves the interplay of the inter-crystalline layer forming, the crystal core phase separation, and considerable defective centers. The proof-of-concept developed in this study can be applied to any nonlinear optical fiber comprised of hybrid materials, depending on the practical applications.

Not only do the outstanding electrochromic devices provide a fast switching response, but they can also block light and heat to reduce energy consumption in buildings. Herein, we fabricated an outstanding WO3/NiO nanorods-based electrochromic device consisting of a working electrode of 1D WO3 nanorods/ITO/glass substrate and a counter electrode of 1D NiO nanorods/ITO/glass substrate. The 1D NiO nanorods with a large surface area act as an ion storage layer, which can offer a huge number of electrons to form small polarons and the localized surface plasmon resonance on the 1D WO3 nanorods. The high small polaron content causes strong lattice distortion, which helps the Li+ ions easily diffuse into the 1D WO3 nanorods and gives the 1D WO3/NiO nanorods-based electrochromic device excellent electrochromic characteristics. The electrochromic characteristics include high optical transmittance difference (~61, ~89 %), high coloration efficiency (174, 386 cm2/C) and fast coloration/bleaching switching times (~2.05/~0.74 s, ~0.85/~1.0 s) at the wavelengths of 680 and 1000 nm, respectively. These characteristics make the WO3/NiO nanorods-based electrochromic device a very promising smart window candidate for lighting control and energy-saving applications.

Correction for 'Doping-free bandgap tuning in one-dimensional Magnéli-phase nanorods of Mo

Background Areca nut has anti-inflammatory, antiparasitic, antihypertensive, and antidepressant properties. The pathological hallmarks of inflammatory joint diseases are an increased number of osteoclasts and impaired differentiation of osteoblasts, which may disrupt the bone remodeling balance and eventually lead to bone loss. Purpose The present study assessed the effects of arecoline, the main alkaloid found in areca nut, on osteoclast and osteoblast differentiation and function. Method M-CSF/RANKL-stimulated murine bone marrow-derived macrophages (BMMs) were incubated with several concentrations of arecoline, and TRAP staining and pit formation were assessed to monitor osteoclast formation. Quantitative real-time RT-PCR and western blot analyses were used to analyze the expression of osteoclast-associated genes and signaling pathways. The effects of arecoline on bone were investigated in an in vivo mouse model of lipopolysaccharide (LPS)-induced trabecular bone loss after oral administration of arecoline. Alizarin red S staining and assays to measure ALP activity and the transcription level of osteoblast-related genes were used to evaluate the effects of arecoline on osteoblast differentiation and bone mineralization. Results In a dose-dependent manner, arecoline at concentrations of 50–100 μM reduced both the development of TRAP-positive multinucleated osteoclasts and the formation of resorption pits in M-CSF/RANKL-stimulated BMMs. In M-CSF/RANKL-stimulated BMMs, arecoline also suppressed the expression and translocation of c-Fos and NFATcl, and osteoclast differentiated-related genes via interference with the AKT, MAPK, and NF-kB activation pathways. Femur bone loss and microcomputed tomography parameters were recovered by oral administration of arecoline in the mouse LPS-induced bone loss model. Lastly, arecoline increased ALP activity, bone mineralization, and the expression of osteoblast differentiation-related genes, such as ALP and Runx2, in MC3T3-E1 cells. Conclusion Our data suggest that arecoline may attenuate or prevent bone loss by suppressing osteoclastogenesis and promoting osteoblastogenesis. These findings provide evidence supporting arecoline's use as a potential therapeutic agent in bone-loss disorders and diseases.

The temperature-dependent effects on the ultraviolet (UV) photoluminescence (PL) enhancement, blueshift, thermal quenching, and chromaticity of the two-dimensional (2D) Zn nanosheets, 2D-hierarchical ZnO nanostructures, and 2D-hierarchical ZnO/Zn nanostructures are presented. In this study, 2D Zn nanosheets were synthesized using a hot-plate metal vapor deposition technique, after which 2D-hierarchical ZnO nanostructures and ZnO/Zn were prepared from the 2D Zn nanosheets by a simple thermal annealing method. The enhancement and blueshift of the UV PL emissions from the three nanostructures at low temperatures arose from three distinct PL mechanisms. For the ZnO nanostructures, the UV PL emission enhancements and blueshifts at low temperature were due to the conversion of the free excitons (FXs) to neutral-donor-bound-excitons (D0Xs). The ZnO/Zn nanostructures possessed the highest UV PL intensities among the three nanostructures, because the free electrons from the Zn portions across the metal–semiconductor heterojunctions greatly assisted in enhancing the PL emissions. The enhancement and thermal quenching were quantitatively analyzed with simple normalization methods. The results show that all three kinds of nanostructures are excellent candidates for use in UV light emitters.

We present how an effective fiber drawing process followed by low-cost and controllable etching enables atomically smooth YAG crystal fiber, producing high-crystallinity, defect-free, and ultra-sharp tapered probes with apexes down to 1.5 nm.

Continuous-wave (CW) room-temperature (RT) laser operation with low energy consumption is an ultimate goal for electrically driven lasers. A monolithically integrated perovskite laser in a chip-level fiber scheme is ideal. However, because of the well-recognized air and thermal instabilities of perovskites, laser action in a perovskite has mostly been limited to either pulsed or cryogenic-temperature operations. Most CW laser operations at RT have had poor durability. Here, crystal fibers that have robust and high-heat-load nature are shown to be the key to enabling the first demonstration of ultralow-threshold CW RT laser action in a compact, monolithic, and inexpensive crystal fiber/nanoperovskite hybrid architecture that is directly pumped with a 405 nm diode laser. Purcell-enhanced light-matter coupling between the atomically smooth fiber microcavity and the perovskite nanocrystallites gain medium enables a high Q (≈1500) and a high β (0.31). This 762 nm laser outperforms previously reported structures with a record-low threshold of 132 nW and an optical-to-optical slope conversion efficiency of 2.93%, and it delivers a stable output for CW and RT operation. These results represent a significant advancement toward monolithic all-optical integration.

The role of suppressor of cytokine signaling (SOCS) in maintaining the immunotolerance of renal allograft is unknown. To clarify this, peripheral blood mononuclear cells (PBMCs) from renal transplant patients with or without rejection were analyzed for the expression of SOCS family proteins by cell culture, immunoblot, flowcytometry and quantitative reverse transcription-polymerase chain reaction (qPCR). Patients with renal graft rejection expressed lower levels of SOCS1 while those without rejection showed a higher SOCS1 expression in the PBMC either on stimulation or not. In addition, SOCS1 was constitutively expressed in normal individuals as well as renal transplant patients with graft tolerance while patients with rejection exhibited down-regulation of the SOCS1 but not SOCS3. The qPCR tests and flowcytometric measurements have also showed that the reduction of SOCS1 expression in rejection could be quantitatively evaluated. These results have suggested that down-regulation of SOCS1 may be regarded as a biomarker for early detection of renal allograft rejection.