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The commercialization of organic thin film transistors (OTFTs) is partly hindered by the high cost and stubborn work function (WF) of common Au source/drain (S/D) electrodes. In this work, indium tin oxide (ITO) S/D electrodes modified with three different nitrogenous interlayers including 1,4‐bis(2‐hydroxyethyl) piperazine (HEP), polyethylenimine ethoxylated (PEIE), and branched polyethylenimine (PEI) are adopted to fabricate n‐type OTFTs. The WF of bare ITO is 4.7 eV, whereas ITO modified with nitrogenous interlayers exhibits WFs ranging from 4.1 to 3.6 eV. By the first‐principle calculation and element analysis, the protonated amines are critical for the reduction of ITO surface WF. Besides, the interlayers with higher nitrogen contents are more likely to improve the wettability of octadecyltrichlorosilane (OTS) modified ITO substrates, and help to gain the continuous and oriented poly[2,5‐bis(4‐tetradecyloctadecyl)pyrrolo[3,4‐c]pyrrole‐1,4(2H,5H)‐dione‐alt‐5,5′‐di(thiophen‐2‐yl)‐2,2′‐(E)‐1,2‐bis(3,4‐difluorothien‐2‐yl)‐ethene] (P4FTVT‐C32) semiconductor thin films. Therefore, P4FTVT‐C32 based OTFTs with maximum electron field‐effect mobility of 1.95 cm2 V−1 s−1 are achieved by PEI treatments. These results indicate that the ITO S/D electrodes modified by nitrogenous interlayers can greatly slash costs and promote commercialization of OTFTs. [ABSTRACT FROM AUTHOR]

Background: With the development of artificial intelligence (AI), medicine has entered the era of intelligent medicine, and various aspects, such as medical education and talent cultivation, are also being redefined. The cultivation of clinical thinking abilities poses a formidable challenge even for seasoned clinical educators, as offline training modalities often fall short in bridging the divide between current practice and the desired ideal. Consequently, there arises an imperative need for the expeditious development of a web-based database, tailored to empower physicians in their quest to learn and hone their clinical reasoning skills., Objective: This study aimed to introduce an app named "XueYiKu," which includes consultations, physical examinations, auxiliary examinations, and diagnosis, incorporating AI and actual complete hospital medical records to build an online-learning platform using human-computer interaction., Methods: The "XueYiKu" app was designed as a contactless, self-service, trial-and-error system application based on actual complete hospital medical records and natural language processing technology to comprehensively assess the "clinical competence" of residents at different stages. Case extraction was performed at a hospital's case data center, and the best-matching cases were differentiated through natural language processing, word segmentation, synonym conversion, and sorting. More than 400 teaching cases covering 65 kinds of diseases were released for students to learn, and the subjects covered internal medicine, surgery, gynecology and obstetrics, and pediatrics. The difficulty of learning cases was divided into four levels in ascending order. Moreover, the learning and teaching effects were evaluated using 6 dimensions covering systematicness, agility, logic, knowledge expansion, multidimensional evaluation indicators, and preciseness., Results: From the app's first launch on the Android platform in May 2019 to the last version updated in May 2023, the total number of teacher and student users was 6209 and 1180, respectively. The top 3 subjects most frequently learned were respirology (n=606, 24.1%), general surgery (n=506, 20.1%), and urinary surgery (n=390, 15.5%). For diseases, pneumonia was the most frequently learned, followed by cholecystolithiasis (n=216, 14.1%), benign prostate hyperplasia (n=196, 12.8%), and bladder tumor (n=193, 12.6%). Among 479 students, roughly a third (n=168, 35.1%) scored in the 60 to 80 range, and half of them scored over 80 points (n=238, 49.7%). The app enabled medical students' learning to become more active and self-motivated, with a variety of formats, and provided real-time feedback through assessments on the platform. The learning effect was satisfactory overall and provided important precedence for establishing scientific models and methods for assessing clinical thinking skills in the future., Conclusions: The integration of AI and medical education will undoubtedly assist in the restructuring of education processes; promote the evolution of the education ecosystem; and provide new convenient ways for independent learning, interactive communication, and educational resource sharing., (© Heng Wang, Danni Zheng, Mengying Wang, Hong Ji, Jiangli Han, Yan Wang, Ning Shen, Jie Qiao. Originally published in JMIR Formative Research (https://formative.jmir.org).)

Afferent baroreflex failure (ABF) is a rare disease. It refers to the clinical syndrome caused by the impairment of the afferent limb of the baroreflex or its central connections at the level of the medulla. The recognized causes include trauma, surgery in related areas (radical neck tumor surgery, carotid endarterectomy), neck radiotherapy, brain stem stroke, tumor growth paraganglioma and hereditary diseases, among which the most common cause is extensive neck surgery or radiotherapy for neck cancer. The main manifestations are fluctuating hypertension, orthostatic hypotension, paroxysmal tachycardia and bradycardia. This case is a young man, whose main feature is blood pressure fluctuation, accom-panied by neurogenic orthostatic hypotension (nOH). After examination, the common causes of hypertension and nOH were ruled out. Combined with the previous neck radiotherapy and neck lymph node dissection, it was considered that the blood pressure regulation was abnormal due to the damage of carotid sinus baroreceptor after radiotherapy for nasopharyngeal carcinoma and neck lymph node dissection, which was called ABF. At the same time, the patient was complicated with chronic hyponatremia. Combined with clinical and laboratory examination, the final consideration was caused by syndrome of in- appropriate antidiuretic hormone (SIADH). Baroreceptors controlled the secretion of heart rate, blood pressure and antidiuretic hormone through the mandatory "inhibition" signal. We speculate that the carotid sinus baroreceptor was damaged after neck radiotherapy and surgery, which leads to abnormal blood pressure regulation and nOH, while the function of inhibiting ADH secretion was weakened, resulting in higher ADH than normal level and mild hyponatremia. The goal of treating ABF patients was to reduce the frequency and amplitude of sudden changes in blood pressure and heart rate, and to alleviate the onset of symptomatic hypotension. At present, drug treatment is still controversial, and non-drug treatment may alleviate some patients' symptoms, but long-term effective treatment still needs further study. The incidence of ABF is not high, but it may lead to serious cardiovascular and cerebrovascular events, and the mechanism involved is extremely complicated, and there are few related studies. The reports of relevant medical records warn that patients undergoing neck radiotherapy or surgery should minimize the da-mage to the baroreceptor in the carotid sinus in order to reduce the adverse prognosis caused by complications.

Objective: To evaluate whether index of microcirculatory resistance (IMR) is associated with left ventricular (LV) remodeling in acute anterior ST elevation myocardial infarction (STEMI) patients undergoing primary percutaneous coronary intervention (PPCI)., Methods: This was a single-center retrospective cohort study. The patients with first anterior STEMI who received PPCI from January 2014 to August 2017 in Peking University Third Hospital was enrolled. After PPCI, IMR was measured immediately by using pressure/temperature guidewire. The success rate of IMR measurement was 100%. Also we collected some related clinical data from the medical records and laboratory results. Infarct size [assessed as creatine kinase (CK) peak], echocardiography at baseline and 1 year follow-up were assessed. LV adverse remodeling (LVAR) was defined as ≥20% increase in LV end-diastolic volume (LVEDV)., Results: A total of forty-three patients were enrolled, with an average age of (58.7±12.4) years.The patients were divided into two groups as IMR ≤25 and IMR>25 by normal values recommended by previous literature. Compared with IMR ≤25 group, IMR>25 group had a higher percentage of initial thrombolysis in myocardial infraction (TIMI) grade 0 (95.7% vs. 65.0%, P =0.029), higher serum CK peak value [4 090 (383, 15 833) vs. 1 580 (396, 5 583), P =0.004]. The IMR>25 group suffered higher rates of ventricular aneurysm (30.4% vs. 5.0%, P =0.021). There was no difference in LVEDV [(111.0±18.8) mL vs. (115.0±23.6) mL, P =0.503] between the two groups 1 day after MI, but after 1 year, LVEDV in IMR>25 group was significantly higher than in IMR≤25 group [(141.5±33.7) mL vs. (115.9±27.9) mL, P =0.018]. The incidence of LVAR was more significant in IMR>25 group (47.4% vs. 11.8%, P =0.024). Binary Logistics regression showed that IMR [ B =0.079, exp( B ) (95% CI )=1.082 (1.018－1.149), P =0.011] and serum triglyceride level [ B =1.610, exp( B ) (95% CI )=5.005 (1.380－18.152), P =0.014] were the predictors of LVAR 1 year after MI. IMR had a good predictive value for LVAR 1 year after MI [area under the curve (AUC)=0.749, P =0.019], IMR>29 was a good cutoff value with sensitivity 81.8% and specificity 68.0%., Conclusion: Our study elaborates that immediate measurement of IMR after PPCI in patients with STEMI can reflect the microvascular function.And IMR could be used as a quantitative biomarker to predict LVAR after STEMI.

Objective: To investigate the effect of glucocorticosteroids on severe acute respiratory syndrome (SARS) and chest X ray changes after discontinuation of glucocorticosteroids treatment., Methods: To retrospectively study the clinical characteristics of 5 cases with SARS and chest X ray changes after discontinuation of glucocorticosteroids., Results: 5 cases were medical workers and had exposure to SARS patients. The incubation periods were 2 to 7 days. They had high fever from the onset of the disease. There were lung infiltrates 1 to 6 days after fever and then methylprednisolone was given to them. Two or three days after glucocorticosteroids treatment, clinical symptoms in these patients were disappeared. The clinical symptoms in case 1, cases 2, case 4 and case 5 weren't deteriorated after discontinuation of methylprednisolone while the presentation in chest X ray was progressed 3-6 days later. No more methylprednisolone was given to the patients and the infiltrates in chest X ray was gradually absorbed in 5-11 days. The temperature in case 3 was elevated again and the shadow in chest X ray was progressed after discontinuation of methylprednisolone due to the low dosage of glucocorticosteroids. When the dosage of methylprednisolone was increased, the temperature tended to be normal and the lung infiltrates began to absorb gradually., Conclusion: For the patients with non-severe SARS, if the symptoms were disappeared after discontinuation of glucocorticosteroids, the lung shadow may be progressed. we can closely observe the condition of the disease and no more glucocortisteroids needed to be given to the patients. The lung shadow could be absorbed gradually.