Low-Cost High-Resolution Microendoscopy for the Detection of Esophageal Squamous Cell Neoplasia: An International Trial

Background & Aims: Esophageal squamous cell neoplasia has a high mortality rate as a result of late detection. In high-risk regions such as China, screening is performed by Lugol’s chromoendoscopy (LCE). LCE has low specificity, resulting in unnecessary tissue biopsy with a subsequent increase in procedure cost and risk. The purpose of this study was to evaluate the accuracy of a novel, low-cost, high-resolution microendoscope (HRME) as an adjunct to LCE. Methods: In this prospective trial, 147 consecutive high-risk patients were enrolled from 2 US and 2 Chinese tertiary centers. Three expert and 4 novice endoscopists performed white-light endoscopy followed by LCE and HRME. All optical images were compared with the gold standard of histopathology. Results: By using a per-biopsy analysis, the sensitivity of LCE vs LCE + HRME was 96% vs 91% (P = .0832), specificity was 48% vs 88% (P < .001), positive predictive value was 22% vs 45% (P < .0001), negative predictive value was 98% vs 98% (P = .3551), and overall accuracy was 57% vs 90% (P < .001), respectively. By using a per-patient analysis, the sensitivity of LCE vs LCE + HRME was 100% vs 95% (P = .16), specificity was 29% vs 79% (P < .001), positive predictive value was 32% vs 60%, 100% vs 98%, and accuracy was 47% vs 83% (P < .001). With the use of HRME, 136 biopsies (60%; 95% confidence interval, 53%–66%) could have been spared, and 55 patients (48%; 95% confidence interval, 38%–57%) could have been spared any biopsy. Conclusions: In this trial, HRME improved the accuracy of LCE for esophageal squamous cell neoplasia screening and surveillance. HRME may be a cost-effective optical biopsy adjunct to LCE, potentially reducing unnecessary biopsies and facilitating real-time decision making in globally underserved regions. ClinicalTrials.gov, NCT 01384708

Lattice-contraction triggered synchronous electrochromic actuator.

Materials with synchronous capabilities of color change and actuation have prospects for application in biomimetic dual-stealth camouflage and artificial intelligence. However, color/shape dual-responsive devices involve stimuli that are difficult to control such as gas, light or magnetism, and the devices show poor coordination. Here, a flexible composite film with electrochromic/actuating (238° bending angle) dual-responsive phenomena, excellent reversibility, high synchronization, and fast response speed (< 5 s) utilizes a single active component, W18O49 nanowires. From in situ synchrotron X-ray diffraction, first principles calculations/numerical simulations, and a series of control experiments, the actuating mechanism for macroscopic deformation is elucidated as pseudocapacitance-based reversible lattice contraction/recovery of W18O49 nanowires (i.e. nanostructure change at the atomic level) during lithium ion intercalation/de-intercalation. In addition, we demonstrate the W18O49 nanowires in a solid-state ionic polymer-metal composite actuator that operates stably in air with a significant pseudocapacitive actuation

Expression of HIWI in human esophageal squamous cell carcinoma is significantly associated with poorer prognosis

<p>Abstract</p> <p>Background</p> <p>HIWI, the human homologue of Piwi family, is present in CD34⁺hematopoietic stem cells and germ cells, but not in well-differentiated cell populations, indicating that HIWI may play an impotent role in determining or maintaining stemness of these cells. That HIWI expression has been detected in several type tumours may suggest its association with clinical outcome in cancer patients.</p> <p>Methods</p> <p>With the methods of real-time PCR, western blot, immunocytochemistry and immunohistochemistry, the expression of HIWI in three esophageal squamous cancer cell lines KYSE70, KYSE140 and KYSE450 has been characterized. Then, we investigated HIWI expression in a series of 153 esophageal squamous cell carcinomas using immunohistochemistry and explored its association with clinicopathological features.</p> <p>Results</p> <p>The expression of HIWI was observed in tumour cell nuclei or/and cytoplasm in 137 (89.5%) cases, 16 (10.5%) cases were negative in both nuclei and cytoplasm. 86 (56.2%) were strongly positive in cytoplasm, while 49 (32.0%) were strongly positive in nuclei. The expression level of HIWI in cytoplasm of esophageal cancer cells was significantly associated with histological grade (<it>P </it>= 0.011), T stage (<it>P </it>= 0.035), and clinic outcome (<it>P </it>< 0.001), while there was no correlation between the nuclear HIWI expression and clinicopathological features.</p> <p>Conclusion</p> <p>The expression of HIWI in the cytoplasm of esophageal cancer cells is significantly associated with higher histological grade, clinical stage and poorer clinical outcome, indicating its possible involvement in cancer development.</p

Methylprednisolone as Adjunct to Endovascular Thrombectomy for Large-Vessel Occlusion Stroke

Importance It is uncertain whether intravenous methylprednisolone improves outcomes for patients with acute ischemic stroke due to large-vessel occlusion (LVO) undergoing endovascular thrombectomy. Objective To assess the efficacy and adverse events of adjunctive intravenous low-dose methylprednisolone to endovascular thrombectomy for acute ischemic stroke secondary to LVO. Design, Setting, and Participants This investigator-initiated, randomized, double-blind, placebo-controlled trial was implemented at 82 hospitals in China, enrolling 1680 patients with stroke and proximal intracranial LVO presenting within 24 hours of time last known to be well. Recruitment took place between February 9, 2022, and June 30, 2023, with a final follow-up on September 30, 2023.InterventionsEligible patients were randomly assigned to intravenous methylprednisolone (n = 839) at 2 mg/kg/d or placebo (n = 841) for 3 days adjunctive to endovascular thrombectomy. Main Outcomes and Measures The primary efficacy outcome was disability level at 90 days as measured by the overall distribution of the modified Rankin Scale scores (range, 0 [no symptoms] to 6 [death]). The primary safety outcomes included mortality at 90 days and the incidence of symptomatic intracranial hemorrhage within 48 hours. Results Among 1680 patients randomized (median age, 69 years; 727 female [43.3%]), 1673 (99.6%) completed the trial. The median 90-day modified Rankin Scale score was 3 (IQR, 1-5) in the methylprednisolone group vs 3 (IQR, 1-6) in the placebo group (adjusted generalized odds ratio for a lower level of disability, 1.10 [95% CI, 0.96-1.25]; P = .17). In the methylprednisolone group, there was a lower mortality rate (23.2% vs 28.5%; adjusted risk ratio, 0.84 [95% CI, 0.71-0.98]; P = .03) and a lower rate of symptomatic intracranial hemorrhage (8.6% vs 11.7%; adjusted risk ratio, 0.74 [95% CI, 0.55-0.99]; P = .04) compared with placebo. Conclusions and Relevance Among patients with acute ischemic stroke due to LVO undergoing endovascular thrombectomy, adjunctive methylprednisolone added to endovascular thrombectomy did not significantly improve the degree of overall disability.Trial RegistrationChiCTR.org.cn Identifier: ChiCTR210005172

Research progress of Ti3C2Tx-based composites application in electrode for supercapacitors

Titanium carbide (Ti3C2Tx) as one of MXene materials, has unique structure, excellent conductivity, stability and superior electrochemical properties. It is often used as electrode material for supercapacitors. Based on the characteristics of the layered structure of Ti3C2Tx materials, the research progress in Ti3C2Tx based composite materials used for supercapacitor electrode was reviewed, and the structure, properties, preparation and electrochemical performance of Ti3C2Tx materials compounded with various types of materials through different technical means were emphatically described. The reasons for improving the properties of Ti3C2Tx matrix composites were summarized, including increasing the layer spacing, providing more active sites, and improving the toughness. Finally, the future research priorities of Ti3C2Tx matrix composites were pointed out, such as exploring new matrix parent phases, enriching etching methods, improving existing composites, and exploring more and more efficient composites

Enhanced Power Conversion Efficiency of P3HT : PC71BM Bulk Heterojunction Polymer Solar Cells by Doping a High-Mobility Small Organic Molecule

The effect of molecular doping with TIPS-pentacene on the photovoltaic performance of polymer solar cells (PSCs) with a structure of ITO/ZnO/poly(3-hexylthiophene-2,5-diyl) (P3HT) : [6,6]-phenyl C71-butyric acid methyl ester (PC71BM) : TIPS-pentacene/MoOx/Ag was systematically investigated by adjusting TIPS-pentacene doping ratios ranged from 0.3 to 1.2 wt%. The device with 0.6 wt% TIPS-pentacene exhibited the enhanced short-circuit current and fill factor by 1.23 mA/cm2 and 7.8%, respectively, resulting in a maximum power conversion efficiency of 4.13%, which is one-third higher than that of the undoped one. The photovoltaic performance improvement was mainly due to the balanced charge carrier mobility, enhanced crystallinity, and matched cascade energy level alignment in TIPS-pentacene doped active layer, resulting in the efficient charge separation, transport, and collection

Highly Efficient and Stable Organic Solar Cells via Interface Engineering with a Nanostructured ITR-GO/PFN Bilayer Cathode Interlayer

An innovative bilayer cathode interlayer (CIL) with a nanostructure consisting of in situ thermal reduced graphene oxide (ITR-GO) and poly[(9,9-bis(3′-(N,N-dimethylamion)propyl)-2,7-fluorene)-alt-2,7-(9,9-dioctyl) fluorene] (PFN) has been fabricated for inverted organic solar cells (OSCs). An approach to prepare a CIL of high electronic quality by using ITR-GO as a template to modulate the morphology of the interface between the active layer and electrode and to further reduce the work function of the electrode has also been realized. This bilayer ITR-GO/PFN CIL is processed by a spray-coating method with facile in situ thermal reduction. Meanwhile, the CIL shows a good charge transport efficiency and less charge recombination, which leads to a significant enhancement of the power conversion efficiency from 6.47% to 8.34% for Poly({4,8-bis[(2-ethylhexyl)oxy]benzo[1,2-b:4,5-b′]dithiophene-2,6-diyl}{3-fluoro-2-[(2-ethylhexyl)carbonyl]thieno[3,4-b]thiophenediyl} (PTB7):[6,6]-phenyl-C71-butyric acid methyl ester (PC71BM)-based OSCs. In addition, the long-term stability of the OSC is improved by using the ITR-GO/PFN CIL when compared with the pristine device. These results indicate that the bilayer ITR-GO/PFN CIL is a promising way to realize high-efficiency and stable OSCs by using water-soluble conjugated polymer electrolytes such as PFN

Enhanced Power Conversion Efficiency of P3HT : PC 71 BM Bulk Heterojunction Polymer Solar Cells by Doping a High-Mobility Small Organic Molecule

The effect of molecular doping with TIPS-pentacene on the photovoltaic performance of polymer solar cells (PSCs) with a structure of ITO/ZnO/poly(3-hexylthiophene-2,5-diyl) (P3HT) : [6,6]-phenyl C71-butyric acid methyl ester (PC 71 BM) : TIPSpentacene/MoO x /Ag was systematically investigated by adjusting TIPS-pentacene doping ratios ranged from 0.3 to 1.2 wt%. The device with 0.6 wt% TIPS-pentacene exhibited the enhanced short-circuit current and fill factor by 1.23 mA/cm 2 and 7.8%, respectively, resulting in a maximum power conversion efficiency of 4.13%, which is one-third higher than that of the undoped one. The photovoltaic performance improvement was mainly due to the balanced charge carrier mobility, enhanced crystallinity, and matched cascade energy level alignment in TIPS-pentacene doped active layer, resulting in the efficient charge separation, transport, and collection