Biomechanical Computed Tomography analysis (BCT) for clinical assessment of osteoporosis.

The surgeon general of the USA defines osteoporosis as "a skeletal disorder characterized by compromised bone strength, predisposing to an increased risk of fracture." Measuring bone strength, Biomechanical Computed Tomography analysis (BCT), namely, finite element analysis of a patient's clinical-resolution computed tomography (CT) scan, is now available in the USA as a Medicare screening benefit for osteoporosis diagnostic testing. Helping to address under-diagnosis of osteoporosis, BCT can be applied "opportunistically" to most existing CT scans that include the spine or hip regions and were previously obtained for an unrelated medical indication. For the BCT test, no modifications are required to standard clinical CT imaging protocols. The analysis provides measurements of bone strength as well as a dual-energy X-ray absorptiometry (DXA)-equivalent bone mineral density (BMD) T-score at the hip and a volumetric BMD of trabecular bone at the spine. Based on both the bone strength and BMD measurements, a physician can identify osteoporosis and assess fracture risk (high, increased, not increased), without needing confirmation by DXA. To help introduce BCT to clinicians and health care professionals, we describe in this review the currently available clinical implementation of the test (VirtuOst), its application for managing patients, and the underlying supporting evidence; we also discuss its main limitations and how its results can be interpreted clinically. Together, this body of evidence supports BCT as an accurate and convenient diagnostic test for osteoporosis in both sexes, particularly when used opportunistically for patients already with CT. Biomechanical Computed Tomography analysis (BCT) uses a patient's CT scan to measure both bone strength and bone mineral density at the hip or spine. Performing at least as well as DXA for both diagnosing osteoporosis and assessing fracture risk, BCT is particularly well-suited to "opportunistic" use for the patient without a recent DXA who is undergoing or has previously undergone CT testing (including hip or spine regions) for an unrelated medical condition

Bimodal polarons as a function of morphology in high efficiency polymer/acceptor blends for organic photovoltaics

The polymer PffBT4T-C9C13 (poly[(5,6-difluoro-2,1,3-benzothiadiazole-4,7-diyl)[3,3′′′-bis (2-decyltetradecyl)[2,2′:5′,2′′:5′′,2′′ -quaterthiophene]-5,5′′′-diyl]]) produces organic solar cells of >11% efficiency with both fullerenes and non-fullerenes. We present a comprehensive morphology and spectroscopy study of this polymer and its blends, focusing on atomic force microscopy, x-ray diffraction, and transient absorption spectroscopy on microsecond timescales. Unusually, fullerene-induced ordering is observed, with the polymer/fullerene blend displaying a greater crystallinity compared to the pristine polymer. This was correlated with the appearance of bimodal polarons: fast-decaying polarons in the pristine amorphous polymer domains and trapped polarons localised in the fullerene-induced ordering (crystallline) domains. The lifetime of the trapped polaron was significantly enhanced upon thermal annealing, and the complex relationship observed between lifetime and film crystallinity suggest a contribution from trap states at the interfaces between ordered and disordered domains that lead to inhibited recombination. In contrast, blends incorporating the well-known analogue PffBT4T-2OD (with a shorter alkyl chain length) exhibit neither fullerene-induced ordering nor bimodal polarons. However, both PffBT4T-C9C13 and PffBT4T-2OD polymer blends show clear evidence of polymer triplet formation, which is the first time triplets have been identified in PffBT4T-based blends. In this study, we remark upon the complex relationship between morphology and the photophysics. This relationship will open the door to the synthesis of new molecules to control the blend morphology and thus optimise organic photovoltaic performance

Organic photovoltaics: The current challenges

Organic photovoltaics are remarkably close to reaching a landmark power conversion efficiency of 20%. Given the current urgent concerns regarding climate change, research into renewable energy solutions is crucially important. In this perspective article, we highlight several key aspects of organic photovoltaics, ranging from fundamental understanding to implementation, that need to be addressed to ensure the success of this promising technology. We cover the intriguing ability of some acceptors to undergo efficient charge photogeneration in the absence of an energetic driving force and the effects of the resulting state hybridization. We explore one of the primary loss mechanisms of organic photovoltaics - non-radiative voltage losses - and the influence of the energy gap law. Triplet states are becoming increasingly relevant owing to their presence in even the most efficient non-fullerene blends, and we assess their role as both a loss mechanism and a potential strategy to enhance efficiency. Finally, two ways in which the implementation of organic photovoltaics can be simplified are addressed. The standard bulk heterojunction architecture could be superseded by either single material photovoltaics or sequentially deposited heterojunctions, and the attributes of both are considered. While several important challenges still lie ahead for organic photovoltaics, their future is, indeed, bright

Truncated conjugation in fused heterocycle-based conducting polymers: when greater planarity does not enhance conjugation

One of the main assumptions in the design of new conjugated polymer materials for their use in organic electronics is that higher coplanarity leads to greater conjugation along the polymer backbone. Conventionally, a more planar monomer structure induces a larger backbone coplanarity, thus leading to a greater overlap of the carbon π-orbitals and therefore a higher degree of π-electron delocalisation. However, here we present a case that counters the validity of this assumption. Different diselenophene-based polymers were studied where one polymer possesses two selenophene rings fused together to create a more rigid, planar structure. The effects of this greater polymer coplanarity were examined using Raman spectroscopy and theoretical calculations. Raman spectra showed a large difference between the vibrational modes of the fused and unfused polymers, indicating very different electronic structures. Resonance Raman spectroscopy confirmed the rigidity of the fused selenophene polymer and also revealed, by studying the excitation profiles of the different bands, the presence of two shorter, uncoupled conjugation pathways. Supported by Density Functional Theory (DFT) calculations, we have demonstrated that the reason for this lack of conjugation is a distortion of the selenophene rings due to the induced planarity, forming a new truncated conjugation pathway through the selenophene β-position and bypassing the beneficial α-position. This effect was studied using DFT in an ample range of derivatives, where substitution of the selenium atom with other heteroatoms still maintained the same unconventional conjugation-planarity relationship, confirming the generality of this phenomenon. This work establishes an important structure-property relationship for conjugated polymers that will help rational design of more efficient organic electronics materials

Lewis Base Passivation Mediates Charge Transfer at Perovskite Heterojunctions

Understanding interfacial charge transfer processes such as trap-mediated recombination and injection into charge transport layers (CTLs) is crucial for the improvement of perovskite solar cells. Herein, we reveal that the chemical binding of charge transport layers to CH3NH3PbI3 defect sites is an integral part of the interfacial charge injection mechanism in both n-i-p and p-i-n architectures. Specifically, we use a mixture of optical and X-ray photoelectron spectroscopy to show that binding interactions occur via Lewis base interactions between electron-donating moieties on hole transport layers and the CH3NH3PbI3 surface. We then correlate the extent of binding with an improvement in the yield and longer lifetime of injected holes with transient absorption spectroscopy. Our results show that passivation-mediated charge transfer has been occurring undetected in some of the most common perovskite configurations and elucidate a key design rule for the chemical structure of next-generation CTLs

Healthcare Resource Utilization Among Patients in England with Systemic Sclerosis-Associated Interstitial Lung Disease: A Retrospective Database Analysis

Introduction Systemic sclerosis-associated interstitial lung disease (SSc-ILD) places a substantial burden on patients and healthcare systems. The objectives of this study were to describe clinical characteristics and assess healthcare resource utilization and costs of patients with SSc-ILD in England, compared with patients with non-pulmonary organ involvement related to SSc (SSc-OOI). Methods This population-based retrospective study used data from the Clinical Practice Research Datalink linked to Hospital Episode Statistics. Data were extracted from medical records dated January 1, 2005 to March 31, 2016. Patients with SSc were identified and placed in subgroups based on organ involvement: SSc-ILD, SSc-OOI, and both (SSc-ILD-OOI). Patients with SSc-ILD-OOI were included in both the SSc-ILD and SSc-OOI subgroups. All-cause healthcare costs, excluding medication costs, were calculated to 2016 British pounds sterling (£). Results This study included 675 patients with SSc: 174 (26%) had neither ILD nor other organ involvement (OOI); 127 (19%) had SSc-ILD; 477 (71%) had SSc-OOI; 103 (15%) had SSc-ILD-OOI. Age-weighted median [interquartile range (IQR)] annual healthcare costs per patient were: £1496 (£664–£2817) in SSc only; £6375 (£3451–£15,041) in SSc-ILD; £4084 (£1454–£10,105) in SSc-OOI; £6632 (£4023–£17,009) in SSc-ILD-OOI. In multivariate analysis, older age at diagnosis, diagnosis of anemia, and number of comorbid diseases were associated with higher yearly healthcare costs. Conclusion The annual healthcare cost for patients with SSc-ILD is substantial, and higher than that of patients with SSc-OOI or SSc only. These results quantify the economic burden of SSc-ILD in a real-world setting, and highlight the need for treatment of this disease

Exploring the Relationship between BODIPY Structure and Spectroscopic Properties to Design Fluorophores for Bioimaging

Designing chromophores for biological applications requires a fundamental understanding of how the chemical structure of a chromophore influences its photophysical properties. We here describe the synthesis of a library of BODIPY dyes, exploring diversity at various positions around the BODIPY core. The results show that the nature and position of substituents have a dramatic effect on the spectroscopic properties. Substituting in a heavy atom or adjusting the size and orientation of a conjugated system provides a means of altering the spectroscopic profiles with high precision. The insight from the structure–activity relationship was applied to devise a new BODIPY dye with rationally designed photochemical properties including absorption towards the near‐infrared region. The dye also exhibited switch‐on fluorescence to enable visualisation of cells with high signal‐to‐noise ratio without washing‐out of unbound dye. The BODIPY‐based probe is non‐cytotoxic and compatible with staining procedures including cell fixation and immunofluorescence microscopy

Discerning Bulk and Interfacial Polarons in a Dual Electron Donor/Acceptor Polymer

The active layer of organic solar cells typically possesses a complex morphology, with amorphous donor/acceptor mixed domains present in addition to purer, more crystalline domains. These crystalline domains may represent an energy sink for free charges that aids charge separation and suppresses bimolecular recombination. The first step in exploiting this behavior is the identification and characterization of charges located in these different domains. Herein, the generation and recombination of both bulk and interfacial polarons are demonstrated in the dual electron donor/acceptor polymer XIND using transient absorption spectroscopy. The absorption spectra of XIND bulk polarons, present in pristine polymer domains, are clearly distinguishable from those of polarons present at the donor/acceptor interface. Furthermore, it is shown that photogenerated polarons are transferred from the interface to the bulk. These findings support the energy sink hypothesis and offer a way to maximize morphology relationships to enhance charge generation and suppress recombination

Solvent-dependent photophysics of a red-shifted, biocompatible coumarin photocage

Controlling the activity of biomolecules with light-triggered photocages is an important research tool in the life sciences. We describe here a coumarin photocage that unusually combines the biocompatible optical properties of strong absorption at a long wavelength close to 500 nm and high photolysis quantum yields. The favourable properties are achieved by synthetically installing on the photocage scaffold a diethyl amino styryl moiety and a thionoester group rather than the lactone typical for coumarins. The photocage's photophysics are analysed with microsecond transient absorption spectroscopy to reveal the nature of the excited state in the photolysis pathway. The excited state is found to be strongly dependent on solvent polarity with a triplet state formed in DMSO and a charge-separated state in water that is likely due to aggregation. A long triplet lifetime is also correlated with a high photolysis quantum yield. Our study on the biocompatible photocage reveals fundamental insight for designing advanced photocages such as longer wavelengths in different solvent conditions tailored for applications in basic and applied research