Efficacy and safety of eight enhanced therapies for treatment-resistant depression: A systematic review and network meta-analysis of RCTs.

BACKGROUND: Treatment-Resistant Depression (TRD) challenges psychiatric treatment, with existing guidelines covering only a subset of augmentation strategies. METHODS: A network meta-analysis following PRISMA guidelines examined the efficacy and safety of TRD treatments, analyzing 72 randomized controlled trials from eight databases, assessing response and remission rates, tolerability, and safety through the Cochrane Risk of Bias Tool and CINeMA framework. FINDINGS: Including 12,105 participants, the analysis highlighted ECT, Ketamine, Esketamine, and Psilocybin as superior first-line treatments due to their optimal balance between effectiveness and tolerability. Brexpiprazole and Quetiapine showed no significant efficacy over placebo in response rates, while Esketamine and Psilocybin exhibited lower tolerability. INTERPRETATION: The results advocate for ECT, Ketamine, Esketamine, and Psilocybin as preferred treatments for TRD, guiding clinical practice with evidence-based recommendations for enhancing treatment outcomes. This study underscores the importance of considering both efficacy and safety in selecting augmentation strategies for TRD.

Performance Improvement and Application of Degradable Poly-l-lactide and Yttrium-Doped Zinc Oxide Hybrid Films for Energy Harvesting.

Piezoelectric nanogenerators (PENGs) are booming for energy collection and wearable energy supply as one of the next generations of green energy-harvesting devices. Balancing the output, safety, degradation, and cost is the key to solving the bottleneck of PENG application. In this regard, yttrium (Y)-doped zinc oxide (ZnO) (Y-ZnO) was synthesized and embedded into polylactide (PLLA) for developing degradable piezoelectric composite films with an enhanced energy-harvesting performance. The synthesized Y-ZnO exhibits high piezoelectric properties benefiting from the stronger polarity of the Y-O bond and regulation of oxygen vacancy concentration, which improve the output performance of the composite film with Y-ZnO and PLLA (Y-Z-PLLA). The obtained open-circuit voltage (Voc), short-circuit current (Isc), and instantaneous power density of the optimized Y-Z-PLLA PENG reach 17.52 V, 2.45 µA, and 1.76 µW/cm2, respectively. The proposed PENG also shows good degradability. In addition, practical applications of the proposed PENG were demonstrated by converting biomechanical energy, such as walking, running, and jumping, into electricity.

Enhancing ecosystem productivity and stability with increasing canopy structural complexity in global forests.

Forest canopy structural complexity (CSC) plays a crucial role in shaping forest ecosystem productivity and stability, but the precise nature of their relationships remains controversial. Here, we mapped the global distribution of forest CSC and revealed the factors influencing its distribution using worldwide light detection and ranging data. We find that forest CSC predominantly demonstrates significant positive relationships with forest ecosystem productivity and stability globally, although substantial variations exist among forest ecoregions. The effects of forest CSC on productivity and stability are the balanced results of biodiversity and resource availability, providing valuable insights for comprehending forest ecosystem functions. Managed forests are found to have lower CSC but more potent enhancing effects of forest CSC on ecosystem productivity and stability than intact forests, highlighting the urgent need to integrate forest CSC into the development of forest management plans for effective climate change mitigation.

Carbon storage through China's planted forest expansion.

China's extensive planted forests play a crucial role in carbon storage, vital for climate change mitigation. However, the complex spatiotemporal dynamics of China's planted forest area and its carbon storage remain uncaptured. Here we reveal such changes in China's planted forests from 1990 to 2020 using satellite and field data. Results show a doubling of planted forest area, a trend that intensified post-2000. These changes lead to China's planted forest carbon storage increasing from 675.6 ± 12.5 Tg C in 1990 to 1,873.1 ± 16.2 Tg C in 2020, with an average rate of ~ 40 Tg C yr-1. The area expansion of planted forests contributed ~ 53% (637.2 ± 5.4 Tg C) of the total above increased carbon storage in planted forests compared with planted forest growth. This proactive policy-driven expansion of planted forests has catalyzed a swift increase in carbon storage, aligning with China's Carbon Neutrality Target for 2060.

In vitro heterochronic parabiosis identifies pigment epithelium-derived factor as a systemic mediator of rejuvenation by young blood.

Several decades of heterochronic parabiosis (HCPB) studies have demonstrated the restorative impact of young blood, and deleterious influence of aged blood, on physiological function and homeostasis across tissues, although few of the factors responsible for these observations have been identified. Here we develop an in vitro HCPB system to identify these circulating factors, using replicative lifespan (RLS) of primary human fibroblasts as an endpoint of cellular health. We find that RLS is inversely correlated with serum donor age and sensitive to the presence or absence of specific serum components. Through in vitro HCPB, we identify the secreted protein pigment epithelium-derived factor (PEDF) as a circulating factor that extends RLS of primary human fibroblasts and declines with age in mammals. Systemic administration of PEDF to aged mice reverses age-related functional decline and pathology across several tissues, improving cognitive function and reducing hepatic fibrosis and renal lipid accumulation. Together, our data supports PEDF as a systemic mediator of the effect of young blood on organismal health and homeostasis and establishes our in vitro HCPB system as a valuable screening platform for the identification of candidate circulating factors involved in aging and rejuvenation.

Twisted photonic Weyl meta-crystals and aperiodic Fermi arc scattering.

As a milestone in the exploration of topological physics, Fermi arcs bridging Weyl points have been extensively studied. Weyl points, as are Fermi arcs, are believed to be only stable when preserving translation symmetry. However, no experimental observation of aperiodic Fermi arcs has been reported so far. Here, we continuously twist a bi-block Weyl meta-crystal and experimentally observe the twisted Fermi arc reconstruction. Although both the Weyl meta-crystals individually preserve translational symmetry, continuous twisting operation leads to the aperiodic hybridization and scattering of Fermi arcs on the interface, which is found to be determined by the singular total reflection around Weyl points. Our work unveils the aperiodic scattering of Fermi arcs and opens the door to continuously manipulating Fermi arcs.

Re-analysis of gene mutations found in pituitary stalk interruption syndrome and a new hypothesis on the etiology.

Background: Pituitary stalk interruption syndrome (PSIS) is a complex clinical syndrome characterized by varied pituitary hormone deficiencies, leading to severe manifestations across multiple systems. These include lifelong infertility, short stature, mental retardation, and potentially life-threatening pituitary crises if not promptly diagnosed and treated. Despite extensive research, the precise pathogenesis of PSIS remains unclear. Currently, there are two proposed theories regarding the pathogenic mechanisms: the genetic defect theory and the perinatal injury theory. Methods: We systematically searched English databases (PubMed, Web of Science, Embase) and Chinese databases (CNKI, WanFang Med Online, Sinomed) up to February 24, 2023, to summarize studies on gene sequencing in PSIS patients. Enrichment analyses of reported mutated genes were subsequently performed using the Metascape platform. Results: Our study included 37 articles. KEGG enrichment analysis revealed mutated genes were enriched in the Notch signaling pathway, Wnt signaling pathway, and Hedgehog signaling pathway. GO enrichment analysis demonstrated mutated genes were enriched in biological processes such as embryonic development, brain development, axon development and guidance, and development of other organs. Conclusion: Based on our summary and analyses, we propose a new hypothesis: disruptions in normal embryonic development, partially stemming from the genetic background and/or specific gene mutations in individuals, may increase the likelihood of abnormal fetal deliveries, where different degrees of traction during delivery may lead to different levels of pituitary stalk interruption and posterior lobe ectopia. The clinical diversity observed in PSIS patients may result from a combination of genetic background, specific mutations, and variable degrees of traction during delivery.

[Comparison of Different Doses of ACTH Used in ACTH Stimulation Test to Determine the Subtypes of Primary Aldosteronism]. / ä¸åŒå‰‚é‡ä¿ƒè‚¾ä¸Šè ºçš®è´¨æ¿€ç´ å ´å¥‹è¯•éªŒåœ¨åŽŸå‘æ€§é†›å›ºé ®å¢žå¤šç—‡åˆ†åž‹è¯Šæ–­ä¸­çš„æ¯”è¾ƒ.

Objective: To compare the diagnostic value of adrenocorticotropic hormone (ACTH) stimulation test (AST) with different doses of ACTH combined with midnight administration of 1 mg dexamethasone for the determination of the subtypes of primary hyperaldosteronism (PA). Methods: This is a prospective observational study. Patients diagnosed with PA in the Department of Endocrinology, the First Medical Center of of Chinese PLA General Hospital from January 1, 2020 to September 30, 2022 underwent AST with different doses of ACTH. All patients received 1 mg dexamethasone at midnight for inhibition. Then, the patients were randomly assigned to 25-unit and 50-unit ACTH treatment groups by a ratio of 1:2. Subtype classification and diagnosis of aldosterone-producing adenoma (APA) and idiopathic hyperaldosteronism (IHA) was made on the basis of adrenal venous blood samples and/or postoperative pathology and clinical follow-up findings. Receiver operating characteristics (ROC) curves were plotted to examine the diagnostic efficacy and the difference of AST by varying doses of ACTH in distinguishing APA and IHA. Results: A total of 82 patients, including 49 patients with APA (59.8%) and 33 patients with IHA (40.2%), were enrolled. There were 29 patients in the 25-unit ACTH group (35.4%) and 53 patients in the 50-unit ACTH group (64.6%). There were no significant differences in age, sex, blood pressure, minimum serum potassium, and biochemical parameters between the 25-unit and 50-unit groups. After ACTH stimulation, plasma aldosterone concentration (PAC), cortisol (F), and PAC/F at different points of time showed no statistical difference between the two groups (P>0.05). The area under the curve (AUC) of PAC in the 25-unit group was higher than that of PAC/F. The AUC of PAC reached the maximum at 90 minutes (0.948, 95% confidence interval [CI]: 0870-1.000) and the optimal cutoff was 38.0 ng/dL, which had a sensitivity of 92.9% and a specificity of 86.7% for differentiating APA and IHA. Similar to the 25-unit group, the maximum AUC of PAC in the 50-unit group was greater than that of PAC/F. The AUC of PAC reached the maximum 90 minutes (0.930, 95% CI: 0.840-0.994) and the optimal cutoff was 39.6 ng/dL, which had a sensitivity of 91.2% and a specificity of 83.3%. The AUC of PAC at different points of time in the 25-unit ACTH group (0.862-0.948) was greater than that of 50-unit ACTH group (0.823-0.930), but the difference was not statistical significance. Conclusion: AST with 25-unit or 50-unit ACTH combined with small-dose dexamethasone can be used in PA subtype determination, ie, differentiation between APA and IHA. The optimal PAC cut-off values for 25-unit or 50-unit ACTH are similar, being 38.0 ng/dL and 39.6 ng/dL, respectively, and both cutoff values show higher sensitivity and specificity at 90 min. The AST with 25-unit ACTH has the smaller dose and the better safety. Therefore, it is recommended for the diagnosis of PA subtypes.

SARS-CoV-2 serosurvey of healthy, privately owned cats presenting to a New York City animal hospital in the early phase of the COVID-19 pandemic (2020-2021).

Both domestic and non-domestic cats are now established to be susceptible to infection by SARS-CoV-2, the cause of the ongoing COVID-19 pandemic. While serious disease in cats may occur in some instances, the majority of infections appear to be subclinical. Differing prevalence data for SARS-CoV-2 infection of cats have been reported, and are highly context-dependent. Here, we report a retrospective serological survey of cats presented to an animal practice in New York City, located in close proximity to a large medical center that treated the first wave of COVID-19 patients in the US in the Spring of 2020. We sampled 79, mostly indoor, cats between June 2020 to May 2021, the early part of which time the community was under a strict public health "lock-down". Using a highly sensitive and specific fluorescent bead-based multiplex assay, we found an overall prevalence of 13/79 (16%) serologically-positive animals for the study period; however, cats sampled in the Fall of 2020 had a confirmed positive prevalence of 44%. For SARS-CoV-2 seropositive cats, we performed viral neutralization test with live SARS-CoV-2 to additionally confirm presence of SARS-CoV-2 specific antibodies. Of the thirteen seropositive cats, 7/13 (54%) were also positive by virus neutralization, and 2 of seropositive cats had previously documented respiratory signs, with high neutralization titers of 1:1024 and 1:4096; overall however, there was no statistically significant association of SARS-CoV-2 seropositivity with respiratory signs, or with breed, sex or age of the animals. Follow up sampling of cats, while limited in scope, showed that positive serological titers were maintained over time. In comparison, we found an overall confirmed positive prevalence of 51% for feline coronavirus (FCoV), an endemic virus of cats, with 30% confirmed negative for FCoV. We demonstrate the impact of SARS-CoV in a defined feline population during the first wave of SARS-CoV-2 infection of humans, and suggest that human-cat transmission was substantial in our study group. Our data provide a new context for SARS-CoV-2 transmission events across species.

Associations between atherosclerotic luminal stenosis in the distal internal carotid artery and diffuse wall thickening in its upstream segment.

OBJECTIVES: Significant atherosclerotic stenosis or occlusion in the distal internal carotid artery (ICA) may induce diffuse wall thickening (DWT) in the upstream arterial wall. This study aimed to assess the association of atherosclerotic steno-occlusive diseases in the distal ICA with DWT in the upstream ipsilateral ICA. METHODS: Individuals with atherosclerotic stenosis in the distal ICA, detected by carotid MR vessel wall imaging using 3D pre- and post-contrast T1 volume isotropic turbo spin-echo acquisition (T1-VISTA) sequence, were enrolled. The associations of vessel wall thickening, the longitudinal extent of DWT, enhancement of the upstream ipsilateral ICA, and stenosis degree in the distal ICA were examined. RESULTS: Totally 64 arteries in 55 patients with atherosclerotic steno-occlusive distal ICAs were included. Significant correlations were found between distal ICA stenosis and DWT in the petrous ICA (r = 0.422, p = 0.001), DWT severity (r = 0.474, p < 0.001), the longitudinal extent of DWT in the ICA (r = 0.671, p < 0.001), enhancement in the petrous ICA (r = 0.409, p = 0.001), and enhancement degree (r = 0.651, p < 0.001). In addition, high degree of enhancement was correlated with both increased wall thickness and increased prevalence of DWT in the petrous ICA (both p < 0.001). CONCLUSIONS: DWT of the petrous ICA is commonly detected in patients with atherosclerotic steno-occlusive disease in the distal ICA. The degree of stenosis in the distal ICA is associated with wall thickening and its longitudinal extent in the upstream segments. CLINICAL RELEVANCE STATEMENT: Diffuse wall thickening is a common secondary change in atherosclerotic steno-occlusive disease in the intracranial carotid. This phenomenon constitutes a confounding factor in the distinction between atherosclerosis and inflammatory vasculopathies, and could be reversed after alleviated atherosclerotic stenosis. KEY POINTS: • Diffuse wall thickening of the petrous internal carotid artery is commonly detected in patients with atherosclerotic steno-occlusive disease in the distal internal carotid artery. • The phenomenon of diffuse wall thickening could be reversed after stenosis alleviation. • Carotid artery atherosclerosis with diffuse wall thickening should warrant a differential diagnosis from other steno-occlusive diseases, including moyamoya diseases and Takayasu aortitis.

Long-term cognitive effects of electroconvulsive therapy in major depressive disorder: A systematic review and meta-analysis.

OBJECTIVE: Electroconvulsive therapy (ECT) is endorsed as a principal treatment approach for major depressive disorder (MDD) worldwide. Despite prior studies highlighting potential short-term cognitive deficits post-ECT, the debate regarding its long-term implications persists. This study endeavors to elucidate the reasons for this contention using an evidence-based approach. METHODS: This investigation, meticulously aligned with PRISMA guidelines, was prospectively enlisted on PROSPERO (CRD42023439259). A comprehensive search was performed across various databases, including PubMed, Cochrane Library, Web of Science, Embase, SCOPUS, PsycINFO, CINAHL Plus, and OpenGrey. This review, traversing the literature from inception until June 2023, encapsulated 10 studies (five RCTs and five quasi-experimental studies) involving a cohort of 868 individuals diagnosed with major depressive disorder. RESULTS: The meta-analysis revealed that the persistent discourse on ECT-induced long-term cognitive impairment chiefly emanates from the inadequacies in the specificity and sensitivity of conventional assessment instruments. Conversely, subgroup analyses showed that cognitive impairment in ECT, as gauged by the nascent assessment tool, Electroconvulsive Therapy Cognitive Assessment (ECCA) (SMD = -0.94, 95 % CI [-1.33, -0.54], p < 0.00001), exerted a detrimental influence on the long-term trajectory of individuals with MDD. Notably, there was an adverse effect of ECT on the subdomain of long-term learning cognitive abilities in patients with MDD (SMD = -0.37, 95 % CI [-0.55, -0.18], p < 0.0001). Contrarily, memory (SMD = 0.16, 95 % CI [-0.02, 0.34], p = 0.08), attention (SMD = 0.23, 95 % CI [-0.07, 0.54], p = 0.14), language (SMD = -0.10, 95 % CI [-0.25, 0.05], p = 0.19), spatial perception, and orientation (SMD = -0.04, 95 % CI [-0.28, 0.20], p = 0.75) exhibited no significant detriments. Intriguingly, ECT showed favorable effects on executive function and processing speed among patients with MDD (SMD = 0.52, 95 % CI [0.29, 0.74], p < 0.00001). CONCLUSION: This meta-analysis underscores ECCA's superior sensitivity of the ECCA compared to the MMSE or MoCA in detecting cognitive changes in patients with post-ECT MDD. Following Electroconvulsive Therapy (ECT), deterioration was observed in overall cognitive function and learning capabilities, while memory, attention, language, and spatial perception remained stable. Notably, enhancements were discerned in executive function and processing speed, which not only augmented academic perspectives but also steered the formulation of international clinical guidelines, accentuating the progressive role of ECT in the therapeutic approach to MDD.

Optimization Mechanism of Nozzle Parameters and Characterization of Nanofibers in Centrifugal Spinning.

Nanofibers are an emerging kind of nano-material, widely used in several application domains such as biomedicine, high-efficiency filtration media, precision electronics, and optical devices. Centrifugal spinning, which is a novel nanofiber production technology, has been widely studied. This paper proposes a structural parameter optimization design method of a bent-tube nozzle. The mathematical model of the spinning solution motion in the nozzle is first developed. The optimization function of the structure parameters of the bent-tube nozzle is then obtained by calculation. Afterwards, these parameters are optimized using a neural network algorithm. The obtained results show that, when the bending angle is 15°, the curvature radius is 10 mm, the outlet radius is 0.205 mm, and the head loss of the solution can be minimized. Finally, centrifugal spinning experiments are conducted and the influence of the centrifugal spinning parameters on the nanofibers is analyzed. In addition, the optimized bent-tube nozzle improves the surface morphology of the nanofibers as their diameter distribution becomes more uniform.

Triple-output phase unwrapping network with a physical prior in fringe projection profilometry.

Deep learning has been attracting more and more attention in the phase unwrapping of fringe projection profilometry (FPP) in recent years. In order to improve the accuracy of the deep-learning-based unwrapped phase methods from a single fringe pattern, this paper proposes a single-input triple-output neural network structure with a physical prior. In the proposed network, a single-input triple-output network structure is developed to convert the input fringe pattern into three intermediate outputs: the wrapped phase, the fringe order, the coarse unwrapped phase, and the final output high-precision unwrapped phase from the three outputs. Moreover, a new, to the best of our knowledge, loss function is designed to improve the performance of the model using a physical prior about these three outputs in FPP. Numerous experiments demonstrated that the proposed network is able to improve the accuracy of the unwrapped phase, which can also be extended to other deep learning phase unwrapping models.

Tree mortality during long-term droughts is lower in structurally complex forest stands.

Increasing drought frequency and severity in a warming climate threaten forest ecosystems with widespread tree deaths. Canopy structure is important in regulating tree mortality during drought, but how it functions remains controversial. Here, we show that the interplay between tree size and forest structure explains drought-induced tree mortality during the 2012-2016 California drought. Through an analysis of over one million trees, we find that tree mortality rate follows a "negative-positive-negative" piecewise relationship with tree height, and maintains a consistent negative relationship with neighborhood canopy structure (a measure of tree competition). Trees overshadowed by tall neighboring trees experienced lower mortality, likely due to reduced exposure to solar radiation load and lower water demand from evapotranspiration. Our findings demonstrate the significance of neighborhood canopy structure in influencing tree mortality and suggest that re-establishing heterogeneity in canopy structure could improve drought resiliency. Our study also indicates the potential of advances in remote-sensing technologies for silvicultural design, supporting the transition to multi-benefit forest management.

Tunable Optical Frequency Comb Generated Using Periodic Windows in a Laser and Its Application for Distance Measurement.

A novel method for the generation of an optical frequency comb (OFC) is presented. The proposed approach uses a laser diode with optical feedback and operating at a specific nonlinear dynamic state named periodic window. In this case, the laser spectrum exhibits a feature with a series of discrete, equally spaced frequency components, and the repetition rate can be flexibly adjusted by varying the system parameters (e.g., external cavity length), which can provide many potential applications. As an application example, a dual-OFC system for distance measurement is presented. The results demonstrate the system's ability to achieve target distance detection, underscoring its potential for real-world applications in this field.

Evaluation on quantum illumination radar with quantum limited amplification.

Based on Quantum illumination (QI) protocol, researcshers have developed prototypes of quantum radar and demonstrated its quantum enhancement. Nevertheless, there are still difficulties in the practical application for QI radar, especially the trade-off between the detection range and quantum enhancement, as well as the construction of the optimized receiver. Some studies have suggested that the potential solutions to these difficulties are to deploy the quantum limited amplifiers in QI radars, and have envisioned different amplification schemes. In this paper, we establish a universal and effective method to evaluate the signal-to-noise ratio of QI radar. It connects QI radar theory with classical radar signal processing theory, providing support for researchers to evaluate the performance of various QI radar schemes from a radar perspective. Based on this method, we prove that any quantum limited phase-insensitive amplification scheme will seriously weaken the quantum enhancement of QI radar. Furthermore, we also demonstrate that the QI radar with phase-sensitive amplified idler has no advantage over the optimal classical illumination. These results can help us avoid some unreasonable QI radar schemes. In addition, we believe that the proposed method can also be applied to explore other potential QI radar schemes and contribute to promoting the application development of QI radar.

Coexistence of Dirac points and nodal chains in photonic metacrystal.

Gapless topological phases, i.e. topological semimetals, come in various forms such as Weyl/Dirac semimetals, nodal line/chain semimetals, and surface-node semimetals. However, the coexistence of two or more topological phases in a single system is still rare. Here, we propose the coexistence of Dirac points and nodal chain degeneracies in a judiciously designed photonic metacrystal. The designed metacrystal exhibits nodal line degeneracies lying in perpendicular planes, which are chained together at the Brillouin zone boundary. Interestingly, the Dirac points, which are protected by nonsymmorphic symmetries, are located right at the intersection points of nodal chains. The nontrivial Z2 topology of the Dirac points is revealed by the surface states. The Dirac points and nodal chains are located in a clean frequency range. Our results provide a platform for studying the connection between different topological phases.

Analysis of characteristics of four patients with adrenal unicentric Castleman disease.

Background: Castleman Disease (CD) is a group of diseases with characteristic lymph node histopathology, characterized by marked enlargement of deep or superficial lymph nodes. Adrenal CD is rarely reported, and an accurate preoperative diagnosis of adrenal CD is difficult. Method: We report four cases of CD in the adrenal gland confirmed by pathology and review the characteristics of this rare disease, highlighting the necessity of diagnostic evaluation and follow-up of the patients. Results: All of the patients sought medical advice because of adrenal incidentalomas. No significant abnormalities were presented in the biochemistry or endocrine systems. The imaging suggested a moderate-to-large mass with uneven moderate contrast enhancement of the adrenal region, similar to a pheochromocytoma. All cases were misdiagnosed as pheochromocytomas before operation and finally confirmed by histopathology. Three cases were pathologically diagnosed as hyaline vascular CD, and one case was diagnosed as plasma cell CD. All the patients are alive without recurrence after a median follow-up of 8 years. Conclusion: The adrenal CD should be considered after excluding pheochromocytoma and malignancy in the adrenal region. The long-term prognosis of patients with complete resection of the mass is excellent.

Scalar topological photonic nested meta-crystals and skyrmion surface states in the light cone continuum.

Topological photonics is rapidly expanding. However, discovering three-dimensional topological electromagnetic systems can be more challenging than electronic systems for two reasons. First, the vectorial nature of electromagnetic waves results in complicated band dispersions, and simple tight-binding-type predictions usually fail. Second, topological electromagnetic surface modes inside the light cone have very low quality factors (Q factors). Here, we propose the concept of scalar topological photonics to address these challenges. Our approach is experimentally validated by employing a nested meta-crystal configuration using connected coaxial waveguides. They exhibit scalar-wave-like band dispersions, making the search for photonic topological phases an easier task. Their surface states have skyrmion-like electric field distributions, resulting in a whole, bright surface state band inside the light cone continuum. As such, the topological surface states in our three-dimensional nested crystals can be exposed to air, making such systems well-suited for practical applications.