Improving strength and toughness of graphene film through metal ion bridging.

The fangs, jaws, and mandibles of marine invertebrates such as Chiton and Glycera show excellent mechanical properties, which are mostly contributed to the interactions between metal (Fe, Cu, Zn, etc.) and oxygen-containing functional groups in proteins. Inspired by these load-bearing skeletal biomaterials, we improved tensile strength and toughness of graphene films through bridging graphene oxide (GO) nanosheets by metal ions. By optimizing the metal coordination form and density of cross-linking network. We revealed the relationship between mechanical properties and the unique spatial geometry of the GO nanosheets bridged by different valence metal ions. The results demonstrated that the divalent metal ions form tetrahedral geometry with carboxylate groups on the edges of the GO nanosheets, and the bond energy is relatively low, which is helpful for improving the toughness of resultant graphene films. While the trivalent metal ions are easily to form octahedral geometry with the GO nanosheets with higher bond energy, which is better for enhancing the tensile strength of graphene films. After reduction, the reduced GO (rGO) film bridged by divalent metal ions shows 43% improvement in toughness, while the rGO film bridged by trivalent metal ions shows 64% improvement in tensile strength. Our work reveals the mechanism of metal coordination bond energy and spatial geometry to improve the mechanical properties of graphene films, which lays a theoretical foundation for improving the tensile strength and toughness of resultant graphene films, and provides an avenue for fabricating high-performance graphene films and other two-dimensional nanocomposites.

Factors influencing the fate of chemical food safety hazards in the terrestrial circular primary food production system-A comprehensive review.

Food safety is recognized as a major hurdle in the transition toward circular food production systems due to the potential reintroduction and accumulation of chemical contaminants in these food systems. Effectively managing these hazardous contaminants in a risk-based manner requires quantitative insights into the factors influencing the presence and fate of contaminants in the entire circular food chain. A systematic literature review was performed to gain an up-to-date overview of the known factors and their influence on the transfer and accumulation of contaminants. This review focused on the terrestrial circular primary food production system, including the pathways between waste- or byproduct-based fertilizers, soil, crops, animal feed, and farmed animals. This review revealed an imbalance in research regarding the different pathways: studies on the soil-to-crop pathway were most abundant. The factors identified can be categorized as compound-related (intrinsic) factors, such as hydrophobicity, molecular weight, and chain length, and extrinsic factors, such as soil organic matter and carbon, pH, milk yield of cows, crop age, and biomass. Quantitative data on the influence of the identified factors were limited. Most studies quantified the influence of individual factors, whereas only a few studies quantified the combined effect of multiple factors. By providing a holistic insight into the influential factors and the quantification of their influence on the fate of contaminants, this review contributes to the improvement of food safety management for chemical hazards when transitioning to a circular food system.

Water Radiocatalysis for Selective Aqueous-Phase Methane Carboxylation with Carbon Dioxide into Acetic Acid at Room Temperature.

Methane (CH4) carboxylation with carbon dioxide (CO2) into acetic acid (CH3COOH) is an ideal chemical reaction to utilize both greenhouse gases with 100% atom efficiency but remains a great challenge under mild conditions. Herein, we introduce a concept of water (H2O) radiocatalysis for efficient and selective aqueous-phase CH4 carboxylation with CO2 into CH3COOH at room temperature. H2O radiolysis occurs under γ-ray radiation to produce ·OH radicals and hydrated electrons that efficiently react with CH4 and CO2, respectively, to produce ·CH3 radicals and ·CO2- species facilely coupling to produce CH3COOH. CH3COOH selectivity as high as 96.9 and 96.6% calculated respectively from CH4 and CO2 and a CH3COOH production rate of as high as 121.9 µmol·h-1 are acquired. The water radiocatalysis driven by γ-rays is also applicable to selectively produce organic acids from other hydrocarbons and CO2.

Accurate Measurements of NH3 Differential Adsorption Heat Unveil Structural Sensitivity of Brønsted Acid and Brønsted/Lewis Acid Synergy in Zeolites.

Differential adsorption heats of NH3 on a series of zeolites, including MOR, MFI, FER, and BEA, are accurately measured to probe their acidity using flow-pulse adsorption microcalorimetry. Initial adsorption heats of NH3 at Brønsted acid sites (BAS) vary between 105 to 136 kJ/mol, depending on framework aluminum amounts and topography structures of zeolites. A Brønsted/Lewis acid synergy between BAS and proximate tricoordinated framework-associated aluminum species is identified to generate super acid sites with initial adsorption heats of NH3 around 150 kJ/mol, but occurs only in the MFI zeolites and sensitively depends on the Si/Al ratio. These accurate data of NH3 differential adsorption heats unveil structural sensitivity of BAS and Brønsted/Lewis acid synergy in zeolites and provide experimental benchmark data for fundamental understanding of acidity and acid-catalysis of zeolites.

PdCu nanoalloy decorated photocatalysts for efficient and selective oxidative coupling of methane in flow reactors.

Methane activation by photocatalysis is one of the promising sustainable technologies for chemical synthesis. However, the current efficiency and stability of the process are moderate. Herein, a PdCu nanoalloy (~2.3 nm) was decorated on TiO2, which works for the efficient, stable, and selective photocatalytic oxidative coupling of methane at room temperature. A high methane conversion rate of 2480 µmol g-1 h-1 to C2 with an apparent quantum efficiency of ~8.4% has been achieved. More importantly, the photocatalyst exhibits the turnover frequency and turnover number of 116 h-1 and 12,642 with respect to PdCu, representing a record among all the photocatalytic processes (λ > 300 nm) operated at room temperature, together with a long stability of over 112 hours. The nanoalloy works as a hole acceptor, in which Pd softens and weakens C-H bond in methane and Cu decreases the adsorption energy of C2 products, leading to the high efficiency and long-time stability.

Traces of Potassium Induce Restructuring of the Anatase TiO2(001)-(1×4) Surface from a Reactive to an Inert Structure.

Reconstruction of solid surfaces is generally accompanied by changes in surface activities. Here, via a combined experimental and theoretical study, we successfully identified that a trace amount of potassium dopant restructures the mineral anatase TiO2(001) single-crystal surface from an added molecule (ADM) termination to an added oxygen (AOM) one without changing the (1×4) periodicity. The anatase TiO2(001)-(1×4)-ADM surface terminated with 4-fold coordinated Ti4c and 2-fold coordinated O2c sites is (photo)catalytically active, whereas the anatase TiO2(001)-(1×4)-AOM surface terminated with O2c and inaccessible 5-fold coordinated Ti5c sites is inert. These results unveiled a mechanism of dopant-induced transformation from a reactive to an inert TiO2(001)-(1×4) surface, which unifies the existing arguments about the surface structures and (photo)catalytic activity of anatase TiO2(001)-(1×4).

Synergy of Bulk Defects and Surface Defects on TiO2 for Highly Efficient Photocatalytic Production of H2O2.

Artificial photosynthesis of H2O2 by TiO2-based semiconductors is a promising approach for H2O2 production. However, the efficiency of pristine TiO2 is still limited by rapid charge separation and low O2 adsorption capacity. Here, we found that the synergy between bulk and surface defects on TiO2 could overcome this demanding bottleneck. The introduced bulk defects act as hole acceptors to induce directional hole transfer, efficiently boosting electron-hole separation. Furthermore, the adsorption of O2 is strengthened by the introduced surface defects. Consequently, this synergy of bulk and surface defects on TiO2 significantly improves the photocatalytic performance, with a H2O2 production rate of 4560 µmol h-1 g-1, outperforming most reported TiO2-based photocatalysts. This work not only provides a new insight into the mechanism of surface/bulk defects in photocatalysis but also highlights that surface/bulk regulation holds great promise for achiveing efficient photocatalytic conversion.

Cu Facet-Dependent Elementary Surface Reaction Kinetics of CO2 Hydrogenation to Methanol Catalyzed by ZrO2/Cu Inverse Catalysts.

ZrO2-Cu-based catalysts are active in catalyzing the hydrogenation of CO2 to methanol. Herein, we report Cu facet effects on the catalytic performance of ZrO2/Cu inverse catalysts in CO2 hydrogenation to methanol using various Cu nanocrystals with well-defined Cu morphologies and facets. The ZrO2-Cu interface is the active site, in which the ZrO2-Cu{100} and ZrO2-Cu{110} interfaces exhibit similar apparent activation energies of ∼42.6 kJ/mol, smaller than that of the ZrO2-Cu{111} interface (∼64.5 kJ/mol). Temporal in situ diffuse reflectance infrared Fourier transform spectroscopy characterization results identify the bridge formate hydrogenation as the rate-determining elementary surface reaction under typical reaction temperatures, whose activation energy is similar at the ZrO2-Cu{100} (∼36.3 kJ/mol) and ZrO2-Cu{110} (∼40.5 kJ/mol) interfaces and larger at the ZrO2-Cu{111} interface (∼54.5 kJ/mol). This fundamental understanding suggests Cu facet engineering as a promising strategy to improve the catalytic performance of ZrO2/Cu inverse catalysts for CO2 hydrogenation to methanol.

Locally advanced rectal cancer with dMMR/MSI-H may be excused from surgery after neoadjuvant anti-PD-1 monotherapy: a multiple-center, cohort study.

Objective: Examine patients with locally advanced rectal cancer (LARC) with deficient mismatch repair (dMMR) or microsatellite instability-high (MSI-H) who received neoadjuvant immunotherapy (nIT), and compare the outcomes of those who chose a watch-and-wait (WW) approach after achieving clinical complete response (cCR) or near-cCR with those who underwent surgery and were confirmed as pathological complete response (pCR). Methods: LARC patients with dMMR/MSI-H who received nIT were retrospectively examined. The endpoints were 2-year overall survival (OS), 2-year disease-free survival (DFS), local recurrence (LR), and distant metastasis (DM). The efficacy of programmed cell death protein-1 (PD-1) inhibitor, immune-related adverse events (irAEs), surgery-related adverse events (srAEs), and enterostomy were also recorded. Results: Twenty patients who received a PD-1 inhibitor as initial nIT were examined. Eighteen patients (90%) achieved complete response (CR) after a median of 7 nIT cycles, including 11 with pCR after surgery (pCR group), and 7 chose a WW strategy after evaluation as cCR or near-cCR (WW group). Both groups had median follow-up times of 25.0 months. Neither group had a case of LR or DM, and the 2-year DFS and OS in each group was 100%. The two groups had similar incidences of irAEs (P=0.627). In the pCR group, however, 2 patients (18.2%) had permanent colostomy, 3 (27.3%) had temporary ileostomy, and 2 (18.2%) had srAEs. Conclusion: Neoadjuvant PD-1 blockade had high efficacy and led to a high rate of CR in LARC patients with dMMR/MSI-H. A WW strategy appears to be a safe and reliable option for these patients who achieve cCR or near-cCR after nIT.

Direct Probing of Water Adsorption on Liquid-Phase Exfoliated WS2 Films Formed by the Langmuir-Schaefer Technique.

Tungsten disulfide, a transition metal dichalcogenide, has numerous applications as active components in gas- and chemical-sensing devices, photovoltaic sources, photocatalyst substrates, etc. In such devices, the presence of water in the sensing environment is a factor whose role has not been well-understood. To address this problem, the in situ probing of H2O molecule adsorption on WS2 films supported on solid substrates has been performed in a near-ambient pressure X-ray photoelectron spectroscopy (NAP-XPS) setup. Instead, on the individual nanoflakes or spray-coated samples, the measurements were performed on highly transparent, homogeneous, thin films of WS2 nanosheets self-assembled at the interface of two immiscible liquids, water and toluene, transferred onto a solid substrate by the Langmuir-Schaefer technique. This experiment shows that edge defects in nanoflakes, tungsten dangling bond ensuing the exfoliation in the liquid phase, represent active sites for the WO3, WO3-x, and WO3·nH2O formation under ambient conditions. These oxides interact with water molecules when the WS2 films are exposed to water vapor in the NAP-XPS reaction cell. However, water molecules do not influence the W-S chemical bond, thus indicating the physisorption of H2O molecules at the WS2 film surface.

Memory-dictated dynamics of single-atom Pt on CeO2 for CO oxidation.

Single atoms of platinum group metals on CeO2 represent a potential approach to lower precious metal requirements for automobile exhaust treatment catalysts. Here we show the dynamic evolution of two types of single-atom Pt (Pt1) on CeO2, i.e., adsorbed Pt1 in Pt/CeO2 and square planar Pt1 in PtATCeO2, fabricated at 500 °C and by atom-trapping method at 800 °C, respectively. Adsorbed Pt1 in Pt/CeO2 is mobile with the in situ formation of few-atom Pt clusters during CO oxidation, contributing to high reactivity with near-zero reaction order in CO. In contrast, square planar Pt1 in PtATCeO2 is strongly anchored to the support during CO oxidation leading to relatively low reactivity with a positive reaction order in CO. Reduction of both Pt/CeO2 and PtATCeO2 in CO transforms Pt1 to Pt nanoparticles. However, both catalysts retain the memory of their initial Pt1 state after reoxidative treatments, which illustrates the importance of the initial single-atom structure in practical applications.

Buried Interface Dielectric Layer Engineering for Highly Efficient and Stable Inverted Perovskite Solar Cells and Modules.

Stability and scalability are essential and urgent requirements for the commercialization of perovskite solar cells (PSCs), which are retarded by the non-ideal interface leading to non-radiative recombination and degradation. Extensive efforts are devoted to reducing the defects at the perovskite surface. However, the effects of the buried interface on the degradation and non-radiative recombination need to be further investigated. Herein, an omnibearing strategy to modify buried and top surfaces of perovskite film to reduce interfacial defects, by incorporating aluminum oxide (Al2 O3 ) as a dielectric layer and growth scaffolds (buried surface) and phenethylammonium bromide as a passivation layer (buried and top surfaces), is demonstrated. Consequently, the open-circuit voltage is extensively boosted from 1.02 to 1.14 V with the incorporation of Al2 O3 filling the voids between grains, resulting in dense morphology of buried interface and reduced recombination centers. Finally, the impressive efficiencies of 23.1% (0.1 cm2 ) and 22.4% (1 cm2 ) are achieved with superior stability, which remain 96% (0.1 cm2 ) and 89% (1 cm2 ) of its initial performance after 1200 (0.1 cm2 ) and 2500 h (1 cm2 ) illumination, respectively. The dual modification provides a universal method to reduce interfacial defects, revealing a promising prospect in developing high-performance PSCs and modules.

High quantum efficiency of hydrogen production from methanol aqueous solution with PtCu-TiO2 photocatalysts.

Methanol with 12.5 wt% H2 content is widely considered a liquid hydrogen medium. Taking into account water with 11.1 wt% H2 content, H2 synthesis from the mixture of water and methanol is a promising method for on-demand hydrogen production. We demonstrate an atomic-level catalyst design strategy using the synergy between single atoms and nanodots for H2 production. The PtCu-TiO2 sandwich photocatalyst achieves a remarkable H2 formation rate (2,383.9 µmol h-1) with a high apparent quantum efficiency (99.2%). Furthermore, the oxidation product is a high-value chemical formaldehyde with 98.6% selectivity instead of CO2, leading to a nearly zero-carbon-emission process. Detailed investigations indicate a dual role of the copper atoms: an electron acceptor to facilitate photoelectron transfer to Pt, and a hole acceptor for the selective oxidation of methanol to formaldehyde, thus avoiding over-oxidation to CO2. The synergy between Pt nanodots and Cu single atoms together reduces the activation energy of this process to 13.2 kJ mol-1.

Short- and Long-Term Effects of Different Antibiotics on the Gut Microbiota and Cytokines Level in Mice.

Background: Antibiotics are the first line of treatment for infectious diseases. However, their overuse can increase the spread of drug-resistant bacteria. The present study analyzed the impact of different types of antibiotics on the gut microbiome and cytokines level of mice. Methods: A total of five groups of 8-week-old male BALB/c mice (n = 35) were treated with piperacillin-tazobactam (TZP), ceftriaxone (CRO), tigecycline (TGC), levofloxacin (LEV) or normal saline (Ctrl), respectively, for up to 4 weeks. Fecal samples were analyzed by bacterial 16S rRNA gene sequencing for bacterial identification. Blood samples were used for the determination of 23 serum cytokines using multiplex immunoassay. Results: Exposure to antibiotics was shown to affect the normal weight gain of mice. Significant changes in gut composition caused by TZP, CRO and TGC treatment included the decreased abundance of Bacteroidetes (p < 0.01), Muribaculaceae (p < 0.01) and Lachnospiraceae (p < 0.01), and the increased abundance of Proteobacteria (p < 0.05), Enterobacteriaceae (including Klebsiella and Enterobacter) (p < 0.01) and Enterococcaceae (including Enterococcus) (p < 0.01). After 4-week treatment, the TZP, CRO and LEV groups had significantly lower concentrations of several serum cytokines. Correlation analysis of the top 30 bacterial genera and cytokines showed that Enterococcus and Klebsiella were strongly positively correlated with tumor necrosis factor-α (TNF-α), interleukins (IL) IL-12p70 and IL-1ß. Desulfovibrio, Candidatus Saccharimonas, norank_f__norank_o__Clostridia_UCG-014, Lactobacillus, and Roseburia were strongly negatively correlated with these cytokines. Conclusion: This study demonstrates the effects of various antibiotics on the intestinal microflora and immune status of mice. Compared with TZP, CRO and TGC, LEV had minimal impact on the gut microbiota. In addition to TGC, long-term TZP, CRO and LEV intervention can lead to a decrease in serum cytokine levels, which may depend on the intestinal microflora, antibiotic used and the duration of treatment.

Molecular oxygen enhances H2O2 utilization for the photocatalytic conversion of methane to liquid-phase oxygenates.

H2O2 is widely used as an oxidant for photocatalytic methane conversion to value-added chemicals over oxide-based photocatalysts under mild conditions, but suffers from low utilization efficiencies. Herein, we report that O2 is an efficient molecular additive to enhance the utilization efficiency of H2O2 by suppressing H2O2 adsorption on oxides and consequent photogenerated holes-mediated H2O2 dissociation into O2. In photocatalytic methane conversion over an anatase TiO2 nanocrystals predominantly enclosed by the {001} facets (denoted as TiO2{001})-C3N4 composite photocatalyst at room temperature and ambient pressure, O2 additive significantly enhances the utilization efficiency of H2O2 up to 93.3%, giving formic acid and liquid-phase oxygenates selectivities respectively of 69.8% and 97% and a formic acid yield of 486 µmolHCOOH·gcatalyst-1·h-1. Efficient charge separation within TiO2{001}-C3N4 heterojunctions, photogenerated holes-mediated activation of CH4 into ·CH3 radicals on TiO2{001} and photogenerated electrons-mediated activation of H2O2 into ·OOH radicals on C3N4, and preferential dissociative adsorption of methanol on TiO2{001} are responsible for the active and selective photocatalytic conversion of methane to formic acid over TiO2{001}-C3N4 composite photocatalyst.

Towards big data behavioral analysis: rethinking GPS trajectory mining approaches from geographic, semantic, and quantitative perspectives.

The question regarding the actual usage of built environments is of immense importance in behavioral research. Yet traditional methods of collecting and analyzing data on movements and activities often lack needed accuracy and granularity. Thus, this article reviewed and summarized the applicability of emergent GPS trajectory mining approaches in the field of architecture from geographic, semantic, and quantitative perspectives, respectively. Accordingly, three experiments based on a case study using real GPS trajectory data from visitors to the Palace Museum in China were conducted to examine the usefulness and weakness of the aforementioned approaches. The findings revealed that although all three dimensions of the trajectory mining approaches had the potential to provide useful information for architectural and urban design, the higher the dimensionality in utilizing the data, the more effective the approach was in discovering generalizable knowledge of human behavioral pattern. Furthermore, the results suggested that to gain insights into the typological characteristics of human behaviors related to the built environments, the contribution of trajectory data alone was limited, hence, conventional field surveys and questionnaires which contain information on individual characteristics and spatial features should be used in conjunction. Future research and practical implications were outlined.

Step Site-Specific Semihydrogenation of Acetylene on the Au Surface.

Supported Au catalysts are highly selective and size-sensitive in catalytic hydrogenation of alkynes under mild conditions. Using thermal-programmed desorption and density functional theory calculations, we study the hydrogenation reactions of C2 hydrocarbons with atomic H and clarify the site-specific selective hydrogenation of C2H2 on Au(997) at low temperatures. On atomic H(a) covered Au(997), hydrogenation of C2H2 goes with 100% selectivity to C2H4 at steps, yet no hydrogenation occurs at terraces; adsorbed C2H4 on neither steps nor terraces reacts with H(a). DFT calculations suggest that the increased adsorption free energies and appropriate reaction barriers of C2 species at steps lead to the step-site specific semihydrogenation of C2H2. These results elucidate the elementary surface reactions between C2 hydrocarbons and atomic H on Au surfaces at the molecular level and significantly deepen the fundamental understanding of the unique selectivity of Au catalysts.

Accuracy of Oxygen Saturation Measurements in Patients with Obesity Undergoing Bariatric Surgery.

BACKGROUND: We aimed to determine the magnitude, direction, and influencing factors of the concordance between arterial oxygen saturation (SaO2) and peripheral capillary oxygen saturation (SpO2) in patients with obesity undergoing bariatric surgery, supporting the measurement of SaO2 and SpO2 in key populations. METHODS: Patients with obesity undergoing bariatric surgery from 2017 to 2020 were included. Preoperative SpO2 and SaO2 were collected. Linear correlation and multiple linear regression analyses were performed to characterize the relationships between body mass index (BMI), age, and sex with pulse oximetry and arterial blood gas (ABG) parameters. Bland-Altman analysis was applied to determine the concordance between SpO2 and SaO2 and the limits of this concordance. RESULTS: A total of 134 patients with obesity undergoing bariatric surgery were enrolled. SaO2 was negatively associated with BMI (p < 0.0001) and age (p = 0.006), and SpO2 was negatively associated with BMI (p = 0.021) but not with age. SpO2 overestimated SaO2 in 91% of patients with a bias of 2.05%. This bias increased by 203% in hypoxemic patients compared with nonhypoxemic patients (p < 0.0001). The bias was 1.3-fold higher (p = 0.023) in patients with a high obesity surgery mortality risk score (OS-MRS) than in those with low or intermediate scores. CONCLUSION: Compared with SpO2, preoperative SaO2 can more accurately reflect the real oxygen saturation in patients with obesity undergoing bariatric surgery, especially for those with BMI ≥ 40 kg/m2, age ≥ 40 years, and high OS-MRS. ABG analysis can provide a more reliable basis for accurate and timely monitoring, ensuring the perioperative safety of susceptible patients.

Effectiveness of cloud-based rehabilitation in children with developmental language disorder during the COVID-19 pandemic: A prospective cohort study.

During the coronavirus disease 2019 pandemic, we considered the case of a child with developmental language disorder (DLD) who could not go to the hospital on time to receive timely rehabilitation treatment due to disrupted hospital operations. The application of cloud-based rehabilitation platforms has provided significant advantages and convenience for children with DLD in-home remote rehabilitation. Among them, the JingYun Rehab Cloud Platform is the most widely used in mainland China. It is an interactive telerehabilitation system developed by Weixin Huang that delivers personalized home rehabilitation for special education children. In this study, we used the JingYun Rehab Cloud Platform to investigate the extent to which cloud-based rehabilitation is effective for children with DLD in terms of language and cognitive outcomes. This was a prospective cohort study including all children who were evaluated and diagnosed with DLD through Sign-Significant Relations and were followed up at the rehabilitation clinic of our institute. We followed 162 children with DLD for 3 months, including 84 children with DLD who participated in remote cloud-based rehabilitation on the JingYun Rehab Cloud Platform and 78 children with DLD as the control group who underwent home-based rehabilitation. Language abilities of both groups were assessed using the Chinese version of the Peabody Picture Vocabulary Test-Revised. Several measures of training performance (language, memory, and cognition tasks) were assessed before and after cloud-based rehabilitation in the remote cloud-based rehabilitation group. Children with DLD in the cloud-based rehabilitation group performed significantly better in language abilities, as assessed by the Peabody Picture Vocabulary Test-Revised, than children with DLD in the control group. Furthermore, for children who participated in remote cloud-based rehabilitation, the frequency of training sessions was proportional to their performance on language, memory, and cognition tasks. This study demonstrated the effectiveness of cloud-based rehabilitation on the JingYun Rehab Cloud Platform in treating children with DLD.

Anti-PD-1-based immunotherapy as curative-intent treatment in dMMR/MSI-H rectal cancer: A multicentre cohort study.

BACKGROUND: In a portion of patients with DNA mismatch repair-deficient (dMMR)/microsatellite instability-high (MSI-H) rectal cancer, clinical complete response (cCR) could be achieved after anti-programmed cell death protein 1 (anti-PD-1) immunotherapy. However, no data are available concerning the safety of omitting surgery and adopting immunotherapy as a curative-intent treatment for these patients. METHODS: We retrospectively collected a series of patients with dMMR/MSI-H rectal adenocarcinoma who had cCR after receiving anti-PD-1 immunotherapy and adopted immunotherapy as curative-intent treatment from six institutions. Survival outcomes were analysed using the Kaplan-Meier method. RESULTS: Nineteen patients were included with a median age of 48 (range 19-63). One patient was diagnosed with stage I disease, four with stage II disease and fourteen with stage III disease. Sixteen patients received anti-PD-1 immunotherapy as the first line of therapy, and eleven patients were treated with single-agent anti-PD-1 antibodies. The median time from the start of treatment to cCR was 3.8 (range 0.7-6.5) months. During a median follow-up of 17.1 (range 3.1-33.5) months since achieving cCR, no local or distant relapse was observed. Two-year local recurrence-free survival, distant metastasis-free survival, disease free-survival and overall survival for the whole cohort were 100%, 100%, 100% and 100%, respectively. CONCLUSIONS: For patients with dMMR/MSI-H locally advanced rectal cancer who achieved cCR during anti-PD-1 immunotherapy, adopting immunotherapy as curative-intent treatment might be an alternative option. Longer follow-up and larger cohorts are warranted to verify this innovative treatment approach.