Enhanced Survival with Lymphadenectomy in Early-Stage Metachronous Second Primary Lung Cancer: A Retrospective Analysis.

INTRODUCTION: Lymphadenectomy is a cornerstone in the surgical management of resectable primary lung cancer. However, its prognostic significance in early-stage metachronous second primary lung cancer (MSPLC) remains poorly understood. This retrospective study aimed to evaluate the prognostic impact of lymphadenectomy in these patients using data from the Surveillance, Epidemiology, and End Results (SEER) Database. METHODS: A retrospective cohort study was conducted using data from the SEER Database for patients surgically treated for stage I MSPLC between 2004 and 2015. Propensity score-matching was employed to create comparable cohorts, and the Cox proportional hazards model was utilized to estimate the hazard ratio (HR) for overall survival after lymphadenectomy compared to non-lymphadenectomy. Survival analysis was performed using Kaplan-Meier curves and the log-rank test. RESULTS: Among 920 identified patients with MSPLC, 574 (62.4%) underwent lymphadenectomy. Propensity score-matching yielded 255 patients in both the lymphadenectomy and non-lymphadenectomy groups. Over a median follow-up of 38 months, the 5-year overall survival probability after a diagnosis of MSPLC was 58.7% in the lymphadenectomy group and 43.9% in the non-lymphadenectomy group (HR: 0.76; 95% confidence interval 0.64-0.90; p = 0.002). CONCLUSION: In this population-based study, lymphadenectomy is associated with prolonged overall survival in patients with stage I MSPLC. These findings suggest the potential benefit of incorporating lymphadenectomy into the surgical management of MSPLC, providing valuable guidance for thoracic surgeons in clinical decision-making.

Restructuring Electrolyte Solvation by a Versatile Diluent Toward Beyond 99.9% Coulombic Efficiency of Sodium Plating/Stripping at Ultralow Temperatures.

The reversible and durable operation of sodium metal batteries at low temperatures (LT) is essential for cold-climate applications but is plagued by dendritic Na plating and unstable solid-electrolyte interphase (SEI). Current Coulombic efficiencies of sodium plating/stripping at LT fall far below 99.9%, representing a significant performance gap yet to be filled. Here, the solvation structure of the conventional 1 m NaPF6 in diglyme electrolyte by facile cyclic ether (1,3-dioxolane, DOL) dilution is efficiently reconfigured. DOL diluents help shield the Na+-PF6 - Coulombic interaction and intermolecular forces of diglyme, leading to anomalously high Na+-ion conductivity. Besides, DOL participates in the solvation sheath and weakens the chelation of Na+ by diglyme for facilitated desolvation. More importantly, it promotes concentrated electron cloud distribution around PF6 - in the solvates and promotes their preferential decomposition. A desired inorganic-rich SEI is generated with compositional uniformity, high ionic conductivity, and high Young's modulus. Consequently, a record-high Coulombic efficiency over 99.9% is achieved at an ultralow temperature of -55 °C, and a 1 Ah capacity pouch cell of initial anode-free sodium metal battery retains 95% of the first discharge capacity over 100 cycles at -25 °C. This study thus provides new insights for formulating electrolytes toward increased Na reversibility at LT.

Biomimetic Construction of Ferrite Quantum Dot/Graphene Heterostructure for Enhancing Ion/Charge Transfer in Supercapacitors.

Spinel ferrites are regarded as promising electrode materials for supercapacitors (SCs) in virtue of their low cost and high theoretical specific capacitances. However, bulk ferrites suffer from limited electrical conductivity, sluggish ion transport, and inadequate active sites. Therefore, rational structural design and composition regulation of the ferrites are approaches to overcome these limitations. Herein, a general biomimetic mineralization synthetic strategy is proposed to synthesize ferrite (XFe2 O4 , X = Ni, Co, Mn) quantum dot/graphene (QD/G) heterostructures. Anchoring ferrite QD on the graphene sheets not only strengthens the structural stability, but also forms the electrical conductivity network needed to boost the ion diffusion and charge transfer. The optimized NiFe2 O4 QD/G heterostructure exhibits specific capacitances of 697.5 F g-1 at 1 A g-1 , and exceptional cycling performance. Furthermore, the fabricated symmetrical SCs deliver energy densities of 24.4 and 17.4 Wh kg-1 at power densities of 499.3 and 4304.2 W kg-1 , respectively. Density functional theory calculations indicate the combination of NiFe2 O4 QD and graphene facilitates the adsorption of potassium atoms, ensuring rapid ion/charge transfer. This work enriches the application of the biomimetic mineralization synthesis and provides effective strategies for boosting ion/charge transfer, which may offer a new way to develop advanced electrodes for SCs.

The Origin of Solvent Deprotonation in LiI-added Aprotic Electrolytes for Li-O2 Batteries.

LiI and LiBr have been employed as soluble redox mediators (RMs) in electrolytes to address the sluggish oxygen evolution reaction kinetics during charging in aprotic Li-O2 batteries. Compared to LiBr, LiI exhibits a redox potential closer to the theoretical one of discharge products, indicating a higher energy efficiency. However, the reason for the occurrence of solvent deprotonation in LiI-added electrolytes remains unclear. Here, by combining ab initio calculations and experimental validation, we find that it is the nucleophile I O 3 - ${{{\rm I}{\rm O}}_{3}^{-}}$ that triggers the solvent deprotonation and LiOH formation via nucleophilic attack, rather than the increased solvent acidity or the elongated C-H bond as previously suggested. As a comparison, the formation of B r O 3 - ${{{\rm B}{\rm r}{\rm O}}_{3}^{-}}$ in LiBr-added electrolytes is found to be thermodynamically unfavorable, explaining the absence of LiOH formation. These findings provide important insight into the solvent deprotonation and pave the way for the practical application of LiI RM in aprotic Li-O2 batteries.

Constructing Co@TiO2 Nanoarray Heterostructure with Schottky Contact for Selective Electrocatalytic Nitrate Reduction to Ammonia.

Electrochemical nitrate (NO3 - ) reduction reaction (NO3 - RR) is a potential sustainable route for large-scale ambient ammonia (NH3 ) synthesis and regulating the nitrogen cycle. However, as this reaction involves multi-electron transfer steps, it urgently needs efficient electrocatalysts on promoting NH3  selectivity. Herein, a rational design of Co nanoparticles anchored on TiO2  nanobelt array on titanium plate (Co@TiO2 /TP) is presented as a high-efficiency electrocatalyst for NO3 - RR. Density theory calculations demonstrate that the constructed Schottky heterostructures coupling metallic Co with semiconductor TiO2  develop a built-in electric field, which can accelerate the rate determining step and facilitate NO3 - adsorption, ensuring the selective conversion to NH3 . Expectantly, the Co@TiO2 /TP electrocatalyst attains an excellent Faradaic efficiency of 96.7% and a high NH3  yield of 800.0 µmol h-1  cm-2  under neutral solution. More importantly, Co@TiO2 /TP heterostructure catalyst also presents a remarkable stability in 50-h electrolysis test.

Measures to achieve carbon neutrality: What is the role of energy structure, infrastructure, and financial inclusion.

Infrastructure and energy structure play key roles in the adaptation of a sustainable environment. In order to achieve a desirable infrastructure and energy structure, financial inclusion is essential. Thus, the current study investigates the nexus of energy structure, infrastructure, financial inclusion, and carbon emissions in the countries of the Organization for Economic Co-operation and Development (OECD). In particular, the well-known nexus of growth and environment is employed to estimate the linkages using data between 2001 and 2020. The findings suggest the supportive role of infrastructure, energy structure, and financial inclusion in abating carbon emissions. The OECD economies should enhance their investment in infrastructure and energy structure. Moreover, in order to achieve a sustainable environment in the long-run, financial inclusion should also be expanded. The results are also robust to the short- and long-run policy implications. This study is conductive to the implementation of the United Nations (UN) Sustainable Development Goals.

Sb Nanoparticles Embedded in the N-Doped Carbon Fibers as Binder-Free Anode for Flexible Li-Ion Batteries.

Antimony (Sb) is considered a promising anode for Li-ion batteries (LIBs) because of its high theoretical specific capacity and safe Li-ion insertion potential; however, the LIBs suffer from dramatic volume variation. The volume expansion results in unstable electrode/electrolyte interphase and active material exfoliation during lithiation and delithiation processes. Designing flexible free-standing electrodes can effectively inhibit the exfoliation of the electrode materials from the current collector. However, the generally adopted methods for preparing flexible free-standing electrodes are complex and high cost. To address these issues, we report the synthesis of a unique Sb nanoparticle@N-doped porous carbon fiber structure as a free-standing electrode via an electrospinning method and surface passivation. Such a hierarchical structure possesses a robust framework with rich voids and a stable solid electrolyte interphase (SEI) film, which can well accommodate the mechanical strain and avoid electrode cracks and pulverization during lithiation/delithiation processes. When evaluated as an anode for LIBs, the as-prepared nanoarchitectures exhibited a high initial reversible capacity (675 mAh g-1) and good cyclability (480 mAh g-1 after 300 cycles at a current density of 400 mA g-1), along with a superior rate capability (420 mA h g-1 at 1 A g-1). This work could offer a simple, effective, and efficient approach to improve flexible and free-standing alloy-based anode materials for high performance Li-ion batteries.

Carbon-Nanotube-Encapsulated-Sulfur Cathodes for Lithium-Sulfur Batteries: Integrated Computational Design and Experimental Validation.

To mitigate lithium-polysulfides (Li-PSs) shuttle in lithium-sulfur batteries (LiSBs), a unique carbon-nanotube-encapsulated-sulfur (S@CNT) cathode material with optimum open-ring sizes (ORSs) on the CNT walls were designed using an integrated computational approach followed by experimental validation. By calculating the transport barrier of Li+ ion through ORSs on the CNT walls and comparing the molecular size of solvents and Li-PSs with ORSs, optimum open-rings with 16-30 surrounding carbon atoms were predicted to selectively allow transportation of Li+ ion and evaporated sulfur while blocking both Li-PS and solvent molecules. A CNT oxidation process was proposed and simulated to generate these ORSs, and the results indicated that the optimum ORSs can be achieved by narrowly controlling the oxidation parameters. Subsequently, S@CNT cathodes were experimentally synthesized, confirming that optimum ORSs were generated in CNT oxidized at 475 K and exhibited more stable cycling behavior.

Sarcoidosis-like reaction after neoadjuvant pembrolizumab combined with chemotherapy mimicking disease progression of NSCLC induced encouraging discovery of pathological complete response.

Neoadjuvant chemoimmunotherapy has demonstrated improved efficacy and prognosis in stage IIa-IIIb patients with non-small cell lung cancer (NSCLC). Drug-induced sarcoidosis-like reaction (DISR), an autoimmune reaction, has been reported as a type of immune-related adverse event that may mimic disease progression. Here, we report the case of patient with NSCLC who developed DISR during neoadjuvant chemoimmunotherapy and finally achieved pathological complete response after surgery.

Decreased exosome-delivered miR-486-5p is responsible for the peritoneal metastasis of gastric cancer cells by promoting EMT progress.

BACKGROUND: The present study aims to investigate the preliminary mechanism underlying the peritoneal metastasis of gastric cancer cells. METHODS: Exosomes from GC9811 cells (Con-Exo) and from GC9811-P cells (PM-Exo) were extracted by ultracentrifugation, which were identified with transmission electron microscopy (TEM) and nanoparticle trafficking analysis, as well as the expression of CD9, CD63, and CD81 detected by Western blot assay. α-SMA expression was determined by immunofluorescence assay and Western blot assay. The levels of Snail1, E-cadherin, and Actin-related protein 3 (ACTR3) were evaluated by Western blot assay. MiRNA array was performed on exosomes to screen the differentially expressed miRNAs. The expressions of miRNAs, SMAD2, CDK4, and ACTR3 were determined by QRT-PCR. The delivery of miR-486-5p was confirmed by laser confocal detection. RESULTS: Firstly, TEM, nanoparticle trafficking analysis, and Western blot assays were used to confirm the successful extraction of Con-Exo and PM-Exo. The incubation of Con-Exo and PM-Exo could decrease E-cadherin expression and increase of α-SMA respectively in HMrSV5 cells, with the increased proportion of fusiform cells. More significant changes were observed in PM-Exo-treated HMrSV5 cells. Secondary, compared to Con-Exo, miR-486-5p and miR-132-3p were found downregulated, and miR-132-5p was found upregulated in PM-Exo. The transfection of miR-486-5p and miR-132-3p was observed to suppress EMT, and the transfection of miR-132-3p was observed to induce EMT. Laser confocal detection confirmed the delivery of miR-486-5p from gastric cancer cells to HMrSV5 cells through exosomes. Lastly, the expression of Mothers against decapentaplegic homolog 2 (SMAD2), cyclin-dependent kinase 4 (CDK4), and ACTR3 was found to be downregulated via miR-486-5p. CONCLUSION: Decreased delivery of miR-486-5p via exosomes might be responsible for the peritoneal metastasis of gastric cancer cells by promoting epithelial-mesenchymal transition progress.

Effortless retaliation: the neural dynamics of interpersonal intentions in the Chicken Game using brain-computer interface.

The desire for retaliation is a common response across a majority of human societies. However, the neural mechanisms underlying aggression and retaliation remain unclear. Previous studies on social intentions are confounded by a low-level response-related brain activity. Using an Electroencephalogram (EEG)-based brain-computer interface combined with the Chicken Game, our study examined the neural dynamics of aggression and retaliation after controlling for nonessential response-related neural signals. Our results show that aggression is associated with reduced alpha event-related desynchronization (alpha-ERD), indicating reduced mental effort. Moreover, retaliation and tit-for-tat strategy use are also linked with smaller alpha-ERD. Our study provides a novel method to minimize motor confounds and demonstrates that choosing aggression and retaliation is less effortful in social conflicts.

Clinical characteristics and prognostic factors of male yolk sac tumor: a Surveillance, Epidemiology, and End Results program study.

INTRODUCTION: Yolk sac tumor (YST) is a rare malignant germ cell tumor, which usually affects young males. Because of the low incidence, few studies on YST have been published. In our study, we aim to investigate the clinical characteristics, survival and risk factors of male YST patients based on the Surveillance, Epidemiology, and End Results (SEER) program. METHODS: We identified 569 male YST patients from the SEER-18 database with additional treatment fields. Clinical characteristics, survival and prognostic factors were described in the study. Chi-square tests were applied to analyze categorical and continuous variables between different groups. Univariate and multivariate Cox proportional hazard model were performed to assess the relative impacts of risk factors on cancer-specific survival (CSS) in YST patients. Kaplan-Meier method and the log-rank test were used to analyze differences in survival that were significant. RESULTS: The major primary sites of YST were testis (74.69%), mediastinum (15.47%), retroperitoneum (2.64%) and central nervous system (1.24%). The 3-year and 5-year CSS was 70.0%, 56.5% vs. 97.2%, 96.0% for the mediastinal and testicular YST patients, respectively (p < 0.001). Primary site of mediastinum, distant SEER Summary stage were independent factors of poor prognosis (hazard ratio (HR) = 2.010 (1.094-3.695), p = 0.025; HR = 6.501 (2.294-18.424), p < 0.001, respectively). Receiving surgery was a good prognosis factor for all patients (HR = 0.495 (0.260-0.940), p = 0.032) and for the mediastinal group (p = 0.0019). Being treated with chemotherapy indicated poor outcome in all patients (HR = 3.624 (1.050-12.507), p = 0.042) and in the localized testicular YST patients (p = 0.0077). CONCLUSION: For the first time, our study revealed the primary site distribution of male YST, and summarized the clinical characteristics, survival and prognostic factors based on the SEER database, which provided important epidemiological evidence for clinical practice.

The Bonding Nature and Adhesion of Polyacrylic Acid Coating on Li-Metal for Li Dendrite Prevention.

The success of polyacrylic acid (PAA) to suppress Li dendrite growth suggests that the mechanical properties of polymer-based coatings, including the modulus, toughness, and interfacial adhesion are important design criteria. However, the measurement of the adhesion of thin PAA, as well as other polymer coatings to the reactive Li-metal anode surface is limited experimentally and challenging computationally. In this paper, a strategy was proposed to estimate the adhesion and delamination of the PAA(polymer)/Li interface, based on the bonding nature at the simpler PAA (oligomer)/Li interfaces using density functional theory calculations. It has been shown that the carboxylic acid groups in PAA reacted strongly with metallic Li, which significantly enhances the interfacial adhesion through the Li-O bonds formation, Li ionization and its incorporation into PAA, and -H or -OH termination of Li after decomposition of the COOH functional group. During delamination, it was found that the most likely PAA delamination route involved breaking partial Li-O bonds and lifting some ionized Li atoms from the Li-metal, especially for the Li atoms that showed a charge closer to +1 or are bonded with two O atoms from PAA. Based on the average bonding energies from PAA(oligomer)/Li interface delamination calculations, the work of separation, Wsep, of the PAA(polymer)/Li interface was estimated to be ∼1.0 (J/m2). The high Wsep of PAA (polymer)/Li was comparable with the Li2O/Li interface and higher than Li2CO3/Li and LiF/Li interfaces. This order correlated well with the areal density of Li-O bonds, which can serve as a descriptor for the interfacial adhesion. This computational approach can be applied to other interfaces with polymer-based coatings.

Cathode porosity is a missing key parameter to optimize lithium-sulfur battery energy density.

While high sulfur loading has been pursued as a key parameter to build realistic high-energy lithium-sulfur batteries, less attention has been paid to the cathode porosity, which is much higher in sulfur/carbon composite cathodes than in traditional lithium-ion battery electrodes. For high-energy lithium-sulfur batteries, a dense electrode with low porosity is desired to minimize electrolyte intake, parasitic weight, and cost. Here we report the profound impact on the discharge polarization, reversible capacity, and cell cycling life of lithium-sulfur batteries by decreasing cathode porosities from 70 to 40%. According to the developed mechanism-based analytical model, we demonstrate that sulfur utilization is limited by the solubility of lithium-polysulfides and further conversion from lithium-polysulfides to Li2S is limited by the electronically accessible surface area of the carbon matrix. Finally, we predict an optimized cathode porosity to maximize the cell level volumetric energy density without sacrificing the sulfur utilization.

High-Energy Rechargeable Metallic Lithium Battery at -70 °C Enabled by a Cosolvent Electrolyte.

Lithium metal is an ideal anode for high-energy rechargeable batteries at low temperature, yet hindered by the electrochemical instability with the electrolyte. Concentrated electrolytes can improve the oxidative/reductive stability, but encounter high viscosity. Herein, a co-solvent formulation was designed to resolve the dilemma. By adding electrochemically "inert" dichloromethane (DCM) as a diluent in concentrated ethyl acetate (EA)-based electrolyte, the co-solvent electrolyte demonstrated a high ionic conductivity (0.6 mS cm-1 ), low viscosity (0.35 Pa s), and wide range of potential window (0-4.85 V) at -70 °C. Spectral characterizations and simulations show these unique properties are associated with the co-solvation structure, in which high-concentration clusters of salt in the EA solvent were surrounded by mobile DCM diluent. Overall, this novel electrolyte enabled rechargeable metallic Li battery with high energy (178 Wh kg-1 ) and power (2877 W kg-1 ) at -70 °C.

How Solid-Electrolyte Interphase Forms in Aqueous Electrolytes.

Solid-electrolyte interphase (SEI) is the key component that enables all advanced electrochemical devices, the best representative of which is Li-ion battery (LIB). It kinetically stabilizes electrolytes at potentials far beyond their thermodynamic stability limits, so that cell reactions could proceed reversibly. Its ad hoc chemistry and formation mechanism has been a topic under intensive investigation since the first commercialization of LIB 25 years ago. Traditionally SEI can only be formed in nonaqueous electrolytes. However, recent efforts successfully transplanted this concept into aqueous media, leading to significant expansion in the electrochemical stability window of aqueous electrolytes from 1.23 V to beyond 4.0 V. This not only made it possible to construct a series of high voltage/energy density aqueous LIBs with unprecedented safety, but also brought high flexibility and even "open configurations" that have been hitherto unavailable for any LIB chemistries. While this new class of aqueous electrolytes has been successfully demonstrated to support diversified battery chemistries, the chemistry and formation mechanism of the key component, an aqueous SEI, has remained virtually unknown. In this work, combining various spectroscopic, electrochemical and computational techniques, we rigorously examined this new interphase, and comprehensively characterized its chemical composition, microstructure and stability in battery environment. A dynamic picture obtained reveals how a dense and protective interphase forms on anode surface under competitive decompositions of salt anion, dissolved ambient gases and water molecule. By establishing basic laws governing the successful formation of an aqueous SEI, the in-depth understanding presented in this work will assist the efforts in tailor-designing better interphases that enable more energetic chemistries operating farther away from equilibria in aqueous media.