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BACKGROUND: The construction of the ordered health delivery system in China aims to enhance equity and optimize the efficient use of medical resources by rationally allocating patients to different levels of medical institutions based on the severity of their condition. However, superior hospitals have been overcrowded, and primary healthcare facilities have been underutilized in recent years. China has developed a new case-based payment method called "Diagnostic Intervention Package" (DIP). The government is trying to use this economic lever to encourage medical institutions to actively assume treatment tasks consistent with their functional positioning and service capabilities. METHODS: This study takes Tai'an, a DIP pilot city, as a case study and uses an interrupted time series analysis to analyze the impact of DIP reform on the case severity and service scope of medical institutions at different levels. RESULTS: The results show that after the DIP reform, the proportion of patients receiving complicated procedures (tertiary hospitals: ß3 = 0.197, P < 0.001; secondary hospitals: ß3 = 0.132, P = 0.020) and the case mix index (tertiary hospitals: ß3 = 0.022, P < 0.001; secondary hospitals: ß3 = 0.008, P < 0.001) in tertiary and secondary hospitals increased, and the proportion of primary-DIP-groups cases decreased (tertiary hospitals: ß3 = -0.290, P < 0.001; secondary hospitals: ß3 = -1.200, P < 0.001), aligning with the anticipated policy objectives. However, the proportion of patients receiving complicated procedures (ß3 = 0.186, P = 0.002) and the case mix index (ß3 = 0.002, P < 0.001) in primary healthcare facilities increased after the reform, while the proportion of primary-DIP-groups cases (ß3 = -0.515, P = 0.005) and primary-DIP-groups coverage (ß3 = -2.011, P < 0.001) decreased, which will reduce the utilization efficiency of medical resources and increase inequity. CONCLUSION: The DIP reform did not effectively promote the construction of the ordered health delivery system. Policymakers need to adjust economic incentives and implement restraint mechanisms to regulate the behavior of medical institutions.
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Hospitais , Assistência Médica , China , Programas Governamentais , Análise de Séries Temporais Interrompida , Projetos PilotoRESUMO
Metal-free organic phosphorescence materials are of imperious demands in optoelectronics and bioelectronics. However, it is still a formidable challenge to develop a material with simultaneous efficiency and lifetime enhancement under ambient conditions. In this study, we design and synthesize a new class of high efficient ultralong organic phosphorescence (UOP) materials through self-assembly of melamine and aromatic acids in aqueous media. A supramolecular framework can be formed via multiple intermolecular interactions, building a rigid environment to lock the molecules firmly in a three-dimensional network, which not only effectively limits the nonradiative decay of the triplet excitons but also promotes the intersystem crossing. Thus, the supermolecules we designed synchronously achieve an ultralong emission lifetime of up to 1.91 s and a high phosphorescence quantum efficiency of 24.3% under ambient conditions. To the best of our knowledge, this is the best performance of UOP materials with simultaneous efficiency and lifetime enhancement. Furthermore, it is successfully applied in a barcode identification in darkness. This result not only paves the way toward high efficient UOP materials but also expands their applications.
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Ultralong organic phosphorescence (UOP) based on metal-free porous materials is rarely reported owing to rapid nonradiative transition under ambient conditions. In this study, hydrogen-bonded organic aromatic frameworks (HOAFs) with different pore sizes were constructed through strong intralayer π-π interactions to enable ultralong phosphorescence in metal-free porous materials under ambient conditions for the first time. Impressively, yellow UOP with a lifetime of 79.8â ms observed for PhTCz-1 lasted for several seconds upon ceasing the excitation. For PhTCz-2 and PhTCz-3, on account of oxygen-dependent phosphorescence quenching, UOP could only be visualized in N2 , thus demonstrating the potential of phosphorescent porous materials for oxygen sensing. This result not only outlines a principle for the design of new HOFs with high thermal stability, but also expands the scope of metal-free luminescent materials with the property of UOP.
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A new type of materials, organic salts in the crystal state, have ultralong organic phosphorescence (UOP) under ambient conditions. The change of cations (NH4+ , Na+ , or K+ ) in these phosphors gives access to tunable UOP colors ranging from sky blue to yellow green, along with ultralong emission lifetimes of over 504â ms. Single-crystal analysis reveals that unique ionic bonding can promote an ordered arrangement of organic salts in crystal state, which then can facilitate molecular aggregation for UOP generation. Additionally, reversible ultralong phosphorescence can be realized through the alternative employment of fuming gases (ammonia and hydrogen chloride), demonstrating its potential as a candidate for visual ammonic or hydrogen chloride gas sensing. The results provide an environmental responsible and practicable synthetic approach to expanding the scope of ultralong organic phosphorescent materials as well as their applications.
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Unverified or false information spread by irresponsible users can amplify the dissemination of fake news or misinformation. This phenomenon may not only undermine the credibility of social media platforms but also pose severe consequences for individuals and society. This study applies and extends the prototypical willingness model with the aim of comprehending the reasons, and decision-making process driving users' unverified information-sharing behavior a reasoned and intended pathway or an impulsive and unconscious one. Data from a sample of 646 users were analyzed using Structural Equation Modeling to assess the determinative effect of both the reasoned pathway (attitude toward unverified information-sharing, subjective norm, and perceived behavioral control) and the social-reaction pathway (prototype favorability and similarity). Findings highlight the substantial role of the social-reaction pathway in forecasting users' unverified information-sharing behavior, with prototype similarity and attitude being the dominant predictors. Meanwhile, components of the reasoned pathway, specifically perceived behavior control, and attitude, also exhibited significant contributions toward predicting the behavior. In summary, while a deliberate, reasoned process has some influence, the sharing of unverified information on social media by users is primarily an intuitive, spontaneous response to specific online circumstances. This study therefore offers valuable insights that could aid relevant stakeholders in effectively regulating the spread of misinformation. Against this backdrop, highlighting potential risks associated with sharing unverified information and the negative portrayal of users propagating misinformation may contribute to the development of a more critical perspective toward online information sharing by users themselves.
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Mídias Sociais , Humanos , Atitude , Disseminação de Informação , Comunicação , Comportamento ImpulsivoRESUMO
The proliferation of unverified or false information by irresponsible users can significantly amplify the spread of misinformation or fake news. Despite growing research on unverified information sharing, a comprehensive understanding of the varying influences of different factors and strategies to mitigate this issue remains under investigation. To address this research gap, this study, rooted in the theory of herd behavior, develops, and tests a model theorizing the reasons behind social media users' unverified information sharing. Data was collected from 510 respondents across six regions of China using a convenience sampling method. The collected data was analyzed using Mplus. The results from this study indicated that perceived severity, state uncertainty, and herding have a significant positive influence on unverified information sharing. These results enrich the understanding of unverified information-sharing behavior among Chinese social media users. Drawing from these results, we suggest platform administrators and policymakers mitigate herd behavior tendencies and stem the spread of misinformation by disseminating timely, accurate, and authoritative information. Since this action will reduce users' perceptions of severity and uncertainty. Social media users are also advised to stay vigilant over the implications of herd behavior and foster a more critical attitude towards information sharing.
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Disseminação de Informação , Mídias Sociais , Humanos , China , Feminino , Adulto , Masculino , Incerteza , Enganação , Adulto Jovem , ComunicaçãoRESUMO
Controlling the surface diffusion of particles on 2D devices creates opportunities for advancing microscopic processes such as nanoassembly, thin-film growth, and catalysis. Here, we demonstrate the ability to control the diffusion of F4TCNQ molecules at the surface of clean graphene field-effect transistors (FETs) via electrostatic gating. Tuning the back-gate voltage (VG) of a graphene FET switches molecular adsorbates between negative and neutral charge states, leading to dramatic changes in their diffusion properties. Scanning tunneling microscopy measurements reveal that the diffusivity of neutral molecules decreases rapidly with a decreasing VG and involves rotational diffusion processes. The molecular diffusivity of negatively charged molecules, on the other hand, remains nearly constant over a wide range of applied VG values and is dominated by purely translational processes. First-principles density functional theory calculations confirm that the energy landscapes experienced by neutral vs charged molecules lead to diffusion behavior consistent with experiment. Gate-tunability of the diffusion barrier for F4TCNQ molecules on graphene enables graphene FETs to act as diffusion switches.
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Forest fires are an important disturbance factor in forest ecosystems, and obviously change the soil environment. Arbuscular mycorrhizal fungi, as a medium and bridge between vegetation and soil, play a crucial role in mediating plant nutrient uptake and regulating the productivity, stability, and succession of vegetation-soil systems. To investigate the effects of forest fires on the community structure and diversity of arbuscular mycorrhizal fungi in cold-temperate Larix gmelinii forests, we collected soils from light, moderate, and heavy fire disturbance forests and a natural forest as a control forest in Greater Khingan Larix gmelinii forests, in the northeast of China. The community structure and diversity of arbuscular mycorrhizal fungi was sequenced using Illumina MiSeq technology and we analyzed the correlation with the soil physicochemical characteristics. The results showed that the contents of microbial biomass content (MBC), moisture content (MC), total nitrogen (TN), and available phosphors (AP) increased significantly (p < 0.05) with increasing fire intensity (from Light to heavy fire), but available potassium (AK) decreased significantly (p < 0.05). These changes were not significant. A total of 14,554 valid sequences from all sequences were classified into 66 ASVs that belonged into one phylum, one order, four families, and four genera. The genera included Glomus, Ambispora, Paraglomus, and Acaulospora, and Glomus was the dominant genus (the genera with the five most relative abundances) in the control and heavy-fire forests. Non-metric multidimensional scaling (NMDS) analysis showed that forest fires significantly affected the community structure of arbuscular mycorrhizal fungi (p < 0.01). Redundancy analysis (RDA) showed that MBC, SOC, and AP contents significantly affected the composition structure and diversity of arbuscular mycorrhizal fungi communities. This study indicated that forest fires affected the composition and diversity of soil arbuscular mycorrhizal fungi communities through changing the soil physicochemical parameters (MBC, SOC, and AP) in cold-temperate Larix gmelinii forests. The study of soil physicochemical properties and arbuscular mycorrhizal fungi diversity in cold-temperate Larix gmelinii forests in the Greater Khingan Mountains after forest fires provides a reference basis for the revegetation and reconstruction of fire sites.
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Fungi have important ecological functions in the soil of forests, where they decompose organic matter, provide plants with nutrients, increase plant water uptake, and improve plant resistance to adversity, disease, and disturbance. A forest fire presents a serious disturbance of the local ecosystem and can be considered an important component affecting the function of ecosystem biomes; however, the response of soil fungi to fire disturbance is largely unknown. To investigate the effects of fire disturbance on the community composition and diversity of soil fungi in a taiga forest, we collected soil from plots that had undergone a light, moderate, and heavy fire 10 years previously, with the inclusion of a fire-free control. The present soil fungi were characterized using Illumina MiSeq technology, and the sequences were analyzed to identify differences in the community composition and diversity in response to the changed soil physicochemical properties. The results showed that the Chao1 index, which characterizes the alpha diversity of the fungi, did not change significantly. In contrast, the Shannon index increased significantly (p < 0.05) and the Simpson index decreased significantly (p < 0.05) following a light or heavy fire disturbance compared to the control. The relative abundance of Basidiomycota was significantly higher in the soil of the fire sites than that in the control (p < 0.01), and the relative abundance of Ascomycota was significantly lower (p < 0.01). The results of principal coordinates analyses (PCoAs) showed that fire disturbance highly significantly affected the beta diversity of soil fungi (p < 0.001), while the results of canonical correlation analysis (CCA) indicated that the available nitrogen (AN), moisture content (MC), pH, available potassium (AK), and total nitrogen (TN) contents of the soil significantly affected the compositional structure and diversity of the soil fungal communities. The results of functional prediction showed that the majority of the detected soil fungi were symbiotrophs, followed by saprotrophs and saprotroph-symbiotrophs, with ectomycorrhiza being the dominant functional taxon. Fire disturbance significantly reduced the relative abundance of ectomycorrhiza (p < 0.05). This study illustrates that fire disturbance alters the structural composition, diversity, dominance, and relative abundance of the guilds of soil fungal communities in taiga forest, and strongly affected the beta diversity of soil fungi, with AN, MC, pH, AK, and TN being the most important factors affecting their community structure. The results may provide a useful reference for the restoration and rehabilitation of taiga forests after fire disturbance.
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INTRODUCTION: With the normalization of COVID-19 prevention and control, a large number of intergenerational audiences with different cognition preferences and value orientations have started to pour into non-acquaintance virtual communities (VCs) to address their social needs by disclosing their own thoughts, feelings and experiences toward certain topics. To avoid the negative impacts of self-disclosure, this study introduced the concept of social integration into cyber society among non-acquaintance VCs, such as the topic-based VCs. Our theoretical model considers both the psychological antecedents and consequences of VC audiences' social integration and our findings have implications for public online (and even offline) social life. Moreover, this research could play a guiding role in improving VC audiences' social integration status in future online learning and telecommuting scenarios. METHOD: To assess the theoretical model constructed in this manuscript, we conducted an online survey in two different topic-based VCs among Microblog and yielded 472 useable responses from intergenerational audiences, among which 28.81% were born before 1985, 26.67% were born from 1985 to 1995, and 48.52% were born after 1995. Our sample consisted of 208 individuals from Health Regimen VC and 264 individuals from Star Chasing VC, 200 (42.37%) were men and 272 (57.63%) were women. RESULTS: Our structural equation model (SEM) indicated that individuals' self-disclosure in topic-based VCs might not directly guide them to acquire social integration. However, intimacy and cognitive communion derived from VC audiences' self-disclosure might not only enhance their social integration, but also improve their psychological well-being. In addition, VC audiences' social integration mediated the relationship between intimacy and psychological well-being, and the relationship between cognitive communion and psychological well-being. Moreover, VC audiences' intimacy was found to have a direct influence on their cognitive communion. CONCLUSION: In the context of topic-based VCs, audiences' self-disclosure could significantly foster their intimacy and cognitive communion with others, and both intimacy and cognitive communion are conductive to VC audiences' social integration. Thus, audiences in topic-based VCs who wish to improve their psychological well-being need to disclose themselves and build corresponding psychological foundations (i.e., intimacy and cognitive communion) to enhance their social integration. Meanwhile, topic-based VCs should pay attention to the cultivation of intimacy and cognitive communion among audiences while encouraging them to reveal themselves.
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Synthetic polymer materials are widely used in contemporary public art creation. This review summarizes the application methods and current situation of synthetic polymer materials in public art, analyzes the reasons behind them and points out the deficiencies in this research field. Finally, the development trend of the interaction between synthetic polymer materials and public art is put forward.
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Immunotherapy has become a promising form of treatment for cancers. There is a need to predict response to immunotherapy accurately. In the UCSC Xena, pan-cancer analysis revealed a positive relationship between APOBEC3B (A3B) and tumor mutational burden (R = 0.28, P < 0.001) and microsatellite instability (R = 0.12, P < 0.05). Naturally, the A3B high expression group had higher tumor mutational burden and microsatellite instability than the low expression group. The bladder cancer (BLCA) cohort in The Cancer Genome Atlas (TCGA) revealed tumor mutational signatures of A3B high and low expression groups. Compared to the low expression group, the high expression group had a higher number of SNPs and mutations. Subsequently, A3B was profiled for immune cell infiltration and immune checkpoints in bladder cancer. The results showed that A3B was positively correlated with most immune cells. Compared with the A3B low expression group, the A3B high expression group had higher expression of immune checkpoints. A3B was positively correlated with CD274 (R = 0.12, P = 0.016). This indicated that the high expression of A3B may have a better response to immunotherapy. Furthermore, data from the IMvigor210 immunotherapy clinical trial was used to confirm the findings of this study. The combined survival analysis of A3B and CD274 showed that the group of patients with high expression of CD274 and A3B was found to have a significantly higher survival rate than the rest of the patient group (P < 0.047). The results demonstrated that A3B has a significant role in immunotherapy. Moreover, the combined biomarkers of A3B and CD274 were more effective in predicting response to immunotherapy in bladder urothelial carcinoma. The findings of this study provide valuable insights for precision medicine.
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Introduction: Contributors' self-identity is a critical element in the sustainable development of online knowledge communities (OKCs). However, research concerning the formation mechanism of contributors' self-identity remains scarce. This research posits information support, novel posting and sense of self-worth as mediating variables between social identity and self-identity to construct a path model, aiming to explore the way in which self-identity is formed on the basis of social identity in OKCs. Methods: To examine this mode, an online survey was administered to many different OKCs, and 515 usable questionnaire responses were collected. Structural equation modeling was then employed to examine the model. Results: The R2 value of self-identity was 0.627, thus indicating that the model was able to explain 62.7% of the variance in self-identity. We find that self-identity emerges through the mediating effects of information support, novel posting and sense of self-worth. In addition, social identity can elicit novel posting and information support, which are all beneficial for enhancing the dynamics of OKCs and further generate sense of self-worth. We also observe that although social identity and individualized behavior (novel posting) are generally incompatible, they can be compatible in the context of OKCs. Discussion: Self-identity as a contributor can be formed on the basis of social identity via the social path and the psychological path in OKCs, while the two paths for fostering self-identity are not independent of each other, and there is also a very strong link between behavioral and psychological mechanisms.
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Colon adenocarcinoma (COAD) is a prevalent malignant tumor that severely threatens human health across the globe. Immunotherapy is an essential need for patients with COAD. N7-methylguanosine (m7G) has been associated with human diseases, and non-coding RNAs (lncRNAs) regulate various tumor-related biological processes. Nonetheless, the m7G-related lncRNAs involved in COAD regulation are limited. This study aims to construct the clustering features and prognostic model of m7G-related lncRNAs in COAD. First, The Cancer Genome Atlas (TCGA) database was used to identify m7G-related differentially expressed lncRNAs (DELs), based on which COAD cases could be classified into two subtypes. Subsequently, univariate Cox analysis was used to identify 9 prognostic m7G-related lncRNAs. Further, Five candidates were screened by LASSO-Cox regression to develop new models. The patients were divided into high-risk and low-risk groups based on the median risk score. Consequently, the Kaplan-Meier survival curve demonstrated a statistically significant overall survival (OS) between the high- and low-risk groups (P<0.001). Multivariate Cox regression analysis revealed that risk score is an independent prognostic factor in COAD patients (P<0.001). This confirms the clinical applicability of the model. Additionally, we performed Gene Set Enrichment Analysis (GSEA), which uncovered the biological and functional differences between risk subgroups, i.e., enrichment of immune-related diseases in the high-risk group and enrichment of metabolic-related pathways in the low-risk group. In a drug sensitivity analysis, high-risk group were more sensitive to some chemotherapeutics and targeted drugs than low-risk group. Eventually, the stability of the model was confirmed by qRT-PCR. Our study unraveled the features of different immune states of COAD and established a prognostic model, including five m7G-related lncRNAs for COAD patients. These results will bolster clinical treatment and survival prediction of COAD.
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Redox mediators (RMs) have become a significant point in the now-established Li-O2 battery system to reduce the charging overpotential in the oxygen evolution process. Nevertheless, a major inherent barrier of the RM is the redox shuttling between the Li metal anode and mobile RM, resulting in the corrosion of Li and depletion of RM. In this study, taking iodide/triiodide as a model RM, we propose an effective strategy by immersing the Li metal anode in I2 steam to create a 1.5 µm thick surface protective layer. The resultant ionic conductive LiI layer on the Li metal anode can not only suppress Li dendrite growth but also act as a buffer layer between the RM and bare Li. By combining the iodide/triiodide RM with the LiI protective layer, the Li-O2 battery shows low and steady charge voltage plateaus of â¼3.6 V over 70 cycles. Importantly, the symmetrical cell using the LiI-protected Li electrode exhibited small Li plating/stripping overpotentials (â¼20 mV, 480 h), far superior to that of the bare Li electrode (â¼70 mV, 300 h). The in situ interfacial observation shows that dendrite growth on the Li metal can be effectively suppressed by optimizing the LiI protective layer.
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OBJECTIVE: To investigate the alterations in gene expression profiles of cervical cancer cell line SiHa over-expressing miR-519d. METHODS: SiHa cells were transfected with a miR-519d mimic or a negative control (NC) and the changes in gene expression profiles were examined using NimbleGen human gene expression microarray. Bioinformatics approaches based on the microarray data were used to identify the targeted genes of miR-519d. Real-time quantitative PCR was employed to confirm the expression of the potential target genes. RESULTS: A total of 5172 genes were found to be differentially expressed in SiHa cells over-expressing miR-519d, including 2476 up-regulated and 2796 down-regulated genes. We identified 164 potential target genes of miR-519d, and their functions were predicted using Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) biological pathway analysis, and STRING database and pSTIING were used to search the key nodes in the protein-protein interactions and transcriptional regulatory networks in cancer. Real-time quantitative PCR confirmed the differential expressions of several candidate target genes. CONCLUSIONS: Over-expression of miR-519d alters gene expression profiles in SiHa cells. The 164 target genes of miR-519d we identified may provide insights into the role of miR-519d in cervical tumorigenesis.
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Compared to planar carbazole, the molecular conjugation of iminodibenzyl (Id) was destroyed by a C-C bond and a twisted structure was formed, which exhibited blue-shifted ultralong phosphorescence with a lifetime of 402 ms in a crystal under ambient conditions. For the presence of an oscillating C-C bond between the two benzene rings in Id, more than one molecular configuration in the crystal was discovered by X-ray single-crystal analysis. Moreover, its ultralong phosphorescence color changed from blue to green by varying the excitation wavelength in solution at 77 K. Theoretical calculations also confirmed that different molecular configurations had certain impact on the phosphorescent photophysical properties. This result will allow a major step forward in expanding the scope of ultralong organic phosphorescent (UOP) materials, building a bridge to realize the relationship between molecular structure and UOP property.
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Volatile organic compounds (VOCs) are widespread in our daily life and greatly harmful to human health, as well as to the environment. To date, it remains a formidable challenge to develop a highly sensitive visual system for selective detection of VOCs. Herein, we report on a metal-free organic molecule of 2,4-di(10 H-phenothiazin-10-yl)-1,3,5-triazine (TDP) with ultralong organic phosphorescence (UOP) feature as a visible chemical probe for chloroform detection. In the pristine solid state, this phosphor shows a green UOP with a lifetime of 56 ms after the removal of excitation light source; however, the UOP greatly diminishes when fumed with chloroform, which is ascribed to the variation in both radiative and nonradiative transitions in crystal with embedded chloroform. Remarkably, TDP materials demonstrate great potential as a visual chemical probe for chloroform, showing high sensitivity, excellent selectivity, and good repeatability. The limitation for chloroform detection is as low as 5 ppm. Combining experimental data and theoretical calculations, it is reasoned that the space confinement via intermolecular interactions between chloroform and TDP molecules play a vital role for high selectivity of chloroform detection. These results pave the way toward expanding the scope of organic luminogens with UOP as well as their applications.
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Visible light is much more available and less harmful than ultraviolet light, but ultralong organic phosphorescence (UOP) with visible-light excitation remains a formidable challenge. Here, a concise chemical approach is provided to obtain bright UOP by tuning the molecular packing in the solid state under irradiation of available visible light, e.g., a cell phone flashlight under ambient conditions (room temperature and in air). The excitation spectra exhibit an obvious redshift via the incorporation of halogen atoms to tune intermolecular interactions. UOP is achieved through H-aggregation to stabilize the excited triplet state, with a high phosphorescence efficiency of 8.3% and a considerably long lifetime of 0.84 s. Within a brightness of 0.32 mcd m-2 that can be recognized by the naked eye, UOP can last for 104 s in total. Given these features, ultralong organic phosphorescent materials are used to successfully realize dual data encryption and decryption. Moreover, well-dispersed UOP nanoparticles are prepared by polymer-matrix encapsulation in an aqueous solution, and their applications in bioimaging are tentatively being studied. This result will pave the way toward expanding metal-free organic phosphorescent materials and their applications.