Pathologic assessment of hepatocellular carcinoma in the era of immunotherapy: a narrative review.

Background and Objective: Immune checkpoint inhibitor (ICI)-based therapy has achieved impressive success in various cancer types. Several ICIs have been unprecedentedly approved as the treatment regimens for advanced hepatocellular carcinoma (HCC) in recent decade. Meanwhile, numerous clinical trials are being performed to exploit more ICIs into initially unresectable HCC and postoperative HCC to expectantly induce adequate tumor downstaging for further resection or implement adjuvant treatment for relapse-free survival, respectively. In this review, we aim to summarize some pragmatic histomorphologic, immunohistochemical, and molecular pathologic parameters which promisingly indicate the response of neoadjuvant/conversion ICI-related therapy and predict the efficacy of adjuvant/therapeutic ICI-related therapy for HCC. Methods: We searched PubMed using the terms hepatocellular carcinoma, immunotherapy, immune checkpoint inhibitor, immune checkpoint blockade, conversion therapy, neoadjuvant therapy, adjuvant therapy, biomarker, pathologic evaluation, pathologic assessment till February 2023. Key Content and Findings: Although there is no consensus regarding the pathologic evaluation of relevant HCC specimens, it is encouraging that a few of studies have concentrated on this field, and moreover, the methods and parameters noted on other cancer types are also worthy of reference. For the pathologic assessment of HCC specimens underwent immunotherapy, a suitable sampling scheme, identifying immunotherapy-related pathologic response, and quantification of pathologic response rate should be emphasized. For the patients of HCC who are scheduled to receive immunotherapy, tumor-infiltrating lymphocyte, intratumoral tertiary lymphoid structure, programmed cell death ligand 1, Wnt/ß-catenin, microsatellite instability and mismatch repair, tumor mutational burden and tumor neoantigen, as well as some other signaling pathways are the potential predictive biomarkers of treatment response of ICI. Conclusions: The management of HCC in the era of immunotherapy arises a brand-new pathological challenge that is to provide an immunotherapy-related diagnostic report. Albeit many related researches are preclinical or insufficient, they may tremendously alter the immunotherapy strategy of HCC in future.

The Effect of Cataract Surgery on the Risk of Dementia: A Nationwide Cohort Study.

BACKGROUND: An advanced age and the female sex are widely recognized risk factors for both cataract and dementia. We investigated the effect of cataract surgery on the incidence of dementia in a Korean population aged ≥ 45 years with a previous diagnosis of cataract. METHODS: This nationwide cohort study was performed using Korean National Health Insurance Service data collected from 2006 to 2017. A total of 300,327 subjects aged ≥ 45 years with a history of cataract diagnosis but no previous diagnosis of dementia were analyzed. The relationship between cataract surgery and dementia was evaluated, applying a time-varying analysis to evaluate the hazard ratio (HR) and 95% confidence interval (CI) values according to dementia. It was calculated via a multivariable Cox regression model, with adjustments for age, sex, visual acuity (VA), ocular and systemic comorbidities, and social factors (including body mass index, income, smoking, and drinking). RESULTS: In the multivariate analysis, the cataract surgery group showed a marginal difference in dementia development (HR 1.10 [95% CI 1.02-1.19]) because both cataract and dementia share common risk factors. However, in the subgroup analysis, men (HR 0.49 [95% CI 0.26-0.90]) and patients under 65 years of age (HR 0.88 [95% CI 0.79-0.99]) in the group with cataract surgery and good VA showed a significantly lower incidence of dementia. CONCLUSION: Through visual improvement, together with timely surgical intervention, the procedure can alleviate the risk of dementia in visually impaired patients, especially in younger and male patients.

A portable system for economical nucleic acid amplification testing.

Introduction: Regular and rapid large-scale screening for pathogens is crucial for controlling pandemics like Coronavirus Disease 2019 (COVID-19). In this study, we present the development of a digital point-of-care testing (POCT) system utilizing microfluidic paper-based analytical devices (µPADs) for the detection of SARS-CoV-2 gene fragments. The system incorporates temperature tuning and fluorescent detection components, along with intelligent and autonomous image acquisition and self-recognition programs. Methods: The developed POCT system is based on the nucleic acid amplification test (NAAT), a well-established molecular biology technique for detecting and amplifying nucleic acids. We successfully detected artificially synthesized SARS-CoV-2 gene fragments, namely ORF1ab gene, N gene, and E gene, with minimal reagent consumption of only 2.2 µL per readout, representing a mere 11% of the requirements of conventional in-tube methods. The power dissipation of the system was low, at 6.4 W. Results: Our testing results demonstrated that the proposed approach achieved a limit of detection of 1000 copies/mL, which is equivalent to detecting 1 copy or a single RNA template per reaction. By employing standard curve analysis, the quantity of the target templates can be accurately determined. Conclusion: The developed digital POCT system shows great promise for rapid and reliable detection of SARS-CoV-2 gene fragments, offering a cost-effective and efficient solution for controlling pandemics. Its compatibility with other diagnostic techniques and low reagent consumption make it a viable option to enhance healthcare in resource-limited areas.

Mercury and selenium co-ingestion assessment via rice consumption using an in-vitro method: Bioaccessibility and interactions.

Mercury (Hg) was reported to accumulate in rice grains, and, together with the selenium (Se) was found in rice, the co-exposure of Hg-Se via rice consumption may present significant health effects to human. This research collected rice samples containing high Hg:high Se and high Se:low Hg concentrations from high Hg and high Se background areas. The physiologically based extraction test (PBET) in vitro digestion model was utilized to obtain bioaccessibility data from samples. The results showed relatively low bioaccessible for Hg (<60%) and Se (<25%) in both rice sample groups, and no statistically significant antagonism was identified. However, the correlations of Hg and Se bioaccessibility showed an inverse pattern for the two sample groups. A negative correlation was detected in the high Se background rice group and a positive correlation in the high Hg background group, suggesting various micro forms of Hg and Se in rice from different planting locations. In addition, when the benefit-risk value (BRV) was calculated, some "fake" positive results showed while Hg and Se concentrations were directly used, which indicated that bioaccessibility should not be neglected in benefit-risk assessment.

[Occurrence and Health Risk Assessment of Multiple Pesticides in Drinking Water Sources of Southeast China].

To elucidate the pollution characteristics and ecological risks of pesticide micro-pollutants in typical drinking water sources in Southeast China, the detection frequency, detection concentration, and risk quotient of each pesticide for three different trophic levels of organisms (green algae, daphnia, and fish) were analyzed for a total of 55 commonly used pesticides in 19 categories, including benzimidazoles, amides, triazoles, and organophosphates, in seven reservoirs in Southeast China. Among the 55 pesticides analyzed, two pesticides (carbendazim and acetochlor) had a detection frequency of 100%, and 12 pesticides had a detection frequency of 80% or more. The highest detection concentration was found for carbendazim (77.7 ng·L-1), followed by that of acetochlor (51.6 ng·L-1). The results of the risk assessment showed that most of the pesticides were at low risk in the target areas. For the three organisms, acetochlor was the risk-dominant pesticide for green algae, whereas carbendazim was the risk-dominant pesticide for fish and daphnia.

Identifying and comparing low-value care recommendations for coronary heart disease prevention, diagnosis, and treatment in the US and China.

BACKGROUND: Low-value care provides little or no benefit, causes harm and incurs unnecessary costs. Low-value care for coronary heart disease (CHD) is particularly prevalent in the US and China. Identifying low-value care services is the first step in reducing these services. There is currently limited data on identifying a comprehensive CHD low-value care list in the US and China. We aimed to identify and compare low-value care recommendations for CHD prevention, diagnosis, and treatment in the US and China. METHODS: Clinical practice guidelines (CPGs) related to CHD in the US and China were screened for do-not-do recommendations stating that specific services should be avoided. The similarities and discrepancies of low-value care recommendations for CHD between the two countries were then compared. RESULTS: We found a total of 38 low-value care recommendations in 6 Chinese CPGs and 98 recommendations in 11 US CPGs. In the US, the most common types of low-value care recommendations were therapeutic medications (44, 44.9%), followed by therapeutic procedures (27, 27.6%), diagnostic imaging (16, 16.3%), diagnostic testing (9, 9.2%) and primary prevention (2, 2.0%). In China, the most common types were therapeutic medications (18, 47.4%), followed by therapeutic procedures (13, 34.2%), diagnostic testing (4, 10.5%), and diagnostic imaging (3, 7.9%). CONCLUSION: In this study, a comprehensive list of low-value care for CHD in the US and China was established and potentially become the important targets for de-implementation for both countries. The findings may have important implications for other countries, especially low-and middle-income countries, to reduce low-value care for CHD.

A Practical Risk Classification of Early Recurrence in Hepatocellular Carcinoma Patients with Microvascular invasion after Hepatectomy: A Decision Tree Analysis.

PURPOSE: This study was designed to establish risk classifications for early recurrence in hepatocellular carcinoma (HCC) patients with microvascular invasion (MVI) after hepatectomy. METHODS: The data of 563 HCC patients with MVI after hepatectomy from two hospitals were retrospectively reviewed. Kaplan-Meier curves and Cox proportional hazards regression models were used to analyse early recurrence. The risk classification for early recurrence was established by using classification and regression tree (CART) analysis and validated by using two independent validation cohorts from two hospitals. RESULTS: Multivariate analysis revealed that four indices, namely, infection of chronic viral hepatitis, MVI classification, tumour size, and serum alpha-fetoprotein (AFP), were independent prognostic factors for early recurrence in HCC patients with MVI. By CART analysis, MVI classification and serum AFP became the nodes of a decision tree and 3-stratification classifications that satisfactorily determined the risk of early recurrence were established. The area under the time-dependent receiver operating characteristic curve (AUC) values of the classification for early recurrence at 0.5, 1.0, and 2.0 years were 0.75, 0.73, and 0.71, respectively, which were all significantly higher than three common classic HCC stages (BCLC stage, Chinese stage, and TNM stage). The calibration curves showed good agreement between predictions by classification for early recurrence and actual survival outcomes. These prediction results also were confirmed in the independent internal and external validation cohorts. CONCLUSIONS: The 3 stratification classifications enabled satisfactory risk evaluation of early recurrence in HCC patients with MVI after hepatectomy.

Minimal energy cost to initialize a bit with tolerable error.

Landauer's principle imposes a fundamental limit on the energy cost to perfectly initialize a classical bit, which is only reached under the ideal operation with infinitely long time. The question on the cost in the practical operation for a bit has been raised under the constraint by the finiteness of operation time. We discover a raise-up of energy cost by L^{2}(ε)/τ from the Landaeur's limit (k_{B}Tln2) for a finite-time τ initialization of a bit with an error probability ε. The thermodynamic length L(ε) between the states before and after initializing in the parametric space increases monotonously as the error decreases. For example, in the constant dissipation coefficient (γ_{0}) case, the minimal additional cost is 0.997k_{B}T/(γ_{0}τ) for ε=1% and 1.288k_{B}T/(γ_{0}τ) for ε=0.1%. Furthermore, the optimal protocol to reach the bound of minimal energy cost is proposed for the bit initialization realized via a finite-time isothermal process.

Geodesic Path for the Minimal Energy Cost in Shortcuts to Isothermality.

Shortcuts to isothermality are driving strategies to steer the system to its equilibrium states within finite time, and enable evaluating the impact of a control promptly. Finding the optimal scheme to minimize the energy cost is of critical importance in applications of this strategy in pharmaceutical drug tests, biological selection, and quantum computation. We prove the equivalence between designing the optimal scheme and finding the geodesic path in the space of control parameters. Such equivalence allows a systematic and universal approach to find the optimal control to reduce the energy cost. We demonstrate the current method with examples of a Brownian particle trapped in controllable harmonic potentials.

Three-dimensional ophthalmic artery model reconstruction and assessment captured by computed tomographic angiography in non-arteritic anterior ischemic optic neuropathy patients.

BACKGROUND: The ophthalmic artery (OA) was first reconstructed using computer software. The structural differences of ophthalmic arteries in non-arteritic anterior ischemic optic neuropathy (NAION) and normal eyes, in addition to hemodynamic alterations, were assessed. METHODS: Thirty-one NAION eyes, 19 uninvolved eyes with NAION, and a control group of 26 healthy eyes were retrospectively included. Computed tomographic angiography data were recorded, and corresponding three-dimensional OA models were constructed. Initial OA and internal carotid artery (ICA) diameters and the angle between them were analyzed. Three different OA models were used to evaluate hemodynamic performance. The statistical relationships between the initial diameters of the OA and ICA and the angle between the OA and ICA were described. RESULTS: OA diameters in NAION eyes were significantly smaller than those in both uninvolved and healthy eyes (P<0.05). There was no significant difference between uninvolved and healthy eyes (P=0.31). The initial ICA diameter and the angle between the OA and ICA did not significantly differ among the three groups. In the three models, the blood flow velocity in the initial ophthalmic arteries of uninvolved eyes was higher than that in the NAION eyes. The mass flows of the right and left ophthalmic arteries, accounting for the ipsilateral ICA in the control model, were 0.57%. However, these values in uninvolved and NAION eyes were 1.36% and 0.25%, respectively. CONCLUSIONS: NAION is associated with a smaller initial OA diameter, which may be related to hypoperfusion. To our knowledge, this is the first pilot study to analyze hemodynamic alterations using OA models.

Can population BRCA screening be applied in non-Ashkenazi Jewish populations? Experience in Macau population.

BACKGROUND: Pathogenic mutation in BRCA genes causes high cancer risk. Identifying the mutation carriers plays key roles in preventing BRCA mutation-related cancer. Population screening has demonstrated its power for comprehensive identification of the mutation carriers. However, it is only recommended for the Ashkenazi Jewish population with high prevalence of three founder mutations, but not for non-Ashkenazi Jewish populations as the cost-effectiveness could be too low due to their lower mutation prevalence and lack of founder mutation. Population screening would not benefit the majority of the human population for BRCA mutation-related cancer prevention. METHODS: We used population BRCA screening in 6000 residents, 1% of the Macau population, an ethnic Chinese population with unique genetic, linguistic and cultural features, and its BRCA mutation has not been analysed before. RESULTS: We called BRCA variants, identified 18 carriers with 14 pathogenic mutations and determined the prevalence of 0.29% in the population (95% CI 0.15% to 0.42%). We compared the testing cost between the Ashkenazi Jewish population, the Sephardi Jewish population and the Macau population, and observed only a few fold differences. CONCLUSION: Our study shows that testing cost is not the most important factor in considering population BRCA screening, at least for the populations in the developed countries/regions, regardless of the status of mutation prevalence and founder mutation.

Down-regulation of long non-coding RNA SNHG14 protects against acute lung injury induced by lipopolysaccharide through microRNA-34c-3p-dependent inhibition of WISP1.

BACKGROUND: Accumulating evidence has shown the important roles of long non-coding RNAs (lncRNAs) in acute lung injury (ALI). This study aimed to investigate the potential role of lncRNA small nucleolar RNA host gene 14 (SNHG14) in lipopolysaccharides (LPS)-induced ALI. METHODS: Expression of SNHG14, microRNA-34c-3p (miR-34c-3p) and Wnt1 inducible signaling pathway protein 1 (WISP1) in LPS-exposed mouse alveolar macrophages (MH-S) and lung tissues from mice with LPS-induced ALI was determined by reverse transcription quantitative polymerase chain reaction. The interactions among SNHG14, miR-34c-3p and WISP1 were analyzed by dual-luciferase reporter and RIP assays. Using gain-of-function or loss-of-function approaches, the contents of proinflammatory proteins were determined and MH-S cell viability was assessed to evaluate the in vitro functions of SNHG14, miR-34c-3p and WISP1, and wet/dry weight ratio and proinflammatory proteins in lung tissues were determined to assess their in vivo effects. RESULTS: SNHG14 and WISP1 expression was increased, while miR-34c-3p was decreased in ALI models. SNHG14 bound to miR-34c-3p, resulting in impaired miR-34c-3p-dependent down-regulation of WISP1. Both SNHG14 silencing and miR-34c-3p over-expression reduced the levels of proinflammatory proteins IL-18, IL-1ß, TNF-α and IL-6 and inhibited MH-S cell viability. SNHG14 silencing or miR-34c-3p over-expression decreased the wet/dry weight ratio in lung tissues from ALI mice. The reductions induced by SNHG14 silencing or miR-34c-3p over-expression were rescued by WISP1 over-expression. CONCLUSION: This study demonstrated that lncRNA SNHG14 silencing alleviated inflammation in LPS-induced ALI through miR-34c-3p-mediated inhibition of WISP1. Our findings suggest that lncRNA SNHG14 may serve as a therapeutic target for ALI.

Lung cancer imaging methods in China from 2005 to 2014: A national, multicenter study.

BACKGROUND: The study was conducted to examine changes in diagnostic and staging imaging methods for lung cancer in China over a 10-year period and to determine the relationships between such changes and socioeconomic development. METHODS: This was a hospital-based, nationwide, multicenter retrospective study of primary lung cancer cases. The data were extracted from the 10-year primary lung cancer databases at eight tertiary hospitals from various geographic areas in China. The chi-squared test was used to assess the differences and the Cochran-Armitage trend test was used to estimate the trends of changes. RESULTS: A total of 7184 lung cancer cases were analyzed. Over the 10-year period, the utilization ratio of diagnostic imaging methods, such as chest computed tomography (CT) and chest magnetic resonance imaging (MRI), increased from 65.79% to 81.42% and from 0.73% to 1.96%, respectively, while the utilization ratio of chest X-ray declined from 50.15% to 30.93%. Staging imaging methods, such as positron emission tomography-CT, neck ultrasound, brain MRI, bone scintigraphy, and bone MRI increased from 0.73% to 9.29%, 22.95% to 47.92%, 8.77% to 40.71%, 42.40% to 62.22%, and 0.88% to 4.65%, respectively; abdominal ultrasound declined from 83.33% to 59.9%. These trends were more notable in less developed areas than in areas with substantial economic development. CONCLUSION: Overall, chest CT was the most common radiological diagnostic method for lung cancer in China. Imaging methods for lung cancer tend to be used in a diverse, rational, and regionally balanced manner.

[Distribution and Removal of Antibiotic Resistance Genes in Two Sequential Wastewater Treatment Plants].

Wastewater treatment plants (WWTPs) have been regarded as important point-sources of antibiotic resistance genes (ARGs) in aquatic environments. To investigate the distribution and removal of ARGs in WWTPs, a pharmaceutical wastewater treatment plant (PWWTP) and an integrated wastewater treatment plant (IWWTP) in a fine-chemical industrial park were chosen, and polymerase chain reaction (PCR) and real-time PCR techniques were used to determine the occurrence and abundances of ARGs along the treatment processes. Ten and fifteen ARGs were detected initially in the influents of PWWTP and IWWTP respectively, in which tetracycline and sulfonamide resistance genes were frequently reported, while dfrA13 was first reported in WWTPs. The most abundant ARGs in the influents were sul Ⅰ and sul Ⅱ, followed by dfrA13, tetQ, floR, tetO, and tetW. The total ARGs increased by 0.21 log after the treatment by PWWTP, whose effluent contributed 0.87% to the inflow yet 5.05% to the total ARGs of IWWTP. Finally the total ARGs removed by IWWTP was 1.03 log, with the remaining ARGs then transported within the final effluent to the nearby coastal area. The authors concluded that the environmental and other impacts from the spread of ARGs on the microbial communities of the coastal environment needed further study.

Visual quality assessment after presbyopic laser in-situ keratomileusis.

AIM: To assess visual quality after presbyopia correction using an aspheric ablation profile and a micro-monovision protocol. METHODS: This is a retrospective interventional study. Fifty-four eyes of 27 patients (mean age, 50.2±7.5y) who underwent presbyopia correction with an aspheric micro-monovision protocol were enrolled. The values of modulation transfer function (MTF) cutoff frequency, Strehl ratio, objective scattering index (OSI) and accommodation range were quantitatively assessed using the HD analyzer. Preoperative and postoperative contrast sensitivity (CS) at far (2.5 m) and near (40 cm) distance and higher-order aberrations (HOAs) were analyzed. Subjective visual satisfaction was evaluated by self-reported questionnaire regarding optical visual symptoms. RESULTS: One year after presbyopia correction, no significant differences were found in the MTF cutoff frequency, Strehl ratio and OSI, however, the HD analyzer accommodation range significantly differed postoperatively (P=0.004). Postoperative CS at 12 and 18 cpd at near showed statistically significant improvement (P=0.020 and 0.008, respectively). Visual performance by self-reported questionnaire revealed satisfactory results in terms of subjective visual quality improvement. CONCLUSION: Objective optical quality parameters show good visual outcomes. Subjective visual quality assessed by self-reported questionnaire in the presbyopia correction group show satisfactory results.

Correlates of Condom-use Self-efficacy on the EPPM-based Integrated Model among Chinese College Students.

OBJECTIVE: To explore the predictors of condom-use self-efficacy in Chinese college students according to the extended parallel process model (EPPM)-based integrated model. METHODS: A total of 3,081 college students were anonymously surveyed through self-administered questionnaires in Guangzhou and Harbin, China. A structural equation model was applied to assess the integrated model. RESULTS: Among the participants, 1,387 (46.7%) were male, 1,586 (53.3%) were female, and the average age was 18.6 years. The final integrated model was acceptable. Apart from the direct effect (r = 0.23), perceived severity had two indirect effects on condom-use self-efficacy through the attitude to HIV education (r = 0.40) and intention to engage in premarital sex (r = -0.16), respectively. However, the perceived susceptibility mediated through the intention to engage in premarital sex (intent-to-premarital-sex) had a poor indirect impact on condom-use self-efficacy (total effect was -0.06). Furthermore, attitude toward HIV health education (r = 0.49) and intent-to-premarital-sex (r = -0.31) had a strong direct effect on condom-use self-efficacy. In addition, male students perceived higher susceptibility, stronger intent-to-premarital-sex, and lower condom-use self-efficacy than female students. CONCLUSION: The integrated model may be used to assess the determinants of condom-use self-efficacy among Chinese college students. Future research should focus on raising the severity perception, HIV-risk-reduction motivation, and the premarital abstinence intention among college students. Furthermore, considering the gender differences observed in the present survey, single-sex HIV education is required in school-based HIV/sex intervention.

Assessment of mutations in KCNN2 and ZNF135 to patient neurological symptoms.

Exome sequencing from a patient with neurological and developmental symptoms revealed two mutations in separate genes. One was a homozygous transition mutation that results in an in-frame, premature translational stop codon in the ZNF135 gene predicted to encode a transcriptional repressor. Another mutation was heterozygous, a single nucleotide duplication in the KCNN2 gene that encodes a Ca-activated K channel, SK2, and leads to a translational frame shift and a premature stop codon. Heterologous expression studies, brain slice recordings, and coordination tests from a transgenic mouse line carrying the SK2 mutation suggest that it does not contribute to the patient's symptoms. ZNF135 is expressed in human brain and it is likely that the homozygous mutation underlies the human phenotype.

Performance Evaluation Model for Application Layer Firewalls.

Application layer firewalls protect the trusted area network against information security risks. However, firewall performance may affect user experience. Therefore, performance analysis plays a significant role in the evaluation of application layer firewalls. This paper presents an analytic model of the application layer firewall, based on a system analysis to evaluate the capability of the firewall. In order to enable users to improve the performance of the application layer firewall with limited resources, resource allocation was evaluated to obtain the optimal resource allocation scheme in terms of throughput, delay, and packet loss rate. The proposed model employs the Erlangian queuing model to analyze the performance parameters of the system with regard to the three layers (network, transport, and application layers). Then, the analysis results of all the layers are combined to obtain the overall system performance indicators. A discrete event simulation method was used to evaluate the proposed model. Finally, limited service desk resources were allocated to obtain the values of the performance indicators under different resource allocation scenarios in order to determine the optimal allocation scheme. Under limited resource allocation, this scheme enables users to maximize the performance of the application layer firewall.

Social organization of Shortridge's capped langur (Trachypithecus shortridgei) at the Dulongjiang Valley in Yunnan, China.

Non-human primates often live in socially stable groups characterized by bonded relationships among individuals. Social organization can be used to evaluate living conditions and expansion potential. Bisexual group size, ratio of males to females and group composition are essential elements determining the type of social organization. Although the first report on Shortridge's capped langurs (Trachypithecus shortridgei) was in the 1970s, until now, the species only inhabits forests of the Dulongjiang valley in northwest Yunnan, China, with c. 250-370 individuals in 19 populations. To understand its social organization, we collected data from five groups of Shortridge's langurs at Silaluo in the Dulongjiang valley during August 2012-October 2013. Family groups consist of one adult male, 2-3 adult females and up to five young. Group size averaged 8 (7-9) individuals. The ratio of adult males to females (M/F) was 1:2.9, infants to adult females was (I/F) 1:2.2; and ratio of adults to immatures was 1:1.2, indicating the potential of a population increasing. Birth season was during March-July and the inter-birth interval was two years.

Highly-flexible, low-cost, all stainless steel mesh-based dye-sensitized solar cells.

Highly-flexible, ITO-free dye-sensitized solar cells (DSSCs) are fabricated in a simple, all-solution-based, facile, and controllable way. A double mesh structure is applied to DSSCs, and the design principles, especially scale parameters, are analyzed delicately to ensure the power conversion efficiency and mechanical flexibility of the device. The good flexibility of mesh-based DSSCs is verified by systematic bending tests compared to conventional flexible DSSCs based on PET/ITO or metal foil substrates. Commercial carbon ink is used as a counter electrode material, and it is proved to be low-cost and efficient. The double mesh structure design provides an attractive strategy toward the development of flexible and wearable electrochemical energy supplies.