Atlas of Metastatic Gastric Cancer Links Ferroptosis to Disease Progression and Immunotherapy Response.

BACKGROUND & AIMS: Metastases from gastric adenocarcinoma (GAC) lead to high morbidity and mortality. Developing innovative and effective therapies requires a comprehensive understanding of the tumor and immune biology of advanced GAC. Yet, collecting matched specimens from advanced, treatment-naïve patients with GAC poses a significant challenge, limiting the scope of current research, which has focused predominantly on localized tumors. This gap hinders deeper insight into the metastatic dynamics of GAC. METHODS: We performed in-depth single-cell transcriptome and immune profiling on 68 paired, treatment-naïve, primary metastatic tumors to delineate alterations in cancer cells and their tumor microenvironment during metastatic progression. To validate our observations, we conducted comprehensive functional studies both in vitro and in vivo, using cell lines and multiple patient-derived xenograft and novel mouse models of GAC. RESULTS: Liver and peritoneal metastases exhibited distinct properties in cancer cells and dynamics of tumor microenvironment phenotypes, supporting the notion that cancer cells and their local tumor microenvironments co-evolve at metastatic sites. Our study also revealed differential activation of cancer meta-programs across metastases. We observed evasion of cancer cell ferroptosis via GPX4 up-regulation during GAC progression. Conditional depletion of Gpx4 or pharmacologic inhibition of ferroptosis resistance significantly attenuated tumor growth and metastatic progression. In addition, ferroptosis-resensitizing treatments augmented the efficacy of chimeric antigen receptor T-cell therapy. CONCLUSIONS: This study represents the largest single-cell dataset of metastatic GACs to date. High-resolution mapping of the molecular and cellular dynamics of GAC metastasis has revealed a rationale for targeting ferroptosis defense in combination with chimeric antigen receptor T-cell therapy as a novel therapeutic strategy with potential immense clinical implications.

Constructing Asymmetric Fe-Nb Diatomic Sites to Enhance ORR Activity and Durability.

Iron-nitrogen-carbon (Fe-N-C) materials have been identified as a promising class of platinum (Pt)-free catalysts for the oxygen reduction reaction (ORR). However, the dissolution and oxidation of Fe atoms severely restrict their long-term stability and performance. Modulating the active microstructure of Fe-N-C is a feasible strategy to enhance the ORR activity and stability. Compared with common 3d transition metals (Co, Ni, etc.), the 4d transition metal atom Nb has fewer d electrons and more unoccupied orbitals, which could potentially forge a more robust interaction with the Fe site to optimize the binding energy of the oxygen-containing intermediates while maintaining stability. Herein, an asymmetric Fe-Nb diatomic site catalyst (FeNb/c-SNC) was synthesized, which exhibited superior ORR performance and stability compared with those of Fe single-atom catalysts (SACs). The strong interaction within the Fe-Nb diatomic sites optimized the desorption energy of key intermediates (*OH), so that the adsorption energy of Fe-*OH approaches the apex of the volcano plot, thus exhibiting optimal ORR activity. More importantly, introducing Nb atoms could effectively strengthen the Fe-N bonding and suppress Fe demetalation, causing an outstanding stability. The zinc-air battery (ZAB) and hydroxide exchange membrane fuel cell (HEMFC) equipped with our FeNb/c-SNC could deliver high peak power densities of 314 mW cm-2 and 1.18 W cm-2, respectively. Notably, the stable operation time for ZAB and HEMFC increased by 9.1 and 5.8 times compared to Fe SACs, respectively. This research offers further insights into developing stable Fe-based atomic-level catalytic materials for the energy conversion process.

Highly Dispersed Ultrasmall High-Entropy Alloys Nanoparticles as Efficient Electrocatalysts for Oxygen Reduction in Acidic Media.

High-entropy alloys nanoparticles (HEAs NPs) have gained considerable attention due to their extensive compositional tunability and intriguing catalytic properties. However, the synthesis of highly dispersed ultrasmall HEAs NPs remains a formidable challenge due to their inherent thermodynamic instability. In this study, highly dispersed ultrasmall (ca. 2 nm) PtCuGaFeCo HEAs NPs are synthesized using a one-pot solution-based method at 160 °C and atmospheric pressure. The PtCuGaFeCo NPs exhibit good catalytic activity for the oxygen reduction reaction (ORR). The half-wave potential relative to the reversible hydrogen electrode (RHE) reaches 0.88 V, and the mass activity and specific activity are approximately six times and four times higher than that of the commercial Pt/C catalyst. Based on X-ray photoelectron spectroscopy (XPS) and X-ray absorption spectroscopy (XAS) analyses, the surface strain and optimized coordination environments of PtCuGaFeCo have led to high ORR activities in acidic media. Moreover, the ultrasmall size also plays an important role in enhancing catalytic performance. The work presents a facile and viable synthesis strategy for preparing the ultrasmall HEAs NPs, offering great potential in energy and electrocatalysis applications through entropy engineering.

Enhancing Conductivity in Silicon Heterojunction Solar Cells with Silver Nanowire-Assisted Ti3C2Tx MXene Electrodes for Cost-Effective and Scalable Photovoltaics.

Silicon heterojunction (SHJ) solar cells have set world-record efficiencies among single-junction silicon solar cells, accelerating their commercial deployment. Despite these clear efficiency advantages, the high costs associated with low-temperature silver pastes (LTSP) for metallization have driven the search for more economical alternatives in mass production. 2D transition metal carbides (MXenes) have attracted significant attention due to their tunable optoelectronic properties and metal-like conductivity, the highest among all solution-processed 2D materials. MXenes have emerged as a cost-effective alternative for rear-side electrodes in SHJ solar cells. However, the use of MXene electrodes has so far been limited to lab-scale SHJ solar cells. The efficiency of these devices has been constrained by a fill factor (FF) of under 73%, primarily due to suboptimal charge transport at the contact layer/MXene interface. Herein, a silver nanowire (AgNW)-assisted Ti3C2Tx MXene electrode contact is introduced and explores the potential of this hybrid electrode in industry-scale solar cells. By incorporating this hybrid electrode into SHJ solar cells, 9.0 cm2 cells are achieved with an efficiency of 24.04% (FF of 81.64%) and 252 cm2 cells with an efficiency of 22.17% (FF of 76.86%), among the top-performing SHJ devices with non-metallic electrodes to date. Additionally, the stability and cost-effectiveness of these solar cells are discussed.

Quality Evaluation of Guidelines for the Diagnosis and Treatment of Liver Failure.

OBJECTIVES: This study aimed to systematically assess the methodological quality and key recommendations of the guidelines for the diagnosis and treatment of liver failure (LF), furnishing constructive insights for guideline developers and equipping clinicians with evidence-based information to facilitate informed decision-making. DATA SOURCES: Electronic databases and manual searches from January 2011 to August 2023. STUDY SELECTION: Two reviewers independently screened titles and abstracts, then full texts for eligibility. Fourteen guidelines were included. DATA EXTRACTION AND SYNTHESIS: Two reviewers extracted data and checked by two others. Methodological quality of the guidelines was appraised using the Appraisal of Guidelines for Research and Evaluation II tool. Of the 14 guidelines, only the guidelines established by the Society of Critical Care Medicine and the American College of Gastroenterology (2023) achieved an aggregate quality score exceeding 60%, thereby meriting clinical recommendations. It emerged that there remains ample room for enhancement in the quality of the guidelines, particularly within the domains of stakeholder engagement, rigor, and applicability. Furthermore, an in-depth scrutiny of common recommendations and supporting evidence drawn from the 10 adult LF guidelines unveiled several key issues: controversy exists in the recommendation, the absence of supporting evidence and confusing use of evidence for recommendations, and a preference in evidence selection. CONCLUSIONS: There are high differences in methodological quality and recommendations among LF guidelines. Improving these existing problems and controversies will benefit existing clinical practice and will be an effective way for developers to upgrade the guidelines.

Landscape of clinical drug development of ADCs used for the pharmacotherapy of cancers: an overview of clinical trial registry data from 2002 to 2022.

BACKGROUND: To provide reference for clinical development of ADCs in the industry, we analyzed the landscape and characteristics of clinical trials about antibody-drug conjugates (ADCs). METHOD: Clinical trials to study ADCs used for the pharmacotherapy of cancers initiated by the sponsor were searched in the Cite line Pharma Intelligence (Trialtrove database), and the landscape and characteristics of these clinical trials were analyzed from multiple perspectives, such as the number, phases, status, indications, and targets of the clinical trials. RESULT: As of December 31, 2022, a total of 431 clinical trials have been initiated to study ADCs used for the pharmacotherapy of cancers, and the number of the last 10 years was 5.5 times as large as the first 11 years. These clinical trials involved 47 indications, including breast cancer, lymphoma (lymphoma, non-Hodgkin's and lymphoma, Hodgkin's), unspecified solid tumor, bladder cancer and lung cancer (lung, non-small cell cancer and lung, small cell cancer). As for each of these five indications, 50 + clinical trials have been carried out, accounting for as high as 48.50% (454/936). ADCs involve 38 targets, which are relatively concentrated. Among them, ERBB2 (HER2) and TNFRSF8 (CD30) involve in 100 + registered clinical trials, and TNFRSF17 (BCMA), NECTIN4 and CD19 in 10 + trials. The clinical trials for these five targets account for 79.02% (354/448) of the total number. Up to 93.97% (405/431) of these clinical trials explored the correlation between biomarkers and efficacy. Up to 45.91% (292/636) of Lots (lines of treatment) applied in the clinical trials were the second line. Until December 31, 2022, 54.52% (235/431) of the clinical trials have been completed or terminated. CONCLUSION: ADCs are a hotspot of research and development in oncology clinical trials, but the indications, targets, phases, and Lot that have been registered are seemingly relatively concentrated at present. This study provides a comprehensive analysis which can assist researchers/developer quickly grasp relevant knowledge to assess a product and also providing new clues and ideas for future research.

Manganese(III) Triacetate-Mediated Cross Coupling of Organoboron Compounds with Trichloroethylene (TCE): Synthesis of 1,1-Dichloroalkenes.

Herein, we report an efficient method for the synthesis of 1,1-dichloroalkenes from organoboron compounds. This reaction proceeds in the presence of manganese(III) triacetate using trichloroethylene (TCE) as the vinylation reagent. This reaction can tolerate various types of organoboron compounds and various functional groups. The yields are moderate to good. Surprisingly, this transformation could even be achieved in the presence of manganese(II) acetate. Furthermore, this synthetic strategy could be applied to the synthesis of 1,1,2-trichloro-, 1-chloro-, and 2-chloroalkenes.

Development and validation of a noninvasive prediction model of autoimmune hepatitis in patients with liver diseases.

BACKGROUND AND AIMS: There is no golden standard for the diagnosis of autoimmune hepatitis which still dependent on liver biopsy currently. So, we developed a noninvasive prediction model to help optimize the diagnosis of autoimmune hepatitis. METHODS: From January 2017 to December 2019, 1739 patients who had undergone liver biopsy were seen in the second hospital of Nanjing, of which 128 were here for consultation. Clinical, laboratory, and histologic data were obtained retrospectively. Multivariable logistic regression analysis was employed to create a nomogram model that predicting the risk of autoimmune hepatitis. Internal and external validation was both performed to evaluate the model. RESULTS: A total of 1288 patients with liver biopsy were enrolled (1184 from the second hospital of Nanjing, the remaining 104 from other centers). After the univariate and multivariate logistic regression analysis, nine variables including ALT, IgG, ALP/AST, ALB, ANA, AMA, HBsAg, age, and gender were selected to establish the noninvasive prediction model. The nomogram model exhibits good prediction in diagnosing autoimmune hepatitis with AUROC of 0.967 (95% CI: 0.776-0.891) in internal validation and 0.835 (95% CI: 0.752-0.919) in external validation. CONCLUSIONS: ALT, IgG, ALP/AST, ALB, ANA, AMA, HBsAg, age, and gender are predictive factors for the diagnosis of autoimmune hepatitis in patients with unexplained liver diseases. The predictive nomogram model built by the nine predictors achieved good prediction for diagnosing autoimmune hepatitis.

Development and validation of nomogram for predicting early recurrence after radical gastrectomy of gastric cancer.

BACKGROUND: After radical surgery, early detection of recurrence and metastasis is a crucial factor in enhancing the prognosis and survival of patients with gastric cancer (GC). Therefore, assessing the risk of recurrence in gastric cancer patients and determining the timing for postoperative recurrence is crucial. METHODS: The clinicopathological data of 521 patients with recurrent gastric cancer, who underwent radical gastrectomy at Zhejiang Cancer Hospital between January 2010 and January 2017, were retrospectively analyzed. These patients were randomly divided into two groups: a training group (n = 365) and a validation group (n = 156). In the training set, patients were further categorized into early recurrence (n = 263) and late recurrence (n = 102) groups based on a 2-year boundary. Comparative analyses of clinicopathological features and prognoses were conducted between these two groups. Subsequently, a nomogram for predicting early recurrence was developed and validated. RESULTS: In this study, the developed nomogram incorporated age, serous infiltration, lymph node metastasis, recurrence mode, and the tumour marker CA19-9. In the training cohort, the area under the curve (AUC value) was 0.739 (95% CI, 0.682-0.798), with a corresponding C-index of 0.739. This nomogram was subsequently validated in an independent validation cohort, yielding an AUC of 0.743 (95% CI, 0.652-0.833) and a C-index of 0.743. Furthermore, independent risk factors for prognosis were identified, including age, absence of postoperative chemotherapy, early recurrence, lymph node metastasis, abdominal metastasis, and vascular cancer embolus. CONCLUSION: Independent risk factors for gastric cancer recurrence following radical surgery were utilized to construct a nomogram for predicting early relapse. This nomogram effectively assesses the risk of recurrence, aids in treatment decision-making and follow-up planning in clinical settings, and demonstrated strong performance in the validation cohort.

HTR3A Promotes Non-small Cell Lung Cancer Through the FOXH1/Wnt3A Signaling Pathway.

5-Hydroxytryptamine receptors (5-HTRs) are strongly correlated with tumor progression in various types of cancer. Despite this, the underlying mechanisms responsible for the role of 5-HTRs in non-small cell lung cancer (NSCLC) remains unclear. This study aimed to investigate the relationship between 5-hydroxytryptamine receptor 3A (HTR3A) and NSCLC development. Our findings indicated a higher distribution of HTR3A expression in NSCLC tissues when compared with normal tissues, where patients with high HTR3A levels demonstrated shorter overall survival times. In vitro analyses revealed that overexpression of HTR3A facilitated the proliferation and migration of NSCLC cell lines (A549 and NCI-H3255). Similarly, a notable acceleration of tumor growth and enhanced pulmonary tumorigenic potential were observed in HTR3A-overexpressing tumor-bearing mice. Mechanistically, upregulation of Forkhead Box H1 (FOXH1) by HTR3A led to the activation of Wnt3A/ß-catenin signaling pathways, thereby promoting the development of NSCLC. Our report thus highlights the significance of the HTR3A/FOXH1 axis during tumor progression in NSCLC, proposing HTR3A as a possible diagnostic indicator and candidate target for clinical therapy.

Aroma-sensory properties of Gouda cheeses based on young Chinese consumers' preferences.

The objective of this study was to examine the aroma profiles of 12 Gouda cheeses sold in China and to determine which aromas were preferred by young Chinese consumers (n = 110). The consumers selected 11 descriptors of the aromas of the Gouda cheeses in a check-all-that-apply questionnaire. These 11 descriptors were used by a panel of experts for sensory analysis to perform a quantitative descriptive analysis of the cheeses. A principal component analysis of the data from the quantitative descriptive analysis revealed that the characteristic aromas of young Gouda cheeses, medium-aged Gouda cheeses, and aged Gouda cheeses were "milky" and "whey"; "creamy" and "sour"; and "rancid" and "nutty," respectively. The results of a penalty analysis combined with the check-all-that-apply results and the preference scores showed that the 3 groups of young Chinese consumers (those who often ate cheese, occasionally ate cheese, and never ate cheese) preferred the Gouda cheeses with "milky" or "creamy" aromas and did not enjoy those with "sour" or "rancid" aromas. Occasional cheese eaters comprised the majority of the young Chinese consumers, and they were more tolerant of the Gouda cheeses with "whey" and "sulfury" aromas than those who often or never ate cheese. In addition, we identified a positive correlation between the consumers' preferences for the aromas of the Gouda cheeses and their willingness to pay for them. Overall, the results of this study should help promote the development of Gouda cheeses and associated products that meet the preferences of young Chinese consumers.

Electrical Impedance Tomography-Based Electronic Skin for Multi-Touch Tactile Sensing Using Hydrogel Material and FISTA Algorithm.

Flexible electronic skin (e-skin) can enable robots to have sensory forms similar to human skin, enhancing their ability to obtain more information from touch. The non-invasive nature of electrical impedance tomography (EIT) technology allows electrodes to be arranged only at the edges of the skin, ensuring the stretchability and elasticity of the skin's interior. However, the image quality reconstructed by EIT technology has deteriorated in multi-touch identification, where it is challenging to clearly reflect the number of touchpoints and accurately size the touch areas. This paper proposed an EIT-based flexible tactile sensor that employs self-made hydrogel material as the primary sensing medium. The sensor's structure, fabrication process, and tactile imaging principle were elaborated. To improve the quality of image reconstruction, the fast iterative shrinkage-thresholding algorithm (FISTA) was embedded into the EIDORS toolkit. The performances of the e-skin in aspects of assessing the touching area, quantitative force sensing and multi-touch identification were examined. Results showed that the mean intersection over union (MIoU) of the reconstructed images was improved up to 0.84, and the tactile position can be accurately imaged in the case of the number of the touchpoints up to seven (larger than two to four touchpoints in existing studies), proving that the combination of the proposed sensor and imaging algorithm has high sensitivity and accuracy in multi-touch tactile sensing. The presented e-skin shows potential promise for the application in complex human-robot interaction (HRI) environments, such as prosthetics and wearable devices.

Crystal Growth Regulation of Ruddlesden-Popper Perovskites via Self-Assembly of Semiconductor Spacers for Efficient Solar Cells.

The crystal growth and orientation of two-dimensional (2D) perovskite films significantly impact solar cell performance. Here, we incorporated robust quadrupole-quadrupole interactions to govern the crystal growth of 2D Ruddlesden-Popper (RP) perovskites. This was achieved through the development of two unique semiconductor spacers, namely PTMA and 5FPTMA, with different dipole moments. The ((5FPTMA)0.1 (PTMA)0.9 )2 MAn-1 Pbn I3n+1 (nominal n=5, 5F/PTMA-Pb) film shows a preferred vertical orientation, reduced grain boundaries, and released residual strain compared to (PTMA)2 MAn-1 Pbn I3n+1 (nominal n=5, PTMA-Pb), resulting in a decreased exciton binding energy and reduced electron-phonon coupling coefficients. In contrast to PTMA-Pb device with an efficiency of 15.66 %, the 5F/PTMA-Pb device achieved a champion efficiency of 18.56 %, making it among the best efficiency for 2D RP perovskite solar cells employing an MA-based semiconductor spacer. This work offers significant insights into comprehending the crystal growth process of 2D RP perovskite films through the utilization of quadrupole-quadrupole interactions between semiconductor spacers.

Stepwise Protonation of Three-Dimensional Covalent Organic Frameworks for Enhancing Hydrogen Peroxide Photosynthesis.

Three-dimensional covalent organic frameworks (3D COFs), recognized for their tailorable structures and accessible active sites, offer a promising platform for developing advanced photocatalysts. However, the difficulty in the synthesis and functionalization of 3D COFs hinders their further development. In this study, we present a series of 3D-bcu-COFs with 8 connected porphyrin units linked by linear linkers through imine bonds as a versatile platform for photocatalyst design. The photoresponse of 3D-bcu-COFs was initially modulated by functionalizing linear linkers with benzo-thiadiazole or benzo-selenadiazole groups. Furthermore, taking advantage of the well-exposed porphyrin and imine sites in 3D-bcu-COFs, their photocatalytic activity was optimized by stepwise protonation of imine bonds and porphyrin centers. The dual protonated COF with benzo-selenadiazole groups exhibited enhanced charge separation, leading to an increased photocatalytic H2O2 production under visible light. This enhancement demonstrates the combined benefits of linker functionalization and stepwise protonation on photocatalytic efficiency.

Bimodal Oxidation Electrochemiluminescence Mechanism of Coreactant-Embedded Covalent Organic Frameworks via Postsynthetic Modification.

Electrochemiluminescence (ECL) efficiency is determined by charge transfer between coreactants and emitters in coreactant systems, which are usually limited by their slow intermolecular charge transfer. In this study, a covalent organic framework (COF) with aldehyde residue was synthesized, and then coreactants were covalently integrated into the skeleton through the postsynthetic modification strategy, resulting in a crystalline coreactant-embedded COF nanoemitter (C-COF). Compared to the pristine COF with an equivalent external coreactant, C-COF exhibited an extraordinary 1008-fold enhancement of ECL intensity due to the rapid intrareticular charge transfer. Significantly, with the pH increase, C-COF shows protonation-induced ECL enhancement for the first ECL peaked at +1.1 V and an opposite trend for the second ECL at +1.4 V, which were attributed to the antedating oxidation of coreactant in framework and COF self-oxidation, respectively. The resulting bimodal oxidation ECL mechanism was rationalized by spectral characterization and density functional theory calculations. The postsynthetic coreactant-embedded nanoemitters present innovative and universal avenues for advancing ECL systems.

Efficient plasma metabolic fingerprinting as a novel tool for diagnosis and prognosis of gastric cancer: a large-scale, multicentre study.

OBJECTIVE: Metabolic biomarkers are expected to decode the phenotype of gastric cancer (GC) and lead to high-performance blood tests towards GC diagnosis and prognosis. We attempted to develop diagnostic and prognostic models for GC based on plasma metabolic information. DESIGN: We conducted a large-scale, multicentre study comprising 1944 participants from 7 centres in retrospective cohort and 264 participants in prospective cohort. Discovery and verification phases of diagnostic and prognostic models were conducted in retrospective cohort through machine learning and Cox regression of plasma metabolic fingerprints (PMFs) obtained by nanoparticle-enhanced laser desorption/ionisation-mass spectrometry (NPELDI-MS). Furthermore, the developed diagnostic model was validated in prospective cohort by both NPELDI-MS and ultra-performance liquid chromatography-MS (UPLC-MS). RESULTS: We demonstrated the high throughput, desirable reproducibility and limited centre-specific effects of PMFs obtained through NPELDI-MS. In retrospective cohort, we achieved diagnostic performance with areas under curves (AUCs) of 0.862-0.988 in the discovery (n=1157 from 5 centres) and independent external verification dataset (n=787 from another 2 centres), through 5 different machine learning of PMFs, including neural network, ridge regression, lasso regression, support vector machine and random forest. Further, a metabolic panel consisting of 21 metabolites was constructed and identified for GC diagnosis with AUCs of 0.921-0.971 and 0.907-0.940 in the discovery and verification dataset, respectively. In the prospective study (n=264 from lead centre), both NPELDI-MS and UPLC-MS were applied to detect and validate the metabolic panel, and the diagnostic AUCs were 0.855-0.918 and 0.856-0.916, respectively. Moreover, we constructed a prognosis scoring system for GC in retrospective cohort, which can effectively predict the survival of GC patients. CONCLUSION: We developed and validated diagnostic and prognostic models for GC, which also contribute to advanced metabolic analysis towards diseases, including but not limited to GC.

Outcome Evaluation of Repeat Stereotactic Radiosurgery for Cerebral Arteriovenous Malformations.

BACKGROUND: Repeat stereotactic radiosurgery (SRS) for persistent cerebral arteriovenous malformation (AVM) has generally favorable patient outcomes. However, reporting studies are limited by small patient numbers and single-institution biases. The purpose of this study was to provide the combined experience of multiple centers, in an effort to fully define the role of repeat SRS for patients with arteriovenous malformation. METHODS: This multicenter, retrospective cohort study included patients treated with repeat, single-fraction SRS between 1987 and 2022. Follow-up began at repeat SRS. The primary outcome was a favorable patient outcome, defined as a composite of nidus obliteration in the absence of hemorrhage or radiation-induced neurological deterioration. Secondary outcomes were obliteration, hemorrhage risk, and symptomatic radiation-induced changes. Competing risk analysis was performed to compute yearly rates and identify predictors for each outcome. RESULTS: The cohort comprised 505 patients (254 [50.3%] males; median [interquartile range] age, 34 [15] years) from 14 centers. The median clinical and magnetic resonance imaging follow-up was 52 (interquartile range, 61) and 47 (interquartile range, 52) months, respectively. At last follow-up, favorable outcome was achieved by 268 (53.1%) patients (5-year probability, 50% [95% CI, 45%-55%]) and obliteration by 300 (59.4%) patients (5-year probability, 56% [95% CI, 51%-61%]). Twenty-eight patients (5.6%) experienced post-SRS hemorrhage with an annual incidence rate of 1.38 per 100 patient-years. Symptomatic radiation-induced changes were evident in 28 (5.6%) patients, with most occurring in the first 3 years. Larger nidus volumes (between 2 and 4 cm3, subdistribution hazard, 0.61 [95% CI, 0.44-0.86]; P=0.005; >4 cm3, subdistribution hazard, 0.47 [95% CI, 0.32-0.7]; P<0.001) and brainstem/basal ganglia involvement (subdistribution hazard, 0.6 [95% CI, 0.45-0.81]; P<0.001) were associated with reduced probability of favorable outcome. CONCLUSIONS: Repeat SRS confers reasonable obliteration rates with a low complication risk. With most complications occurring in the first 3 years, extending the latency period to 5 years generally increases the rate of favorable patient outcomes and reduces the necessity of a third intervention.

Stabilizing Copper by a Reconstruction-Resistant Atomic Cu-O-Si Interface for Electrochemical CO2 Reduction.

Copper (Cu), a promising catalyst for electrochemical CO2 reduction (CO2R) to multi-electron reduction products, suffers from an unavoidable and uncontrollable reconstruction process during the reaction, which not only may lead to catalyst deactivation but also brings great challenges to the exploration of the structure-performance relationship. Herein, we present an efficient strategy for stabilizing Cu with silica and synthesize reconstruction-resistant CuSiOx amorphous nanotube catalysts with abundant atomic Cu-O-Si interfacial sites. The strong interfacial interaction between Cu and silica makes the Cu-O-Si interfacial sites ultrastable in the CO2R reaction without any apparent reconstruction, thus exhibiting high CO2-to-CH4 selectivity (72.5%) and stability (FECH4 remains above 60% after 12 h of test). A remarkable CO2-to-CH4 conversion rate of 0.22 µmol cm-2 s-1 was also achieved in a flow cell device. This work provides a very promising route for the design of highly active and stable Cu-based CO2R catalysts.

Engineering Molecular Heterostructured Catalyst for Oxygen Reduction Reaction.

Introducing a second metal species into atomically dispersed metal-nitrogen-carbon (M-N-C) catalysts to construct diatomic sites (DASs) is an effective strategy to elevate their activities and stabilities. However, the common pyrolysis-based method usually leads to substantial uncertainty for the formation of DASs, and the precise identification of the resulting DASs is also rather difficult. In this regard, we developed a two-step specific-adsorption strategy (pyrolysis-free) and constructed a DAS catalyst featuring FeCo "molecular heterostructures" (FeCo-MHs). In order to rule out the possibility of the two apparently neighboring (in the electron microscopy image) Fe/Co atoms being dispersed respectively on the top/bottom surfaces of the carbon support and thus forming "false" MHs, we conducted in situ rotation (by 8°, far above the critical angle of 5.3°) and directly identified the individual FeCo-MHs. The formation of FeCo-MHs could modulate the magnetic moments of the metal centers and increase the ratio of low-spin Fe(II)-N4 moiety; thus the intrinsic activity could be optimized at the apex of the volcano-plot (a relationship as a function of magnetic moments of metal-phthalocyanine complexes and catalytic activities). The FeCo-MHs catalyst displays an exceptional ORR activity (E1/2 = 0.95 V) and could be used to construct high-performance cathodes for hydroxide exchange membrane fuel cells and zinc-air batteries.

Photocurrent Polarity Reversal Induced by Electron-Donor Release for the Highly Sensitive Photoelectrochemical Detection of Vascular Endothelial Growth Factor 165.

Photocurrent polarity reversal is a switching process between the anodic and cathodic pathways and is critical for eliminating false positivity and improving detection sensitivity in photoelectrochemical (PEC) sensing. In this study, we construct a PEC sensor with excellent photocurrent polarity reversal induced by ascorbic acid (AA) as an electron donor with the energy level matching the photoactive material zirconium metal-organic framework (ZrMOF). The ZrMOF-modified electrode demonstrates cathodic photocurrent in the presence of O2 as an electron acceptor, while the anodic photocurrent is generated in the presence of AA, achieving photocurrent polarity reversal. By the in situ release of AA from AA-encapsulated apoferritin modified with DNA 2 (AA@APO-S2) as a detection tag in the presence of trypsin after the recognition of hairpin DNA-modified indium tin oxide to the reaction product of aptamer/DNA 1 with the target protein and the following rolling cycle amplification for introducing the detection tag to the sensing interface, the reversed photocurrent shows an enhanced photocurrent response to the target protein, leading to a highly sensitive PEC sensing strategy. This strategy realizes the detection of vascular endothelial growth factor 165 with good specificity, a wide linear range, and a low detection limit down to 5.3 fM. The actual sample analysis offers the detection results of the proposed PEC sensor comparable to those of commercial enzyme-linked immunosorbent assay tests, indicating the promising application of the photocurrent polarity reversal-based PEC sensing strategy in biomolecule detection and clinical diagnosis.