Optimized Intermediates Adsorption Configuration on Co-Doped Fe2 P@NiP2 Heterojunction Interface for Enhanced Electrocatalytic Nitrate-To-Ammonia Conversion.

The extraction of ammonia (NH3 ) through electrocatalytic nitrate reduction reaction (NO3 - RR) represents a sustainable avenue in NH3 generation and utilization. However, the catalytic efficiency of the NO3 - RR is hindered by the sluggish kinetics. This study first theoretically found that phosphide-based heterostructure can alter the adsorption structure of intermediates in the nitrate-to-ammonia process, thereby achieving precise regulation of the energy barrier in the rate-determining step. Based on theoretical design, a novel Co-doped Fe2 P@NiP2 heterojunction catalyst is successfully synthesized, which deliver a notable NH3 yield rate of 0.395 mmol h-1  cm-2 at -0.7 V versus RHE, as well as a remarkable ammonia Faraday efficiency of 97.2% at -0.6 V versus RHE. Experimental and theoretical results further confirm that redistributing electrons and shifting the center of the d-band upwards through interfacial doping modulate intermediates adsorption strength and inhibition of hydrogen evolution, leading to excellent performance in NO3 - -to-NH3 . Further integrating the Co-Fe2 P@NiP2 catalyst into a Zn-nitrate battery exhibits a substantial voltage output of 1.49 V and a commendable power density of 13.2 mW cm-2 . The heteroatom-doped heterojunction strategy provides a versatile route for developing advanced catalysts, thereby broadening the horizons of electrocatalytic methodologies for nitrate reduction and ammonia synthesis.

Electrochemical Oxidation Enables Radical Dearomative Spiroannulation to 2H-Spiro[benzofuran-3,9'-fluoren]-2-one.

Developing pragmatic strategies for accessing functional benzofuran-2-ones from 3-([1,1'-biphenyl]-2-yl)benzofuran remains an enduring challenge. Herein, we have achieved a highly discriminating electrochemical oxidative dearomative spiroannulation of 3-([1,1'-biphenyl]-2-yl)benzofuran, culminating in the synthesis of 2H-spiro[benzofuran-3,9'-fluoren]-2-one derivatives. By harnessing the electrophilic intermediates of benzofuryl radical cations supported by DFT calculations, we attain exceptional regioselectivity while eliminating the need for stoichiometric oxidants. Mechanistic investigations reveal a sequence of events involving the benzofuran radical cation, encompassing the capture of H2O, nucleophilic arene attack, and subsequent deprotonation, ultimately yielding the final benzofuran-2-ones.

Effects of age and disease duration on the efficacy and safety of iGlarLixi in Asian people with type 2 diabetes: A post hoc analysis of the LixiLan-O-AP and LixiLan-L-CN trials.

AIM: To evaluate the effect of age and disease duration on the efficacy and safety of iGlarLixi versus insulin glargine 100 units/ml (iGlar) or lixisenatide (Lixi) alone in Asian people with type 2 diabetes (T2D) uncontrolled on oral antidiabetic drugs (LixiLan-O-AP) or basal insulin ± oral antidiabetic drugs (LixiLan-L-CN). MATERIALS AND METHODS: In this post hoc analysis, the glycated haemoglobin (HbA1c) changes were assessed from baseline to week 24 (LixiLan-O-AP) or 30 (LixiLan-L-CN) in subgroups defined by baseline age (<65, ≥65 years) and duration of T2D. The proportion who achieved the composite of HbA1c <7% (<53.0 mmol/mol) without weight gain and without symptomatic hypoglycaemia (plasma glucose ≤3.9 mmol/L) and the incidences of hypoglycaemia and gastrointestinal disorders were also analysed. RESULTS: HbA1c reductions were consistently greater with iGlarLixi versus iGlar or Lixi across all subgroups, including participants aged ≥65 years and those with T2D for ≥15 or ≥20 years. Greater proportions of participants achieved HbA1c <7% (<53.0 mmol/mol) without weight gain or hypoglycaemia with iGlarLixi versus iGlar or Lixi, regardless of age or T2D duration. Hypoglycaemia incidence was similar with iGlarLixi versus iGlar across most subgroups; the incidence of gastrointestinal disorders was lower with iGlarLixi versus Lixi in all subgroups. CONCLUSIONS: iGlarLixi showed consistent efficacy and safety across all age and disease duration subgroups in Asian people with uncontrolled T2D, including older individuals and those with longstanding disease.

Efficacy and safety of intragastric expandable oral capsules in adults with overweight or obesity: A randomized, double-blind, placebo-controlled trial.

AIM: This trial assessed the efficacy and safety of 2.24 g intragastric expandable capsules twice per day versus placebo for weight management in adults with overweight or obesity. METHODS: This double-blind, placebo-controlled study included adults with a body mass index of at least 24 kg/m2 and no more than 40 kg/m2 . In total, 280 participants were recruited from six hospitals in China and were assigned in a 1:1 ratio to receive 2.24 g oral intragastric expandable capsules or placebo for 24 weeks. Coprimary endpoints were the percentage change in body weight from baseline and the rate of weight reduction of ≥5%, assessed using both the full analysis set and per protocol set. RESULTS: At baseline, the mean body weight was 81.8 kg, and the mean body mass index was 29.4 kg/m2 . The mean body weight change at week 24 was -4.9% with intragastric expandable capsules versus -1.9% with placebo [estimated treatment difference (ETD) -3.0%, 95% confidence interval (CI) -4.1 to -1.9; p < .001] using the full analysis set and -6.1% versus -2.5% (ETD -3.6%, 95% CI -5.0 to -2.3; p < .001), respectively, using the per protocol set. The percentage of participants who had weight loss exceeding 5% was 45.0% in the intragastric expandable capsule group versus 19.7% in the placebo group (ETD 25.3%, 95% CI 14.7-35.9; p < .001) in the full analysis set and 55.9% versus 26.2% (ETD 29.6%, 95% CI 17.1-42.2; p < .001), respectively, in the per protocol set. Waist circumference significantly decreased at week 24 (intragastric expandable capsules vs. placebo: -5.6 ± 8.3 cm vs. -2.9 ± 4.8 cm; p = .003). The most common adverse events associated with the use of intragastric expandable capsules were gastrointestinal disorders (intragastric expandable capsule vs. placebo, 25.0% vs. 21.9%), and most were mild and transient. CONCLUSIONS: In this 24-week trial including participants with overweight or obesity, 2.24 g of intragastric expandable capsules twice daily led to a clinically meaningful reduction in body weight compared with placebo.

Prusogliptin (DBPR108) monotherapy in treatment-naïve patients with type 2 diabetes: A randomized, double-blind, active and placebo-controlled, phase 3 study.

AIM: This study aimed to assess the efficacy and safety of prusogliptin (DBPR108), a novel and highly selective dipeptidyl peptidase-4 inhibitor, in individuals with type 2 diabetes who had not been using glucose-lowering agents regularly for the 8 weeks before the screening period. MATERIALS AND METHODS: In this multicentre, randomized, double-blind, phase 3 study, adult patients with type 2 diabetes were randomly assigned to receive either DBPR108 100 mg, sitagliptin 100 mg, or placebo once daily during the initial 24-week double-blind treatment period, followed by a 28-week open-label extension period during which all patients received DBPR108 100 mg once daily. The primary endpoint was the mean change in glycated haemoglobin (HbA1c) levels from baseline to week 24. RESULTS: In total, 766 patients were enrolled and received DBPR108 100 mg (n = 462), sitagliptin 100 mg (n = 152), or placebo (n = 152). The mean age of all patients was 54.3 ± 10.5 years, with 58% being men. The median duration of type 2 diabetes was 0.38 (0.02, 2.65) years, and the mean HbA1c (SD) at baseline was 7.94% (0.62), 7.88% (0.61) and 7.83% (0.59) for DBPR108, sitagliptin and placebo groups, respectively. At week 24, the least square mean (SE) changes from baseline in HbA1c were -0.63% (0.04%) for DBPR108, -0.60% (0.07%) for sitagliptin and -0.02% (0.07%) for placebo. The mean treatment difference between DBPR108 and placebo was -0.61% (95% CI -0.77% to -0.44%), and between DBPR108 and sitagliptin was -0.03% (95% CI -0.19% to 0.13%). These results indicate that DBPR108 was superior to placebo and non-inferior to sitagliptin. DBPR108 also significantly reduced fasting and postprandial plasma glucose levels and had little effect on body weight. The mean (SD) changes in HbA1c from baseline to week 52 were -0.50% (0.97%) for the DBPR108 group, -0.46% (0.96%) for the sitagliptin group and -0.41% (0.95%) for the placebo group. The incidence of adverse events was comparable across all three groups. CONCLUSIONS: DBPR108 showed superiority to placebo and non-inferiority to sitagliptin in terms of glycaemic control over the initial 24 weeks in treatment-naïve patients with type 2 diabetes. Furthermore, its efficacy was sustained for up to 52 weeks.

Tunable multiple nonvolatile resistance states in a MnSe-based van der Waals multiferroic tunnel junction.

Two-dimensional (2D) van der Waals (vdW) multiferroic tunnel junctions (MFTJs) composed of a ferromagnetic metal and a ferroelectric barrier have controllable thickness and clean interface and can realize the coexistence of tunneling magnetoresistance (TMR) and tunneling electroresistance (TER). Therefore, they have enormous potential application in nonvolatile multistate memories. Here, using first principles combined with non-equilibrium Green's function method, we have systematically investigated the spin-dependent transport properties of Fe3GeTe2/MnSe/Fe3GeTe2 vdW MFTJs with various numbers of barrier layers. By controlling the polarization orientation of the ferroelectric barrier MnSe and the magnetization alignment of the ferromagnetic electrodes Fe3GeTe2, the MnSe-based MFTJs exhibit four nonvolatile resistance states, with the TMR (TER) becoming higher and reaching a maximum of 1.4 × 106% (4114%) as the MnSe layers increase from a bilayer to a tetralayer. Using asymmetric Cu and Fe3GeTe2 as the electrodes, the TER can be further improved from 349% to 618%. Moreover, there is a perfect spin filtering effect in these MFTJs. This work demonstrates the potential applications of MnSe-based devices in multistate nonvolatile memories and spin filters, which will stimulate experimental studies on layer-controllable spintronic devices.

Dynamics of Information Flow and Task Allocation of Social Insect Colonies: Impacts of Spatial Interactions and Task Switching.

Models of social interaction dynamics have been powerful tools for understanding the efficiency of information spread and the robustness of task allocation in social insect colonies. How workers spatially distribute within the colony, or spatial heterogeneity degree (SHD), plays a vital role in contact dynamics, influencing information spread and task allocation. We used agent-based models to explore factors affecting spatial heterogeneity and information flow, including the number of task groups, variation in spatial arrangements, and levels of task switching, to study: (1) the impact of multiple task groups on SHD, contact dynamics, and information spread, and (2) the impact of task switching on SHD and contact dynamics. Both models show a strong linear relationship between the dynamics of SHD and contact dynamics, which exists for different initial conditions. The multiple-task-group model without task switching reveals the impacts of the number and spatial arrangements of task locations on information transmission. The task-switching model allows task-switching with a probability through contact between individuals. The model indicates that the task-switching mechanism enables a dynamical state of task-related spatial fidelity at the individual level. This spatial fidelity can assist the colony in redistributing their workforce, with consequent effects on the dynamics of spatial heterogeneity degree. The spatial fidelity of a task group is the proportion of workers who perform that task and have preferential walking styles toward their task location. Our analysis shows that the task switching rate between two tasks is an exponentially decreasing function of the spatial fidelity and contact rate. Higher spatial fidelity leads to more agents aggregating to task location, reducing contact between groups, thus making task switching more difficult. Our results provide important insights into the mechanisms that generate spatial heterogeneity and deepen our understanding of how spatial heterogeneity impacts task allocation, social interaction, and information spread.

Exposure to a mixture of metal(loid)s and sleep quality in pregnant women during early pregnancy: A cross-sectional study.

Biological characteristics of pregnant women during early pregnancy make them susceptible to both poor sleep quality and metal/metalloid exposure. However, the effects of metal(loid) exposure on sleep quality in pregnant women remain unknown and unexplored. We aimed to examine the relationship between exposure to a mixture of metal(loid)s and pregnant women's sleep quality during early pregnancy. We recruited 493 pregnant women in the first trimester from prenatal clinics in Jinan, Shandong Province, China, and collected their spot urine samples. All urine specimens were assessed for eight metal(loid)s: arsenic (As), cadmium (Cd), iron (Fe), zinc (Zn), molybdenum (Mo), lead (Pb), selenium (Se), and mercury (Hg). We used the Pittsburgh Sleep Quality Index (PSQI) to assess sleep quality. Linear regression, logistic regression, generalized additive models (GAMs), quantile g-computation, and Bayesian kernel machine regression (BKMR) were applied to investigate the relationships between metal(loid) exposure and sleep quality. The results from single metal(loid) models, quantile g-computation models, and BKMR models consistently suggested that Fe was positively related to women's sleep quality. Moreover, in the quantile g-computation models, As was the most critical contributor to the negative effects of the metal(loid) mixture on sleep quality. In addition, we found significant As by Fe interaction for scores of PSQI and habitual sleep efficiency, Pb by Fe interaction for PSQI and sleep latency, and Hg by Fe interaction for PSQI, suggesting the interactive effects of As and Fe, Pb and Fe, Hg and Fe on sleep quality and specific sleep components. Our study provided the first-hand evidence of the effects of metal(loid) exposure on pregnant women's sleep quality. The underlying mechanisms need to be explored in the future.

Preoperative EABR evaluation of auditory pathway integrity in patients with different etiology and postoperative effect estimation.

OBJECTIVES: To evaluate the effect of electrical auditory brainstem response (EABR) on the integrity evaluation of auditory pathway and the prediction of postoperative effect of cochlear implantation in patients with different etiology of hearing loss. METHODS: A total of 580 patients with neuropathic deafness who underwent cochlear implantation surgery from August 2011 to December 2020 were selected for EABR test. The preoperative EABR waveform was analyzed, and parameters such as V wave amplitude, threshold, latency and interval of each wave, and slope of V wave I/O curve were measured. Neural response telemetry (NRT) test was performed during MAP 1 month after operation, and C and T values of the machine were recorded. RESULTS: The total EABR extraction rate was 98.45% among 580 patients, including 100% for the normal structure group and enlarged vestibular aqueduct group (LVAS), 92.44% for other malformed group. The average threshold of V wave in patients with normal cochlear structure was significantly better than the malformation groups (p < 0.05). The total extraction rate of NRT was 78.62%, including 99.72% in the group with normal structure, 95.65% in the LVAS group, 1.85-88.24% in the group with other malformations, and 0% in the cochlear ossification group. The correlation analysis showed a statistically significant correlation between the average preoperative EABR threshold and the C value of NRT. CONCLUSIONS: Preoperative EABR could evaluate the integrity of auditory conduction pathway of patients with cochlear implantation and predict the postoperative hearing rehabilitation effect.

Effects of Fe-N co-modified biochar on methanogenesis performance, microbial community, and metabolic pathway during anaerobic co-digestion of alternanthera philoxeroides and cow manure.

The performance of anaerobic digestion (AD) is susceptible to disturbances in feedstock degradation, intermediates accumulation, and methanogenic archaea activity. To improve the methanogenesis performance of the AD system, Fe-N co-modified biochar was prepared under different pyrolysis temperatures (300,500, and 700 °C). Meanwhile, pristine and Fe-modified biochar were also derived from alternanthera philoxeroides (AP). The aim was to compare the effects of Fe-N co-modification, Fe modification, and pristine biochar on the methanogenic performance and explicit the responding mechanism of the microbial community in anaerobic co-digestion (coAD) of AP and cow manure (CM). The highest cumulative methane production was obtained with the addition of Fe-N-BC500 (260.38 mL/gVS), which was 42.37 % higher than the control, while the acetic acid, propionic acid, and butyric acid concentration of Fe-N-BC were increased by 147.58 %, 44.25 %, and 194.06 % compared with the control, respectively. The co-modified biochar enhanced the abundance of Chloroflexi and Methanosarcina in the AD system. Metabolic pathway analysis revealed that the increased methane production was related to the formation and metabolism of volatile fatty acids and that Fe-N-BC500 enhanced the biosynthesis of coenzyme A and the cell activity of microorganisms, accelerating the degradation of propionic acid and enhancing the hydrogenotrophic methanogenesis pathway. Overall, Fe-N co-modified biochar was proved to be an effective promoter for accelerated methane production during AD.

Constructing Ru@C3 N4 /Cu Tandem Electrocatalyst with Dual-Active Sites for Enhanced Nitrate Electroreduction to Ammonia.

Electroreduction of nitrate to ammonia reaction (NO3 - RR) is considered as a promising carbon-free energy technique, which can eliminate nitrate from waste-water also produce value-added ammonia. However, it remains a challenge for achieving satisfied ammonia selectivity and Faraday efficiency (FE) due to the complex multiple-electron reduction process. Herein, a novel Tandem electrocatalyst that Ru dispersed on the porous graphitized C3 N4 (g-C3 N4 ) encapsulated with self-supported Cu nanowires (denoted as Ru@C3 N4 /Cu) for NO3 - RR is presented. As expected, a high ammonia yield of 0.249 mmol h-1  cm-2 at -0.9 V and high FENH3 of 91.3% at -0.8 V versus RHE can be obtained, while achieving excellent nitrate conversion (96.1%) and ammonia selectivity (91.4%) in neutral solution. In addition, density functional theory (DFT) calculations further demonstrate that the superior NO3 - RR performance is mainly resulted from the synergistic effect between the Ru and Cu dual-active sites, which can significantly enhance the adsorption of NO3 - and facilitate hydrogenation, as well as suppress the hydrogen evolution reaction, thus lead to highly improved NO3 - RR performances. This novel design strategy would pave a feasible avenue for the development of advanced NO3 - RR electrocatalysts.

Bioinspired Dual-Mode Stretchable Strain Sensor Based on Magnetic Nanocomposites for Strain/Magnetic Discrimination.

Recently, flexible stretchable sensors have been gaining attention for their excellent adaptability for electronic skin applications. However, the preparation of stretchable strain sensors that achieve dual-mode sensing while still retaining ultra-low detection limit of strain, high sensitivity, and low cost is a pressing task. Herein, a high-performance dual-mode stretchable strain sensor (DMSSS) based on biomimetic scorpion foot slit microstructures and multi-walled carbon nanotubes (MWCNTs)/graphene (GR)/silicone rubber (SR)/Fe3 O4 nanocomposites is proposed, which can accurately sense strain and magnetic stimuli. The DMSSS exhibits a large strain detection range (≈160%), sensitivity up to 100.56 (130-160%), an ultra-low detection limit of strain (0.16% strain), and superior durability (9000 cycles of stretch/release). The sensor can accurately recognize sign language movement, as well as realize object proximity information perception and whole process information monitoring. Furthermore, human joint movements and micro-expressions can be monitored in real-time. Therefore, the DMSSS of this work opens up promising prospects for applications in sign language pose recognition, non-contact sensing, human-computer interaction, and electronic skin.

Over 50 W all-fiber mid-infrared supercontinuum laser.

Broadband supercontinuum laser sources in the mid-infrared region have attracted enormous interest and found significant applications in spectroscopy, imaging, sensing, defense, and security. Despite recent advances in mid-infrared supercontinuum laser sources using infrared fibers, the average power of those laser sources is limited to 10-watt-level, and further power scaling to over 50 W (or hundred-watt-level) remains a significant technological challenge. Here, we report an over 50 W all-fiber mid-infrared supercontinuum laser source with a spectral range from 1220 to 3740 nm, by using low loss (<0.1 dB/m) fluorotellurite fibers we developed as the nonlinear medium and a tilted fusion splicing method for reducing the reflection from the fluorotellurite-silica fiber joint. Furthermore, the scalability of all-fiber mid-infrared supercontinuum laser sources using fluorotellurite fibers is analyzed by considering thermal effects and optical damage, which verifies its potential of power scaling to hundred-watt-level. Our results pave the way for realizing all-fiber hundred-watt-level mid-infrared lasers for real applications.

iGlarLixi provides a higher derived time-in-range versus insulin glargine 100 U/mL or lixisenatide in Asian Pacific people with type 2 diabetes: A post hoc analysis.

AIM: To evaluate the efficacy of iGlarLixi in the Asian Pacific (AP) population with type 2 diabetes (T2D) using derived time-in-ranges calculated from seven-point self-measured blood glucose. METHODS: Two phase III trials were analysed. LixiLan-O-AP was performed in insulin-naive T2D patients (n = 878) randomized to iGlarLixi, glargine 100 units/mL (iGlar) or lixisenatide (Lixi). LixiLan-L-CN was performed in insulin-treated T2D patients (n = 426) randomized to iGlarLixi or iGlar. Changes in derived time-in-ranges from baseline to end-of-treatment (EOT) and estimated treatment differences (ETDs) were analysed. The proportions of patients achieving 70% or higher derived time-in-range (dTIR), 5% or higher dTIR improvement, and the composite triple target (≥ 70% dTIR, < 4% derived time-below-the-range [dTBR] and < 25% derived time-above-the-range [dTAR]) were calculated. RESULTS: The changes from baseline to EOT in dTIR with iGlarLixi were greater versus iGlar (ETD1 : 11.45% [95% CI, 7.66% to 15.24%]) or Lixi (ETD2 : 20.54% [95% CI, 15.74% to 25.33%]) in LixiLan-O-AP, and versus iGlar (ETD: 16.59% [95% CI, 12.09% to 21.08%]) in LixiLan-L-CN. In LixiLan-O-AP, the proportions of patients achieving 70% or higher dTIR or 5% or higher dTIR improvement at EOT with iGlarLixi were 77.5% and 77.8%, respectively, higher than with iGlar (61.1% and 75.3%) or Lixi (47.0% and 53.0%). In LixiLan-L-CN, the proportions of patients achieving 70% or higher dTIR or 5% or higher dTIR improvement at EOT were 71.4% and 59.8% with iGlarLixi, greater than with iGlar (45.4% and 39.5%). More patients achieved the triple target with iGlarLixi compared with iGlar or Lixi. CONCLUSION: iGlarLixi achieved greater improvements in dTIR parameters versus iGlar or Lixi in insulin-naïve and insulin-experienced AP people with T2D.

In Vitro and In Vivo Antitumor Assay of Mitochondrially Targeted Fluorescent Half-Sandwich Iridium(III) Pyridine Complexes.

Half-sandwich iridium(III) complexes show potential value in the anticancer field. However, complexes with favorable luminescence performance are rare, which limits further investigation of the anticancer mechanism. In this paper, 10 triphenylamine-modified fluorescent half-sandwich iridium(III) pyridine complexes {[(η5-Cpx)Ir(L)Cl2]} (Ir1-Ir10) were prepared and showed potential antiproliferative activity, effectively inhibiting the migration of A549 cells. Ir6, showing the best activity among these complexes, exhibited excellent fluorescence performance (absolute fluorescence quantum yield of 15.17%) in solution. Laser confocal detection showed that Ir6 followed an energy-dependent cellular uptake mechanism, specifically accumulating in mitochondria (Pearson co-localization coefficient of 0.95). A Western blot assay further confirmed the existence of a mitochondrial apoptotic channel. Additionally, Ir6 could arrest the cell cycle at the G2/M phase, catalyze NADH oxidation, reduce the mitochondrial membrane potential, induce an increase in the level of intracellular reactive oxygen species, and exhibit a mechanism of oxidation. An in vivo antitumor assay confirmed that Ir6 can effectively inhibit tumor growth and is safer than cisplatin.

Bioinspired Engineering of Fillable Gradient Structure into Flexible Capacitive Pressure Sensor Toward Ultra-High Sensitivity and Wide Working Range.

Tactile sensing is required for electronic skin and intelligent robots to function properly. However, the dielectric layer's poor structural compressibility in conventional pressure sensors results in a limited pressure sensing range and low sensitivity. To solve this issue, a flexible pressure sensor with a crocodile-inspired fillable gradient structure is provided. The fillable gradient structure and grooves in the pressure sensor accommodate the deformed microstructure that permits the enhancement of the media layer compressibility via COMSOL finite element simulation and optimization. The pressure sensor exhibits a high sensitivity of up to 0.97 k Pa-1 (0-4 kPa), a wide pressure detection range (7 Pa-380 kPa), and outstanding repeatability. The sensor can detect Morse code, robotic grabbing, and human motion monitoring. As a result, flexible sensors with a bionic fillable gradient structure pave the way for wearable devices and offer a novel method for achieving highly precise tactile perception.

The pure spin current and fully spin-polarized current induced by the photogalvanic effect and spin-Seebeck effect in halogen-decorated phosphorene.

The control of spin transport is a fundamental but crucial task in spintronics and realization of high spin polarization transport and pure spin currents is particularly desired. By combining the non-equilibrium Green's function with first principles calculations, it is shown that halogen adsorption can transform a black phosphorene monolayer from a nonmagnetic semiconductor to a magnetic semiconductor with two almost symmetric spin-split states near the Fermi level, which provides two isolated transport channels. Further investigations demonstrate that a device based on halogen-decorated phosphorene can behave multifunctionally, where a pure spin photocurrent and a fully spin-polarized photocurrent can be effectively controlled by tuning the photon energy or polarization angle of the incident light. In addition, pure spin current can also be induced by a temperature gradient, resulting in a perfect spin Seebeck effect. This work demonstrates that the halogen-decorated phosphorene systems have potential applications of high integration density and low energy dissipation in two-dimensional spintronic devices.

Effect of Artificial Intelligence-based Health Education Accurately Linking System (AI-HEALS) for Type 2 diabetes self-management: protocol for a mixed-methods study.

BACKGROUND: Patients with type 2 diabetes (T2DM) have an increasing need for personalized and Precise management as medical technology advances. Artificial intelligence (AI) technologies on mobile devices are being developed gradually in a variety of healthcare fields. As an AI field, knowledge graph (KG) is being developed to extract and store structured knowledge from massive data sets. It has great prospects for T2DM medical information retrieval, clinical decision-making, and individual intelligent question and answering (QA), but has yet to be thoroughly researched in T2DM intervention. Therefore, we designed an artificial intelligence-based health education accurately linking system (AI-HEALS) to evaluate if the AI-HEALS-based intervention could help patients with T2DM improve their self-management abilities and blood glucose control in primary healthcare. METHODS: This is a nested mixed-method study that includes a community-based cluster-randomized control trial and personal in-depth interviews. Individuals with T2DM between the ages of 18 and 75 will be recruited from 40-45 community health centers in Beijing, China. Participants will either receive standard diabetes primary care (SDPC) (control, 3 months) or SDPC plus AI-HEALS online health education program (intervention, 3 months). The AI-HEALS runs in the WeChat service platform, which includes a KBQA, a system of physiological indicators and lifestyle recording and monitoring, medication and blood glucose monitoring reminders, and automated, personalized message sending. Data on sociodemography, medical examination, blood glucose, and self-management behavior will be collected at baseline, as well as 1,3,6,12, and 18 months later. The primary outcome is to reduce HbA1c levels. Secondary outcomes include changes in self-management behavior, social cognition, psychology, T2DM skills, and health literacy. Furthermore, the cost-effectiveness of the AI-HEALS-based intervention will be evaluated. DISCUSSION: KBQA system is an innovative and cost-effective technology for health education and promotion for T2DM patients, but it is not yet widely used in the T2DM interventions. This trial will provide evidence on the efficacy of AI and mHealth-based personalized interventions in primary care for improving T2DM outcomes and self-management behaviors. TRIAL REGISTRATION: Biomedical Ethics Committee of Peking University: IRB00001052-22,058, 2022/06/06; Clinical Trials: ChiCTR2300068952, 02/03/2023.

Evaluation of auditory pathway by EABR before cochlear implantation and the postoperative effect analysis.

OBJECTIVE: To investigate the evaluation value of electrically evoked auditory brainstem response (EABR) monitoring before cochlear implantation in patients with cochlear nerve defects (CND). METHODS: A total of 54 patients with cochlear nerve defects who underwent cochlear implantation in our hospital from 2011 to 2018 were selected as the CND group, and 20 patients with normal cochlear implantation were selected as the control group. The preoperative audiological characteristics, EABR characteristics and follow-up neural response telemetry results of the two groups were retrospectively analysed, and the preoperative EABR threshold and initiation C value were subjected to linear regression and correlation analysis. RESULTS: The EABR waveform of the CND group was significantly different from the control group in terms of average wave V threshold, average dynamic range and V-wave I/O curve slope (P < 0.05). Average C value and dynamic range had a statistically significant difference from the control group (P < 0.05). Statistically significant positive correlations were found between the EABR threshold and C value, wave V I/O slope and postoperative category of auditory perception (P < 0.05). CONCLUSIONS: The EABR test can be used to evaluate the auditory pathway function before cochlear implantation and its postoperative effect in patients with CND.

Immune Checkpoint Inhibitor-related New-onset Thyroid Dysfunction: A Retrospective Analysis Using the US FDA Adverse Event Reporting System.

OBJECTIVES: The study aimed to investigate the prevalence and demographic characteristics of an immune checkpoint inhibitor (ICI)-related thyroid dysfunction (ICI-TD), and to explore risk factors of poor clinical outcome using data from the US Food and Drug Administration (FDA) Adverse Event Reporting System (FAERS). METHODS: This is a retrospective study. All cases, aged over 18-year olds, of new-onset or new-diagnosed thyroid dysfunction related to FDA-approved ICIs from January 1, 2011 to December 31, 2020 were identified using FAERS. Data of age, gender, other combined endocrinopathies related to ICIs besides ICI-TDs, and the prognosis was analyzed. RESULTS: In total, 2.60% (2971/114 121) cases of ICI-TDs were identified. Among them, 1842 (62.0%) developed hypothyroidism, 675 (22.7%) were hyperthyroidism, and 454 (15.3%) presented in thyroiditis without the mention of thyroid function. Patients on anti- programmed cell death protein-1 (PD-1) therapy displayed higher risk of hypothyroidism compared with other 3 regimens, respectively (P < .01 for all). The likelihood of other immune-related endocrinopathies in patients on the combination therapy of anti-cytotoxic T-cell-associated protein-4 (CTLA-4) and anti-PD-1 was significantly elevated than anti-PD-1 (odds ratio [OR] 2.362, 95% confidence interval [CI] [1.925-2.898], P < .001) and anti-programmed death-ligand 1 (PD-L1) regimens (OR 4.857, 95%CI [3.228-7.308], P < .001). The risk of severe cases was positively related to hypothyroidism in individuals on anti-PD-1 therapy (OR 1.587, 95%CI [1.146-2.197], P = .005) and those on anti-CTLA-4 therapy (OR 3.616, 95%CI [1.285-10.171], P = .015). The risk of severe cases was positively associated with the comorbidity with other endocrinopathies (anti-PD-1 group, OR 0.285, 95%CI [0.200-0.467], P < .001; anti-PD-1+anti-CTLA-4 group, OR 0.574, 95%CI [0.371-0.890], P = .013). CONCLUSIONS: Regular monitor of thyroid function is indispensable, since ICI-TDs manifested as hypothyroidism or hyperthyroidism, especially those on the combination therapy. Awareness among health care professionals is critical when hypothyroidism occurs, which might indicate poor clinical outcomes.