Changes of PK/PD of Meropenem in patients with abdominal septic shock and exploration of clinical rational administration plan: a prospective exploratory study.

This study aimed to explore the changes of pharmacokinetic parameters after meropenem in patients with abdominal septic shock after gastrointestinal perforation, and to simulate the probability of different dosing regimens achieving different pharmacodynamic goals. The study included 12 patients, and utilized high performance liquid chromatography-tandem mass spectrometry to monitor the plasma concentration of meropenem. The probability of target attainment (PTA) for different minimum inhibitory concentration (MIC) values and %fT > 4MIC was compared among simulated dosing regimens. The results showed that in 96 blood samples from 12 patients, the clearance (CL) of meropenem in the normal and abnormal creatinine clearance subgroups were 7.7 ± 1.8 and 4.4 ± 1.1 L/h, respectively, and the apparent volume of distribution (Vd) was 22.6 ± 5.1 and 17.2 ± 5.8 L, respectively. 2. Regardless of the subgroup, 0.5 g/q6h infusion over 6 h regimen achieved a PTA > 90% when MIC ≤ 0.5 mg/L. 1.0 g/q6h infusion regimen compared with other regimen, in most cases, the probability of making PTA > 90% is higher. For patients at low MIC, 0.5 g/q6h infusion over 6 h may be preferable. For patients at high MIC, a dose regimen of 1.0 g/q6 h infusion over 6 h may be preferable. Further research is needed to confirm this exploratory result.

A bias voltage controlled electrode-molecule interface in single-molecule junctions.

Tuning the electrode-molecule interface stands at the heart of functional single-molecule devices. Herein, we report that the electrode-molecule interface of difluoro-substituted benzothiadiazole (FBTZ)-based single-molecule junctions can be modulated by the bias voltage. At low bias voltage (100 mV), the dative Au-N linkage is formed and at high bias voltage (600 mV), a covalent Au-C linkage is constructed. These junctions show distinct conductance. Interestingly, dominant charge carriers in Au-N- and Au-C-based junctions are different, as evidenced by dft calculations. These results provide a new strategy for regulating the electrode-molecule interface, which will advance the development of molecular electronics.

SIEVE: One-stop differential expression, variability, and skewness analyses using RNA-Seq data.

Motivation: RNA-Seq data analysis is commonly biased towards detecting differentially expressed genes and insufficiently conveys the complexity of gene expression changes between biological conditions. This bias arises because discrete models of RNA-Seq count data cannot fully characterize the mean, variance, and skewness of gene expression distribution using independent model parameters. A unified framework that simultaneously tests for differential expression, variability, and skewness is needed to realize the full potential of RNA-Seq data analysis in a systems biology context. Results: We present SIEVE, a statistical methodology that provides the desired unified framework. SIEVE embraces a compositional data analysis framework that transforms discrete RNA-Seq counts to a continuous form with a distribution that is well-fitted by a skew-normal distribution. Simulation results show that SIEVE controls the false discovery rate and probability of Type II error better than existing methods for differential expression analysis. Analysis of the Mayo RNA-Seq dataset for Alzheimer's disease using SIEVE reveals that a gene set with significant expression difference in mean, standard deviation and skewness between the control and the Alzheimer's disease group strongly predicts a subject's disease state. Furthermore, functional enrichment analysis shows that relying solely on differentially expressed genes detects only a segment of a much broader spectrum of biological aspects associated with Alzheimer's disease. The latter aspects can only be revealed using genes that show differential variability and skewness. Thus, SIEVE enables fresh perspectives for understanding the intricate changes in gene expression that occur in complex diseases. Availability: The SIEVE R package and source codes are available at https://github.com/Divo-Lee/SIEVE .

Alcohol-Processable All-Polymer n-Type Thermoelectrics.

The general strategy for n-type organic thermoelectric is to blend n-type conjugated polymer hosts with small molecule dopants. In this work, all-polymer n-type thermoelectric is reported by dissolving a novel n-type conjugated polymer and a polymer dopant, poly(ethyleneimine) (PEI), in alcohol solution, followed by spin-coating to give polymer host/polymer dopant blend film. To this end, an alcohol-soluble n-type conjugated polymer is developed by attaching polar and branched oligo (ethylene glycol) (OEG) side chains to a cyano-substituted poly(thiophene-alt-co-thiazole) main chain. The main chain results in the n-type property and the OEG side chain leads to the solubility in hexafluorineisopropanol (HFIP). In the polymer host/polymer dopant blend film, the Coulombic interaction between the dopant counterions and the negatively charged polymer chains is reduced and the ordered stacking of the polymer host is preserved. As a result, the polymer host/polymer dopant blend exhibits the power factor of 36.9 µW m-1 K-1, which is one time higher than that of the control polymer host/small molecule dopant blend. Moreover, the polymer host/polymer dopant blend shows much better thermal stability than the control polymer host/small molecule dopant blend. This research demonstrates the high performance and excellent stability of all-polymer n-type thermoelectric.

Glycol Monomethyl Ether-Substituted Carbazolyl Hole-Transporting Material for Stable Inverted Perovskite Solar Cells with Efficiency of 25.52.

Organic self-assembled molecules (OSAMs) based hole transporting materials play a pivotal role in achieving highly efficient and stable inverted perovskite solar cells (IPSCs). However, the reported carbazol-based OSAMs have serious drawbacks, such as poor solubility in alcohol solution, worse matched energy arrangement with perovskite, and limited molecular species, which greatly limit the device performance. To address above problems, a novel OSAM 4-(3,6-glycol monomethyl ether-9H-carbazol-9-yl) butyl]phosphonic acid (GM-4PACz) was synthesized as hole-transporting material by introducing glycol monomethyl ether (GM) side chains at carbazolyl unit. GM groups enhance the surface energy of Indium Tin Oxide (ITO)/SAM substrate to facilitate the nucleation and growth of up perovskite film, suppress cation defects, release the residual stress at SAM/perovskite interface, and evaluate energy level for matching with perovskite. Consequently, the GM-4PACz based IPSC achieves a champion PCE of 25.52%, a respectable open-circuit voltage (VOC) of 1.21 V, a high stability, possessing 93.29% and 91.75% of their initial efficiency after aging in air for 2000 h or tracking at maximum power point for 1000 h, respectively.

Detecting bone marrow infiltration in nonosteolytic multiple myeloma through separation of hydroxyapatite via the two-material decomposition technique in spectral computed tomography.

Background: Conventional computed tomography (CT) has low sensitivity for the diagnosis of bone marrow infiltration in nonosteolytic multiple myeloma (NOL-MM). This study aimed to compare the performance of the two-material decomposition technique of spectral CT with the removal of X-ray absorption components of calcium (Ca) versus that of hydroxyapatite (HAP) for diagnosis of NOL-MM. Methods: From October 2022 to March 2023, a total of 41 consecutive patients with MM without focal bone lesions undergoing chest spectral CT and thoracic spine magnetic resonance imaging (MRI) in Fujian Medical University Union Hospital were prospectively enrolled; meanwhile, another set of 41 age- and sex-matched healthy consecutive participants were selected as a comparison group. Based on MRI findings, patients with MM were classified with a diffuse infiltration pattern MM (DP-MM) or a normal pattern MM (NP-MM). Regions of interest (ROIs) were manually drawn on vertebrae. CT values of 70-keV images and basic material density within the ROIs were stored. The basic two-material pairs included a Ca-related pair (Ca-X) and an HAP-related pair (HAP-X), with X referring to fat, water, or muscle. Material density values DCa(X), DX(Ca), DHAP(X), and DX(HAP) were each used to diagnose MM, and the area under the receiver operating characteristic curve (AUC) was used to assess diagnostic performance. Results: The 41 patients with NOL-MM included 30 with DP-MM and 11 with NP-MM. CT value, DCa(X), and DHAP(X) were comparable between the NOL-MM, DP-MM, NP-MM, and comparison groups. DX(HAP) was better than DX(Ca) for distinguishing the NOL-MM group from the comparison group {AUC [95% confidence interval (CI)], 0.874 (0.800, 0.949) vs. 0.737 (0.630, 0.844); P=0.02}, the DP-MM group from the comparison group [AUC (95% CI), 0.933 (0.878, 0.989) vs. 0.785 (0.677, 0.894); P=0.01], the NP-MM group from the comparison group [AUC (95% CI), 0.714 (0.540, 0.888) vs. 0.605 (0.429, 0.782); P=0.03], and the DP-MM group from the NP-MM group [AUC (95% CI), 0.809 (0.654, 0.964) vs. 0.736 (0.566, 0.907); P=0.049]. The diagnostic performance of DX(HAP) and DX(Ca) was influenced only by the removed material, while the X material had no influence. Conclusions: The spectral CT two-material decomposition technique with removal of X-ray absorption components of HAP is useful for diagnosis of NOL-MM, irrespective of the paired material.

Enhanced Photovoltaic Performance of Asymmetrical Benzo Dithiophene Homopolymer Donor Materials in Nonfullerene Acceptor-Based Organic Photovoltaics.

Although much promising synthetic progress in conjugated polymer-based organic solar cells (OSCs) has resulted in significant improvement in power conversion efficiencies (PCEs) of from over 15 to >19.0% in the last five years, the sophisticated and complex reactions from at least two families' monomers with remarkably different electron push-pull effects could still pose an unavoidable material burden for the commercialization of OSCs in the coming future. Therefore, the method of preparing a homopolymer from a sole monomer would significantly reduce the synthetic steps and costs in order to pave the way for the large-scale production of OSC materials. Therefore, alkylthio-thiophenyl-substituted benzo[1,2-b;4,5-b']dithiophene (BDTTS) as the sole and key structural moiety with dihalogen and distannyl functional groups was designed and synthesized, respectively, in this study, for facile monomer syntheses and polymerizations to achieve three wide-bandgap homopolymer donors of BDTTS-alt-BDTT-Cl (P13), BDTTS-alt-BDTT (P15), and BDTTS (P14), respectively. The structural symmetry dependency on their physical, electrochemical, and optical properties, thin-film morphologies, and photovoltaic (PV) performance was investigated in detail. As a result, OSCs based on the asymmetric polymer P15, paired with BTP-eC9 as the electron acceptor, presented the best PV performance, with a PCE of 11.5%, a fill factor (FF) of 65.87%, and a short-circuit current (JSC) of 22.04 mA·cm-2, respectively. This PCE value is among the highest ones reported for BDT-type homopolymer donor-based OPVs, providing us with knowledge for obtaining promising PV performance from devices made of P15-like materials.

Homogeneous Age-hardening of Large-sized Al-Sc Foams via Micro-alloying with Zr and Ti.

Al-based foams have drawn increasing attention from industry due to their integration of structure and functional properties. However, large-sized Al-based foams still cannot be homogeneously strengthened by long-time aging due to their low thermal conductivity. In this study, we proposed an age-hardening approach that was applied in large-sized Al-0.16Sc-0.17Zr (wt.%) foams via micro-alloying with Zr and Ti compared with Al-0.21Sc foams; it not only achieved homogeneous strength by long-term aging but also reduced the cost of the alloy by substituting Zr and Ti for the more expensive Sc content. The results show that the Al3(Sc, Zr, Ti) phase with a core-shell structure as a crucial precipitation strengthening phase by micro-alloying with Zr and Ti was less prone to coarsening after a prolonged aging heat treatment. Therefore, the yielding strength of Al-Sc foam micro-alloying with Zr and Ti remained almost unchanged after a maximum aging time of 1440 h due to less coarsening precipitate, which is consistent with the results of mechanical experiments. These findings provide a new way for the heat treatment strengthening of large-sized Al-based foams, thus promoting their industrial applications.

Suppressing the Conductance of Single-Molecule Junctions Fabricated by sp2 C-H Bond Metalation.

High-conducting single-molecule junctions have attracted a great deal of attention, but insulating single-molecule junctions, which are critical in molecular circuits, have been less investigated due to the long-standing challenges. Herein, the in situ formation of a Au-C linker via electrical-potential-mediated sp2 C-H bond metalation of polyfluoroarenes with the assistance of scanning tunneling microscope-based break junction technique is reported. This metalation process is bias-dependent and occurs with an electropositive electrode, and the formed junction is highly oriented. Surprisingly, these polyfluoroarenes exhibit unexpected low conductance even under short molecular lengths and are superior molecular insulators. Flicker noise analysis and DFT calculations confirm that the insulating properties of polyfluoroarenes are ascribed to their multiple fluorine substituents. Our results pave a way for constructing oriented asymmetric molecular junctions and provide an efficient strategy to suppress the single-molecule conductance, which will aid in the design of molecular insulators and advance the development of self-integrating functional molecular circuits.

In Situ Synthesized Low-Dimensional Perovskite for >25% Efficiency Stable MA-Free Perovskite Solar Cells.

Developing an additive to effectively regulate the perovskite crystallization kinetics for the optimized optoelectronic properties of perovskite film plays a vital role in obtaining high efficiency and stable perovskite solar cells (PSCs). Herein, a new additive is designed and directly synthesized in perovskite precursor solution by utilizing an addition reaction between but-3-yn-1-amine hydrochloride (BAH) and formamidinium iodide. It is found that its product may control the intermediate precursor phase for regulating perovskite nucleation, leading to advantageous 2D perovskite to induce growth of perovskite along the preferred [001] orientation with not only released lattice strain but also strong interaction with perovskite to passivate its surface defects. By taking advantage of the above synergistic effects, the optimized PSC delivers an efficiency of 25.19% and a high open-circuit voltage (VOC) of 1.22 V. Additionally, the devices demonstrate good stability, remaining over 90% of their initial efficiencies under ambient atmosphere conditions for 60 days, high temperature of 85 °C for 200 h, or maximum power point tracking for 500 h.

Efficient all-small-molecule organic solar cells processed with non-halogen solvent.

All-small-molecule organic solar cells with good batch-to-batch reproducibility combined with non-halogen solvent processing show great potential for commercialization. However, non-halogen solvent processing of all-small-molecule organic solar cells are rarely reported and its power conversion efficiencies are very difficult to improve. Herein, we designed and synthesized a small molecule donor BM-ClEH that can take advantage of strong aggregation property induced by intramolecular chlorine-sulfur non-covalent interaction to improve molecular pre-aggregation in tetrahydrofuran and corresponding micromorphology after film formation. Tetrahydrofuran-fabricated all-small-molecule organic solar cells based on BM-ClEH:BO-4Cl achieved high power conversion efficiencies of 15.0% in binary device and 16.1% in ternary device under thermal annealing treatment. In contrast, weakly aggregated BM-HEH without chlorine-sulfur non-covalent bond is almost inefficient under same processing conditions due to poor pre-aggregation induced disordered π-π stacking, indistinct phase separation and exciton dissociation. This work promotes the development of non-halogen solvent processing of all-small-molecule organic solar cells and provides further guidance.

Sequentially Processed Bulk-Heterojunction-Buried Structure for Efficient Organic Solar Cells with 500 nm Thickness.

Large-area printing fabrication is a distinctive feature of organic solar cells (OSCs). However, the advance of upscalable fabrication is challenged by the thickness of organic active layers considering the importance of both exciton dissociation and charge collection. In this work, a bulk-heterojunction-buried (buried-BHJ) structure is introduced by sequential deposition to realize efficient exciton dissociation and charge collection, thereby contributing to efficient OSCs with 500 nm thick active layers. The buried-BHJ distributes donor and acceptor phases in the vertical direction as charge transport channels, while numerous BHJ interfaces are buried in each phase to facilitate exciton dissociation simultaneously. It is found that buried-BHJ configurations possess efficient exciton dissociation and rapid charge transport, resulting in reduced recombination losses. In comparison with traditional structures, the buried-BHJ structure displays a decent tolerance to film thickness. In particular, a power conversion efficiency of 16.0% is achieved with active layers at a thickness of 500 nm. To the best of the authors' knowledge, this represents the champion efficiency of thick film OSCs.

Tunable Donor Aggregation Dominance in a Ternary Matrix of All-Polymer Blends with Improved Efficiency and Stability.

Using two structurally similar polymer acceptors in constructing high-efficiency ternary all-polymer solar cells is a widely acknowledged strategy; however, the focus thus far has not been on how polymer acceptor(s) would tune the aggregation of polymer donors, and furthermore film morphology and device performance (efficiency and stability). Herein, it is reported that matching of the celebrity acceptor PY-IT and the donor PBQx-TCl results in enhanced H-aggregation in PBQx-TCl, which can be finely tuned by controlling the amount of the second acceptor PY-IV. Consequently, the efficiency-optimized PY-IV weight ratio (0.2/1.2) leads to a state-of-the-art power conversion efficiency of 18.81%, wherein light-illuminated operational stability is also enhanced along with well-protected thermal stability. Such enhancements in the efficiency and operational and thermal stabilities of solar cells can be attributed to morphology optimization and the desired glass transition temperature of the target active layer based on comprehensive characterization. In addition to being a high-power conversion efficiency case for all-polymer solar cells, these enhancements are also a successful attempt for using combined acceptors to tune donor aggregation toward optimal morphology, which provides a theoretical basis for the construction of other types of organic photovoltaics beyond all-polymer solar cells.

Physiological and autophagy evaluation of different pear varieties (Pyrus spp.) in response to Botryosphaeria dothidea infection.

Ring rot disease is one of the most common diseases in pear orchards. To better understand the physiology, biochemistry and autophagic changes of different pear varieties after Botryosphaeria dothidea (B.dothidea) infection, we evaluated eight different pear varieties for B. dothidea resistance. The susceptible varieties had larger spot diameters, lower chlorophyll contents and higher malondialdehyde contents than the resistant varieties. In disease-resistant varieties, reactive oxygen species (ROS) levels were relatively lower, while the ROS metabolism (antioxidant enzyme activities and the ascorbic acid-glutathione cycle) was also maintained at higher levels, and it induced a significant upregulation of related gene expression. In addition, autophagy, as an important evaluation index, was found to have more autophagic activity in disease-resistant varieties than in susceptible varieties, suggesting that pathogen infestation drives plants to increase autophagy to defend against pathogens. In summary, the results of this study reveal that different resistant pear varieties enhance plant resistance to the disease through a series of physio-biochemical changes and autophagic activity after inoculation with B. dothidea. This study provides clear physiological and biochemical traits for pear disease resistance selection, potential genetic resources and material basis for pear disease control and disease resistance, breeding and points out the direction for research on the mechanism of pear resistance to B. dothidea.

Enteral feeding strategies in patients with acute gastrointestinal injury: From limited to progressive to open feeding.

Acute gastrointestinal injury (AGI) is very common in critically ill patients, and its severity is positively correlated with mortality. Critically ill patients with digestive and absorption dysfunction caused by AGI face higher nutritional risks, making nutritional support particularly important. Early enteral nutrition (EN) support is extremely important because it can promote the recovery of intestinal function, protect the intestinal mucosal barrier, reduce microbiota translocation, reduce postoperative complications, shorten hospital stay, and improve clinical prognosis. In recent years, many nutritional guidelines have been proposed for critically ill patients; however, there are few recommendations for the implementation of EN in patients with AGI, and their quality of evidence is low. The use of EN feeding strategies in critically ill patients with AGI remains controversial. The aim of this review was to elaborate on how EN feeding strategies should transition from limited to progressive to open feeding and explain the time window for this transition.

Manipulating the charge transport via incorporating a cobalt bridge into a single-molecule junction.

Cobalt-bridged organometallic molecular wires (p-Co-p, p-Co-m and m-Co-m) are synthesized, and their charge transport properties are studied. The experimental results show that the quantum interference (QI) effects of cobalt-bridged organometallic wires are determined by the anchoring group. Interestingly, the cobalt-bridge reduces the conductance of the junctions and tunes the QI effect of the wires. These results demonstrate the unique property of metal-bridged organometallic molecular wires and their potential applications in molecular electronics.

White Matter Hyperintensities on Post-Stroke Balance and Gait Recovery: A Prospective Cohort Study Protocol.

INTRODUCTION: White matter hyperintensities (WMH) are commonly associated with balance and gait disturbances. Little is known whether WMH may affect post-stroke balance and gait recovery. We aim to investigate the association of post-stroke balance and gait recovery with imaging marker of WMH on magnetic resonance imaging (MRI). METHODS: This prospective cohort study will enroll consecutive patients with first-ever ischemic hemisphere stroke, between September 2023 and December 2024. Clinical data will be collected on day 30±3 and at 3-month after stroke onset. WMH on FLAIR are graded according to the modified Fazekas scale. Resting-state functional MRI (rs-fMRI) and diffusion tensor imaging (DTI) will be acquired to evaluate functional and structural connectivity. The primary endpoint is balance recovery, defined as a Postural Assessment Scale for Stroke score of 32 or higher at 3-month. The secondary endpoint is gait recovery, assessed using the modified Fugl-Meyer Gait Assessment at 3-month. We will investigate the association of post-stroke balance and gait recovery with WMH severity as well as WMH-related functional and structural connectivity. CONCLUSION: The study may contribute to clarify the effect of WMH on post-stroke balance and gait disorder recovery.

The intensity of organ support: Restrictive or aggressive therapy for critically ill patients.

The intensity of organ support has received attention in recent years. To make better clinical decisions, we should understand the mechanisms and benefits, and disadvantages of the different intensities of organ support in critically ill patients. Therapeutic strategies such as supplemental oxygen therapy, mechanical ventilation, respiratory stimulant, vasoactive agents, transfusion, albumin infusion, fluid management, renal placement, and nutrition support, if they are implemented in accordance with an aggressive strategy, could result in side effects and/or complications, resulting in iatrogenic harm in critically ill patients. It is found that the intensity of organ support is not a determining factor in prognosis. A normal rather than supernormal physiological target is recommended for support therapy.

Quantitative three-dimensional imaging of chemical short-range order via machine learning enhanced atom probe tomography.

Chemical short-range order (CSRO) refers to atoms of specific elements self-organising within a disordered crystalline matrix to form particular atomic neighbourhoods. CSRO is typically characterized indirectly, using volume-averaged or through projection microscopy techniques that fail to capture the three-dimensional atomistic architectures. Here, we present a machine-learning enhanced approach to break the inherent resolution limits of atom probe tomography enabling three-dimensional imaging of multiple CSROs. We showcase our approach by addressing a long-standing question encountered in body-centred-cubic Fe-Al alloys that see anomalous property changes upon heat treatment. We use it to evidence non-statistical B2-CSRO instead of the generally-expected D03-CSRO. We introduce quantitative correlations among annealing temperature, CSRO, and nano-hardness and electrical resistivity. Our approach is further validated on modified D03-CSRO detected in Fe-Ga. The proposed strategy can be generally employed to investigate short/medium/long-range ordering phenomena in different materials and help design future high-performance materials.