Conductive Robust Interfaces with Fluoro-Borate Based Electrolyte Additive for 4.6 V Well-Cycled LiNi0.90Co0.06Mn0.04O2||Li Batteries.

Owing to the outstanding comprehensive properties of high energy density, excellent cycling ability, and reasonable cost, Ni-rich layered oxides (NCM) are the most promising cathode for lithium-ion batteries (LIBs). To further enhance the specific capacity of Ni-rich layered oxides, it is necessary to increase the cut-off voltage to a higher level. However, a higher cut-off voltage can lead to substantial structural changes and trigger interface side reactions, presenting significant challenges for practical applications (cycle life and safety). Herein, to solve above issues, tris(hexafluoroisopropyl)borate (TFPB) is introduced as a high voltage electrolyte additive for LiNi0.90Co0.06Mn0.04O2 cathode. Based on detail in situ/ex situ characterization, this study proves that TFPB forms a protective solid-state interphase (SEI) layer on the Li-anode. Additionally, derivatives of TFPB are easily oxidatively decomposed to create a dense cathode electrolyte interphase (CEI) film on the cathode. This CEI film effectively prevents the continuous oxidation of the electrolyte and mitigates the adverse effects of HF on the battery. Benefit from the protective SEI and CEI layer, the LiNi0.90Co0.06Mn0.04O2||Li battery with a TFPB-containing electrolyte maintains an unprecedented level of performance, with a capacity retention of 89.1% after 100 cycles under the ultrahigh cut-off voltage of 4.6 V (vs Li/Li+).

Zone-Folded Longitudinal Acoustic Phonons Driving Self-Trapped State Emission in Colloidal CdSe Nanoplatelet Superlattices.

Colloidal CdSe nanoplatelets (NPLs) have substantial potential in light-emitting applications because of their quantum-well-like characteristics. The self-trapped state (STS), originating from strong electron-phonon coupling (EPC), is promising in white light luminance because of its broadband emission. However, achieving STS in CdSe NPLs is extremely challenging because of their intrinsic weak EPC nature. Herein, we developed a strong STS emission in the spectral range of 450-600 nm by building superlattice (SL) structures with colloidal CdSe NPLs. We demonstrated that STS is generated via strong coupling of excitons and zone-folded longitudinal acoustic phonons with formation time of ∼450 fs and localization length of ∼0.56 nm. The Huang-Rhys factor, describing the EPC strength in SL structure, is estimated to be ∼19.9, which is much larger than that (∼0.1) of monodispersed CdSe NPLs. Our results provide an in-depth understanding of STS and a platform for generating and manipulating STS by designing SL structures.

Sub-2 nm Ultrasmall High-Entropy Alloy Nanoparticles for Extremely Superior Electrocatalytic Hydrogen Evolution.

The development of sufficiently effective catalysts with extremely superior performance for electrocatalytic hydrogen production still remains a formidable challenge, especially in acidic media. Here, we report ultrasmall high-entropy alloy (us-HEA) nanoparticles (NPs) with the best-level performance for hydrogen evolution reaction (HER). The us-HEA (NiCoFePtRh) NPs show an average diameter of 1.68 nm, which is the smallest size in the reported HEAs. The atomic structure, coordinational structure, and electronic structure of the us-HEAs were comprehensively clarified. The us-HEA/C achieves an ultrahigh mass activity of 28.3 A mg-1noble metals at -0.05 V (vs the reversible hydrogen electrode, RHE) for HER in 0.5 M H2SO4 solution, which is 40.4 and 74.5 times higher than those of the commercial Pt/C and Rh/C catalysts, respectively. Moreover, the us-HEA/C demonstrates an ultrahigh turnover frequency of 30.1 s-1 at 50 mV overpotential (41.8 times higher than that of the Pt/C catalyst) and excellent stability with no decay after 10 000 cycles. Operando X-ray absorption spectroscopy and theoretical calculations reveal the actual active sites, tunable electronic structures, and a synergistic effect among five elements, which endow significantly enhanced HER activity. This work not only engineers a general and scalable strategy for synthesizing us-HEA NPs and elucidates the complex structural information and catalytic mechanisms of multielement HEA system in depth, but also highlights HEAs as sufficiently advanced catalysts and accelerates the research of HEAs in energy-related applications.

The surgical perspective in neoadjuvant immunotherapy for resectable non-small cell lung cancer.

BACKGROUND: The recent novel conception of neoadjuvant immunotherapy has generated interest among surgeons worldwide, especially the lack of experience involving surgical treatment for the neoadjuvant immunotherapy population. METHODS: Patients with non-small cell lung cancer (NSCLC), who underwent neoadjuvant immunotherapy or chemo-immunotherapy, were retrospectively collected between September 2018 and April 2020. Demographic data, pathological and clinical features, therapeutic regimens and outcome data of all individuals were collected by retrospective chart review. Operative details, information of neoadjuvant therapy, were also abstracted. RESULTS: In total, 31 patients were included in the final analysis. The patients' median age was 61 years. In total, 29 of the patients were males, while 2 were females. Patients received a median of 3 doses before resection. The median duration from final treatment to surgery was 34 days. After neoadjuvant treatment, post-treatment computed tomography scan showed that 24 patients had partial response. In total, 12 of 31 patients had a major pathological response, 15 pathological downstaging. Three patients had no residual viable tumor. A positive surgical margin was identified in 7 cases. One or more postoperative complications occurred in 18 of all 31 patients. In total, 26 patients underwent next-generation sequencing before surgery in total. Among them, 2 patients were detected STK11 mutations, none of whom had a major pathological response by final pathological examination. CONCLUSIONS: Pulmonary resection after neoadjuvant immunotherapy or chemo-immunotherapy for resectable NSCLC appears to be safe with low operative mortality and morbidity rate in the current population.

Single-Crystal α-Fe2O3 with Engineered Exposed (001) Facet for High-Rate, Long-Cycle-Life Lithium-Ion Battery Anode.

Designing electrode materials with engineered exposed facets provides a novel strategy to improve their electrochemical properties. However, the controllability of the exposed facet remains a daunting challenge, and a deep understanding of the correlation between exposed facet and Li+-transfer behavior has been rarely reported. In this work, single-crystal α-Fe2O3 hexagonal nanosheets with an exposed (001) facet are prepared with the assistance of aluminum ions through a one-step hydrothermal process, and structural characterizations reveal an Al3+-concentration-dependent-growth mechanism for the α-Fe2O3 nanosheets. Furthermore, such α-Fe2O3 nanosheets, when used as lithium-ion battery anodes, exhibit high specific capacity (1261.3 mAh g-1 at 200 mA g-1), high rate capability (with a reversible capacity of approximately 605 mAh g-1 at 10 A g-1), and excellent cyclic stability (with a capacity of over 900 mAh g-1 during 500 cycles). The superior electrochemical performance of α-Fe2O3 nanosheets is attributed to the pseudocapacitive behavior, Al-doping in the α-Fe2O3 structure, and improved Li+-transfer property across the (001) facet, as elucidated by first-principles calculations based on density functional theory. These results reveal the underlying mechanism of Li+ transfer across different facets and thus provide insights into the understanding of the excellent electrochemical performance.

Understanding the Improved Kinetics and Cyclability of a Li2MnSiO4 Cathode with Calcium Substitution.

Limited practical capacity and poor cyclability caused by sluggish kinetics and structural instability are essential aspects that constrain the potential application of Li2MnSiO4 cathode materials. Herein, Li2Mn1- xCa xSiO4/C nanoplates are synthesized using a diethylene-glycol-assisted solvothermal method, targeting to circumvent its drawbacks. Compared with the pristine material, the Ca-substituted material exhibits enhanced electrochemical kinetics and improved cycle life performance. In combination with experimental studies and first-principles calculations, we reveal that Ca incorporation enhances electronic conductivity and the Li-ion diffusion coefficient of the Ca-substituted material, and it improves the structural stability by reducing the lattice distortion. It also shrinks the crystal size and alleviates structure collapse to enhance cycling performance. It is demonstrated that Ca can alleviate the two detrimental factors and shed lights on the further searching for suitable dopants.

Genomic Alteration During Metastasis of Lung Adenocarcinoma.

BACKGROUND/AIMS: Recurrent gene mutation has been identified by the analysis of exonic DNA from lung adenocarcinoma, but its progression has not been extensively profiled. The investigation of the mutational landscape of tumors provides new insights into cancer genome evolution and further discovers the interplay of somatic mutation, adaptation of clones to their environment and natural selection. Cancer development involves cycles of genomic damage, epigenetic deregulation, and increased cellular proliferation that eventually culminate in the carcinoma phenotype. METHODS: Comparative whole exome sequencing of both primary and metastatic tumor tissues from four patients of stage IV lung adenocarcinoma patients with chest wall metastasis was performed. Both primary and metastatic tumors were diagnosed through biopsy followed by surgical resection. All tumor specimens were cut into several pieces to assess potential heterogenic clones within the tumor tissue. Adjacent normal lung tissue was also obtained to provide germline mutation background. RESULTS: By modeling and analyzing progression of the cancer metastasis based on non-synonymous variants, we defined the extent of heterogeneity of cancer genomes and identified similar cancer evolution pattern in the four patients: metastasis was an early event occurring right after the primary cancer formation and evolution in the metastatic tumor was continuously and simultaneously in progression with that in the primary tumor. By characterizing the clonal hierarchy of genetic lesions, we further charted a pathway of oncogenic events along which genes may drive lung adenocarcinoma metastasis, such as TAS2R31 and UMODL1, involving in G-protein coupled receptor protein signaling pathway. CONCLUSION: The candidate genes identified in this study may become targets for the treatment of lung adenocarcinoma metastasis.

Different roles of myofibroblasts in the tumorigenesis of nonsmall cell lung cancer.

Myofibroblasts play a critical role in the cancer cell growth, invasion, and tumor-associated vascularization during the carcinogenesis of nonsmall cell lung cancer (NSCLC), whereas the underlying molecular bases are not completely understood. We isolated Lin-negative, Sca1-low, and CD49e-high myofibroblasts from the NSCLC tissues of the patients and modified the levels of either transforming growth factor ß 1 (TGFß1) or vascular endothelial growth factor A (VEGF-A) in these cells. We found that coculture with TGFß1-overexpressing myofibroblasts significantly decreased the NSCLC cell growth in an MTT assay through proliferation suppression rather than modulation of cell apoptosis, while significantly increased the NSCLC cell invasiveness in either a transwell migration assay or a scratch wound healing migration assay. However, modulation of TGFß1 levels in myofibroblasts did not significantly alter vessel formation in a human umbilical vein endothelial cells (HUVECs) transwell collagen gel assay. On the other hand, overexpression of VEGF-A in myofibroblasts significantly increased vessel formation in the HUVECs transwell collagen gel assay. Together, these data suggest that myofibroblasts may regulate cancer cell growth and invasion through TGFß1 but modulate cancer-associated neovascularization through VEGF-A. Hence, targeting different signaling pathways in myofibroblasts may delicately control NSCLC growth and invasion.

A new technique combining virtual simulation and methylene blue staining for the localization of small peripheral pulmonary lesions.

BACKGROUND: Quickly and accurately localizing small peripheral pulmonary lesions can avoid prolonged operative time and unplanned open thoracotomy. In this study, we aimed to introduce and evaluate a new technique combining virtual simulation and methylene blue staining for the localization of small peripheral pulmonary lesions. METHODS: Seventy four (74) patients with 80 peripheral pulmonary lesions <20 mm in size on computer tomography (CT) were virtually punctured using a radiotherapy planning simulator on the day before operation. Under general anaesthesia, methylene blue dye was injected to the virtually identified point according to the surface point, angle and depth previously determined by the simulator. The wedge resection of the marked lesion was performed under video-assisted thoracoscopic surgery (VATS) and the specimens were sent for immediate pathologic examination. According to pathology results, appropriate surgical procedures were decided and undertaken. RESULTS: The average lesion size was 10.4±3.5 mm (range: 4-17 mm) and the average distance to the pleural surface was 9.4±4.9 mm. Our preoperative localization procedure was successful in 75 of 80 (94%) lesions. Histological examination showed 28 benign lesions and 52 lung cancers. The shortest distance between the edges of the stain and lesion was 5.1±3.1 mm. Localization time was 17.4±2.3 min. All patients with malignant lesions subsequently underwent lobectomy and systematic lymph node dissection. No complications were observed in all participants. CONCLUSIONS: The novel technique combining the preoperative virtual simulation and methylene blue staining techniques has a high success rate for localizing small peripheral pulmonary lesions, particularly for those tiny lesions which are difficult to visualise and palpate during VATS.

Evaluation of the surgical fat-filling procedure in the treatment of refractory cough after systematic mediastinal lymphadenectomy in patients with right lung cancer.

BACKGROUND: To evaluate the efficacy of the surgical fat-filling procedure (SFFP) in the treatment of refractory cough and quality of life (QOL) after systematic mediastinal lymphadenectomy in patients with right lung cancer. METHODS: This is a blinded, randomized, controlled clinical trial to evaluate refractory cough and QOL in patients after mediastinal lymphadenectomy for lung cancer. One hundred eligible lung cancer patients were randomly divided into two groups: the fat-filling group and non-filling group. In the fat-filling group, post-lymphadenectomy residual cavities (PLRCs) were filled with fatty tissue autografts after lymph node dissection. In the non-filling group, the PLRCs remained unfilled. Clinical endpoints were postoperative cough score and QOL. RESULTS: The SFFP did not increase intraoperative bleeding, extend operation time, or hospital stay. Further, night cough was significantly improved after 4 wk in the fat-filling group after the removal of a chest drainage tube. QOL issues, such as emotional condition, functional status, and additional concerns, demonstrated a remarkable improvement in the fat-filling group at postoperative 1 mo compared with the non-filling (control) group. CONCLUSIONS: This study demonstrates that filling PLRCs with fatty tissue autografts is a safe and partially effective treatment for refractory cough after major pulmonary resection and mediastinal lymphadenectomy. This novel procedure significantly improved patient QOL and may prove useful as a relatively safe preventive surgical adjunct operation for refractory cough.

A green aqueous binder to enhance the electrochemical performance of Li-rich disordered rock salt cathode material.

Li-rich disordered rock-salt oxides (DRX) are considered an attractive cathode material in the future battery field due to their excellent energy density and specific capacity. Nevertheless, anionic redox provides high capacity while causing O2 over-oxidation to O2, resulting in voltage hysteresis and capacity decay. Herein, the crystal structure of Li1.3Mn0.4Ti0.3O1.7F0.3 (LMTOF) cathode is stabilized by using sodium carboxymethylcellulose (CMC) binders replacing traditional polyvinylidene difluoride (PVDF) binders. The electrochemical impedance spectroscopy (EIS) and galvanostatic intermittent titration technique (GITT) reveal that the CMC-based LMTOF electrode has higher electronic conductivity and lithium-ion diffusion kinetics. Moreover, CMC has been demonstrated to improve the O2- reversibility, reduce the amounts of byproducts from electrolyte decomposition and suppress transition metal dissolution by Na+/Li+ exchange reaction. Furthermore, the CMC-based LMTOF electrode also exhibits less volume change upon lithiation/delithiation processes compared to the PVDF-based electrode, resulting in enhanced structural stability during cycling. Benefiting from these features, the CMC binders can effectively improve the cycling life and rate performance of the LMTOF cathode, and the CMC-based LMTOF electrode shows good capacity retention of 94.5 % after 30 cycles at 20 mA/g and 66.7 % after 100 cycles at 200 mA/g. This finding indicates that CMC as a binder can efficiently stabilize the structure and improve the electrochemical performance of Li-rich disordered rock-salt oxides cathode, making it possible for practical Li-ion battery applications.

Who benefit from adjuvant chemotherapy in stage I lung adenocarcinoma? A multi-dimensional model for candidate selection.

BACKGROUND: Despite promising overall survival of stage I lung adenocarcinoma (LUAD) patients, 10-25 % of them still went through recurrence after surgery. [1] While it is still disputable whether adjuvant chemotherapy is necessary for stage I patients. [2] IASLC grading system for non-mucinous LUAD shows that minor high-grade patterns are significant indicator of poor prognosis. [3] Other risk factors, such as, pleura invasion, lympho-vascular invasion, STAS, etc. are also related to poor prognosis. [4-6] There still lack evidence whether IASLC grade itself or together with other risk factors can guide the use of adjuvant therapy in stage I patients. In this article, we tried to establish a multi-variable recurrence prediction model for stage I LUAD patients that is able to identify candidates of adjuvant chemotherapy. METHODS: We retrospectively collected patients who underwent lung surgery from 2018.8.1 to 2018.12.31 at our institution and diagnosed with lung adenocarcinoma pT1-2aN0M0 (stage I). Clinical data, manifestation on CT scan, pathologic features, driver gene mutations and follow-up information were collected. Cox proportional hazards regression analyses were performed utilizing the non-adjuvant cohort to predict disease free survival (DFS) and a nomogram was constructed and applied to the total cohort. Kaplan-Meier method was used to compare DFS between groups. Statistical analysis was conducted by R version 3.6.3. FINDINGS: A total of 913 stage I LUAD patients were included in this study. Median follow-up time is 48.1 months.4-year and 5-year DFS are 92.9 % and 89.6 % for the total cohort. 65 patient experienced recurrence or death. 4-year DFS are 97.0 %,94.6 % and 76.2 %, and 5-year DFS are 95.5 %, 90.0 % and 74.1 % in IASLC Grade1, 2 and 3, respectively(p < 0.0001). High-risk patients defined by single risk factors, such as, IASLC grade 3, pleura invasion, STAS, less LN resected could not benefit from adjuvant therapy. A LASSO-COX regression model was built and patients are divided into high-risk and low-risk groups. In the high-risk group, patients underwent adjuvant chemotherapy have longer DFS than those who did not (p = 0.024), while in the low-risk group, patients underwent adjuvant chemotherapy have inferior DFS than those who did not (p < 0.001). INTERPRETATION: IASLC grading is a significant indicator of DFS, however it could not guide adjuvant therapy in our stage I LUAD cohort. Growth patterns and T indicators together with other risk factors could identify high-risk patients that are potential candidate of adjuvant therapy, including some stage IA LUAD patients.

A Stress Self-Adaptive Silicon/Carbon "Ordered Structures" to Suppress the Electro-Chemo-Mechanical Failure: Piezo-Electrochemistry and Piezo-Ionic Dynamics.

Construction of ordered structures that respond rapidly to environmental stimuli has fascinating possibilities for utilization in energy storage, wearable electronics, and biotechnology. Silicon/carbon (Si/C) anodes with extremely high energy densities have sparked widespread interest for lithium-ion batteries (LIBs), while their implementation is constrained via mechanical structure deterioration, continued growth of the solid electrolyte interface (SEI), and cycling instability. In this study, a piezoelectric Bi0.5 Na0.5 TiO3 (BNT) layer is facilely deposited onto Si/C@CNTs anodes to drive piezoelectric fields upon large volume expansion of Si/C@CNTs electrode materials, resulting in the modulation of interfacial Li+ kinetics during cycling and providing an electrochemical reaction with a mechanically robust and chemically stable substrate. In-depth investigations into theoretical computation, multi-scale in/ex situ characterizations, and finite element analysis reveal that the improved structural stability, suppressed volume variations, and controlled ion transportation are responsible for the improvement mechanism of BNT decorating. These discoveries provide insight into the surface coupling technique between mechanical and electric fields to control the interfacial Li+ kinetics behavior and improve structural stability for alloy-based anodes, which will also spark a great deal attention from researchers and technologists in multifunctional surface engineering for electrochemical systems.

A low-cost naphthaldiimide based organic cathode for rechargeable lithium-ion batteries.

Recently, the development of cathode materials is becoming an important issue for lithium-ion batteries (LIBs). Compared with inorganic cathodes, the organic cathodes are developing rapidly, ascribing to their distinct merits in light weight, low cost, massive organic resources and high capacity. In this paper, a cost-efficiency naphthaldiimide (NDI) based derivative, 2,7-bis(2-((2-hydroxyethyl) amino) ethyl) benzo[lmn] [3,8] phenanthroline-1,3,6,8(2H, 7H)-tetraone (NDI-NHOH), was used as organic cathode in LIBs. The NDI-NHOH was synthesized easily via one-step process, and it showed very high thermal stability. Through mixing NDI-NHOH with acetylene black and polyvinylidene fluoride (weight ratio of 6:3:1) as composite cathode in lithium-metal based LIBs, the NDI-NHOH presented versatile electrochemical properties. From cyclic voltammetry (CV) test, it exhibited two reversible peaks for oxidation and reduction in the first cycle, respectively. Notably, the oxidation and reduction peaks were located at 2.54, 3.22 and 2.14, 2.32 V vs. Li+/Li, respectively. By employing NDI-NHOH as cathode, it demonstrated a specific capacity of about 80 mAh g-1 in the range of 1.5-3.5 V, where the batteries retained a capacity retention of 50% over 20 cycles. According to the LIBs study, it suggests that the NDI-NHOH-based derivative shows a potentially promising candidate as efficient organic cathode materials for high-performance metal-ions batteries.

A random forest algorithm predicting model combining intraoperative frozen section analysis and clinical features guides surgical strategy for peripheral solitary pulmonary nodules.

Background: Intraoperative frozen section (FS) analysis has been used to guide the extent of resection in patients with solitary pulmonary nodules (SPNs), but its accuracy varies greatly among different hospitals. Artificial intelligence (AI) and multidimensional data technology are developing rapidly these years, meanwhile, surgeons need better methods to guide the surgical strategy of SPNs. We established predicting models combining FS results with multidimensional perioperative clinical features using logistic regression analysis and the random forest (RF) algorithm to get more accurate extent of SPN resection. Methods: Patients with peripheral SPNs who underwent FS-guided surgical resection at the Shanghai Chest Hospital (January 2017-December 2018) were retrospectively examined (N=3,089). The accuracy of intraoperative FS-guided resection extent was analyzed and used as Model 1. The clinical features (sex, age, CT features, tumor markers, smoking history, lesion size and nodule location) of patients were collected, and Models 2 and 3 were established using logistic regression and RF algorithms to combine the FS with clinical features. We confirmed the performance of these models in an external validation cohort of 117 patients from Hwa Mei Hospital, University of Chinese Academy of Science (Ningbo No. 2 Hospital). We compared the effectiveness in classifying low/high-risk groups of SPN among them. Results: The accuracy of FS analysis was 61.3%. Model 3 exhibited the best diagnostic accuracy and had an area under the curve of 0.903 in n the internal validation cohort and 0.919 in the external validation cohort. The calibration plots and net reclassification index (NRI) of Model 3 also exhibited significantly better performance than the other models. Improved diagnostic accuracy was observed in in both internal and external validation cohort. Conclusions: Using an RF algorithm, clinical characteristics can be combined with intraoperative FS analysis to significantly improve intraoperative judgment accuracy for low- and high-risk tumors, and may serve as a reliable complementary method when FS evaluation is equivocal, improving the accuracy of the extent of surgical resection.

Homologous recombination deficiency (HRD) can predict the therapeutic outcomes of immuno-neoadjuvant therapy in NSCLC patients.

BACKGROUND: Neoadjuvant immunotherapy is emerging as novel effective intervention in lung cancer, but study to unearth effective surrogates indicating its therapeutic outcomes is limited. We investigated the genetic changes between non-small cell lung cancer (NSCLC) patients with varied response to neoadjuvant immunotherapy and discovered highly potential biomarkers with indicative capability in predicting outcomes. METHODS: In this study, 3 adenocarcinoma and 11 squamous cell carcinoma NSCLC patients were treated by neoadjuvant immunotherapy with variated regimens followed by surgical resection. Treatment-naive FFPE or fresh tissues and blood samples were subjected to whole-exome sequencing (WES). Genetic alternations were compared between differently-responded patients. Findings were further validated in multiple public cohorts. RESULTS: DNA damage repair (DDR)-related InDel signatures and DDR-related gene mutations were enriched in better-responded patients, i.e., major pathological response (MPR) group. Besides, MPR patients exhibited provoked genome instability and unique homologous recombination deficiency (HRD) events. By further inspecting alternation status of homology-dependent recombination (HR) pathway genes, the clonal alternations were exclusively enriched in MPR group. Additionally, associations between HR gene alternations, percentage of viable tumor cells and HRD event were identified, which orchestrated tumor mutational burden (TMB), mutational intratumor heterogeneity (ITH), somatic copy number alteration (SCNA) ITH and clonal neoantigen load in patients. Validations in public cohorts further supported the generality of our findings. CONCLUSIONS: We reported for the first time the association between HRD event and enhanced neoadjuvant immunotherapy response in lung cancer. The power of HRD event in patient therapeutic stratification persisted in multifaceted public cohorts. We propose that HR pathway gene status could serve as novel and additional indicators guiding immune-neoadjuvant and immunotherapy treatment decisions for NSCLC patients.

Remote monitoring of patient recovery following lung cancer surgery: a messenger application approach.

BACKGROUND: Repeated assessment of patient recovery after discharge is challenging. This study used a popular messenger application to remotely collect patient self-reported symptoms and their severity so as to monitor patient recovery and identify the factors affecting the recovery of symptoms following lung cancer surgery. METHODS: This prospective observational study was conducted at a single tertiary lung cancer center in China between November 2018 and June 2019. Participants received demonstration videos and repeated symptom surveys regarding pain and cough severity (assessed using numeric rating scores of 0-10 for pain and 0-6 for cough) at 2, 4, 6, 8, and 12 weeks after discharge via a smartphone program bound to the WeChat application. Patients who responded to at least 3 of the 5 post-discharge surveys were included in this study. The data were analyzed to investigate the symptom recovery and its related factors. RESULTS: Of the 826 patients enrolled, 589 (71.3%) responded to at least three surveys. The average pain score reduced from 4.1±2.5 at 2 weeks to 2.2±2.0 at 12 weeks (P<0.001). Factors associated with higher pain severity included the female gender, age over 60 years, thoracotomy, longer operation time (>90 minutes), and prolonged chest tube drainage (>7 days). The average cough score decreased from 2.34±1.30 at 2 weeks to 1.93±1.26 at 12 weeks (P<0.001). Being female and a prolonged operation time (>90 min) were related to increased cough severity. Sublobar resection and limited lymphadenectomy may contribute to lower cough severity post-surgery. CONCLUSIONS: The messenger application-based remote monitoring successfully collected post-discharge symptom information and identified factors associated with recovery following lung surgery.

Reaction Mechanism and Structural Evolution of Fluorographite Cathodes in Solid-State K/Na/Li Batteries.

Fluorographites (CFx ) are ultrahigh-energy-density cathode materials for alkaline-metal primary batteries. However, they are generally not rechargeable. To elucidate the reaction mechanism of CFx cathodes, in situ transmission electron microscopy characterizations and ab initio calculations are employed. It is found that it is a two-phase mechanism upon K/Na/Li ion insertion; crystalline KF (crystalline NaF nanoparticles and amorphous LiF) is generated uniformly within the amorphous carbon matrix, retaining an unchanged volume during the discharge process. The diffusivity for K/Na/Li ion migration within the CFx is ≈2.2-2.5 × 10-12 , 3.4-5.3 × 10-12 , and 1.8-2.5 × 10-11 cm2 s-1 , respectively, which is comparable to the diffusivity of K/Na/Li ions in liquid-state cells. Encouraged by the in situ transmission electron microscopy (TEM) results, a new rechargeable all-solid-state Li/CFx battery is further designed that shows a part of the reversible specific discharge capacity at the 2nd cycle. These findings demonstrate that a solid-state electrolyte provides a different reaction process compared with a conventional liquid electrolyte, and enables CFx to be partly rechargeable in solid-state Li batteries.

Prognostic Value of Inflammatory Biomarkers in Patients With Stage I Lung Adenocarcinoma Treated With Surgical Dissection.

OBJECTIVE: Inflammation plays a crucial role in tumorigenesis and progression. Our purpose was to investigate the prognostic value of neutrophil-to-lymphocyte ratio (NLR), systemic inflammation response index (SIRI) and systemic immune-inflammation index (SII), and develop a nomogram to predict the cancer-specific survival (CSS) and disease-free survival (DFS) of stage I lung adenocarcinoma patients. METHODS: 1431 patients undergoing surgical resection with pathologically confirmed stage I lung adenocarcinoma were reviewed. The optimal cut-off values for NLR, SII, and SIRI were defined by the receiver operating characteristic (ROC) curve. Cox proportional hazards regression analyses were performed to recognize factors significantly correlated with CSS and DFS to construct the nomogram. The value of adjuvant chemotherapy on model-defined high-risk and low-risk patients was further explored. RESULTS: The cohort had a median follow-up time of 63 months. Multivariate analysis revealed that higher NLR (≥2.606), higher SIRI (≥0.705), higher SII (≥580.671), later T stage, histological pattern with solid or micropapillary components and radiologic features with solid nodules were significantly associated with worse CSS and DFS. The concordance index (C-index) of the nomogram established by all these factors was higher than that of the TNM staging system both in CSS (validation set 0.778 vs 0.652) and DFS (validation set 0.758 vs 0.695). Furthermore, the value of the established nomogram on risk stratification in stage I lung adenocarcinoma patients was validated. CONCLUSIONS: Higher NLR, SII and SIRI pretreatment were associated with worse survival outcomes. A practical nomogram based on these three inflammatory biomarkers may help clinicians to precisely stratify stage I lung adenocarcinoma patients into high- and low-risk and implement individualized treatment.

[ERCC1 expression as a predictor of survival after operation in stage I non-small cell lung cancer patients].

BACKGROUND AND OBJECTIVE: Proteins of the nucleotide excision repair pathway can repair DNA damage. The excision repair cross-complementing (ERCC) gene family reduce damagement of DNA by nucleotide excision and repair. The aim of this study is to investigate the expressions of ERCC1 (members of DNA repair gene family) in patients with non-small cell lung cancer (NSCLC) as well as their clinical prognostic significance. METHODS: Expression levels ofERCC1 were detected by IHC in 118 stage I NSCLC patients. Kaplan-Meier survival curve, and Cox multivariate regression analysis were used for statistical analysis. RESULTS: The patients with high expression of ERCC1 had significantly longer survival time than those with low expression of ERCC1, and Cox multivariate regression analysis showed that expression of RRM1 was an independent prognostic factor for NSCLC patients. CONCLUSION: NSCLC patients with high ERCC1 expression have a better survival when compared to patients with low ERCC1 expression. Therefore, an intact DNA repair mechanism may reduce the accumulation of genetic aberrations that are thought to contribute to a tumor malignant potential and therefore the risk of relapse after definitive treatment.