Incidence of low-level viremia and its impact on virologic failure among people living with HIV who started an integrase strand transfer inhibitors: a longitudinal cohort study.

BACKGROUND: Low-level viremia (LLV) has been identified as a potential precursor to virologic failure (VF), yet its clinical implications, particularly within the context of Integrase Strand Transfer Inhibitors (INSTIs)-based regimens, remain insufficiently explored. The study aimed to investigate the relationship between LLV and VF within ART-naïve patients on INSTIs-based regimens in China. METHODS: A longitudinal cohort study was conducted with ART-naïve patients aged ≥ 18 years at Beijing Ditan Hospital, under the Chinese National Free Antiretroviral Treatment Program (NFATP). The LLV was defined as a viral load (VL) ranging from 50 to 199 copies/mL after six months of ART initiation, and VF as a VL ≥ 200 copies/mL. Sensitive analyses were also performed, defining LLV as 50-999 copies/mL and VF as exceeding 1000 copies/mL. Multivariate logistic regression, Kaplan-Meier (KM) curve, and Generalized Estimating Equation (GEE) models were used to evaluate the risk factors associated with LLV and VF events. RESULTS: The study involved 830 ART-naïve patients, comprising 600 in the INSTIs group and 230 in the protease inhibitors (PIs) group. LLV events were observed in 10.4% of patients on PIs-based regimens and and 3.2% on INSTIs-based regimens (P < 0.001). INSTIs-based regimens demonstrated a protective effect against LLV events (aHR = 0.27, 95% CI 0.137-0.532). VF events occurred in 10.9% of patients on PIs-based regimens and 2.0% on INSTIs-based regimens, respectively (P < 0.001). The occurrence of LLV events significantly increased the risk of VF by 123.5% (95% CI 7.5%-364.4%), while the integrase inhibitors were associated with a 76.9% (95% CI 59.1%-86.9%) reduction in VF risk. CONCLUSION: Our findings indicate that INSTIs-based regimens are critical protective factors against LLV and subsequent VF. These results underscore the importance of HIV viral load monitoring to ensuring effective treatment outcomes, highlighting the necessity for prompt and precise monitoring to refine HIV treatment methodologies.

High-Performance Photoinduced Memory with Ultrafast Charge Transfer Based on MoS2 /SWCNTs Network Van Der Waals Heterostructure.

Photoinduced memory devices with fast program/erase operations are crucial for modern communication technology, especially for high-throughput data storage and transfer. Although some photoinduced memories based on 2D materials have already demonstrated desirable performance, the program/erase speed is still limited to hundreds of micro-seconds. A high-speed photoinduced memory based on MoS2 /single-walled carbon nanotubes (SWCNTs) network mixed-dimensional van der Waals heterostructure is demonstrated here. An intrinsic ultrafast charge transfer occurs at the heterostructure interface between MoS2 and SWCNTs (below 50 fs), therefore enabling a record program/erase speed of ≈32/0.4 ms, which is faster than that of the previous reports. Furthermore, benefiting from the unique device structure and material properties, while achieving high-speed program/erase operation, the device can simultaneously obtain high program/erase ratio (≈106 ), appropriate storage time (≈103  s), record-breaking detectivity (≈1016  Jones) and multibit storage capacity with a simple program/erase operation. It even has a potential application as a flexible optoelectronic device. Therefore, the designed concept here opens an avenue for high-throughput fast data communications.

Self-assembled nanowire array capacitors: capacitance and interface state profile.

Direct characterization of the capacitance and interface states is very important for understanding the electronic properties of a nanowire transistor. However, the capacitance of a single nanowire is too small to precisely measure. In this work we have fabricated metal-oxide-semiconductor capacitors based on a large array of self-assembled Si nanowires. The capacitance and conductance of the nanowire array capacitors are directly measured and the interface state profile is determined by using the conductance method. We demonstrate that the nanowire array capacitor is an effective platform for studying the electronic properties of nanoscale interfaces. This approach provides a useful and efficient metrology for the study of the physics and device properties of nanoscale metal-oxide-semiconductor structures.

Achieving High-Performance Polymer-Wrapper-Free Aligned Carbon Nanotube Field-Effect Transistors Through Degradable Polymer Wrapping and Efficient Removal Techniques.

Semiconducting carbon nanotubes (s-CNTs) have emerged as a promising alternative to traditional silicon for ultrascaled field-effect transistors (FETs), owing to their exceptional properties. Aligned s-CNTs (A-CNTs) are particularly favored for practical applications due to their ability to provide higher driving current and lower contact resistance compared with individual s-CNTs or random networks. Achieving high-semiconducting-purity A-CNTs typically involves conjugated polymer wrapping for selective separation of s-CNTs, followed by self-assembly techniques. However, the presence of the polymer wrapper on A-CNTs can adversely impact electrical contact, gating efficiency, carrier transport, and device-to-device variations, necessitating its complete removal. While various methods have been explored for polymer removal, accurately characterizing the extent of removal remains a challenge. Traditional techniques such as absorption spectroscopy and X-ray photoelectron spectroscopy (XPS) may not accurately depict the remaining polymer content on A-CNTs due to their inherent detection limits. Consequently, the performance of FETs based on pure polymer-wrapper-free A-CNTs is unclear. In this study, we present an approach for preparing high-semiconducting-purity and polymer-wrapper-free A-CNTs using poly[(9,9-dioctylfluorenyl-2,7-dinitrilomethine)-(9,9-dioctylfluorenyl-2,7-dimethine)] (PFO-N-PFO), a degradable polymer, in conjunction with a modified dimension-limited self-alignment process (m-DLSA). Comprehensive transmission electron microscopy (TEM) characterizations, complemented by absorption and XPS characterizations, provide robust evidence of the successful near-complete removal of the polymer wrapper via a cleaning procedure involving acidic degradation, hot solvent rinsing, and vacuum annealing. Furthermore, top-gated FETs based on these high-semiconducting-purity and polymer-wrapper-free A-CNTs exhibit good performance metrics, including an on-current (Ion) of 2.2 mA/µm, peak transconductance (gm) of 1.1 mS/µm, low contact resistance (Rc) of 191 Ω·µm, and negligible hysteresis, representing a significant advancement in the CNT-based FET technology.

Sub-180-nanometer-thick ultraconformable high-performance carbon nanotube-based dual-gate transistors and differential amplifiers.

There is increased interest in ultrathin flexible devices with thicknesses of <1 micrometers due to excellent conformability toward advanced laminated bioelectronics. However, because of limitations in materials, device structure, and fabrication methodology, the performance of these ultrathin devices and circuits is insufficient to support higher-level applications. Here, we report high-performance carbon nanotube-based thin-film transistors (TFTs) and differential amplifiers on ultrathin polyimide films with a total thickness of <180 nanometers. A dual-gate structure is introduced to guarantee excellent gate control efficiency and mechanical stability of the ultrathin TFTs, which exhibit high transconductance (8.96 microsiemens per micrometer), high mobility (127 square centimeters per volt per second), and steep subthreshold swing (84 millivolts per decade), and can sustain a bending radius of curvature of <10 micrometers. The differential amplifier achieves the highest gain-bandwidth product (1.83 megahertz) among flexible differential amplifiers, enabling higher-gain amplification of weak signals over an extended frequency spectrum that is demonstrated by amplification of electromyography signals in situ.

Extraordinary control of terahertz beam reflectance in graphene electro-absorption modulators.

We demonstrate a graphene-based electro-absorption modulator achieving extraordinary control of terahertz reflectance. By concentrating the electric field intensity in an active layer of graphene, an extraordinary modulation depth of 64% is achieved while simultaneously exhibiting low insertion loss (∼2 dB), which is remarkable since the active region of the device is atomically thin. This modulator performance, among the best reported to date, indicates the enormous potential of graphene for terahertz reconfigurable optoelectronic devices.

High-Performance Shortwave Infrared Detector Based on Multilayer Carbon Nanotube Films.

Carbon nanotube (CNT) is an ideal candidate material for shortwave infrared (SWIR) detectors due to its large band gap tunability, strong infrared light absorption, and high mobility. Furthermore, the photodetectors based on CNT can be prepared on any substrate using a low-temperature process, which is conducive to three-dimensional (3D) integration. However, owing to the absorption limitation (<2%) of a single-layer network CNT film with low density, the photodetectors of CNT film show low photocurrent responsivity and detectivity. In this paper, we optimize the thickness of the high-purity semiconducting network CNT films to increase the photocurrent responsivity of the photodetectors. When the thickness of network CNT film is about 5 nm, the responsivity of the zero-bias voltage can reach 32 mA/W at 1800 nm wavelength. Then, using stacked CNT films and contact electrode design, the photodetectors exhibit a maximum responsivity of 120 mA/W at 1800 nm wavelength. The photodetectors with stacked CNT films and local n-type channel doping demonstrated a wide response spectral range of 1200-2100 nm, a peak detectivity of 3.94 × 109 Jones at room temperature, and a linear dynamic range over 118 dB. Moreover, the peak detectivity is over 2.27 × 1011 Jones when the temperature is 180 K. Our work demonstrates the potential of the CNT film for future SWIR imaging at a low cost.

Efficacy and Safety of Fractional CO2 Laser Combined with Halometasone Cream for Treatment of Moderate-to-Severe Chronic Hand Eczema: A Prospective, Single-Center, Parallel-Group, Open-Label Randomized Trial.

INTRODUCTION: The purpose of this study was to assess the efficacy and safety of fractional CO2 laser combined with halometasone cream in patients with moderate-to-severe chronic hand eczema (CHE). METHODS: A prospective, single-center, parallel-group, open-label randomized trial including 67 patients with moderate-to-severe CHE was carried out. Patients were randomly assigned to group A (n = 33, fractional CO2 laser once every 4 weeks 1-2 times and halometasone cream twice daily for 8 weeks) or group B (n = 34, halometasone cream alone twice daily for 8 weeks). The primary endpoint was the proportion of patients achieving treatment success at week 12 in each group. Secondary endpoints included differences between groups in the change of hand eczema severity index (HECSI), patient global assessment (PaGA), dermatology life quality index (DLQI), and quality of life in hand eczema questionnaire (QOLHEQ) from baseline to week 12. Relapse rate and adverse effects were also recorded. RESULTS: A total of 29 patients in each group completed the trial. At week 12, the treatment success rate was 62.1% (18/29) in group A and 27.6% (8/29) in group B (p = 0.009). At week 12, HECSI, PaGA, DLQI, and QOLHEQ all decreased compared with baseline in both groups (p < 0.05). HECSI, DLQI, and QOLHEQ decreased more in group A than group B (p = 0.014, 0.010, and 0.014, respectively), but there was no significant difference in change of PaGA between the two groups (1.0 versus 3.0, p = 0.419). Among patients achieving treatment success, 11.1% (2/18) patients in group A and 50.0% (4/8) patients in group B relapsed at week 24 (p = 0.011). Skin pigmentation was the most common adverse effect. CONCLUSIONS: For patients with moderate-to-severe CHE, fractional CO2 laser combined with halometasone cream is more effective than halometasone cream alone, with few adverse effects. TRIAL REGISTRATION NUMBER: ChiCTR2100051948.

Thirteen-year viral suppression and immunologic recovery of LPV/r-based regimens in pediatric HIV treatment: a multicenter cohort study in resource-constrained settings of China.

Background: Antiretroviral Therapy (ART) in children remains challenging due to resource-constrained settings. We conducted a 13-year, prospective, multicenter cohort study on the effectiveness and safety of LPV/r-based regimens in ART-naive and ART-experienced children. Methods: From January 2008 to May 2021, children living with HIV-1 were recruited with LPV/r-based regimens from 8 clinical research sites in 6 provinces in China. Effectiveness outcomes were virologic failure (defined as at least two consecutive measurements of VL > 200 copies/mL after 6 months of ART) and immune response (defined as CD4% recovered to more than 25% after 12 months of treatment). The safety outcomes were treatment-related grade 2-4 adverse events and abnormal laboratory test results. Results: A total of 345 ART-naïve children and 113 ART-experienced children were included in this cohort study. The median follow-up time was 7.3 (IQR 5.5-10.5) years. The incidence density of virologic failure was 4.1 (95% CI 3.3-4.9) per 100 person-years in ART-naïve children and 5.0 (95% CI 3.5-6.5) per 100 person-years in ART-experienced children. Kaplan Meyer (KM) curve analysis showed children with ART experience were at a higher risk of virologic failure (p < 0.05). The risk factors of virologic failure in ART-naïve children were clinic setting in rural hospitals (aHR = 2.251, 1.108-4.575), annual missed dose times >5 days of LPV intake (aHR = 1.889, 1.004-3.554); The risk factor of virologic failure in ART-experienced children was missed dose times >5 days (aHR = 2.689, 1.299-5.604) and mother as caregivers for ART administration (aHR = 0.475, 0.238-0.948). However, during long-term treatment, viral suppression rates between ART-naïve and ART-experienced children remained similar. No significant differences were observed in the immune response, treatment-related grade 2-4 events, and abnormal laboratory test results between ART-naïve children and ART-experienced children. Conclusion: Our research underscores that with consistent, long-term treatment of LPV/r-based regimens, ART-experienced children can achieve therapeutic outcomes comparable to ART-naïve children. It provides crucial insights on LPV/r-based regimens in pediatric HIV treatment, especially in resource-limited settings where high-cost Integrase Strand Transfer Inhibitors (INSTs) are inaccessible. This evidence-based understanding provides an essential addition to the global therapeutic strategies for pediatric HIV treatment.

High-performance carbon nanotube light-emitting diodes with asymmetric contacts.

Electroluminescence (EL) measurements are carried out on a two-terminal carbon nanotube (CNT) based light-emitting diode (LED). This two-terminal device is composed of an asymmetrically contacted semiconducting single-walled carbon nanotube (SWCNT). On the one end the SWCNT is contacted with Sc and on the other end with Pd. At large forward bias, with the Sc contact being grounded, electrons can be injected barrier-free into the conduction band of the SWCNT from the Sc contact and holes be injected into the valence band from the Pd electrode. The injected electrons and holes recombine radiatively in the SWCNT channel yielding a narrowly peaked emission peak with a full width at half-maximum of about 30 meV. Detailed EL spectroscopy measurements show that the emission is excitons dominated process, showing little overlap with that associated with the continuum states. The performance of the LED is compared with that based on a three-terminal field-effect transistor (FET) that is fabricated on the same SWCNT. The conversion efficiency of the two-terminal diode is shown to be more than three times higher than that of the FET based device, and the emission peak of the LED is much narrower and operation voltage is lower.

Efficacy and Safety of 5% Minoxidil Alone, Minoxidil Plus Oral Spironolactone, and Minoxidil Plus Microneedling on Female Pattern Hair Loss: A Prospective, Single-Center, Parallel-Group, Evaluator Blinded, Randomized Trial.

Background: The efficacy of topical minoxidil (MX) alone on female pattern hair loss (FPHL) is limited. Combination therapy based on topical MX is currently expected to provide better outcomes. Objectives: This study aimed to assess whether the combined therapies including MX plus oral spironolactone (SPT) and MX plus microneedling (MN) have advantages in efficacy and safety over topical MX alone on mild-to-moderate FPHL with normal hormone levels in the blood and regular menstrual cycle. Methods: A prospective, single-center, parallel-group, evaluator blinded, randomized trial including 120 non-menopause women with proven FPHL (Sinclair class II-III) was performed in China. Patients were randomly assigned to three groups, namely, the MX group (5% topical MX alone, once daily), the MX + SPT group (MX plus SPT 80-100 mg daily), and the MX+MN group (MX plus MN every 2 weeks, 12 sessions). The change from the baseline to week 24 was assessed in hair growth (hair density and diameter under dermoscope), scalp tissue structure (epidermal thickness, dermis thickness, and average hair follicle diameter under ultrasound biomicroscopy), physician's global assessment (using a 7-point global-assessment scale and Sinclair's stage change), patient evaluation (Women's Androgenetic Alopecia Quality of Life Questionnaire and Sinclair's hair-shedding score) and side effects. Results: In total, 115 participants completed the trial. At week 24, the hair density increased most in MX + MN group and increased least in MX group (p < 0.001 for MX + MN group vs. MX + SPT group; p = 0.009 for MX + SPT group vs. MX group). The hair shaft diameter significantly increased in all groups (p < 0.001, respectively), but there were no significant differences among the three groups (p = 0.905). The epidermal thickness and average hair follicle diameter only increased in MX + MN group. Dermis thickness increased in all groups, but there were no significant differences among the three groups. Both physician's and patient assessments showed improvement in all three groups. Scalp pruritus was the most common side effect. The MX + SPT group had the most reported adverse effects. Limitations: The main limitations of this study are the relatively small sample size, the exclusion of severe FPHL patients, and the potential bias from unblinded treatments among the 3 groups. Conclusion: Topical MX combined with MN is a better choice than either MX plus oral SPT or MX alone for the treatment of mild-to-moderate FPHL patients.

High-Performance Carbon Nanotube-Based Transient Complementary Electronics.

Transient electronics is an emerging class of electronic devices that can physically degrade or disintegrate after a stable period of service, showing a vast prospect in applications of "green" consumer electronics, hardware-secure devices, medical implants, etc. Complementary metal-oxide-semiconductor (CMOS) technology is dominant in integrated circuit design for its advantages of low static power consumption, high noise immunity, and simple design layout, which also work and are highly preferred for transient electronics. However, the performance of complementary transient electronics is severely restricted by the confined selection of transient materials and compatible fabrication strategies. Here, we report the realization of high-performance transient complementary electronics based on carbon nanotube thin films via a reliable electrostatic doping method. Under a low operating voltage of 2 V, on a 1.5 µm-thick water-soluble substrate made of poly(vinyl alcohol), the width-normalized on-state currents of the p-type and n-type transient thin-film transistors (TFTs) reach 4.5 and 4.7 µA/µm, and the width-normalized transconductances reach 2.8 and 3.7 µS/µm, respectively. Meanwhile, these TFTs show small subthreshold swings no more than 108 mV/dec and current on/off ratios above 106 with good uniformity. Transient CMOS inverters, as basic circuit components, are demonstrated with a voltage gain of 24 and a high noise immunity of 67.4%. Finally, both the degradation of the active components and the disintegration of the functional system are continuously monitored with nontraceable remains after 10 and 5 h, respectively.

Carbon Nanotube-Based Flexible Ferroelectric Synaptic Transistors for Neuromorphic Computing.

Biological nervous systems evolved in nature have marvelous information processing capacities, which have great reference value for modern information technologies. To expand the function of electronic devices with applications in smart health monitoring and treatment, wearable energy-efficient computing, neuroprosthetics, etc., flexible artificial synapses for neuromorphic computing will play a crucial role. Here, carbon nanotube-based ferroelectric synaptic transistors are realized on ultrathin flexible substrates via a low-temperature approach not exceeding 90 °C to grow ferroelectric dielectrics in which the single-pulse, paired-pulse, and repetitive-pulse responses testify to well-mimicked plasticity in artificial synapses. The long-term potentiation and long-term depression processes in the device demonstrate a dynamic range as large as 2000×, and 360 distinguishable conductance states are achieved with a weight increase/decrease nonlinearity of no more than 1 by applying stepped identical pulses. The stability of the device is verified by the almost unchanged performance after the device is kept in ambient conditions without additional passivation for 240 days. An artificial neural network-based simulation is conducted to benchmark the hardware performance of the neuromorphic devices in which a pattern recognition accuracy of 95.24% is achieved.

Carbon nanotube-based flexible high-speed circuits with sub-nanosecond stage delays.

High-speed flexible circuits are required in flexible systems to realize real-time information analysis or to construct wireless communication modules for emerging applications. Here, we present scaled carbon nanotube-based thin film transistors (CNT-TFTs) with channel lengths down to 450 nm on 2-µm-thick parylene substrates, achieving state-of-the-art performances of high on-state current (187.6 µA µm-1) and large transconductance (123.3 µS µm-1). Scaling behavior analyses reveal that the enhanced performance introduced by scaling is attributed to channel resistance reduction while the contact resistance (180 ± 50 kΩ per tube) remains unchanged, which is comparable to that achieved in devices on rigid substrates, indicating great potential in ultimate scaled flexible CNT-TFTs with high performance comparable to their counterparts on rigid substrates where contact resistance dominates the performance. Five-stage flexible ring oscillators are built to benchmark the speed of scaled devices, demonstrating a 281 ps stage delay at a low supply voltage of 2.6 V.

Efficacy and Safety of Long-Pulsed 755-nm Alexandrite Laser for Keratosis Pilaris: A Split-Body Randomized Clinical Trial.

INTRODUCTION: Keratosis pilaris (KP) is a disfiguring disease and is resistant to treatment. Several treatment methods are available, but the efficacy is limited. This prospective, rater-blinded, split-body comparative study investigated the efficacy and safety of long-pulsed 755-nm alexandrite laser in the treatment of KP. METHODS: Twenty-two patients with KP of bilateral arms were enrolled in this study. All participants were randomized and treated with a long-pulsed 755-nm alexandrite laser on the left or right arm in four sessions held 3 weeks apart. The unified moisturizing lotion was applied on both left and right arms once a day. Physicians' assessment scores and patients' self-assessment scores were recorded, and skin imaging changes in dermoscopy, high-frequency ultrasound, and skin biopsy were obtained at baseline and 4 weeks after the fourth treatment. RESULTS: Of the 21 patients who completed the study, 15 were women and 6 were men. At 4 weeks after the fourth treatment, the laser side showed significantly lower total (2.0 versus 4.5), roughness (1.0 versus 2.0), and redness (1.0 versus 2.0) scores according to physicians' assessment (all P < 0.05). Furthermore, the laser side showed significantly lower total (2.0 versus 4.0), roughness (1.0 versus 2.0), and redness scores (1.0 versus 2.0) according to the patients' self-assessment (all P < 0.05). The proportions of patients who achieved dermoscopically and ultrasonographically showed excellent improvements in follicular plugs (57.1% versus 14.3%), perifollicular erythema (52.4% versus 9.5%), perifollicular hyperpigmentation (47.6% versus 14.3%), and the number of epidermal bulges (57.1% versus 19.1%) in the laser side was significantly higher than those who achieved such improvements in the control side (all P < 0.05). Histopathology showed that the follicular plugs and inflammatory cell infiltration were improved at the final visit. Three patients exhibited reversible postinflammatory hyperpigmentation. CONCLUSION: Long-pulsed 755-nm alexandrite laser treatment is effective and safe in treating both skin roughness and redness in KP. TRIAL REGISTRATION NUMBER: ChiCTR2100054489.

Efficacy of Microneedling Combined With Local Application of Human Umbilical Cord-Derived Mesenchymal Stem Cells Conditioned Media in Skin Brightness and Rejuvenation: A Randomized Controlled Split-Face Study.

Background: Fighting skin aging signs is one of the major challenges of the 21st century, recently, mesenchymal stem cells (MSCs) and microneedling (MN) have been applied for anti-aging. This study aims to evaluate the efficacy of the combination of MN and human umbilical cord-derived mesenchymal stem cells conditioned media (hUC-MSCs-CM) in skin brightness and rejuvenation. Methods: Thirty volunteers with facial skin aging were recruited for the randomized, controlled split-face study. The left and right sides of the face were randomly applied with saline via MN or hUC-MSCs-CM via MN. Five sessions were performed for each volunteer at 2-week intervals. Two dermatologists evaluated the clinical improvement, in terms of skin brightness and texture. A satisfaction score based on a self-evaluation questionnaire was recorded at 2 weeks after the last treatment. The objective evaluation was recorded before the first treatment, and at 2 weeks after the last treatment. Results: Twenty-eight volunteers with a mean (SD) age of 41 (6.54) years old completed the trial. The investigator's assessment for skin brightness and texture, and the self-satisfaction score revealed statistically better effects in hUC-MSCs-CM -plus-MN group than in MN alone (MN saline) group. No severe side effects were reported during the whole study period. Compared to MN alone group, the objective assessment revealed significant improvements in skin brightness (reduced melanin index, ultraviolet spots, and brown spots) and skin texture (reduced wrinkles and pores, and increased skin elasticity) in hUC-MSCs-CM-plus-MN group, while there were no obvious differences in skin hydration, trans-epidermal water loss, and the erythema index. Conclusion: The combination of hUC-MSCs-CM and MN exhibite anti-aging efficacy, and this could be used for facial rejuvenation in the future.

An epidermal electronic system for physiological information acquisition, processing, and storage with an integrated flash memory array.

Epidermal electronic systems that simultaneously provide physiological information acquisition, processing, and storage are in high demand for health care/clinical applications. However, these system-level demonstrations using flexible devices are still challenging because of obstacles in device performance, functional module construction, or integration scale. Here, on the basis of carbon nanotubes, we present an epidermal system that incorporates flexible sensors, sensor interface circuits, and an integrated flash memory array to collect physiological information from the human body surface; amplify weak biosignals by high-performance differential amplifiers (voltage gain of 27 decibels, common-mode rejection ratio of >43 decibels, and gain bandwidth product of >22 kilohertz); and store the processed information in the memory array with performance on par with industrial standards (retention time of 108 seconds, program/erase voltages of ±2 volts, and endurance of 106 cycles). The results shed light on the great application potential of epidermal electronic systems in personalized diagnostic and physiological monitoring.

Growth and performance of yttrium oxide as an ideal high-kappa gate dielectric for carbon-based electronics.

High-quality yttrium oxide (Y(2)O(3)) is investigated as an ideal high-kappa gate dielectric for carbon-based electronics through a simple and cheap process. Utilizing the excellent wetting behavior of yttrium on sp(2) carbon framework, ultrathin (about few nm) and uniform Y(2)O(3) layers have been directly grown on the surfaces of carbon nanotube (CNT) and graphene without using noncovalent functionalization layers or introducing large structural distortion and damage. A top-gate CNT field-effect transistor (FET) adopting 5 nm Y(2)O(3) layer as its top-gate dielectric shows excellent device characteristics, including an ideal subthreshold swing of 60 mV/decade (up to the theoretical limit of an ideal FET at room temperature). The high electrical quality Y(2)O(3) dielectric layer has also been integrated into a graphene FET as its top-gate dielectric with a capacitance of up to 1200 nF/cm(2), showing an improvement on the gate efficiency and on state transconductance of over 100 times when compared with that of its back-gate counterpart.

Case Report: The First Reported Case of Bullous Lichen Planus-Systemic Lupus Erythematosus Overlap Syndrome.

Introduction: Lichen planus/lupus erythematosus overlap syndrome is rarely seen in the clinic and has the characteristic clinical manifestations, histopathology, and immunopathology of lichen planus (LP) and lupus erythematosus (LE). This is the first reported case of bullous lichen planus (BLP)/systemic lupus erythematosus (SLE) overlap syndrome with hair loss as the first symptom. Case Presentation: A 48-year-old female presented with alopecia for half a year, and skin lesions accompanied by itching on her face, trunk, and limbs for 3 months. She had a history suggestive of photosensitivity. Laboratory tests and histopathology were performed for diagnosis. Histopathologic features of the upper arm and back of the hand were consistent with BLP, whereas the scalp lesion indicated LE. Laboratory examination indicated positive for antinuclear antibody (ANA) (1:160), leukopenia, increased urinary protein, decreased C3/C4, and normal BP180. The patient was given glucocorticoid combined with acitretin and immunosuppressive therapy after a definite diagnosis of BLP/SLE overlap syndrome. The lesions of the patient disappeared and some hair had regrown during the two years of follow-up. Conclusion: This is the first reported case of BLP/SLE overlap syndrome which responded well to glucocorticoids, retinoids, and immunosuppressive drugs. Multiple biopsies from characteristic lesions will guide doctors to avoid misdiagnoses and delayed treatment.

Comparison of the Efficacy of Melasma Treatments: A Network Meta-Analysis of Randomized Controlled Trials.

Background: Melasma is an acquired pigmentation disorder with challenges in treatment because of its refractory nature and high risk of recurrence. Objectives: This study aimed to compare the efficacy and side effects of 14 common therapies for melasma using a systematic review and network meta-analysis (NMA). Methods: The PubMed, Embase, and Cochrane Library databases were searched till December 2020 using the melasma area and severity index as a therapeutic index. A total of 59 randomized controlled trials (RCTs) met the inclusion criteria and were selected. Results: The ranking of relative efficacy compared with placebo in descending order was Q-switched Nd:Yag 1,064-nm laser (QSND), intense pulsed light, ablative fractional laser (AFL), triple combined cream (TCC), topical vitamin C, oral tranexamic acid (oTA), peeling, azelaic acid, microneedles (MNs), topical tranexamic acid (tTA), tretinoin, picosecond laser, hydroquinone (HQ), and non-AFL. Moreover, QSND was more effective than HQ and tTA against melasma. The ranking of percentage (%) of side effects in ascending order for each of 14 therapies with more than 80 participants was tretinoin (10.1%), oTA (17.6%), HQ (18.2%), AFL (20.0%), QSND (21.5%), TCC (25.7%), tTA (36.75%), peeling (38.0%), and MN (52.3%). Taking both efficacy and safety into consideration, TCC was found to be the most favorable selection among the topical drugs for melasma. QSND and AFL were still the best ways to treat melasma among photoelectric devices. oTA as system administration was a promising way recommended for melasma. Among 31 studies, 87% (27/31) studies showed that the efficacy of combination therapies is superior to that of single therapy. The quality of evidence in this study was generally high because of nearly 50% of split-face RCTs. Conclusions: Based on the published studies, this NMA indicated that QSND, AFL, TCC, and oTA would be the preferred ways to treat melasma for dermatologists. However, more attention should be paid to the efficacy and safety simultaneously during the clinical application. Most of the results were in line with those of the previous studies, but a large number of RCTs should be included for validation or update. Systematic Review Registration: identifier: CRD42021239203.