An ordered, self-assembled nanocomposite with efficient electronic and ionic transport.

Mixed conductors-materials that can efficiently conduct both ionic and electronic species-are an important class of functional solids. Here we demonstrate an organic nanocomposite that spontaneously forms when mixing an organic semiconductor with an ionic liquid and exhibits efficient room-temperature mixed conduction. We use a polymer known to form a semicrystalline microstructure to template ion intercalation into the side-chain domains of the crystallites, which leaves electronic transport pathways intact. Thus, the resulting material is ordered, exhibiting alternating layers of rigid semiconducting sheets and soft ion-conducting layers. This unique dual-network microstructure leads to a dynamic ionic/electronic nanocomposite with liquid-like ionic transport and highly mobile electronic charges. Using a combination of operando X-ray scattering and in situ spectroscopy, we confirm the ordered structure of the nanocomposite and uncover the mechanisms that give rise to efficient electron transport. These results provide fundamental insights into charge transport in organic semiconductors, as well as suggesting a pathway towards future improvements in these nanocomposites.

Molecular Design Strategies toward Improvement of Charge Injection and Ionic Conduction in Organic Mixed Ionic-Electronic Conductors for Organic Electrochemical Transistors.

Expanding the toolbox of the biology and electronics mutual conjunction is a primary aim of bioelectronics. The organic electrochemical transistor (OECT) has undeniably become a predominant device for mixed conduction materials, offering impressive transconduction properties alongside a relatively simple device architecture. In this review, we focus on the discussion of recent material developments in the area of mixed conductors for bioelectronic applications by means of thorough structure-property investigation and analysis of current challenges. Fundamental operation principles of the OECT are revisited, and characterization methods are highlighted. Current bioelectronic applications of organic mixed ionic-electronic conductors (OMIECs) are underlined. Challenges in the performance and operational stability of OECT channel materials as well as potential strategies for mitigating them, are discussed. This is further expanded to sketch a synopsis of the history of mixed conduction materials for both p- and n-type channel operation, detailing the synthetic challenges and milestones which have been overcome to frequently produce higher performing OECT devices. The cumulative work of multiple research groups is summarized, and synthetic design strategies are extracted to present a series of design principles that can be utilized to drive figure-of-merit performance values even further for future OMIEC materials.

Synthetic Nuances to Maximize n-Type Organic Electrochemical Transistor and Thermoelectric Performance in Fused Lactam Polymers.

A series of fully fused n-type mixed conduction lactam polymers p(g7NCnN), systematically increasing the alkyl side chain content, are synthesized via an inexpensive, nontoxic, precious-metal-free aldol polycondensation. Employing these polymers as channel materials in organic electrochemical transistors (OECTs) affords state-of-the-art n-type performance with p(g7NC10N) recording an OECT electron mobility of 1.20 × 10-2 cm2 V-1 s-1 and a µC* figure of merit of 1.83 F cm-1 V-1 s-1. In parallel to high OECT performance, upon solution doping with (4-(1,3-dimethyl-2,3-dihydro-1H-benzoimidazol-2-yl)phenyl)dimethylamine (N-DMBI), the highest thermoelectric performance is observed for p(g7NC4N), with a maximum electrical conductivity of 7.67 S cm-1 and a power factor of 10.4 µW m-1 K-2. These results are among the highest reported for n-type polymers. Importantly, while this series of fused polylactam organic mixed ionic-electronic conductors (OMIECs) highlights that synthetic molecular design strategies to bolster OECT performance can be translated to also achieve high organic thermoelectric (OTE) performance, a nuanced synthetic approach must be used to optimize performance. Herein, we outline the performance metrics and provide new insights into the molecular design guidelines for the next generation of high-performance n-type materials for mixed conduction applications, presenting for the first time the results of a single polymer series within both OECT and OTE applications.

Reversible Electrochemical Charging of n-Type Conjugated Polymer Electrodes in Aqueous Electrolytes.

Conjugated polymers achieve redox activity in electrochemical devices by combining redox-active, electronically conducting backbones with ion-transporting side chains that can be tuned for different electrolytes. In aqueous electrolytes, redox activity can be accomplished by attaching hydrophilic side chains to the polymer backbone, which enables ionic transport and allows volumetric charging of polymer electrodes. While this approach has been beneficial for achieving fast electrochemical charging in aqueous solutions, little is known about the relationship between water uptake by the polymers during electrochemical charging and the stability and redox potentials of the electrodes, particularly for electron-transporting conjugated polymers. We find that excessive water uptake during the electrochemical charging of polymer electrodes harms the reversibility of electrochemical processes and results in irreversible swelling of the polymer. We show that small changes of the side chain composition can significantly increase the reversibility of the redox behavior of the materials in aqueous electrolytes, improving the capacity of the polymer by more than one order of magnitude. Finally, we show that tuning the local environment of the redox-active polymer by attaching hydrophilic side chains can help to reach high fractions of the theoretical capacity for single-phase electrodes in aqueous electrolytes. Our work shows the importance of chemical design strategies for achieving high electrochemical stability for conjugated polymers in aqueous electrolytes.

Chromosomal instability during neurogenesis in Huntington's disease.

Huntington's disease (HD) is a fatal neurodegenerative disease caused by expansion of CAG repeats in the Huntingtin gene (HTT). Neither its pathogenic mechanisms nor the normal functions of HTT are well understood. To model HD in humans, we engineered a genetic allelic series of isogenic human embryonic stem cell (hESC) lines with graded increases in CAG repeat length. Neural differentiation of these lines unveiled a novel developmental HD phenotype: the appearance of giant multinucleated telencephalic neurons at an abundance directly proportional to CAG repeat length, generated by a chromosomal instability and failed cytokinesis over multiple rounds of DNA replication. We conclude that disrupted neurogenesis during development is an important, unrecognized aspect of HD pathogenesis. To address the function of normal HTT protein we generated HTT+/- and HTT-/- lines. Surprisingly, the same phenotype emerged in HTT-/- but not HTT+/- lines. We conclude that HD is a developmental disorder characterized by chromosomal instability that impairs neurogenesis, and that HD represents a genetic dominant-negative loss of function, contrary to the prevalent gain-of-toxic-function hypothesis. The consequences of developmental alterations should be considered as a new target for HD therapies.

n-Type Rigid Semiconducting Polymers Bearing Oligo(Ethylene Glycol) Side Chains for High-Performance Organic Electrochemical Transistors.

N-type conjugated polymers as the semiconducting component of organic electrochemical transistors (OECTs) are still undeveloped with respect to their p-type counterparts. Herein, we report two rigid n-type conjugated polymers bearing oligo(ethylene glycol) (OEG) side chains, PgNaN and PgNgN, which demonstrated an essentially torsion-free π-conjugated backbone. The planarity and electron-deficient rigid structures enable the resulting polymers to achieve high electron mobility in an OECT device of up to the 10-3  cm2 V-1 s-1 range, with a deep-lying LUMO energy level lower than -4.0 eV. Prominently, the polymers exhibited a high device performance with a maximum dimensionally normalized transconductance of 0.212 S cm-1 and the product of charge-carrier mobility µ and volumetric capacitance C* of 0.662±0.113 F cm-1 V-1 s-1 , which are among the highest in n-type conjugated polymers reported to date. Moreover, the polymers are synthesized via a metal-free aldol-condensation polymerization, which is beneficial to their application in bioelectronics.

Polaron Delocalization in Donor-Acceptor Polymers and its Impact on Organic Electrochemical Transistor Performance.

Donor-acceptor (D-A) polymers are promising materials for organic electrochemical transistors (OECTs), as they minimize detrimental faradaic side-reactions during OECT operation, yet their steady-state OECT performance still lags far behind their all-donor counterparts. We report three D-A polymers based on the diketopyrrolopyrrole unit that afford OECT performances similar to those of all-donor polymers, hence representing a significant improvement to the previously developed D-A copolymers. In addition to improved OECT performance, DFT simulations of the polymers and their respective hole polarons also reveal a positive correlation between hole polaron delocalization and steady-state OECT performance, providing new insights into the design of OECT materials. Importantly, we demonstrate how polaron delocalization can be tuned directly at the molecular level by selection of the building blocks comprising the polymers' conjugated backbone, thus paving the way for the development of even higher performing OECT polymers.

Critical review of the molecular design progress in non-fullerene electron acceptors towards commercially viable organic solar cells.

Fullerenes have formed an integral part of high performance organic solar cells over the last 20 years, however their inherent limitations in terms of synthetic flexibility, cost and stability have acted as a motivation to develop replacements; the so-called non-fullerene electron acceptors. A rapid evolution of such materials has taken place over the last few years, yielding a number of promising candidates that can exceed the device performance of fullerenes and provide opportunities to improve upon the stability and processability of organic solar cells. In this review we explore the structure-property relationships of a library of non-fullerene acceptors, highlighting the important chemical modifications that have led to progress in the field and provide an outlook for future innovations in electron acceptors for use in organic photovoltaics.

Intraneuronal Amyloid Beta Accumulation Disrupts Hippocampal CRTC1-Dependent Gene Expression and Cognitive Function in a Rat Model of Alzheimer Disease.

In Alzheimer disease (AD), the accumulation of amyloid beta (Aß) begins decades before cognitive symptoms and progresses from intraneuronal material to extracellular plaques. To date, however, the precise mechanism by which the early buildup of Aß peptides leads to cognitive dysfunction remains unknown. Here, we investigate the impact of the early Aß accumulation on temporal and frontal lobe dysfunction. We compared the performance of McGill-R-Thy1-APP transgenic AD rats with wild-type littermate controls on a visual discrimination task using a touchscreen operant platform. Subsequently, we conducted studies to establish the biochemical and molecular basis for the behavioral alterations. It was found that the presence of intraneuronal Aß caused a severe associative learning deficit in the AD rats. This coincided with reduced nuclear translocation and genomic occupancy of the CREB co-activator, CRTC1, and decreased production of synaptic plasticity-associated transcripts Arc, c-fos, Egr1, and Bdnf. Thus, blockade of CRTC1-dependent gene expression in the early, preplaque phase of AD-like pathology provides a molecular basis for the cognitive deficits that figure so prominently in early AD.

Distressing Visions at the End of Life: Case Report and Review of the Literature.

There is a growing body of literature documenting dreams, visions, and other trans-personal communications that occur as part of the dying process, often called end-of-life dreams and visions (ELDVs) or deathbed communications (DBCs). This paper describes a unique case involving distressing visions at the end of life, provides a review of existing literature around ELDVs, and will provide a framework within which to approach the patient experiencing distressing ELDVs.

Ethical and Practical Considerations of Perimortem Gamete Procurement for Palliative Care Providers.

Requests for perimortem gamete procurement (PGP) typically arise by a surrogate decision maker after the unexpected death or incapacitation of a reproductive-aged individual. Palliative care clinicians should have a working knowledge of the medical, ethical, and practical considerations pertaining to such requests. In this paper, we describe a case in which the PGP request originated from an incapacitated patient's parents. We review the technologies associated with PGP and posthumous assisted reproduction (PAR) and discuss the ethical and legal issues involved in such cases, including recent position statements from national and international reproductive health groups. Finally, we provider readers with a stepwise approach for considering requests for PGP.

Charge Carrier Induced Structural Ordering And Disordering in Organic Mixed Ionic Electronic Conductors.

Operational stability underpins the successful application of organic mixed ionic-electronic conductors (OMIECs) in a wide range of fields, including biosensing, neuromorphic computing, and wearable electronics. In this work, both the operation and stability of a p-type OMIEC material of various molecular weights are investigated. Electrochemical transistor measurements reveal that device operation is very stable for at least 300 charging/discharging cycles independent of molecular weight, provided the charge density is kept below the threshold where strong charge-charge interactions become likely. When electrochemically charged to higher charge densities, an increase in device hysteresis and a decrease in conductivity due to a drop in the hole mobility arising from long-range microstructural disruptions are observed. By employing operando X-ray scattering techniques, two regimes of polaron-induced structural changes are found: 1) polaron-induced structural ordering at low carrier densities, and 2) irreversible structural disordering that disrupts charge transport at high carrier densities, where charge-charge interactions are significant. These operando measurements also reveal that the transfer curve hysteresis at high carrier densities is accompanied by an analogous structural hysteresis, providing a microstructural basis for such instabilities. This work provides a mechanistic understanding of the structural dynamics and material instabilities of OMIEC materials during device operation.

Eutectogels as a Semisolid Electrolyte for Organic Electrochemical Transistors.

Organic electrochemical transistors (OECTs) are signal transducers offering high amplification, which makes them particularly advantageous for detecting weak biological signals. While OECTs typically operate with aqueous electrolytes, those employing solid-like gels as the dielectric layer can be excellent candidates for constructing wearable electrophysiology probes. Despite their potential, the impact of the gel electrolyte type and composition on the operation of the OECT and the associated device design considerations for optimal performance with a chosen electrolyte have remained ambiguous. In this work, we investigate the influence of three types of gel electrolytes-hydrogels, eutectogels, and iongels, each with varying compositions on the performance of OECTs. Our findings highlight the superiority of the eutectogel electrolyte, which comprises poly(glycerol 1,3-diglycerolate diacrylate) as the polymer matrix and choline chloride in combination with 1,3-propanediol deep eutectic solvent as the ionic component. This eutectogel electrolyte outperforms hydrogel and iongel counterparts of equivalent dimensions, yielding the most favorable transient and steady-state performance for both p-type depletion and p-type/n-type enhancement mode transistors gated with silver/silver chloride (Ag/AgCl). Furthermore, the eutectogel-integrated enhancement mode OECTs exhibit exceptional operational stability, reflected in the absence of signal-to-noise ratio (SNR) variation in the simulated electrocardiogram (ECG) recordings conducted continuously over a period of 5 h, as well as daily measurements spanning 30 days. Eutectogel-based OECTs also exhibit higher ECG signal amplitudes and SNR than their counterparts, utilizing the commercially available hydrogel, which is the most common electrolyte for cutaneous electrodes. These findings underscore the potential of eutectogels as a semisolid electrolyte for OECTs, particularly in applications demanding robust and prolonged physiological signal monitoring.

The Role of Side Chains and Hydration on Mixed Charge Transport in n-Type Polymer Films.

Introducing ethylene glycol (EG) side chains to a conjugated polymer backbone is a well-established synthetic strategy for designing organic mixed ion-electron conductors (OMIECs). However, the impact that film swelling has on mixed conduction properties has yet to be scoped, particularly for electron-transporting (n-type) OMIECs. Here, the authors investigate the effect of the length of branched EG chains on mixed charge transport of n-type OMIECs based on a naphthalene-1,4,5,8-tetracarboxylic-diimide-bithiophene backbone. Atomic force microscopy (AFM), grazing-incidence wide-angle X-ray scattering (GIWAXS), and scanning tunneling microscopy (STM) are used to establish the similarities between the common-backbone films in dry conditions. Electrochemical quartz crystal microbalance with dissipation monitoring (EQCM-D) and in situ GIWAXS measurements reveal stark changes in film swelling properties and microstructure during electrochemical doping, depending on the side chain length. It is found that even in the loss of the crystallite content upon contact with the aqueous electrolyte, the films can effectively transport charges and that it is rather the high water content that harms the electronic interconnectivity within the OMIEC films. These results highlight the importance of controlling water uptake in the films to impede charge transport in n-type electrochemical devices.

Stable n-Type Perylene Derivative Ladder Polymer with Antiambipolarity for Electrically Reconfigurable Organic Logic Gates.

Organic electrochemical transistors (OECTs) are one of the promising building blocks to realize next-generation bioelectronics. To date, however, the performance and signal processing capabilities of these devices remain limited by their stability and speed. Herein, the authors demonstrate stable and fast n-type organic electrochemical transistors based on a side-chain-free ladder polymer, poly(benzimidazoanthradiisoquinolinedione). The device demonstrated fast normalized transient speed of 0.56 ± 0.17 ms um-2 and excellent long-term stability in aqueous electrolytes, with no significant drop in its doping current after 50 000 successive doping/dedoping cycles and 2-month storage at ambient conditions. These unique characteristics make this polymer especially suitable for bioelectronics, such as being used as a pull-down channel in a complementary inverter for long-term stable detection of electrophysiological signals. Moreover, the developed device shows a reversible anti-ambipolar behavior, enabling reconfigurable electronics to be realized using a single material. These results go beyond the conventional OECT and demonstrate the potential of OECTs to exhibit dynamically configurable functionalities for next-generation reconfigurable electronics.

Myeloid progenitor dysregulation fuels immunosuppressive macrophages in tumors.

Monocyte-derived macrophages (mo-macs) drive immunosuppression in the tumor microenvironment (TME) and tumor-enhanced myelopoiesis in the bone marrow (BM) fuels these populations. Here, we performed paired transcriptome and chromatin analysis over the continuum of BM myeloid progenitors, circulating monocytes, and tumor-infiltrating mo-macs in mice and in patients with lung cancer to identify myeloid progenitor programs that fuel pro-tumorigenic mo-macs. Analyzing chromatin accessibility and histone mark changes, we show that lung tumors prime accessibility for Nfe2l2 (NRF2) in BM myeloid progenitors as a cytoprotective response to oxidative stress. NRF2 activity is sustained and increased during monocyte differentiation into mo-macs in the lung TME to regulate oxidative stress, in turn promoting metabolic adaptation, resistance to cell death, and contributing to immunosuppressive phenotype. NRF2 genetic deletion and pharmacological inhibition significantly reduced mo-macs' survival and immunosuppression in the TME, enabling NK and T cell therapeutic antitumor immunity and synergizing with checkpoint blockade strategies. Altogether, our study identifies a targetable epigenetic node of myeloid progenitor dysregulation that sustains immunoregulatory mo-macs in the TME.

Off the Beaten Path: Caring for People Engaging in Potentially Unsafe Low Evidence Therapies.

Palliative care clinicians regularly care for patients with serious illnesses, many of whom are engaging in the use of complementary and alternative medicine (CAM) either alone or along with conventional medical therapies. A subset of these patients may be engaging in therapies that have little or no evidence for efficacy and carry significant potential risks to their health. These therapies, however, may carry a great deal of significance for the patient and family for whom conventional medicine has failed or is otherwise deemed untenable. Dismissing such therapies as "quackery" risks alienating patients and damaging or even severing a therapeutic relationship. When faced with patients who are engaging in potentially unsafe low-evidence therapies (PULETs), clinicians themselves may experience a great deal of moral distress when deciding how to balance supporting the hope PULETs may represent with the principles of nonmaleficence and autonomy. In this article, we will review the definition of PULETs and distinguish them from most CAM therapies. Drawing upon existing writings in the CAM literature, we will then review a framework to evaluate the relative risk/benefit ratio of such therapies followed by a review of the ethical and legal aspects of care. Finally, utilizing existing principles and tools in emotion-based communication, we present a communication approach to foster continued collaboration and care for patients who engage in PULETs.

Ionic Liquid Gated Organic Electrochemical Transistors with Broadened Bandwidth.

The organic electrochemical transistor (OECT) is a biosignal transducer known for its high amplification but relatively slow operation. Here, we demonstrate that the use of an ionic liquid as the dielectric medium significantly improves the switching speed of a p-type enhancement-mode OECT, regardless of the gate electrode used. The OECT response time with the ionic liquid improves up to ca. 41-fold and 46-fold for the silver/silver chloride (Ag/AgCl) and gold (Au) gates, respectively, compared with devices gated with the phosphate buffered saline (PBS) solution. Notably, the transistor gain remains uncompromised, and its maximum is reached at lower voltages compared to those of PBS-gated devices with Ag/AgCl as the gate electrode. Through ultraviolet-visible spectroscopy and etching X-ray photoelectron spectroscopy characterizations, we reveal that the enhanced bandwidth is associated with the prediffused ionic liquid inside the polymer, leading to a higher doping level compared to PBS. Using the ionic liquid-gated OECTs, we successfully detect electrocardiography (ECG) signals, which exhibit a complete waveform with well-distinguished features and a stable signal baseline. By integrating nonaqueous electrolytes that enhance the device bandwidth, we unlock the potential of enhancement-mode OECTs for physiological signal acquisition and other real-time biosignal monitoring applications.

2D metal-organic frameworks for ultraflexible electrochemical transistors with high transconductance and fast response speeds.

Electrochemical transistors (ECTs) have shown broad applications in bioelectronics and neuromorphic devices due to their high transconductance, low working voltage, and versatile device design. To further improve the device performance, semiconductor materials with both high carrier mobilities and large capacitances in electrolytes are needed. Here, we demonstrate ECTs based on highly oriented two-dimensional conjugated metal-organic frameworks (2D c-MOFs). The ion-conductive vertical nanopores formed within the 2D c-MOFs films lead to the most convenient ion transfer in the bulk and high volumetric capacitance, endowing the devices with fast speeds and ultrahigh transconductance. Ultraflexible device arrays are successfully used for wearable on-skin recording of electrocardiogram (ECG) signals along different directions, which can provide various waveforms comparable with those of multilead ECG measurement systems for monitoring heart conditions. These results indicate that 2D c-MOFs are excellent semiconductor materials for high-performance ECTs with promising applications in flexible and wearable electronics.