A Rapid and Robust Light-and-Solution-Triggered In Situ Crafting of Organic Passivating Membrane over Metal Halide Perovskites for Markedly Improved Stability and Photocatalysis.

Despite intriguing optoelectronic attributes in solar cells, light-emitting diodes, and photocatalysis, the instability of organic-inorganic perovskites poises a grand challenge for long-term applications. Herein, we report a simple yet robust strategy via light-and-solution treatment to create an organic membrane that effectively passivates CH3NH3PbI3 (MAPbI3). Specifically, the restructuring of MA+ is observed on MAPbI3 in aqueous hydrogen iodide. HIO3 molecules are generated via the reaction between water and I2 induced by photocatalysis when MAPbI3 is illuminated. The hydrogen bonding between HIO3 molecules at different perovskite particles not only directs the creeplike growth of perovskite particles but also in situ forms a passivating layer firmly anchoring on the perovskite surface with hydrophilic -NH3+ groups tethering to perovskites and hydrophobic -CH3 moieties exposed to air. Intriguingly, such MA+ film greatly improves the stability of perovskites against moisture as well as their crystal quality, considerably enhancing the photocatalytic hydrogen evolution rate.

Prevalence and risk factors of severe postpartum hemorrhage: a retrospective cohort study.

BACKGROUND: Although maternal deaths are rare in developed regions, the morbidity associated with severe postpartum hemorrhage (SPPH) remains a major problem. To determine the prevalence and risk factors of SPPH, we analyzed data of women who gave birth in Guangzhou Medical Centre for Critical Pregnant Women, which received a large quantity of critically ill obstetric patients who were transferred from other hospitals in Southern China. METHODS: In this study, we conducted a retrospective case-control study to determine the prevalence and risk factors for SPPH among a cohort of women who gave birth after 28 weeks of gestation between January 2015 and August 2019. SPPH was defined as an estimated blood loss ≥1000 mL and total blood transfusion≥4 units. Logistic regression analysis was used to identify independent risk factors for SPPH. RESULTS: SPPH was observed in 532 mothers (1.56%) among the total population of 34,178 mothers. Placenta-related problems (55.83%) were the major identified causes of SPPH, while uterine atony without associated retention of placental tissues accounted for 38.91%. The risk factors for SPPH were maternal age < 18 years (adjusted OR [aOR] = 11.52, 95% CI: 1.51-87.62), previous cesarean section (aOR = 2.57, 95% CI: 1.90-3.47), history of postpartum hemorrhage (aOR = 4.94, 95% CI: 2.63-9.29), conception through in vitro fertilization (aOR = 1.78, 95% CI: 1.31-2.43), pre-delivery anemia (aOR = 2.37, 95% CI: 1.88-3.00), stillbirth (aOR = 2.61, 95% CI: 1.02-6.69), prolonged labor (aOR = 5.24, 95% CI: 3.10-8.86), placenta previa (aOR = 9.75, 95% CI: 7.45-12.75), placenta abruption (aOR = 3.85, 95% CI: 1.91-7.76), placenta accrete spectrum (aOR = 8.00, 95% CI: 6.20-10.33), and macrosomia (aOR = 2.30, 95% CI: 1.38-3.83). CONCLUSION: Maternal age < 18 years, previous cesarean section, history of PPH, conception through IVF, pre-delivery anemia, stillbirth, prolonged labor, placenta previa, placental abruption, PAS, and macrosomia were risk factors for SPPH. Extra vigilance during the antenatal and peripartum periods is needed to identify women who have risk factors and enable early intervention to prevent SPPH.

Sarcopenic Obesity and Outcomes for Patients With Cancer.

Importance: The European Society for Clinical Nutrition and Metabolism (ESPEN) and the European Association for the Study of Obesity (EASO) have recently proposed a consensus definition and diagnostic criteria for sarcopenic obesity (SO). Objective: To implement the ESPEN-EASO diagnostic algorithm to investigate the prevalence of SO and its association with outcomes in patients with solid tumor cancers, with particular regard to associations among SO, overall survival (OS), and patient quality of life (QoL). Design, Setting, and Participants: This prospective cohort study included patients diagnosed with solid tumor starting in May 7, 2013, with the last follow-up on June 30, 2022. Patients with solid tumors were categorized into SO and non-SO groups according to ESPEN-EASO criteria. The primary outcome was OS and the secondary outcomes included patient QoL and risk of intensive care unit (ICU) admission. Data were analyzed from June to December 2023. Results: A total of 6790 patients were included in the study (mean [SD] age, 59.64 [10.77] years; 3489 were female [51.4%]). The prevalence of SO was 4.36% (296 of 6790) in the whole cohort and 14.98% (296 of 1976) in the subgroup with obesity. SO prevalence increased with age. During a median (IQR) follow-up period of 6.83 (5.67-7.04) years, 2103 patients died. Cox regression analysis indicated that SO was independently associated with lower OS (hazard ratio [HR], 1.54; 95% CI, 1.23-1.92), which was observed in both men (HR, 1.51; 95% CI, 1.09-2.10) and women (HR, 1.53; 95% CI, 1.12-2.07). SO was also associated with poorer QoL and higher risk of ICU admission (odds ratio, 2.39; 95% CI, 1.06-5.29). Among the diagnostic components of SO, low hand grip strength (HGS) was the only SO component associated with poor OS (HR, 1.15; 95% CI, 1.04-1.28). Conclusions and Relevance: This cohort study of SO found that SO was significantly associated with lower OS, poorer QoL, and higher risk of ICU admission. Weak HGS, 1 of the diagnostic conditions, was the only component of SO associated with OS. The ESPEN-EASO algorithm appears to be an applicable tool to identify cancer-associated SO, which represents a major clinical complication and factor associated with risk for poor outcomes in these patients.

Age Differences in the Association of Sleep Duration Trajectory With Cancer Risk and Cancer-Specific Mortality: Prospective Cohort Study.

BACKGROUND: Baseline sleep duration is associated with cancer risk and cancer-specific mortality; however, the association between longitudinal patterns of sleep duration and these risks remains unknown. OBJECTIVE: This study aimed to elucidate the association between sleep duration trajectory and cancer risk and cancer-specific mortality. METHODS: The participants recruited in this study were from the Kailuan cohort, with all participants aged between 18 and 98 years and without cancer at baseline. The sleep duration of participants was continuously recorded in 2006, 2008, and 2010. Latent mixture modeling was used to identify shared sleep duration trajectories. Furthermore, the Cox proportional risk model was used to examine the association of sleep duration trajectory with cancer risk and cancer-specific mortality. RESULTS: A total of 53,273 participants were included in the present study, of whom 40,909 (76.79%) were men and 12,364 (23.21%) were women. The average age of the participants was 49.03 (SD 11.76) years. During a median follow-up of 10.99 (IQR 10.27-11.15) years, 2705 participants developed cancers. Three sleep duration trajectories were identified: normal-stable (44,844/53,273, 84.18%), median-stable (5877/53,273, 11.03%), and decreasing low-stable (2552/53,273, 4.79%). Compared with the normal-stable group, the decreasing low-stable group had increased cancer risk (hazard ratio [HR] 1.39, 95% CI 1.16-1.65) and cancer-specific mortality (HR 1.54, 95% CI 1.18-2.06). Dividing the participants by an age cutoff of 45 years revealed an increase in cancer risk (HR 1.88, 95% CI 1.30-2.71) and cancer-specific mortality (HR 2.52, 95% CI 1.22-5.19) only in participants younger than 45 years, rather than middle-aged or older participants. Joint analysis revealed that compared with participants who had a stable sleep duration within the normal range and did not snore, those with a shortened sleep duration and snoring had the highest cancer risk (HR 2.62, 95% CI 1.46-4.70). CONCLUSIONS: Sleep duration trajectories and quality are closely associated with cancer risk and cancer-specific mortality. However, these associations differ with age and are more pronounced in individuals aged <45 years. TRIAL REGISTRATION: Chinese Clinical Trial Registry ChiCTR-TNRC-11001489; http://tinyurl.com/2u89hrhx.

Association between serum total testosterone levels and metabolic syndrome among adult women in the United States, NHANES 2011-2016.

Objective: To investigate the association between serum total testosterone (TT) levels and metabolic syndrome (MetS) or its components among adult women. Methods: 2,678 women from NHANES 2011-2016 were included in this cross-sectional study. MetS was determined according to the National Cholesterol Education Program Adult Treatment Panel III guidelines. The association between serum TT levels and MetS was evaluated by two logistics regression models and the adjusted restricted cubic spline (RCS). Stratified analysis and sensitive analysis were also conducted. Results: Continuous TT levels were negatively associated with the occurrence of MetS, and the ORs associated with per SD increase in ln TT were 0.70 (95%CI: 0.58-0.85) in 2011-2014 and 0.56 (95%CI: 0.39-0.79) in 2015-2016 in Model A. High TT group were less likely to have MetS (OR=0.60, 95%CI: 0.45-0.80 in 2011-2014 and OR=0.50, 95%CI: 0.32-0.78 in 2015-2016) when compared to the low TT group. When TT levels were divided into quartiles, TT levels were negatively correlated with the incidence of MetS (p for trend < 0.001). Similar trend was observed in Model B. Multivariate-adjusted logistic regression with RCS exhibited that TT had a L-shaped dose-response association with MetS or its components. Interaction analyses revealed that women who were less than 50 years old (OR=0.37, 95%CI: 0.22, 0.63), with depression (OR=0.50, 95%CI: 0.29, 0.87) or being smokers (OR=0.37, 95%CI: 0.23, 0.54) showed lower ORs than those who were over 50 years old (OR=0.66, 95%CI: 0.40, 1.09), without depression (OR=0.59, 95%CI: 0.41, 0.85) or non-smokers (OR=0.59, 95%CI: 0.39, 0.89) when measure the association between ln TT and the occurrence of MetS. Conclusions: Our study indicated that TT levels are negatively correlated with the occurrence of MetS, with interaction effects of age, smoke behaviors, and depressive status.

Association between the Composite Dietary Antioxidant Index and Atherosclerotic Cardiovascular Disease in Postmenopausal Women: A Cross-Sectional Study of NHANES Data, 2013-2018.

The relationship between composite dietary antioxidant index (CDAI) levels and the risk of atherosclerotic cardiovascular disease (ASCVD) in postmenopausal women is unknown. In total, 3109 women from the National Health and Nutrition Examination Survey 2013-2018 were included in this cross-sectional study. We evaluated the association between CDAI levels and the risk of ASCVD by using three logistic regression models and restricted cubic splines. A stratified analysis and sensitivity analysis were also conducted. The restricted cubic splines exhibited an L-shaped dose-response association between CDAI levels and the ASCVD risk. Logistic regression analysis found that CDAI levels were negatively associated with the occurrence of ASCVD. The ORs associated with a per-SD increase in CDAI were 0.67 (95% CI: 0.51-0.88) for ASCVD risk. Similarly, women in the group with high CDAI levels were less likely to have ASCVD (OR = 0.71, 95% CI: 0.50-0.98) compared to those in the group with low CDAI levels. When the CDAI levels were divided into quartiles, it was found that the ORs for ASCVD with CDAI levels in Q2 (-1.04-1.11), Q3 (1.11-3.72), and Q4 (3.72-43.87) were 0.63 (0.44, 0.90), 0.64 (0.42, 0.94), and 0.51 (0.27, 0.97), respectively, compared to those with CDAI levels in Q1 (-6.83--1.04). In addition, age, high-density lipoprotein cholesterol levels, and smoking behaviors acted as potential modifiers, and ORs were more significant in women aged 40-69 years, in individuals with low high-density lipoprotein cholesterol levels, and in smokers (p for interaction <0.05). These findings may offer valuable insights into the role of CDAI levels in the development of ASCVD among postmenopausal women.

Reducing the risk of gestational diabetes mellitus in chronic hepatitis B virus carriers via more strict control of gestational weight gain.

OBJECTIVE: To explore the association between gestational weight gain (GWG) and gestational diabetes mellitus (GDM) in hepatitis B surface antigen (HBsAg) -positive women using a retrospective cohort study to provide advice on the management of GWG. METHODS: Our study included 39 539 pregnant women who gave birth at the Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China. Patients were divided into two groups: the HBsAg-negative and HBsAg-positive groups, comprising 36 500 and 3039 participants, respectively. We used univariate and multivariable logistic regression analyses to explore the association between GWG and GDM in maternal hepatitis B virus (HBV) carrier women. RESULTS: Being HBsAg positive and excessive GWG were independent risk factors for GDM. Excessive GWG was associated with a higher risk of GDM in HBsAg-positive women. Among pre-pregnancy women of normal weight, HBsAg-positive women with adequate GWG had a higher risk of GDM than HBsAg-negative women, whereas HBsAg-positive women with inadequate GWG had a lower risk of GDM. CONCLUSIONS: The optimal GWG ranges for pre-pregnancy normal-weight HBsAg-positive pregnancies might be lower than the US Institute of Medicine recommendations. HBsAg-positive women should strictly control GWG to reduce the risk of GDM.

Development and validation of a predictive model for severe postpartum hemorrhage in women undergoing vaginal delivery: A retrospective cohort study.

OBJECTIVE: To develop a predictive tool to accurately screen women at high risk of severe postpartum hemorrhage (SPPH) undergoing vaginal delivery. METHODS: We analyzed 28 150 mothers who underwent vaginal delivery after 28 weeks of pregnancy in the Third Affiliated Hospital of Guangzhou Medical University from January 2015 to August 2019. Two-thirds of the cohort were randomly allocated to a training set (n = 18 766) and the rest to a validation set (n = 9384). In the training set, we built a radiomic nomogram based on multivariate logistic analysis, and calibration and C-index were evaluated. The performance of the validated nomogram was then tested in the validation cohort. RESULTS: Independent risk factors for SPPH in women undergoing vaginal delivery were previous cesarean section, history of PPH, in vitro fertilization, anemia, intrauterine death, prolonged labor, low-lying placenta, placental abruption, placenta accreta spectrum, and macrosomia. Good calibration was observed for the probability of SPPH in the validation cohort, and the C-index of the nomogram for the prediction of SPPH was 0.861 (95% confidence interval 0.820-0.902). CONCLUSION: This model would be a useful tool to accurately screen for women at high-risk of SPPH undergoing vaginal delivery. It would be expected to be an effective tool to guide clinical practice and further reduce maternal mortality.

How Materials and Device Factors Determine the Performance: A Unified Solution for Transistors with Nontrivial Gates and Transistor-Diode Hybrid Integration.

Advanced field-effect transistors (FETs) with nontrivial gates (e.g., offset-gates, mid-gates, split-gates, or multi-gates) or hybrid integrations (e.g., with diodes, photodetectors, or field-emitters) have been extensively developed in pursuit for the "More-than-Moore" demand. But understanding their conduction mechanisms and predicting current-voltage relations is rather difficult due to countless combinations of materials and device factors. Here, it is shown that they could be understood within the same physical picture, i.e., charge transport from gated to nongated semiconductors. One proposes an indicator based on material and device factors for characterizing the transport and derives a unified and simplified solution for describing the current-voltage relations, current saturation, channel potentials, and drift field. It is verified by simulations and experiments of different types of devices with varied materials and device factors, employing organic, oxide, nanomaterial semiconductors in transistors or hybrid integrations. The concise and unified solution provides general rules for quick understanding and designing of these complex, innovative devices.

Clinical outcome of high-intensity focused ultrasound as the preoperative management of cesarean scar pregnancy.

OBJECTIVE: The aim of this study was to retrospectively evaluate the feasibility and safety of high-intensity focused ultrasound (HIFU) treatment as the preoperative management of cesarean scar pregnancy (CSP). MATERIALS AND METHODS: 225 patients with definite Type I CSP were treated with suction curettage under hysteroscopic guidance. Among them, 103 patients chose HIFU treatment before hysteroscopy (assign to the HIFU group), and the other 122 patients without any pretreatment before hysteroscopy to the control group. The successful rate, volume of intraoperative blood loss, time for serum ß-human chorionic gonadotropin (ß-hCG) level returned to normal, gestational sac disappeared, normal menstrual recovery, and adverse effects were collected and analyzed to compare the two approaches. RESULTS: The successful rate (98.06%) in the HIFU group was higher than that (91.80%) in the contrast group. The median ablation time was 39 min and the median HIFU sonication time was 106.6 s. The median volume of intraoperative blood loss in the HIFU group was lower than that in the contrast group (P < 0.001), and the median time of gestational sac disappeared in the HIFU group was shorter than that in the contrast group. There were no statistically significant differences in the time of serum ß-hCG returned to normal and days of menstrual recovery between the 2 groups. CONCLUSION: Based on our results, it appears that HIFU ablation is a safe and effective modality as pre-treatment before hysteroscopy in the management of CSP.

Reduced graphene oxide-induced crystallization of CuPc interfacial layer for high performance of perovskite photodetectors.

Perovskite-based photodetectors have great potential in light-signal conversion; the suppression of the dark current is regarded as one of the main concerns within the academic research communities to achieve a high-performance photodetector. Interfacial engineering in the transport layer is considered as one of the most essential methods for enhancement of perovskite photodetectors. Here, a nanocomposite thin film of tetra-sulfonated copper phthalocyanines and reduced graphene oxide (TS-CuPc/rGO) was investigated as the interfacial layer in perovskite-based photodetectors. Photodetectors with the TS-CuPc/rGO thin film as the interfacial layer exhibited a low dark current density of 2.2 × 10-8 A cm-2 at bias of -0.1 V as well as high responsivity and detectivity of ∼357 mA W-1 and ∼4.2 × 1012 jones, respectively; moreover, we observed an ON/OFF ratio of 7.33 × 103 to 520 nm light with an intensity of ∼0.077 mW cm-2. Our study revealed that with rGO additives, TS-CuPc molecules were favorable for the formation of an edge-on stacking film with high crystallinity. The rGO-induced crystalline TS-CuPc thin film with lower crystallographic defects effectively reduced the carrier recombination rate at the interfaces, leading to a suppressed dark current and enhanced photocurrent in the photodetector device, when compared to the less crystalline TS-CuPc layer.

Guided Formation of Large Crystals of Organic and Perovskite Semiconductors by an Ultrasonicated Dispenser and Their Application as the Active Matrix of Photodetectors.

The crystallization of organic or perovskite semiconductors reflects the intermolecular interactions and crucially determines the charge transport in opto-electronic devices. In this report, we demonstrate and investigate the use of an ultrasonicated dispenser to guide the formation of crystals of organic and perovskite semiconductors. The moving speed of the dispenser affects the match between the concentration gradient and evaporation rate near the three-phase contact lines and thus the generation of various crystallization morphologies. The mechanism of crystallization is given by a relationship between the calculated concentration gradient profile and the degree of crystal alignment. Highly ordered, aligned crystals are achieved for both organic bis(triisopropylsilylethynyl)-pentacene and perovskite MAPbI3 semiconductors. Absorption spectra, Raman scattering spectroscopy analysis, and grazing incidence wide-angle X-ray scattering measurement reveal the strong anisotropy of the crystalline structures. The aligned crystals lead to remarkably enhanced electrical performances in an organic thin-film transistor (OTFT) and perovskite photodetector. As a demonstration, we combine the OTFT with photodetectors to achieve an active matrix of normally off, gate-tunable photodetectors that operate under ambient conditions.