In Situ Forming Asymmetric Gel Polymer Electrolyte Enhances the Performance of High-Voltage Lithium Metal Batteries.

With the rapid evolution of electric vehicle technology, concerns regarding range anxiety and safety have become increasingly pronounced. Battery systems with high specific energy and enhanced security, featuring ternary cathodes paired with lithium (Li) metal anodes, are poised to emerge as next-generation electrochemical devices. However, the asymmetric configuration of the battery structure, characterized by the robust oxidative behavior of the ternary cathodes juxtaposed with the vigorous reductive activity of the Li metal anodes, imposes elevated requisites for the electrolytes. Herein, a well-designed gel polymer electrolyte with asymmetric structure was successfully prepared based on the Ritter reaction of cyanoethyl poly(vinyl alcohol) (PVA-CN) and cationic ring-opening polymerization of s-Trioxane. With the aid of the sieving effect of separator, the in situ asymmetric gel polymer electrolyte has good compatibility with both the high-voltage cathodes and Li anodes. The amide groups generated by PVA-CN after the Ritter reaction and additional cyano groups can tolerate high voltages up to 5.1 V, matching with ternary cathodes without any challenges. The functional amide and cyano groups participate in the formation of the cathode electrolyte interface and stabilize the cathode structure. Meanwhile, the in situ formed ether-based polyformaldehyde electrolyte is beneficial for promoting uniform Li deposition on anode surfaces. Li-Li symmetric cells demonstrate sustained stability over 2000 h of cycling at a current density of 1 mA cm-2 for 1 mAh cm-2. Furthermore, the capacity retention rate of Li(Ni0.6Mn0.2Co0.2)O2-Li cells with 0.5 C cycling after 300 cycles is 92.2%, demonstrating excellent cycle stability. The electrolyte preparation strategy provides a strategy for the progress of high-performance electrolytes and promotes the rapid development of high-energy-density Li metal batteries.

Tumor contour irregularity on preoperative CT predicts prognosis in renal cell carcinoma: a multi-institutional study.

Background: Radiology-based prognostic biomarkers play a crucial role in patient counseling, enhancing surveillance, and designing clinical trials effectively. This study aims to assess the predictive significance of preoperative CT-based tumor contour irregularity in determining clinical outcomes among patients with renal cell carcinoma (RCC). Methods: We conducted a retrospective multi-institutional review involving 2218 patients pathologically diagnosed with RCC. The training and internal validation sets included patients at Zhongshan Hospital between January 2009 and August 2019. The external test set comprised patients from the First Affiliated Hospital, Zhejiang University School of Medicine (January 2016 to January 2018), the Xiamen Branch of Zhongshan Hospital (November 2017 to June 2023), and the Cancer Imaging Archive. The contour irregularity degree (CID), quantified as the ratio of irregular cross-sections to the total tumor cross-sections, was analyzed for its prognostic relevance across different subgroups of RCC patients. A novel CID-based scoring system was developed, and its predictive efficacy was evaluated and compared with existing prognostic models. Findings: The CID exhibited significant discriminatory power in predicting overall survival (OS), recurrence-free survival (RFS), and disease-specific survival (DSS) among patients with RCC tumors measuring 3 cm or larger (all p < 0.001). Multivariate analyses confirmed the CID as an independent prognostic indicator. Notably, the CID augmented prognostic stratification among RCC patients within distinct risk subgroups delineated by SSIGN models and ISUP grades. The CID-based nomogram (C-Model) demonstrated robust predictive performance, with C-index values of 0.88 (95%CI: 0.84-0.92) in the training set, 0.92 (95%CI: 0.88-0.98) in the internal validation set, and 0.86 (95%CI: 0.81-0.90) in the external test set, surpassing existing prognostic models. Interpretation: Routine imaging-based assessment of the CID serves as an independent prognostic factor, offering incremental prognostic value to existing models in RCC patients with tumors measuring 3 cm or larger. Funding: This study was funded by grants from National Natural Science Foundation of China; Shanghai Municipal Health Commission; China National Key R&D Program and Science and Technology Commission of Shanghai Municipality.

Constructing Multiscale Fibrous Morphology to Achieve 20% Efficiency Organic Solar Cells by Mixing High and Low Molecular Weight D18.

This study underscores the significance of precisely manipulating the morphology of the active layer in organic solar cells (OSCs). By blending polymer donors of D18 with varying molecular weights, a multiscale interpenetrating fiber network structure within the active layer is successfully created. The introduction of 10% low molecular weight D18 (LW-D18) into high molecular weight D18 (HW-D18) produces MIX-D18, which exhibits an extended exciton diffusion distance and orderly molecular stacking. Devices utilizing MIX-D18 demonstrate superior electron and hole transport, improves exciton dissociation, enhances charge collection efficiency, and reduces trap-assisted recombination compared to the other two materials. Through the use of the nonfullerene acceptor L8-BO, a remarkable power conversion efficiency (PCE) of 20.0% is achieved. This methodology, which integrates the favorable attributes of high and low molecular weight polymers, opens a new avenue for enhancing the performance of OSCs.

Polyphyly of Boehmeria (Urticaceae) congruent with plastome structural variation.

Boehmeria is a taxonomically challenging group within the nettle family (Urticaceae). The polyphyly of the genus has been proposed by previous studies with respect to five genera (Debregeasia, Cypholophus, Sarcochlamys, Archiboehmeria, and Astrothalamus). Extensive homoplasy of morphological characters has made generic delimitation problematic. Previous studies in other plant groups suggest that plastome structural variations have the potential to provide characters useful in reconstructing evolutionary relationships. We aimed to test this across Boehmeria and its allied genera by mapping plastome structural variations onto a resolved strongly supported phylogeny. In doing so, we expanded the sampling of the plastome to include Cypholophus, Sarcochlamys, Archiboehmeria, and Astrothalamus for the first time. The results of our phylogenomic analyses provide strong support for Sarcochlamys as being more closely related to Leucosyke puya than to Boehmeria and for the clustering of Boehmeria s.l. into four subclades. The sizes of the plastomes in Boehmeria s.l. ranged from 142,627 bp to 170,958 bp. The plastomes recovered a typical quadripartite structure comprising 127~146 genes. We observe several obvious structural variations across the taxa such as gene loss and multiple gene duplication, inverted repeat (IR) contraction and wide expansions, and inversions. Moreover, we recover a trend for these variations that the early clades were relatively conserved in evolution, whereas the later diverging clades were variable. We propose that the structural variations documented may be linked to the adaptation of Boehmeria s.l. to a wide range of habitats, from moist broadleaf forests in Asia to xeric shrublands and deserts in Africa. This study confirms that variation in plastome gene loss/duplication, IR contraction/expansion, and inversions can provide evidence useful for the reconstruction of evolutionary relationships.

Prostate cancer stem cells and their targeted therapies.

Prostate cancer (PCa) is the most common malignancy among men worldwide. Through androgen receptor signaling inhibitor (ARSI) treatment, patients eventually succumb to castration-resistant prostate cancer (CRPC). For this, the prostate cancer stem cells (PCSCs), as a minor population of tumor cells that can promote tumor relapse, ARSI resistance, and disease progression, are gaining attention. Therefore, specific therapy targeting PCSCs has momentum. This study reviewed the identification and characterization of PCSCs and PCSC-based putative biomarkers and summarized their mechanisms of action. We further discussed clinical trials of novel therapeutic interventions focused on PCSC-related pathways, the PCSC microenvironment, cutting-edge miRNA therapy, and immunotherapy approaches from a mechanistic standpoint. This review provides updated insights into PCSC plasticity, identifying new PCSC biomarkers and optimized treatments for patients with advanced PCa.

Diagnostic performance of a modified O-RADS classification system for adnexal lesions incorporating clinical features.

PURPOSE: To compare the diagnostic efficacy of the Ovarian-Adnexal Reporting and Data System (O-RADS) MRI score with that of the modified O-RADS score on the basis of a simplified contrast-enhanced (CE) MRI protocol in characterizing adnexal masses with solid tissue. The added value of clinical features was evaluated to improve the ability of the scoring system to classify adnexal masses. METHODS: A total of 124 patients with 124 adnexal lesions containing solid tissue were included in this two-center retrospective study. Among them, there were 40 benign lesions (40/124, 32.3%) and 84 were malignant lesions (84/124, 67.7%). Three radiologists independently reviewed the images and assigned the O-RADS MRI score and the modified O-RADS score for each adnexal mass. Histopathology was used as the reference standard. The diagnostic efficacy of the two scoring methods was compared. Univariate and multivariate logistic regression were performed to evaluate the value of significant features in the prediction of malignant tumors. RESULTS: The O-RADS MRI score and modified O-RADS score showed sensitivity at 100.0% (95% CI, 95.7-100.0%) and 71.4% (95% CI, 60.5-80.8%), specificity at 12.5% (95% CI, 4.2-26.8%) and 75.0% (95% CI, 58.8-87.3%), respectively. The area under the curve of the modified O-RADS score was higher than the O-RADS score (0.732 [95% CI, 0.645-0.808] vs 0.575 [95% CI, 0.483-0.663]; p < 0.001). Multivariate analysis showed that the modified O-RADS score 4b or 5 combined with patient age > 38.5 years, nullipara, maximum diameter > 40.5 mm and HE4 > 78.9 pmol/L significantly improved the diagnostic efficacy up to 0.954 (95% CI, 0.901-0.984) (p < 0.001). CONCLUSION: A modified O-RADS score combined with certain clinical features can significantly improve the diagnostic efficacy in predicting malignant tumors.

Radiomics predict the WHO/ISUP nuclear grade and survival in clear cell renal cell carcinoma.

OBJECTIVES: This study aimed to assess the predictive value of radiomics derived from intratumoral and peritumoral regions and to develop a radiomics nomogram to predict preoperative nuclear grade and overall survival (OS) in patients with clear cell renal cell carcinoma (ccRCC). METHODS: The study included 395 patients with ccRCC from our institution. The patients in Center A (anonymous) institution were randomly divided into a training cohort (n = 284) and an internal validation cohort (n = 71). An external validation cohort comprising 40 patients from Center B also was included. Computed tomography (CT) radiomics features were extracted from the internal area of the tumor (IAT) and IAT combined peritumoral areas of the tumor at 3 mm (PAT 3 mm) and 5 mm (PAT 5 mm). Independent predictors from both clinical and radiomics scores (Radscore) were used to construct a radiomics nomogram. Kaplan-Meier analysis with a log-rank test was performed to evaluate the correlation between factors and OS. RESULTS: The PAT 5-mm radiomics model (RM) exhibited exceptional predictive capability for grading, achieving an area under the curves of 0.80, 0.80, and 0.90 in the training, internal validation, and external validation cohorts. The nomogram and RM gained from the PAT 5-mm region were more clinically useful than the clinical model. The association between OS and predicted nuclear grade derived from the PAT 5-mm Radscore and the nomogram-predicted score was statistically significant (p < 0.05). CONCLUSION: The CT-based radiomics and nomograms showed valuable predictive capabilities for the World Health Organization/International Society of Urological Pathology grade and OS in patients with ccRCC. CRITICAL RELEVANCE STATEMENT: The intratumoral and peritumoral radiomics are feasible and promising to predict nuclear grade and overall survival in patients with clear cell renal cell carcinoma, which can contribute to the development of personalized preoperative treatment strategies. KEY POINTS: The multi-regional radiomics features are associated with clear cell renal cell carcinoma (ccRCC) grading and prognosis. The combination of intratumoral and peritumoral 5 mm regional features demonstrated superior predictive performance for grading. The nomogram and radiomics models have a broad range of clinical applications.

Polygalaqii, a new species of Polygalaceae from limestone landform in Southern Hunan, China.

Polygalaqii, a new species, is described and illustrated from limestone landform in southern Hunan, China. The new species resembles P.fallax and P.arillata in flower structure of the plants, but readily differs from the latter two in having erect and shorter inflorescences (0.2-1cm VS 10-15cm VS 7-10cm), and fewer flowers (1-5 flowers VS 10-30 flowers VS 10-20 flowers), and the latter two have a later flowering period (late March to mid-April VS May to August VS May to October). And it is an extremely unique new species that will hibernate in the hot summer of July and August. Following the IUCN Red List Criteria, P.qii is assessed as 'Data Deficient (DD)'.

Clinical efficacy of ultrasound-guided chondroitin polysulfate from bovine trachea combined with fractional CO2 laser in the treatment of scar after burn repair.

Introduction: One common and very upsetting side effect of burn injuries is scarring, which presents serious difficulties for patients and medical professionals alike. Aim: To assess a new therapeutic approach for treating scars following burn repair procedures in terms of its clinical efficacy. Material and methods: This method administers Hirudoid under ultrasound guidance in addition to fractional CO2 laser treatment. An extensive analysis of the effects of this combination treatment on functional results, patient satisfaction, and scar appearance is being conducted as part of this research. Fractional CO2 laser treatment is utilized for its capacity to stimulate collagen remodelling and decrease scar hypertrophy, while Hirudoid, a topical medicine containing heparinoid, is used to minimize inflammation and enhance tissue healing. Enrolling patients who have had burn repair surgery is the goal of a quasi-experimental study. Conventional scar care methods are performed on the control group, whereas the experimental group is treated with fractional CO2 laser therapy after applying Hirudoid under ultrasound guidance. Throughout the research period, clinical evaluations are carried out on a regular basis. These evaluations cover scar features, pain thresholds, and patient-reported results. Results: The first findings show that the experimental group significantly outperformed the control group in terms of overall look, pigmentation, and scar texture. Functional examinations point to possible improvements in terms of scar flexibility and the range of motion, while patient-reported outcomes show improved satisfaction with the combination therapy. In order to guarantee the combination therapy's viability and tolerance in a clinical context, its side effects and safety profiles are also extensively assessed. In order to improve scar management following burn healing, the study intends to provide important insights into the creation of more patient-friendly and successful therapies. Conclusions: A potential approach to enhancing the clinical results of burn scar treatment is the study of fractional CO2 laser therapy in conjunction with ultrasound-guided Hirudoid. Enhancing scar management tactics via the combination of sophisticated technology and therapy modalities may eventually improve the quality of life for burn injury victims.

Pediatric WNT medulloblastoma predisposition in intraoperative blood loss: a retrospective observational cohort study.

Introduction: Molecular subgroups influence the vascular architecture within medulloblastomas, particularly the wingless (WNT) subgroup, which contributes to its propensity for primary tumor hemorrhage. Whether this mechanism affects intraoperative blood loss remains unknown. This study aimed to assess the association between WNT medulloblastoma and the predisposition for blood loss. Methods: This was a retrospective observational study using data from a neuro-oncology center comprising molecular data on patients treated between December 31, 2014, and April 30, 2023. Differences between WNT and other subgroups in the risk of primary outcome-intraoperative blood loss were assessed using multivariable-adjusted linear regression. Results: Of the 148 patients included in the analysis, 18 patients (12.2%) had WNT, 42 (28.4%) had sonic hedgehog (SHH) TP53-wildtype, 7 (4.7%) had SHH TP53-mutant, and 81 (54.7%) were non-WNT/ non-SHH. The WNT subgroup more frequently underwent primary intratumoral hemorrhage (22% vs. 3.8%; p = 0.011). The median intraoperative blood loss was 400.00 (interquartile range [IQR] 250, 500) mL for WNT and 300.00 [200, 400] mL for the other subgroups (p = 0.136), with an adjusted ß of 135.264 (95% confidence intervals [CI], 11.701-258.827; p = 0.032). Similar results were observed in both midline and noninfiltrative margin medulloblastoma. Discussion: WNT medulloblastoma is typically associated with primary intratumoral hemorrhage and intraoperative blood loss. The validity of determining the surgical approach based on predicted molecular subtypes from imaging data is questionable. However, attempting to engage in risk communication with patients in a molecular-specific way is worthwhile to validate.

Cross-Linkable Binders for Si Anodes in High-Energy-Density Lithium-Ion Batteries.

Although silicon (Si) has a high theoretical capacity, the large volume expansion during lithiation has greatly hindered its application in high-energy-density lithium-ion batteries (LIBs). Among the strategies for improving the performance of Si anode, the role of binders should not be underestimated. Here, a novel strategy for designing a cross-linkable binder for Si anode has been proposed. The binder with hydroxyl and nitrile groups can be in situ covalently cross-linked through the amide group in the batteries. The cross-linked binder (c-POAH) shows high elasticity and strong adhesion to Si particles and the current collector. Si||Li half coin cells using the c-POAH binder have excellent cycle performance and the capacity retention ratio is 67.1% after 100 cycles at 0.2 C. Scanning electronic microscopy images show that the c-POAH binder can contribute to suppressing the pulverization of the Si anode. Moreover, the investigation with X-ray photoelectronic spectrum demonstrates that the decomposition of the liquid electrolyte on Si anode has been mitigated and the c-POAH binder can promote the formation of a more stable SEI film. Our strategy of endowing the binder with good elasticity through in situ cross-linking has opened up a new route for developing binders, which will definitely promote the application of Si anodes in high-energy-density LIBs.

Neurosurgical short-term outcomes for pediatric medulloblastoma patients and molecular correlations: a 10-year single-center observation cohort study.

This study examined the risk factors for short-term outcomes, focusing particularly on the associations among molecular subgroups. The analysis focused on the data of pediatric patients with medulloblastoma between 2013 and 2023, as well as operative complications, length of stay from surgery to adjuvant treatment, 30-day unplanned reoperation, unplanned readmission, and mortality. 148 patients were included. Patients with the SHH TP53-wildtype exhibited a lower incidence of complications (45.2% vs. 66.0%, odds ratio [OR] 0.358, 95% confidence interval [CI] 0.160 - 0.802). Female sex (0.437, 0.207 - 0.919) was identified as an independent protective factor for complications, and brainstem involvement (1.900, 1.297 - 2.784) was identified as a risk factor. Surgical time was associated with an increased risk of complications (1.004, 1.001 - 1.008), duration of hospitalization (1.006, 1.003 - 1.010), and reoperation (1.003, 1.001 - 1.006). Age was found to be a predictor of improved outcomes, as each additional year was associated with a 14.1% decrease in the likelihood of experiencing a prolonged length of stay (0.859, 0.772 - 0.956). Patients without metastasis exhibited a reduced risk of reoperation (0.322, 0.133 - 0.784) and readmission (0.208, 0.074 - 0.581). There is a significant degree of variability in the occurrence of operative complications in pediatric patients with medulloblastoma. SHH TP53-wildtype medulloblastoma is commonly correlated with a decreased incidence of complications. The short-term outcomes of patients are influenced by various unmodifiable endogenous factors. These findings could enhance the knowledge of onconeurosurgeons and alleviate the challenges associated with patient/parent education through personalized risk communication. However, the importance of a dedicated center with expertise surgical team and experienced neurosurgeon in improving neurosurgical outcomes appears self-evident.

Development of a CT-assessed adiposity nomogram for predicting outcome in localized ccRCC.

PURPOSE: This study aimed to develop and validate a computed tomography-based nomogram assessing visceral and subcutaneous adiposity for predicting outcomes in localized clear cell renal cell carcinoma (ccRCC). METHODS: A cohort of 364 patients with pathologically confirmed ccRCC participated in this retrospective study, with 254 patients assigned to the training set and 110 to the validation set (a 7:3 distribution ratio). The adipose score (AS) was generated using the least absolute shrinkage and selection operator Cox regression. Subsequently, a nomogram was constructed by integrating the clinical independent predictor with the AS to predict disease-free survival (DFS) in localized ccRCC after surgery. The performance of the nomogram was compared with the University of California, Los Angeles, Integrated Staging System (UISS), and the Stage, Size, Grade, and Necrosis (SSIGN) score. RESULTS: In both the training and validation cohorts, the nomogram exhibited superior discrimination compared to SSIGN and UISS (C-index: 0.897 vs. 0.781 vs. 0.776 in the training cohort, and 0.752 vs. 0.596 vs. 0.686 in the validation cohort; 5 year AUC: 0.907 vs. 0.805 vs. 0.820 in the training cohort, and 0.832 vs. 0.577 vs. 0.726 in the validation cohort). Decision curve analysis (DCA) revealed a superior net benefit across a wider range of threshold probabilities for predicting 5 year DFS compared to UISS and SSIGN scores. CONCLUSIONS: The developed prognostic nomogram demonstrated high accuracy and overall superior performance compared to existing prognostic models.

Developing a dormancy-associated ECM signature in TNBC that is linked to immunosuppressive tumor microenvironment and selective sensitivity to MAPK inhibitors.

Aims: Cellular dormancy is a state of quiescence subpopulation of tumor cells, characterized by low differentiation and lack of mitotic activity. They could evade chemotherapy and targeted therapy, leading to drug resistance and disease recurrence. Recent studies have shown a correlation between dormant cancer cells and unique extracellular matrix (ECM) composition, which is critical in regulating cell behavior. However, their interacting roles in TNBC patients remains to be characterized. Main methods: Dormant cancer cells in MDA-MB-231 cell line with highest PKH26 dye-retaining were FACS-sorted and gene expression was then analyzed. Dormant associated ECM (DA-ECM) signature was characterized by pathway analysis. Unsupervised hierarchical clustering was used to define distinct ECM features for TNBC patients. ECM-specific tumor biology was defined by integration of bulk RNA-seq with single-cell RNA-seq data, analysis of ligand-receptor interactions and enriched biological pathways, and in silico drug screening. We validated the sensitivity of dormant cancer cells to MAPK inhibitors by flow cytometry in vitro. Key findings: We observed that dormant TNBC cells preferentially expressed ∼10 % DA-ECM genes. The DA-ECM High subtype defined by unsupervised hierarchical clustering analysis was associated with immunosuppressive tumor microenvironment. Moreover, ligand-receptor interaction and pathway analysis revealed that the DA-ECM High subtype may likely help maintain tumor cell dormancy through MAPK, Hedgehog and Notch signaling pathways. Finally, in silico drug screening against the DA-ECM signature and in vitro assay showed dormant cancer cells were relatively sensitive to the MAPK pathway inhibitors, which may represent a potential therapeutic strategy for treating TNBC. Significance: Collectively, our research revealed that dormancy-associated ECM characterized tumor cells possess significant ECM remodeling capacity, and treatment strategies towards these cells could improve TNBC patient outcome.

Deep Learning Assessment of Small Renal Masses at Contrast-enhanced Multiphase CT.

Background Accurate characterization of suspicious small renal masses is crucial for optimized management. Deep learning (DL) algorithms may assist with this effort. Purpose To develop and validate a DL algorithm for identifying benign small renal masses at contrast-enhanced multiphase CT. Materials and Methods Surgically resected renal masses measuring 3 cm or less in diameter at contrast-enhanced CT were included. The DL algorithm was developed by using retrospective data from one hospital between 2009 and 2021, with patients randomly allocated in a training and internal test set ratio of 8:2. Between 2013 and 2021, external testing was performed on data from five independent hospitals. A prospective test set was obtained between 2021 and 2022 from one hospital. Algorithm performance was evaluated by using the area under the receiver operating characteristic curve (AUC) and compared with the results of seven clinicians using the DeLong test. Results A total of 1703 patients (mean age, 56 years ± 12 [SD]; 619 female) with a single renal mass per patient were evaluated. The retrospective data set included 1063 lesions (874 in training set, 189 internal test set); the multicenter external test set included 537 lesions (12.3%, 66 benign) with 89 subcentimeter (≤1 cm) lesions (16.6%); and the prospective test set included 103 lesions (13.6%, 14 benign) with 20 (19.4%) subcentimeter lesions. The DL algorithm performance was comparable with that of urological radiologists: for the external test set, AUC was 0.80 (95% CI: 0.75, 0.85) versus 0.84 (95% CI: 0.78, 0.88) (P = .61); for the prospective test set, AUC was 0.87 (95% CI: 0.79, 0.93) versus 0.92 (95% CI: 0.86, 0.96) (P = .70). For subcentimeter lesions in the external test set, the algorithm and urological radiologists had similar AUC of 0.74 (95% CI: 0.63, 0.83) and 0.81 (95% CI: 0.68, 0.92) (P = .78), respectively. Conclusion The multiphase CT-based DL algorithm showed comparable performance with that of radiologists for identifying benign small renal masses, including lesions of 1 cm or less. Published under a CC BY 4.0 license. Supplemental material is available for this article.

Can Gender-Specific Renal and Visceral Fat Be Evaluated by CT Predict Fuhrman Nuclear Classification of Clear Cell Renal Cell Carcinoma?

BACKGROUND: Evidence of the association between obesity and renal cell carcinoma progression is contradictory. The effects of renal cell carcinoma on fat distribution are still unknown. OBJECTIVE: The goal of this study was to determine the ability of various forms of fat deposition to predict the Fuhrman nuclear grade of clear cell renal cell carcinoma [ccRCC]. METHODS: This retrospective study included 320 patients with pathologically proven ccRCC [215 men and 105 women; 263 low-grade ccRCC and 57 highgrade ccRCC]. Based on computed tomography scans, adipose tissue in various body regions was classified into the perirenal fat area [PFA], visceral fat area [VFA], total fat area [TFA], subcutaneous fat area [SFA], and hepatic steatosis [HS]. Subsequently, the relative VFA [rVFA] was computed. Age, sex, body mass index, and maximal tumor diameter were also regarded as clinical factors. Univariate and multivariate logistic regression studies were conducted to evaluate whether there was an association between body fat composition and the Fuhrman classification and whether it was related to gender. RESULTS: After correcting for age, males with low-grade ccRCC exhibited higher TFA [257.6 vs. 203.0, p = 0.002], VFA [151.6 vs.115.5, p = 0.007], SFA [106.0 vs. 87.5, p = 0.015], PFA [55.1 vs. 30.4, p < 0.001], and HS [18% vs. 0%, p = 0.031] than those with high-grade ccRCC. There was no significant difference among rVFA in males. In females, there was no significant difference in any of the parameters. VFA and PFA remained independent predictors for high-grade ccRCC in males in both the monovariate [VFA: odds ratio [OR] 0.992, 95% confidence interval [CI] 0.987-0.997, p = 0.004; PFA: OR 0.949, 95% CI 0.930-0.970, p < 0.001] and multivariate [VFA: OR 1.028, 95% CI 1.001-1.074, p < 0.001; PFA: OR 0.878, 95% CI 0.833-0.926, p < 0.001] models. CONCLUSION: Gender-specific adipose tissue in different locations demonstrated varied values for predicting high-grade ccRCC and may be utilized as an independent predictor of high-grade ccRCC in male patients.

Realizing dendrite-free lithium deposition with three-dimensional soft-rigid nanofiber interlayers.

Lithium (Li) metal is regarded as the most desirable anode candidates for high-energy-density batteries by virtue of its lowest redox potential and ultrahigh theoretical specific capacity. However, uncontrollable Li dendritic growth, infinite volume variation and unstable solid electrolyte interface (SEI) ineluctably plague its commercialization process. Herein, the three-dimensional (3D) nanofiber functional layers with synergistic soft-rigid feature, consisting of tin oxide (SnO2)-anchored polyvinylidene fluoride (PVDF) nanofibers, are directly electrospun on copper current collector. This strategy can effectively regulate uniform Li deposition and strengthen SEI stability through the dual effect of physical accommodation and chemical ionic intervention. On the one hand, the nanofiber interlayers with excellent electrolyte affinity and well-distributed Li+ transport pathways can promote uniform Li+ flux distribution and large-size Li deposition. On the other hand, the rigid SnO2 contributes to reducing Li nucleation overpotential and stabilizing SEI layer assisted by its spontaneous reaction with Li. As a result, the smooth and dense Li deposition is achieved by such soft-rigid nanofiber interlayers, thereby extending the cycling life and improving the safety application of Li metal batteries. This work offers a new route for efficient protection of Li metal anodes and brings a new inspiration for developing high-energy-density Li metal batteries.

Esophageal cancer detection via non-contrast CT and deep learning.

Background: Esophageal cancer is the seventh most frequently diagnosed cancer with a high mortality rate and the sixth leading cause of cancer deaths in the world. Early detection of esophageal cancer is very vital for the patients. Traditionally, contrast computed tomography (CT) was used to detect esophageal carcinomas, but with the development of deep learning (DL) technology, it may now be possible for non-contrast CT to detect esophageal carcinomas. In this study, we aimed to establish a DL-based diagnostic system to stage esophageal cancer from non-contrast chest CT images. Methods: In this retrospective dual-center study, we included 397 primary esophageal cancer patients with pathologically confirmed non-contrast chest CT images, as well as 250 healthy individuals without esophageal tumors, confirmed through endoscopic examination. The images of these participants were treated as the training data. Additionally, images from 100 esophageal cancer patients and 100 healthy individuals were enrolled for model validation. The esophagus segmentation was performed using the no-new-Net (nnU-Net) model; based on the segmentation result and feature extraction, a decision tree was employed to classify whether cancer is present or not. We compared the diagnostic efficacy of the DL-based method with the performance of radiologists with various levels of experience. Meanwhile, a diagnostic performance comparison of radiologists with and without the aid of the DL-based method was also conducted. Results: In this study, the DL-based method demonstrated a high level of diagnostic efficacy in the detection of esophageal cancer, with a performance of AUC of 0.890, sensitivity of 0.900, specificity of 0.880, accuracy of 0.882, and F-score of 0.891. Furthermore, the incorporation of the DL-based method resulted in a significant improvement of the AUC values w.r.t. of three radiologists from 0.855/0.820/0.930 to 0.910/0.955/0.965 (p = 0.0004/<0.0001/0.0068, with DeLong's test). Conclusion: The DL-based method shows a satisfactory performance of sensitivity and specificity for detecting esophageal cancers from non-contrast chest CT images. With the aid of the DL-based method, radiologists can attain better diagnostic workup for esophageal cancer and minimize the chance of missing esophageal cancers in reading the CT scans acquired for health check-up purposes.

Mucin-producing tumors of the ovary--preoperative differentiation between metastatic ovarian mucinous carcinoma and primary mucinous malignant tumors.

OBJECTIVE: To investigate the clinical and magnetic resonance imaging (MRI) features for preoperatively discriminating  primary ovarian mucinous malignant tumors (POMTs) and metastatic mucinous carcinomas involving the ovary (MOMCs). METHODS: This retrospective multicenter study enrolled 61 patients with 22 POMTs and 49 MOMCs, which were pathologically proved between November 2014 to Jane 2023. The clinical and MRI features were evaluated and compared between POMTs and MOMCs. Univariate and multivariate analyses were performed to identify the significant variables between the two groups, which were then incorporated into a predictive nomogram, and ROC curve analysis was subsequently carried out to evaluate diagnostic performance. RESULTS: 35.9% patients with MOMCs were discovered synchronously with the primary carcinomas; 25.6% patients with MOMCs were bilateral, and all of the patients with POMTs were unilateral. The biomarker CEA was significantly different between the two groups (p = 0.002). There were significant differences in the following MRI features: tumor size, configuration, enhanced pattern, the number of cysts, honeycomb sign, stained-glass appearance, ascites, size diversity ratio, signal diversity ratio. The locular size diversity ratio (p = 0.005, OR = 1.31), and signal intensity diversity ratio (p = 0.10, OR = 4.01) were independent predictors for MOMCs. The combination of above independent criteria yielded the largest area under curve of 0.922 with a sensitivity of 82.3% and specificity of 88.9%. CONCLUSIONS: Patients with MOMCs were more commonly bilaterally and having higher levels of CEA, but did not always had a malignant tumor history. For ovarian mucin-producing tumors, the uniform locular sizes and signal intensities were more predict MOMCs.