Parkinson's disease with hyposmia and dysautonomia: does it represent a distinct subtype?

BACKGROUND AND PURPOSE: Olfactory dysfunction or dysautonomia is one of the earliest prodromal nonmotor symptoms of Parkinson's disease (PD). We aimed to investigate whether PD patients with dysautonomia and hyposmia at the de novo stage present different prognoses regarding PD dementia (PDD) conversion, motor complication development, and change in levodopa-equivalent doses (LED). METHODS: In this retrograde cohort study, we included 105 patients with newly diagnosed PD patients who underwent cross-cultural smell identification test (CC-SIT), autonomic function tests (AFT), and dopamine transporter (DAT) scan at the de novo stage. PD patients were divided into Hyposmia + /Dysautonomia + (H + /D +) and Hyposmia - /Dysautonomia - (H - /D -) groups depending on the result of AFT and CC-SIT. Baseline clinical, cognitive, imaging characteristics, longitudinal risks of PDD development and motor complication occurrence, and longitudinal LED changes were compared between the two groups. RESULTS: When compared with the H - /D - group, the H + /D + group showed lower standardized uptake value ratios in all subregions, lower asymmetry index, and steeper ventral - dorsal gradient in the DAT scan. The H + /D + group exhibited poorer performance in frontal/executive function and a higher risk of PDD development. The risk of motor complications including levodopa-induced dyskinesia, wearing off, and freezing of gait, was comparable between the two groups. The analysis of longitudinal changes in LED using a linear mixed model showed that the increase of LED in the H + /D + group was more rapid. CONCLUSIONS: Our results suggest that PD patients with dysautonomia and hyposmia at the de novo stage show a higher risk of PD dementia conversion and rapid progression of motor symptoms.

Local Structures of Ex-Solved Nanoparticles Identified by Machine-Learned Potentials.

In this study, we identify the local structures of ex-solved nanoparticles using machine-learned potentials (MLPs). We develop a method for training machine-learned potentials by sampling local structures of heterointerface configurations as a training set with its efficacy tested on the Ni/MgO system, illustrating that the error in interface energy is only 0.004 eV/Å2. Using the developed scheme, we train an MLP for the Ni/La0.5Ca0.5TiO3 ex-solution system and identify the local structures for both exo- and endo-type particles. The established model aligns well with the experimental observations, accurately predicting a nucleation size of 0.45 nm. Lastly, the density functional theory calculations on the established atomistic model verify that the kinetic barrier for the dry reforming of methane are substantially reduced by 0.49 eV on the ex-solved catalysts compared to that on the impregnated catalysts. Our findings offer insights into the local structures, growth mechanisms, and underlying origin of the catalytic properties of ex-solved nanoparticles.

Alteration of medial temporal lobe metabolism related to Alzheimer's disease and dementia with lewy bodies.

BACKGROUND: Association of medial temporal lobe (MTL) metabolism with Alzheimer's disease (AD) and dementia with Lewy bodies (DLB) has not been evaluated considering their mixed disease (MD). METHODS: 131 patients with AD, 133 with DLB, 122 with MD, and 28 normal controls (NCs) underwent neuropsychological tests, assessments for parkinsonism, cognitive fluctuation (CF), and visual hallucinations (VH), and 18F-fluorodeoxyglucose PET to quantify MTL metabolism in the amygdala, hippocampus, and entorhinal cortex. The effects of AD and DLB on MTL metabolism were evaluated using general linear models (GLMs). Associations between MTL metabolism, cognition, and clinical features were evaluated using GLMs or logistic regression models separately performed for the AD spectrum (NC + AD + MD), DLB spectrum (NC + DLB + MD), and disease groups (AD + DLB + MD). Covariates included age, sex, and education. RESULTS: AD was associated with hippocampal/entorhinal hypometabolism, whereas DLB was associated with relative amygdalar/hippocampal hypermetabolism. Relative MTL hypermetabolism was associated with lower attention/visuospatial/executive scores and severe parkinsonism in both the AD and DLB spectra and disease groups. Left hippocampal/entorhinal hypometabolism was associated with lower verbal memory scores, whereas right hippocampal hypometabolism was associated with lower visual memory scores in both the AD spectrum and disease groups. Relative MTL hypermetabolism was associated with an increased risk of CF and VH in the disease group, and relative amygdalar hypermetabolism was associated with an increased risk of VH in the DLB spectrum. CONCLUSIONS: Entorhinal-hippocampal hypometabolism and relative amygdala-hippocampal hypermetabolism could be characteristics of AD- and DLB-related neurodegeneration, respectively.

Dopamine transporter positron emission tomography in patients with Alzheimer's disease with Lewy body disease features.

In 36 normal controls (NC), 37 patients with Alzheimer's disease (AD) without parkinsonism (ADP-), 31 AD with parkinsonism (ADP+), and 40 AD with dementia with Lewy bodies (ADDLB), dual-phase dopamine transporter (DAT) positron emission tomography (PET) were performed to evaluate the diagnostic performance of DAT and early-to-delayed uptake ratios (E/Ds) in the anterior caudate (AC), posterior caudate (PC), anterior putamen (AP), posterior putamen (PP), and substantia nigra (SN) to differentiate ADP+/ADDLB from NC, and their effects on parkinsonism and cognition. DAT-SN and E/D-PP showed higher accuracies to differentiate ADP+/ADDLB from NC than DAT-PP. Among AD patients, lower DAT in the putamen and PC and higher E/Ds in the striatum were associated with severe parkinsonism, while higher E/Ds in the putamen, PC, and SN were associated with executive dysfunction. Our results suggest that decreased DAT-SN and increased E/D-PP could be biomarkers differentiating ADP+/ADDLB from pure AD and controls. Meanwhile, increased E/Ds in the putamen could reflect the severity of DLB presenting with parkinsonism and executive dysfunction among AD patients.

Critical role of electrons in the short lifetime of blue OLEDs.

Designing robust blue organic light-emitting diodes is a long-standing challenge in the display industry. The highly energetic states of blue emitters cause various degradation paths, leading to collective luminance drops in a competitive manner. However, a key mechanism of the operational degradation of organic light-emitting diodes has yet to be elucidated. Here, we show that electron-induced degradation reactions play a critical role in the short lifetime of blue organic light-emitting diodes. Our control experiments demonstrate that the operational lifetime of a whole device can only be explained when excitons and electrons exist together. We examine the atomistic mechanisms of the electron-induced degradation reactions by analyzing their energetic profiles using computational methods. Mass spectrometric analysis of aged devices further confirm the key mechanisms. These results provide new insight into rational design of robust blue organic light-emitting diodes.

Stability and Equilibrium Structures of Unknown Ternary Metal Oxides Explored by Machine-Learned Potentials.

Ternary metal oxides are crucial components in a wide range of applications and have been extensively cataloged in experimental materials databases. However, there still exist cation combinations with unknown stability and structures of their compounds in oxide forms. In this study, we employ extensive crystal structure prediction methods, accelerated by machine-learned potentials, to investigate these untapped chemical spaces. We examine 181 ternary metal oxide systems, encompassing most cations except for partially filled 3d or f shells, and determine their lowest-energy crystal structures with representative stoichiometry derived from prevalent oxidation states or recommender systems. Consequently, we discover 45 ternary oxide systems containing stable compounds against decomposition into binary or elemental phases, the majority of which incorporate noble metals. Comparisons with other theoretical databases highlight the strengths and limitations of informatics-based material searches. With a relatively modest computational resource requirement, we contend that heuristic-based structure searches, as demonstrated in this study, offer a promising approach for future materials discovery endeavors.

Neuropsychological Comparison of Patients With Alzheimer's Disease and Dementia With Lewy Bodies.

BACKGROUND AND PURPOSE: This study aimed to determine the neuropsychological differences between patients with early-stage Alzheimer's disease (AD) and dementia with Lewy bodies (DLB) with a Clinical Dementia Rating (CDR) score of ≤1. METHODS: We examined 168 patients with AD (126 with CDR score=0.5, 42 with CDR score=1) and 169 patients with DLB (104 with CDR score=0.5, 65 with CDR score=1) whose diagnoses were supported by 18F-flobetaben positron-emission tomography (PET) and 18F-N-(3-fluoropropyl)-2ß-carbon ethoxy-3ß-(4-iodophenyl) nortropane PET. Neuropsychological test scores were compared after controlling for age, sex, and education duration. Using a cutoff motor score on the Unified Parkinson's Disease Rating Scale of 20, patients with AD were further divided into AD with parkinsonism (ADP+, n=86) and AD without parkinsonism (ADP-, n=82). RESULTS: At CDR scores of both 0.5 and 1, the DLB group had lower scores on the attention (digit-span forward at CDR score=0.5 and backward at CDR score=1), visuospatial, and executive (color reading Stroop test at CDR score=0.5 and phonemic fluency test, Stroop tests, and digit symbol coding at CDR score=1) tests than the AD group, but higher scores on the memory tests. The ADP- and ADP+ subgroups had comparable scores on most neuropsychological tests, but the ADP+ subgroup had lower scores on the color reading Stroop test. CONCLUSIONS: Patients with DLB had worse attention, visuospatial, and executive functions but better memory function than patients with AD. Parkinsonism was not uncommon in the patients with AD and could be related to attention and executive dysfunction.

Association of Neuropsychiatric Symptom Profiles With Cognitive Decline in Patients With Parkinson Disease and Mild Cognitive Impairment.

BACKGROUND AND OBJECTIVES: Neuropsychiatric symptoms (NPS) are closely associated with cognitive decline in patients with Parkinson disease (PD). We investigated which profiles of NPS are associated with the risk of dementia in PD with mild cognitive impairment (PD-MCI). METHODS: We retrospectively assessed 338 patients with PD-MCI from a single tertiary hospital, who underwent neuropsychological tests and a neuropsychiatric inventory (NPI) questionnaire. We conducted a factor analysis of the dichotomized presence of 12 NPI symptoms, yielding 3 NPI factors: factor 1, mood symptoms; factor 2, hyperactivity-related symptoms; and factor 3, psychotic symptoms. Factor analysis of the severity of NPI symptoms also identified similar NPI factors. The neuropsychiatric correlates of NPI factors were evaluated using general linear models for cognitive tests. Subsequently, we evaluated the hazard ratio (HR) of NPI factors on conversion to dementia. RESULTS: A higher prevalence factor 1 score was associated with lower scores in the verbal memory (ß = -0.15; 95% CI -0.24 to -0.06; p = 0.001) and executive domains (ß = -0.16; 95% CI -0.28 to -0.04; p = 0.007), whereas higher severity factor 2 scores were associated with lower scores in the naming (ß = -0.16; 95% CI -0.28 to -0.03; p = 0.012), visuospatial (ß = -0.24; 95% CI -0.41 to -0.07; p = 0.005), and verbal memory domains (ß = -0.15; 95% CI -0.24 to -0.05; p = 0.005). A higher severity factor 3 score was associated with lower scores in the visuospatial domain (ß = -0.25; 95% CI -0.46 to -0.07; p = 0.007). Cox regression models demonstrated that the risk of dementia was increased in those with higher prevalence factor 1 (HR = 1.48, 95% CI 1.17-1.88, p = 0.001) and factor 2 scores (HR = 1.27, 95% CI 1.07-1.51, p = 0.007) and severity factor 3 score (HR = 1.52, 95% CI 1.29-1.80, p < 0.001) after adjusting for age, sex, education, disease duration, scores for cognition and parkinsonism, and levodopa equivalent dose. DISCUSSION: This study demonstrated that a higher burden of NPS is associated with dementia conversion in patients with PD-MCI.

Striatal dopamine transporter uptake, parkinsonism and cognition in Alzheimer's disease.

BACKGROUND AND PURPOSE: The correlates of motor parkinsonism in Alzheimer's disease (AD) remain controversial. The effects of nigrostriatal dopaminergic degeneration on parkinsonism and cognition in biomarker-validated patients with AD were evaluated. METHODS: This study recruited 116 patients with AD who underwent dual-phase 18 F-N-(3-fluoropropyl)-2ß-carbon ethoxy-3ß-(4-iodophenyl) nortropane positron emission tomography, 18 F-florbetaben positron emission tomography, 3 T brain magnetic resonance imaging, and Unified Parkinson's Disease Rating Scale (UPDRS) and neuropsychological tests. The mean cortical thickness in the frontal, temporal, parietal and occipital cortices, and the dopamine transporter (DAT) uptake in the caudate, anterior/posterior putamen and substantia nigra were quantified. The relationship between DAT uptake, mean lobar cortical thickness, UPDRS motor score and cognition was investigated using general linear models (GLMs) after controlling for age, sex, education, intracranial volume, and deep and periventricular white matter hyperintensities. A path analysis was performed for the UPDRS motor score with the same covariates. RESULTS: Path analysis and multivariable GLMs for UPDRS motor score showed that lower caudate DAT uptake was directly associated with a higher UPDRS motor score, whereas caudate DAT uptake confounded the association between mean frontal/parietal thickness and UPDRS motor score. Multivariable GLMs for cognitive scores showed that lower caudate DAT uptake was associated with visuospatial/executive dysfunction independent of mean frontal or parietal thickness. CONCLUSIONS: Nigrostriatal dopaminergic dysfunction is associated with parkinsonism and visuospatial/executive dysfunction in patients with AD.

Improving the quality of ultrasound images acquired using a therapeutic transducer.

To enhance the effectiveness and safety of focused ultrasound (FUS) therapy, ultrasound image-based guidance and treatment monitoring are crucial. However, the use of FUS transducers for both therapy and imaging is impractical due to their low spatial resolution, signal-to-noise ratio (SNR), and contrast-to-noise ratio (CNR). To address this issue, we propose a new method that significantly improve the quality of images obtained by a FUS transducer. The proposed method employs coded excitation to enhance SNR and Wiener deconvolution to solve the problem of low axial resolution resulting from the narrow spectral bandwidth of FUS transducers. Specifically, the method eliminates the impulse response of a FUS transducer from received ultrasound signals using Wiener deconvolution, and pulse compression is performed using a mismatched filter. Simulation and commercial phantom experiments confirmed that the proposed method significantly improves the quality of images acquired by the FUS transducer. The -6 dB axial resolution was improved 1.27 mm to 0.37 mm that was similar to the resolution achieved by the imaging transducer, i.e., 0.33 mm. SNR and CNR also increased from 16.5 dB and 0.69 to 29.1 dB and 3.03, respectively, that were also similar to those by the imaging transducer (27.8 dB and 3.16). Based on the results, we believe that the proposed method has great potential to enhance the clinical utility of FUS transducers in ultrasound image-guided therapy.

Exploring Subtypes of Repetitive Behavior in Children with Autism Through Functional Analysis and Wearable Technology: a Pilot Biobehavioral Assessment.

Objectives: Prior research has established assessment methodologies, such as functional analysis to identify specific contexts in which restricted and repetitive behavior (RRB) occurs, and measures of heart rate variability (HRV) to index the level of autonomic arousal in individuals with autism spectrum disorder (ASD). Yet, a gap remains in integrating multiple assessment methodologies to examine the complex underlying mechanisms of RRB. This study piloted a multi-disciplinary approach to assess both the functional behavioral and neurophysiological factors that may underlie occurrences of RRB. The study (a) evaluated the effect of a modified functional analysis protocol on delineating functional subtypes of RRB and (b) explored the effect of using a wearable technology within a functional analysis on identifying the relationship between RRB and HRV. Method: A single-case alternating treatment design was used to randomly alternate noncontingent low-stimulation and high-stimulation conditions in a modified functional analysis protocol. Simultaneous measurement of RRB and HRV was obtained through direct behavioral observations and a wristband that collects blood volume pulse, respectively. Visual analysis of time series data was used to determine the functional subtypes of RRB, and nonparametric correlational analyses were conducted to determine the association between HRV and RRB. Results: Findings from a sample of six participants suggest preliminary effectiveness of the assessment protocol in identifying subtypes of RRB and a significant correlation between HRV and RRB. Conclusions: This study demonstrates the potential effect and usability of a wearable technology-aided biobehavioral approach to assess RRB and HRV in individuals with ASD.

Therapeutic Potential of Chungsangboha-tang for the Treatment of Asthma: A Review of Preclinical and Clinical Studies.

In traditional Korean medicine, Chungsangboha-tang (CSBHT) and its modified forms are used to treat various respiratory disorders, including asthma. This study aimed to identify research trends, clarify the effectiveness of CSBHT and related prescriptions, and lay a foundation for future research. We conducted a literature review using PubMed, Embase, Google Scholar, Oriental Medicine Advanced Searching Integrated System, National Digital Science Links, Korean Medical Database, Wanfang Data, and Chinese National Knowledge Infrastructure databases. We analyzed 25 studies, including 5 in vitro studies, 6 animal studies, and 14 human studies. Many studies evaluated the efficacy of CSBHT and its related prescriptions, including experimental studies on its effectiveness in asthma. The main mechanism of action involves the anti-inflammatory effect caused by the regulation of various immune cells, cytokines, and chemokines. In addition, clinical trials on asthma reported the benefits of CSBHT and its related prescriptions. However, there has been no randomized controlled study of clinical trials on the clinical effectiveness of CSBHT in asthma. Therefore, large-scale randomized controlled studies should be conducted in the future.

Circularly Polarized Light Can Override and Amplify Asymmetry in Supramolecular Helices.

Circularly polarized light (CPL) is an inherently chiral entity and is considered one of the possible deterministic signals that led to the evolution of homochirality. While accumulating examples indicate that chirality beyond the molecular level can be induced by CPL, not much is yet known about circumstances where the spin angular momentum of light competes with existing molecular chiral information during the chirality induction and amplification processes. Here we present a light-triggered supramolecular polymerization system where chiral information can both be transmitted and nonlinearly amplified in a "sergeants-and-soldiers" manner. While matching handedness with CPL resulted in further amplification, we determined that opposite handedness could override molecular information at the supramolecular level when the enantiomeric excess was low. The presence of a critical chiral bias suggests a bifurcation point in the homochirality evolution under random external chiral perturbation. Our results also highlight opportunities for the orthogonal control of supramolecular chirality decoupled from molecular chirality preexisting in the system.

First-Principles Calculations of Luminescence Spectra of Real-Scale Quantum Dots.

The luminescence line shape is an important feature of semiconductor quantum dots (QDs) and affects performance in various optical applications. Here, we report a first-principles method to predict the luminescence spectrum of thousands of atom QDs. In our approach, neural network potential calculations are combined with density functional theory calculations to describe exciton-phonon coupling (EPC). Using the calculated EPC, the luminescence spectrum is evaluated within the Franck-Condon approximation. Our approach results in the luminescence line shape for an InP/ZnSe core/shell QD (3406 atoms) that exhibits excellent agreement with the experiments. From a detailed analysis of EPC, we reveal that the coupling of both acoustic and optical phonons to an exciton are important in determining the spectral line shapes of core/shell QDs, which is in contrast with previous studies. On the basis of the present simulation results, we provide guidelines for designing high-performance core/shell QDs with ultrasharp emission spectra.

Identification of Active Sites for CO2 Reduction on Graphene-Supported Single-Atom Catalysts.

Transition metal- and nitrogen-codoped graphene (referred to as M-N-G, where M is a transition metal) has emerged as an important type of single-atom catalysts with high selectivities and activities for electrochemical CO2 reduction (CO2 R) to CO. However, despite extensive previous studies on the catalytic origin, the active site in M-N-G catalysts remains puzzling. In this study, density functional theory calculations and computational hydrogen electrode model is used to investigate CO2 R reaction energies on Zn-N-G, which exhibits outstanding catalytic performance, and to examine kinetic barriers of reduction reactions by using the climbing image nudged elastic band method. We find that single Zn atoms binding to N and C atoms in divacancy sites of graphene cannot serve as active sites to enable CO production, owing to *OCHO formation (* denotes an adsorbate) at an initial protonation process. This contradicts the widely accepted CO2 R mechanism whereby single metal atoms are considered catalytic sites. In contrast, the C atom that is the nearest neighbor of the single Zn atom (CNN ) is found to be highly active and the Zn atom plays a role as an enhancer of the catalytic activity of the CNN . Detailed analysis of the CO2 R pathway to CO on the CNN site reveals that *COOH is favorably formed at an initial electrochemical step, and every reaction step becomes downhill in energy at small applied potentials of about -0.3 V with respect to reversible hydrogen electrode. Electronic structure analysis is also used to elucidate the origin of the CO2 R activity of the CNN site.

Effectiveness of synthetic aperture focusing and coherence factor weighting for intravascular ultrasound imaging.

Synthetic aperture focusing (SAF) and coherence factor weighting (CFW) have been used to improve the lateral resolution of ultrasound images. Although the two methods are effective for array-based ultrasound imaging, many researchers have also employed the methods for single-element-based imaging including intravascular ultrasound (IVUS) imaging. For single-element-based imaging, CFW is generally calculated from the scanlines obtained by SAF and applied to the scanline obtained after coherent summation of the SAF delayed scanlines, which is called a SAF-CFW method. In the paper, a theoretical model was derived to explore the effectiveness of SAF and CFW for single-element-based imaging, and the model was used to explain that SAF is not effective for IVUS imaging in terms of enhancing the spatial resolution, although it has the advantage of improving a contrast-to-noise ratio (CNR). This means that the SAF-CFW method is not optimal for improving the spatial resolution of IVUS imaging. In contrast, it was found in simulations and experiments that applying CFW to the target scanline itself is beneficial for the spatial resolution rather than a coherent summed scanline for IVUS SAF imaging, but CNR was not as good as SAF and SAF-CFW. As a result of both simulation and experimentation, it could be concluded that focused IVUS transducers without the application of those methods may be more advantageous to improve the spatial and contrast resolution simultaneously, considering the system complexity in the implementation of such imaging methods.

Holistic Approach to the Mechanism Study of Thermal Degradation of Organic Light-Emitting Diode Materials.

The design of stable organic light-emitting diode materials is the key to long lifetime displays under various stressful conditions. Elucidating the degradation mechanism of the materials at the molecular level provides useful information for securing high stability. Previous works based on experiments or computations disclosed only a part of the whole degradation process. Here, we propose a holistic approach to the systematic analysis of the degradation mechanism by combining experimental mass analysis and computation in a semi-automated fashion. The mass analysis identifies molecular weights of feasible products from degradation reactions. Then, the computational analysis goes through initiation, propagation, and termination phases. The initiation phase determines radical fragments and reactive sites, triggering the propagation process. In the propagation phase, we subsequently perform intermediate sampling, reaction network construction, and kinetic analysis. As a proof of concept, this approach was applied to the thermal degradation problem during the sublimation purification process. Two major pathways were successfully elucidated with full atomistic details.

Adatom Doping of Transition Metals in ReSe2 Nanosheets for Enhanced Electrocatalytic Hydrogen Evolution Reaction.

Two-dimensional Re dichalcogenide nanostructures are promising electrocatalysts for the hydrogen evolution reaction (HER). Herein, we report the adatom doping of various transition metals (TM = Mn, Fe, Co, Ni, and Cu) in ReSe2 nanosheets synthesized using a solvothermal reaction. As the atomic number of TM increases from Mn to Cu, the adatoms on Re sites become more favored over the substitution. In the case of Ni, the fraction of adatoms reaches 90%. Ni doping resulted in the most effective enhancement in the HER catalytic performance, which was characterized by overpotentials of 82 and 109 mV at 10 mA cm-2 in 0.5 M H2SO4 and 1 M KOH, respectively, and the Tafel slopes of 54 and 81 mV dec-1. First-principles calculations predicted that the adatom doping structures (TMs on Re sites) have higher catalytic activity compared with the substitution ones. The adsorbed H atoms formed a midgap hybridized state via direct bonding with the orbitals of TM adatom. The present work provides a deeper understanding into how TM doping can provide the catalytically active sites in these ReSe2 nanosheets.

Fundamental Limit of the Emission Linewidths of Quantum Dots: An Ab Initio Study of CdSe Nanocrystals.

The emission linewidth of a semiconducting nanocrystal (NC) significantly affects its performance in light-emitting applications, but its fundamental limit is still elusive. Herein, we analyze the exciton-phonon coupling (EPC) from Huang-Rhys (HR) factors using ab initio calculations and compute emission line shapes of CdSe NCs. When surface traps are absent, acoustic modes are found to dominate EPC. The computed linewidths are mainly determined by the size of NCs, being largely insensitive to the shape and crystal structure. Linewidths obtained in this work are much smaller than most measurements on homogeneous linewidths, but they are consistent with a CdSe/CdxZn1-xSe (core/shell) NC [Park, Y.-S.; Lim, J.; Klimov, V. I. Nat. Mater. 2019 18, 249-255]. Based on this comparison, it is concluded that the large linewidths in most experiments originated from internal fields by surface (or interface) traps or quasi-type II band alignment that amplifies EPC. Thus, the present results on NCs with ideal passivation provide the fundamental minimum of homogeneous linewidths, indicating that only the CdSe/CdxZn1-xSe NC has achieved this limit through well-controlled synthesis of shell structures. To further verify the role of internal fields, we model NCs with charged surface defects. We find that the internal field significantly increases HR factors and linewidths, in reasonable agreement with experiments on single cores. By revealing the fundamental limit of the emission linewidths of quantum dots, this work will pave the way for engineering quantum dots with an ultrasharp spectrum.