The Learning Curve of Total Arch Replacement via Single Upper Hemisternotomy Approach in Aortic Dissection.

Purpose: Upper hemisternotomy (UHS) has benefits over conventional full sternotomy because it ameliorates trauma during cardiac surgery. Owing to its challenging and technically demanding nature, this incision in acute type A aortic dissection (ATAAD) has rarely been reported. This study aimed to analyze the learning curve of total arch replacement (TAR) with moderate hypothermic circulatory arrest via a single UHS approach, which is necessary to guide the training of surgeons in adopting minimally invasive procedures. Patients and Methods: A total of 202 consecutive patients who were definitively diagnosed with ATAAD between July 2016 and June 2021 were enrolled in this retrospective analysis. Patients were divided into three groups based on cumulative sum plots for circulatory arrest time in chronological order. Perioperative characteristics were compared between the groups. Results: There was significant difference in the circulatory arrest time and cross-clamp time respectively among three groups (39.0 min vs 28.0 min vs 15.0 min, P < 0.001; 104.5 min vs 106.2 min vs 84.1 min, P < 0.001). The ventilation time and first 24-h chest tube drainage were statistically different among groups (35.5 h vs 24.0 h vs 19.0 h, P = 0.031; 220.0 mL vs 192.5 mL vs 125.5 mL, P = 0.043). No other clinical outcome was observed as significant difference. Conclusion: A cardiac surgeon can convert a conventional full sternotomy to a single UHS for TAR after experiencing a learning curve, to ensure patient safety. The mastery of this minimally invasive surgical technique may be beneficial for the prognosis of patients with ATAAD.

Infrared nano-imaging of Dirac magnetoexcitons in graphene.

Magnetic fields can have profound effects on the motion of electrons in quantum materials. Two-dimensional electron systems subject to strong magnetic fields are expected to exhibit quantized Hall conductivity, chiral edge currents and distinctive collective modes referred to as magnetoplasmons and magnetoexcitons. Generating these propagating collective modes in charge-neutral samples and imaging them at their native nanometre length scales have thus far been experimentally elusive. Here we visualize propagating magnetoexciton polaritons at their native length scales and report their magnetic-field-tunable dispersion in near-charge-neutral graphene. Imaging these collective modes and their associated nano-electro-optical responses allows us to identify polariton-modulated optical and photo-thermal electric effects at the sample edges, which are the most pronounced near charge neutrality. Our work is enabled by innovations in cryogenic near-field optical microscopy techniques that allow for the nano-imaging of the near-field responses of two-dimensional materials under magnetic fields up to 7 T. This nano-magneto-optics approach allows us to explore and manipulate magnetopolaritons in specimens with low carrier doping via harnessing high magnetic fields.

Ambipolar charge-transfer graphene plasmonic cavities.

Plasmon polaritons in van der Waals materials hold promise for various photonics applications1-4. The deterministic imprinting of spatial patterns of high carrier density in plasmonic cavities and nanoscale circuitry can enable the realization of advanced nonlinear nanophotonic5 and strong light-matter interaction platforms6. Here we demonstrate an oxidation-activated charge transfer strategy to program ambipolar low-loss graphene plasmonic structures. By covering graphene with transition-metal dichalcogenides and subsequently oxidizing the transition-metal dichalcogenides into transition-metal oxides, we activate charge transfer rooted in the dissimilar work functions between transition-metal oxides and graphene. Nano-infrared imaging reveals ambipolar low-loss plasmon polaritons at the transition-metal-oxide/graphene interfaces. Further, by inserting dielectric van der Waals spacers, we can precisely control the electron and hole densities induced by oxidation-activated charge transfer and achieve plasmons with a near-intrinsic quality factor. Using this strategy, we imprint plasmonic cavities with laterally abrupt doping profiles with nanoscale precision and demonstrate plasmonic whispering-gallery resonators based on suspended graphene encapsulated in transition-metal oxides.

Insight into the nonlinear effect of COVID-19 on well-being in China: Commuting, a vital ingredient.

Background: COVID-19 had a devastating impact on people's work, travel, and well-being worldwide. As one of the first countries to be affected by the virus and develop relatively well-executed pandemic control, China has witnessed a significant shift in people's well-being and habits, related to both commuting and social interaction. In this context, what factors and the extent to which they contribute to well-being are worth exploring. Methods: Through a questionnaire survey within mainland China, 688 valid sheets were collected, capturing various aspects of individuals' life, including travel, and social status. Focusing on commuting and other factors, a Gradient Boosting Decision Tree (GBDT) model was developed based on 300 sheets reporting working trips, to analyze the effects on well-being. Two indicators, i.e., the Relative Importance (RI) and Partial Dependency Plot (PDP), were used to quantify and visualize the effects of the explanatory factors and the synergy among them. Results: Commuting characteristics are the most critical ingredients, followed by social interactions to explain subjective well-being. Commuting stress poses the most substantial effect. Less stressful commuting trips can solidly improve overall well-being. Better life satisfaction is linked with shorter confinement periods and increased restriction levels. Meanwhile, the switch from in-person to online social interactions had less impact on young people's life satisfaction. Older people were unsatisfied with this change, which had a significant negative impact on their life satisfaction. Conclusions: From the synergy of commuting stress and commuting time on well-being, the effect of commuting time on well-being is mediated by commuting stress in the case of China. Even if one is satisfied with online communication, the extent of enhancement on well-being is minimal, for it still cannot replace face-to-face interaction. The findings can be beneficial in improving the overall well-being of society during the pandemic and after the virus has been eradicated.

Exact Solution for Elastic Networks on Curved Surfaces.

The problem of characterizing the structure of an elastic network constrained to lie on a frozen curved surface appears in many areas of science and has been addressed by many different approaches, most notably, extending linear elasticity or through effective defect interaction models. In this Letter, we show that the problem can be solved by considering nonlinear elasticity in an exact form without resorting to any approximation in terms of geometric quantities. In this way, we are able to consider different effects that have been unwieldy or not viable to include in the past, such as a finite line tension, explicit dependence on the Poisson ratio, or the determination of the particle positions for the entire lattice. Several geometries with rotational symmetry are solved explicitly. Comparison with linear elasticity reveals an agreement that extends beyond its strict range of applicability. Implications for the problem of the characterization of virus assembly are also discussed.

Visualizing Atomically Layered Magnetism in CrSBr.

2D materials can host long-range magnetic order in the presence of underlying magnetic anisotropy. The ability to realize the full potential of 2D magnets necessitates systematic investigation of the role of individual atomic layers and nanoscale inhomogeneity (i.e., strain) on the emergence of stable magnetic phases. Here, spatially dependent magnetism in few-layer CrSBr is revealed using magnetic force microscopy (MFM) and Monte Carlo-based simulations. Nanoscale visualization of the magnetic sheet susceptibility is extracted from MFM data and force-distance curves, revealing a characteristic onset of both intra- and interlayer magnetic correlations as a function of temperature and layer-thickness. These results demonstrate that the presence of a single uncompensated layer in odd-layer terraces significantly reduces the stability of the low-temperature antiferromagnetic (AFM) phase and gives rise to multiple coexisting magnetic ground states at temperatures close to the bulk Néel temperature (TN ). Furthermore, the AFM phase can be reliably suppressed using modest fields (≈16 mT) from the MFM probe, behaving as a nanoscale magnetic switch. This prototypical study of few-layer CrSBr demonstrates the critical role of layer parity on field-tunable 2D magnetism and validates MFM for use in nanomagnetometry of 2D materials (despite the ubiquitous absence of bulk zero-field magnetism in magnetized sheets).

Ancestry-inclusive dog genomics challenges popular breed stereotypes.

Behavioral genetics in dogs has focused on modern breeds, which are isolated subgroups with distinctive physical and, purportedly, behavioral characteristics. We interrogated breed stereotypes by surveying owners of 18,385 purebred and mixed-breed dogs and genotyping 2155 dogs. Most behavioral traits are heritable [heritability (h2) > 25%], and admixture patterns in mixed-breed dogs reveal breed propensities. Breed explains just 9% of behavioral variation in individuals. Genome-wide association analyses identify 11 loci that are significantly associated with behavior, and characteristic breed behaviors exhibit genetic complexity. Behavioral loci are not unusually differentiated in breeds, but breed propensities align, albeit weakly, with ancestral function. We propose that behaviors perceived as characteristic of modern breeds derive from thousands of years of polygenic adaptation that predates breed formation, with modern breeds distinguished primarily by aesthetic traits.

Nonlinear nanoelectrodynamics of a Weyl metal.

Chiral Weyl fermions with linear energy-momentum dispersion in the bulk accompanied by Fermi-arc states on the surfaces prompt a host of enticing optical effects. While new Weyl semimetal materials keep emerging, the available optical probes are limited. In particular, isolating bulk and surface electrodynamics in Weyl conductors remains a challenge. We devised an approach to the problem based on near-field photocurrent imaging at the nanoscale and applied this technique to a prototypical Weyl semimetal TaIrTe4 As a first step, we visualized nano-photocurrent patterns in real space and demonstrated their connection to bulk nonlinear conductivity tensors through extensive modeling augmented with density functional theory calculations. Notably, our nanoscale probe gives access to not only the in-plane but also the out-of-plane electric fields so that it is feasible to interrogate all allowed nonlinear tensors including those that remained dormant in conventional far-field optics. Surface- and bulk-related nonlinear contributions are distinguished through their "symmetry fingerprints" in the photocurrent maps. Robust photocurrents also appear at mirror-symmetry breaking edges of TaIrTe4 single crystals that we assign to nonlinear conductivity tensors forbidden in the bulk. Nano-photocurrent spectroscopy at the boundary reveals a strong resonance structure absent in the interior of the sample, providing evidence for elusive surface states.

Overexpressing long non-coding RNA OIP5-AS1 ameliorates sepsis-induced lung injury in a rat model via regulating the miR-128-3p/Sirtuin-1 pathway.

Sepsis, resulting from infections, is a systemic inflammatory response syndrome with a high fatality rate. The present study revolves around probing into the function and molecular mechanism of long non-coding RNA OIP5 antisense RNA 1 (lncRNA OIP5-AS1) in modulating acute lung injury (ALI) mediated by sepsis. Here, a sepsis model was constructed using cecal ligation and puncture (CLP) surgery in vivo. The alveolar macrophage cell line NR8383 and the alveolar type II cell line RLE-6TN were dealt with lipopolysaccharide (LPS) for in-vitro experiments. We discovered that OIP5-AS1 and Sirtuin1 (SIRT1) were markedly down-regulated in sepsis models elicited by CLP or LPS, while miR-128-3p experienced a dramatic up-regulation. OIP5-AS1 overexpression attenuated NR8383 and RLE-6TN cell apoptosis triggered by LPS and suppressed the expressions of nuclear factor kappa B (NF-κB), inducible nitric oxide synthase (iNOS), interleukin-1ß (IL-1ß), tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6) in NR8383 and RLE-6TN cells, whereas miR-128-3p overexpression resulted in the opposite phenomenon. Moreover, OIP5-AS1 overexpression relieved lung edema, lung epithelial cell apoptosis, infiltration of myeloperoxidase (MPO)-labeled polymorphonuclear neutrophils (PMN), inflammatory responses triggered by CLP in vivo. Mechanistically, miR-128-3p, which targeted SIRT1, was hobbled by OIP5-AS1. All in all, OIP5-AS1 overexpression enhanced sepsis-induced ALI by modulating the miR-128-3p/SIRT1 pathway, which helps create new insights into sepsis treatment.

Relationships between RNA topology and nucleocapsid structure in a model icosahedral virus.

The process of genome packaging in most of viruses is poorly understood, notably the role of the genome itself in the nucleocapsid structure. For simple icosahedral single-stranded RNA viruses, the branched topology due to the RNA secondary structure is thought to lower the free energy required to complete a virion. We investigate the structure of nucleocapsids packaging RNA segments with various degrees of compactness by small-angle x-ray scattering and cryotransmission electron microscopy. The structural differences are mild even though compact RNA segments lead on average to better-ordered and more uniform particles across the sample. Numerical calculations confirm that the free energy is lowered for the RNA segments displaying the larger number of branch points. The effect is, however, opposite with synthetic polyelectrolytes, in which a star topology gives rise to more disorder in the capsids than a linear topology. If RNA compactness and size account in part for the proper assembly of the nucleocapsid and the genome selectivity, other factors most likely related to the host cell environment during viral assembly must come into play as well.

Programmable Bloch polaritons in graphene.

Efficient control of photons is enabled by hybridizing light with matter. The resulting light-matter quasi-particles can be readily programmed by manipulating either their photonic or matter constituents. Here, we hybridized infrared photons with graphene Dirac electrons to form surface plasmon polaritons (SPPs) and uncovered a previously unexplored means to control SPPs in structures with periodically modulated carrier density. In these periodic structures, common SPPs with continuous dispersion are transformed into Bloch polaritons with attendant discrete bands separated by bandgaps. We explored directional Bloch polaritons and steered their propagation by dialing the proper gate voltage. Fourier analysis of the near-field images corroborates that this on-demand nano-optics functionality is rooted in the polaritonic band structure. Our programmable polaritonic platform paves the way for the much-sought benefits of on-the-chip photonic circuits.

C9N4 and C2N6S3 monolayers as promising anchoring materials for lithium-sulfur batteries: weakening the shuttle effect via optimizing lithium bonds.

The notorious polysulfide shuttle effect is a crucial factor responsible for the degradation of Li-S batteries. A good way to suppress the shuttle effect is to effectively anchor dissoluble lithium polysulfides (LPSs, Li2Sn) on appropriate substrates. Previous studies have revealed that Li of Li2Sn is prone to interact with the N of N-containing materials to form Li-N bonds. In this work, by means of density functional theory (DFT) computations, we explored the possibility to form Li bonds on ten different N-containing monolayers, including BN, C2N, C2N6S3, C9N4, a covalent triazine framework (CTF), g-C3N4, p-C3N4, C3N5, S-N2S, and T-N2S, by examining the adsorption behavior of Li2Sn (n = 1, 2, 3, 4, 6, 8) on these two-dimensional (2D) anchoring materials (AMs), and investigated the performance of the formed Li bonds (if any) in inhibiting the shuttle effect. By comparing and analyzing the nitrogen content, the N-containing pore size, charge transfer, and Li bonds, we found that the N content and N-containing pore size correlate with the number of Li bonds, and the formed Li-N bonds between LPSs and AMs correspond well with the adsorption energies of the LPSs. The C9N4 and C2N6S3 monolayers were identified as promising AMs in Li-S batteries. From the view of Li bonds, this work provides guidelines for designing 2D N-containing materials as anchoring materials to reduce the shuttle effect in Li-S batteries, and thus improving the performance of Li-S batteries.

A super stable assembled P nanowire with variant structural and magnetic/electronic properties via transition metal adsorption.

By means of first-principles calculations, we systematically investigated the structure, stability and magnetic and electronic properties of one-dimensional P nanowire (1D-P10 NW) assembled by Pn subunits (n = 2, 8) and transition metal doped 1D-P10 NW. Our calculations showed that the assembled 1D-P10 NW is super stable in thermodynamic, dynamic, thermal and chemical perspectives. Moreover, when the assembled 1D-P10 NW is decorated with transition metals (TM = Ti ∼ Zn, Zr ∼ Mo), structural transformation occurs (to sandwich or quasi-sandwich chains), and various magnetic and electronic characteristics are introduced to the nanowire. Particularly, the sandwich chains 1D-Mn2@P10 and 1D-V1@P5 are a ferromagnetic semiconductor and a ferromagnetic half-metal, respectively, and the magnetic anisotropy energies are both ∼0.3 meV per Mn/V atom. Our theoretical studies proposed a super stable 1D P nanowire and also offer a feasible approach to reach P5-TM-P5-TM chains with diverse magnetic and electronic properties, as well as ferromagnetic vdW-type 2D systems, which are promising in nanoelectronic devices and spintronics.

Effect of the charge distribution of virus coat proteins on the length of packaged RNAs.

Single-stranded RNA viruses efficiently encapsulate their genome into a protein shell called the capsid. Electrostatic interactions between the positive charges in the capsid protein's N-terminal tail and the negatively charged genome have been postulated as the main driving force for virus assembly. Recent experimental results indicate that the N-terminal tail with the same number of charges and same lengths packages different amounts of RNA, which reveals that electrostatics alone cannot explain all the observed outcomes of the RNA self-assembly experiments. Using a mean-field theory, we show that the combined effect of genome configurational entropy and electrostatics can explain to some extent the amount of packaged RNA with mutant proteins where the location and number of charges on the tails are altered. Understanding the factors contributing to the virus assembly could promote the attempt to block viral infections or to build capsids for gene therapy applications.

PD-1 and its ligands are important immune checkpoints in cancer.

Checkpoint programmed death-1 (PD-1)/programmed cell death ligands (PD-Ls) have been identified as negative immunoregulatory molecules that promote immune evasion of tumor cells. The interaction of PD-1 and PD-Ls inhibits the function of T cells and tumor-infiltrating lymphocytes (TIL) while increasing the function of immunosuppressive regulatory T cells (Tregs). This condition causes the tumor cells to evade immune response. Thus, the blockade of PD-1/PD-L1 enhances anti-tumor immunity by reducing the number and/or the suppressive activity of Tregs and by restoring the activity of effector T cells. Furthermore, some monoclonal antibodies blockading PD-1/PD-Ls axis have achieved good effect and received Food and Drug Administration approval. The role of PD-1/PD-Ls in tumors has been well studied, but little is known on the mechanism by which PD-1 blocks T-cell activation. In this study, we provide a brief overview on the discovery and regulatory mechanism of PD-1 and PD-L1 dysregulation in tumors, as well as the function and signaling pathway of PD-1 and its ligands; their roles in tumor evasion and clinical treatment were also studied.

Decreased expression of 14-3-3 σ, an early event of malignant transformation of respiratory epithelium, also facilitates progression of squamous cell lung cancer.

BACKGROUND: It has been shown that 14-3-3 σ serves as a tumor suppressor gene, and is downregulated in various tumor tissues. However, the role of 14-3-3 σ during the initiation and progression of lung squamous cell carcinoma (SqCC) is not well understood. METHODS: The expression status of 14-3-3 σ in archival tissue samples from 40 lung SqCC patients (36 with normal bronchia, 19 squamous metaplasia, and 17 dysplasia/carcinoma in situ, in their tissue samples) was examined by immunohistochemical analysis. The proliferation rate and tumor formation ability of the H520 cell transfected with 14-3-3 σ was tested with methyl thiazolyl tetrazolium assay and nude mice subcutaneous injection, respectively. RESULTS: In the normal bronchial epithelia, 14-3-3 σ was highly expressed, whereas it was significantly decreased in precancerous and cancerous tissues. Compared with matched invasive cancer tissues, the expression level of 14-3-3 σ in squamous metaplasia was significantly higher (P = 0.049), while that in dysplasia/carcinoma in situ showed no significant changes (P = 0.135). Statistical analysis showed that the expression level of 14-3-3 σ in tumor tissue was associated with the differentiation grade of the tumor (P = 0.001) and the prognosis of the patient (P = 0.003). The overexpression of 14-3-3 σ significantly suppressed the proliferation of H520 cells in vitro and in vivo. CONCLUSION: The inactivation of 14-3-3 σ may be a very early event in tumorigenesis and could facilitate the initiation and progression of lung SqCC in a sustainable way.

Novel T-shaped linear-stapled intrathoracic esophagogastric anastomosis for minimally invasive Ivor Lewis esophagectomy.

We report a novel T-shaped linear-stapled intrathoracic esophagogastric anastomosis for minimally invasive Ivor Lewis esophagectomy. A unique feature of this technique is a "gastric pouch" that is preserved proximal to the gastric conduit and which serves as the stapler-firing pathway to protect the gastric conduit. The linear stapler is placed through an auxiliary port in the seventh intercostal space on the right posterior axillary line and fired along the longitudinal axis of the thorax, without being constrained by limited intrathoracic space. This technique, which has been performed in 8 patients, is efficient, reliable, and easy to perform.

Anticancer effects of adenovirus-mediated calreticulin and melanoma-associated antigen 3 expression on non-small cell lung cancer cells.

Non-small cell lung cancer (NSCLC) is highly prevalent and needs novel therapies. Melanoma-associated antigen 3 (MAGE-A3) is a lung cancer antigen and calreticulin (CALR) can modulate immune responses. Our previous study has shown that up-regulated MAGE-A3 and CALR expression inhibits the proliferation and invasion of glioma cells. In this study, we examined the effect of adenovirus (Ad)-mediated MAGE-A3 and/or CALR expression on the proliferation, invasion, and apoptosis of human NSCLC cells and on the vascular tube formation of human endothelial cells as well as on dendritic cell (DC) activation and induced CD8(+) cytotoxic T lymphocyte (CTL) activity in vitro. We found that low levels of CALR and MAGE-A3 were expressed by A549 cells, but only very low CALR was expressed by DC. Up-regulated CALR and MAGE-A3 expression by infection with Ad-CALR/MAGE-A3 significantly inhibited the proliferation and invasion, but promoted the apoptosis of A549 cells. Up-regulated CALR and MAGE-A3 expression significantly inhibited cyclin D1 expression and the AKT, ERK1/2 and NF-κB expression and phosphorylation in A549 cells. Up-regulated CALR expression inhibited the tube formation in human endothelial cells. Up-regulated CALR and MAGE-A3 expression synergistically enhanced classical DC activation by enhancing IL-12, but reducing IL-10 secretion. Furthermore, CTLs induced by up-regulated CALR and MAGE-A3 expressing DCs synergistically triggered A549 cell apoptosis, which was abrogated by treatment with anti-HLA I, but not anti-HLA II antibodies. Moreover, CTLs induced by CALR and MAGE-A3-expressing DCs had a higher frequency of A549-specific IFN-γ-secreting T cells. Our data indicated that up-regulated CALR and MAGE-A3 expression inhibited the carcinogenesis of NSCLC by modulating the AKT, ERK MAPK and NF-κB signaling and enhanced classical DC activation and MAGE-A3-specific CTL cytotoxicity. Therefore, our findings may provide new insights in understanding the role of CALR in modulating antigen-specific T cell immunity and may aid in the design of new therapies for NSCLC.