Comparing Sonazoid contrast-enhanced ultrasound to contrast-enhanced CT and MRI for differentially diagnosing renal lesions: a prospective multicenter study.

PURPOSE: To evaluate the diagnostic performance of contrast-enhanced (CE) ultrasound using Sonazoid (SNZ-CEUS) by comparing with contrast-enhanced computed tomography (CE-CT) and contrast-enhanced magnetic resonance imaging (CE-MRI) for differentiating benign and malignant renal masses. MATERIALS AND METHODS: 306 consecutive patients (from 7 centers) with renal masses (40 benign tumors, 266 malignant tumors) diagnosed by both SNZ-CEUS, CE-CT or CE-MRI were enrolled between September 2020 and February 2021. The examinations were performed within 7 days, but the sequence was not fixed. Histologic results were available for 301 of 306 (98.37%) lesions and 5 lesions were considered benign after at least 2 year follow-up without change in size and image characteristics. The diagnostic performances were evaluated by sensitivity, specificity, positive predictive value, negative predictive value, and compared by McNemar's test. RESULTS: In the head-to-head comparison, SNZ-CEUS and CE-MRI had comparable sensitivity (95.60 vs. 94.51%, P = 0.997), specificity (65.22 vs. 73.91%, P = 0.752), positive predictive value (91.58 vs. 93.48%) and negative predictive value (78.95 vs. 77.27%); SNZ-CEUS and CE-CT showed similar sensitivity (97.31 vs. 96.24%, P = 0.724); however, SNZ-CEUS had relatively lower than specificity than CE-CT (59.09 vs. 68.18%, P = 0.683). For nodules > 4 cm, CE-MRI demonstrated higher specificity than SNZ-CEUS (90.91 vs. 72.73%, P = 0.617) without compromise the sensitivity. CONCLUSIONS: SNZ-CEUS, CE-CT, and CE-MRI demonstrate desirable and comparable sensitivity for the differentiation of renal mass. However, the specificity of all three imaging modalities is not satisfactory. SNZ-CEUS may be a suitable alternative modality for patients with renal dysfunction and those allergic to gadolinium or iodine-based agents.

Blended controlled-release nitrogen fertilizer increases rice post-anthesis nitrogen accumulation, translocation and nitrogen-use efficiency.

One-time application of blended controlled-release nitrogen fertilizer (CRN) has the potential to solve the difficulty of top-dressing fertilizer in the cultivation of rice and reduce the cost of CRN fertilizer application. However, its effects on rice dry matter and nitrogen (N) accumulation and translocation, yield and N-use efficiency (NUE) remain uncertain. Field experiments were carried out at three sites (Mingguang, Chaohu, and Guichi) in the Yangtze River Delta in China to compare the effects of the conventional split applications of urea and the blended CRN and on post-anthesis dry matter and N accumulation and translocation, yield, and NUE in rice at 0, 60, 120, 180, and 240 kg N ha-1. The results showed that at the equal N application rates, compared under the conventional N fertilizer treatment, the blended CRN application significantly increased the rice yield by an average of 0.9-6.9%, mainly due to increase the number of spikelets per panicle. The highest yield achieved with blended CRN treatment occurred at 200 kg N ha-1, with an NUE of 45.9%. Moreover, in comparison to the conventional N fertilizer, the blended CRN treatment increased pre-anthesis N translocation (Pre-NT) by 1.0-19.8%, and the contribution of pre-NT to grain N by 0.2-8.7%, and NUE by 3.2-28.4%. Meanwhile, the blended CRN treatment reduced labor costs by 1800 Yuan ha-1 and enhanced the economic gains by 21.5-68.8%. Therefore, one-time application of blended CRN ≤ 200 kg N ha-1 application rate improved rice yield, NUE, and economic profit compared to equivalent rates of split applied conventional N fertilizers.

Twisted moiré conductive thermal metasurface.

Extensive investigations on the moiré magic angle in twisted bilayer graphene have unlocked the emerging field-twistronics. Recently, its optics analogue, namely opto-twistronics, further expands the potential universal applicability of twistronics. However, since heat diffusion neither possesses the dispersion like photons nor carries the band structure as electrons, the real magic angle in electrons or photons is ill-defined for heat diffusion, making it elusive to understand or design any thermal analogue of magic angle. Here, we introduce and experimentally validate the twisted thermotics in a twisted diffusion system by judiciously tailoring thermal coupling, in which twisting an analog thermal magic angle would result in the function switching from cloaking to concentration. Our work provides insights for the tunable heat diffusion control, and opens up an unexpected branch for twistronics -- twisted thermotics, paving the way towards field manipulation in twisted configurations including but not limited to fluids.

Extended lymphadenectomy based on the TRIANGLE for pancreatic head cancer: a single-center experience.

BACKGROUND: This study was to compare the safety and efficacy of different lymphadenectomy methods in patients with pancreatic head cancer undergoing pancreaticoduodenectomy (PD). MATERIAL AND METHODS: A total of 150 patients were included in this study. Patients were divided into Group A (n = 79), Group B (n = 44), and Group C (n = 27) according to the different lymphadenectomy methods. The clinical endpoint was time to progression (TTP) and overall survival (OS). Postoperative complications of different lymphadenectomy methods were compared respectively. TTP and OS of the three groups were compared by Kaplan-Meier curves. RESULTS: There were no significant differences between the three groups in operative time (P = 0.300), death in the hospital (P = 0.253), postoperative hemorrhage (P = 0.863), postoperative pancreatic fistula (POPF) B/C (P = 0.306), bile leakage (P = 0.215), intestinal fistula (P = 0.177), lymphatic leakage (P = 0.267), delayed gastric emptying [(DGE) (P = 0.283)], ICU stay (P = 0.506), and postoperative hospital stay [(PHS) (P = 0.810)]. Median TTP in Groups B and C was significantly longer than in Group A (log-rank test, A vs B: P = 0.0005, A vs C: P = 0.0001). Median OS between the three groups has no statistical difference (P = 0.1546). CONCLUSIONS: Extended lymphadenectomy methods based on the TRIANGLE do not increase perioperative complications significantly and can effectively delay tumor progression in patients with pancreatic head cancer.

Impact of preoperative transcatheter arterial chemoembolization (TACE) on postoperative long-term survival in patients with nonsmall hepatocellular carcinoma: a propensity score matching analysis.

BACKGROUND: The purpose of this propensity score matching (PSM) analysis was to compare the effects of preoperative transcatheter arterial chemoembolization (TACE) and non-TACE on the long-term survival of patients who undergo radical hepatectomy. METHODS: PSM analysis was performed for 387 patients with hepatocellular carcinoma (HCC) (single > 3 cm or multiple) who underwent radical resection of HCC at our centre from January 2011 to June 2018. The patients were allocated to a preoperative TACE group (n = 77) and a non-TACE group (n = 310). The main outcome measures were progression-free survival (PFS) and overall survival (OS) since the treatment date. RESULTS: After PSM, 67 patients were included in each of the TACE and non-TACE groups. The median PFS times in the preoperative TACE and non-TACE groups were 24.0 and 11.3 months, respectively (p = 0.0117). The median OS times in the preoperative TACE and non-TACE groups were 41.5 and 29.0 months, respectively (p = 0.0114). Multivariate Cox proportional hazard regression analysis revealed that preoperative TACE (hazard ratio, 1.733; 95% CI, 1.168-2.570) and tumour thrombosis (hazard ratio, 0.323; 95% CI, 0.141-0.742) were independent risk factors significantly associated with OS. CONCLUSIONS: Preoperative TACE is related to improving PFS and OS after resection of HCC. Preoperative TACE and tumour thrombus volume were also found to be independent risk factors associated with OS.

General deep learning framework for emissivity engineering.

Wavelength-selective thermal emitters (WS-TEs) have been frequently designed to achieve desired target emissivity spectra, as a typical emissivity engineering, for broad applications such as thermal camouflage, radiative cooling, and gas sensing, etc. However, previous designs require prior knowledge of materials or structures for different applications and the designed WS-TEs usually vary from applications to applications in terms of materials and structures, thus lacking of a general design framework for emissivity engineering across different applications. Moreover, previous designs fail to tackle the simultaneous design of both materials and structures, as they either fix materials to design structures or fix structures to select suitable materials. Herein, we employ the deep Q-learning network algorithm, a reinforcement learning method based on deep learning framework, to design multilayer WS-TEs. To demonstrate the general validity, three WS-TEs are designed for various applications, including thermal camouflage, radiative cooling and gas sensing, which are then fabricated and measured. The merits of the deep Q-learning algorithm include that it can (1) offer a general design framework for WS-TEs beyond one-dimensional multilayer structures; (2) autonomously select suitable materials from a self-built material library and (3) autonomously optimize structural parameters for the target emissivity spectra. The present framework is demonstrated to be feasible and efficient in designing WS-TEs across different applications, and the design parameters are highly scalable in materials, structures, dimensions, and the target functions, offering a general framework for emissivity engineering and paving the way for efficient design of nonlinear optimization problems beyond thermal metamaterials.

Preparation and anti-triple-negative breast cancer cell effect of a nanoparticle for the codelivery of paclitaxel and gemcitabine.

Amphiphilic polymers (HA-ANI) were prepared by grafting hyaluronic acid (HA) and 6-(2-nitroimidazole)hexylamine (ANI) and then self-assemble in water to form nanoparticles (NPs) that could be loaded with paclitaxel (PTX) and gemcitabine (GEM) by dialysis. Infrared spectroscopy and 1H-NMR indicated the successful synthesis of HA-ANI. Three different ratios of NPs were prepared by adjusting the ratios of hydrophilic and hydrophobic materials, and the particle size decreased as the ratio of hydrophilic materials increased. When HA:ANI = 2.0:1, the nanoparticles had the smallest size distribution, good stability and near spherical shape and had high drug loading and encapsulation rates. In vitro release experiments revealed that NADPH could accelerate the drug release from NPs. Cellular uptake rate reached 86.50% at 6 h. The toxic effect of dual drug-loaded nanoparticles (P/G NPs) on MDA-MB-231 cells at 48 h was stronger than that of the free drug. The AO/EB double-staining assay revealed that a large number of late apoptotic cells appeared in the P/G NPs group, and the degree of cell damage was significantly stronger than that of the free drug group. In the cell migration assay, the 24 h-cell migration rate of the P/G NPs group was 5.99%, which was much lower than that of the free group (13.87% and 17.00%). In conclusion, MDA-MB-231 cells could effectively take up P/G NPs, while the introduction of the nano-codelivery system could significantly enhance the toxicity of the drug to MDA-MB-231 cells as well as the migration inhibition effect.

Ultrahigh-efficient material informatics inverse design of thermal metamaterials for visible-infrared-compatible camouflage.

Multispectral camouflage technologies, especially in the most frequently-used visible and infrared (VIS-IR) bands, are in increasing demand for the ever-growing multispectral detection technologies. Nevertheless, the efficient design of proper materials and structures for VIS-IR camouflage is still challenging because of the stringent requirement for selective spectra in a large VIS-IR wavelength range and the increasing demand for flexible color and infrared signal adaptivity. Here, a material-informatics-based inverse design framework is proposed to efficiently design multilayer germanium (Ge) and zinc sulfide (ZnS) metamaterials by evaluating only ~1% of the total candidates. The designed metamaterials exhibit excellent color matching and infrared camouflage performance from different observation angles and temperatures through both simulations and infrared experiments. The present material informatics inverse design framework is highly efficient and can be applied to other multi-objective optimization problems beyond multispectral camouflage.

A novel nomogram based on the hematological prognosis risk scoring system can predict the overall survival of patients with hepatocellular carcinoma.

BACKGROUND: This study aimed to establish and validate a nomogram based on a hematological prognostic risk scoring system to predict the overall survival in patients with unresectable hepatocellular carcinoma (HCC). MATERIALS AND METHODS: Patients diagnosed with unresectable HCC undergoing transcatheter arterial chemoembolization (TACE) in 2012-2016 and 2017-2018 were included in the development set and validation set, respectively. The clinical outcome was overall survival (OS). The LASSO regression analysis was used to construct a hematological prognostic risk scoring system (HPR) by using the 18 hematological markers of patients in the development set. Combining the features of oncology on the basis of HPR to construct a nomogram for OS. In the development set and validation sets, the C-index, calibration curve, and decision curve analysis (DCA) were used to evaluate the prediction performance of the nomogram. RESULTS: Multiple markers of immunity, coagulation, liver function, and nutrition, including red blood cell distribution width-coefficient of variation (RDW-CV), platelet (PLT), aspartate transferase (AST), alkaline phosphatase (ALP), prognostic nutritional index (PNI), and fibrinogen (Fib), construct the HPR. HPR was an independent risk factor for OS in patients with HCC. The C-index of the nomogram was 0.731 (95% confidence interval (CI) 0.712-0.749) and 0.696 (95% CI 0.668-0.725) in the development set and the validation set, respectively. CONCLUSIONS: HPR was a complement to the clinical features of patients with unresectable HCC. The nomogram based on HPR proved to be a practical and effective method for prognosticating HCC patients who undergo TACE.

Directional Radiative Cooling via Exceptional Epsilon-Based Microcavities.

The advent of nanophotonics enables the regulation of thermal emission in the momentum domain as well as in the frequency domain. However, earlier attempts to steer thermal emission in a certain direction were restricted to a narrow spectrum or specific polarization, and thus their average (8-14 µm) emissivity (εav) and angular selectivity were nominal. Therefore, the practical uses of directional thermal emitters have remained unclarified. Here, we report broadband, polarization-irrelevant, amplified directional thermal emission from hollow microcavities covered with deep-subwavelength-thickness oxide shells. A hexagonal array of SiO2/AlOX (100/100 nm) hollow microcavities designed by Bayesian optimization exhibited εav values of 0.51-0.62 at 60°-75° and 0.29-0.32 at 5°-20°, yielding a parabolic antenna-shaped distribution. The angular selectivity peaked at 8, 9.1, 10.9, and 12 µm, which were identified as the epsilon-near-zero (via Berreman modes) and maximum-negative-permittivity (via photon-tunneling modes) wavelengths of SiO2 and AlOX, respectively, thus supporting phonon-polariton resonance mediated broadband side emission. As proof-of-concept experiments, we demonstrated that these exceptional epsilon-based microcavities could provide thermal comfort to users and practical cooling performance to optoelectronic devices.

Homogeneous Zero-Index Thermal Metadevice for Thermal Camouflaging and Super-Expanding.

The infinite effective thermal conductivity (IETC) can be considered to be an equivalence of the effective zero index in photonics. A recent highly rotating metadevice has been discovered to approach near IETC, subsequently demonstrating a cloaking effect. However, this near IETC, related to a rotating radius, is quite inhomogeneous, and the high-speed rotating motor also needs a high energy input, limiting its further applications. Herein, we propose and realize an evolution of this homogeneous zero-index thermal metadevice for robust camouflaging and super-expanding through out-of-plane modulations rather than high-speed rotation. Both the theoretical simulations and experiments verify a homogeneous IETC and the corresponding thermal functionalities beyond cloaking. The recipe for our homogeneous zero-index thermal metadevice involves an external thermostat, which can be easily adjusted for various thermal applications. Our study may provide meaningful insights into the design of powerful thermal metadevices with IETCs in a more flexible way.

Reconfigurable mechano-responsive soft film for adaptive visible and infrared dual-band camouflage.

Learning from nature in terms of the camouflage used by species has enabled the continuous development of camouflage technologies for the visible to mid-infrared bands to prevent objects from being detected by sophisticated multispectral detectors, thereby avoiding potential threats. However, achieving visible and infrared dual-band camouflage without destructive interference while also realizing rapidly responsive adaptivity to the varying background remains challenging for high-demand camouflage systems. Here, we report a reconfigurable mechano-responsive soft film for dual-band camouflage. Its modulation ranges for visible transmittance and longwave infrared emittance can be up to 66.3% and 21%, respectively. Rigorous optical simulations are performed to elucidate the modulation mechanism of dual-band camouflage and identify the optimal wrinkles required to achieve the goal. The broadband modulation capability (figure of merit) of the camouflage film can be as high as 2.91. Other advantages, such as simple fabrication and a fast response, make this film a potential candidate for dual-band camouflage that can adapt to diverse environments.

An all-cellulose sponge with a nanofiller-assisted hierarchical cellular structure for fruit maintaining freshness.

Cellulose sponges with compressibility and resilience are an ideal packaging material for fruits with fragile skin. Here, a soft and elastic all-cellulose sponge (CS) with a hierarchical cellular structure was fabricated, where the long molecular chain cellulose constructed major pores, the cellulose at nanoscale acted as an elastic nanofiller to fill the gaps of long molecular chain cellulose fibers and constructed minor pores. With these two kinds of pores, this structure can absorb strain hierarchically. The sponge can protect fruits from mechanical damage when dropped or repeated vibration. Furthermore, the CS modified with chlorogenic acid (C-CGAS) had excellent antibacterial and antifungal abilities. Therefore, C-CGAS could extend the storage time of strawberries to 18 days without any microbial invasion, which is the longest storage time reported thus far. This study provides a new idea for the preparation of polymer sponges and a new design for the development of antimicrobial packaging materials.

Natural phenolics and flavonoids modified the hierarchical cellular cellulose sponges for efficient water disinfection.

Disinfecting microbially contaminated water in a safe and sustainable way is a great challenge. The phenolics and flavonoids in plants are ideal antibacterial agents for biosafety. Herein, an all-plant-derived antibacterial sponge with a hierarchical cellular structure was prepared from natural phenolic and flavonoid crude extracts and cellulose for water purification. After being modified by quercetin, the quercetin-cellulose sponge (Q-CS) exhibits great toughness, elasticity and a large specific surface area, which benefited from a unique hierarchical cellular structure. Q-CS shows ultrahigh water flux (4.5 × 105 L·m-2·h-1·bar-1) and excellent antibacterial abilities against Escherichia coli and Staphylococcus aureus (<1.87 % viability). Sponges modified with crude pyrola (P-CS) and mulberry leaf extracts (M-CS) have similar properties compared with Q-CS. The good performances of P-CS and M-CS show the strong antibacterial applications of natural crude extract. This work provides a strategy for fabricating sustainable and safe antibacterial sponges for water disinfection.

Soft and elastic silver nanoparticle-cellulose sponge as fresh-keeping packaging to protect strawberries from physical damage and microbial invasion.

Strawberry is a nutritious food that is susceptible to mechanical injury and microbiological infection. Traditional coatings for strawberry packaging provide resistance against microbial infection but not against mechanical damage. In this study, a soft and elastic cellulose sponge modified with silver nanoparticles (AgNPs@CS-1:1) was prepared as strawberry packaging material, and it provided effective protection against mechanical damage. In addition, after 1000 cyclic compression, AgNPs@CS-1:1 presented only 16.80% unrecoverable deformation and still had elasticity, suggesting its fatigue resistance and durable protection for strawberry against damage caused by repeated vibrations during transportation. In addition, AgNPs@CS-1:1 had good antibacterial (E. coli and S. aureus) and antifungal (Rhizopus stolonifer) abilities. The storage time of strawberries packaged by AgNPs@CS-1:1 was extended to 12 days without microbial invasion. Thus, AgNPs@CS-1:1 provided dual protection at the physical and microbial levels. This study proposes a new method for the preservation of strawberries based on the utilization of cellulose.

Leveraging Hydrophilic Hierarchical Channels to Regulate Excessive Water for High-Efficiency Solar Steam Yield.

Both the solar absorptance and water content in solar-driven interface evaporation (SDIE) devices are of equal importance for efficient solar steam yield and freshwater production, but water content regulation has garnered relatively less attention, as it is more challenging to balance the water supply rate and the evaporation rate inside SDIE devices. Herein, an SDIE device is designed by coating natural luffa with polypyrrole, which could effectively regulate the water content during the solar steam yield by its unique hydrophilic hierarchical channels to transform excessive water from the bulk state into the film state on the porous skeleton. The hierarchical channels revealed by cryoelectron microscopy experiments not only reduce the loss of heat in unevaporated water but also offer abundant escape channels for solar steam, thus enabling the proposed SDIE device to achieve an evaporation rate of 2.38 kg m-2 h-1 under 1 sun illumination. This work reveals the key role of hierarchical channels for water regulation in the high-efficiency solar steam yield and triggers further application of natural biomaterials with unique structures in the field of solar interfacial evaporation.

High-thermopower polarized electrolytes enabled by methylcellulose for low-grade heat harvesting.

Low-grade heat exists ubiquitously in the environment. Thermogalvanic cells (TGCs) are promising for converting the widespread low-grade heat directly into electricity owing to relatively high thermopowers of redox reactions. This work reports polarized electrolytes with ultrahigh thermopowers of -8.18 mV K-1 for n-type and 9.62 mV K-1 for p-type. The electrolyte consists of I-/I3- redox couple, methylcellulose, and KCl. Thermoresponsive methylcellulose leads to polarization switching from n-type to p-type above a transition temperature due to the strong hydrophobic interaction between methylcellulose and I3- ions. The giant thermopowers can be attributed to the simultaneously enhanced entropy change and concentration difference of redox couple enabled by the gelation of methylcellulose and KCl-induced complexation. The p-type TGC with the optimized electrolyte achieves a normalized maximum power density of 0.36 mW m-2 K-2, which is far superior to other reported I-/I3--based TGCs. This work demonstrates cost-effective, high-thermopower polarized electrolytes for low-grade heat harvesting.

Robustly printable freeform thermal metamaterials.

Thermal metamaterials have exhibited great potential on manipulating, controlling and processing the flow of heat, and enabled many promising thermal metadevices, including thermal concentrator, rotator, cloak, etc. However, three long-standing challenges remain formidable, i.e., transformation optics-induced anisotropic material parameters, the limited shape adaptability of experimental thermal metadevices, and a priori knowledge of background temperatures and thermal functionalities. Here, we present robustly printable freeform thermal metamaterials to address these long-standing difficulties. This recipe, taking the local thermal conductivity tensors as the input, resorts to topology optimization for the freeform designs of topological functional cells (TFCs), and then directly assembles and prints them. Three freeform thermal metadevices (concentrator, rotator, and cloak) are specifically designed and 3D-printed, and their omnidirectional concentrating, rotating, and cloaking functionalities are demonstrated both numerically and experimentally. Our study paves a powerful and flexible design paradigm toward advanced thermal metamaterials with complex shapes, omnidirectional functionality, background temperature independence, and fast-prototyping capability.

High-throughput screening of a high-Q mid-infrared Tamm emitter by material informatics.

Narrowband mid-infrared emitters, quantified by the Q-factor, have garnered a lot of attention due to their emerging applications from chemical and biosensing to efficient thermal utilization. Previous studies reported high Q-factor emitters within several selected wavelengths, still lacking a large database of emitter structures with very high Q-factors. In this Letter, we utilized the Monte Carlo Tree Search (MCTS) algorithm under the framework of material informatics to optimize the Tamm emitters at the infrared range (from 3 to 10 µm) for achieving a high Q-factor and high emissivity simultaneously, providing a large database of high and sharp emission peaks in the infrared. Through the MCTS algorithm, the structure with a Q-factor of 508 and an emissivity peak of 0.92 at 4.225 µm is obtained, far surpassing the previous results, and the underlying mechanism is discussed by electric field simulations. The high Q-factor emitters in the database show good monochromatism and high emissivity, accelerating the selection of proper perfect emitters for desired wavelengths. This Letter also paves a feasible avenue for the emitter and absorber design with ultrahigh monochromatism.