Analysis of influencing factors of HPV vaccination willingness of female sex workers in urban entertainment venues based on the IMB model in Guangxi, China.

OBJECTIVE: Understanding HPV vaccination willingness and its influencing factors among female sex workers (FSWs) in entertainment venues in an urban area of Guangxi, China. METHODS: From 15 August to 15 October 2022, FSWs in entertainment venues with commercial sex trade in an urban area of Guangxi were selected as the study subjects for the questionnaire survey using the method of intentional sampling. The questionnaire based on the information-motivation-behavior (IMB) skills model was used to collect the basic characteristics, HPV and HPV vaccine-related information and cognition, motivation to vaccinate, behavioral skills and willingness to vaccinate from the research targets. A multifactor logistic regression model was used to analyze the factors influencing the research targets' willingness to receive HPV vaccination. RESULTS: Of the 921 research targets, 712 (77.31%) were willing to receive HPV vaccination. The higher the level of knowledge regarding HPV and HPV vaccine-related information, the higher the motivation for HPV vaccination. In addition, the higher the behavioral skills score, the higher the willingness of FSWs in entertainment venues to receive HPV vaccination (P<0.001). FSWs in entertainment venues with lower venue grades [OR(95% CI)=0.693 (0.539, 0.891), P=0.004] were more reluctant to receive HPV vaccination. Those who favored the effectiveness of the vaccine in preventing the disease [OR(95% CI)=2.144 (1.449, 3.174), P<0.001] and those who had heard of HPV vaccine [OR(95% CI)=2.105 (1.451, 3.054), P<0.001], were able to perceive the benefits of HPV vaccination [OR(95% CI)=1.134 (1.045, 1.230), P=0.002]. These individuals acquired greater behavioral skills i.e., self-decision making for HPV vaccination [OR(95% CI)=1.130 (1.008, 1.267), P=0.036] and self-efficacy [OR(95% CI)=1.135 (1.081, 1.191), P<0.001] and they were more willing to receive HPV vaccine. CONCLUSIONS: There was a relatively high HPV vaccination willingness among FSWs in entertainment venues in an urban area of Guangxi, China. Attention should be focused on introducing the benefits of primary prevention measures such as the HPV vaccine for individuals and behavioral skills for HPV vaccination in order to increase their willingness to be vaccinated thus increasing their HPV vaccination rate.

Contaminant occurrence, water quality criteria and tiered ecological risk assessment in water: A case study of antifouling biocides in the Qiantang River and its estuary, Eastern China.

Antifouling biocides may cause adverse effects on non-target species. This study aims to determine the distribution, sources, and ecological risks of antifouling biocides in the surface waters of the Qiantang River and its estuary in eastern China. The concentrations of total antifouling biocides were ranged from 12.9 to 215 ng/L for all water samples. Atrazine, diuron and tributyltin were the major compounds in the water bodies of the study area. The acute and chronic toxicity criteria for tributyltin, diuron and atrazine were derived for freshwater and saltwater, respectively, based on the species sensitivity distribution approach. The freshwater and saltwater criteria were slightly different, and the toxicity to aquatic organisms could be summarized as tributyltin > diuron > atrazine. The graded ecological risk rating showed that the long-term risk of TBT was significant in coastal waters. The pollution of TBT in the Qiantang River deserves further attention.

How the clinical dosage of bone cement biomechanically affects adjacent vertebrae.

OBJECTIVE: This study evaluated the biomechanical changes in the adjacent vertebrae under a physiological load (500 N) when the clinically relevant amount of bone cement was injected into fractured cadaver vertebral bodies. METHODS: The embalmed cadaver thoracolumbar specimens in which each vertebral body (T12-L2) had a BMD of < 0.75 g/cm2 were used for the experiment. For establishing a fracture model, the upper one third of the L1 vertebra was performed wedge osteotomy and the superior endplate was kept complete. Stiffness of specimens was measured in different states. Strain of the adjacent vertebral body and intervertebral disc were measured in pre-fracture, post-fracture, and after augmentation by non-contact optical strain measurement system. RESULTS: The average amount of bone cement was 4.4 ml (3.8-5.0 ml). The stiffness of after augmentation was significantly higher than the stiffness of post-fracture (p < 0.05), but still lower than pre-fracture stiffness (p < 0.05). After augmentation, the adjacent upper vertebral strain showed no significant difference (p > 0.05) with pre-fracture, while the strain of adjacent lower vertebral body was significantly higher than that before fracture (p < 0.05). In flexion, T12/L1 intervertebral disc strain was significantly greater after augmentation than after the fracture (p < 0.05), but there was no significant difference from that before the fracture (p > 0.05); L1/2 vertebral strain after augmentation was significantly less than that after the fracture (p < 0.05), but there was no significant difference from that before the fracture (p > 0.05). CONCLUSIONS: PVP may therefore have partially reversed the abnormal strain state of adjacent vertebral bodies which was caused by fracture.

[Breeding and variety characteristics of a new variety of Fritillaria thunbergii "Zhebei 3"].

A new variety "Zhebei 3(Zhejiao Pharmaceutical 2018002)" was selected and bred from multi seeded Fritillaria thunbergii mutants by systematic breeding method. From 2012 to 2016, the traits assessment, disease resistance appraisal, plot ratios and regional trials of the variety were continuously carried out. The results showed that "Zhebei 3" emerged early and had late seedlings. The average growth period was about 100 days, which was 6 days and 12 days higher than the "Zhebei 1" and "Zhebei 2". The average yield was 5 095.5 kg·hm~(-2), which was 14.42% and 17.71% higher than of the control respectively. The average proliferation rate of bulbs was 261.2%, which was 37.46% and 31.58% higher than that of the control, respectively. The propagation coefficient of bulbs was about 1∶2.6, and the total amount of peimine and peiminine was 0.172 2%, which was 4.49% and 29.47% higher than the control, respectively. The identification of disease resistance showed that it was resistance to bulb stem(soft) rot, better than the control. "Zhebei 3" has stable characters, high yield, good quality, strong disease resistance, and moderate propagation coefficient which is suitable for planting in Zhejiang province.

[Ecology suitability study of Trollius chinensis].

Based on the distribution information of 110 samples and 55 environmental factors, Maxent model was used to predict the ecology suitability regions of Trollius chinensis. The study aims at providing theory basis for the cultivation of T. chinensis. The results showed that the Maxent model prediction result was good (AUC>0.9) and the main factors effecting the ecology suitability regions of T. chinensis were precipitation in July, standard deviation of seasonal variation of temperature, annual mean temperature, precipitation in August and altitude. The ecology suitable regions of T. chinensis mainly concentrated in Shanxi, Hebei, east of Inner Mongolia, west of Jilin and Liaoning, north of Shaanxi, south of Ningxia, east and south of Gansu, and east of Qinghai. The results indicated that except for traditional distribution regions, north of Shaanxi, south of Ningxia, east and south of Gansu, and east of Qinghai could selected as the regions for cultivation of T. chinensis. It provides theory basis for selecting suitable regions to cultivate T. chinensis.

Is Short Same-Segment Fixation Really Better than Short-Segment Posterior Fixation in the Treatment of Thoracolumbar Fractures?

STUDY DESIGN: A retrospective study. OBJECTIVE: This retrospective study assessed whether short same-segment fixation (SSSF) is better than short-segment posterior fixation (SSPF) for reducing thoracolumbar fractures, improving the kyphosis angle, maintaining vertebral height, or reducing the incidence of broken screws. SUMMARY OF BACKGROUND DATA: In clinical practice, single-segment thoracolumbar fractures were then more likely to be treated with SSPF that included pedicle fixation at the level of the fracture (short same-segment fixation, or SSSF). Whether SSSF could really achieve vertebral height recovery, improve the kyphosis, reduce postoperative kyphosis loss, and reduce the incidence of internal fixation failure better than SSPF. METHODS: Patients treated with SSPF or SSSF at our institution during 2006 to 2014 were reviewed. Effects of thoracolumbar fracture reduction, improved kyphosis angle, and maintaining vertebral height were compared between groups. Logistic regression analysis was used to identify factors related to instrumentation breakage and correlation analysis to assess possible relations between loss of correction of the kyphosis angle (LAWAC) and other factors. RESULTS: Altogether, 130 patients were enrolled (53 SSPF, 77 SSSF). SSPF (22F, 31M) group's mean (range) age was 37.7 (16-60) years, and the follow-up was 26.2 (9-120) months. SSSF (27F, 50M) group's mean (range) age was 39.3 (17-61) years, and the follow-up was 23.2 (9-60) months. All patients underwent either internal fixation or screw repair. Immediately postoperatively, restoration after middle vertebral fractures was better in SSSF patients than in SSPF patients (P = 0.003), with no differences in other fracture-related factors (P > 0.05). Only LAWAC was significantly associated with instrumentation breakage (P < 0.05). Also, immediately postoperatively, the anterior/posterior vertebral heights ratio was negatively related to LAWAC. CONCLUSION: Pedicle fixation of the fracture did not obtain better recovery of anterior or posterior vertebral heights nor did it improve AWA restoration. There was no significant difference in LAWAC between groups or in the incidence of broken screws. LAWAC may increase the incidence of broken screws. LEVEL OF EVIDENCE: 4.

[Association of vitamin D receptor gene polymorphisms with susceptibility to bone and joint tuberculosis in Chinese Han population].

OBJECTIVE: To investigate the association between vitamin D receptor (VDR) gene Apa I polymorphism and the susceptibility to bone and joint tuberculosis in Chinese Han population. METHODS: Between May, 2015 and June, 2016, 100 patients with bone and joint tuberculosis and 100 healthy volunteers were recruited concomitantly in Heyuan Hospital of Traditional Chinese Medicine. Vitamin D receptor gene Apa I polymorphisms in these subjects were analyzed using SNaPshot. RESULT: The genotype frequencies of Apa I-AA, Apa I-Aa and Apa I-aa were 51%, 41%, and 8% in the case group and 33%, 55%, and 12% in the control group, respectively, showing significant differences between the two groups (P<0.05). The genotype of Apa I-AA was significantly higher in the case group with an odds ratio (OR) of 2.073 (95% CI: 1.142-3.763). CONCLUSION: The Apa I polymorphisms of the VDR gene are associated with the susceptibility to bone and joint tuberculosis in Chinese Han population, and individuals with a Apa I-AA genotype are at greater risks to develop bone and joint tuberculosis.

Fluorene Conjugated Polymer/Nickel Oxide Nanocomposite Hole Transport Layer Enhances the Efficiency of Organic Photovoltaic Devices.

A nanocomposite layer comprising the conjugated polymer poly[(9,9-bis(3'-(N,N-dimethylamino)propyl)-2,7-fluorene)-alt-2,7-(9,9-dioctyl)fluorene] (PFN) and nickel oxide (NiOx) has been employed as the hole transport layer (HTL) in organic photovoltaics (OPVs) featuring PBDTTBO-C8 and [6,6]-phenyl-C71-butyric acid methyl ester (PC71BM) as the active layer. The optimal device incorporating the PFN:NiOx nanocomposite as the HTLs displayed a power conversion efficiency (PCE) to 6.2%, up from 4.5% for the corresponding device incorporating pristine NiOx as the HTL layer: a nearly 40% improvement in PCE. X-ray photoelectron spectroscopy (XPS) was used to determine the types of chemical bonding, ultraviolet photoelectron spectroscopy (UPS) to measure the change in work function, and atomic force microscopy (AFM) to examine the morphology of the composite layers. The growth of nickel trioxide, Ni2O3, in the PFN:NiOx layer played a key role in producing the p-doping effect and in tuning the work function, thereby improving the overall device performance.

[Fabrication of a new composite scaffold material for delivering rifampicin and its sustained drug release in rats].

OBJECTIVE: To fabricate a new composite scaffold material as an implant for sustained delivery of rifampicin and evaluate its performance of sustained drug release and biocompatibility. METHODS: The composite scaffold material was prepared by loading poly(lactic-co-glycolic) acid (PLGA) microspheres that encapsulated rifampicin in a biphasic calcium composite material with a negative surface charge. The in vitro drug release characteristics of the microspheres and the composite scaffold material were evaluated; the in vivo drug release profile of the composite scaffold material implanted in a rat muscle pouch was evaluated using high-performance liquid chromatography. The biochemical parameters of the serum and liver histopathologies of the rats receiving the transplantation were observed to assess the biocompatibility of the composite scaffold material. RESULTS: The encapsulation efficiency and drug loading efficiency of microspheres were (56.05±5.33)% and (29.80±2.88)%, respectively. The cumulative drug release rate of the microspheres in vitro was (94.19±5.4)% at 28 days, as compared with the rate of (82.23±6.28)% of composite scaffold material. The drug-loaded composite scaffold material showed a good performance of in vivo drug release in rats, and the local drug concentration still reached 16.18±0.35 µg/g at 28 days after implantation. Implantation of the composite scaffold material resulted in transient and reversible liver injury, which was fully reparred at 28 days after the implantation. CONCLUSION: The composite scaffold material possesses a good sustained drug release capacity and a good biocompatibility, and can serve as an alternative approach to conventional antituberculous chemotherapy.

Is duration of preoperative anti-tuberculosis treatment a risk factor for postoperative relapse or non-healing of spinal tuberculosis?

PURPOSE: This study evaluated the relationship between spinal TB postoperative recurrence or non-healing and duration of preoperative anti-TB treatment (ATT). METHODS: From January 2004 to January 2013, patients who underwent surgery for spinal TB and met this study's inclusion criteria were retrospectively reviewed. Observed parameters were age, sex, initial ESR, preoperative ESR, degree of ESR change, initial CRP, preoperative CRP, degree of CRP change, duration of preoperative ATT, surgical approach, presence of internal fixation, location of spinal lesion, number of involved segments, duration of operation, and intraoperative blood loss. The data were analyzed by univariate and multivariate analyses for spinal TB recurrence or non-healing to determine related risk factors. RESULTS: A total of 223 patients met the inclusion criteria. There were 84 female and 139 male patients with a mean age of 42.2 years (range 2-85 years). The follow-up period was 18-72 months (average 28.7 months). Among 223 patients observed, 23 patients had postoperative relapse or non-healing (10.3 %) during the follow-up period. Statistical analysis indicated that the location of a spinal lesion was significantly associated with postoperative relapse or non-healing. Risk of postoperative relapse or non-healing in thoracolumbar TB was 2.524-fold (95 % CI 1.026-6.580) that of lumbosacral TB. CONCLUSIONS: Duration of preoperative ATT may not be a risk factor for postoperative recurrence or non-healing of spinal TB. Junctional zones such as the lumbosacral and thoracolumbar junction have a higher recurrence rate than non junctional.

Clinical outcomes after decompressive laminectomy for symptomatic ossification of ligamentum flavum at the thoracic spine.

Ossification of the ligamentum flavum (OLF) is a rare disease that causes acquired thoracic spinal canal stenosis and thoracic myelopathy. The aim of this study was to investigate clinical outcomes of symptomatic thoracic OLF treated using posterior decompressive laminectomy. We retrospectively analyzed the medical records of 22 patients who underwent posterior decompressive laminectomy for symptomatic thoracic OLF. The surgical results were evaluated using the modified Japanese Orthopaedic Association (JOA) scoring system and Hirabayashi recovery rate. The intensity of pain was evaluated using a visual analog scale (VAS). The mean duration of follow-up was 35.6months. The mean JOA score was significantly improved at final follow-up (9.18±standard deviation of 1.53 points [range, 6-11 points]) compared with before surgery (5.64±2.04 points [range, 3-9 points]) (P<0.001). The mean Hirabayashi recovery rate was 65.49% (range, 20-100%). Recovery outcomes were excellent in nine patients, good in eight patients, fair in four patients and unchanged in one patient. No patient was classified as deteriorated. The VAS scores were 2.82±3.08 before surgery and 0.59±1.05 at final follow-up (P=0.001). Surgical complications, which resolved after appropriate and prompt treatment, included dural tear in five patients, cerebrospinal fluid leakage in one patient, immediate postoperative neurologic deterioration in one patient, epidural hematoma in one patient, and wound infection in one patient. Our findings suggest that posterior decompressive laminectomy is an effective treatment for symptomatic thoracic OLF and provides satisfactory clinical improvement, but surgery for thoracic OLF is associated with a relatively high incidence of complications.

Preparation of rAAV9 to Overexpress or Knockdown Genes in Mouse Hearts.

Controlling the expression or activity of specific genes through the myocardial delivery of genetic materials in murine models permits the investigation of gene functions. Their therapeutic potential in the heart can also be determined. There are limited approaches for in vivo molecular intervention in the mouse heart. Recombinant adeno-associated virus (rAAV)-based genome engineering has been utilized as an essential tool for in vivo cardiac gene manipulation. The specific advantages of this technology include high efficiency, high specificity, low genomic integration rate, minimal immunogenicity, and minimal pathogenicity. Here, a detailed procedure to construct, package, and purify the rAAV9 vectors is described. Subcutaneous injection of rAAV9 into neonatal pups results in robust expression or efficient knockdown of the gene(s) of interest in the mouse heart, but not in the liver and other tissues. Using the cardiac-specific TnnT2 promoter, high expression of GFP gene in the heart was obtained. Additionally, target mRNA was inhibited in the heart when a rAAV9-U6-shRNA was utilized. Working knowledge of rAAV9 technology may be useful for cardiovascular investigations.

Comparison of VerifyNow P2Y12 and thrombelastography for assessing clopidogrel response in stroke patients in China.

Poor response to clopidogrel is often associated with recurrent ischemic events, and reliable platelet function tests are needed to identify clopidogrel low response (CLR). The aim of the study was to compare the consistency of VerifyNow P2Y12 and thrombelastography (TEG) in acute ischemic stroke patients treated with clopidogrel. Patients hospitalized in Changhai Hospital from August 2012 to September 2013 and assigned to treatment with a daily 75-mg dose of clopidogrel. The blood samples were taken on the 5-7th day to assess the capability of VerifyNow P2Y12 and TEG for evaluation of clopidogrel response, and all instrument parameters were used to perform correlation analysis. Patients with CLR were detected by using the methods and criteria published earlier (PRU ≥ 230 assayed by VerifyNow P2Y12 or TEG-Inhib% ≤30 % measured by TEG). Totally 58 patients were enrolled for the study and there were wide varieties in parameters of VerifyNow P2Y12 and TEG. Results showed a total of 17 and 9 patients, respectively, identified as CLR assessed by VerifyNow P2Y12 and TEG, but only three patients were detected to be clopidogrel low responders with both tests. The kappa consistency analysis showed poor consistency between VerifyNow P2Y12 and TEG results in terms of CLR (Kappa = -0.0349, p = 0.7730). Linear regression also demonstrated poor correlation between VerifyNow-PRU/VerifyNow-Inhib% and TEG-Inhib% (p = 0.07901 and p = 0.3788, respectively). Our study demonstrated that there was poor correlation between VerifyNow P2Y12 and TEG results, and VerifyNow P2Y12 showed a larger proportion of CLR than TEG.

Influence of Genetic Polymorphisms on Clopidogrel Response and Clinical Outcomes in Patients with Acute Ischemic Stroke CYP2C19 Genotype on Clopidogrel Response.

OBJECTIVES: This study sought to evaluate the influence of the genetic polymorphisms on platelet reactivity and clinical outcomes in acute ischemic stroke patients taking clopidogrel. BACKGROUND: Little research has been published on relationships between genetic polymorphisms, platelet reactivity, and clinical outcomes in stroke patients treated with clopidogrel. METHODS: Patients hospitalized in Changhai Hospital with acute ischemic stroke were randomly enrolled into treatment with a 75-mg daily maintenance dose of clopidogrel. Genotyping was detected by the MassARRAY iPLEX genotyping system (Sequenom Inc, San Diego, CA), and platelet reactivity was evaluated by the VerifyNow P2Y12 test (Accumetrics Inc., San Diego, CA). Sixteen single nucleotide polymorphisms (SNPs) within 9 genes were selected and high on-clopidogrel platelet reactivity (HPR) was defined as P2Y12 reaction units (PRU) value ≥230. The primary endpoint was ischemic events, including major adverse cardiac events (MACE), recurrence of stroke, transient ischemic attack (TIA), and the composite of vascular death, and the secondary endpoint was bleeding. RESULTS: Of the 345 patients recruited, 275 (79.7%) patients were followed up for 1 year and 122 (35.4%) patients were categorized as HPR. Among the SNPs selected, only the CYP2C19*2 allele and the CYP2C19*3 allele were statistically significantly associated with PRU (P < 0.001 and P = 0.003, respectively). Similarly, the prevalence of HPR was associated with CYP2C19*2 and CYP2C19*3 (P < 0.001 and P = 0.001, respectively). During the 1 year of follow-up, a total of 64 (23.3%) cases of clinical events occurred, including 60 ischemic events and 4 bleeding events. There were no correlation between CYP2C19 variant alleles and clinical outcomes (P > 0.05), but a statistically significant relevance was found between the HPR and the ischemic events in 1 year of follow-up (P = 0.001). CONCLUSIONS: CYP2C19*2 and CYP2C19*3 had a significant impact on clopidogrel response, but was not associated with ischemic events during 1 year of follow-up in patients with acute ischemic stroke. HPR was an independent risk factor for ischemic events, and the VerifyNow P2Y12 test may be available to guide individualized antiplatelet therapies in stroke patients in China.

Tanshinone IIA Prevents Rat Basilar Artery Smooth Muscle Cells Proliferation by Inactivation of PDK1 During the Development of Hypertension.

Basilar vascular smooth muscle cells (BASMCs) hyperplasia is a prominent feature of cerebrovascular remodeling and stroke during the development of hypertension. Tanshinone IIA (Tan) has been reported to exhibit a protective effect against the pathological features of hypertension. Previous studies have shown that phosphoinostitide-3 kinase (PI3K)/3'-phosphoinostitide dependent kinase (PDK1)/AKT pathway is involved in the regulation of proliferation of various cell types. Therefore, there may be a crosstalk between Tan antihypertension processes and PI3K/PDK1/AKT proliferative effect in BASMCs. To test this hypothesis, we used a 2-kidney, 2-clip hypertension model to examine the effect of Tan on PI3K/PDK1/AKT pathway by cellular, molecular, and biochemical approaches. Our results revealed that the abundance of PDK1 in plasma was paralleled with an increase in blood pressure and the cross-sectional area of basilar artery in hypertensive rats. Tan decreased blood pressure and hypertension-induced PDK1 phosphorylation but produced no effect on the phosphorylation of PI3K. Moreover, Tan attenuated endothelin 1 induced the activation of PDK1/AKT pathway in rat BASMCs. Tan could inhibit cell cycle transition by regulating the expression of cyclin D1 and p27, in turn, prevent proliferation of BASMCs. Our study provides a novel mechanism by which Tan prevents cerebrovascular cell proliferation during hypertension, and thus Tan may be a potential therapeutic agent for cerebrovascular remodeling and stroke.

Risk factors of new symptomatic vertebral compression fractures in osteoporotic patients undergone percutaneous vertebroplasty.

PURPOSE: This study evaluated the risk factors of new vertebral compression fractures (VCFs) following percutaneous vertebroplasty (PVP). METHODS: From June 2005 to January 2011, patients with osteoporotic VCFs (OVCFs) who were treated with PVP and met this study's inclusion criteria were retrospectively reviewed. Observed parameters were age, sex, bone mineral density, body mass index, amount of bone cement, cement leakage into the disk, preoperative kyphosis, preoperative degree of anterior vertebral compression, preoperative degree of middle vertebral compression, kyphosis correction, anterior vertebral height restoration, middle vertebral height restoration, and number of initial symptomatic fractures (levels treated). The data were analyzed by univariate and multivariate analysis for the emergence of new fractures after PVP to determine related risk factors. RESULTS: A total of 182 patients met the inclusion criteria. There were 155 female and 27 male patients with a mean age of 69.7 years (range 49-91 years). The follow-up period was 24-50 months (average 26.4 months). A total of 294 VCFs among 182 patients were observed, 28 new VCFs occurred in 21 patients (21/182, 11.5 %) during the follow-up period. Statistical analysis indicated that higher BMI (P = 0.004) and a greater number of initial symptomatic fractures (P = 0.017) were significantly associated with new VCFs after PVP. It is the most obvious that the risk of new fractures increased 2.518-fold (95 % CI 1.176-5.395), when the number of initial VCFs increased by one level. CONCLUSIONS: The incidence of new symptomatic VCFs after PVP was higher in osteoporotic patients with initial multiple-level fractures.

Solution-processed zinc oxide/polyethylenimine nanocomposites as tunable electron transport layers for highly efficient bulk heterojunction polymer solar cells.

In this study, we employed polyethylenimine-doped sol-gel-processed zinc oxide composites (ZnO:PEI) as efficient electron transport layers (ETL) for facilitating electron extraction in inverted polymer solar cells. Using ultraviolet photoelectron spectroscopy, synchrotron grazing-incidence small-angle X-ray scattering and transmission electron microscopy, we observed that ZnO:PEI composite films' energy bands could be tuned considerably by varying the content of PEI up to 7 wt %-the conduction band ranged from 4.32 to 4.0 eV-and the structural order of ZnO in the ZnO:PEI thin films would be enhanced to align perpendicular to the ITO electrode, particularly at 7 wt % PEI, facilitating electron transport vertically. We then prepared two types of bulk heterojunction systems-based on poly(3-hexylthiophene) (P3HT):phenyl-C61-butryric acid methyl ester (PC61BM) and benzo[1,2-b:4,5-b́]dithiophene-thiophene-2,1,3-benzooxadiazole (PBDTTBO):phenyl-C71-butryric acid methyl ester (PC71BM)-that incorporated the ZnO:PEI composite layers. When using a composite of ZnO:PEI (93:7, w/w) as the ETL, the power conversion efficiency (PCE) of the P3HT:PC61BM (1:1, w/w) device improved to 4.6% from a value of 3.7% for the corresponding device that incorporated pristine ZnO as the ETL-a relative increase of 24%. For the PBDTTBO:PC71BM (1:2, w/w) device featuring the same amount of PEI blended in the ETL, the PCE improved to 8.7% from a value of 7.3% for the corresponding device that featured pure ZnO as its ETL-a relative increase of 20%. Accordingly, ZnO:PEI composites can be effective ETLs within organic photovoltaics.

Symmetry and coplanarity of organic molecules affect their packing and photovoltaic properties in solution-processed solar cells.

In this study we synthesized three acceptor-donor-acceptor (A-D-A) organic molecules, TB3t-BT, TB3t-BTT, and TB3t-BDT, comprising 2,2'-bithiophene (BT), benzo[1,2-b:3,4-b':5,6-d″]trithiophene (BTT), and benzo[1,2-b;4,5-b']dithiophene (BDT) units, respectively, as central cores (donors), terthiophene (3t) as π-conjugated spacers, and thiobarbituric acid (TB) units as acceptors. These molecules display different degrees of coplanarity as evidenced by the differences in dihedral angles calculated from density functional theory. By using differential scanning calorimetry and X-ray diffractions for probing their crystallization characteristics and molecular packing in active layers, we found that the symmetry and coplanarity of molecules would significantly affect the melting/crystallization behavior and the formation of crystalline domains in the blend film with fullerene, PC61BM. TB3t-BT and TB3t-BDT, which each possess an inversion center and display high crystallinity in their pristine state, but they have different driving forces in crystallization, presumably because of different degrees of coplanarity. On the other hand, the asymmetrical TB3t-BTT behaved as an amorphous material even though it possesses a coplanar structure. Among our tested systems, the device comprising as-spun TB3t-BDT/PC61BM (6:4, w/w) active layer featured crystalline domains and displayed the highest power conversion efficiency (PCE) of 4.1%. In contrast, the as-spun TB3t-BT/PC61BM (6:4, w/w) active layer showed well-mixed morphology and with a device PCE of 0.2%; it increased to 3.9% after annealing the active layer at 150 °C for 15 min. As for TB3t-BTT, it required a higher content of fullerene in the TB3t-BTT/PC61BM (4:6, w/w) active layer to optimize its device PCE to 1.6%.

Esophageal perforation related to anterior cervical spinal surgery.

Esophageal perforation is an uncommon but potentially fatal complication of anterior cervical spinal surgery. This study aimed to investigate the diagnosis and treatment of cervical esophageal perforation related to spinal surgery. Among 1097 consecutive cases of anterior cervical spinal surgery that were managed at our institution over a 20 year period, five patients with esophageal perforation were identified. We performed a retrospective review of the diagnoses and treatment of esophageal perforation in these five patients as well as another patient who was transferred from another hospital. The esophageal perforations in all six patients were recognized during the early postoperative period. All patients presented with neck pain, dysphagia, odynophagia, coughing, fever and incision swelling and drainage. Diagnosis was confirmed by one or several of the following methods: contrast swallow study; endoscopy; cervical radiographs; or oral methylene blue. Nasogastric tube, intravenous antibiotics, enteral and parenteral nutrition, and open drainage were conducted in all patients. The wound was debrided in three patients, while two had implant removal and primary suture of the perforation. Five patients had a good recovery with healing of the esophagus, while one patient died due to severe pneumonia. The early diagnosis of esophageal perforation related to cervical spinal surgery relies on clinical suspicion and efficient investigation. The selection of appropriate treatment options, which include esophageal rest, antibiotic administration, nutrition support, wound debridement, open drainage, and surgical repair, largely depends on when the perforation is recognized. Early diagnosis and prompt management of this complication are likely to result in a good clinical outcome.

Distribution of crystalline polymer and fullerene clusters in both horizontal and vertical directions of high-efficiency bulk heterojunction solar cells.

In this study, we used (i) synchrotron grazing-incidence small-/wide-angle X-ray scattering to elucidate the crystallinity of the polymer PBTC12TPD and the sizes of the clusters of the fullerenes PC61BM and ThC61BM and (ii) transmission electron microscopy/electron energy loss spectroscopy to decipher both horizontal and vertical distributions of fullerenes in PBTC12TPD/fullerene films processed with chloroform, chlorobenzene and dichlorobezene. We found that the crystallinity of the polymer and the sizes along with the distributions of the fullerene clusters were critically dependent on the solubility of the polymer in the processing solvent when the solubility of fullerenes is much higher than that of the polymer in the solvent. In particular, with chloroform (CF) as the processing solvent, the polymer and fullerene units in the PBTC12TPD/ThC61BM layer not only give rise to higher crystallinity and a more uniform and finer fullerene cluster dispersion but also formed nanometer scale interpenetrating network structures and presented a gradient in the distribution of the fullerene clusters and polymer, with a higher polymer density near the anode and a higher fullerene density near the cathode. As a result of combined contributions from the enhanced polymer crystallinity, finer and more uniform fullerene dispersion and gradient distributions, both the short current density and the fill factor for the device incorporating the CF-processed active layer increase substantially over that of the device incorporating a dichlorobenzene-processed active layer; the resulting power conversion efficiency of the device incorporating the CF-processed active layer was enhanced by 46% relative to that of the device incorporating a dichlorobenzene-processed active layer.