Perioperative outcomes of bilateral axillo-breast approach robotic thyroidectomy (BABART) versus minimally invasive thyroidectomy (MIT): a systematic review and meta-analysis.

Minimally invasive thyroidectomy (MIT) is increasingly being used for the thyroid tumors. The comparison of bilateral axillo-breast approach robotic thyroidectomy (BABART) with other MIT has not yet led to a unified conclusion with regard to surgical outcomes. To conduct a systematic review and meta-analysis of the literature on the surgical outcomes of BABART compared with MIT. We performed a systematic search in PubMed, Web of Science, Embase and Cochrane Library database for randomized control trials (RCTs) and non-RCTs that compare BABART to MIT. The primary outcomes included perioperative, postoperative complications. The odds ratio (OR) and mean difference (MD) were applied for the comparison of dichotomous and continuous variables with 95% confidence intervals (CIs). Nine studies, comprising 3645 patients, were included in the meta-analysis. Our findings indicated that there were no significant differences in hospital stay, number of retrieved lymph nodes, recurrent laryngeal nerve (RLN) injury, and vocal cord dysfunction between BABRT and MIT. However, BABART was associated with a shorter operation time (MD = - 21.45 min, 95% CI [- 47.27, 4.38], p = 0.1) and lower rate of permanent hypoparathyroidism (OR = 0.42, 95% CI [0.20, 0.88], p = 0.02). Additionally, the MIT group had reduced postoperative pain score (MD = 0.45, 95% CI [0.02, 0.88], p = 0.04) and lower rate of hypocalcemia (OR = 2.31, 95% CI [1.04, 5.13], p = 0.04) than the BABART group. In comparison with MIT, BABART exhibits better results in terms of operative time and the rate of permanent hypoparathyroidism, with no significant difference in hospital stay, number of retrieved lymph nodes, RLN injury, and vocal cord dysfunction. However, the postoperative pain score and the rate of hypocalcemia of MIT are slightly better that of BABART.

Scalable Synthesis of High-Quality Ultrathin Ferroelectric Magnesium Molybdenum Oxide.

The development of ultrathin, stable ferroelectric materials is crucial for advancing high-density, low-power electronic devices. Nonetheless, ultrathin ferroelectric materials are rare due to the critical size effect. Here, a novel ferroelectric material, magnesium molybdenum oxide (Mg2 Mo3 O8 ) is presented. High-quality ultrathin Mg2 Mo3 O8 crystals are synthesized using chemical vapor deposition (CVD). Ultrathin Mg2 Mo3 O8 has a wide bandgap (≈4.4 eV) and nonlinear optical response. Mg2 Mo3 O8 crystals of varying thicknesses exhibit out-of-plane ferroelectric properties at room temperature, with ferroelectricity retained even at a 2 nm thickness. The Mg2 Mo3 O8 exhibits a relatively large remanent polarization ranging from 33 to 52 µC cm- 2 , which is tunable by changing its thickness. Notably, Mg2 Mo3 O8 possesses a high Curie temperature (>980 °C) across various thicknesses. Moreover, the as-grown Mg2 Mo3 O8 crystals display remarkable stability under harsh environments. This work introduces nolanites-type crystal into ultrathin ferroelectrics. The scalable synthesis of stable ultrathin ferroelectric Mg2 Mo3 O8 expands the scope of ferroelectric materials and may prosper applications of ferroelectrics.

Giant tunnelling electroresistance in atomic-scale ferroelectric tunnel junctions.

Ferroelectric tunnel junctions are promising towards high-reliability and low-power non-volatile memories and computing devices. Yet it is challenging to maintain a high tunnelling electroresistance when the ferroelectric layer is thinned down towards atomic scale because of the ferroelectric structural instability and large depolarization field. Here we report ferroelectric tunnel junctions based on samarium-substituted layered bismuth oxide, which can maintain tunnelling electroresistance of 7 × 105 with the samarium-substituted bismuth oxide film down to one nanometer, three orders of magnitude higher than previous reports with such thickness, owing to efficient barrier modulation by the large ferroelectric polarization. These ferroelectric tunnel junctions demonstrate up to 32 resistance states without any write-verify technique, high endurance (over 5 × 109), high linearity of conductance modulation, and long retention time (10 years). Furthermore, tunnelling electroresistance over 109 is achieved in ferroelectric tunnel junctions with 4.6-nanometer samarium-substituted bismuth oxide layer, which is higher than commercial flash memories. The results show high potential towards multi-level and reliable non-volatile memories.

Anion-induced robust ferroelectricity in sulfurized pseudo-rhombohedral epitaxial BiFeO3 thin films via polarization rotation.

Polarization rotation caused by various strains, such as substrate and/or chemical strain, is essential to control the electronic structure and properties of ferroelectric materials. This study proposes anion-induced polarization rotation with chemical strain, which effectively improves ferroelectricity. A method for the sulfurization of BiFeO3 thin films by introducing sulfur anions is presented. The sulfurized films exhibited substantial enhancement in room-temperature ferroelectric polarization through polarization rotation and distortion, with a 170% increase in the remnant polarization from 58 to 100.7 µC cm-2. According to first-principles calculations and the results of X-ray absorption spectroscopy and high-angle annular dark-field scanning transmission electron microscopy, this enhancement arose from the introduction of S atoms driving the re-distribution of the lone-pair electrons of Bi, resulting in the rotation of the polarization state from the [001] direction to the [110] or [111] one. The presented method of anion-driven polarization rotation might enable the improvement of the properties of oxide materials.

Development and validation of nomograms for predicting survival outcomes in patients with T1-2N1 breast cancer to identify those who could not benefit from postmastectomy radiotherapy.

Purpose: In this study, we aimed to develop and validate nomograms for predicting the survival outcomes in patients with T1-2N1 breast cancer to identify the patients who could not benefit from postmastectomy radiotherapy (PMRT). Methods: Data from 10191 patients with T1-2N1 breast cancer were extracted from the Surveillance, Epidemiology, and End Results (SEER) database. Of them, 6542 patients who had not received PMRT formed the training set. Concurrently, we retrospectively enrolled 419 patients from the Affiliated Hospital of North Sichuan Medical College (NSMC), and 286 patients who did not undergo PMRT formed the external validation set. The least absolute shrinkage and selection operator (LASSO) and multivariate Cox regression analyses were used for selecting prognostic factors in the training set. Using the selected factors, two prognostic nomograms were constructed. The nomograms' performance was assessed using the concordance index (C-index), calibration curves, decision curve analysis (DCA), and risk subgroup classification. The stabilized inverse probability of treatment weights (IPTWs) was used to balance the baseline characteristics of the different risk groups. Finally, the survival outcomes and effectiveness of PMRT after IPTW adjustment were evaluated using adjusted Kaplan-Meier curves and Cox regression models. Results: The 8-year overall survival (OS) and breast cancer-specific survival (BCSS) rates for the SEER cohort were 84.3% and 90.1%, with a median follow-up time of 76 months, while those for the NSMC cohort were 84.1% and 86.9%, with a median follow-up time of 73 months. Moreover, significant differences were observed in the survival curves for the different risk subgroups (P < 0.001) in both SEER and NSMC cohorts. The subgroup analysis after adjustment by IPTW revealed that PMRT was significantly associated with improved OS and BCSS in the intermediate- (hazard ratio [HR] = 0.72, 95% confidence interval [CI]: 0.59-0.88, P=0.001; HR = 0.77, 95% CI: 0.62-0.95, P = 0.015) and high- (HR=0.66, 95% CI: 0.52-0.83, P<0.001; HR=0.74, 95% CI: 0.56-0.99, P=0.039) risk groups. However, PMRT had no significant effects on patients in the low-risk groups. Conclusion: According to the prognostic nomogram, we performed risk subgroup classification and found that patients in the low-risk group did not benefit from PMRT.

Heterostructure-Engineered Semiconductor Quantum Dots toward Photocatalyzed-Redox Cooperative Coupling Reaction.

Semiconductor quantum dots have been emerging as one of the most ideal materials for artificial photosynthesis. Here, we report the assembled ZnS-CdS hybrid heterostructure for efficient coupling cooperative redox catalysis toward the oxidation of 1-phenylethanol to acetophenone/2,3-diphenyl-2,3-butanediol (pinacol) integrated with the reduction of protons to H2. The strong interaction and typical type-I band-position alignment between CdS quantum dots and ZnS quantum dots result in efficient separation and transfer of electron-hole pairs, thus distinctly enhancing the coupled photocatalyzed-redox activity and stability. The optimal ZnS-CdS hybrid also delivers a superior performance for various aromatic alcohol coupling photoredox reaction, and the ratio of electrons and holes consumed in such redox reaction is close to 1.0, indicating a high atom economy of cooperative coupling catalysis. In addition, by recycling the scattered light in the near field of a SiO2 sphere, the SiO2-supported ZnS-CdS (denoted as ZnS-CdS/SiO2) catalyst can further achieve a 3.5-fold higher yield than ZnS-CdS hybrid. Mechanistic research clarifies that the oxidation of 1-phenylethanol proceeds through the pivotal radical intermediates of •C(CH3)(OH)Ph. This work is expected to promote the rational design of semiconductor quantum dots-based heterostructured catalysts for coupling photoredox catalysis in organic synthesis and clean fuels production.

Ferroelectricity in layered bismuth oxide down to 1 nanometer.

Atomic-scale ferroelectrics are of great interest for high-density electronics, particularly field-effect transistors, low-power logic, and nonvolatile memories. We devised a film with a layered structure of bismuth oxide that can stabilize the ferroelectric state down to 1 nanometer through samarium bondage. This film can be grown on a variety of substrates with a cost-effective chemical solution deposition. We observed a standard ferroelectric hysteresis loop down to a thickness of ~1 nanometer. The thin films with thicknesses that range from 1 to 4.56 nanometers possess a relatively large remanent polarization from 17 to 50 microcoulombs per square centimeter. We verified the structure with first-principles calculations, which also pointed to the material being a lone pair-driven ferroelectric material. The structure design of the ultrathin ferroelectric films has great potential for the manufacturing of atomic-scale electronic devices.

Effect of cell density on the malignant biological behavior of breast cancer by altering the subcellular localization of ANXA2 and its clinical implications

To investigate the subcellular localization of ANXA2 in breast cancer of different cell densities in humans and its relationship with the clinicopathological features of patients. To investigate the differences in ANXA2 subcellular localization in MDA-MB-231 cells of different cell densities. To compare the proliferation, invasion, and migration ability of MDA-MB-231 cells under different ANXA2 subcellular localization.MethodsImmunohistochemistry was applied to detect the subcellular localization of ANXA2 in tissue sections of 60 breast cancer patients, and the association with ANXA2 subcellular localization was verified in conjunction with cell density. To investigate the relationship between cell density and clinicopathological data of breast cancer patients. To establish high- and low-density models of MDA-MB-231 breast cancer cell lines and verify the subcellular localization of ANXA2 using immunofluorescence and observation under confocal microscopy. The proliferation, migration, and invasion ability of MDA-MB-231 cells under different subcellular localization of ANXA2 were detected and compared using CCK-8 assay and Transwell assay. After changing the subcellular localization of ANXA2 in high-density MDA-MB-231 cells with PY-60, changes in biological behaviors of the compared MDA-MB-231 cells were observed. Two different 4T1 cell lines with high and low densities were implanted subcutaneously in nude mice to observe the effects of different cell densities on tumor growth in nude mice.ResultsThe clinical data showed that breast cancer with high cell density had higher T stage and higher TNM stage, and the cell density was positively correlated with breast cancer mass size. ANXA2 was mainly localized to the cell membrane when the cell density of breast cancer cells was high and to the cytoplasm when the cell density was low. (AU)

Stereoselective insertion of cyclopropenes into Mg-Mg bonds.

The reaction of cyclopropenes with compounds containing Mg-Mg bonds is reported. 1,2-Dimagnesiation occurs exclusively by syn-addition to the least hindered face of the alkene forming a single diastereomeric product. DFT calculations support a concerted and stereoselective mechanism. These findings shed new light on the stereochemistry of reactions involving magnesium reagents.

Effect of cell density on the malignant biological behavior of breast cancer by altering the subcellular localization of ANXA2 and its clinical implications.

OBJECTIVE: To investigate the subcellular localization of ANXA2 in breast cancer of different cell densities in humans and its relationship with the clinicopathological features of patients. To investigate the differences in ANXA2 subcellular localization in MDA-MB-231 cells of different cell densities. To compare the proliferation, invasion, and migration ability of MDA-MB-231 cells under different ANXA2 subcellular localization. METHODS: Immunohistochemistry was applied to detect the subcellular localization of ANXA2 in tissue sections of 60 breast cancer patients, and the association with ANXA2 subcellular localization was verified in conjunction with cell density. To investigate the relationship between cell density and clinicopathological data of breast cancer patients. To establish high- and low-density models of MDA-MB-231 breast cancer cell lines and verify the subcellular localization of ANXA2 using immunofluorescence and observation under confocal microscopy. The proliferation, migration, and invasion ability of MDA-MB-231 cells under different subcellular localization of ANXA2 were detected and compared using CCK-8 assay and Transwell assay. After changing the subcellular localization of ANXA2 in high-density MDA-MB-231 cells with PY-60, changes in biological behaviors of the compared MDA-MB-231 cells were observed. Two different 4T1 cell lines with high and low densities were implanted subcutaneously in nude mice to observe the effects of different cell densities on tumor growth in nude mice. RESULTS: The clinical data showed that breast cancer with high cell density had higher T stage and higher TNM stage, and the cell density was positively correlated with breast cancer mass size. ANXA2 was mainly localized to the cell membrane when the cell density of breast cancer cells was high and to the cytoplasm when the cell density was low. The CCK-8 assay showed that the proliferation rate of MDA-MB-231 cells increased (P < 0.05) after shifting the subcellular localization of ANXA2 from the cell membrane to the cytoplasm. Transwell invasion assay and Transwell migration assay showed that the invasion and migration ability of MDA-MB-231 cells increased significantly after the subcellular localization of ANXA2 was transferred from the cell membrane to the cytoplasm (P < 0.05). The animal experiments showed that high-density breast cancer cells could promote the growth of subcutaneous tumors in nude mice relative to low-density breast cancer cells. CONCLUSION: Cell density can regulate the subcellular localization of ANXA2, and changes in the subcellular localization of ANXA2 are accompanied by the changes in the biological behavior of breast cancer.

Role of oxygen vacancies in colossal polarization in SmFeO3-δ thin films.

The orthorhombic rare-earth manganates and ferrites multiferroics are promising candidates for the next generation multistate spintronic devices. However, their ferroelectric polarization is small, and transition temperature is far below room temperature (RT). The improvement of ferroelectricity remains challenging. Here, through the subtle strain and defect engineering, an RT colossal polarization of 4.14 µC/cm2 is achieved in SmFeO3-δ films, which is two orders of magnitude larger than its bulk and is also the largest one among the orthorhombic rare-earth manganite and ferrite family. Meanwhile, its RT magnetism is uniformly distributed in the film. Combining the integrated differential phase-contrast imaging and density functional theory calculations, we reveal the origin of this superior ferroelectricity in which the purposely introduced oxygen vacancies in the Fe-O layer distorts the FeO6 octahedral cage and drives the Fe ion away from its high-symmetry position. The present approach can be applied to improve ferroelectric properties for multiferroics.

Direct Observation of Polarization Rotation in the Monoclinic MB Phase under Electrical Loading.

The monoclinic phase has received a lot of research because of its importance in explaining the origin of high piezoelectric and ferroelectric performances around the morphotropic phase boundary. In the present study, we have investigated the detailed structural evolution in monoclinic PbZr0.535Ti0.465O3 ferroelectric ceramics induced by an electric field with in situ high-energy synchrotron diffraction combined with two-dimensional (2D) geometry scattering technology. It has been discovered that an electric-field-induced single monoclinic MB phase persists indefinitely. The lattice, unit cell volume, and spontaneous polarization of the monoclinic MB structure exhibit significant and flexible responses to the external electric field, i.e., the spontaneous polarization rotates continuously and the lattice and unit cell volume present a butterfly form under the influence of the bipolar electric field. Particularly, direct experimental evidence demonstrates that the macropolarization of PbZr0.535Ti0.465O3 is derived from the spontaneous polarization rotation rather than domain switching, and its volume expansion plays a vital role in the piezoelectric response.

Chemical-Pressure-Modulated BaTiO3 Thin Films with Large Spontaneous Polarization and High Curie Temperature.

Although BaTiO3 is one of the most famous lead-free piezomaterials, it suffers from small spontaneous and low Curie temperature. Chemical pressure, as a mild way to modulate the structures and properties of materials by element doping, has been utilized to enhance the ferroelectricity of BaTiO3 but is not efficient enough. Here, we report a promoted chemical pressure route to prepare high-performance BaTiO3 films, achieving the highest remanent polarization, Pr (100 µC/cm2), to date and high Curie temperature, Tc (above 1000 °C). The negative chemical pressure (∼-5.7 GPa) was imposed by the coherent lattice strain from large cubic BaO to small tetragonal BaTiO3, generating high tetragonality (c/a = 1.12) and facilitating large displacements of Ti. Such negative pressure is especially significant to the bonding states, i.e., hybridization of Ba 5p-O 2p, whereas ionic bonding in bulk and strong bonding of Ti eg and O 2p, which contribute to the tremendously enhanced polarization. The promoted chemical pressure method shows general potential in improving ferroelectric and other functional materials.

A Combined Computational and Experimental Study of Rh-Catalyzed C-H Silylation with Silacyclobutanes: Insights Leading to a More Efficient Catalyst System.

The study of new C-H silylation reagents and reactions remains an important topic. We reported that under Rh catalysis, silacyclobutanes (SCBs) for the first time were able to react with C(sp2)-H and C(sp3)-H bonds, however the underlying reasons for such a new reactivity were not understood. Through this combined computational and experimental study on C-H silylation with SCBs, we not only depict a reaction pathway that fully accounts for the reactivity and all the experimental findings but also streamline a more efficient catalyst that significantly improves the reaction rates and yields. Our key findings include: (1) the active catalytic species is a [Rh]-H as opposed to the previously proposed [Rh]-Cl; (2) the [Rh]-H is generated via a reductive elimination/ß-hydride (ß-H) elimination sequence, as opposed to previously proposed endocyclic ß-H elimination; (3) the regio- and enantio-determining steps are identified; (4) and of the same importance, the discretely synthesized [Rh]-H is shown to be a more efficient catalyst. This work suggests that the [Rh]-H/diphosphine system should find further applications in C-H silylations involving SCBs.

Relationship among the Crystal Structure, Texture, and Macroscopic Properties of Tetragonal (Pb,La)(Zr,Ti)O3 Ferroelectrics Investigated by In Situ High-Energy Synchrotron Diffraction.

In situ diffraction investigations have played an important role in experimentally revealing the mechanism of piezoelectric and ferroelectric properties. In this study, a pure tetragonal ferroelectric ceramic of La-doped PbZr0.5Ti0.5O3 (LaPZT50) was investigated to eliminate the complex influence of phase coexistence. The electric field evolutions of the crystal structure, domain switching, and lattice deformation of the tetragonal phase have been revealed by in situ high-energy synchrotron X-ray diffraction. We found that the crystal structure of LaPZT50 is quite stable, showing a negligible change in the Pb-O bond length, unit cell volume, and spontaneous polarization upon application of an in situ external electric field. Importantly, the maximum macroscopic polarization of tetragonal LaPZT50 is defined by the 111-oriented grains. As determined by the intensity difference, the switching of non-180° domains plays a more significant role in contributing to the macroscopic strain than lattice deformation. These results further imply that the phase coexistence around the morphotropic phase boundary facilitates domain wall motion in the tetragonal phase and improves the ferroelectric and piezoelectric properties.

Synthesis of ortho-Phenolic Sulfilimines via an Intermolecular Sulfur Atom Transfer Cascade Reaction.

To expand the toolbox for the synthesis of ortho-phenolic sulfilimines, sigmatropic rearrangements were introduced to the field of sulfilimine chemistry. Herein we report a N-H sulfenylation/[2,3]-sigmatropic rearrangement cascade reaction. This mild reaction enables commercially available thiols to serve as the sulfenylation reagent and generates water as the sole byproduct. Moreover, the reaction has a wide substrate scope and can be conducted on a gram scale with excellent reaction efficiency.

Controllable Ferromagnetism in Super-tetragonal PbTiO3 through Strain Engineering.

The coupling strain in nanoscale systems can achieve control of the physical properties in functional materials, such as ferromagnets, ferroelectrics, and superconductors. Here, we directly demonstrate the atomic-scale structure of super-tetragonal PbTiO3 nanocomposite epitaxial thin films, including the extraordinary coupling of strain transition and the existence of the oxygen vacancies. Large strain gradients, both longitudinal and transverse (∼3 × 107 m-1), have been observed. The original non-magnetic ferroelectric composites notably evoke ferromagnetic properties, derived from the combination of Ti3+ and oxygen vacancies. The saturation ferromagnetic moment can be controlled by the strain of both the interphase and substrate, optimized to a high value of ∼55 emu/cc in 10-nm thick nanocomposite epitaxial thin films on the LaAlO3 substrate. Strain engineering provides a route to explore multiferroic systems in conventional non-magnetic ferroelectric oxides and to create functional data storage devices from both ferroelectrics and ferromagnetics.

Facile difluoromethylation of aliphatic alcohols with an S-(difluoro-methyl)sulfonium salt: reaction, scope and mechanistic study.

A facile and practical approach for the difluoromethylation of aliphatic alcohols with an S-(difluoromethyl)sulfonium salt was developed. A wide variety of alcohols with broad functional groups are compatible to furnish the corresponding alkyl difluoromethyl ethers in good to excellent yields under mild reaction conditions. Control experiments and DFT computational studies suggest that the difluoromethylation of alcohols mainly proceeds via a difluorocarbene pathway involving a five-membered transition state with the participation of water, whose crucial role in this reaction was also elucidated by control experiments.

Rhodium-Catalyzed C═N Bond Formation through a Rebound Hydrolysis Mechanism and Application in ß-Lactam Synthesis.

A rhodium-catalyzed reaction of N-hydroxyanilines with diazo compounds to produce α-imino esters was developed. Distinct from the commonly accepted 1,2-H transfer for normal X-H insertion reactions, density functional theory calculations indicate that this transformation proceeds via a novel rebound hydrolysis mechanism. Furthermore, a three-component reaction was explored to synthesize highly functionalized ß-lactams in good yields and diastereoselectivities.

Rh(II)/Brønsted Acid Catalyzed General and Highly Diastereo- and Enantioselective Propargylation of in Situ Generated Oxonium Ylides and C-Alkynyl N-Boc N,O-Acetals: Synthesis of Polyfunctional Propargylamines.

The first metal/organo cooperatively catalyzed asymmetric reaction of C-alkynyl N-Boc-protected N,O-acetals with in situ generated oxonium ylides has been developed. This new type of propargylation allows for the efficient synthesis of structurally diverse unreported chiral propargylamines bearing oxa-quaternary stereocenters. The reaction features unprecedented substrate scope and high diastereo- and enantioselectivity. Theoretical studies suggest a novel cooperative catalysis model and the unique transfer of R2OH.