Preparation of Ru-doped TiO2 nanotube arrays through anodizing TiRu alloys for bifunctional HER/OER electrocatalysts.

In this research, Ru-doped TiO2 nanotube arrays (Ru-TNTA) were prepared by anodizing TiRu alloys, and the effects of annealing temperature, Ru content and test temperature on their performances for the hydrogen evolution reaction (HER) and the oxygen evolution reaction (OER) were investigated. The results show that the unannealed Ru-TNTA (a-Ru-TNTA) exhibits superior activity for the HER, and the Ru-TNTA annealed at 450 °C (c-Ru-TNTA) shows excellent activity for the OER. The Ru content of TiRu impacts the electrochemically active surface area (ECSA) and the charge transfer resistance (Rct) significantly. When the Ru content of Ru-TNTA is 6%, its performance is optimal. Moreover, the electrocatalytic activity of Ru-TNTA improves with increasing test temperature, and the overpotentials of a-Ru-TNTA and c-Ru-TNTA at 80 °C are 19 mV and 227 mV (10 mA cm-2), respectively. Ru-TNTA exhibits excellent electrocatalytic performance for water splitting and good stability, which provides a new idea for the preparation of advanced bifunctional electrocatalysts for water splitting.

Good functional outcome following bilateral external capsule hemorrhage mimicking bilateral basal ganglia hemorrhage in a coma patient.

Simultaneous spontaneous bilateral external capsule hemorrhage is a rare clinical entity with extremely poor outcome. However, knowledge on the effective management of this fatal disease is limited. Herein,we described a case of a 42-year-old man with acute coma and quadriplegia as well as respiratory failure related to the disease. The patient underwent minimally invasive surgery plus local thrombolysis. Consequently, he recovered with satisfactory neurological function recovery on the 180th day of follow-up.

A Script-Based Automatic Intensity Modulated Radiation Therapy Planning Method With Robust Optimization for Craniospinal Irradiation.

This report describes a script-based automatic planning method with robust optimization for craniospinal irradiation (CSI) to reduce sensitivity to field matching errors and increase planning efficiency. The data of 10 CSI patients with planning target volume (PTV) lengths between 49.8 and 85.0 cm were retrospectively studied. Robust intensity modulated radiation therapy plans with ±5-mm longitudinal position uncertainty were generated by the automatic planning script. A simple dose prediction model and a self-adjusting method were implied in the automatic plans. The plans' robustness against setup errors was evaluated by deliberately shifting the middle beamset ±5 mm in the superior-inferior direction. Manual and nonrobust plans were also created to evaluate the automatic robust plans' quality, efficiency, and robustness. There were no significant differences between the manual and automatic plans in terms of homogeneity index; conformity index; D1%, D2%, and D98% of PTV; and average doses of organs at risk. However, the D99% of the PTV in the automatic plans was slightly inferior to that in the manual plans. Compared with the manual plans, the automatic plans greatly increased efficiency, with a reduction in planning time of approximately 48%. When ±5-mm superior-inferior errors were introduced, the average deviations of the maximum dose D1% and minimum dose D99% to the spinal cord were 4.9% (±1.1%) and -3.4% (±1.3%), respectively. However, the corresponding values of the nonrobust plans were 20.0% (±5.4%) and -21.2 (±6.3%), respectively. The script-based automatic CSI planning method, combining robust optimization and a dose prediction model, efficiently created a good-quality plan that was robust to setup errors.

Through converting the surface complex on TiO2 nanorods to generate superoxide and singlet oxygen to remove CN.

Cyanide (CN-) is extensively used in the process of plating devices and for surface treatment in the electroplating industry and is extremely hazardous to humans and the environment. Peroxymonosulfate (PMS)-based advanced oxidation processes (AOPs) hold considerable promise for CN- removal. However, the activity of sulfate radical and hydroxyl radical generated in the PMS activation process is low in the base condition, leading to a drop in its efficiency in CN- removal. Thus, a photo-electrocatalytic system (PEC), developed using a TiO2 photoanode and a carbon aerogel cathode, was used to activate PMS for the removal of CN- from wastewater through the generation of radicals and non-radicals. The PEC/PMS system could effectively remove CN-, with the removal efficiency reaching 98.5% within 2 min, when PMS concentration was at the 0.25 mmol/L level, and the applied bias voltage was -0.5 V. The main active species in the PEC/PMS system were superoxide radicals and singlet oxygen, which was proved through electron paramagnetic resonance detection and quenching experiments. Results obtained through in-situ Raman measurements, photocurrent tests, and electrochemical impedance spectroscopy measurements indicated that the TiO2 could activate PMS to generate active species. Following many cycles of experimentation, it was discovered that the system displayed high catalytic performance and possessed satisfactory stability to remove CN- economically and efficiently.

Safely completed radiotherapy in a patient with breast cancer and right axillary vein approach cardiac pacemaker implantation: A case report.

Pacemaker implantation is becoming increasingly common in patients with breast cancer. Comprehensive treatment options, such as surgery, chemotherapy, radiation therapy, targeted therapy and immunotherapy, have greatly improved the prognosis of patients with breast cancer. In particular, radiotherapy is an important means of comprehensive breast cancer treatment that can reduce recurrence and prolong survival in high-risk patients who underwent mastectomy. The pacemaker electrical pulse generator is typically implanted subcutaneously in the left subclavian area above the pectoral muscle through the subclavian vein. The present report implemented a new method of 'temporary pacemaker electrode and permanent artificial pacemaker placement' through the right axillary vein in a patient with breast cancer. An electrical pulse generator was placed in the right subcutaneous subclavian tissue. The pacemaker was placed under the right clavicle, and the pacemaker was included as organ at risk (OAR). Dose of planning organ at risk volume (PRV) with additional 6 mm margin to the pacemaker was limited during radiotherapy planning design. This patient with breast cancer, who was also complicated with other underlying comorbidities (such as atrial fibrillation, coronary atherosclerosis, cardiac insufficiency, hypertension, type 2 diabetes mellitus) and implanted with a cardiac pacemaker, was treated with safe (means that the patient has not developed heart disease because of the pacemaker problem) and effective (tumor can be effectively controlled under the condition that the pacemaker does not malfunction) radiotherapy. At present, the patient has successfully completed radiation therapy for breast cancer with no recurrence or metastasis. To the best of our knowledge, the present report is the first to document this application, demonstrating the treatment of a patient with breast cancer and cardiac pacemaker implantation, which is worthy of further study and continuous improvement in clinical practice.

Super-Hydrophilic Microporous Ni(OH)x/Ni3 S2 Heterostructure Electrocatalyst for Large-Current-Density Hydrogen Evolution.

Exploiting active and stable non-precious metal electrocatalysts for alkaline hydrogen evolution reaction (HER) at large current density plays a key role in realizing large-scale industrial hydrogen generation. Herein, a self-supported microporous Ni(OH)x/Ni3 S2 heterostructure electrocatalyst on nickel foam (Ni(OH)x/Ni3 S2 /NF) that possesses super-hydrophilic property through an electrochemical process is rationally designed and fabricated. Benefiting from the super-hydrophilic property, microporous feature, and self-supported structure, the electrocatalyst exhibits an exceptional HER performance at large current density in 1.0 M KOH, only requiring low overpotential of 126, 193, and 238 mV to reach a current density of 100, 500, and 1000 mA cm-2 , respectively, and displaying a long-term durability up to 1000 h, which is among the state-of-the-art non-precious metal electrocatalysts. Combining hard X-rays absorption spectroscopy and first-principles calculation, it also reveals that the strong electronic coupling at the interface of the heterostructure facilitates the dissociation of H2 O molecular, accelerating the HER kinetics in alkaline electrolyte. This work sheds a light on developing advanced non-precious metal electrocatalysts for industrial hydrogen production by means of constructing a super-hydrophilic microporous heterostructure.

Paeoniflorin drives the immunomodulatory effects of mesenchymal stem cells by regulating Th1/Th2 cytokines in oral lichen planus.

Lichen planus (LP) is a chronic inflammatory disease. Oral lichen planus (OLP) mainly appears as oral mucosal reticular or ulcerative lesions with an unknown etiology. We aimed to explore the immunomodulatory effect of paeoniflorin (PF) in mesenchymal stem cells (MSCs) and the potential involvement of Th1/Th2 cytokines in OLP. The effects of paeoniflorin on the proliferation and migration of MSCs were detected by Cell Counting Kit-8 (CCK8) and Transwell assays. MSCs were subjected to osteogenic, adipogenic and neurogenic induction followed by Alizarin red, oil red O, real-time PCR and immunofluorescence assays. We found that paeoniflorin promoted the proliferation, migration and multilineage differentiation of MSCs from OLP lesions (OLP-MSCs) in vitro. Paeoniflorin pretreatment increased the inhibitory effect of OLP-MSCs on peripheral blood mononuclear cells. Furthermore, paeoniflorin-pretreated OLP-MSCs simultaneously decreased Th1 cytokine levels and increased Th2 cytokine levels in T lymphocyte cocultures. Finally, paeoniflorin-pretreated OLP-MSCs also promoted the Th1/Th2 balance both in vitro and in the serum of mice that received skin allografts. In conclusion, paeoniflorin enhanced MSC immunomodulation and changed the inflammatory microenvironment via T lymphocytes, suggesting that the improvement of OLP-MSCs is a promising therapeutic approach for OLP.

3D-printed bolus ensures the precise postmastectomy chest wall radiation therapy for breast cancer.

Purpose: To investigate the values of a 3D-printed bolus ensuring the precise postmastectomy chest wall radiation therapy for breast cancer. Methods and materials: In the preclinical study on the anthropomorphic phantom, the 3D-printed bolus was used for dosimetry and fitness evaluation. The dosimetric parameters of planning target volume (PTV) were assessed, including Dmin, Dmax, Dmean, D95%, homogeneity index (HI), conformity index (CI), and organs at risk (OARs). The absolute percentage differences (|%diff|) between the theory and fact skin dose were also estimated, and the follow-up was conducted for potential skin side effects. Results: In preclinical studies, a 3D-printed bolus can better ensure the radiation coverage of PTV (HI 0.05, CI 99.91%), the dose accuracy (|%diff| 0.99%), and skin fitness (mean air gap 1.01 mm). Of the 27 eligible patients, we evaluated the radiation dose parameter (median(min-max): Dmin 4967(4789-5099) cGy, Dmax 5447(5369-5589) cGy, Dmean 5236(5171-5323) cGy, D95% 5053(4936-5156) cGy, HI 0.07 (0.06-0.17), and CI 99.94% (97.41%-100%)) and assessed the dose of OARs (ipsilateral lung: Dmean 1341(1208-1385) cGy, V5 48.06%(39.75%-48.97%), V20 24.55%(21.58%-26.93%), V30 18.40%(15.96%-19.16%); heart: Dmean 339(138-640) cGy, V30 1.10%(0%-6.14%), V40 0.38%(0%-4.39%); spinal cord PRV: Dmax 639(389-898) cGy). The skin doses in vivo were Dtheory 208.85(203.16-212.53) cGy, Dfact 209.53(204.14-214.42) cGy, and |%diff| 1.77% (0.89-2.94%). Of the 360 patients enrolled in the skin side effect follow-up study (including the above 27 patients), grade 1 was the most common toxicity (321, 89.2%), some of which progressing to grade 2 or grade 3 (32, 8.9% or 7, 1.9%); the radiotherapy interruption rate was 1.1%. Conclusion: A 3D-printed bolus can guarantee the precise radiation dose on skin surface, good fitness to skin, and controllable acute skin toxicity, which possesses a great clinical application value in postmastectomy chest call radiation therapy for breast cancer.

Facile preparation of MnO2-TiO2 nanotube arrays composite electrode for electrochemical detection of hydrogen peroxide.

The MnO2-TNTA composite electrodes were obtained through depositing MnO2 into TiO2 nanotube arrays (TNTA) by successive ionic layer adsorption reaction (SILAR) and subsequent hydrothermal method. The MnO2-TNTA nanocomposites were used as electrochemical sensors for the detection of hydrogen peroxide (H2O2). The preparation conditions of MnO2-TNTA electrodes and test conditions affect the electrochemical detection performance significantly. The optimal conditions are listed as follows: the number of SILAR cycles, 6 times; KMnO4 solution temperature, 50 °C; supporting electrolyte, 0.5 M NaOH. Under these conditions, the MnO2-TNTA electrode exhibits the best performance for detecting H2O2. The optimized MnO2-TNTA electrode has a minimum detection limit of 0.6 µM (S/N = 3) and a linear range of 5 µM âˆ¼ 13 mM, which is much superior to the previously-reported electrodes. Moreover, the optimized MnO2-TNTA electrode possesses high selectivity, excellent stability and good reproducibility in the detection of H2O2. When used in the determination of H2O2 content in actual samples including disinfectant and milk, it also shows good accuracy, ideal recovery (96.00% âˆ¼ 102.67%) and high precision (RSD < 4.0%).

Modulating the Electronic Structure of Nickel Sulfide Electrocatalysts by Chlorine Doping toward Highly Efficient Alkaline Hydrogen Evolution.

The exploration of indurative and stable low-cost catalysts for hydrogen evolution reaction (HER) is of great importance for hydrogen energy economy, but it still faces challenges. Herein, we report a Cl-doped Ni3S2 (Cl-Ni3S2) nanoplate catalyst vertically grown on Ni foam with outstanding activity and durability for HER, which only requires an overpotential of 67 mV to reach a current density of 10 mA cm-2 in alkaline media and exhibits negligible degradation after 30 h of operation. Both the advanced X-ray absorption fine structure (XAFS) and density functional theory (DFT) calculation validate that Cl doping can optimize the electronic structure and the intrinsic activity of Ni3S2. This study devoted to the revelation of the impact of ionic doping on the activity of catalysts at the atomic scale can provide the direction for the rational design of novel and advanced HER electrocatalysts.

A Nomogram for the Determination of the Necessity of Concurrent Chemotherapy in Patients With Stage II-IVa Nasopharyngeal Carcinoma.

BACKGROUND: The efficiency of concurrent chemotherapy (CC) remains controversial for stage II-IVa nasopharyngeal carcinoma (NPC) patients treated with induction chemotherapy (IC) followed by intensity-modulated radiotherapy (IMRT). Therefore, we aimed to propose a nomogram to identify patients who would benefit from CC. METHODS: A total of 434 NPC patients (stage II-IVa) treated with IC followed by IMRT between January 2010 and December 2015 were included. There were 808 dosimetric parameters extracted by the in-house script for each patient. A dosimetric signature was developed with the least absolute shrinkage and selection operator algorithm. A nomogram was built by incorporating clinical factors and dosimetric signature using Cox regression to predict recurrence-free survival (RFS). The C-index was used to evaluate the performance of the nomogram. The patients were stratified into low- and high-risk recurrence according to the optimal cutoff of risk score. RESULTS: The nomogram incorporating age, TNM stage, and dosimetric signature yielded a C-index of 0.719 (95% confidence interval, 0.658-0.78). In the low-risk group, CC was associated with a 9.4% increase of 5-year locoregional RFS and an 8.8% increase of 5-year overall survival (OS), whereas it was not significantly associated with an improvement of locoregional RFS (LRFS) and OS in the high-risk group. However, in the high-risk group, patients could benefit from adjuvant chemotherapy (AC) by improving 33.6% of the 5-year LRFS. CONCLUSIONS: The nomogram performed an individualized risk quantification of RFS in patients with stage II-IVa NPC treated with IC followed by IMRT. Patients with low risk could benefit from CC, whereas patients with high risk may require additional AC.

Radiomics analysis of EPID measurements for patient positioning error detection in thyroid associated ophthalmopathy radiotherapy.

PURPOSE: Electronic portal imaging detector (EPID)-based patient positioning verification is an important component of safe radiotherapy treatment delivery. In computer simulation studies, learning-based approaches have proven to be superior to conventional gamma analysis in the detection of positioning errors. To approximate a clinical scenario, the detectability of positioning errors via EPID measurements was assessed using radiomics analysis for patients with thyroid-associated ophthalmopathy. METHODS: Treatment plans of 40 patients with thyroid-associated ophthalmopathy were delivered to a solid anthropomorphic head phantom. To simulate positioning errors, combinations of 0-, 2-, and 4-mm translation errors in the left-right (LR), superior-inferior (SI), and anterior-posterior (AP) directions were introduced to the phantom. The positioning errors-induced dose differences between measured portal dose images were used to predict the magnitude and direction of positioning errors. The detectability of positioning errors was assessed via radiomics analysis of the dose differences. Three classification models-support vector machine (SVM), k-nearest neighbors (KNN), and XGBoost-were used for the detection of positioning errors (positioning errors larger or smaller than 3 mm in an arbitrary direction) and direction classification (positioning errors larger or smaller than 3 mm in a specific direction). The receiver operating characteristic curve and the area under the ROC curve (AUC) were used to evaluate the performance of classification models. RESULTS: For the detection of positioning errors, the AUC values of SVM, KNN, and XGBoost models were all above 0.90. For LR, SI, and AP direction classification, the highest AUC values were 0.76, 0.91, and 0.80, respectively. CONCLUSIONS: Combined radiomics and machine learning approaches are capable of detecting the magnitude and direction of positioning errors from EPID measurements. This study is a further step toward machine learning-based positioning error detection during treatment delivery with EPID measurements.

Engineering sulfur vacancies into Fe9S10 nanosheet arrays for efficient alkaline hydrogen evolution.

The development of Earth-abundant transition metal sulfide electrocatalysts with excellent activity and stability toward the alkaline hydrogen evolution reaction (HER) is critical but challenging. Iron-based sulfides are favored due to their economic benefits and good stability, but their intrinsic catalytic activity still needs to be improved urgently. Herein, we successfully prepared Fe9S10 nanosheet arrays on iron foam (Fe9S10/IF) through a simple one-step method and utilized plasma treatment to introduce S vacancies (Fe9S10-Vs/IF) to regulate their intrinsic catalytic activity. The final materials demonstrate excellent HER performance, and only need 149 mV to drive a current density of 10 mA cm-2 and a small Tafel slope of 50 mV dec-1. The experimental results show that the existence of S vacancies can enhance their intrinsic electrocatalytic activity. This work provides a reference value for the future regulation of iron-based sulfides and is devoted to the development of non-precious metal catalysts toward the HER.

Association of Satellite Sign with Postoperative Rebleeding in Patients Undergoing Stereotactic Minimally Invasive Surgery for Hypertensive Intracerebral Haemorrhage.

There are few studies regarding imaging markers for predicting postoperative rebleeding after stereotactic minimally invasive surgery (MIS) for hypertensive intracerebral haemorrhage (ICH), and little is known about the relationship between satellite sign on computed tomography (CT) scans and postoperative rebleeding after MIS. This study aimed to determine the value of the CT satellite sign in predicting postoperative rebleeding in patients with hypertensive ICH who undergo stereotactic MIS. We retrospectively examined and analysed 105 patients with hypertensive ICH who underwent standard stereotactic MIS for hematoma evacuation within 72 h following admission. Postoperative rebleeding occurred in 14 of 65 (21.5%) patients with the satellite sign on baseline CT, and in 5 of the 40 (12.5%) patients without the satellite sign. This difference was statistically significant. Positive and negative values of the satellite sign for predicting postoperative rebleeding were 21.5% and 87.5%, respectively. Multivariate logistic regression analysis verified that baseline ICH volume and intraventricular rupture were independent predictors of postoperative rebleeding. In conclusion, the satellite sign on baseline CT scans may not predict postoperative rebleeding following stereotactic MIS for hypertensive ICH.

Facile Preparation of Granular Copper Films as Cathode for Enhanced Electrochemical Degradation of Methyl Orange.

In this paper, granular copper films (GCFs) were prepared through electrodeposition in CuSO4 solution containing triethanolamine, and the films were used as electro-Fenton-like cathodes for degradation of methyl orange (MO). The effects of triethanolamine concentration, pH value, current intensity and temperature on the morphology of the films, as well as the MO decolorization ratio (DR), were investigated in detail. Results show that when the concentration of triethanolamine is 0.2 wt%, the prepared GCF exhibits the best performance. Under room temperature and neutral conditions, no external O2 or catalyst, MO is completely decolorized after 240 min. Compared with the commonly used carbon cathode, the GCF cathode can increase the MO decolorization rate by approximately 70.9%. The kinetics of the electrochemical degradation reaction is also discussed.

Designing Zn-doped nickel sulfide catalysts with an optimized electronic structure for enhanced hydrogen evolution reaction.

Designing non-noble-metal electrocatalysts with excellent performance and economic benefits toward the hydrogen evolution reaction (HER) is extremely crucial for future energy development. In particular, the rational cationic-doped strategy can effectively tailor the electronic structure of the catalysts and improve the free energy of the adsorbed intermediate, thus enhancing HER performance. Herein we reported Zn-doped Ni3S2 nanosheet arrays supported on Ni foam (Zn-Ni3S2/NF) that were synthesized by a two-step hydrothermal process for improving HER catalysis under alkaline conditions. Remarkably, the obtained Zn-Ni3S2/NF displays excellent HER catalytic performance with an overpotential of 78 mV to reach a current density of 10 mA cm-2 and dramatic long-term stability for 18 h in 1 M KOH. In addition, the results based on the density functional theory calculations reveal that Zn dopants can modulate the electronic structure of Ni3S2 and optimize the hydrogen adsorption free energy (ΔGH*). Thus cationic-doping engineering provides an efficient method to enhance the intrinsic activities of transition-metal sulfides, which may contribute to the development of nonprecious electrocatalysts for HER.

Hippocampal proteomic analysis reveals activation of necroptosis and ferroptosis in a mouse model of chronic unpredictable mild stress-induced depression.

Neuronal loss has been identified in depression, but its mechanisms are not fully understood. Proteomic analyses provide a novel insight to explore the potential mechanisms of such pathological alterations. In this study, mice were treated with chronic unpredictable mild stress (CUMS) for 2 months to establish depression models. The hippocampus was analyzed for proteomic patterns by mass spectrometry followed by Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analyses. Behavioral tests showed that mice receiving CUMS showed depression-like symptoms such as anhedonia in the sucrose preference test (SPT) and behavioral despair in the forced swimming test (FST). CUMS induced anxiety-like behaviors in the open field test (OFT), but did not impair spatial learning and memory ability in the Morris water maze (MWM) test. Out of 4046 quantified proteins, 47 differentially expressed proteins were obtained between the CUMS and control groups. These proteins were functionally enriched in a series of biological processes. Among the notably enriched pathways, necroptosis and ferroptosis were significantly activated. Western blot and biochemical assay analyses identified changes in receptor-interacting protein kinase 3 (RIP3), phosphorylated mixed lineage kinase domain-like protein (p-MLKL), ferritin light chain 1 (Ftl1) and lipid peroxidation that were related to necroptosis and ferroptosis. Further, we found reduced levels of alpha-crystallin B (Cryab) and brain-derived neurotrophic factor (BDNF), which were also associated with neuronal survival. Our study highlighted that necroptosis and ferroptosis were involved in depression and partially account for neuronal loss, thereby providing potentially novel targets for the treatment of depression.

Effective method to reduce the normal brain dose in single-isocenter hypofractionated stereotactic radiotherapy for multiple brain metastases.

BACKGROUND AND PURPOSE: Island blocking and dose leakage problems will lead to unnecessary irradiation to normal brain tissue (NBT) in hypofractionated stereotactic radiotherapy (HSRT) for multiple brain metastases (BM) with single-isocenter volumetric modulated arc therapy (VMAT). The present study aimed at investigating whether reducing the number of metastases irradiated by each arc beam could minimize these two problems. MATERIALS AND METHODS: A total of 32 non-small-cell lung cancer (NSCLC) patients with multiple BM received HSRT (24-36 Gy/3 fractions) with single-isocenter VMAT, where each arc beam only irradiated partial metastases (pm-VMAT), were enrolled in this retrospective study. Conventional single-isocenter VMAT plans, where each arc beam irradiated whole metastases (wm-VMAT), was regenerated and compared with pm-VMAT plans. Furthermore, the clinical efficacy and toxicities were evaluated. RESULTS: Pm-VMAT achieved similar target coverage as that with wm-VMAT, with better dose fall-off (P < 0.001) and NBT sparing (P < 0.001). However, pm-VMAT resulted in more monitor units (MU) and longer beam-on time (P < 0.001). The intracranial objective response rate and disease control rate for all patients were 75% and 100%, respectively. The local control rates at 1 year and 2 year were 96.2% and 60.2%, respectively. The median progression-free survival and overall survival were 10.3 months (95% confidence interval [CI] 6.8-13.2) and 18.5 months (95% CI 15.9-20.1), respectively. All treatment-related adverse events were grade 1 or 2, and 3 lesions (2.31%) from 2 patients (6.25%) demonstrated radiation necrosis after HSRT. CONCLUSION: HSRT with pm-VMAT is effective and has limited toxicities for NSCLC patients with multiple BM. Pm-VMAT could provide better NBT sparing while maintaining target dose coverage.

Al-doped nickel sulfide nanosheet arrays as highly efficient bifunctional electrocatalysts for overall water splitting.

The development of low-cost, high-activity, durable non-precious metal bifunctional electrocatalysts is of great importance in the production of hydrogen by water electrolysis. In this work, we have prepared new Al-doped Ni3S2 nanosheet arrays grown on Ni foam (Al-Ni3S2/NF) as an excellent bifunctional electrocatalyst in the hydrogen evolution reaction (HER) and oxygen evolution reaction (OER). The Al-Ni3S2/NF electrode obtained only requires extremely low overpotentials of 86 and 223 mV for the HER and OER to achieve a current density of 10 mA cm-2 in 1 M KOH, respectively. Moreover, the electrolytic cell assembled using this electrode as both cathode and anode provides a current density of 10 mA cm-2 at an extremely low battery voltage of 1.58 V relative to that with Ni3S2/NF (1.71 V). Additionally, both experimental results and theoretical calculations reveal that the increased electrochemical active surface area and optimized intermediate adsorption free energies are responsible for the enhanced electrocatalytic performance. This work provides a promising bifunctional electrocatalyst for water electrolysis in alkaline media with broad application prospects.

A Cross-Sectional Study of Psychological Status in Different Epidemic Areas in China After the COVID-19 Outbreak.

Background: The outbreak of coronavirus disease 2019 in Wuhan, Hubei Province, China has seriously affected people's mental health. We aimed to assess the psychological impact of the coronavirus disease 2019 on health care workers and non-health care workers in three different epidemic areas in China and to identify independent risk factors. Methods: We surveyed 1,020 non-health care workers and 480 health care workers in Wuhan, other cities in Hubei except Wuhan and other provinces in China except Hubei. Results: Health care workers in Hubei had higher levels of anxiety and depression than non-health care workers (p < 0.05), but there was no such difference in other provinces in China except Hubei (p > 0.05). Compared with other regions, health care workers in Wuhan was more anxious (p < 0.05), and this anxiety may be caused by concerns about occupational exposure and wearing protective clothing for a long time daily; health care workers in Hubei had more obvious depression (p < 0.05), which may be associated with long days participating in epidemic work and wearing protective clothing for a long time daily. Meanwhile, 62.5% of health care workers were proud of their work. The anxiety and depression of non-health care workers in Wuhan were also the most serious. Conclusions: In Wuhan, where the epidemic is most severe, levels of anxiety and depression seem to be higher, especially among health care workers. This information may help to better prepare for future events.