High-density switchable skyrmion-like polar nanodomains integrated on silicon.

Topological domains in ferroelectrics1-5 have received much attention recently owing to their novel functionalities and potential applications6,7 in electronic devices. So far, however, such topological polar structures have been observed only in superlattices grown on oxide substrates, which limits their applications in silicon-based electronics. Here we report the realization of room-temperature skyrmion-like polar nanodomains in lead titanate/strontium titanate bilayers transferred onto silicon. Moreover, an external electric field can reversibly switch these nanodomains into the other type of polar texture, which substantially modifies their resistive behaviours. The polar-configuration-modulated resistance is ascribed to the distinct band bending and charge carrier distribution in the core of the two types of polar texture. The integration of high-density (more than 200 gigabits per square inch) switchable skyrmion-like polar nanodomains on silicon may enable non-volatile memory applications using topological polar structures in oxides.

Mapping of Long-Wavelength Phonon Contribution in the Thermal Transport of Alloyed Semiconductor Superlattices.

The mapping of long-wavelength phonons is important to understand and manipulate the thermal transport in multilayered structures, but it remains a long-standing challenge due to the collective behaviors of phonons. In this study, an experimental demonstration of mapping the long-wavelength phonons in an alloyed Al0.1Ga0.9As/Al0.9Ga0.1As superlattice system is reported. Multiple strategies to filter out the short- to mid-wavelength phonons are used. The phonon mean-free-path-dependent thermal transport properties directly demonstrate both the suppression effect of the ErAs nanoislands and the contribution of long-wavelength phonons. The contribution from phonons with mean free path longer than 1 µm is clearly demonstrated. A model based on the Boltzmann transport equation is proposed to calculate and describe the thermal transport properties, which depicts a clear physical picture of the transport mechanisms. This method can be extended to map different wavelength phonons and become a universal strategy to explore their thermal transport in various application scenarios.

Ultralow thermal conductivity of 2D Dion-Jacobson (PDA)(FA)n - 1PbnI3n + 1 perovskite films.

Two-dimensional (2D) perovskites exhibit enhanced thermal stability compared to three-dimensional perovskites, especially the emerging 2D Dion-Jacobson (DJ) phase perovskite. However, the heat transfer mechanisms in DJ phase perovskites are rarely reported. Herein, we determine thermal conductivities of (PDA)(FA)n - 1PbnI3n + 1 films with n = 1-6 by time-domain thermoreflectance. The measured results indicate that the thermal conductivities of these films are extremely low, showing a trend from decline to rise with increasing n values, and reaching to the lowest when n = 2. We measure the propagation of acoustic phonons in films with n = 1-3 by time-domain Brillouin scattering and find phonon velocity plays a key role in the thermal conductivity, which can be explained by the mismatch of spring constants between the inorganic layer and the organic layer using the bead-spring model. The gradually increasing thermal conductivity for larger n values is attributed to the gradual transformation of the grain orientation from horizontal to vertical, which is demonstrated by the grazing-incidence wide-angle x ray scattering (GIWAXS) results. Our work deepens the understanding of the thermal transport process in 2D DJ phase perovskite films and provides insights into thermal management solutions for their devices.

Observation of Free-Boundary-Induced Chiral Anomaly Bulk States in Elastic Twisted Kagome Metamaterials.

Chiral anomaly bulk states (CABSs) can be realized by choosing appropriate boundary conditions in a finite-size waveguide composed of two-dimensional Dirac semimetals, which have unidirectional and robust transport similar to that of valley edge states. CABSs use almost all available guiding space, which greatly improves the utilization of metamaterials. Here, free-boundary-induced CABSs in elastic twisted kagome metamaterials with C_{3v} symmetry are experimentally confirmed. The robust valley-locked transport and complete valley state conversion are experimentally observed. Importantly, the sign of the group velocity near the K and K^{'} points can be reversed by suspending masses at the boundary to manipulate the onsite potential. Moreover, CABSs are demonstrated in nanoelectromechanical phononic crystals by constructing an impedance-mismatched hard boundary. These results open new possibilities for designing more compact, space-efficient, and robust elastic wave macro- and microfunctional devices.

Non-Abelian Topological Phases and Their Quotient Relations in Acoustic Systems.

Non-Abelian topological phases (NATPs) exhibit enigmatic intrinsic physics distinct from well-established Abelian topological phases, while lacking straightforward configuration and manipulation, especially for classical waves. In this Letter, we exploit novel braiding-type couplings among a pair of triple-component acoustic dipoles, which act as functional elements with effective imaginary couplings. Sequencing them in one dimension allows us to generate acoustic NATPs in a compact yet time-reversal invariant Hermitian system. We further provide the whole phase diagram that encompasses all i, j, and k non-Abelian phases, and directly demonstrate their unique quotient relations via different end point states. Our NATPs based on real-space braiding may inspire the exploration of acoustic devices with non-commutative characters.

Radiomics-based nomogram guides adaptive de-intensification in locoregionally advanced nasopharyngeal carcinoma following induction chemotherapy.

OBJECTIVES: This study aimed to construct a radiomics-based model for prognosis and benefit prediction of concurrent chemoradiotherapy (CCRT) versus intensity-modulated radiotherapy (IMRT) in locoregionally advanced nasopharyngeal carcinoma (LANPC) following induction chemotherapy (IC). MATERIALS AND METHODS: A cohort of 718 LANPC patients treated with IC + IMRT or IC + CCRT were retrospectively enrolled and assigned to a training set (n = 503) and a validation set (n = 215). Radiomic features were extracted from pre-IC and post-IC MRI. After feature selection, a delta-radiomics signature was built with LASSO-Cox regression. A nomogram incorporating independent clinical indicators and the delta-radiomics signature was then developed and evaluated for calibration and discrimination. Risk stratification by the nomogram was evaluated with Kaplan-Meier methods. RESULTS: The delta-radiomics signature, which comprised 19 selected features, was independently associated with prognosis. The nomogram, composed of the delta-radiomics signature, age, T category, N category, treatment, and pre-treatment EBV DNA, showed great calibration and discrimination with an area under the receiver operator characteristic curve of 0.80 (95% CI 0.75-0.85) and 0.75 (95% CI 0.64-0.85) in the training and validation sets. Risk stratification by the nomogram, excluding the treatment factor, resulted in two groups with distinct overall survival. Significantly better outcomes were observed in the high-risk patients with IC + CCRT compared to those with IC + IMRT, while comparable outcomes between IC + IMRT and IC + CCRT were shown for low-risk patients. CONCLUSION: The radiomics-based nomogram can predict prognosis and survival benefits from concurrent chemotherapy for LANPC following IC. Low-risk patients determined by the nomogram may be potential candidates for omitting concurrent chemotherapy during IMRT. CLINICAL RELEVANCE STATEMENT: The radiomics-based nomogram was constructed for risk stratification and patient selection. It can help guide clinical decision-making for patients with locoregionally advanced nasopharyngeal carcinoma following induction chemotherapy, and avoid unnecessary toxicity caused by overtreatment. KEY POINTS: • The benefits from concurrent chemotherapy remained controversial for locoregionally advanced nasopharyngeal carcinoma following induction chemotherapy. • Radiomics-based nomogram achieved prognosis and benefits prediction of concurrent chemotherapy. • Low-risk patients defined by the nomogram were candidates for de-intensification.

The efficacy and safety of combined therapy with endobronchial tamponade and bronchial artery embolization for massive hemoptysis.

BACKGROUND: Massive hemoptysis is characterized by its life-threatening nature, potentially leading to airway obstruction and asphyxia. The objective of this study was to evaluate the clinical effectiveness of combining endobronchial tamponade with bronchial artery embolization (BAE) in the treatment of massive hemoptysis. METHODS: Between March 2018 and March 2022, a total of 67 patients with massive hemoptysis who underwent BAE were divided into two groups: the combination group (n = 26) and the BAE group (n = 41). Technical and clinical success rates were assessed, and adverse events were monitored following the treatment. Blood gas analysis and coagulation function indicators were collected before and after the treatment, and recurrence and survival rates were recorded during the follow-up period. RESULTS: All patients achieved technical success. There were no significant differences in the clinical success rate, recurrence rates at 3 and 6 months, and mortality rates at 3 months, 6 months, and 1 year between the combination group and the BAE group. However, the hemoptysis recurrence rate at 1 year was significantly lower in the combination group compared to the BAE group (15.4% vs. 39.0%, P = 0.039). No serious adverse events were reported in either group. After treatment, the combination group showed higher levels of arterial partial pressure of oxygen (PaO2), oxygenation index (PaO2/FiO2), fibrinogen (FIB), and D-dimer (D-D) compared to the BAE group (P < 0.05). Multivariate regression analysis demonstrated a significant correlation between combined therapy and hemoptysis-free survival. CONCLUSION: Combination therapy, compared to embolization alone, exhibits superior efficacy in improving respiratory function, correcting hypoxia, stopping bleeding, and preventing recurrence. It is considered an effective and safe treatment for massive hemoptysis.

Integrative Management of Chemotherapy-Related Fatigue in Lung Cancer Patients with the Traditional Chinese Medicine Guiqi Erxian.

Objective: To observe the efficacy of Guiqi Erxian granule on chemotherapy-related fatigue in patients with lung cancer treated with chemotherapy. Methods: A total of 76 lung cancer patients with chemotherapy-related fatigue as the main symptom from January 2017 to May 2018 were enrolled and randomly divided into a control group and a treatment group, n = 38/group. The patients in the control group received chemotherapy and basic treatment. The patients in the treatment group received oral Guiqi Erxian granule 20 g each time, three times daily, in addition to the chemotherapy and basic treatment. The brief fatigue inventory (BFI) scale, Cancer Fatigue Scale (CFS), chronic illness therapy fatigue scale, and traditional Chinese medicine (TCM) symptom scale were evaluated on 1 day before treatment, and on day 7 and day 14 of treatment. Adverse reactions were observed and recorded. Results: Compared to the control group, the total score and scores of each dimension of the BFI and CFS decreased in the treatment group; the effect on fatigue severity and fatigue impact scores in the BFI scale, and the emotional and physical dimension scores in the CFS were improved significantly (P < .05). Compared to the control group, except for the social/family well-being, the scores in the other dimensions of the chronic illness therapy-fatigue scale improved significantly (P < .05). Compared to the control group, the TCM syndrome score in the treatment group decreased significantly (P < .05). Conclusion: Guiqi Erxian granules can improve chemotherapy-related fatigue and quality of life in lung cancer patients receiving chemotherapy, with no obvious side effects, and can be explored as a potential treatment.

Evidence for Intermittent Theta Burst Transcranial Magnetic Stimulation for Dysphagia after Stroke: A Systematic Review and Meta-analysis.

Dysphagia is the most common serious complication after stroke, with an incidence of about 37-78%, which seriously affects the independence of patients in daily life and clinical recovery. Repetitive transcranial magnetic stimulation (rTMS), as a non-invasive neuromodulation technique, is an emerging option for post-stroke dysphagia. Theta burst stimulation (TBS) is a new mode of transcranial magnetic stimulation that simulates the frequency of pulses released in the hippocampus.Intermittent theta burst stimulation (iTBS) has been shown to increase cortical excitability and improve swallowing function in patients. Our study sought to summarize existing clinical randomized controlled trials to provide evidence-based medical evidence for the clinical use of iTBS. A computer search was conducted on 4 Chinese (Chinese Biomedical Literature Database, VIP Information Resource System, CNKI, and Wanfang Medical Science) and 4 English (including Cochrane Library, Embase, PubMed, Web of Science) databases to retrieve all randomized controlled trials in Chinese and English that explored the effects of Intermittent Theta Burst Stimulation for post-stroke dysphagia. The retrieval years are from database construction to 23 November 2023. The primary outcome measure was a change in Penetration/Aspiration Scale (PAS), Standardized Swallowing Assessment (SSA) and Functional Oral Intake Scale (FOIS), Secondary outcomes included Fiberoptic Endoscopic Dysphagia Severity Scale (FEDSS), water-swallowing test (WST) etc. A meta-analysis by Standardized Mean Difference (SMD) and 95% confidence interval (CI) was performed with RevMan 5.3. we appraise risk of bias(RoB) of each study with the Cochrane RoB tool. Detailed instructions for using the Cochrane RoB tool are provided in the Cochrane Handbook for Systematic Reviews of Interventions (The Cochrane Handbook). Nine studies were obtained from eight databases after screening by inclusion and exclusion criteria, 567 patients from 9 studies were included in the meta-analysis, and one study was included in the qualitative analysis due to different control groups. Two of the nine studies had an unclear risk of bias, and four studies were at low risk. The results showed that iTBS significantly improved SSA, PAS, FOIS, and PAS scores in stroke patients compared to the control group(P < 0.05), and promoted swallowing function recovery. Our systematic review provides the first evidence of the efficacy of iTBS in improving dysphagia in stroke patients. However, the number of available studies limits the persuasiveness of the evidence and further validation by additional randomized controlled trials is needed.

Spatiotemporal Acoustic Vortex Beams with Transverse Orbital Angular Momentum.

Recently, the discovery of optical spatiotemporal (ST) vortex beams with transverse orbital angular momentum (OAM) has attracted increasing attention and is expected to extend the research scope and open new opportunities for practical applications of OAM states. The ST vortex beams are also applicable to other physical fields that involve wave phenomena, and here we develop the ST vortex concept in the field of acoustics and report the generation of Bessel-type ST acoustic vortex beams. The ST vortex beams are fully characterized using the scalar approach for the pressure field and the vector approach for the velocity field. We further investigate the transverse spreading effect and construct ST vortex beams with an ellipse-shaped spectrum to reduce the spreading effect. We also experimentally demonstrated the orthogonality relations between ST vortex beams with different charges. Our study successfully demonstrates the versatility of the acoustic system for exploring and discovering spatiotemporally structured waves, inspiring further investigation of exotic wave physics.