The prognostic value of global myocardium strain by CMR-feature tracking in immune checkpoint inhibitor-associated myocarditis.

OBJECTIVES: Immune checkpoint inhibitor (ICI)-associated myocarditis is a potentially fatal complication. Sparse published researches evaluated the prognostic value of cardiovascular magnetic resonance feature tracking (CMR-FT) for ICI-associated myocarditis. METHODS: In the single-center retrospective study, 52 patients with ICI-associated myocarditis and CMR were included from August 2018 to July 2021. The ICI-associated myocarditis was diagnosed by using the clinical criteria of the European Society of Cardiology guidelines. Major adverse cardiovascular events (MACE) were comprised of cardiovascular death, cardiogenic shock, cardiac arrest, and complete heart block. RESULTS: During a median follow-up of 171 days, 14 (27%) patients developed MACE. For patients with MACE, the global circumferential strain (GCS), global radial strain (GRS), global longitudinal strain (GLS), and left ventricular ejection fraction (LVEF) were significantly worse and native T1 values and late gadolinium enhancement (LGE) extent were significantly increased, compared with patients without MACE (p < 0.05). The GLS remained the independent factor associated with a higher risk of MACE (hazard ratio (HR): 2.115; 95% confidence interval (CI): 1.379-3.246; p = 0.001) when adjusting for LVEF, LGE extent, age, sex, body mass index, steroid treatment, and prior cardiotoxic chemotherapy or radiation. After adjustment for LVEF, the GLS remained the independent risk factor associated with a higher rate of MACE among patients with a preserved LVEF (HR: 1.358; 95% CI: 1.007-1.830; p = 0.045). CONCLUSIONS: GLS could provide independent prognostic value over GCS, GRS, traditional CMR features, and clinical features in patients with ICI-associated myocarditis. KEY POINTS: • The global circumferential strain (GCS), global radial strain (GRS), and global longitudinal strain (GLS) by cardiovascular magnetic resonance feature tracking were significantly impaired in patients with an immune checkpoint inhibitor (ICI)-associated myocarditis. • GLS was still significantly impaired in patients with preserved left ventricular ejection fraction. • The worse GLS was an independent risk factor over GCS, GRS, traditional CMR features, and clinical features for predicting major adverse cardiovascular events in patients with ICI-associated myocarditis.

Hydrogen-bonded supramolecular conjugated polymer nanoparticles for white light-emitting devices.

Supramolecular polyfluorenol enable assembly into conjugated polymer nanoparticles (CPNs). Poly{9-[4-(octyloxy)phenyl]fluoren-9-ol-2,7-diyl} (PPFOH)-based supramolecular nanoparticles are prepared via reprecipitation. PPFOH nanoparticles with diameters ranging from 40 to 200 nm are obtained by adding different amounts of water into DMF solution. Size-dependent luminescence is observed in PPFOH-based hydrogen-bonded nanoparticles that is different from that of poly(9,9-dioctylfluorenes). Finally, white light-emitting devices using CPNs with a size of 80 nm exhibit white emission with the CIE coordinates (0.31, 0.34). Amphiphilic conjugated polymer nanoparticles are potential organic nano-inks for the fabrication of organic devices in printed electronics.

Clinical Outcomes of Severe Rhinosinusitis Complicated with Cavernous Sinus Syndrome.

Background: Various diseases involving the cavernous sinus can cause a condition called cavernous sinus syndrome (CSS), which is characterized by ophthalmoplegia or sensory deficits over the face resulting from the compression effect of internal structure. While tumor compression is the most reported cause of CSS, statistical data on CSS caused by infections are limited. Its risk factors, treatment methods, and clinical outcomes are not well-documented. Methods: In this retrospective study, we reviewed the data of patients admitted to a tertiary medical center from 2015 to 2022 with a diagnosis of acute and chronic sinusitis and at least one diagnostic code for CSS symptoms. We manually reviewed whether patients were involved in two or more of the following cranial nerves (CN): CN III, CN IV, CN V, or CN VI, or at least one of these nerves with a neuroimaging-confirmed lesion in the cavernous sinus. Results: Nine patients were diagnosed with rhinosinusitis-related CSS. The most common comorbidity was type 2 diabetes, and the most common clinical manifestations were diplopia and blurred vision. The sphenoid sinus was the most affected sinus. One patient expired due to a severe brain abscess infection without surgery. The remaining patients underwent functional endoscopic sinus surgery, and 50% of the pathology reports indicated fungal infections. Staphylococcus spp. was the most cultured bacteria, and Amoxycillin/Clavulanate was the most used antibiotic. Only four patients had total recovery during the follow-up one year later. Conclusions: CSS is a rare but serious complication of rhinosinusitis. Patients with diabetes and the elderly may be at a higher risk for this complication. Even after treatment, some patients may still have neurological symptoms.

Bottom-up synthesis of nanoscale conjugation-interrupted frameworks and their electrical properties.

Soluble covalent organic nanoframeworks up to generation 2.5 (G2.5) are synthesized with self-similar H-shaped conformations by using a bottom-up approach including iterative C-H bond functionalization. The electrical characteristics of nanoscale thin-film semiconductors of the conjugation-interrupted frameworks can be tuned by post-modification with diazonium salt.

Supramolecular luminescence from oligofluorenol-based supramolecular polymer semiconductors.

Supramolecular luminescence stems from non-covalent exciton behaviors of active π-segments in supramolecular entities or aggregates via intermolecular forces. Herein, a π-conjugated oligofluorenol, containing self-complementary double hydrogen bonds, was synthesized using Suzuki coupling as a supramolecular semiconductor. Terfluorenol-based random supramolecular polymers were confirmed via concentration-dependent nuclear magnetic resonance (NMR) and dynamic light scattering (DLS). The photoluminescent spectra of the TFOH-1 solution exhibit a green emission band (g-band) at approximately ~520 nm with reversible features, as confirmed through titration experiments. Supramolecular luminescence of TFOH-1 thin films serves as robust evidence for the aggregates of g-band. Our results suggest that the presence of polyfluorene ketone defects is a sufficient condition, rather than a sufficient-necessary condition for the g-band. Supramolecular electroluminescence will push organic devices into the fields of supramolecular optoelectronics, spintronics, and mechatronics.

Validation of an Automated Cardiothoracic Ratio Calculation for Hemodialysis Patients.

Cardiomegaly is associated with poor clinical outcomes and is assessed by routine monitoring of the cardiothoracic ratio (CTR) from chest X-rays (CXRs). Judgment of the margins of the heart and lungs is subjective and may vary between different operators. METHODS: Patients aged > 19 years in our hemodialysis unit from March 2021 to October 2021 were enrolled. The borders of the lungs and heart on CXRs were labeled by two nephrologists as the ground truth (nephrologist-defined mask). We implemented AlbuNet-34, a U-Net variant, to predict the heart and lung margins from CXR images and to automatically calculate the CTRs. RESULTS: The coefficient of determination (R2) obtained using the neural network model was 0.96, compared with an R2 of 0.90 obtained by nurse practitioners. The mean difference between the CTRs calculated by the nurse practitioners and senior nephrologists was 1.52 ± 1.46%, and that between the neural network model and the nephrologists was 0.83 ± 0.87% (p < 0.001). The mean CTR calculation duration was 85 s using the manual method and less than 2 s using the automated method (p < 0.001). CONCLUSIONS: Our study confirmed the validity of automated CTR calculations. By achieving high accuracy and saving time, our model can be implemented in clinical practice.

Applying quantitative CMR parameters for detecting myocardial lesion in immune checkpoint inhibitors-associated myocarditis.

PURPOSE: Sparse researches evaluated the quantitative cardiovascular magnetic resonance (CMR) parameters for immune checkpoint inhibitors (ICI)-associated myocarditis. We aimed to apply quantitative CMR mappings and late gadolinium enhancement (LGE) extent for detecting ICI-associated myocarditis. METHOD: The retrospective study included patients with ICI-associated myocarditis and CMR examination from August 2018 to August 2021 in our hospital. ICI-associated myocarditis was clinically diagnosed based on the clinical criteria by European Society of Cardiology guidelines. The multiparametric CMR images including T2 mapping and black blood T2-weighted images were used to evaluate myocardial edema. The myocardial edema ratio (ER) ≥ 2.0 was applied for determining myocardial edema on T2-weighted images. RESULTS: 56 patients with ICI-associated myocarditis were included. The global T2 value and native T1 value of patients with ICI-associated myocarditis were significantly higher than the reference ranges in our hospital (p < 0.05). The rate of elevated global T2 value (92%) was significantly higher than those of abnormal native T1 value (73%), ER (52%) and LGE presence (68%) in patients with ICI-associated myocarditis (p < 0.05). The LGE extent and left ventricular ejection fraction of patients with ICI-associated myocarditis were 10.38 ± 9.64% and 56.42 ± 8.54%, respectively. LGE extent inversely correlated with left ventricular ejection fraction (r = -0.38, p = 0.004) but positively correlated with native T1 value (r = 0.28, p < 0.04) and extracellular volume (r = 0.50, p = 0.001). CONCLUSIONS: T2 mapping could detect higher rate of patients with ICI-associated myocarditis than native T1 mapping, ER and LGE presence. LGE extent inversely correlated with left ventricular ejection fraction but positively correlated with native T1 value and extracellular volume in patients with ICI-associated myocarditis.

Halogen bonding in the co-crystallization of potentially ditopic diiodotetrafluorobenzene: a powerful tool for constructing multicomponent supramolecular assemblies.

Halogen bonding is emerging as a significant driving force for supramolecular self-assembly and has aroused great interest during the last two decades. Among the various halogen-bonding donors, we take notice of the ability of 1,4-diiodotetrafluorobenzene (1,4-DITFB) to co-crystallize with diverse halogen-bonding acceptors in the range from neutral Lewis bases (nitrogen-containing compounds, N-oxides, chalcogenides, aromatic hydrocarbons and organometallic complexes) to anions (halide ions, thio/selenocyanate ions and tetrahedral oxyanions), leading to a great variety of supramolecular architectures such as discrete assemblies, 1D infinite chains and 2D/3D networks. Some of them act as promising functional materials (e.g. fluorescence, phosphorescence, optical waveguide, laser, non-linear optics, dielectric and magnetism) and soft materials (e.g. liquid crystal and supramolecular gel). Here we focus on the supramolecular structures of multicomponent complexes and their related physicochemical properties, highlight representative examples and show clearly the main directions that remain to be developed and improved in this area. From the point of view of crystal engineering and supramolecular chemistry, the complexes summarized here should give helpful information for further design and investigation of the elusive category of halogen-bonding supramolecular functional materials.

Photophysical and Fluorescence Anisotropic Behavior of Polyfluorene ß-Conformation Films.

We demonstrate a systematic visualization of the unique photophysical and fluorescence anisotropic properties of polyfluorene coplanar conformation (ß-conformation) using time-resolved scanning confocal fluorescence imaging (FLIM) and fluorescence anisotropy imaging microscopy (FAIM) measurements. We observe inhomogeneous morphologies and fluorescence decay profiles at various micrometer-sized regions within all types of polyfluorene ß-conformational spin-coated films. Poly(9,9-dioctylfluorene-2,7-diyl) (PFO) and poly[4-(octyloxy)-9,9-diphenylfluoren-2,7-diyl]-co-[5-(octyloxy)-9,9-diphenylfluoren-2,7-diyl] (PODPF) ß-domains both have shorter lifetime than those of the glassy conformation for the longer effective conjugated length and rigid chain structures. Besides, ß-conformational regions have larger fluorescence anisotropy for the low molecular rotational motion and high chain orientation, while the low anisotropy in glassy conformational regions shows more rotational freedom of the chain and efficient energy migration from amorphous regions to ß-conformation as a whole. Finally, ultrastable ASE threshold in the PODPF ß-conformational films also confirms its potential application in organic lasers. In this regard, FLIM and FAIM measurements provide an effective platform to explore the fundamental photophysical process of conformational transitions in conjugated polymer.

Synthesis and Crystal Structure of Highly Strained [4]Cyclofluorene: Green-Emitting Fluorophore.

[4]Cyclo-9,9-dipropyl-2,7-fluorene ([4]CF) with the strain energy of 79.8 kcal/mol is synthesized in high quantum yield. Impressively, hoop-shaped [4]CF exhibits a green fluorescence emission around 512 nm offering a new explanation for the green band (g-band) in polyfluorenes. The solution-processed [4]CF-based organic light emitting diode (OLED) has also been fabricated with the a stronger green band emission. Strained semiconductors offer a promising approach to fabricating multifunctional optoelectronic materials in organic electronics and biomedicine.

Supramolecular Polymer-Molecule Complexes as Gain Media for Ultraviolet Lasers.

A novel supramolecular system comprising a complex of 9,9'-diphenyl-9H,9'H-2,2'-bifluorene-9,9'-diol (DPFOH) with poly(methyl methacrylate) (PMMA) is presented as an attractive system for optical gain in the ultraviolet. The analogue compound 9,9'-diphenyl-9H,9'H-2,2'-bifluorene (DPFO8) without an -OH substituent was synthesized alongside DPFOH to confirm the importance of its chemical structure to the thin-film microstructure. A hydrogen-bonding interaction allows the molecule such as DPFOH and a combination of DPFOH and PMMA to have an excellent solution-processed high quality coating film. In stark contrast to the DPFO8 system, we find that the addition of 1 wt % DPFOH to PMMA leads to spontaneous formation of a supramolecular complex via hydrogen bonding interactions, giving rise to a homogeneous film with relatively high photoluminescence quantum efficiency ∼38 (±5)%. The demonstration of ultraviolet laser action with peak wavelength emission at 385 nm provided further evidence of the high optical quality of the DPFOH/PMMA supramolecular complex films. The DPFOH/PMMA supramolecular complex has great potential for use in low-cost solution-processed optoelectronic devices.

[The role of first pass and delayed contrast-enhancement magnetic resonance imaging in patients with myocardial infarction].

OBJECTIVE: To evaluate the role of contrast-enhancement magnetic resonance imaging (CeMRI) in patients with myocardial infarction (MI). METHODS: There were twenty-three patients enrolled in this study. After dynamic observation, there were 20 patients who were diagnosed as MI. All those patients underwent coronary artery angiography and CeMRI. MRI was performed with a 1.5-T magnet (AVANTO, SIMENS). After tagged images were acquired, the patients received an intravenous bolus of 0.1 mmol/kg Gd-DTPA at a rate of 5 ml/s. A first-pass perfusion scan was acquired simultaneously with a bolus injection. A second bolus of 0.3 mmol/kg Gd-DTPA was given following the first-pass images. Delayed images were acquired 5 minutes after the second bolus by using an inversion-recovery prepared gated fast-gradient echo-pulse sequence. RESULTS: Hypoenhancement was seen in 20 patients at the first-pass perfusion at the myocardial infarction site, while hyperenhancement was seen at delayed CeMRI. Myocardial infarction area in delayed CeMRI was 16.58% +/- 9.73%, which was correlated positively with peak CK and cTnT (r = 0.821, P < 0.01 and r = 0.565, P < 0.05), respectively. The ejection fraction (EF) detected by MRI was 0.46 +/- 0.13, while the left ventricular EF (LVEF) detected by left ventriculography was 0.49 +/- 0.16. There was no difference between two parameters. CONCLUSIONS: CeMRI may play an important role in the diagnosis and prognosis of patients with MI.

Friedel-Crafts bottom-up synthesis of fluorene-based soluble luminescent organic nanogrids.

A series of fluorene-based grid molecules (so-called Grid fluorenes) have been synthesized by means of shape-supported cyclization, starting from H-shaped precursors via the alternative Friedel-Crafts reactions of fluorenols and Suzuki cross-coupling reactions with key cyclization yields up to 26%. Fluorenol approaches and nanogrids open a door to soluble one-, two-, or three-dimensional nanoporous polymers as next-generation polymer mechano-semiconductors facing a new era of consciousness.

Fluorene-based macromolecular nanostructures and nanomaterials for organic (opto)electronics.

Nanotechnology not only opens up the realm of nanoelectronics and nanophotonics, but also upgrades organic thin-film electronics and optoelectronics. In this review, we introduce polymer semiconductors and plastic electronics briefly, followed by various top-down and bottom-up nano approaches to organic electronics. Subsequently, we highlight the progress in polyfluorene-based nanoparticles and nanowires (nanofibres), their tunable optoelectronic properties as well as their applications in polymer light-emitting devices, solar cells, field-effect transistors, photodetectors, lasers, optical waveguides and others. Finally, an outlook is given with regard to four-element complex devices via organic nanotechnology and molecular manufacturing that will spread to areas such as organic mechatronics in the framework of robotic-directed science and technology.