Optical Cooling of Dot-in-Crystal Halide Perovskites: Challenges of Nonlinear Exciton Recombination.

Highly efficient anti-Stokes (AS) photoluminescence (PL) is observed from halide perovskite quantum dots (QDs) due to their strong electron-phonon interactions. The AS PL is particularly intriguing, as it suggests the potential for semiconductor optical cooling if the external quantum efficiency approaches 100%. However, the PL quantum efficiency in QDs is primarily dominated by multiparticle nonradiative Auger recombination processes under intense photoexcitation, which impose limits on the optical cooling gain. Here, we investigate the Auger recombination of dot-in-crystal perovskites. We quantitatively estimate the maximum optical cooling gain and the corresponding excitation intensity. We further conducted optical cooling experiments and demonstrate a maximum photocooling of approximately 9 K from room temperature. Additionally, we confirmed that increasing the excitation intensity leads to a transition from photocooling to photoheating. These observations are consistent with our time-resolved measurements, offering insights into the potential and limitations of optical cooling in semiconductor QDs.

Prevalence and electrocardiographic and electrophysiological characteristics of idiopathic ventricular arrhythmias originating from the septal left ventricular summit.

INTRODUCTION: The left ventricular summit (LVS) is the highest point on the epicardial surface of the left ventricle. A part of the LVS that is located between the left coronary arteries (lateral-LVS) is one of the major sites of idiopathic ventricular arrhythmia (VA) origins. Some idiopathic epicardial VAs can be ablated at endocardial sites adjacent to the epicardial area septal to the lateral-LVS (septal-LVS). This study examined the prevalence and electrocardiographic and electrophysiological characteristics of septal-LVS VAs. METHODS: We studied consecutive patients with idiopathic VAs originating from the LVS (67 patients) and aortic root (93 patients). RESULTS: Based on the ablation results, among 67 LVS VAs, 54 were classified as lateral and 13 as septal-LVS VAs. As compared with the lateral-LVS VAs, the septal-LVS VAs were characterized by a greater prevalence of left bundle branch block with left inferior-axis QRS pattern, later precordial transition, lower R-wave amplitude ratio in leads III to II, lower Q-wave amplitude ratio in leads aVL to aVR, and later local ventricular activation time relative to the QRS onset during VAs (V-QRS) in the great cardiac vein. The electrocardiographic and electrophysiological characteristics of the septal-LVS VAs were similar to those of the aortic root VAs. However, the V-QRS at the successful ablation site was significantly later during the septal-LVS VAs than aortic root VAs (p < .0001). The precordial transition was significantly later during the septal-LVS VAs than aortic root VAs (p < .05). CONCLUSIONS: Septal-LVS VAs are considered a distinct subgroup of idiopathic VAs originating from the left ventricular outflow tract.

Emerging Role of Renal Sympathetic Denervation as an Adjunct Therapy to Atrial Fibrillation Ablation.

The central anatomical locus in the context of atrial fibrillation (AF) ablation has been the pulmonary veins. Despite the attainment of a modest long-term success rate through pulmonary vein isolation (PVI), the pursuit of achieving a therapeutic efficacy nearing a definitive cure has spurred an investigation into alternative strategies and anatomical loci beyond the pulmonary veins. Despite extensive exploration, none of these alternative targets have succeeded in establishing themselves as routine ablation sites comparable to the pulmonary veins. Consequently, there exists an imperative for further inquiry and refinement of ablation strategies to propel advancements within the domain of AF ablation, thereby augmenting patient outcomes. Simultaneously, the examination of the autonomic system's role in AF pathophysiology introduces an additional ablation target aimed at rectifying sympathovagal imbalance. This discourse presents a contemporary review of renal denervation (RDN) as an emergent and auspicious technique poised to complement PVI, thereby contributing substantively to the augmentation of long-term success within the ambit of AF rhythm-control strategies.

Prediction of patient-specific quality assurance for volumetric modulated arc therapy using radiomics-based machine learning with dose distribution.

PURPOSE: We sought to develop machine learning models to predict the results of patient-specific quality assurance (QA) for volumetric modulated arc therapy (VMAT), which were represented by several dose-evaluation metrics-including the gamma passing rates (GPRs)-and criteria based on the radiomic features of 3D dose distribution in a phantom. METHODS: A total of 4,250 radiomic features of 3D dose distribution in a cylindrical dummy phantom for 140 arcs from 106 clinical VMAT plans were extracted. We obtained the following dose-evaluation metrics: GPRs with global and local normalization, the dose difference (DD) in 1% and 2% passing rates (DD1% and DD2%) for 10% and 50% dose threshold, and the distance-to-agreement in 1-mm and 2-mm passing rates (DTA1 mm and DTA2 mm) for 0.5%/mm and 1.0%.mm dose gradient threshold determined by measurement using a diode array in patient-specific QA. The machine learning regression models for predicting the values of the dose-evaluation metrics using the radiomic features were developed based on the elastic net (EN) and extra trees (ET) models. The feature selection and tuning of hyperparameters were performed with nested cross-validation in which four-fold cross-validation is used within the inner loop, and the performance of each model was evaluated in terms of the root mean square error (RMSE), the mean absolute error (MAE), and Spearman's rank correlation coefficient. RESULTS: The RMSE and MAE for the developed machine learning models ranged from <1% to nearly <10% depending on the dose-evaluation metric, the criteria, and dose and dose gradient thresholds used for both machine learning models. It was advantageous to focus on high dose region for predicating global GPR, DDs, and DTAs. For certain metrics and criteria, it was possible to create models applicable for patients' heterogeneity by training only with dose distributions in phantom. CONCLUSIONS: The developed machine learning models showed high performance for predicting dose-evaluation metrics especially for high dose region depending on the metric and criteria. Our results demonstrate that the radiomic features of dose distribution can be considered good indicators of the plan complexity and useful in predicting measured dose evaluation metrics.

Tetrapodal Hole-Collecting Monolayer Materials Based on Saddle-Like Cyclooctatetraene Core for Inverted Perovskite Solar Cells.

Hole-collecting monolayers have greatly advanced the development of positive-intrinsic-negative perovskite solar cells (p-i-n PSCs). To date, however, most of the anchoring groups in the reported monolayer materials are designed to bind to the transparent conductive oxide (TCO) surface, resulting in less availability for other functions such as tuning the wettability of the monolayer surface. In this work, we developed two anchorable molecules, 4PATTI-C3 and 4PATTI-C4, by employing a saddle-like indole-fused cyclooctatetraene as a p-core with four phosphonic acid anchoring groups linked through propyl or butyl chains. Both molecules form monolayers on TCO substrates. Thanks to the saddle shape of a cyclooctatetraene skeleton, two of the four phosphonic acid anchoring groups were found to point upward, resulting in hydrophilic surfaces. Compared to the devices using 4PATTI-C4 as the hole-collecting monolayer, 4PATTI-C3-based devices exhibit a faster hole-collection process, leading to higher power conversion efficiencies of up to 21.7% and 21.4% for a mini-cell (0.1 cm2) and a mini-module (1.62 cm2), respectively, together with good operational stability. This work represents how structural modification of multipodal molecules could substantially modulate the functions of the hole-collecting monolayers after being adsorbed onto TCO substrates.

Tripodal Triazatruxene Derivative as a Face-On Oriented Hole-Collecting Monolayer for Efficient and Stable Inverted Perovskite Solar Cells.

Hole-collecting monolayers have drawn attention in perovskite solar cell research due to their ease of processing, high performance, and good durability. Since molecules in the hole-collecting monolayer are typically composed of functionalized π-conjugated structures, hole extraction is expected to be more efficient when the π-cores are oriented face-on with respect to the adjacent surfaces. However, strategies for reliably controlling the molecular orientation in monolayers remain elusive. In this work, multiple phosphonic acid anchoring groups were used to control the molecular orientation of a series of triazatruxene derivatives chemisorbed on a transparent conducting oxide electrode surface. Using infrared reflection absorption spectroscopy and metastable atom electron spectroscopy, we found that multipodal derivatives align face-on to the electrode surface, while the monopodal counterpart adopts a more tilted configuration. The face-on orientation was found to facilitate hole extraction, leading to inverted perovskite solar cells with enhanced stability and high-power conversion efficiencies up to 23.0%.

Temperature dependence of photoluminescence spectrum of single lead halide perovskite nanocrystals: Effect of size on the phase transition temperature.

Photoluminescence (PL) spectroscopy of individual semiconductor nanocrystals (NCs) is a powerful method for understanding the intrinsic optical properties of these materials. Here, we report the temperature dependence of the PL spectra of single perovskite FAPbBr3 and CsPbBr3 NCs [FA = HC(NH2)2]. The temperature dependences of the PL linewidths were mainly determined by the Fröhlich interaction between excitons and longitudinal optical phonons. For FAPbBr3 NCs, a redshift in the PL peak energy appeared between 100 and 150 K, which was because of the orthorhombic-to-tetragonal phase transition. We found that the phase transition temperature of FAPbBr3 NCs decreases with decreasing NC size.

Deep learning-based detection and classification of multi-leaf collimator modeling errors in volumetric modulated radiation therapy.

PURPOSE: The purpose of this study was to create and evaluate deep learning-based models to detect and classify errors of multi-leaf collimator (MLC) modeling parameters in volumetric modulated radiation therapy (VMAT), namely the transmission factor (TF) and the dosimetric leaf gap (DLG). METHODS: A total of 33 clinical VMAT plans for prostate and head-and-neck cancer were used, assuming a cylindrical and homogeneous phantom, and error plans were created by altering the original value of the TF and the DLG by ± 10, 20, and 30% in the treatment planning system (TPS). The Gaussian filters of σ = 0.5 $\sigma = 0.5$ and 1.0 were applied to the planar dose maps of the error-free plan to mimic the measurement dose map, and thus dose difference maps between the error-free and error plans were obtained. We evaluated 3 deep learning-based models, created to perform the following detections/classifications: (1) error-free versus TF error, (2) error-free versus DLG error, and (3) TF versus DLG error. Models to classify the sign of the errors were also created and evaluated. A gamma analysis was performed for comparison. RESULTS: The detection and classification of TF and DLG error were feasible for σ = 0.5 $\sigma = 0.5$ ; however, a considerable reduction of accuracy was observed for σ = 1.0 $\sigma = 1.0$ depending on the magnitude of error and treatment site. The sign of errors was detectable by the specifically trained models for σ = 0.5 $\sigma = 0.5$ and 1.0. The gamma analysis could not detect errors. CONCLUSIONS: We demonstrated that the deep learning-based models could feasibly detect and classify TF and DLG errors in VMAT dose distributions, depending on the magnitude of the error, treatment site, and the degree of mimicked measurement doses.

Exciton-Phonon and Trion-Phonon Couplings Revealed by Photoluminescence Spectroscopy of Single CsPbBr3 Perovskite Nanocrystals.

Lead halide perovskite nanocrystals (NCs) have outstanding photoluminescence (PL) properties and excellent potential for light-emitting diodes and single-photon sources. Here, we report the multiple-peak structures originating from excitons, trions, and biexcitons in low-temperature PL spectra of single CsPbBr3 NCs. We found fine-structure splitting in the PL peaks of bright excitons and biexcitons and also in the longitudinal-optical (LO)-phonon replicas of excitons. LO-phonon replicas of trions are clearly observed under strong photoexcitation, which do not show fine-structure splitting. From size-dependent analyses of these replicas, we clarified that both exciton-phonon and trion-phonon couplings become larger for smaller NCs and the coupling strengths of trions are larger than those of excitons in large NCs. These behaviors can be explained by the spatial distributions of the electron and hole wave functions in the NCs. Our findings provide essential information on electron-phonon couplings in perovskites and for the design of high-purity single-photon sources.

Biomechanical gait analysis for a hip disarticulation prosthesis: power source for the swing phase of a hip disarticulation prosthetic limb.

[Purpose] This study aimed to clarify the power source for the swing phase of a hip disarticulation prosthetic limb using biomechanical gait analysis. [Participants and Methods] In this cross-sectional study, six participants who underwent hip disarticulation and seven healthy adults were recruited. Their gaits were assessed using the three-dimensional motion analysis and four force plates. [Results] From pre-swing to initial swing, the angle of the lumbar spine's angle changed by 9° from the flexion to extension positions. However, the power of the lumbar spine was <0.003 W/kg for the entire gait cycle. The peak value of joint moment and hip joint power on the unaffected side were 1 nm/kg and 0.7 W/kg, respectively. From pre-swing to initial swing, the prosthetic limb is pushed forward by extension of the hip joint on the intact side, while the spine returns to the flexion direction. [Conclusion] The hip extension force on the unaffected side was the main force responsible for swinging out the prosthesis, not the lumbar vertebrae's force.

Changes in physical function of frail elderly females in the one-year long-term care prevention program.

[Purpose] This study investigated changes in the physical function of frail elderly females who participated in a long-term care prevention project for ≥1 year. [Participants and Methods] There were 125 females included. Measurement items were body mass index, 5-m maximum gait time, 5-m normal gait time, standing on one leg with eyes open, timed up and go test, and grip strength and measured every six months. [Results] Grip strength decreased significantly after six months and one year compared to that of the start. The other measurements had no significant differences at start, after six months, and after one year. [Conclusion] This study investigated changes in physical functions in the frail community-dwelling elderly females one year after starting in a long-term prevention care program. Consequently, after one year in the program, no change was noted in measurements, such as gait speed, but only grip strength decreased. Likely, the exercise program mainly targeted the lower limb muscles. Therefore, although functions mainly use the lower limbs, such as walking, may be maintained, those using the upper limbs may be affected by aging.

Association between knee function and kinesiophobia 6 months after anterior cruciate ligament reconstruction.

[Purpose] Kinesiophobia after anterior cruciate ligament reconstruction has been identified as an inhibitor of return to sports. This study aimed to clarify the relationship between kinesiophobia and knee function 6 months after anterior cruciate ligament reconstruction when the patient intends to return to sports. [Participants and Methods] A total of 66 patients who underwent primary anterior cruciate ligament reconstruction (mean age 17.3 ± 2.6 years, 17 males and 49 females, Tegner activity score ≥7) were included in the study. The 11-item version of Tampa scale of kinesiophobia was used to evaluate kinesiophobia 6 months postoperatively. Knee function was evaluated with knee extension muscle strength, tibial anterior displacement, heel buttock distance, heel height difference, anterior knee pain score, and single-leg hop test. The relationship between Tampa scale of kinesiophobia, patient characteristics, and knee function was investigated. [Results] A low Anterior knee pain score and low single-leg hop test, male gender, and age were significant factors associated with kinesiophobia. [Conclusion] Kinesiophobia was associated with a low anterior knee pain score and low single-leg hop test 6 months after anterior cruciate ligament reconstruction. Patients with a low single-leg hop test score or severe pain may need rehabilitation to reduce kinesiophobia.

A convenient method for assessing steady-state carrier density and lifetime in solar cell materials using pulse excitation measurements.

We describe the relation of the carrier lifetime of a light-absorber material determined with pulse-excitation time-resolved techniques to the steady-state carrier density and lifetime in a solar cell under continuous-wave excitation. Our approach constitutes a simple experimental examination of the excitation-fluence-dependent carrier lifetime of absorber materials. It provides the steady-state carrier density and lifetime under 1-sun solar illumination for metal halide perovskite solar cells. The determination of the steady-state carrier responses allows the clarification of optical and photovoltaic properties under 1-sun illumination and thus the identification of loss mechanisms in device performance. Model calculations are also provided to show how the carrier lifetime governs the luminescence quantum yields and open-circuit voltages. The calculations quantify a scaling law between a monomolecular recombination lifetime and an open-circuit voltage as a result of a combination of two density-dependent effects.

Luminescence Fine Structures in Single Lead Halide Perovskite Nanocrystals: Size Dependence of the Exciton-Phonon Coupling.

Lead halide perovskite nanocrystals (NCs) have superior photoluminescence (PL) properties, such as high PL quantum yields and wide PL wavelength tunability, for optoelectronic applications. Here, we report the PL spectra of single formamidinium lead halide perovskite FAPbX3 (X = Br, I) NCs examined by single-dot spectroscopy at low temperature. We found four PL peaks in the low-energy region below the strong exciton PL peak that originate from two longitudinal-optical (LO) phonon replicas of the exciton PL, biexcitons, and charged excitons (trions). The binding energies of the biexcitons and trions become larger as the NCs decrease in size. The LO phonon energies show no size dependence, but the Huang-Rhys factors, which reflect the strength of the exciton-phonon coupling, become larger for smaller NCs. Our findings provide important insights into the exciton properties of perovskite NCs.

LiNbO3 -Type Polar Antiferromagnet InVO3 Synthesized under High-Pressure Conditions.

The ambient pressure cation disordered InVO3 bixbyite has been predicted to form a GdFeO3 -type perovskite phase under high pressure and high temperature. Contrary to the expectation, InVO3 was found to crystallize in the polar LiNbO3 -type structure with a calculated spontaneous polarization as large as 74 µC cm-2 . Antiferromagnetic coupling of V3+ magnetic moments and a cooperative magnetic ground state below about 10 K coupled with a polar structure suggest an intriguing ground state of the novel LiNbO3 -type high-pressure InVO3 structure.

Evaluation of the tissue thickness of the supraspinatus and biceps long head tendons using ultrasound among elderly patients with unilateral adhesive capsulitis in the freezing phase.

[Purpose] This study aimed to clarify the changes in the tissue thickness of the abnormal supraspinatus and biceps long-head tendons among elderly patients to select the treatment targets and evaluate the treatment effects in the freezing phase of adhesive capsulitis. [Participants and Methods] Thirty-two elderly patients with unilateral shoulder pain underwent ultrasound of the supraspinatus and biceps long-head tendons, pain evaluation, and orthopedic testing. Both the supraspinatus and biceps long-head tendons were classified as normal, abnormal, and other groups. Participants with negative orthopedic test results were assigned the "normal group". Participants with positive orthopedic test results and resting and night pain were assigned the "abnormal group". Differences in tissue thickness were calculated from the differences between the symptomatic and non-symptomatic sides. [Results] The thickness of the supraspinatus and biceps long-head tendons was significantly higher in the abnormal than in the normal group. [Conclusion] This study clarified the changes in tissue thickness of the abnormal supraspinatus and biceps long-head tendons among elderly patients to select the treatment targets and assess the treatment effects in the freezing phase of adhesive capsulitis. The study results suggest the usefulness of ultrasound for selecting the treatment targets for analgesia and assessing the treatment efficacy in cases of adhesive-capsulitis freezing phase.

Differences in gait kinetics and kinematics between patients with rotating hinge knee and cruciate-retaining prostheses: a cross-sectional study.

[Purpose] Rotating hinge knee prostheses are often used in primary total knee arthroplasty. However, the biomechanics resulting from this treatment remain unexplored. This cross-sectional study compared patient data on gait kinetics and kinematics to assess the efficacy of primary total knee arthroplasty using a rotating hinge knee or other prostheses. [Participants and Methods] Thirty-three participants were assigned to the following groups: rotating hinge knee (n=7); cruciate-retaining prosthesis (n=7); untreated osteoarthritis (n=10); and young adults as a reference group (n=9). Participant data on biomechanical and spatiotemporal parameters were analyzed. [Results] The postoperative course of the rotating hinge knee group was not significantly longer than that of the cruciate-retaining prosthesis group. The knee varus angle and adduction moment of the rotating hinge knee group were significantly smaller than those of the untreated osteoarthritis group. Gait kinetics and kinematics were not different between the rotating hinge knee and cruciate-retaining prosthesis groups. [Conclusion] Participants who had undergone primary total knee arthroplasty with a rotating hinge knee prosthesis had worse preoperative conditions and demonstrated a similar postoperative gait as those who had undergone total knee arthroplasty with other prostheses. Our findings may be used to tailor rehabilitation programs for participants who have undergone total knee arthroplasty with a rotating hinge knee implant.

The Hybrid Neurosurgeon: The Japanese Experience.

OBJECTIVE: In Japan, hybrid neurosurgeons who perform both open surgical clipping as well as endovascular embolization for the treatment of intracranial aneurysms are common. Although many Japanese neurosurgeons can perform surgical clipping of middle cerebral artery aneurysms or internal carotid artery-posterior communicating artery aneurysms and coil embolization of cerebral aneurysms using simple techniques-only a limited number of neurosurgeons are able to perform surgical clipping and endovascular procedures for anterior communicating artery aneurysms, paraclinoid, or posterior circulation aneurysms using both treatment modalities equally and safely. MATERIALS AND METHODS: The senior author's personal experience of more than 500 cases each of surgical clipping and endovascular embolization over the past 25 years included 110 cases of basilar tip aneurysms and 104 cases of paraclinoid internal carotid artery (ICA) aneurysms. RESULTS: The safety and efficacy of both treatments appears to be the same, while the durability of surgical clipping is superior to that of endovascular embolization. Among the 110 basilar tip aneurysms, 18 patients were treated by surgical clipping and 94 were treated by endovascular embolization. The initial results of endovascular therapy seemed to be better than those of surgical clipping, although the rate of retreatment was higher. Among the 104 cases of paraclinoid ICA aneurysm, 23 patients were treated by surgical clipping and 81 were treated by endovascular embolization. The results of both treatments seemed to be same, while surgical clipping had apparently good long-term durability. Over the past 15 years, the frequency of surgical clipping for basilar tip aneurysms has decreased, and the procedure may eventually be abandoned for this type of aneurysm. However, surgical clipping still offers several advantages in the treatment of paraclinoid aneurysms. CONCLUSIONS: Hybrid neurosurgeons can make reasonable decisions concerning the choice of treatment for cerebral aneurysms, as they perform both treatments and understand the benefits and drawbacks of each modality.

Effect of A-Site Cation on Photoluminescence Spectra of Single Lead Bromide Perovskite Nanocrystals.

Lead halide perovskite (APbX3) nanocrystals exhibit photoluminescence (PL) with both wide wavelength tunability and high quantum efficiency. While the Pb-X6 octahedra mainly determines the near-band-edge optical properties and the A-site cation affects the structural stability, the role of the A-site cation in determining the optical properties is still unclear. Here, we report the PL properties of three types of lead bromide perovskite APbBr3 nanocrystals with different cations [A = HC(NH2)2+, CH3NH3+, and Cs+], as revealed by single-dot spectroscopy, and discuss the influence of the A-site cation on the PL spectrum. The nanocrystal size dependences of the PL energy and lifetime show no large variation with the species of the A-site cation. We find that the size of the A-site cation determines the coupling strength between electrons and longitudinal-optical phonons in the nanocrystal and thus affects the PL spectral shape, especially the low-energy tail.

Relationship between muscle echo intensity on ultrasound and isokinetic strength of the three superficial quadriceps femoris muscles in healthy young adults.

[Purpose] The purpose of this study was to clarify the relationship between muscle echo intensity measured with ultrasound and the isokinetic strength of each of the three superficial quadriceps femoris muscles in healthy young adults. [Participants and Methods] We measured the echo intensity of the three superficial muscles of the quadriceps femoris in 25 healthy adults (10 males and 15 females; mean age, 22.3 years) using ultrasound. Moreover, we obtained the maximum force during isokinetic knee extension at 60°/s using an isokinetic dynamometer. [Results] In males and females, a significant negative correlation between echo intensity and muscle strength was found in the VM (r=-0.65 and r=-0.63, respectively). [Conclusion] In both males and females, only the muscle echo intensity of the vastus medialis was found to have a negative correlation with the maximum force during isokinetic knee extension at 60°/s. Our data lay the foundation for simplifying and rationally performing the measurement of muscle echo intensity of the quadriceps femoris. And it would therefore be sufficient to only measure the VM to clarify a relationship between EI and maximum isokinetic force in the quadriceps.