A giant gastrointestinal stromal tumor revealed by a life-threatening hematemesis: A case report of a rare entity and a challenging management.

INTRODUCTION: Gastrointestinal stromal tumors (GIST) are the most common mesenchymal malignancies in the digestive tract. Despite the stomach being their site of predilection, only a few giant GISTs have been discovered in hypovolemic shock and require urgent surgery. CASE PRESENTATION: A 62-year-old patient was admitted for hematemesis. Initial examination revealed a compensated hemodynamic shock with a mass in the left hemi abdomen of 20 cm without signs of portal hypertension or peritonitis. After resuscitation, an abdominal CT scan was performed, showing an exophytic mass of the gastric antrum without local or distant lymph node involvement. Later, the patient went into hemodynamic shock, requiring vasoactive drugs. An urgent midline laparotomy was performed, revealing a 20-cm gastric GIST in the anterior wall of the antrum. Wedge resection was performed. The anatomopathological report confirmed the diagnosis of gastric GIST with a moderate risk of recurrence. The patient received adjuvant therapy for 3 years. No recurrence was detected. CLINICAL DISCUSSION: Bleeding gastric GISTs revealed by a hypovolemic shock is a rare yet critical scenario. Considering GISTs as an etiology of digestive bleeding in life-threatening cases requires a high index of clinical suspicion. Prompt intervention is vital to control hemostasis and ensure patient stability. CONCLUSION: Open surgery is mandatory for large bleeding GISTs. The surgical approach must be tailored to the tumor's specific location. Diligent execution of the surgical procedure is vital to prevent tumor rupture. Despite their size, these tumors have a favorable prognosis, enhanced by adjuvant therapy for moderate to high recurrence risk.

Nano-scale charge trapping memory based on two-dimensional conjugated microporous polymer.

There is a growing interest in new semiconductor nanostructures for future high-density high-performance flexible electronic devices. Two-dimensional conjugated microporous polymers (2D-CMPs) are promising candidates because of their inherent optoelectronic properties. Here, we are reporting a novel donor-acceptor type 2D-CMP based on Pyrene and Isoindigo (PI) for a potential nano-scale charge-trapping memory application. We exfoliated the PI polymer into ~ 2.5 nm thick nanoparticles (NPs) and fabricated a Metal-Insulator-Semiconductor (MIS) device with PI-NPs embedded in the insulator. Conductive AFM (cAFM) is used to examine the confinement mechanism as well as the local charge injection process, where ultrathin high-κ alumina supplied the energy barrier for confining the charge carrier transport. We have achieved a reproducible on-and-off state and a wide memory window (ΔV) of 1.5 V at a relatively small reading current. The device displays a low operation voltage (V < 1 V), with good retention (104 s), and endurance (103 cycles). Furthermore, a theoretical analysis is developed to affirm the measured charge carriers' transport and entrapment mechanisms through and within the fabricated MIS structures. The PI-NPs act as a nanoscale floating gate in the MIS-based memory with deep trapping sites for the charged carriers. Moreover, our results demonstrate that the synthesized 2D-CMP can be promising for future low-power high-density memory applications.

Transferable Ga2O3 Membrane for Vertical and Flexible Electronics via One-Step Exfoliation.

Transferable Ga2O3 thin film membrane is desirable for vertical and flexible solar-blind photonics and high-power electronics applications. However, Ga2O3 epitaxially grown on rigid substrates such as sapphire, Si, and SiC hinders its exfoliation due to the strong covalent bond between Ga2O3 and substrates, determining its lateral device configuration and also hardly reaching the ever-increasing demand for wearable and foldable applications. Mica substrate, which has an atomic-level flat surface and high-temperature tolerance, could be a good candidate for the van der Waals (vdW) epitaxy of crystalline Ga2O3 membrane. Beyond that, benefiting from the weak vdW bond between Ga2O3 and mica substrate, in this work, the Ga2O3 membrane is exfoliated and transferred to arbitrary flexible and adhesive tape, allowing for the vertical and flexible electronic configuration. This straightforward exfoliation method is verified to be consistent and reproducible by the transfer and characterization of thick (∼380 nm)/thin (∼95 nm) κ-phase Ga2O3 and conductive n-type ß-Ga2O3. Vertical photodetectors are fabricated based on the exfoliated Ga2O3 membrane, denoting the peak response at ∼250 nm. Through the integration of Ti/Au Ohmic contact and Ni/Ag Schottky contact electrode, the vertical photodetector exhibits self-powered photodetection behavior with a responsivity of 17 mA/W under zero bias. The vdW-bond-assisted exfoliation of the Ga2O3 membrane demonstrated here could provide enormous opportunities in the pursuit of vertical and flexible Ga2O3 electronics.

Three-dimensional hierarchically porous MoS2 foam as high-rate and stable lithium-ion battery anode.

Architected materials that actively respond to external stimuli hold tantalizing prospects for applications in energy storage, wearable electronics, and bioengineering. Molybdenum disulfide, an excellent two-dimensional building block, is a promising candidate for lithium-ion battery anode. However, the stacked and brittle two-dimensional layered structure limits its rate capability and electrochemical stability. Here we report the dewetting-induced manufacturing of two-dimensional molybdenum disulfide nanosheets into a three-dimensional foam with a structural hierarchy across seven orders of magnitude. Our molybdenum disulfide foam provides an interpenetrating network for efficient charge transport, rapid ion diffusion, and mechanically resilient and chemically stable support for electrochemical reactions. These features induce a pseudocapacitive energy storage mechanism involving molybdenum redox reactions, confirmed by in-situ X-ray absorption near edge structure. The extraordinary electrochemical performance of molybdenum disulfide foam outperforms most reported molybdenum disulfide-based Lithium-ion battery anodes and state-of-the-art materials. This work opens promising inroads for various applications where special properties arise from hierarchical architecture.

Interplay of mechanics and chemistry governs wear of diamond-like carbon coatings interacting with ZDDP-additivated lubricants.

Friction and wear reduction by diamond-like carbon (DLC) in automotive applications can be affected by zinc-dialkyldithiophosphate (ZDDP), which is widely used in engine oils. Our experiments show that DLC's tribological behaviour in ZDDP-additivated oils can be optimised by tailoring its stiffness, surface nano-topography and hydrogen content. An optimal combination of ultralow friction and negligible wear is achieved using hydrogen-free tetrahedral amorphous carbon (ta-C) with moderate hardness. Softer coatings exhibit similarly low wear and thin ZDDP-derived patchy tribofilms but higher friction. Conversely, harder ta-Cs undergo severe wear and sub-surface sulphur contamination. Contact-mechanics and quantum-chemical simulations reveal that shear combined with the high local contact pressure caused by the contact stiffness and average surface slope of hard ta-Cs favour ZDDP fragmentation and sulphur release. In absence of hydrogen, this is followed by local surface cold welding and sub-surface mechanical mixing of sulphur resulting in a decrease of yield stress and wear.

Interfacial memristors in Al-LaNiO3 heterostructures.

Memristive devices are promising circuit elements that enable novel computational approaches which go beyond the von-Neumann paradigms. Here by tuning the chemistry at the Al-LaNiO3 (LNO) interface, a metal-metal junction, we engineer good switching behavior with good electroresistance (ON-OFF resistance ratios of 100), and repeatable multiple resistance states. The active material responsible for such a behavior is a self-formed sandwich of an AlxOy layer at the interface obtained by grabbing oxygen by Al from LNO. Using aberration corrected electron microscopy and transport measurements, it is confirmed that the memristive hysteresis occurs due to the electric field driven O2- (or ) cycling between LNO (reservoir) and the interlayer, which drives the redox reactions forming and dissolving Al nanoclusters in the AlxOy matrix. This work provides clear insights into and details on precise oxygen control at such interfaces and can be useful for newer opportunities in oxitronics.