Baseline Radiomic Signature to Estimate Overall Survival in Patients With NSCLC.

INTRODUCTION: We aimed to define a baseline radiomic signature associated with overall survival (OS) using baseline computed tomography (CT) images obtained from patients with NSCLC treated with nivolumab or chemotherapy. METHODS: The radiomic signature was developed in patients with NSCLC treated with nivolumab in CheckMate-017, -026, and -063. Nivolumab-treated patients were pooled and randomized to training, calibration, or validation sets using a 2:1:1 ratio. From baseline CT images, volume of tumor lesions was semiautomatically segmented, and 38 radiomic variables depicting tumor phenotype were extracted. Association between the radiomic signature and OS was assessed in the nivolumab-treated (validation set) and chemotherapy-treated (test set) patients in these studies. RESULTS: A baseline radiomic signature was identified using CT images obtained from 758 patients. The radiomic signature used a combination of imaging variables (spatial correlation, tumor volume in the liver, and tumor volume in the mediastinal lymph nodes) to output a continuous value, ranging from 0 to 1 (from most to least favorable estimated OS). Given a threshold of 0.55, the sensitivity and specificity of the radiomic signature for predicting 3-month OS were 86% and 77.8%, respectively. The signature was identified in the training set of patients treated with nivolumab and was significantly associated (p < 0.0001) with OS in patients treated with nivolumab or chemotherapy. CONCLUSIONS: The radiomic signature provides an early readout of the anticipated OS in patients with NSCLC treated with nivolumab or chemotherapy. This could provide important prognostic information and may support risk stratification in clinical trials.

Ultra-high vacuum cleaver for the preparation of ionic crystal surfaces.

Cleaving single crystals in situ under ultra-high vacuum conditions provides a reliable and straightforward approach to prepare clean and atomically well-defined surfaces. Here, we present a versatile sample cleaver to efficiently prepare ionic crystal surfaces under ultra-high vacuum conditions, which is suitable for preparation of softer materials, such as alkali halides, and harder materials, such as metal oxides. One of the advantages of the presented cleaver design is that the cleaving blade and anvil to support the crystal are incorporated into the device. Therefore, no particularly strong mechanical manipulator is needed, and it is compatible with existing vacuum chambers equipped with an xyz-manipulator. We demonstrate atomically flat terraces and the atomic structure of NaCl(001), KBr(001), NiO(001), and MgO(001) cleavage planes prepared in situ under ultra-high vacuum conditions and imaged by low-temperature non-contact atomic force microscopy.

Planar π-extended cycloparaphenylenes featuring an all-armchair edge topology.

The [n]cycloparaphenylenes ([n]CPPs)-n para-linked phenylenes that form a closed-loop-have attracted substantial attention due to their unique cyclic structure and highly effective para-conjugation leading to a myriad of fascinating electronic and optoelectronic properties. However, their strained topology prevents the π-extension of CPPs to convert them either into armchair nanobelts or planarized CPP macrocycles. Here we successfully tackle this long-standing challenge and present the bottom-up synthesis and characterization of atomically precise in-plane π-extended [12]CPP on Au(111) by low-temperature scanning probe microscopy and spectroscopy combined with density functional theory. The planar π-extended CPP is a nanographene with an all-armchair edge topology. The exclusive para-conjugation at the periphery yields delocalized electronic states and the planarization maximizes the overlap of p orbitals, which both reduce the bandgap compared to conventional CPPs. Calculations predict ring currents and global aromaticity in the doubly charged system. The intriguing planar ring topology and unique electronic properties make planar π-extended CPPs promising quantum materials.

Host guest chemistry and supramolecular doping in triphenylamine-based covalent frameworks on Au(111).

The post-synthetic modification of covalent organic frameworks (COFs) via host-guest chemistry is an important method to tailor their electronic properties for applications. Due to the limited structural control in the assembly of two-dimensional surface-supported COFs, supramolecular networks are traditionally used at present for host-guest experiments on surfaces, which lack structural and thermal stability, however. Here, we present a combined scanning tunneling microscopy and density functional theory study to understand the host-guest interaction in triphenylamine-based covalently-linked macrocycles and networks on Au(111). These triphenylamine-based structures feature carbonyl and hydrogen functionalized pores that create preferred adsorption sites for trimesic acid (TMA) and halogen atoms. The binding of the TMA through optimized hydrogen-bond interactions is corroborated by selective adsorption positions within the pores. Band structure calculations reveal that the strong intermolecular charge transfer through the TMA bonding reduces the band gap in the triphenylamine COFs, demonstrating the concept of supramolecular doping by host-guest interactions in surface-supported COFs. Halogen atoms selectively adsorb between two carbonyl groups at Au hollow sites. The mainly dispersive interaction of the halogens with the triphenylamine COF leads to a small downshift of the bands. Most of the halogens change their adsorption position selectively upon annealing near the desorption temperature. In conclusion, we demonstrate evidence for supramolecular doping via post-synthetic modification and to track chemical reactions in confined space.

Metalated Graphyne-Based Networks as Two-Dimensional Materials: Crystallization, Topological Defects, Delocalized Electronic States, and Site-Specific Doping.

Graphyne-based two-dimensional (2D) carbon allotropes feature extraordinary physical properties; however, their synthesis as crystalline single-layered materials has remained challenging. We report on the fabrication of large-area organometallic Ag-bis-acetylide networks and their structural and electronic properties on Ag(111) using low-temperature scanning tunneling microscopy combined with density functional theory (DFT) calculations. The metalated graphyne-based networks are robust at room temperature and assembled in a bottom-up approach via surface-assisted dehalogenative homocoupling of terminal alkynyl bromides. Large-area networks of several hundred nanometers with topological defects at domain boundaries are obtained due to the Ag-acetylide bonds' reversible nature. The thermodynamically controlled growth mechanism is explained through the direct observation of intermediates, which differ on Ag(111) and Au(111). Scanning tunneling spectroscopy resolved unoccupied states delocalized across the network. The energy of these states can be shifted locally by the attachment of a different number of Br atoms within the network. DFT revealed that free-standing metal-bis-acetylide networks are semimetals with a linear band dispersion around several high-symmetry points, which suggest the presence of Weyl points. These results demonstrate that the organometallic Ag-bis-acetylide networks feature the typical 2D material properties, which make them of great interest for fundamental studies and electronic materials in devices.

On-Surface Assembly of Hydrogen- and Halogen-Bonded Supramolecular Graphyne-Like Networks.

Demonstrated here is a supramolecular approach to fabricate highly ordered monolayered hydrogen- and halogen-bonded graphyne-like two-dimensional (2D) materials from triethynyltriazine derivatives on Au(111) and Ag(111). The 2D networks are stabilized by N⋅⋅⋅H-C(sp) bonds and N⋅⋅⋅Br-C(sp) bonds to the triazine core. The structural properties and the binding energies of the supramolecular graphynes have been investigated by scanning tunneling microscopy in combination with density-functional theory calculations. It is revealed that the N⋅⋅⋅Br-C(sp) bonds lead to significantly stronger bonded networks compared to the hydrogen-bonded networks. A systematic analysis of the binding energies of triethynyltriazine and triethynylbenzene derivatives further demonstrates that the X3 -synthon, which is commonly observed for bromobenzene derivatives, is weaker than the X6 -synthon for our bromotriethynyl derivatives.

Prevention of Progression of Lipedema With Liposuction Using Tumescent Local Anesthesia: Results of an International Consensus Conference.

BACKGROUND: Lipedema is a chronic, progressive disorder of subcutaneous adipose tissue that usually affects the lower extremities of women. Also known as "two-body syndrome," the fat accumulations in lipedema are unsightly and painful. The disorder is well-known in Europe but is largely unrecognized and underdiagnosed in the United States. OBJECTIVE: To hold the First International Consensus Conference on Lipedema with the purpose of reviewing current European guidelines and the literature regarding the long-term benefits that have been reported to occur after lymph-sparing liposuction for lipedema using tumescent local anesthesia. METHODS: International experts on liposuction for lipedema were convened as part of the First International Congress on Lipedema in Vienna, Austria, June 9 to 10, 2017. RESULTS: Multiple studies from Germany have reported long-term benefits for as long as 8 years after liposuction for lipedema using tumescent local anesthesia. CONCLUSION: Lymph-sparing liposuction using tumescent local anesthesia is currently the only effective treatment for lipedema.

On-Surface Synthesis of Porous Carbon Nanoribbons on Silver: Reaction Kinetics and the Influence of the Surface Structure.

We report on the influence of the surface structure and the reaction kinetics in the bottom-up fabrication of porous nanoribbons on silver surfaces using low-temperature scanning tunneling microscopy. The porous carbon nanoribbons are fabricated by the polymerization of 1,3,5-tris(3-bromophenyl)benzene directly on the Ag surface using an Ullmann-type reaction in combination with dehydrogenative coupling reactions. We demonstrate the successful on-surface synthesis of porous nanoribbons on Ag(111) and Ag(100) even though the self-assemblies of the intermediate organometallic structures and covalently-linked polymer chains are different on both surfaces. Furthermore, we present the formation of isolated porous nanoribbons by kinetic control. Our results give valuable insights into the role of substrate-induced templating effects and the reaction kinetics in the on-surface synthesis of conformationally flexible molecules.

Coordination-Controlled C-C Coupling Products via ortho-Site C-H Activation.

The coordination-restricted ortho-site C-H bond activation and dehydrogenative homocoupling of 4,4'-(1,3-phenylene)dipyridine (1,3-BPyB) and 4,4'-(1,4-phenylene)dipyridine (1,4-BPyB) on different metal surfaces were studied by a combination of scanning tunneling microscopy, noncontact atomic force microscopy, and density functional theory calculations. The coupling products on Cu(111) exhibited certain configurations subject to the spatial restriction of robust two-fold Cu-N coordination bonds. Compared to the V-shaped 1,3-BPyB, the straight backbone of 1,4-BPyB helped to further reduce the variety of reactive products. By utilizing the three-fold coordination of Fe atoms with 1,4-BPyB molecules on Au(111), a large-scale network containing single products was constructed. Our results offer a promising protocol for controllable on-surface synthesis with the aid of robust coordination interactions.

Dehydrative π-extension to nanographenes with zig-zag edges.

Zig-zag nanographenes are promising candidates for the applications in organic electronics due to the electronic properties induced by their periphery. However, the synthetic access to these compounds remains virtually unexplored. There is a lack in efficient and mild strategies origins in the reduced stability, increased reactivity, and low solubility of these compounds. Herein we report a facile access to pristine zig-zag nanographenes, utilizing an acid-promoted intramolecular reductive cyclization of arylaldehydes, and demonstrate a three-step route to nanographenes constituted of angularly fused tetracenes or pentacenes. The mild conditions are scalable to gram quantities and give insoluble nanostructures in close to quantitative yields. The strategy allows the synthesis of elusive low bandgap nanographenes, with values as low as 1.62 eV. Compared to their linear homologues, the structures have an increased stability in the solid-state, even though computational analyses show distinct diradical character. The structures were confirmed by X-ray diffraction or scanning tunneling microscopy.

Assessing the function of pneumococcal neuraminidases NanA, NanB and NanC in in vitro and in vivo lung infection models using monoclonal antibodies.

Streptococcus pneumoniae isolates express up to three neuraminidases (sialidases), NanA, NanB and NanC, all of which cleave the terminal sialic acid of glycan-structures that decorate host cell surfaces. Most research has focused on the role of NanA with limited investigations evaluating the roles of all three neuraminidases in host-pathogen interactions. We generated two highly potent monoclonal antibodies (mAbs), one that blocks the enzymatic activity of NanA and one cross-neutralizing NanB and NanC. Total neuraminidase activity of clinical S. pneumoniae isolates could be inhibited by this mAb combination in enzymatic assays. To detect desialylation of cell surfaces by pneumococcal neuraminidases, primary human tracheal/bronchial mucocilial epithelial tissues were infected with S. pneumoniae and stained with peanut lectin. Simultaneous targeting of the neuraminidases was required to prevent desialylation, suggesting that inhibition of NanA alone is not sufficient to preserve terminal lung glycans. Importantly, we also found that all three neuraminidases increased the interaction of S. pneumoniae with human airway epithelial cells. Lectin-staining of lung tissues of mice pre-treated with mAbs before intranasal challenge with S. pneumoniae confirmed that both anti-NanA and anti-NanBC mAbs were required to effectively block desialylation of the respiratory epithelium in vivo. Despite this, no effect on survival, reduction in pulmonary bacterial load, or significant changes in cytokine responses were observed. This suggests that neuraminidases have no pivotal role in this murine pneumonia model that is induced by high bacterial challenge inocula and does not progress from colonization as it happens in the human host.

Binary supramolecular networks of bridged triphenylamines with different substituents and identical scaffolds.

Based on scanning tunneling microscopy experiments combined with density functional theory, we report the formation and the electronic structure of porous binary supramolecular networks on Au(111). The two triphenylamine derivatives with identical scaffolds intermix due to a maximization of the overall number of H-bonds instead of an optimization of the H-bond strength in the bonding motif. The HOMO-LUMO gap is defined by both molecules, which is typical for electron donor-acceptor networks.

Two-dimensional delocalized states in organometallic bis-acetylide networks on Ag(111).

The electronic structure of surface-supported organometallic networks with Ag-bis-acetylide bonds that are intermediate products in the bottom-up synthesis of graphdiyne and graphdiyne-like networks were studied. Scanning tunneling microscopy (STM) and spectroscopy (STS) reveal a frontier, unoccupied electronic state that is delocalized along the entire organometallic network and proves the covalent nature of the Ag-bis-acetylide bonds. Density-functional theory (DFT) calculations corroborate the spatial distribution of the observed delocalized state and attribute it to band mixing of carbon and silver atoms combined with n-doping of the metal surface. The metal-bis-acetylide bonds are typical metal-organic bonds with mixed character containing covalent and strong ionic contributions. Moreover, the organometallic networks exhibit a characteristic graphene-like band structure with linear band dispersion at each K point.

On-Surface Synthesis of Porous Carbon Nanoribbons from Polymer Chains.

We demonstrate the on-surface synthesis of porous carbon nanoribbons on Ag(111) via a preprogrammed isomerization of conformationally flexible polymer chains followed by dehydrogenation reactions using thermal annealing. The carbon chains are fabricated by polymerization of prochiral 1,3,5-tris(3-bromophenyl)benzene (mTBPB) directly on the surface using an Ullmann-type reaction. At room temperature, mTBPB partially self-assembles in halogen-bonded 2D networks, which transform into organometallic chains and rings after debromination. The chain and ring formation is facilitated by conformational switching from a C3h to Cs symmetry of mTBPB via rotation of m-phenylene units. The high conformational selectivity toward Cs-conformers is templated by the twofold coordination to Ag adatoms. After thermally induced covalent-linking through aryl-aryl coupling, well-ordered nanoporous chains are created. Finally, the rotation of single phenylene units in combination with dehydrogenation cross-linking reactions within the polymer chains leads to the unexpected formation of porous carbon nanoribbons. We unveil the reaction mechanism in a low-temperature scanning tunneling microscopy study and demonstrate that the rotation of m-phenylene units is a powerful design tool to promote structural control in the synthesis of cyclic covalent organic nanostructures on metal surfaces.

Hierarchical on-surface synthesis and electronic structure of carbonyl-functionalized one- and two-dimensional covalent nanoarchitectures.

The fabrication of nanostructures in a bottom-up approach from specific molecular precursors offers the opportunity to create tailored materials for applications in nanoelectronics. However, the formation of defect-free two-dimensional (2D) covalent networks remains a challenge, which makes it difficult to unveil their electronic structure. Here we report on the hierarchical on-surface synthesis of nearly defect-free 2D covalent architectures with carbonyl-functionalized pores on Au(111), which is investigated by low-temperature scanning tunnelling microscopy in combination with density functional theory calculations. The carbonyl-bridged triphenylamine precursors form six-membered macrocycles and one-dimensional (1D) chains as intermediates in an Ullmann-type coupling reaction that are subsequently interlinked to 2D networks. The electronic band gap is narrowed when going from the monomer to 1D and 2D surface-confined π-conjugated organic polymers comprising the same building block. The significant drop of the electronic gap from the monomer to the polymer confirms an efficient conjugation along the triphenylamine units within the nanostructures.

Triethynylmethanol Derivatives: Stable Acetylenic Building Blocks for Surface Chemistry.

The synthesis of non-conjugated, carbon-rich building blocks is described, based on a basic scaffold of triethynylmethanol (TEtM). The substitution of the ethynyl groups can be easily varied (including R3 Si, H, Br), and this allows structural tuning for stabilization, synthetic derivatization, and adsorption on Ag(111) or Au(111). X-ray crystallography helps to explain the surprising stability of the selected derivatives in the solid state, and an unusual form of hydrogen bonding is identified from these analyses. Preliminary efforts to achieve surface-based reactions on Ag(111) and Au(111) are outlined experimentally and computationally.

Growth and Structure of the First Layers of Ice on Ru(0001) and Pt(111).

Scanning tunneling microscopy was used to probe the structure and growth of the first few layers of water on Ru(0001) and Pt(111) at the molecular level. The surface-bound first layer is composed of a mixture of water molecules forming hexagonal structures, both in registry and out-of-registry with the substrate atoms. The hexagons are connected by pentagonal and heptagonal units. At temperatures below 140 K, this layer structure gives rise to the growth of metastable amorphous structures in the second and higher layers. We found that in the transition from amorphous to crystalline ice the structure of the original bottom layer changes to one in perfect local registry with the hexagonal surfaces of Ru(0001) and Pt(111). We further discovered structural defects in the form of extended one-dimensional lines of five- and eight-membered rings that are domain boundaries and stacking faults in the growing ice layers, which lead to the formation of metastable cubic ice.

How Does Water Wet a Surface?

The adsorption and reactions of water on surfaces has attracted great interest, as water is involved in many physical and chemical processes at interfaces. On metal surfaces, the adsorption energy of water is comparable to the hydrogen bond strength in water. Therefore, the delicate balance between the water-water and the water-metal interaction strength determines the stability of water structures. In such systems, kinetic effects play an important role and many metastable states can form with long lifetimes, such that the most stable state may not reached. This has led to difficulties in the theoretical prediction of water structures as well as to some controversial results. The direct imaging using scanning tunneling microscopy (STM) in ultrahigh vacuum at low temperatures offers a reliable means of understanding the local structure and reaction of water molecules, in particular when interpreted in conjunction with density functional theory calculations. In this Account, a selection of recent STM results on the water adsorption and dissociation on close-packed metal surfaces is reviewed, with a particular focus on Ru(0001). The Ru(0001) surface is one where water adsorbs intact in a metastable state at low temperatures and where partially dissociated layers are formed at temperatures above ∼150 K. First, we will describe the structure of intact water clusters starting with the monomer up to the monolayer. We show that icelike wetting layers do not occur on close-packed metal surfaces but instead hydrogen bonded layers in the form of a mixture of pentagonal, hexagonal, and heptagonal molecular rings are observed. Second, we will discuss the dissociation mechanism of water on Ru(0001). We demonstrate that water adsorption changes from dissociative to molecular as a function of the oxygen preadsorbed on Ru. Finally, we briefly review recent STM experiments on bulk ice (Ih and Ic) and water adsorption on insulating thin films. We conclude with an outlook illustrating the manipulation capabilities of STM in respect to probe the proton and hydrogen dynamics in water clusters.