Delayed cardiotoxicity following osimertinib therapy in non-small cell lung cancer: a unique case report.

This case report features a 62-year-old male with stage IB lung adenocarcinoma harboring an epidermal growth factor receptor exon 19 deletion, who underwent treatment with osimertinib following a left upper lobectomy and lymph node dissection. Despite a history of smoking and well-managed type 2 diabetes, the patient developed heart failure 18 months post-initiation of osimertinib therapy, marking one of the latest occurrences of heart failure following osimertinib treatment documented in limited literature. Cardiac MRI revealed significant left ventricular enlargement, lateral wall myocardial thinning, and localized myocardial fibrosis without perfusion defects, a finding not previously reported in literature. This case underscores the severe and unusual cardiac effects of osimertinib in patients with latent risk factors, highlighting the importance of vigilant cardiac monitoring and a multidisciplinary management approach.

Unraveling the mystery: congenital absence of the portal vein and its cardiac implications.

A 25-year-old male with tachycardia and right heart enlargement was diagnosed with atrial-ventricular nodal reentrant tachycardia (AVNRT) and successfully treated with radiofrequency ablation. Cardiac MRI confirmed right heart enlargement but ruled out cardiomyopathy. Further imaging revealed a rare congenital absence of the portal vein (CAPV) with an associated portosystemic shunt. This case highlights the importance of considering CAPV in unexplained cardiac symptoms and structural heart changes.

Microscopic Origins of the Distinct Mechanical Response of ABA and ABC Block Copolymer Nanostructures.

It has been commonly believed that the ordered thermoplastic elastomers formed by the ABC triblock copolymer should have better mechanical performance than that by the ABA counterpart due to the higher bridging fraction. However, the thermoplastic elastomer of ABA was often observed to perform better than that of ABC. To compare the performance of two kinds of thermoplastic elastomers and unveil the underlying microscopic mechanism, we have calculated their stress-strain curves using coarse-grained molecular dynamics simulations in conjunction with self-consistent field theory. It is revealed that the stretching degree of the bridging blocks and the network connectivity play important roles in determining the mechanical properties in addition to the bridging fraction. The higher degree in the stretching of bridging blocks and network connectivity of the structure formed by the ABA triblock copolymer enables its superior mechanical performance over the ABC block copolymer.

Anomalous right coronary artery originating from the left anterior descending artery with stenosis: a highlighted imaging observation.

This imaging observation underscores a rare single coronary artery anomaly, wherein the right coronary artery originates from the left anterior descending artery (LAD). The stenosis in the proximal LAD adds complexity, emphasizing the need for multidisciplinary evaluation and decision-making.

Reexamining the Emergence and Stability of the Square Cylinder Phase in Block Copolymers.

Recently, a few AB-type multiblock copolymers have been successfully designed to form stable square cylinder phase based on self-consistent field theory (SCFT) calculations. The previous works only identify the stability region of the square phase but not analyzing its stability, which is closely related to the free-energy landscape. In this work, we have reexamined the stability of the square phase in B 1 A 1 B 2 A 2 B 3 ${{{\rm B}}_{1}{{\rm A}}_{1}{{\rm B}}_{2}{{\rm A}}_{2}{{\rm B}}_{3}}$ linear pentablock and ( B 1 A B 2 )​ 5 ${({{\rm B}}_{1}{\rm A}{{\rm B}}_{2}{)}_{5}}$ star triblock copolymers by drawing the free-energy landscape with respect to the two dimensions of a rectangular unit cell. Our results demonstrate that the square phase continuously transfers to the rectangular phase as the degree of packing frustration is gradually released. Moreover, the prolate contour lines of the free-energy landscape indicate the weak stability of the square phase in the B 1 A 1 B 2 A 2 B 3 ${{{\rm B}}_{1}{{\rm A}}_{1}{{\rm B}}_{2}{{\rm A}}_{2}{{\rm B}}_{3}}$ copolymer. In contrast, the stability of the square phase is notably improved in the ( B 1 A B 2 )​ 5 ${({{\rm B}}_{1}{\rm A}{{\rm B}}_{2}{)}_{5}}$ copolymer due to its enhanced concentration of bridging configurations. Our work sheds light on the understanding of the stability of the square cylinder phase in block copolymers. Accordingly, we propose some possible strategies for further designing new AB-type block copolymer systems to obtain more stable square phase.

Enhanced dielectric permittivity of hierarchically double-gyroid nanocomposites via macromolecular engineering of block copolymers.

It is a challenging task to realize the periodically bicontinuous gyroid nanostructures of flexible nanocomposites with high loading of functionalized nanoparticles, which could exhibit high dielectric permittivity for energy storage and electronic devices. Herein, with the aid of the concept of macromolecular engineering, we propose novel nanocomposites, composed of A'(A''B)n miktoarm star copolymers and nanoparticles, to obtain a double-gyroid structure through self-consistent field theory coupled with density functional theory. By tailoring the architecture of this copolymer, a large window of the double-gyroid phase extending to a high loading concentration of nanoparticles is achieved, leading to a hierarchical structure of a percolation network of nanoparticles within the gyroid channels. Furthermore, the finite difference quasielectrostatic method is integrated to reveal an enhanced dielectric permittivity of the structured nanocomposites by increasing the loading concentration of nanoparticles. The simultaneous achievement of an ordered double-gyroid phase and high loading nanoparticles represents a crucial step toward the realization of fully three-dimensional network-like metamaterials via a rational molecular design of nanocomposites.

Isolated cardiac amyloidosis with normal interventricular septum thickness: a case report.

Cardiac amyloidosis presented with normal interventricular septum is an extremely rare entity, and diagnosis may be difficult. This report discusses a 44-year-old female who presented with worsening dyspnoea on exertion, orthopnoea, and lower-extremity oedema. Electrocardiogram depicted low voltage in limb leads and a pseudoinfarct pattern. Echocardiogram revealed biatrial dilatation without changes of ventricular chambers and restrictive filling physiology. A diagnosis of cardiac amyloidosis was considered. Cardiac MRI was pursued, showing delayed gadolinium enhancement, and this ultimately led to the myocardial biopsy confirming the diagnosis of cardiac amyloidosis. The case suggests that patients who present with heart failure of uncertain aetiology, amyloidosis could be a cause of cardiomyopathy despite the absence of "classical" echocardiographic features of amyloid deposition such as an increased interventricular septum thickness or"brilliant sparkled"appearance of the myocardium.

Hierarchically Chiral Nanostructures Self-Assembled from Nanoparticle Tethered Block Copolymers.

Chiral nanostructures of nanoparticle assemblies have attracted tremendous interest for their fascinating functional properties. Herein, through theoretical simulations, it is shown that nanoparticle tethered block copolymers can self-assemble into hierarchically chiral nanostructures. Twofold helices are formed in the hierarchically chiral nanostructures: the diblock copolymers form helical supercylinders while the nanoparticles arrange into chiral assemblies wrapped around the helical supercylinders. The hierarchically chiral nanostructures can be formed in a large parameter window. Circular dichroism calculations demonstrate that the coexistence of polymeric helices and chiral nanoparticle assemblies improves the chiroptical activity. These findings can provide guidelines for designing hierarchically ordered chiral nanostructures with advanced functional properties.

Spiral- and meridian-patterned spheres self-assembled from block copolymer/homopolymer binary systems.

Spiral nanostructures, mainly in the 2D form, have been observed in polymer self-assembly, while well-defined 3D spirals are rarely reported. Here we report that a binary system containing polypeptide-based block copolymers and homopolymers can self-assemble into well-defined spiral spheres (3D spirals), in which the homopolymers form the core and the copolymers form the spirals. Upon increasing the preparation temperature, meridian spheres were obtained. Mixing polypeptide block copolymers with opposite backbone chirality also leads to the formation of meridian spheres. In the meridian patterns, a tighter packing manner of the phenyl groups appended to the polypeptide blocks was observed, which is responsible for the spiral-to-meridian transitions. This work enriches the research of spiral assemblies and provides a facile route to switch chiral/achiral nanostructures by regulating the packing manner of the pendant groups.

Distinctive Dielectric Permittivity of Hierarchical Nanostructures with Ordered Nanoparticle Networks Self-Assembled from AB-g-NP/AC Block Copolymer Mixtures.

Directing nanoparticles into ordered organization in polymer matrix to improve macroscopic properties of nanocomposites remains a challenge. Herein, by means of theoretical simulations, we show the high permittivity of hybrid nanostructures designed with mixtures of AB block copolymer-grafted nanoparticles and lamella-forming AC diblock copolymers. The grafted nanoparticles self-assemble into parallel stripes or highly ordered networks in the lamellae of the AC diblock copolymers. The ordered nanoparticle networks, including honeycomb-like and kagomé networks, provide bending and conductive pathways for concentrating electric fields, which results in the improvement of the permittivity. We envisage that this strategy will open a gateway to prepare hierarchically ordered functional nanocomposites with distinctive dielectric properties.

2D Chiral Stripe Nanopatterns Self-Assembled from Rod-Coil Block Copolymers on Microstripes.

Chiral nanoarchitectures usually possess unique and intriguing properties. However, the construction of 2D chiral nanopatterns through polymer self-assembly is a challenge. Reported herein is the formation of chiral stripe nanopatterns through surface self-assembly of polypeptide-based rod-coil block copolymers on microstripes. The nanostripes align oblique to the boundary of the microstripes, resulting in the chirality of the nanopatterns. The chirality of the nanopatterns is closely related to the width of the microstripes, i.e., a narrower width results in higher chirality. Besides, the chiral sense of the nanopatterns can be regulated by the chirality of the polypeptide blocks. This work demonstrates the transmission of chirality from polymer to nanoarchitecture on a confined surface, which can guide the preparation of nanopatterns with tuned chiral features.

Distinctive Morphology Modifiers for Polymer Blends: Roles of Asymmetric Janus Nanoparticles during Phase Separation.

Janus nanoparticles (JPs), which are anisotropic nanoparticles with multiple constituting parts, have been recognized as superior compatibilizers for polymer-blend-based nanocomposites. However, so far, most studies focused on the effects of symmetric JPs on the phase separation dynamics of polymer blends, while the roles of asymmetric JPs during phase separation remain unclear. In this work, the phase separation dynamics of symmetric blends compatibilized by JPs with various compositions was studied by using dissipative particle dynamics (DPD) simulations. It was found that the blends compatibilized by asymmetric JPs tend to undergo morphological transitions from bicontinuous networks to droplets-in-matrix structures at the late stage of phase separation, which is due to the influence of asymmetric JPs on the energetically favored curvature of the interfaces between polymer domains. Such a mechanism is absent for symmetric JPs and other compatibilizers (e.g., triblock copolymers and homogeneous particles) because they lack the unique combination of chemical asymmetry with the particulate nature like the asymmetric JPs. Moreover, it was observed that the asymmetric JPs can stably localize at the interfaces and act as efficient compatibilizers only when the fraction of the minor constituent part exceeds a critical value. These findings not only shed light upon the roles of asymmetric JPs as compatibilizers but also indicate a promising strategy for designing polymer-blend-based nanocomposites with tailor-made structures.

Distinctive Optical Properties of Hierarchically Ordered Nanostructures Self-Assembled from Multiblock Copolymer/Nanoparticle Mixtures.

Hybrid materials with hierarchical nanostructures are of great interest for their advanced functions. However, the effect of the formation of hierarchical nanostructures on properties is not well understood. Here, through combining dissipative particle dynamics simulation and the finite-difference time-domain method, the optical properties of hierarchically ordered nanostructures formed by mixtures of A(BC)n multiblock copolymers and nanoparticles (NPs) are investigated. A series of hierarchically ordered nanostructures with multiple small-length-scale hybrid domains are obtained from the self-assembly of A(BC)n /NP. An increase and blueshift in optical absorption are observed when the number of small-length-scale hybrid domains increases. The small-length-scale hybrid domains enhance light scattering, which consequently contributes to the improved optical performance. These findings can yield guidelines for designing hierarchically ordered functional nanocomposites with light-harvesting characteristics.

Ordered Surface Nanostructures Self-Assembled from Rod-Coil Block Copolymers on Microspheres.

An ordered surface nanostructure endows materials advanced functions. However, fabricating ordered surface-patterned particles via the polymer self-assembly approach is a challenge. Here we report that poly(γ-benzyl-l-glutamate)-block-poly(ethylene glycol) rod-coil block copolymers are able to form uniform-surface micelles on polystyrene microspheres through a solution self-assembly approach. The size of the surface micelles can be varied by the molecular weight of the block copolymers. These surface micelles are arranged in a manner consistent with the Euler theorem. Most of the micelles are six-fold coordinated, and the number difference between the five-fold and the seven-fold coordination is 12. Simulations on model systems qualitatively reproduced the experimental findings and provided direct observations for the surface-patterned particles, including the polymer chain packing manner in surface micelles at the molecular level and the array feature of the surface micelles through 2D projections of the surface patterns.

Assembly of silica rods into tunable branched living nanostructures mediated by coalescence of catalyst droplets.

Branched nanostructures with tunable arm numbers were prepared through the assembly of silica rods mediated by coalescence of catalyst droplets on the end of the rods. The formed primary branched colloids retain living characteristics similar to the original ones, that is, they can further assemble into multilevel and hierarchical branched structures.

Distinct Photovoltaic Performance of Hierarchical Nanostructures Self-Assembled from Multiblock Copolymers.

We applied a multiscale approach coupling dissipative particle dynamics method with a drift-diffusion model to elucidate the photovoltaic properties of multiblock copolymers consisting of alternating electron donor and acceptor blocks. A series of hierarchical lamellae-in-lamellar structures were obtained from the self-assembly of the multiblock copolymers. A distinct improvement in photovoltaic performance upon the morphology transformation from lamella to lamellae-in-lamella was observed. The hierarchical lamellae-in-lamellar structures significantly enhanced exciton dissociation and charge carrier transport, which consequently contributed to the improved photovoltaic performance. On the basis of our theoretical calculations, the hierarchical nanostructures can achieve much enhanced energy conversion efficiencies, improved by around 25% compared with that of general ones, through structure modulation on the number and size of the small-length-scale domains via the molecular design of multiblock copolymers. Our findings are supported by recent experimental evidence and provide guidance for designing advanced photovoltaic materials with hierarchical structures.

Orthostatic hypotension and right heart failure as the initial manifestation of intravenous leiomyomatosis.

A 36-year-old woman, who had a history of myomectomy, presented with lightheadedness after changing position from sitting to standing and effort-related shortness of breath. Echocardiography demonstrated a hyperechoic elongated mobile mass extending from the inferior caval vein to the right atrium. The mass was surgically removed, and histological examination established the diagnosis of intravenous leiomyomatosis. This case caught the attention of our cardiology group to consider the diagnosis when an inferior caval vein or right atrium mass is found in a patient with a history of uterine leiomyomatosis.

Light-chain cardiac amyloidosis with neuropathy: a case report.

Light-chain amyloidosis is a relatively rare multisystem disorder. The disease often is normally difficult to diagnose due to its broad range of characters without specific symptoms. A 62-year-old male patient presented with heart failure after experiencing a long period of unexplained and untreated gastrointestinal symptoms. Clinical examination and laboratory findings indicated a systemic process with cardiac involvement. Echocardiography revealed concentric left ventricular hypertrophy with enhanced echogenicity and preserved ejection fraction. Rectum biopsy confirmed amyloid deposition. The side effect of delayed diagnosis on prognosis and the appropriate diagnostic strategy has been discussed.