Enormous and Tunable Bulk Charge/Spin Photovoltaic Effect in Piezoelectric Binary Materials T-IV-VI and T-V-V.

Understanding the nonlinear response of light and materials is crucial for fundamental physics and next-generation electronic devices. In this work, we have investigated the second-order nonlinear bulk photovoltaic (BPV) and bulk spin photovoltaic (BSPV) effects in the piezoelectric binary materials T-IV-VI and T-V-V (IV = Ge, Sn; VI = S, Se; and V = P, As, Sb, Bi). The independent nonzero conductivity tensors of charge current are derived for these binaries through the symmetry analysis, along with the mechanism for generating pure spin current. These binaries, with their unique folded structure, exhibit significant charge and spin currents under illumination. Furthermore, we find that strain engineering can effectively modulate charge/spin currents by influencing charge density distribution and built-in electric field due to the piezoelectric effect. Our research suggests that the piezoelectric binary materials possess enormous and tunable charge/spin currents, underscoring their potential for applications in nonlinear flexible optoelectronics and spintronics.

Predictive Value of Nutritional Risk for All-Cause Death and Functional Outcomes in Chinese Elderly Patients with Acute Stroke: A 3-Year Follow-Up Study.

Purpose: To explore the predictive value of nutritional risk for all-cause death and functional outcomes among elderly acute stroke patients. Patients and Methods: A total of 479 elderly acute stroke patients were enrolled in this study. The nutritional risk of patients was screened by the GNRI and NRS-2002. The primary outcome was all-cause death, and the secondary outcome was poor prognosis defined as a modified Rankin Scale (mRS) score ≥3. Results: Based on the NRS-2002, patients with nutritional risk had a higher risk of all-cause death at 3 months (adjusted OR: 3.642, 95% CI 1.046~12.689) and at 3 years (adjusted OR: 2.266, 95% CI 1.259~4.076) and a higher risk of adverse functional outcomes at 3 months (adjusted OR: 2.748, 95% CI 1.518~4.972. Based on the GNRI, compared to those without nutritional risk, patients with mild malnutrition also had a higher risk of all-cause death at 3 months (adjusted OR: 7.186, 95% CI 1.550~33.315) and at 3 years (adjusted OR: 2.255, 95% CI 1.211~4.199) and a higher risk of adverse functional outcomes at 3 months (adjusted OR: 1.947, 95% CI 1.030~3.680), so patients with moderate and severe malnutrition had a higher risk of all-cause death at 3 months (adjusted OR: 6.535, 95% CI 1.380~30.945) and at 3 years (adjusted OR: 2.498, 95% CI 1.301~4.799) and a higher risk of adverse functional outcomes at 3 months (adjusted OR: 2.213, 95% CI 1.144~4.279). Conclusion: Nutritional risk increases the risk of poor short-term and long-term outcomes in elderly patients with acute stroke. For elderly stroke patients, we should pay attention to early nutritional risk screening, and effective intervention should be provided to improve the prognosis of such patients.

The utility of Vision Transformer in preoperatively predicting microvascular invasion status of hepatocellular carcinoma.

BACKGROUND: Microvascular invasion (MVI) is a risk factor for early recurrence and poor prognosis of hepatocellular carcinoma (HCC). Preoperative assessment of MVI status is beneficial for clinical therapy and prognosis evaluation. METHODS: A total of 305 surgically resected patients were included retrospectively. All recruited patients underwent plain and contrast-enhanced abdominal CT. They were then randomly divided into training and validation sets in a ratio of 8:2. Self-attention-based ViT-B/16 and ResNet-50 analyzed CT images to predict MVI status preoperatively. Then, Grad-CAM was used to generate an attention map showing the high-risk MVI patches. Using five-fold cross validation, the performance of each model was evaluated. RESULTS: Among 305 HCC patients, 99 patients were pathologically MVI-positive and 206 were MVI-negative. ViT-B/16 with fusion phase predicted the MVI status with an AUC of 0.882 and an accuracy of 86.8% in the validation set, which is similar to ResNet-50 with an AUC of 0.875 and an accuracy of 87.2%. The fusion phase improved performance a bit as compared to the single phase used for MVI prediction. The influence of peritumoral tissue on predictive ability was limited. A color visualization of the suspicious patches where microvascular has invaded was presented by attention maps. CONCLUSION: ViT-B/16 model can predict preoperative MVI status in CT images of HCC patients. Assisted by attention maps, it can assist patients in making tailored treatment decisions.

Fasting blood glucose-to-glycated hemoglobin ratio and all-cause mortality among Chinese in-hospital patients with acute stroke: a 12-month follow-up study.

BACKGROUND: Stroke is a leading cause of death and functional impairment in older people. To assess the prospective association between fasting blood glucose-to-glycated hemoglobin ratio and all-cause mortality and poor prognosis in stroke patients. METHODS: A total of 971 Chinese inpatients with acute stroke (mean age of 65.7) were consecutively enrolled in the prospective clinical study and followed up for 12 months after discharge. Stress hyperglycemia was measured using the ratio of fasting blood glucose (FBG, mmol/L)/glycated hemoglobin (HbA1c, %). The primary outcome was all-cause mortality, and secondary outcomes were poor prognosis defined as infectious complications, a National Institutes of Health Stroke Scale (NIHSS) score ≥ 6, a Barthel Index score ≤ 60, or a modified Rankin Scale (mRS) score of 3-6, presented as multivariate-adjusted odds ratios (ORs) with 95% confidence intervals (CIs) across the quartiles of the FBG/HbA1c ratio. RESULTS: There were 35 (4.1%) all-cause deaths at 3 months and 85 (11.4%) at 12 months. The inpatients with the highest quartile of the FBG/HbA1c ratio had a higher risk of all-cause death at 3 months (adjusted OR: 5.16, 95% CI: 1.03-25.74) and at 12 months (adjusted OR: 2.59, 95% CI: 1.14-5.89)) and a higher risk of infectious complications (adjusted OR 2.37, 95% CI 1.27-4.43) and dysfunction (adjusted OR 1.79, 95% CI 1.06-3.01) during hospitalization than inpatients with the lowest quartile. CONCLUSIONS: Stress hyperglycemia, measured by the FBG/HbA1c ratio, was associated with an increased risk of adverse outcomes, including all-cause death, infectious complications, and dysfunction after stroke.

Correlation between serum total bile acid and nonalcoholic fatty liver disease: A cross-sectional study.

Background: Nonalcoholic fatty liver disease (NAFLD) is a common component of chronic liver disease. Total bile acid (TBA) may influence the NAFLD progression through its signaling pathways. We attempted to find out if there is a correlation between TBA and NAFLD. Methods: 427,507 subjects were enrolled in health examinations conducted by The First Affiliated Hospital of Wenzhou Medical University. Among them, only 67616 met the inclusion criteria. Demographic, clinical, and laboratory data were gathered from all subjects. We used multivariate logistic regression model to find the correlation between serum TBA and NAFLD after adjusting for acknowledged risk factors for NAFLD. Results: A negative correlation was found between the TBA and NAFLD after adjusting for confounders in the multivariate logistic regression model (OR: 0.80; 95% CI: 0.72, 0.88, P < 0.001). After subgroup analysis, we found the interaction between NAFLD and diabetes was significant (P = 0.043). In patients with NAFLD without diabetes, TBA showed a protective effect in NAFLD (OR: 0.75; 95% CI: 0.67, 0.85). Conclusion: TBA is protective for NAFLD, but not in patients with NAFLD and diabetes. Further studies are urgently required to completely explore the underlying mechanisms of TBA in the pathogenesis of NAFLD.

A prospective epidemiological analysis of controlling nutritional status score with the poor functional outcomes in Chinese patients with haemorrhagic stroke.

Nutritional Risk Screening index is a standard tool to assess nutritional risk, but epidemiological data are scarce on controlling nutritional status (CONUT) as a prognostic marker in acute haemorrhagic stroke (AHS). We aimed to explore whether the CONUT may predict a 3-month functional outcome in AHS. In total, 349 Chinese patients with incident AHS were consecutively recruited, and their malnutrition risks were determined using a high CONUT score of ≥ 2. The cohort patients were divided into high-CONUT (≥ 2) and low-CONUT (< 2) groups, and primary outcomes were a poor functional prognosis defined as the modified Rankin Scale (mRS) score of ≥ 3 at post-discharge for 3 months. Odds ratios (OR) with 95 % confidence intervals (CI) for the poor functional prognosis at post-discharge were estimated by using a logistic analysis with additional adjustments for unbalanced variables between the high-CONUT and low-CONUT groups. A total of 328 patients (60·38 ± 12·83 years; 66·77 % male) completed the mRS assessment at post-discharge for 3 months, with 172 patients at malnutrition risk at admission and 104 patients with a poor prognosis. The levels of total cholesterol and total lymphocyte counts were significantly lower in high-CONUT patients than low-CONUT patients (P = 0·012 and < 0·001, respectively). At 3-month post discharge, there was a greater risk for the poor outcome in the high-CONUT compared with the low-CONUT patients at admission (OR: 2·32, 95 % CI: 1·28, 4·17). High-CONUT scores independently predict a 3-month poor prognosis in AHS, which helps to identify those who need additional nutritional managements.

Comparing the prognostic significance of nutritional screening tools and ESPEN-DCM on 3-month and 12-month outcomes in stroke patients.

BACKGROUND AND AIMS: Malnutrition is prevalent among individuals with acute ischaemic stroke (AIS) and may worsen clinical outcomes. There is no consensus on the best tool for nutritional screening in this population. The present study compared four screening tools and one diagnostic tool in terms of their prognostic significance in predicting short-term and long-term outcomes in AIS patients. METHODS: We included patients admitted to five major hospitals in Wenzhou and diagnosed with a primary diagnosis of AIS from October 1 to December 31, 2018. The Controlling Nutritional Status (CONUT) score, the Geriatric Nutritional Risk Index (GNRI), the Malnutrition Universal Screening Tool (MUST), the Nutritional Risk Screening Tool 2002 (NRS-2002) and the European Society for Clinical Nutrition and Metabolism diagnostic criteria for malnutrition (ESPEN-DCM) were assessed at admission. The clinical outcomes were evaluated by the modified Rankin Scale (mRS) and mortality at 3 months and 12 months after discharge. RESULTS: Five hundred and ninety-three patients were included in our prospective study. The mean age was 67.3 ± 12.0 years. Based on the mRS score, 125 patients exhibited poor functional recovery (an mRS ≥3) at 3 months after discharge. Seventeen patients died during the 3-month follow-up period, and the other 25 did not survive 12 months. Multivariate binary logistic regression revealed that inadequate nutritional status at admission, as determined by the CONUT, GNRI, MUST, NRS-2002 and ESPEN-DCM, were independently associated with poor outcomes in AIS patients 3 months after discharge. Both MUST ≥2 and NRS-2002 ≥ 3 showed significant associations with poor outcomes at 12-month post-discharge. Further analysis with the receiver operator characteristic (ROC) curve showed similar results, where all the tools predicted the poor outcomes at 3 months while only the NRS-2002 and MUST scores were significantly associated with the mRS at 12 months post-discharge. Moreover, the area under the curve (AUC) of MUST and NRS-2002 were significantly larger than those for the other tools. The optimal cut-off values of the MUST and NRS-2002 to predict poor outcomes were scores of ≥2 and ≥ 3 points, respectively. CONCLUSIONS: Our data supported a deleterious effect of inadequate nutrition, as evidenced by the nutrition screening tools or ESPEN-DCM, on clinical outcomes during and beyond the acute phase of AIS. We recommended the use of the MUST and NRS-2002 in guiding nutritional support in AIS patients, as they have higher predictive power and can predict both short-term and long-term outcomes.

Being at risk of malnutrition predicts poor outcomes at 3 months in acute ischemic stroke patients.

BACKGROUND: Malnutrition is confirmed to be associated with poor outcomes in stroke patients. The present study aimed to confirm that being at risk of malnutrition assessed by Nutritional Risk Screening Tool 2002 (NRS-2002) and the Controlling Nutritional Status (CONUT) score predicts poor outcomes at 3 months in acute ischemic stroke (AIS) patients. METHODS: In total, 682 patients with AIS were recruited within 7 days of stroke onset consecutively and 110 were dropped out. They were screened for risk of malnutrition using NRS-2002 and the CONUT score. The primary outcome is the follow-up modified Rankin Scale (mRS) score. Poor outcomes were defined as an (mRS) score ≥ 3 at 3 months post discharge. RESULTS: There was a significant difference in the mRS score at 3 months between patients at risk of malnutrition compared to those not at risk assessed by NRS-2002(P < 0.001) and CONUT (P = 0.011). The logistic regression model showed that the risk of malnourishment (according to NRS-2002), low risk of malnourishment (according to CONUT), and the moderate-to-severe risk of malnourishment (according to CONUT) were associated with higher risk of poor outcomes at 3 months (P < 0.001, P = 0.033, and P = 0.007). The multivariate logistic regression model (adjusted for confounding factors) demonstrated that the risk of malnourishment, according to the NRS-2002, was associated with the increasing risk of poor outcomes at 3 months (odds ratio = 2.31; 95% CI: 1.24-4.30; P = 0.008). CONCLUSIONS: The risk of malnutrition assessed by NRS-2002 and CONUT can predict poor outcomes at 3 months in AIS patients. NRS-2002 is superior to CONUT in predicting poor outcomes at 3 months.

A Facile Way to Form a Graded Halide Layer in Perovskite Solar Cells.

A light harvest layer composed of gradual change from formamidinium lead triiodide (FAPbI3) to methylammonium lead triiodide (MAPbI3) was fabricated using a novel two-step process. That is, a graded halide layer structure without extra processing steps is demonstrated. Conventionally, in the fabrication of MAPbI3 perovskite solar cells (PSCs) using two-step process, PbI2 layer was the first deposited on a mesoporous TiO2 coated substrate. The methylammonium iodide (MAI) solvent was then spin-coated on the surface of PbI2 layer and heated to form the MAPbI3 perovskite layer. Double perovskite layers such as FAPbI3 plus MAPbI3 requires twice of the second step which FAI and MAI should be spin-coated individually. This can be tedious and time consuming. We report here a facile way to form a graded perovskite layer, consisting FAPbI3 to MAPbI3, in a single step. FAI was first added into dimethylformamide (DMF) solution that was used to form PbI2 layer, then MAI solution was dripped on top of the FAI/PbI2 layer. The graded perovskite layer structure (FAPbI3/MAPbI3) in a gradient manner are readily formed, where the structure is confirmed by EDS to be FTO/compact TiO2/mesoporous TiO2/FAPbI3(thin)/MAPbI3/Spiro-OMeTAD/Ag. The Jsc, and Voc of solar cells with this graded perovskite layer are enhanced and the efficiency increases from 11.62% to 14.06%.

Strain-Modulated Band Engineering in Two-Dimensional Black Phosphorus/MoS2 van der Waals Heterojunction.

We investigate the band shift and band alignment of two-dimensional (2D) black phosphorus (BP)/MoS2 van der Waals heterojunction (vdW HJ) via uniaxial strain in terms of first-principles calculations and atomic-bond-relaxation method. We find that the band gap of 2D BP/MoS2 HJ decreases linearly with applied tensile strain and Mo-S bond breaks down at 10% tensile strain. Meanwhile, the band gap slightly increases and then monotonically decreases under compressive strain and there appears a semiconductor-to-metal transition at -11 and -12% strain in the y and x directions, respectively. Moreover, 2D BP/MoS2 HJ maintains type-II band alignment for strain applied in the y direction whereas type-II/I band transition appears at -5% strain in the x direction. Moreover, we propose an analytical model to address the strain-modulated band engineering of 2D BP/MoS2 vdW HJ at the atomic level. Our results suggest a promising way to explain the intrinsic mechanism of strain engineering and manipulate the electronic properties of 2D vdW HJs.

Canine heat shock protein 27 promotes proliferation, migration, and doxorubicin resistance in the canine cell line DTK-F.

Canine mammary tumors (CMTs) are the most common type of tumors in female dogs. Heat shock proteins are highly expressed in many cancers and are involved in tumor progression and chemoresistance in CMTs; however, the biological role of canine heat shock protein 27 (cHSP27) in CMTs has not been thoroughly characterized. This study investigated the roles of cHSP27 in cell growth, migration, anchorage, and resistance to doxorubicin (DOX) using DTK-F cells, a CMT cell line that does not express cHSP27. DTK-F cells were transfected with cHSP27 and stable overexpression was established. A mouse monoclonal antibody against cHSP27 was also produced. The biological functions of cHSP27 in DTK-F cells were then evaluated using a variety of assays. Overexpression of cHSP27 was associated with increased cell proliferation, clone formation, migration, and decreased DOX sensitivity. In conclusion, these data provide evidence that cHSP27 overexpression can promote anchorage-independent growth, migration, and increased DOX resistance in CMT cells.

An implantable multifunctional needle type biosensor with integrated RF capability.

We report the development of an implantable multifunctional (glucose and cholesterol) needle type biosensor with integrated RF wireless circuitry for continuous in vivo monitoring of metabolites during short term stays in emergency room or intensive care unit. Silicon-based MEMS technologies are used for the fabrication of micro needle sensors. The whole device is covered by a biocompatible Parylene layer with opening structure at the active areas of electrodes. Electropolymerization of active biomolecules and conducting polymer provides in situ nanoscale physical entrapments of various oxidoreductases (Glucose oxidase and cholesterol oxidase) and functions as a viable matrix for the construction of micro amperometric biosensors. Hybrid CMOS fabrication processes are used to accomplish the 433 MHz ASK RF transmitter and receiver (0.18μm CMOS 1P6M process) and the data converter (0.35μm CMOS 2P4M process). We will present and discuss the detail design and the integrated system performance in this paper.