Stratified Treatment in Pediatric Anaplastic Large Cell Lymphoma: Result of a Prospective Open-Label Multiple-Institution Study.

Purpose: The risk stratification of pediatric anaplastic large cell lymphoma (ALCL) has not been standardized. In this study, new risk factors were included to establish a new risk stratification system for ALCL, and its feasibility in clinical practice was explored. Materials and Methods: On the basis of the non-Hodgkin's lymphoma Berlin-Frankfurt-Munster 95 (NHL-BFM-95) protocol, patients with minimal disseminated disease (MDD), high-risk tumor site (multiple bone, skin, liver, and lung involvement), and small cell/lymphohistiocytic (SC/LH) pathological subtype were enrolled in risk stratification. Patients were treated with a modified NHL-BFM-95 protocol combined with an anaplastic lymphoma kinase inhibitor or vinblastine (VBL). Results: A total of 136 patients were enrolled in this study. The median age was 8.8 years. The 3-year event-free survival (EFS) and overall survival of the entire cohort were 77.7% [95% Confidence Interval (CI), 69.0%-83.9%] and 92.3% (95% CI,86.1%-95.8%), respectively. The 3-year EFS rates of low-risk group (R1), intermediate-risk group (R2), and high-risk group (R3) patients were 100%, 89.5% (95% CI, 76.5%-95.5%, and 67.9% (95% CI, 55.4%-77.6%), respectively. The prognosis of patients with MDD (+), stage IV cancer, SC/LH lymphoma, and high-risk sites was poor, and the 3-year EFS rates were 45.3% (95% CI, 68.6%-19.0%), 65.7% (95% CI, 47.6%-78.9%), 55.7% (95% CI, 26.2%-77.5%), and 70.7% (95% CI, 48.6%-84.6%), respectively. At the end of follow-up, one of the 5 patients who received maintenance therapy with VBL relapsed, and seven patients receiving ALK inhibitor maintenance therapy did not experience relapse. Conclusion: This study has confirmed the poor prognostic of MDD (+) ，high risk site and SC/LH ,but patients with SC/LH lymphoma and MDD (+) at diagnosis still need to receive better treatment (ClinicalTrials.gov number, NCT03971305).

A feature-enhanced network for stroke lesion segmentation from brain MRI images.

Accurate and expeditious segmentation of stroke lesions can greatly assist physicians in making accurate medical diagnoses and administering timely treatments. However, there are two limitations to the current deep learning methods. On the one hand, the attention structure utilizes only local features, which misleads the subsequent segmentation; on the other hand, simple downsampling compromises task-relevant detailed semantic information. To address these challenges, we propose a novel feature refinement and protection network (FRPNet) for stroke lesion segmentation. FRPNet employs a symmetric encoding-decoding structure and incorporates twin attention gate (TAG) and multi-dimension attention pooling (MAP) modules. The TAG module leverages the self-attention mechanism and bi-directional attention to extract both global and local features of the lesion. On the other hand, the MAP module establishes multidimensional pooling attention to effectively mitigate the loss of features during the encoding process. Extensive comparative experiments show that, our method significantly outperforms the state-of-the-art approaches with 60.16% DSC, 36.20px HD and 85.72% DSC, 27.02px HD on two ischemic stroke datasets that contain all stroke stages and several sequences of stroke images. The excellent results that exceed those of existing methods illustrate the efficacy and generalizability of the proposed method. The source code is released on https://github.com/wu2ze2lin2/FRPNet.

Active Center Size-Dependent Fenton-Like Chemistry for Sustainable Water Decontamination.

Accurately controlling catalytic activity and mechanism as well as identifying structure-activity-selectivity correlations in Fenton-like chemistry is essential for designing high-performance catalysts for sustainable water decontamination. Herein, active center size-dependent catalysts with single cobalt atoms (CoSA), atomic clusters (CoAC), and nanoparticles (CoNP) were fabricated to realize the changeover of catalytic activity and mechanism in peroxymonosulfate (PMS)-based Fenton-like chemistry. Catalytic activity and durability vary with the change in metal active center sizes. Besides, reducing the metal size from nanoparticles to single atoms significantly modulates contributions of radical and nonradical mechanisms, thus achieving selective/nonselective degradation. Density functional theory calculations reveal evolutions in catalytic mechanisms of size-dependent catalytic systems over different Gibbs free energies for reactive oxygen species generation. Single-atom site contact with PMS is preferred to induce nonradical mechanisms, while PMS dissociates and generates radicals on clusters and nanoparticles. Differences originating from reaction mechanisms endow developed systems with size-dependent selectivity and mineralization for treating actual hospital wastewater in column reactors. This work brings an in-depth understanding of metal size effects in Fenton-like chemistry and guides the design of intelligent catalysts to fulfill the demand of specific scenes for water purification.

An MgAl layered double hydroxide as a new transition metal-free anode for lithium-ion batteries.

A carbonate intercalated magnesium aluminum layered double hydroxide is used as an anode material for lithium-ion batteries, displaying a maximum discharge specific capacity of 814 mA h g-1 at 200 mA g-1 in this work through utilizing the valence variation of Mg and the conversion between LiOH and LiH/Li2O.

The role of mitochondria-related lncRNAs in characterizing the immune landscape and supervising the prognosis of osteosarcoma.

Mitochondrial damage is related to the functional properties of immune cells as well as to tumorigenesis and progression. Nevertheless, there is an absence concerning the systematic evaluation of mitochondria-associated lncRNAs (MALs) in the immune profile and tumor microenvironment of osteosarcoma patients. Based on transcriptomic and clinicopathological data from the TARGET database, MAL-related patterns were ascertained by consistent clustering, and gene set variation analysis of the different patterns was completed. Next, a MAL-derived scoring system was created using Cox and LASSO regression analyses and validated by Kaplan-Meier and ROC curves. The GSEA, ESTIMATE, and CIBERSORT algorithms were utilized to characterize the immune status and underlying biological functions in the different MAL score groups. MAL-derived risk scores were well stabilized and outperformed traditional clinicopathological features to reliably predict 5-year survival in osteosarcoma cohorts. Moreover, patients with increased MAL scores were observed to suffer from poorer prognosis, higher tumor purity, and an immunosuppressive microenvironment. Based on estimated half-maximal inhibitory concentrations, the low-MAL score group benefited more from gemcitabine and docetaxel, and less from thapsigargin and sunitinib compared to the high-MAL score group. Pan-cancer analysis demonstrated that six hub MALs were strongly correlated with clinical outcomes, immune subtypes, and tumor stemness indices in various common cancers. Finally, we verified the expression patterns of hub MALs in osteosarcoma with qRT-PCR. In summary, we identified the crosstalk between prognostic MALs and tumor-infiltrating immune cells in osteosarcoma, providing a potential strategy to ameliorate clinical stratification management.

TransRender: a transformer-based boundary rendering segmentation network for stroke lesions.

Vision transformer architectures attract widespread interest due to their robust representation capabilities of global features. Transformer-based methods as the encoder achieve superior performance compared to convolutional neural networks and other popular networks in many segmentation tasks for medical images. Due to the complex structure of the brain and the approximate grayscale of healthy tissue and lesions, lesion segmentation suffers from over-smooth boundaries or inaccurate segmentation. Existing methods, including the transformer, utilize stacked convolutional layers as the decoder to uniformly treat each pixel as a grid, which is convenient for feature computation. However, they often neglect the high-frequency features of the boundary and focus excessively on the region features. We propose an effective method for lesion boundary rendering called TransRender, which adaptively selects a series of important points to compute the boundary features in a point-based rendering way. The transformer-based method is selected to capture global information during the encoding stage. Several renders efficiently map the encoded features of different levels to the original spatial resolution by combining global and local features. Furthermore, the point-based function is employed to supervise the render module generating points, so that TransRender can continuously refine the uncertainty region. We conducted substantial experiments on different stroke lesion segmentation datasets to prove the efficiency of TransRender. Several evaluation metrics illustrate that our method can automatically segment the stroke lesion with relatively high accuracy and low calculation complexity.

Coupled Surface-Confinement Effect and Pore Engineering in a Single-Fe-Atom Catalyst for Ultrafast Fenton-like Reaction with High-Valent Iron-Oxo Complex Oxidation.

The nanoconfinement effect in Fenton-like reactions shows great potential in environmental remediation, but the construction of confinement structure and the corresponding mechanism are rarely elucidated systematically. Herein, we proposed a novel peroxymonosulfate (PMS) activation system employing the single Fe atom supported on mesoporous N-doped carbon (FeSA-MNC, specific surface area = 1520.9 m2/g), which could accelerate the catalytic oxidation process via the surface-confinement effect. The degradation activity of the confined system was remarkably increased by 34.6 times compared to its analogue unconfined system. The generation of almost 100% high-valent iron-oxo species was identified via 18O isotope-labeled experiments, quenching tests, and probe methods. The density functional theory illustrated that the surface-confinement effect narrows the gap between the d-band center and Fermi level of the single Fe atom, which strengthens the charge transfer rate at the reaction interface and reduces the free energy barrier for PMS activation. The surface-confinement system exhibited excellent pollutant degradation efficiency, robust resistance to coexisting matter, and adaptation of a wide pH range (3.0-11.0) and various temperature environments (5-40 °C). Finally, the FeSA-MNC/PMS system could achieve 100% sulfamethoxazole removal without significant performance decline after 10,000-bed volumes. This work provides novel and significant insights into the surface-confinement effect in Fenton-like chemistry and guides the design of superior oxidation systems for environmental remediation.

Modulating Electronic Structure Engineering of Atomically Dispersed Cobalt Catalyst in Fenton-like Reaction for Efficient Degradation of Organic Pollutants.

Currently, the lack of model catalysts limits the understanding of the catalytic essence. Herein, we report the functional group modification of model single atom catalysts (SACs) with an accurately regulated electronic structure for accelerating the sluggish kinetics of the Fenton-like reaction. The amino-modified cobalt phthalocyanine anchored on graphene (CoPc/G-NH2) shows superior catalytic performance in the peroxymonosulfate (PMS) based Fenton-like reaction with Co mass-normalized pseudo-first-order reaction rate constants (kobs, 0.2935 min-1), which is increased by 4 and 163 times compared to those of CoPc/G (0.0737 min-1) and Co3O4/G (0.0018 min-1). Density functional theory (DFT) calculations demonstrate that the modification of the -NH2 group narrows the gap between the d-band center and the Fermi level of a single Co atom, which strengthens the charge transfer rate at the reaction interface and reduces the free energy barrier for the activation of PMS. Moreover, the scale-up experiment realizes 100% phenol removal at 7200-bed volumes during 240 h continuous operation without obvious decline in catalytic performance. This work provides in-depth insight into the catalytic mechanism of Fenton-like reactions and demonstrates the electronic engineering of SACs as an effective strategy for improving the Fenton-like activity to achieve the goal of practical application.

Facilely Tuning the First-Shell Coordination Microenvironment in Iron Single-Atom for Fenton-like Chemistry toward Highly Efficient Wastewater Purification.

Precisely identifying the atomic structures in single-atom sites and establishing authentic structure-activity relationships for single-atom catalyst (SAC) coordination are significant challenges. Here, theoretical calculations first predicted the underlying catalytic activity of Fe-NxC4-x sites with diverse first-shell coordination environments. Substituting N with C to coordinate with the central Fe atom induces an inferior Fenton-like catalytic efficiency. Then, Fe-SACs carrying three configurations (Fe-N2C2, Fe-N3C1, and Fe-N4) fabricate facilely and demonstrate that optimized coordination environments of Fe-NxC4-x significantly promote the Fenton-like catalytic activity. Specifically, the reaction rate constant increases from 0.064 to 0.318 min-1 as the coordination number of Fe-N increases from 2 to 4, slightly influencing the nonradical reaction mechanism dominated by 1O2. In-depth theoretical calculations unveil that the modulated coordination environments of Fe-SACs from Fe-N2C2 to Fe-N4 optimize the d-band electronic structures and regulate the binding strength of peroxymonosulfate on Fe-NxC4-x sites, resulting in a reduced energy barrier and enhanced Fenton-like catalytic activity. The catalytic stability and the actual hospital sewage treatment capacity also showed strong coordination dependency. This strategy of local coordination engineering offers a vivid example of modulating SACs with well-regulated coordination environments, ultimately maximizing their catalytic efficiency.

Aqueous Chloride-Ion Battery within a Neutral Electrolyte Based on a CoFe-Cl Layered Double Hydroxide Anode.

Aqueous chloride-ion batteries (ACIBs) with environmental friendliness and high safety hold great potential to fulfill the green energy demand for ocean desalination. Herein, for the first time, a composite consisting of Cl--intercalated CoFe layered double hydroxides (CoFe-Cl-LDH) cross-linked with CNTs (CoFe-Cl-LDH/CNT) is synthesized and demonstrated to be a novel high-performance anode for ACIBs in a neutral NaCl aqueous solution. While exhibiting a high initial capacity of ∼190 mAh g-1 at 200 mA g-1, CoFe-Cl-LDH/CNT is capable of delivering a reversible capacity of ∼125 mAh g-1 after 200 cycles. At a high current density of 400 mA g-1, it still holds a capacity of ∼120 mAh g-1. The excellent Cl- storage performance can be contributed to the unique topochemical transformation feature that reverses intercalation/deintercalation of Cl- along with valence changes of Co2+/Co3+ and Fe2+/Fe3+ during charge/discharge and the improved electronic conductivity by hybridizing with CNTs. It is interesting that the invertible insertion/extraction of interlayer H2O was discovered, which could be beneficial to the capacity after cycles to a certain extent. The Cl--intercalated LDH material declared in this work shows its feasibility on Cl- capture/release in aqueous anion-type batteries and provides a new opportunity for future development of ACIBs or aqueous desalination technology.

Activation of periodate by N-doped iron-based porous carbon for degradation of sulfisoxazole: Significance of catalyst-mediated electron transfer mechanism.

Periodate (PI) has recently been studied as an excellent oxidant in advanced oxidation processes, and its reported mechanism is mainly the formation of reactive oxygen species (ROS). This work presents an efficient approach using N-doped iron-based porous carbon (Fe@N-C) to activate periodate for the degradation of sulfisoxazole (SIZ). Characterization results indicated the catalyst has high catalytic activity, stable structure, and high electron transfer activity. In terms of degradation mechanism, it is pointed out that the non-radical pathway is the dominant mechanism. In order to prove this mechanism, we have carried out scavenging experiments, electron paramagnetic resonance (EPR) analysis, salt bridge experiments and electrochemical experiments, which demonstrate the occurrence of mediated electron transfer mechanism. Fe@N-C could mediate the electron transfer from organic contaminant molecules to PI, thus improving the efficiency of PI utilization, rather than simply inducing the activation of PI through Fe@N-C. The overall results of this study provided a new understanding into the application of Fe@N-C activated PI in wastewater treatment.

Clinical effect of a door shaped individualized dental archwire on the treatment of maxillary transposed canines / 口腔疾病防治

Objective @#To discuss the effectiveness and mechanism for movement of maxillary buccally transposed canines by using a door-shaped individualized dental archwire mechanic and to provide a reference for clinicians.@*Methods@#Eight patients with unilateral maxillary transposed canines were enrolled. All patients were treated with door-shaped individualized archwires. Before treatment (T1) and after the crowns of the transposed canines were moved to the right buccal positions in the dental arch during the treatment (T2), orthopantomograms were taken both at T1 and T2 to compare the linear changes (distance changes of the crown and root apex) and angular changes to study the mechanisms of tooth movement. The probing depth and buccal crown height were measured using a periodontal probe to compare periodontal changes before treatment (T1) and after treatment (T3) between the transposed canines and contralateral canines. @*Results@# All eight transposed canines were successfully brought back to their normal dental arch position but were made more buccal by using the door-shaped individualized dental archwire, with a mean of (11.5 ± 2.7) months. The average overall duration was (28.3 ± 4.7) months. The crown distance changes of the canines from T1 to T2 (8.1 mm) were greater than those of the root apexes (1.5 mm) (P<0.05). The mean angulation changes of the long axes of the canines were 17.5°. There was no significant difference in the depth of periodontal measurement and buccal crown height measurement between T1 and T3 (P>0.05). @*Conclusion @# The buccal movement of maxillary transposed canines under a door-shaped individualized dental archwire was effective and feasible. The movement pattern under this mechanism was controlled tipping.

A clinical report on high­dose cytarabine therapy for children with acute myeloid leukemia.

Despite improvement in the long-term survival rate following pediatric acute myeloid leukemia (AML), the rate remains low, even with optimal treatment. The present study reports the long-term outcome of a small patient group treated with a single drug, high-dose chemotherapy (HDCT) with cytarabine, including consolidation and maintenance therapy. RT-PCR was conducted to assess 43 fusion genes, and after treatment, all cases have been followed up for 20 years (June 2002-December 2020). With an 80% 5-year survival rate, the results of this study highlight the possibility that pediatric AML can be reasonably effectively treated with relatively simple chemotherapy when necessary. HDCT is clinically safe, effective and relatively inexpensive. We propose that in the context of limited resources, HDCT should be considered as an alternative therapy for pediatric AML.

Organic persistent luminescence imaging for biomedical applications.

Persistent luminescence is a unique visual phenomenon that occurs after cessation of excitation light irradiation or following oxidization of luminescent molecules. The energy stored within the molecule is released in a delayed manner, resulting in luminescence that can be maintained for seconds, minutes, hours, or even days. Organic persistent luminescence materials (OPLMs) are highly robust and their facile modification and assembly into biocompatible nanostructures makes them attractive tools for in vivo bioimaging, whilst offering an alternative to conventional fluorescence imaging materials for biomedical applications. In this review, we give attention to the existing limitations of each class of OPLM-based molecular bioimaging probes based on their luminescence mechanisms, and how recent research progress has driven efforts to circumvent their shortcomings. We discuss the multifunctionality-focused design strategies, and the broad biological application prospects of these molecular probes. Furthermore, we provide insights into the next generation of OPLMs being developed for bioimaging techniques.

A Zero-Strain Insertion Cathode Material for Room-Temperature Fluoride-Ion Batteries.

A fluoride-ion battery (FIB) is a novel type of energy storage system that has a higher volumetric energy density and low cost. However, the high working temperature (>150 °C) and unsatisfactory cycling performance of cathode materials are not favorable for their practical application. Herein, fluoride ion-intercalated CoFe layered double hydroxide (LDH) (CoFe-F LDH) was prepared by a facile co-precipitation approach combined with ion-exchange. The CoFe-F LDH shows a reversible capacity of ∼50 mAh g-1 after 100 cycles at room temperature. Although there is still a big gap between FIBs and lithium-ion batteries, the CoFe-F LDH is superior to most cathode materials for FIBs. Another important advantage of CoFe-F LDH FIBs is that they can work at room temperature, which has been rarely achieved in previous reports. The superior performance stems from the unique topochemical transformation property and small volume change (∼0.82%) of LDH in electrochemical cycles. Such a tiny volume change makes LDH a zero-strain cathode material for FIBs. The 2D diffusion pathways and weak interaction between fluoride ions and host layers facilitate the de/intercalation of fluoride ions, accompanied by the chemical state changes of Co2+/Co3+ and Fe2+/Fe3+ couples. First-principles calculations also reveal a low F- diffusion barrier during the cyclic process. These findings expand the application field of LDH materials and propose a novel avenue for the designs of cathode materials toward room-temperature FIBs.

Two-Dimensional Beidellite/Carbon Superlattice for Boosting Lithium-Ion Storage Performance.

Two-dimensional Fe-beidellite/carbon (Fe-BEI@C) superlattice-like heterostructure was prepared by intercalation of glucose in the gallery of layered Fe-BEI followed by calcination. The interlaminar and superficial carbon coating enables Fe-BEI to have good rate performance, fast lithium-ion diffusion, and high pseudocapacitance contribution, leading to excellent lithium storage performance as anode material for lithium-ion batteries (LIBs). The Fe-BEI@C/Li half cell delivers a maximum specific capacity of 850 mAh·g-1 at 0.5 A·g-1 and has a 92.3% retention rate after 100 cycles along with a high-rate performance of 403 mAh·g-1 at 5 A·g-1. The reversible valence state change of Si2+/Si4+ and Fe0/Fex+ (0 < x < 3) in electrochemical cycles are realized without collapse of layered structure. Additionally, the Fe-BEI@C heterostructure displays a high Li+ diffusion coefficient of 10-13∼10-10 cm2 s-1, illustrating fast Li+ transfer in the interlayer of Fe-BEI@C heterostructure. Dynamic analysis reveals that the Si redox reaction is almost dominated by surface control and that of Fe is mainly diffusion-controlled. This work has exploited a novel layered silicate as anode material for LIBs and developed a molecular-level carbon hybridization method to improve their electrochemical performance, which is meaningful for the application of layered silicate in the energy-storage field.

Pivotal roles of N-doped carbon shell and hollow structure in nanoreactor with spatial confined Co species in peroxymonosulfate activation: Obstructing metal leaching and enhancing catalytic stability.

Metal leaching and catalytic stability are the key issues in Fenton-like reaction. Herein, a hollow yolk-shell nanoreactor (HYSCN) with shell confined Co species was fabricated for peroxymonosulfate (PMS) activation to degrade carbamazepine (CBZ). The uniform Co nanoparticles were completely anchored in a hollow void, further confined by a porous N-doped carbon shell. The unique construction significantly reduces Co species leaching in PMS activation and enhances catalytic stability. Co leaching came from HYSCN dropped by almost fourfold compared to CN-8 without shell confined (0.403 mg/L to 0.120 mg/L). The catalytic stability is also greatly improved, confirming the dominant role of heterogeneous catalysis in the HYSCN/PMS system. HYSCN exhibits excellent catalytic performance compared to a solid structure (SCSCN), demonstrating the significance of hollow structures. Mechanism study found that HO•, SO4•- and 1O2 induced in HYSCN/PMS system and the relative contributions were distinguished and quantified by stoichiometric methods. The UPLC-Q-TOF-MS/MS was used to identify the CBZ degraded intermediate products and the possible degradation pathway was proposed. This study will provide theoretical guidance for reducing metal leaching and improving catalytic stability in the PMS activation.

Dual-Path Attention Compensation U-Net for Stroke Lesion Segmentation.

For the segmentation task of stroke lesions, using the attention U-Net model based on the self-attention mechanism can suppress irrelevant regions in an input image while highlighting salient features useful for specific tasks. However, when the lesion is small and the lesion contour is blurred, attention U-Net may generate wrong attention coefficient maps, leading to incorrect segmentation results. To cope with this issue, we propose a dual-path attention compensation U-Net (DPAC-UNet) network, which consists of a primary network and auxiliary path network. Both networks are attention U-Net models and identical in structure. The primary path network is the core network that performs accurate lesion segmentation and outputting of the final segmentation result. The auxiliary path network generates auxiliary attention compensation coefficients and sends them to the primary path network to compensate for and correct possible attention coefficient errors. To realize the compensation mechanism of DPAC-UNet, we propose a weighted binary cross-entropy Tversky (WBCE-Tversky) loss to train the primary path network to achieve accurate segmentation and propose another compound loss function called tolerance loss to train the auxiliary path network to generate auxiliary compensation attention coefficient maps with expanded coverage area to perform compensate operations. We conducted segmentation experiments using the 239 MRI scans of the anatomical tracings of lesions after stroke (ATLAS) dataset to evaluate the performance and effectiveness of our method. The experimental results show that the DSC score of the proposed DPAC-UNet network is 6% higher than the single-path attention U-Net. It is also higher than the existing segmentation methods of the related literature. Therefore, our method demonstrates powerful abilities in the application of stroke lesion segmentation.

Effects of programmed death ligand 1 on the prognosis of neuroblastoma: A protocol for systematic review and meta analysis.

BACKGROUND: Previous studies have investigated the prognostic role of programmed death ligand 1 (PD-L1) expression in patients with neuroblastoma, while the results are still controversial. Therefore, we conducted a meta-analysis to clarify the relationship between the expression of PD-L1 and the prognosis of neuroblastoma. METHODS: Search electronic databases include PubMed, Cochrane, Embase, Scopus and Web of Science, and the search time is set to build the database until January 2021. Hazard ratio (HR) and 95% confidence interval (CI) were used to analyze the included results. Meta-analysis was performed using Stata 15.0 software. RESULTS: This review will be disseminated in print by peer-review. CONCLUSION: The study will provide updated evidence for the evaluation of whether the expression of PD-L1 is associated with poor prognosis in patients with neuroblastoma. ETHICS AND DISSEMINATION: The private information from individuals will not be published. This systematic review also should not damage participants' rights. Ethical approval is not available. The results may be published in a peer-reviewed journal or disseminated in relevant conferences. OSF REGISTRATION NUMBER: DOI 10.17605/OSF.IO/FBCY6.