Hierarchical chiral MOFs with the induced chirality of AIE ligands exhibiting non-reciprocal CPL.

Two pairs of chiral MOFs with hierarchical chiral structures were constructed through assembly of achiral AIE-type multidentate linkers and chiral camphoric acid. Non-reciprocal circularly polarized luminescence (CPL) can be observed on the macroscopic due to the coexistence of optical anisotropic and chiroptical nature. This study provides a new perspective to recognize and construct chiral crystalline materials.

Bifunctional Metamaterials Incorporating Unusual Geminations of Poisson's Ratio and Coefficient of Thermal Expansion.

Natural materials overwhelmingly shrink laterally under stretching and expand upon heating. Through incorporating Poisson's ratio and coefficient of thermal expansion (PR and CTE) in unusual geminations, such as positive PR and negative CTE, negative PR and positive CTE, and even zero PR and zero CTE, bifunctional metamaterials would generate attractive shape control capacity. However, reported bifunctional metamaterials are only theoretically constructed by simple skeletal ribs, and the magnitudes of the bifunctions are still in quite narrow ranges. Here, we propose a methodology for generating novel bifunctional metamaterials consisting of engineering polymers. From concept to refinement, the topology and shape optimization are integrated for programmatically designing bifunctional metamaterials in various germinations of the PR and CTE. The underlying deformation mechanisms of the obtained bifunctions are distinctly revealed. All of the designs with complex architectures and material layouts are fabricated using the multimaterial additive manufacturing, and their effective properties are experimentally characterized. Good agreements of the design, simulation, and experiments are achieved. Especially, the accessible range of the bifunction, namely, PR and CTE, is remarkably enlarged nearly 4 times. These developed approaches open an avenue to explore the bifunctional metamaterials, which are the basis of myriad mechanical- and temperature-sensitive devices, e.g., morphing structures and high-precision components of the sensors/actuators in aerospace and electronical domains.

Accepting Immunotherapy After Multiline Treatment Failure: An Exploration of the Anxiety and Depression in Patients with Advanced Cancer Experience.

BACKGROUND: Tumor immunotherapy is a promising therapeutic strategy for patients with advanced cancers, and some tumors have profound and durable tumor regression. However, immunotherapy is still in the clinical trial stage with elusive long-term effects and complications as a new strategy. It is unclear whether patients possess an accurate understanding of the clinical benefits associated with these agents. OBJECTIVE: To investigate the anxiety and depression of patients with advanced cancer who received immunotherapy using programmed death-1 or programmed death-ligand 1 after multiline treatment failure, explore the influencing factors, and provide a reference for clinical medical staff and psychological support for patients. METHODS: The Hospital Anxiety and Depression Scale was used to calculate the anxiety and depression scores before and after 1, 2, and 3 courses of treatment, respectively. The patients with anxiety and depression were counted. Purposive sampling was used to conduct face-to-face semi-structured interviews with 21 patients to find out the reasons. The obtained data were analyzed and collated using Colaizzi's phenomenological method. RESULTS: One hundred and twenty-six patients with advanced cancers were included in the study. Before and after 1, 2 and 3 courses of treatment, 18.26%, 23.0%, 50% and 54% of patients suffered from anxiety and depression, respectively. The proportion of patients with anxiety and depression during immunotherapy kept increasing, mainly due to therapeutic efficacy below expectation, lack of timely information after treatment, lack of awareness of treatment and drugs, and lack of family and social support. CONCLUSION: Patients with advanced tumors after multiline treatment failure are susceptible to anxiety and depression during immunotherapy. It is necessary to test the emotional state of patients in time and carry out early intervention. Nursing staffs and medical staffs should adopt personalized measures to meet the psychological needs of patients.

Predictive value of neuron-specific enolase, neutrophil-to-lymphocyte-ratio and lymph node metastasis for distant metastasis in small cell lung cancer.

OBJECTIVE: To investigate the value of neuron-specific enolase (NSE), neutrophil-to-lymphocyte ratio (NLR) and lymph node metastasis in predicating distant metastasis in patients with limited-stage small cell lung cancer (LD-SCLC). METHODS: Clinical pathological data of LD-SCLC patients in the First Affiliated Hospital of Wenzhou Medical University between August 2009 and October 2017 were retrospectively analyzed. The age, gender, smoking, TNM, NSE, NLR, chemotherapy cycle, radiotherapy, surgery and new metastasis of lymph nodes of 47 cases with distant metastasis and 47 cases without distant metastasis in 1 year were compared. Finally, factors influencing distant metastasis were determined as the predictors. The receiver operating characteristic (ROC) curve model was established based on logistic regression analysis of the factors obtained. RESULTS: Distant metastasis mainly involved brain (17/47), liver (17/47) and bone (17/47). Univariate analysis showed that patients with new lymph node metastasis, high NSE, pretreatment hilar lymph node metastasis and NLR were more prone to have distant metastasis. Multivariate analysis showed that new lymph node metastasis, high NSE, NLR and pretreatment hilar lymph node metastasis were independent predictors. The predictive model established using these predictors had an AUC of 0.872 (95%CI: 0.803-0.941), a sensitivity of 76.60% and a speciality of 80.85%. CONCLUSION: The new lymph node metastasis, NLR and NSE are predictors of distant metastasis, and thus, may have a profound impact on treatment decision making. Patients with lower NLR and NSE expression levels and less new metastasis of lymph nodes have a lower distant metastasis rate.

Non-Isothermal Crystallization Kinetics of Short Glass Fiber Reinforced Poly (Ether Ether Ketone) Composites.

Due to its excellent chemical and temperature resistances, short glass fiber reinforced poly (ether ether ketone) composite (SGF/PEEK) is a promising material for application in automotive lightweight. Processing conditions, such as cooling rate, need to be well controlled to obtain the optimal crystallite morphology of PEEK composites. Thus, in this paper, the non-isothermal crystallization kinetics and melting behavior of SGF/PEEK were investigated by differential scanning calorimetry (DSC) at different cooling rates, and the crystallite sizes were evaluated by the X-ray diffraction technique (XRD). Crystallization kinetics models and effective activation energies were evaluated to determine the crystallization parameters of the composites. The results suggest that a lower cooling rate enlarges the size of crystallites and enhances the uniformity of size distribution. The addition of glass fibers improves the nucleation rate owing to heterogeneous nucleation while decreasing the growth rate due to retarded movement of the polymer chain. The combined Avrami-Ozawa equation was shown to describe accurately the non-isothermal crystallization. The absolute value of the crystallization activation energy for SGF/PEEK is lower than that of pure PEEK.