High capacity and selective adsorption of Congo red by cellulose-based aerogel with mesoporous structure: Adsorption properties and statistical data simulation.

Large quantities of organic dyes are discharged into the environment, causing serious damage to the ecosystem. Therefore, it is urgent to develop inexpensive adsorbents to remove organic dyes. A novel cellulose-based aerogel (MPPA) with 3D porous structure was prepared by using cassava residue (cellulose) as basic construction blocks, doping ferroferric oxide (Fe3O4) for magnetic separation, and applying polyethyleneimine (PEI) as functional material for highly efficient and selective capture of Congo red (CR). MPPA exhibited porous network structure, numerous active capture sites, nontoxicity, high hydrophilicity, and excellent thermal stability. MPPA showed superior adsorption property for CR, with an equilibrium adsorption capacity of 2018.14 mg/g, and still had an adsorption property of 1189.31 mg/g after five recycling procedures. In addition, MPPA has excellent selectivity for CR in four binary dye systems. The adsorption behavior of MPPA on CR was further explored using a multilayer adsorption model, EDR-IDR hybrid model and AOAS model. Electrostatic potential and independent gradient models were used to further verify the possible interaction between MPPA and CR molecules. In conclusion, MPPA is a promising adsorbent in the field of treating anionic dyes.

Clinical outcomes of KRAS-mutant non-small cell lung cancer under untargeted therapeutic regimes in the real world: a retrospective observational study.

Background: Kirsten rat sarcoma viral oncogene homolog (KRAS) mutation seemingly suffered less effective therapeutic regimens in the absence of widely-accepted targeted drugs compared with other mutation types in non-small cell lung cancer (NSCLC). However, whether these non-selective therapy schedules for KRAS mutation matters is still under debate. Correspondingly, we aimed to compare the long term expectancy of indicated therapeutic regimes and further explore the optimal schemes of KRAS mutated NSCLC in the absence of targeted drugs in this retrospective study cohort. Methods: We conducted a single-center retrospective analysis among 66 patients diagnosed with KRAS-mutant advanced NSCLC from November 2018 to December 2020. These enrolled cases were divided into different subgroups in light of mutant isotypes, pathological characteristics, and therapeutic regimes to uncover indicated long-term survival benefits. Additionally, clinical outcomes of treatment schedules and interventional lines to KRAS-mutant NSCLC were described in detail. Results: This cohort enrolled 8 patients with stage IIIB (12.1%) and 58 patients with stage IV (87.9%) with the median age 62 years, ranging from 32 to 91 years old. Genetically, G12C conducted as the most common KRAS mutation type, accounting for 30.3%. Pemetrexed combined with platinum chemotherapy seemed to be a priority (72.7%), and chemotherapy combined with immunotherapy became an alternative (15.2%) in clinic. Performing further analysis of long-term survival of patients receiving different treatment methods indicated that the median overall survival (mOS) in first-line therapy with antiangiogenesis or untreated was 13 and 12 months, respectively (P=0.79). In the first-line regimen, median survival was 17 months for patients who received combined immune checkpoint inhibitors and 12 months for those who did not (P=0.34). The mOS was 20 months for those who had used immune checkpoint inhibitors and 12 months for those who had not (P=0.11). Survival analysis results of NSCLC patients with different KRAS mutation types showed the median survival time of patients with G12C mutation type and patients without with nonG12C mutation type was 19 and 12 months, respectively (P=0.37). Conclusions: In the absence of KRAS targeted drugs, available treatment plans failed to benefit KRAS mutant sufferers regardless of isotypes, making the KRAS-targeted drugs urgent.

Novel Anti-Cancer Products Targeting AMPK: Natural Herbal Medicine against Breast Cancer.

Breast cancer is a common cancer in women worldwide. The existing clinical treatment strategies have been able to limit the progression of breast cancer and cancer metastasis, but abnormal metabolism, immunosuppression, and multidrug resistance involving multiple regulators remain the major challenges for the treatment of breast cancer. Adenosine 5'-monophosphate (AMP)-Activated Protein Kinase (AMPK) can regulate metabolic reprogramming and reverse the "Warburg effect" via multiple metabolic signaling pathways in breast cancer. Previous studies suggest that the activation of AMPK suppresses the growth and metastasis of breast cancer cells, as well as stimulating the responses of immune cells. However, some other reports claim that the development and poor prognosis of breast cancer are related to the overexpression and aberrant activation of AMPK. Thus, the role of AMPK in the progression of breast cancer is still controversial. In this review, we summarize the current understanding of AMPK, particularly the comprehensive bidirectional functions of AMPK in cancer progression; discuss the pharmacological activators of AMPK and some specific molecules, including the natural products (including berberine, curcumin, (-)-epigallocatechin-3-gallate, ginsenosides, and paclitaxel) that influence the efficacy of these activators in cancer therapy; and elaborate the role of AMPK as a potential therapeutic target for the treatment of breast cancer.

Reactions of Thorium Oxide Clusters with Water: The Effects of Oxygen Content.

Thorium oxide has many important applications in industry. In this article, theoretical calculations have been carried out to explore the hydrolysis reactions of the ThOn (n=1-3) clusters. The reaction mechanisms of the O-deficient ThO and the O-rich ThO3 are compared with the stoichiometric ThO2 . The theoretical results show good agreement with the prior experiments. It is shown that the hydrolysis mainly occurred on the singlet potential surface. The overall reactions consist of two hydrolysis steps which are all favourable in energy. The effects of oxygen content on the hydrolysis are elucidated. Interestingly, among them, the peroxo group O2 2- in ThO3 is converted to the HOO- ligand, behaving like the terminal O2- in the hydrolysis which is transformed into the HO- groups. In addition, natural bond orbital (NBO) analyses were employed to further understand the bonding of the pertinent species and to interpret the differences in hydrolysis.

Titanium-coated PEEK Versus Uncoated PEEK Cages in Lumbar Interbody Fusion: A Systematic Review and Meta-analysis of Randomized Controlled Trial.

STUDY DESIGN: Systematic review and meta-analysis. OBJECTIVE: This study was performed to compare the fusion and subsidence rate of titanium-coated polyetheretherketone (Ti-PEEK) versus polyetheretherketone (PEEK) cages after lumbar fusion and to investigate the clinical effect on patient-reported outcomes (PROMs). SUMMARY OF BACKGROUND DATA: Ti-PEEK cages have been developed to combine the advantages of both titanium alloy and PEEK, but whether they are superior to uncoated PEEK cages in bone fusion is still inconclusive. METHODS: PubMed, EMBASE, ISI Web of Science, CENTRAL, and CNKI were searched to identify randomized controlled trials that compared the efficacy of Ti-PEEK and PEEK cages in lumbar fusion. Difference in fusion rate and subsidence rate was indicated by risk ratio and its associated 95% confidence interval (95% confidence interval). Mean difference was calculated for Oswestry Disability Index and visual analogue scale for low back pain. Subgroup analysis was performed by time course after the surgery. The Grading of Recommendations, Assessment, Development and Evaluation approach was used to evaluate the certainty of evidence. RESULTS: Four randomized controlled trials involving 325 patients (160 patients in Ti-PEEK group and 165 patients in PEEK group) that underwent lumbar fusion were included by our current study. Low to moderate evidence suggested that Ti-PEEK and PEEK cages exhibited equivalent fusion rate and subsidence rate at any follow-up time. Low to moderate evidence suggested that there was no difference in PROMs except for visual analogue scale measured at 6 months (mean difference: -0.57, 95% confidence interval -0.94, -0.21; P =0.002) but the difference was not clinically relevant according to the minimal clinically important difference. CONCLUSION: Low to moderate evidence showed that Ti-PEEK and PEEK had equivalent effect in bone fusion and cages subsidence at any follow-up time after lumbar fusion surgeries. Low to moderate evidence showed no clinically important difference in PROMs.

Therapeutic potential of dental pulp stem cells and their derivatives: Insights from basic research toward clinical applications.

For more than 20 years, researchers have isolated and identified postnatal dental pulp stem cells (DPSCs) from different teeth, including natal teeth, exfoliated deciduous teeth, healthy teeth, and diseased teeth. Their mesenchymal stem cell (MSC)-like immunophenotypic characteristics, high proliferation rate, potential for multidirectional differentiation and biological features were demonstrated to be superior to those of bone marrow MSCs. In addition, several main application forms of DPSCs and their derivatives have been investigated, including stem cell injections, modified stem cells, stem cell sheets and stem cell spheroids. In vitro and in vivo administration of DPSCs and their derivatives exhibited beneficial effects in various disease models of different tissues and organs. Therefore, DPSCs and their derivatives are regarded as excellent candidates for stem cell-based tissue regeneration. In this review, we aim to provide an overview of the potential application of DPSCs and their derivatives in the field of regenerative medicine. We describe the similarities and differences of DPSCs isolated from donors of different ages and health conditions. The methodologies for therapeutic administration of DPSCs and their derivatives are introduced, including single injections and the transplantation of the cells with a support, as cell sheets, or as cell spheroids. We also summarize the underlying mechanisms of the regenerative potential of DPSCs.

Multimodal Analgesia With Sevoflurane Provides Enhanced Intraoperative Analgesic Effects in Percutaneous Nephrolithotomy: A Randomized, Blinded Clinical Trial.

BACKGROUND: Percutaneous nephrolithotomy (PCNL) is the first-line and guideline-recommended treatment for large renal calculi. Multimodal analgesia (MMA) comprising a combination of different analgesics is an increasingly popular method for pain control as it has been shown to reduce postoperative pain and reduce opioid use and the risk of opioid misuse, with a shorter recovery time in various procedures and patient populations. OBJECTIVE: In this study, we tested the hypothesis that MMA with propofol and sevoflurane (PS) can decrease pain intensity during surgery and used IoC2 as a real-time index of the analgesic effect of sevoflurane. STUDY DESIGN: Prospective, single-center, double-blind, randomized controlled clinical trial. SETTING: Xuanwu Hospital of Capital Medical University. METHODS: Patients scheduled for elective percutaneous nephrolithotomy from January 2020 to July 2020 were randomized into 2 groups, standard multimodal analgesia (propofol + sevoflurane group) and control (propofol [P] group). The PS group received propofol 2.5 mg/kg/h along with 1% sevoflurane after induction for 30 minutes during the main anesthetic procedure, and the P group received propofol 5 mg/kg/h by intravenous infusion during the operation. Index of consciousness 2 (IoC2), namely nociception index, intraoperative hemodynamic fluctuation, bispectral index (BIS), electromyography, postanesthesia care unit (PACU) length of stay, visual analog scale (VAS) score, and Aldrete and Steward scores were recorded. RESULTS: A total of 153 patients undergoing PCNL were enrolled. The demographic and clinical characteristics were similar between the 2 groups. IoC2 was reduced in the PS group compared to the P group at T10, T11, T12, T13, T14, and T15 time points, indicating that analgesia was more effective in the former. The BIS of the PS group did not differ significantly from that of the P group except at T12, T13, T14, and T15. PACU length of stay was shorter in the PS group than in the P group (mean [SD]: 54.35 [16.61] vs 47.39 [13.15], P = 0.04). VAS pain scores did not differ significantly between the 2 groups. CONCLUSION: MMA with propofol and sevoflurane provided better analgesia than propofol alone and may be an effective method to reduce stress and the intraoperative nociceptive stimulus response in patients undergoing PCNL, thereby promoting rapid postoperative recovery.

Neuroendocrine-Immune Regulatory Network of Eucommia ulmoides Oliver.

Eucommia ulmoides Oliver (E. ulmoides) is a popular medicinal herb and health supplement in China, Japan, and Korea, and has a variety of pharmaceutical properties. The neuroendocrine-immune (NEI) network is crucial in maintaining homeostasis and physical or psychological functions at a holistic level, consistent with the regulatory theory of natural medicine. This review aims to systematically summarize the chemical compositions, biological roles, and pharmacological properties of E. ulmoides to build a bridge between it and NEI-associated diseases and to provide a perspective for the development of its new clinical applications. After a review of the literature, we found that E. ulmoides has effects on NEI-related diseases including cancer, neurodegenerative disease, hyperlipidemia, osteoporosis, insomnia, hypertension, diabetes mellitus, and obesity. However, clinical studies on E. ulmoides were scarce. In addition, E. ulmoides derivatives are diverse in China, and they are mainly used to enhance immunity, improve hepatic damage, strengthen bones, and lower blood pressure. Through network pharmacological analysis, we uncovered the possibility that E. ulmoides is involved in functional interactions with cancer development, insulin resistance, NAFLD, and various inflammatory pathways associated with NEI diseases. Overall, this review suggests that E. ulmoides has a wide range of applications for NEI-related diseases and provides a direction for its future research and development.

Hypothermia selectively protects the anterior forebrain mesocircuit during global cerebral ischemia.

Hypothermia is an important protective strategy against global cerebral ischemia following cardiac arrest. However, the mechanisms of hypothermia underlying the changes in different regions and connections of the brain have not been fully elucidated. This study aims to identify the metabolic nodes and connection integrity of specific brain regions in rats with global cerebral ischemia that are most affected by hypothermia treatment. 18F-fluorodeoxyglucose positron emission tomography was used to quantitatively determine glucose metabolism in different brain regions in a rat model of global cerebral ischemia established at 31-33°C. Diffusion tensor imaging was also used to reconstruct and explore the brain connections involved. The results showed that, compared with the model rats established at 37-37.5°C, the rat models of global cerebral ischemia established at 31-33°C had smaller hypometabolic regions in the thalamus and primary sensory areas and sustained no obvious thalamic injury. Hypothermia selectively preserved the integrity of the anterior forebrain mesocircuit, exhibiting protective effects on the brain during the global cerebral ischemia. The study was approved by the Institutional Animal Care and Use Committee at Capital Medical University (approval No. XW-AD318-97-019) on December 15, 2019.

O3-Type Na2/3Ni1/3Ti2/3O2 Layered Oxide as a Stable and High-Rate Anode Material for Sodium Storage.

Sodium-ion batteries (SIBs) are currently the most promising candidates for large-scale energy storage devices owing to their low cost and abundant resources. Titanium-based layered oxides have attracted widespread attention as promising anode materials due to delivering a safe potential of about 0.7 V (vs Na+/Na) and a small volume contraction during cycles; P2-type Ti-based layered oxides are typically reported, due to the challenging synthesis of the O3-type counterpart resulting from the high percentage of unstable Ti3+. Herein, we report an anomalous O3-Na2/3Ni1/3Ti2/3O2 layered oxide as an ultrastable and high-rate anode material for SIBs. The anode material delivers a reversible capacity of 112 mA h g-1 after 300 cycles at 0.1 C, a good capacity retention rate of 91% after 1400 cycles at 2 C, and, in particular, a capacity of 52 mA h g-1 even at a high rate of 20 C (1780 mA g-1). Furthermore, the in situ X-ray diffraction monitoring reveals no phase transitions and almost zero strain both underlie the good long-cycle stability. The measured high apparent Na+ diffusion coefficient (2.06 × 10-10 cm2 s-1) and the low migration energy barrier (0.59 eV) from density functional theory calculations are responsible for the superior rate capability. Our results promise advanced high-performance O3-type Ti-based layered oxides as promising anode materials toward application for SIBs.

Priming strategies for controlling stem cell fate: Applications and challenges in dental tissue regeneration.

Mesenchymal stromal cells (MSCs) have attracted intense interest in the field of dental tissue regeneration. Dental tissue is a popular source of MSCs because MSCs can be obtained with minimally invasive procedures. MSCs possess distinct inherent properties of self-renewal, immunomodulation, proangiogenic potential, and multilineage potency, as well as being readily available and easy to culture. However, major issues, including poor engraftment and low survival rates in vivo, remain to be resolved before large-scale application is feasible in clinical treatments. Thus, some recent investigations have sought ways to optimize MSC functions in vitro and in vivo. Currently, priming culture conditions, pretreatment with mechanical and physical stimuli, preconditioning with cytokines and growth factors, and genetic modification of MSCs are considered to be the main strategies; all of which could contribute to improving MSC efficacy in dental regenerative medicine. Research in this field has made tremendous progress and continues to gather interest and stimulate innovation. In this review, we summarize the priming approaches for enhancing the intrinsic biological properties of MSCs such as migration, antiapoptotic effect, proangiogenic potential, and regenerative properties. Challenges in current approaches associated with MSC modification and possible future solutions are also indicated. We aim to outline the present understanding of priming approaches to improve the therapeutic effects of MSCs on dental tissue regeneration.

Cation-Disordered O3-Na0.8Ni0.6Sb0.4O2 Cathode for High-Voltage Sodium-Ion Batteries.

O3-type sodium-layered oxides (such as antimony-based O3 structures) have been suggested as one of the most fascinating cathode materials for sodium-ion batteries (SIBs). Honeycomb-ordered antimony-based O3 structures, however, unsatisfactorily exhibit complex phase transitions and sluggish Na+ kinetics during cycling. Herein, we prepared a completely cationic-disordered O3-type Na0.8Ni0.6Sb0.4O2 compound by composition regulation for SIBs. Surprisingly, the measured redox potentials for typical O3-P3 phase transition are located at 3.4 V. Operando X-ray diffraction confirms a reversible phase transition process from the O3 to P3 structure accompanied with a very small volume change (1.0%) upon sodium extraction and insertion. The low activation barrier energy of 400 meV and the fast Na+ migration of 10-11 cm2·s-1 are further obtained by first-principles calculations and galvanostatic intermittent titration technique, respectively. As a result, the O3-Na0.8Ni0.6Sb0.4O2 cathode displays a reversible capacity of 106 mA h g-1 at 0.1C (12 mA g-1), smooth charge-discharge curves, and a high average working voltage of 3.5 V during battery cycling. The results highlight the importance of searching for a new O3-type structure with cation-disordering and high working voltage for realizing high energy SIBs.

Comprehensive Characterization of Immune Landscape Based on Epithelial-Mesenchymal Transition Signature in OSCC: Implication for Prognosis and Immunotherapy.

Current anatomic TNM stage classification fails to capture the immune heterogeneity of oral squamous cell carcinoma (OSCC). Increasing evidence indicates the strong association between epithelial-mesenchymal transition (EMT) and tumor immune response. In this study, we employed an EMT signature to classify OSCC patients into epithelial- (E-) and mesenchymal- (M-) phenotypes using TCGA and GSE41613 transcriptome data. The ESTIMATE and CIRBERSORT analyses implied that the EMT signature genes originated from the stroma of the bulk tissue. The M-subtype tumors were characterized as "immune-hot" with more immune cell infiltration than the E-subtype ones. The low infiltration of active immune cells, the high infiltration of inactive immune cells, and the high expressions of immune checkpoints demonstrated an immunosuppressive characteristic of the M-subtype tumors. Moreover, we developed and validated a novel prognostic classifier based on the EMT score, the expressions of seven immune checkpoints, and the TNM stages, which could improve the prediction efficiency of the current clinical parameter. Together, our findings provide a better understanding of the tumor immune heterogeneity and may aid guiding immunotherapy in OSCC.

[Characteristics of Dissolved Organic Matter in Overlying Water During Algal Bloom Decay].

In this study, indoor simulation experiments were performed to elucidate the effects of migration and transformation of dissolving organic matter (DOM) during the decay of algal blooms. Based on ultraviolet-visible spectra (UV-vis) and excitation-emission matrix spectroscopy (EEMs), spectral characterizations of dissolved organic matter (DOM) in overlying water were evaluated with analyses of the physical and chemical indexes, variation in dissolved organic carbon (DOC), and variation in dissolved inorganic carbon (DIC). Results showed that at the early stage of decay, a large amount of organic matter was released, and dissolved oxygen (DO) decreased sharply. With the extension of reaction time, DOC gradually changed into DIC, which further changed the oxidation-reduction and acid-base characteristics of the water. UV-vis spectra showed that a large amount of DOM was released with high aromaticity and a high degree of humification, and the released DOM was gradually degraded. With the application of parallel factor analysis in excitation-emission matrix spectroscopy (EEM-PARAFAC), three fluorescence components were analyzed:refractory humic-like substances (C1), protein-like tryptophan substances (C2) produced by algae, and fulvic-like substances (C3) related to microbial activities. Most protein-like tryptophan substances were degraded into fulvic-like substances by microorganisms during the decaying process. Heterotrophic microorganisms promoted the release of algae-derived DOM and accelerated the degradation of DOM. The DOM born during algae blooms decaying process was eventually converted into humic-like substance, which was difficult to be degraded. We analyzed correlations of water quality, UV-vis spectrum, and EEMs parameters. Results showed that ORP was positively correlated (P<0.05) with DO. There was a significant negative correlation (P<0.05) between pH and DOC, which was consistent with the trend of the transformation to from DOC to DIC; C1 was positively correlated (P<0.05) with Fn355; and C2 was significantly positively correlated (P<0.05) with DOC and Fn280; C3 was positively correlated (P<0.05) with FI, BIX and ß:α. The variation trend of these spectral parameters was consistent with that of DOM components. In summary, with the analyses of water quality characteristics and spectral characteristics of DOM in overlying water during algae blooms decaying process, it was expected that our results could contribute to the further exploration of the dynamic migration and transformation of lake DOM and the changes of carbon cycling.

Multitask 3D CBCT-to-CT translation and organs-at-risk segmentation using physics-based data augmentation.

PURPOSE: In current clinical practice, noisy and artifact-ridden weekly cone beam computed tomography (CBCT) images are only used for patient setup during radiotherapy. Treatment planning is performed once at the beginning of the treatment using high-quality planning CT (pCT) images and manual contours for organs-at-risk (OARs) structures. If the quality of the weekly CBCT images can be improved while simultaneously segmenting OAR structures, this can provide critical information for adapting radiotherapy mid-treatment as well as for deriving biomarkers for treatment response. METHODS: Using a novel physics-based data augmentation strategy, we synthesize a large dataset of perfectly/inherently registered pCT and synthetic-CBCT pairs for locally advanced lung cancer patient cohort, which are then used in a multitask three-dimensional (3D) deep learning framework to simultaneously segment and translate real weekly CBCT images to high-quality pCT-like images. RESULTS: We compared the synthetic CT and OAR segmentations generated by the model to real pCT and manual OAR segmentations and showed promising results. The real week 1 (baseline) CBCT images which had an average mean absolute error (MAE) of 162.77 HU compared to pCT images are translated to synthetic CT images that exhibit a drastically improved average MAE of 29.31 HU and average structural similarity of 92% with the pCT images. The average DICE scores of the 3D OARs segmentations are: lungs 0.96, heart 0.88, spinal cord 0.83, and esophagus 0.66. CONCLUSIONS: We demonstrate an approach to translate artifact-ridden CBCT images to high-quality synthetic CT images, while simultaneously generating good quality segmentation masks for different OARs. This approach could allow clinicians to adjust treatment plans using only the routine low-quality CBCT images, potentially improving patient outcomes. Our code, data, and pre-trained models will be made available via our physics-based data augmentation library, Physics-ArX, at https://github.com/nadeemlab/Physics-ArX.

Generalizable cone beam CT esophagus segmentation using physics-based data augmentation.

Automated segmentation of the esophagus is critical in image-guided/adaptive radiotherapy of lung cancer to minimize radiation-induced toxicities such as acute esophagitis. We have developed a semantic physics-based data augmentation method for segmenting the esophagus in both planning CT (pCT) and cone beam CT (CBCT) using 3D convolutional neural networks. One hundred and ninety-one cases with their pCTs and CBCTs from four independent datasets were used to train a modified 3D U-Net architecture and a multi-objective loss function specifically designed for soft-tissue organs such as the esophagus. Scatter artifacts and noises were extracted from week-1 CBCTs using a power-law adaptive histogram equalization method and induced to the corresponding pCT were reconstructed using CBCT reconstruction parameters. Moreover, we leveraged physics-based artifact induction in pCTs to drive the esophagus segmentation in real weekly CBCTs. Segmentations were evaluated using the geometric Dice coefficient and Hausdorff distance as well as dosimetrically using mean esophagus dose and D 5cc. Due to the physics-based data augmentation, our model trained just on the synthetic CBCTs was robust and generalizable enough to also produce state-of-the-art results on the pCTs and CBCTs, achieving Dice overlaps of 0.81 and 0.74, respectively. It is concluded that our physics-based data augmentation spans the realistic noise/artifact spectrum across patient CBCT/pCT data and can generalize well across modalities, eventually improving the accuracy of treatment setup and response analysis.

P3/O3 Integrated Layered Oxide as High-Power and Long-Life Cathode toward Na-Ion Batteries.

Low-cost and stable sodium-layered oxides (such as P2- and O3-phases) are suggested as highly promising cathode materials for Na-ion batteries (NIBs). Biphasic hybridization, mainly involving P2/O3 and P2/P3 biphases, is typically used to boost their electrochemical performances. Herein, a P3/O3 intergrown layered oxide (Na2/3 Ni1/3 Mn1/3 Ti1/3 O2 ) as high-rate and long-life cathode for NIBs via tuning the amounts of Ti substitution in Na2/3 Ni1/3 Mn2/3- x Tix O2 (x = 0, 1/6, 1/3, 2/3) is demonstrated. The X-ray diffraction (XRD) Rietveld refinement and aberration-corrected scanning transmission electron microscopy show the co-existence of P3 and O3 phases, and density functional theory calculation corroborates the appearance of the anomalous O3 phase at the Ti substitution amount of 1/3. The P3/O3 biphasic cathode delivers an unexpected rate capability (≈88.7% of the initial capacity at a high rate of 5 C) and cycling stability (≈68.7% capacity retention after 2000 cycles at 1 C), superior to those of the sing phases P3-Na2/3 Ni1/3 Mn2/3 O2 , P3-Na2/3 Ni1/3 Mn1/2 Ti1/6 O2 , and O3-Na2/3 Ni1/3 Ti2/3 O2 . The highly reversible structural evolution of the P3/O3 integrated cathode observed by ex situ XRD, ex situ X-ray absorption spectra, and the rapid Na+ diffusion kinetics, underpin the enhancement. These results show the important role of P3/O3 biphasic hybridization in designing and engineering layered oxide cathodes for NIBs.

Early Prediction of Acute Esophagitis for Adaptive Radiation Therapy.

PURPOSE: Acute esophagitis (AE) is a common dose-limiting toxicity in radiation therapy of locally advanced non-small cell lung cancer (LA-NSCLC). We developed an early AE prediction model from weekly accumulated esophagus dose and its associated local volumetric change. METHODS AND MATERIALS: Fifty-one patients with LA-NSCLC underwent treatment with intensity modulated radiation therapy to 60 Gy in 2-Gy fractions with concurrent chemotherapy and weekly cone beam computed tomography (CBCT). Twenty-eight patients (55%) developed grade ≥2 AE (≥AE2) at a median of 4 weeks after the start of radiation therapy. For early ≥AE2 prediction, the esophagus on CBCT of the first 2 weeks was deformably registered to the planning computed tomography images, and weekly esophagus dose was accumulated. Week 1-to-week 2 (w1→w2) esophagus volume changes including maximum esophagus expansion (MEex%) and volumes with ≥x% local expansions (VEx%; x = 5, 10, 15) were calculated from the Jacobian map of deformation vector field gradients. Logistic regression model with 5-fold cross-validation was built using combinations of the accumulated mean esophagus doses (MED) and the esophagus change parameters with the lowest P value in univariate analysis. The model was validated on an additional 18 and 11 patients with weekly CBCT and magnetic resonance imaging (MRI), respectively, and compared with models using only planned mean dose (MEDPlan). Performance was assessed using area under the curve (AUC) and Hosmer-Lemeshow test (PHL). RESULTS: Univariately, w1→w2 VE10% (P = .004), VE5% (P = .01) and MEex% (P = .02) significantly predicted ≥AE2. A model combining MEDW2 and w1→w2 VE10% had the best performance (AUC = 0.80; PHL = 0.43), whereas the MEDPlan model had a lower accuracy (AUC = 0.67; PHL = 0.26). The combined model also showed high accuracy in the CBCT (AUC = 0.78) and MRI validations (AUC = 0.75). CONCLUSIONS: A CBCT-based, cross-validated, and internally validated model on MRI with a combination of accumulated esophagus dose and local volume change from the first 2 weeks of chemotherapy significantly improved AE prediction compared with conventional models using only the planned dose. This model could inform plan adaptation early to lower the risk of esophagitis.

Insights on Electrochemical Behaviors of Sodium Peroxide as a Sacrificial Cathode Additive for Boosting Energy Density of Na-Ion Battery.

The development of Na-ion full cells (NIFCs) suffers from the issue that the solid electrolyte interphase formation on the carbon anode consumes the limited sodium from cathode and thus incurs the decreased energy density and poor cyclic stability. To address these issues, we herein report that Na2O2 could be used as a sacrificial Na source through spraying its slurry on the surface of cathode, and investigate its stability as well as electrochemical behavior toward NIFCs. The results show that Na2O2 has good chemical and storage stability under a dry atmosphere and has no negative effect on the electrochemical performance of the cathode. Compared with the pristine cathode, the Na2O2-decorated cathode exhibits higher discharge capacity, superior capacity retention, and rate capability in a full cell with a carbon anode. Our cathode Na compensation strategy provides an effective avenue to make up for the irreversible Na+ loss cause by the formation of solid electrolyte interphase on the anode, thereby promoting the electrochemical performance and energy density of NIFCs toward the large-scale application.