High Cutoff Research Articles

Acute Kidney Injury, Renal Replacement Therapy, and Extracorporeal Membrane Oxygenation Treatment During the COVID-19 Pandemic: Single-Center Experience

Background and Objectives: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) was described in December 2019 for the first time, and it was responsible for a global pandemic. An alarming number of patients with coronavirus disease 2019 (COVID-19) also developed acute kidney injury (AKI), especially those who required extracorporeal membrane oxygenation (ECMO) therapy for acute respiratory distress syndrome (ARDS). The aim of our retrospective observational study was to assess the prognostic significance of AKI in these patients. This study observed, in COVID-19 patients admitted to an intensive care unit (ICU), AKI stages and the need for renal replacement therapy (RRT), assessing the risk factors and outcomes. Moreover, we evaluated the mortality rate of patients treated by ECMO. Materials and Methods: Between November 2020 and December 2022, among 396 patients admitted to our intensive care unit (ICU) diagnosed with SARS-CoV-2 infection, we selected patients with severe ARDS requiring veno-venous (vv) ECMO support and AKI. Results: The 30-day mortality after ECMO positioning was 85.7%. A Cox regression revealed a significant advantage for RRT with a high cut-off (HCO) hemofilter both for ICU mortality (HR 0.17 [95% CI: 0.031–0.935], p = 0.035) and 15 day-mortality after the start of vv-ECMO (HR 0.13 [95%CI: 0.024–0.741], p= 0.021), whereas the early onset of vasoplegic shock after ECMO implantation indicated a higher risk of death (HR 11.55 [95% CI: 1.117–119.567], p = 0.04) during the ICU stay. Conclusions: COVID-19 induces a high risk of AKI and RRT. In our cohort, hypertension, pre-existing renal disease, and mechanical ventilation represented independent risk factors for AKI. Patients requiring ECMO support had a high mortality rate. The early implementation of RRT reduced the risk of death during the ICU stay.

Detection of Central Compartment Lymph Node Metastasis of Thyroid Cancer: Usefulness of Intraoperative Thyroglobulin Measurement in Fine Needle Aspiration Washout with and Without Blue Dye Injection

Background/Objectives: The management of lymph node metastases of the central neck compartment (CNC) in differentiated thyroid carcinoma is debated. The intraoperative measurement of thyroglobulin (Tg) has gained attention in accurately detecting metastases, reducing unnecessary CNC dissections. Methods: A total of 37 patients underwent surgery. An intraoperative assay of thyroglobulin from fine needle aspiration (Tg-FNA) was performed on CNC lymph nodes, identified by blue dye injection in 15 patients (23 nodes, group A) and by palpation in 22 patients (35 nodes, group B). The Tg-FNA values were compared with histology to calculate the diagnostic accuracy. Results: In group A, the blue dye diffused widely, complicating lymph node identification: 2 were metastatic and 21 non-metastatic, with median Tg-FNA levels of 6236 ng/mL and 99.20 ng/mL, respectively. In group B, 8 were metastatic and 27 benign, with median Tg-FNA levels of 4063 ng/mL and 121 ng/mL (p < 0.0001), respectively. ROC analysis identified 500 ng/mL as a cutoff, achieving 100% sensitivity and 74% specificity in group B and 90% sensitivity and 70% specificity overall. Finally, among the non-metastatic lymph nodes, group A exhibited some cases of very high Tg-FNA values compared to group B, with lower accuracy for the cutoff, suggesting that colorant injection might lead to increased Tg-FNA levels. Conclusions: Blue dye injection showed low accuracy. Intraoperative Tg-FNA was reliable in detecting CNC metastases, although a higher cutoff is needed in this compartment compared to what has been reported for lateral lymph nodes. Lymphatic drainage and surgical manipulation might explain these findings. The careful interpretation of Tg-FNA in CNC should be adopted.

P0280 Evaluation of the diagnostic accuracy of trans-perineal ultrasound for predicting rectal histoendoscopic remission in Ulcerative Colitis (The TRINITY Study): A prospective, paired, comparative study with endoscopic ultrasound and trans-abdominal ultrasound

Abstract Background Rectum, frequently involved in Ulcerative colitis (UC) is challenging to evaluate using trans-abdominal sonography (TAS). Earlier single centre study have shown that rectal total wall thickness (TWT) (<4 mm) on trans-perineal ultrasound (TPUS) accurately predicts rectal inflammation(1). Inspite of being point-of-care, TPUS can only evaluate the lower rectum (~5 cm) and studies with trans-vaginal ultrasound have shown higher cut offs for rectal TWT(2). This study (comparison of TRIple Rectal UltrasouNd Imaging Technology : TRINITY) aimed to comprehensively evaluate the diagnostic accuracy of TPUS in predicting rectal histoendoscopic activity, using endoscopic ultrasound (EUS) as the reference standard. Methods 114 UC patients [age 18-70 yr (median- 37), 64 % male, E1: 16, E2: 61, E3: 37] underwent point-of-care TAS and TPUS followed by sigmoidoscopy with biopsy and rectal EUS. On TAS and TPUS, rectal TWT (average of anterior and posterior) and vascularity (Modified Limberg Score, MLS) were evaluated. On EUS, rectal TWT (average of upper, middle and lower and separately lower), vascularity (MLS), mucosal thickness (MT), and submucosal thickness (SMT) were measured. Diagnostic accuracy for predicting endoscopic activity (Ulcerative colitis endoscopic index of severity: UCEIS>1 in rectum) and histologic activity (Nancy Index≥1) was evaluated using receiver operating characteristic (ROC) curves. Results For prediction of both endoscopic and histologic activity, EUS outperformed TPUS. TAS was not useful (p>0.05) For endoscopic activity (n=114): EUS: Mucosal thickness>0.95 mm: AUC:0.95 (p<0.001); average TWT> 4 mm: AUC:0.89 (p<0.001); Vascularity (MLS) >1: AUC:0.93 (p<0.001); SMT>2.2 mm: AUC:0.84,(p<0.001). TPUS: rectal TWT >5.6 mm: AUC:0.68 (p=0.001); MLS ≥1:AUC:0.74 (p<0.001). TAS: TWT >6.3 mm:AUC: 0.57(p=0.25); MLS ≥1:AUC: 0.61 (p=0.04). For predicting histologic activity(n=81): EUS: lower rectal vascularity (MLS ≥1): AUC: 0.84, p<0.001; SMT>2.1 mm: AUC: 0.71, p<0.001; MT≥1 mm: AUC:0.81, p<0.001; TWT>5.6 mm: AUC:0.65, p=0.02. TPUS:rectal TWT≥ 5.6 mm: AUC:0.65 (p=0.02); vascularity (MLS≥1) AUC: 0.65 (p=0.036). TAS:TWT ≥ 6.3 mm: AUC:0.56, p=0.44; vascularity (MLS ≥1), AUC:0.59, p=0.18. Conclusion Although EUS remains the gold standard for assessing rectal inflammation, its invasive nature limits routine clinical use. TPUS offers a point-of-care, non-invasive alternative with moderate accuracy for predicting histoendoscopic remission with higher cut off levels contrary to previous reports. Further refinements in TPUS techniques and protocols are warranted to enhance its widespread applicability in clinical practice.

Breaking Anionic Solvation Barrier for Safe and Durable Potassium-ion Batteries Under Ultrahigh-Voltage Operation.

Ultrahigh-voltage potassium-ion batteries (PIBs) with cost competitiveness represent a viable route towards high energy battery systems. Nevertheless, rapid capacity decay with poor Coulombic efficiencies remains intractable, mainly attributed to interfacial instability from aggressive potassium metal anodes and cathodes. Additionally, high reactivity of K metal and flammable electrolytes pose severe safety hazards. Herein, a weakly solvating fluorinated electrolyte with intrinsically nonflammable feature is successfully developed to enable an ultrahigh-voltage (up to 5.5 V) operation. Through breaking the anionic solvation barrier, synergistic interfacial modulation can be achieved by the formation of robust anion-derived inorganic-rich electrode-electrolyte interfaces on both the cathode and anode. As proof of concept, a representative KVPO4F cathode can sustain 1600 cycles with 84.4% of capacity retention at a high cutoff voltage of 4.95 V. Meanwhile, K plating/stripping process in our designed electrolyte also demonstrates optimized electrochemical reversibility and stability with effectively inhibited potassium dendrites. These findings underscore the critical impact of anion-dominated solvation configuration on synergistic interfacial modulation and electrochemical properties. This work provides new insights into rational design of ultrahigh-voltage and safe electrolyte for advanced PIBs.

Advantages and Challenges of Graphene Transistors for High-Frequency Applications

Graphene is regarded as an ideal material for next-generation high-frequency (HF) electronic devices, attributed to its unique two-dimensional structure, high carrier mobility, and exceptional electrical properties. In recent years, the limitations of conventional silicon-based technologies for high-frequency applications have become increasingly apparent, resulting in heightened interest in graphene transistors, which exhibit significant potential for applications in wireless communications, radar systems, and terahertz technology. These transistors exhibit high cutoff frequency and low noise characteristics, along with favorable bipolar properties, which provide them with significant advantages in radio frequency (RF) applications. However, despite the significant theoretical advantages of graphene materials, their practical application is still restricted by multiple factors. Specifically, insufficient voltage gain from weak current saturation, material uniformity issues, and large-scale production challenges have restricted the widespread adoption of graphene transistors in high-frequency electronic devices. This paper reviews the relevant literature, examines the disparity between the electrical performance and practical applications of graphene transistors, and identifies the key factors influencing their implementation. The results demonstrate that targeted bandgap engineering, innovative device architectures, and the exploration of new materials can help graphene transistors can mitigate existing challenges and position themselves as key components in future HF electronic devices, driving significant advancements and broader integration of related technologies.

Human leukocyte antigen alloimmunization in a randomized trial of amustaline/glutathione pathogen-reduced red cells in complex cardiac surgery patients.

Although alloimmunization risk of pathogen-reduced (PR) platelets has been studied, the risk has not been reported with PR red blood cells (RBCs). In a Phase III, randomized, controlled trial (Red Cell Pathogen Inactivation), cardiac or thoracic-aorta surgery patients were randomized to transfusion with amustaline/glutathione PR versus conventional RBCs. Pre-transfusion and Day 28 samples were evaluated for Human leukocyte antigen (HLA) Class I and Class II antibodies at low, medium, and high cutoff values. The HLA alloimmunization analysis included 114 participants (53% female) in the PR and 113 (51% female) in the conventional RBC arms. In a modified intention-to-treat analysis, 13.7% (N = 29) and 7.2% (N = 15) developed new high-level HLA Class I or Class II antibodies, respectively; however, there was no signal that PR-RBCs affected the rate of HLA Class I (odds ratio (OR) 1.3 [95% confidence interval (CI) 0.62-2.9]) or Class II antibody formation (OR 0.99 [95% CI 0.35-2.8]). Female transfusion recipients had higher risk of developing new high-level HLA Class I antibodies (OR 12.0 [95% CI 3.5-40.9]) and Class II antibodies (OR 5.0 [95% CI 1.4-17]). The mean number of RBC (5.5 vs. 3.6 units, p = 0.018) and platelet (1.8 vs. 1.1 units, p = 0.043) transfusions was higher in subjects with new high-level HLA Class II antibodies. Receipt of amustaline/glutathione PR-RBC units did not affect HLA alloimmunization risk. Female sex and number of RBC and platelet transfusions were risk factors for the development of new high-level HLA Class I and Class II antibodies.

AlScN/GaN HEMTs with 4 A/mm on-current and maximum oscillation frequency >130 GHz

Abstract Aluminum Scandium Nitride (AlScN) is an attractive material for use as a lattice-matched epitaxial barrier layer in GaN high-electron mobility transistors (HEMTs). Here we report the device fabrication, direct current (DC) and radio frequency (RF) characteristics of epitaxial AlScN/AlN/GaN HEMTs on SiC substrates with regrown ohmic contacts. These devices show record high on-current of over 4 A/mm, high cutoff frequency (f T ) of 92.4 GHz and maximum oscillation frequency ( f MAX ) of 134.3 GHz.

Integrated Oxygen-Constraining Strategy for Ni-Rich Layered Oxide Cathodes.

Surface engineering is sought to stabilize nickel-rich layered oxide cathodes in high-energy-density lithium-ion batteries, which suffer from severe surface oxygen loss and rapid structure degradation, especially during deep delithiation at high voltages or high temperatures. Here, we propose a well-designed oxygen-constraining strategy to address the crisis of oxygen evolution. By integrating a La, Fe gradient diffusion layer and a LaFeO3 coating into the Ni-rich layered particles, along with incorporating an antioxidant binder into the electrodes, three progressive lines of defense are constructed: immobilizing the lattice oxygen at the subsurface, blocking the released oxygen at the interface, and capturing the residual singlet oxygen on the external surface. As a result, effective surface passivation, mitigated bulk and surface degradation, suppressed side reactions, and enhanced electrochemical performance are achieved, far beyond conventional single surface modification. The Ni-rich layered oxide cathodes with integrated oxygen-constraining modifications demonstrate impressive cycling stability in both half-cells and full cells, achieving stable long-term cycling even at a high cutoff voltage of 4.7 V and a high temperature of 45 °C. This work provides a multilevel oxygen-constraining strategy, which can be extended to various layered oxide cathodes involving oxygen release challenges, providing an effective path for the development of high-energy-density lithium-ion batteries.

Effect of TiO2 Coating on Structure and Electrochemical Performance of LiNi0.6Co0.2Mn0.2O2 Cathode Material for Lithium-Ion Batteries.

High-nickel ternary LiNi0.6Co0.2Mn0.2O2 (NCM622) is a promising cathode material for lithium-ion batteries due to its high discharge-specific capacity and energy density. However, problems of NCM622 materials, such as unstable surface structure, lithium-nickel co-segregation, and intergranular cracking, led to a decrease in the cycling performance of the material and an inability to fully utilize high specific capacity. Surface coating was the primary approach to address these problems. The effect of TiO2 coating prepared by the sol-gel method on the performance of LiNi0.6Co0.2Mn0.2O2 was studied, mainly including the morphology, cell structure, and electrochemical properties. LiNi0.6Co0.2Mn0.2O2 was coated by TiO2 with a thickness of about 5 nm. Compared with the pristine NCM622 electrode, the electrochemical performance of the TiO2-coated NCM622 electrodes is improved. Among all TiO2-coated NCM622, the NCM622 cathode with TiO2 coating content of 0.5% demonstrates the highest capacity retention of 89.3% and a discharge capacity of 163.9 mAh g-1, in contrast to 80.9% and145 mAh g-1 for the pristine NCM622 electrode, after 100 cycles at 0.3 C between 3 and 4.3 V. The cycle life of the 5 wt% TiO2-coated NCM622 electrode is significantly improved at a high cutoff voltage of 4.6 V. The significantly enhanced cycling performance of TiO2-coated NCM622 materials could be attributed to the TiO2 coating layer that could block the contact between the material surface and the electrolyte, reducing the interface side reaction and inhibiting the transition metal dissolution. At the same time, the coating layer maintained the stability of layered structures, thus reducing the polarization phenomenon of the electrode and alleviating the irreversible capacity loss in the cycle process.

New Insights into the Crystal Structure of Fe0.5TiOPO4 Anode Material for Lithium-Ion Batteries Using Non-Ambient X-Ray Diffraction Measurements

The search for alternative electrode materials for lithium and sodium ion batteries is an expanding field with a continuous effort of research. Among the various materials, polyanionic phosphate compounds M0.5TiOPO4 (M= Fe, Ni, Co, Cu) have been investigated as anode materials for Lithium-ion batteries due to their several advantages.Our research group has been investigating the crystal and electronic structure changes of Fe0.5TiOPO4/C material that occur during the insertion/extraction of lithium ions. Hence, Operando X-ray diffraction (XRD) measurements on Fe0.5TiOPO4/C composite were conducted. The experiments were performed using special electrochemical coin cells with glass windows, which enabled us to conduct operando XRD measurements on the battery cell during operation. The coin cells were prepared in a glovebox under an Argon atmosphere. In-situ Iron-57 Mössbauer and in-situ X-ray Absorption Near Edge Spectroscopy (XANES) were also performed to reveal the electrochemical mechanisms of this material.After analyzing all the results at high and low voltage cut-offs, we found that Fe0.5TiOPO4/C electrode materials maintain their structure crystallinity after cycling between [3.0-1.3V], showing the formation of a new phase at the end of the first discharge. At highly lithiated states, [3.0-0.02V] voltage range, a reduction–decomposition reaction highlights the Li-insertion/extraction behaviors, and low phase crystallinity is observed during cycling.Furthermore, the Iron-57 Mössbauer analysis on the pristine material Fe0.5TiOPO4/C revealed the presence of two distinct Iron environments, which contradicts the previously reported structural observations. To gain more insights into the crystal structure of the pristine material, we conducted XRD measurements between 13 and 300 K conditions. From Rietveld refinements, we determined the newly found crystal structure of Fe0.5TiOPO4/C, which shows that the Fe2+ cations can be in two triangular-based antiprism crystallographic sites. This finding is further supported by DFT calculations, which demonstrate the possibility of the co-existence of several host sites for Fe2+.

Two-Stage Recruitment Design to Reduce Magnetic Resonance Imaging Screening Cost for a Theoretical Clinical Trial of White Matter Hyperintensity Progression.

White matter hyperintensities (WMH) and their progression are associated with risk of dementia and stroke, so are an important target for clinical trials. The cost of broad magnetic resonance imaging (MRI) screening to identify eligible individuals, however, limits the feasibility of designing clinical trials targeting WMH. A low-cost retinal or clinical screening measure before MRI could reduce recruitment costs versus an MRI-only screening design in a hypothetical clinical trial. Data from the Atherosclerosis Risk in Communities study with valid retinal and WMH measurements (N=1311) were used. To identify a population at greater likelihood of significant WMH on MRI and thus reduce the number of screening MRIs required, we evaluated 3 theoretical prescreening measures: (1) retinal, (2) clinical, (3) combined clinical-retinal. Given a target sample for clinical trials (N=646), we calculated screening sample sizes based on the proportion within the population having an elevated score for each prescreening measure (separately) multiplied by the proportion of significant WMH among those with that prescreening feature. Recruitment costs were calculated using estimated retinal and MRI cost estimates. Compared with the estimated cost of MRI-only screening (>$4.24 million, requiring MRI on 6526 participants), prescreening for a high clinical score resulted in total cost of $2.47 million, with an initial screening group of 52 778 participants, with MRI in 3801. A high clinical-retinal score cutoff resulted in costs of $2.9 million while requiring 13 572 participants, with 3801 completing MRI. A 2-stage design with low-cost prescreening measures is a promising approach, resulting in reduced theoretical recruitment costs compared with an MRI-only design.

A butterfly-shaped acceptor with rigid skeleton and unique assembly enables both efficient organic photovoltaics and high-speed organic photodetectors.

It remains challenging to design efficient bifunctional semiconductor materials in organic photovoltaic and photodetector devices. Here, we report a butterfly-shaped molecule, named WD-6, which exhibits low energy disorder and small reorganization energy due to its enhanced molecular rigidity and unique assembly with strong intermolecular interaction. The binary photovoltaic device based on PM6:WD-6 achieved an efficiency of 18.41%. Notably, an efficiency of 19.42% was achieved for the ternary device based on PM6:BTP-eC9:WD-6. Moreover, the photodetection device based on WD-6 demonstrated an ultrafast response speed (205ns response time at λ of 820nm) and a high cutoff frequency of -3dB (2.45MHz), surpassing the values of most commercial Si photodiodes. Based on these findings, we showcased an application of the WD-6-based photodetection device in high-speed optical communication. These results offer valuable insights into the design of organic semiconductor materials capable of simultaneously exhibiting high photovoltaic and photodetective performance.

Waist circumference and waist-to-height ratio: Exploring the associations for high blood pressure risk in school-age adolescents

BackgroundChildhood and adolescent obesity present a global health concern, notably due to its association with adverse outcomes such as high blood pressure (HBP). Waist circumference (WC) and waist-to-height ratio (WHtR) are promising indicators for assessing HBP risk in school-age adolescents. However, their association with Stavnsbo-recommended WC cutoff points and high BP prevalence necessitates further investigation, holding potential implications for early intervention and prevention strategies. ObjectiveInvestigate the association between high blood pressure (HBP) and WC cutoff points advised by Stavnsbo, along with WHtR, in adolescents from privileged socioeconomic backgrounds in Brazil. MethodsThis cross-sectional study in 2022 involved 216 students aged 9 to 16 from a private school in Londrina, Paraná, Brazil. Data, collected through an internal project monitoring anthropometric and social indicators, included validated blood pressure assessments. Statistical analyses, employing t-tests, chi-square tests, and logistic regression, explored relationships between WC, WHtR, and blood pressure, adjusting for covariates. ResultsFemale participants had a lower prevalence of obesity (2.9% vs 5.3%) but a higher prevalence of overweight (27.5% vs 17.5%) compared to males. The overall excess weight prevalence was 26.4%, with females showing lower absolute risk scores for WC (25.5% vs 34.2%), WHtR (19.6% vs 23.7%), and HBP (21.5% vs. 40.3%). Significant associations were observed between HBP and WC (X2 = 9.759, P = 0.002) as well as WHtR (X2 = 6.335, P = 0.012) among males, with those in the “Risk” category exhibiting higher HBP prevalence. Overall, both WC and WHtR demonstrated significant associations with HBP (X2 = 12.428, P < 0.001, and X2 = 9.550, P = 0.002, respectively). Logistic regression indicated higher odds for HBP in males with risk values for WC (OR 3.876 [1.714–8.765 CI], P = 0.001) or WHtR (OR 3.684 [1.457–9.315 CI], P = 0.006). In the overall analysis, participants with risk values for WC had 3.2 (1.688–6.080 CI, P < 0.001) times higher odds, and for WHtR, 3.4 (1.679–6.934 CI, P = 0.001) times higher odds of HBP. ConclusionThis study highlights the associations between WC, WHtR, and HBP in adolescent schoolchildren. The results underscore the significance of gender-specific assessments and emphasize the potential of these anthropometric measures as valuable tools for identifying and managing HBP risk in adolescents. Further research and clinical applications are imperative to deepen understanding and address the health needs of this vulnerable population.

Sb-anchoring single-crystal engineering enables ultra-high-Ni layered oxides with high-voltage tolerance and long-cycle stability

Ni-rich layered oxides are promising cathodes for Li-ion batteries, but the inherent structural defects result in severe surface/bulk degradation during long cycling, especially at high cutoff voltage. Herein we propose a Sb-anchoring single-crystalline engineering to enhance the microstructural and electrochemical stability of ultra-high-Ni layered oxides, where the surface-enriched Sb doping inhibits Li-Ni mixing, suppressing the undesired layered to mixed/rock-salt phase transformation; the bulk-doped Sb rivets into Ni sites, reinforcing the bulk phase stability; the single-crystal endows enhanced crack resistance and reduced surface area, preventing surface parasitic reactions and the subsequent proliferation of cathode electrolyte interfaces. In-situ XRD reveals an essential correlation between cycle stability and phase reversibility, whereas Sb doping into both surface and bulk structures showcases a continuous anchoring effect, largely enhancing the phase transformation reversibility. DFT calculations prove a high oxidation tolerance, as Ni2+ diffusion barrier is higher than the pure cathode. A representative Li(Ni0.9Co0.05Mn0.05)0.99Sb0.01O2 cathode exhibits a high-voltage up to 4.6 V, and a Li(Ni0.9Co0.05Mn0.05)0.99Sb0.01O2//graphite full-cell demonstrates an ultra-high capacity retention of 93.4 % after 1000 cycles at 1 C in 3.0−4.2 V. This simple and efficient cathode engineering will promote the promising application of Ni-rich layered oxides in high-energy Li-ion batteries.

Study on the impact of cutoff voltage on structural and electrochemical stability of sodium-ion layered cathodes

NaNi1/3Fe1/3Mn1/3O2 is recognized for its relatively high theoretical specific capacity and operating voltage, rendering it a sodium-ion cathode material with significant commercial potential. A higher cutoff voltage typically enables more sodium ion deintercalation, thereby achieving higher capacity. However, this increased deintercalation can introduce challenges such as structural instability and side reactions with the electrolyte, leading to electrochemical performance degradation. This study focuses on the migration process of transition metal ions under conditions of high charging cutoff voltage and high sodium removal. At a voltage of 4.3 V, the migration of Ni ions facilitates more charge compensation but is accompanied by irreversible Ni migration, inducing an irreversible phase transition to the O’ phase. Conversely, at a cutoff voltage of 4.1 V, the P3 and O3 phases with high sodium removal demonstrate excellent cycling stability. The specific capacities before and after 150 cycles (at 0.5C) are 142.3 and 113.7 mAh/g, respectively, indicating a tolerable internal structural stress within these high sodium removal phases. This contrasts with the differentiated internal structural stresses generated by the P3, O3, and O’ phases during phase transitions at a cutoff voltage of 4.3 V. The research underscores the importance of regulating reversible crystal phases within the tolerance range of internal stress and avoiding irreversible crystal phases to enhance the cycling stability of cathode materials. These findings provide crucial insights for optimizing NNFMO cathode materials and hold significant implications for the design of high-performance, long-life sodium-ion batteries.

Reversible silicon anodes enabled by fluorinated inorganic-organic hybrid coating

Silicon anodes deliver batteries with energy densities much higher than those based on today’s dominant graphite anodes. However, they commonly exhibit huge volume variations and unfavorable interface stability, causing a gradually diminishing capacity on extended cycling. Most Si-based batteries consisting Si/C composites in industry can only use a very limited amount of Si (<30 % by weight). Exploiting molecular layer deposition (MLD) technique, a fluorine-rich flexible inorganic–organic hybrid alucone (AlFHQ) shell is controllably deposited onto Si electrodes. Employing ex situ XPS and AFM, the AlFHQ film presents reversible electrochemical evolutions in terms of composition and morphology. The interactions the between Li+ and −O−2,3,5,6-fluorobenzene functional groups help to construct a mechanically-chemically robust LiF-rich hybrid solid electrolyte interphase (SEI) on Si anode, delivering enhanced interfacial stability and integrity of electrode. An optimized coating thickness (≈5 nm) for interfacial stabilization and Li+ transport kinetics is demonstrated, namely, Si@AlFHQ-20. The reported fluorine-rich hybrid modification technique endows (a), stable cycling of Si anode (≈3.8 mAh cm−2) with an ultrahigh initial Coulombic efficiency (ICE) of 92.3 %; (b), enhanced rate capability of 1468 mAh/g at 2.0 A g−1 and good cycling performance; and (c), overall cell (Si@AlFHQ-20//LiCoO2@Al2O3) operational stability for more than 100 cycles under stringent cathode conditions (2.68 mAh cm−2, high cutoff voltage at 4.55 V).

Regulating interfacial reactions via quasi-solid polymer electrolyte to enable high-voltage lithium metal batteries

Sulfolane (SUL), known for its low cost, environmental friendliness, and high voltage tolerance, stands out as a promising polar solvent for lithium (Li) metal batteries with high energy density. However, its long-term stability with Li metal is compromised due to its inherently low reduction resistance. To address this issue, we introduce a novel electrolyte strategy, where the reactive SUL is encapsulated within a fluorinated polymer framework formed through in-situ thermal polymerization. The polymer network’s specific structure interacts with SUL, effectively mitigating its electrochemical degradation on the Li metal anode and the NCM811 cathode, thus enhancing electrode stability. This approach not only extends the Li+ plating/stripping reversibility for over 1,000 h at a current density of 0.3 mA cm−2, but also delivers outstanding performance in NCM811||Li batteries, achieving a capacity retention of 78.56 % after 1,000 cycles at 30 °C and 87.14 % after 100 cycles at 60 °C under a high cutoff voltage of 4.5 V.

Is prostatic adenocarcinoma detectable by urine cytology-A multicenter retrospective review.

Urine cytology is robust for the diagnosis of urothelial lesions, but data on the detection rates of prostatic adenocarcinoma in urine cytology is limited. In this study, a multicenter review was performed to define the clinical role of urine cytology in diagnosis of prostatic adenocarcinoma. Cytologic diagnoses of lower tract urine cytology specimens with histology-proven prostatic adenocarcinoma from three institutions, from a period of over two decades, were reviewed. Clinicopathological parameters-tumor grade, stage, histologic features, and preanalytical factors-prostate-specific antigen (PSA) level and lesion size, were retrieved and compared with cytologic diagnoses. In total, 2115 urine cytology specimens from 1119 patients were retrieved. The atypia (or above/C3+) and suspicious (or above/C4+) rates were 19.48% and 3.36%. Bilobar and extracapsular involvement, lymphovascular invasion, Gleason score, and International Society of Urological Pathology grade were associated with a positive urine diagnosis (p < 0.05). The atypia (C3+) and suspicious (C4+) rates of urine cytology in patients with a PSA level of ≤4.0 ng/mL was paradoxically higher (p < 0.01), but PSA levels correlated positively with urine diagnosis at higher cutoffs (>10, >20, >50, >100 ng/mL). All these factors remained significant on multivariate analysis (p < 0.05), including a negative correlation with low-PSA (≤4.0 ng/mL, p = 0.001) and positive correlation with high-PSA (>20 ng/mL, p = 0.020). Lesion size and multifocality were not associated with urine cytology diagnosis (p > 0.05). Urine cytology showed low sensitivity in detection of prostatic adenocarcinoma. Detection rates were largely positively correlated with PSA levels but not for lesion size nor multifocality, limiting its clinical utility.

Application of a validated prognostic plasma protein biomarker test for renal decline in type 2 diabetes to type 1 diabetes: the Fremantle Diabetes Study Phase II

BackgroundThere are scant data relating to prognostic biomarkers for chronic kidney disease (CKD) complicating type 1 diabetes. The aim of this study was to assess the performance of the plasma protein biomarker-based PromarkerD test developed and validated for predicting renal decline in type 2 diabetes in the context of type 1 diabetes.MethodsThe baseline PromarkerD test score was determined in 91 community-based individuals (mean age 46.2 years, 56.5% males) with confirmed type 1 diabetes recruited to the longitudinal observational Fremantle Diabetes Study Phase II. The performance of the PromarkerD test in predicting the risk of incident CKD (estimated glomerular filtration rate (eGFR) < 60 mL/min/1.73m2 in people without CKD at baseline) or an eGFR decline of ≥ 30% over the next four years was determined. The score can range from 0 to 100%, and is categorized as representing low (< 10%), moderate (10% to < 20%) or high (≥ 20%) risk.ResultsThe area under the receiver operating characteristic curve was 0.93 (95% confidence interval 0.87–0.99) for the composite renal endpoint, indicating strong predictive accuracy. The positive and negative predictive values at moderate (10% to < 20%) and high (≥ 20%) risk PromarkerD cut-offs were 46.7–50.0% and ≥ 92.0%, respectively.ConclusionsThese preliminary data suggest that PromarkerD is at least as good a prognostic test for renal decline in type 1 as type 2 diabetes.

B-295 Sensitive and Rapid Homogeneous Immunoassay for the Detection of Zolpidem and its Major Metabolite in Urine

Abstract Background Zolpidem, a schedule IV controlled substance under the Controlled Substances Act, is commonly known as Ambien and Ambien CR, a prescription only treatment for insomnia. Zolpidem is one of the most common prescribed sleep aids in the U.S. due to its rapid sedative effects. The recommended duration of treatment is between two days and four weeks, as long-term use of zolpidem increases the risk of habit formation. Addiction to zolpidem can cause severe side effects, including memory loss, delusion, and in extreme cases, fatal overdose. From 2005-2010, Zolpidem-related emergency room visits doubled, underscoring the need for accurate testing as zolpidem testing plays an important role in cases of misuse, diversion, and forensics. The sole commercially available homogeneous immunoassay for the detection of zolpidem in urine has a relatively high cutoff at 20 ng/mL and poor cross-reactivity (0.02%) to major metabolite zolpidem 4-carboxylic acid. ARK Diagnostics has developed the ARK™ Zolpidem Assay to detect zolpidem at a cutoff concentration of 10 ng/mL with high cross-reactivity to its metabolite, Zolpidem phenyl 4-carboxylic acid and no cross-reactivity to zaleplon and zopiclone at concentrations below 100,000 ng/mL. Methods The ARK™ Zolpidem Assay is a liquid stable homogeneous enzyme immunoassay, consisting of two reagents, with a cutoff concentration of 10 ng/mL and semi-quantitative range up to 40 ng/mL. Preliminary performance characterization for this assay was evaluated on the Beckman Coulter AU680 Automated Clinical Chemistry Analyzer. Precision, analytical recovery, specificity, Histogram Overlap Analysis of ±50% controls and the cutoff, and method comparison with LC-MS/MS were evaluated. Results In semi-quantitative mode, total precision ranged from 2.6 to 3.1% CV. Spiked recovery of zolpidem ranged from 88.6% (2.5 ng/mL) to 96.8% (10 ng/mL). The major metabolite, zolpidem phenyl-4-carboxylic acid, showed an approximate equivalence to the 10 ng/mL zolpidem cutoff at 30 ng/mL (33.3% cross-reactivity). Histogram overlap analysis showed no overlap between cutoff and control levels. Method correlation with LC-MS/MS using authentic urine samples showed an excellent agreement with a specificity of 100% and sensitivity of 100% (15 positives and 100 negatives). Conclusions The ARK™ Zolpidem Assay measures zolpidem and its major metabolite zolpidem phenyl-4-carboxylic acid in human urine with acceptable performance. The assay is sensitive, rapid, and applicable to a wide range of clinical chemistry analyzers.