High efficiency and mechanical robustness are both crucial for the practical applications of all‐polymer solar cells (all‐PSCs) in stretchable and wearable electronics. In this regard, a series of ...new polymer acceptors (PAs) is reported by incorporating a flexible conjugation‐break spacer (FCBS) to achieve highly efficient and mechanically robust all‐PSCs. Incorporation of FCBS affords the effective modulation of the crystallinity and pre‐aggregation of the PAs, and achieves the optimal blend morphology with polymer donor (PD), increasing both the photovoltaic and mechanical properties of all‐PSCs. In particular, an all‐PSC based on PYTS‐0.3 PA incorporated with 30% FCBS and PBDB‐T PD demonstrates a high power conversion efficiency (PCE) of 14.68% and excellent mechanical stretchability with a crack onset strain (COS) of 21.64% and toughness of 3.86 MJ m‐3, which is significantly superior to those of devices with the PA without the FCBS (PYTS‐0.0, PCE = 13.01%, and toughness = 2.70 MJ m‐3). To date, this COS is the highest value reported for PSCs with PCEs of over 8% without any insulating additives. These results reveal that the introduction of FCBS into the conjugated backbone is a highly feasible strategy to simultaneously improve the PCE and stretchability of PSCs.
New polymer acceptors (PAs) are developed by embedding flexible conjugation‐break spacer (FCBS) units into the rigid backbones. The incorporation of FCBS affords effective modulation of the crystallinity and pre‐aggregation of the PA and attains optimal blend morphology. As a result, the all‐polymer solar cells exhibit both a high efficiency of 14.68% and excellent mechanical robustness with a crack onset strain of 21.64%.
Developing high-performance and mechanically robust polymer solar cells (PSCs) is crucial for realizing wearable power sources. While efficient all-polymer solar cells (all-PSCs) can be fabricated ...from polymerized small-molecule acceptors (PSMAs) with high optical absorption and electron mobilities, they still show limited mechanical robustness. Here, we achieve highly efficient and mechanically robust all-PSCs by designing a PSMA (PYFS-Reg) containing sequence-regular flexible spacers (FSs). The regular incorporation of the FS units into PSMAs is essential in simultaneously improving the electrical and mechanical properties of blend films. As a result, all-PSCs featuring PYFS-Reg achieve a high power conversion efficiency (PCE = 16.1%) and stretchability (crack onset strain (COS) = 22.4%), outperforming PSMAs without FSs (
i.e.
, PYBDT, PCE = 12.6% and COS = 11.7%) or with randomly distributed FSs (
i.e.
, PYFS-Ran, PCE = 12.2% and COS = 18.1%). Importantly, these all-PSCs are fabricated by an environmentally benign, non-halogenated solvent process. To further demonstrate their feasible applications in wearable devices, we construct intrinsically stretchable (IS) all-PSCs by using PYFS-Reg-based active layers, which exhibit a high PCE (10.6%) and excellent device stretchability (strain at PCE
80%
= 36.7%).
We report a new molecular design of sequentially regular polymerized small-molecule-acceptors containing flexible spacer (FS) units (PYFS-Reg) to achieve all-polymer solar cells with both high-performance and mechanical stretchability.
Cerebral amyloidosis and severe tauopathy in the brain are key pathological features of Alzheimer's disease (AD). Despite a strong influence of the intestinal microbiota on AD, the causal ...relationship between the gut microbiota and AD pathophysiology is still elusive.
Using a recently developed AD-like pathology with amyloid and neurofibrillary tangles (ADLP
) transgenic mouse model of AD, which shows amyloid plaques, neurofibrillary tangles and reactive gliosis in their brains along with memory deficits, we examined the impact of the gut microbiota on AD pathogenesis.
Composition of the gut microbiota in ADLP
mice differed from that of healthy wild-type (WT) mice. Besides, ADLP
mice showed a loss of epithelial barrier integrity and chronic intestinal and systemic inflammation. Both frequent transfer and transplantation of the faecal microbiota from WT mice into ADLP
mice ameliorated the formation of amyloid β plaques and neurofibrillary tangles, glial reactivity and cognitive impairment. Additionally, the faecal microbiota transfer reversed abnormalities in the colonic expression of genes related to intestinal macrophage activity and the circulating blood inflammatory monocytes in the ADLP
recipient mice.
These results indicate that microbiota-mediated intestinal and systemic immune aberrations contribute to the pathogenesis of AD in ADLP
mice, providing new insights into the relationship between the gut (colonic gene expression, gut permeability), blood (blood immune cell population) and brain (pathology) axis and AD (memory deficits). Thus, restoring gut microbial homeostasis may have beneficial effects on AD treatment.
Intrinsically stretchable organic solar cells (IS‐OSCs), consisting of all stretchable layers, are attracting significant attention as a future power source for wearable electronics. However, most of ...the efficient active layers for OSCs are mechanically brittle due to their rigid molecular structures designed for high electrical and optical properties. Here, a series of new polymer donors (PDs, PhAmX) featuring phenyl amide (N1,N3‐bis((5‐bromothiophen‐2‐yl)methyl)isophthalamide, PhAm)‐based flexible spacer (FS) inducing hydrogen‐bonding (H‐bonding) interactions is developed. These PDs enable IS‐OSCs with a high power conversion efficiency (PCE) of 12.73% and excellent stretchability (PCE retention of >80% of the initial value at 32% strain), representing the best performances among the reported IS‐OSCs to date. The incorporation of PhAm‐based FS enhances the molecular ordering of PDs as well as their interactions with a Y7 acceptor, enhancing the mechanical stretchability and electrical properties simultaneously. It is also found that in rigid OSCs, the PhAm5:Y7 blend achieves a much higher PCE of 17.5% compared to that of the reference PM6:Y7 blend. The impact of the PhAm‐FS linker on the mechanical and photovoltaic properties of OSCs is thoroughly investigated.
Efficient, intrinsically stretchable organic solar cells (IS‐OSCs) are developed by designing a new series of polymer donors (PDs, PhAm) featuring hydrogen‐bonding‐capable flexible spacers. High power conversion efficiency (PCE = 12.7%) and stretchability (PCE retention of > 80% at 32% strain) are demonstrated, which represent the best performances in terms of both PCE and stretchability among the IS‐OSCs reported to date.
Background
With improved short-term surgical outcomes, laparoscopic distal gastrectomy has rapidly gained popularity. However, the safety and feasibility of laparoscopic total gastrectomy (LTG) has ...not yet been proven due to the difficulty of the technique. This single-arm prospective multi-center study was conducted to evaluate the use of LTG for clinical stage I gastric cancer.
Methods
Between October 2012 and January 2014, 170 patients with pathologically proven, clinical stage I gastric adenocarcinoma located at the proximal stomach were enrolled. Twenty-two experienced surgeons from 19 institutions participated in this clinical trial. The primary end point was the incidence of postoperative morbidity and mortality at postoperative 30 days. The severity of postoperative complications was categorized according to Clavien–Dindo classification, and the incidence of postoperative morbidity and mortality was compared with that in a historical control.
Results
Of the enrolled patients, 160 met criteria for inclusion in the full analysis set. Postoperative morbidity and mortality rates reached 20.6% (33/160) and 0.6% (1/160), respectively. Fifteen patients (9.4%) had grade III or higher complications, and three reoperations (1.9%) were performed. The incidence of morbidity after LTG in this trial did not significantly differ from that reported in a previous study for open total gastrectomy (18%).
Conclusions
LTG performed by experienced surgeons showed acceptable postoperative morbidity and mortality for patients with clinical stage I gastric cancer.
Transition-metal-catalyzed activation of C–H and C–C bonds is a challenging area in synthetic organic chemistry. Among various methods to accomplish these processes, the approach using metal–organic ...cooperative catalytic systems is one of the most promising. In this protocol, organic molecules as well as transition metals act as catalysts to bring about reactions, which proceed with high efficiencies and selectivities. Various metal–organic cooperative catalytic systems developed for C–H and C–C bond activation reactions are discussed in this review. Also discussed are how each metal–organic cooperative catalyst affects the reaction mechanism and what kinds of substrates can be applied in each of the catalytic processes.
Adjuvant chemotherapy after surgery improves survival of patients with stage II–III, resectable gastric cancer. However, the overall survival benefit observed after adjuvant chemotherapy is moderate, ...suggesting that not all patients with resectable gastric cancer treated with adjuvant chemotherapy benefit from it. We aimed to develop and validate a predictive test for adjuvant chemotherapy response in patients with resectable, stage II–III gastric cancer.
In this multi-cohort, retrospective study, we developed through a multi-step strategy a predictive test consisting of two rule-based classifier algorithms with predictive value for adjuvant chemotherapy response and prognosis. Exploratory bioinformatics analyses identified biologically relevant candidate genes in gastric cancer transcriptome datasets. In the discovery analysis, a four-gene, real-time RT-PCR assay was developed and analytically validated in formalin-fixed, paraffin-embedded (FFPE) tumour tissues from an internal cohort of 307 patients with stage II–III gastric cancer treated at the Yonsei Cancer Center with D2 gastrectomy plus adjuvant fluorouracil-based chemotherapy (n=193) or surgery alone (n=114). The same internal cohort was used to evaluate the prognostic and chemotherapy response predictive value of the single patient classifier genes using associations with 5-year overall survival. The results were validated with a subset (n=625) of FFPE tumour samples from an independent cohort of patients treated in the CLASSIC trial (NCT00411229), who received D2 gastrectomy plus capecitabine and oxaliplatin chemotherapy (n=323) or surgery alone (n=302). The primary endpoint was 5-year overall survival.
We identified four classifier genes related to relevant gastric cancer features (GZMB, WARS, SFRP4, and CDX1) that formed the single patient classifier assay. In the validation cohort, the prognostic single patient classifier (based on the expression of GZMB, WARS, and SFRP4) identified 79 (13%) of 625 patients as low risk, 296 (47%) as intermediate risk, and 250 (40%) as high risk, and 5-year overall survival for these groups was 83·2% (95% CI 75·2–92·0), 74·8% (69·9–80·1), and 66·0% (60·1–72·4), respectively (p=0·012). The predictive single patient classifier (based on the expression of GZMB, WARS, and CDX1) assigned 281 (45%) of 625 patients in the validation cohort to the chemotherapy-benefit group and 344 (55%) to the no-benefit group. In the predicted chemotherapy-benefit group, 5-year overall survival was significantly improved in those patients who had received adjuvant chemotherapy after surgery compared with those who received surgery only (80% 95% CI 73·5–87·1 vs 64·5% 56·8–73·3; univariate hazard ratio 0·47 95% CI 0·30–0·75, p=0·0015), whereas no such improvement in 5-year overall survival was observed in the no-benefit group (72·9% 66·5–79·9 in patients who received chemotherapy plus surgery vs 72·5% 65·8–79·9 in patients who only had surgery; 0·93 0·62–1·38, p=0·71). The predictive single patient classifier groups (chemotherapy benefit vs no-benefit) could predict adjuvant chemotherapy benefit in terms of 5-year overall survival in the validation cohort (pinteraction=0·036 in univariate analysis). Similar results were obtained in the internal evaluation cohort.
The single patient classifiers validated in this study provide clinically important prognostic information independent of standard risk-stratification methods and predicted chemotherapy response after surgery in two independent cohorts of patients with resectable, stage II–III gastric cancer. The single patient classifiers could complement TNM staging to optimise decision making in patients with resectable gastric cancer who are eligible for adjuvant chemotherapy after surgery. Further validation of these results in prospective studies is warranted.
Ministry of ICT and Future Planning; Ministry of Trade, Industry, and Energy; and Ministry of Health and Welfare.
All‐polymer solar cells (all‐PSCs) are a highly attractive class of photovoltaics for wearable and portable electronics due to their excellent morphological and mechanical stabilities. Recently, new ...types of polymer acceptors (PAs) consisting of non‐fullerene small molecule acceptors (NFSMAs) with strong light absorption have been proposed to enhance the power conversion efficiency (PCE) of all‐PSCs. However, polymerization of NFSMAs often reduces entropy of mixing in PSC blends and prevents the formation of intermixed blend domains required for efficient charge generation and morphological stability. One approach to increase compatibility in these systems is to design PAs that contain the same building blocks as their polymer donor (PD) counterparts. Here, a series of NFSMA‐based PAs P(BDT2BOY5‐X), (X = H, F, Cl) are reported, by copolymerizing NFSMA (Y5‐2BO) with benzodithiophene (BDT), a common donating unit in high‐performance PDs such as PBDB‐T. All‐PSC blends composed of PBDB‐T PD and P(BDT2BOY5‐X) PA show enhanced molecular compatibility, resulting in excellent morphological and electronic properties. Specifically, PBDB‐T:P(BDT2BOY5‐Cl) all‐PSC has a PCE of 11.12%, which is significantly higher than previous PBDB‐T:Y5‐2BO (7.02%) and PBDB‐T:P(NDI2OD‐T2) (6.00%) PSCs. Additionally, the increased compatibility of these all‐PSCs greatly improves their thermal stability and mechanical robustness. For example, the crack onset strain (COS) and toughness of the PBDB‐T:P(BDT2BOY5‐Cl) blend are 15.9% and 3.24 MJ m–3, respectively, in comparison to the PBDB‐T:Y5‐2BO blends at 2.21% and 0.32 MJ m–3.
A new class of polymer acceptors (PAs, P(BDT2BOY5‐X)) consisting of benzodithiophene (BDT) and non‐fullerene small molecule‐accepting units is developed, which shows excellent material compatibility with an efficient BDT‐based polymer donor (PD). The resulting all‐polymer solar cells show excellent photovoltaic efficiency, thermal stability, and mechanical robustness at the same time, benefitting from the high chemical and molecular compatibilities between PD and PA.
Objective
There is no scale for rating the severity of autoimmune encephalitis (AE). In this study, we aimed to develop a novel scale for rating severity in patients with diverse AE syndromes and to ...verify the reliability and validity of the developed scale.
Methods
The key items were generated by a panel of experts and selected according to content validity ratios. The developed scale was initially applied to 50 patients with AE (development cohort) to evaluate its acceptability, reproducibility, internal consistency, and construct validity. Then, the scale was applied to another independent cohort (validation cohort, n = 38).
Results
A new scale consisting of 9 items (seizure, memory dysfunction, psychiatric symptoms, consciousness, language problems, dyskinesia/dystonia, gait instability and ataxia, brainstem dysfunction, and weakness) was developed. Each item was assigned a value of up to 3 points. The total score could therefore range from 0 to 27. We named the scale the Clinical Assessment Scale in Autoimmune Encephalitis (CASE). The new scale showed excellent interobserver (intraclass correlation coefficient ICC = 0.97) and intraobserver (ICC = 0.96) reliability for total scores, was highly correlated with modified Rankin scale (r = 0.86, p < 0.001), and had acceptable internal consistency (Cronbach α = 0.88). Additionally, in the validation cohort, the scale showed high interobserver reliability (ICC = 0.99) and internal consistency (Cronbach α = 0.92).
Interpretation
CASE is a novel clinical scale for AE with a high level of clinimetric properties. It would be suitable for application in clinical practice and might help overcome the limitations of current outcome scales for AE. ANN NEUROL 2019;85:352–358.
Blends of polymer donors (PDs) and small molecule acceptors (SMAs) have afforded highly efficient polymer solar cells (PSCs). However, most of the efficient PSCs are processed using toxic halogenated ...solvents, and they are mechanically fragile. Here, a new series of PDs by incorporating a hydrophilic oligo(ethylene glycol) flexible spacer (OEG‐FS) is developed, and efficient PSCs with a high power conversion efficiency (PCE) of 17.74% processed by a non‐halogenated solvent are demonstrated. Importantly, the incorporation of these OEG‐FSs into the PDs significantly increases the mechanical robustness and ductility of resulting PSCs, making them suitable for application as stretchable devices. The OEG‐FS alleviates excessive backbone rigidity of the PDs while enhancing their pre‐aggregation in the non‐halogenated solvent. In addition, the OEG‐FS in the PDs enhances PD‐SMA interfacial interactions and improves blend morphology, resulting in efficient charge generation and mechanical stress dissipation. The resulting PSCs demonstrate a superior PCE (17.74%) and high crack‐onset strain (COS = 10.50%), outperforming the PSCs without OEG (PCE = 15.64% and COS = 2.99%). Importantly, intrinsically stretchable (IS) PSCs containing the PD featuring OEG‐FS exhibit a high PCE (12.05%) and stretchability (maintaining 80% of the initial PCE after 22% strain), demonstrating their viability for wearable applications.
New polymer donors (PDs) featuring hydrophilic oligo(ethylene glycol) (OEG) spacers are designed to demonstrate intrinsically stretchable (IS) and toluene‐processed polymer solar cells (PSCs). The high power conversion efficiency (PCE, 17.7%) and crack‐onset strain (COS, 10.5%) of the PSC are achieved with the OEG‐containing PDs, outperforming the PSC featuring a PD without the OEG spacer (PCE = 15.6% and COS = 3.0%).
PDF
