The aspartate aminotransferase‐to‐platelet ratio index (APRI), a tool with limited expense and widespread availability, is a promising noninvasive alternative to liver biopsy for detecting hepatic ...fibrosis. The objective of this study was to update the 2007 meta‐analysis to systematically assess the accuracy of APRI in predicting significant fibrosis, severe fibrosis, and cirrhosis stage in hepatitis C virus (HCV) monoinfected and HCV / human immunodeficiency virus (HIV) coinfected individuals. Studies comparing APRI versus biopsy in HCV patients were identified via a thorough literature search. Areas under summary receiver operating characteristic curves (AUROC), sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were used to examine the APRI accuracy for the diagnosis of significant fibrosis, severe fibrosis, and cirrhosis. Heterogeneity was explored using meta‐regression. Twenty‐one additional studies were eligible for the update and, in total, 40 studies were included in this review (n = 8,739). The summary AUROC of the APRI for the diagnosis of significant fibrosis, severe fibrosis, and cirrhosis were 0.77, 0.80, and 0.83, respectively. For significant fibrosis, an APRI threshold of 0.7 was 77% sensitive and 72% specific. For severe fibrosis, a threshold of 1.0 was 61% sensitive and 64% specific. For cirrhosis, a threshold of 1.0 was 76% sensitive and 72% specific. Moreover, we found that the APRI was less accurate for the identification of significant fibrosis, severe fibrosis, and cirrhosis in HIV/HCV coinfected patients. Conclusion: Our large meta‐analysis suggests that APRI can identify hepatitis C‐related fibrosis with a moderate degree of accuracy. Application of this index may decrease the need for staging liver biopsy specimens among chronic hepatitis C patients. (HEPATOLOGY 2011)
Achieving white‐light emission, especially white circularly polarized luminescence (CPL) from a single‐phase material is challenging. Herein, a pair of chiral CuI coordination polymers (1‐M and 1‐P) ...have been prepared by the asymmetrical assembly of achiral ligands and Cu2I2 clusters. The compounds display dual emission bands and can be used as single‐phase white‐light phosphors, achieving a “warm”‐white‐light‐emitting diode with an ultra‐high color rendering index (CRI) of 93.4 and an appropriate correlated color temperature (CCT) of 3632 K. Meanwhile, corresponding CPL signals with maximum dissymmetry factor |glum|=8×10−3 have been observed. Hence, intrinsic white‐light emission and CPL have been realized simultaneously in coordination polymers for the first time. This work gains insight into the nature of chiral assembly from achiral units and offers a prospect for the development of single‐phase white‐CPL materials.
A pair of chiral CuI coordination polymers (1‐P/M) were produced from achiral precursors by crystallization‐driven symmetry‐breaking assembly. The enantiomers feature unique helical layered structures and tunable dual‐emission photoluminescence, achieving intrinsic “warm”‐white emitting with an ultra‐high color rendering index (93.4) and circularly polarized luminescence with a remarkable dissymmetry factor (8×10−3) simultaneously.
Organic semiconductors can be designed and constructed in π‐stacked structures instead of the conventional π‐conjugated structures. Through‐space interaction (TSI) occurs in π‐stacked optoelectronic ...materials. Thus, unlike electronic coupling along the conjugated chain, the functional groups can stack closely to facilitate spatial electron communication. Using π‐stacked motifs, chemists and materials scientists can find new ways for constructing materials with aggregation‐induced emission (AIE), thermally activated delayed fluorescence (TADF), circularly polarized luminescence (CPL), and room‐temperature phosphorescence (RTP), as well as enhanced molecular conductance. Organic optoelectronic devices based on π‐stacked molecules have exhibited very promising performance, with some of them exceeding π‐conjugated analogues. Recently, reports on various organic π‐stacked structures have grown rapidly, prompting this review. Representative molecular scaffolds and newly developed π‐stacked systems could stimulate more attention on through‐space charge transfer the well‐known through‐bond charge transfer. Finally, the opportunities and challenges for utilizing and improving particular materials are discussed. The previous achievements and upcoming prospects may provide new insights into the theory, materials, and devices in the field of organic semiconductors.
Unlike traditional covalent bond‐connected conjugated molecules, π‐stacked small molecules have special advantages in organic semiconductors. This review mainly focuses on the research development of π‐stacked molecular systems and introduces the new characteristics brought by the special molecular configuration and its application in organic semiconductors.
Abstract
Background
The combination therapy of hydrocortisone, vitamin C, and thiamine has been proposed as a potential treatment in patients with sepsis and septic shock. However, subsequent trials ...have reported conflicting results in relation to survival outcomes. Hence, we performed this randomized controlled trial (RCT) to evaluate the efficacy and safety of early combination therapy among adult patients with septic shock.
Methods
This single-center, double-blind RCT enrolled adult patients with diagnosis of septic shock within 12 h from Northern Jiangsu People's Hospital between February 2019 and June 2021. Recruited patients were randomized 1:1 to receive intervention (hydrocortisone 200 mg daily, vitamin C 2 g every 6 h, and thiamine 200 mg every 12 h) or placebo (0.9% saline) for 5 days or until ICU discharge. The primary endpoint was 90-day mortality. The secondary endpoints included mortality at day 28, ICU discharge, and hospital discharge; shock reversal; 72-h Delta SOFA score; ICU-free days, vasopressor-free days, and ventilator support -free days up to day 28; ICU length of stay (LOS) and hospital LOS.
Results
Among 426 patients randomized, a total of 408 patients with septic shock were included in the per-protocol (PP) analysis, of which 203 were assigned to the intervention group and 205 to the placebo group. In the PP population, the primary outcome of 90-day mortality was 39.9% (81/203) and 39.0% (80/205) in the intervention and the placebo groups, respectively, and was not significantly different (
P
= 0.86). There was no significant difference between two groups in 28-day mortality (36.5% vs. 36.1%,
P
= 0.94) or the ICU mortality (31.5% vs. 28.8%,
P
= 0.55) and hospital mortality (34.5% vs. 33.2%,
P
= 0.78). No other secondary outcomes showed significant differences between two groups, including shock reversal, vasopressor-free days, and ICU LOS. Intention-to-treat analysis included all the 426 patients and confirmed these results (all
P
> 0.05).
Conclusion
Among adult patients with septic shock, early use of hydrocortisone, vitamin C, and thiamine combination therapy compared with placebo did not confer survival benefits.
Trial registration
ClinicalTrials.gov:
NCT03872011
, registration date: March 12, 2019.
Graphic Abstract
Significant effort has been made to develop novel material systems to improve the efficiency of near‐infrared organic light‐emitting diodes (NIR OLEDs). Of those, fluorescent chromophores are mostly ...studied because of their advantages in cost and tunability. However, it is still rare for fluorescent NIR emitters to present good color purities in the NIR range and to have high external quantum efficiency (EQE). Here, a wedge‐shaped D‐π‐A‐π‐D emitter APDC‐DTPA with thermally activated delayed fluorescence property and a small single‐triplet splitting (ΔEst) of 0.14 eV is presented. The non‐doped NIR device exhibits excellent performance with a maximum EQE of 2.19% and a peak wavelength of 777 nm. Remarkably, when 10 wt% of APDC‐DTPA is doped in 1,3,5‐tris(1‐phenyl‐1H‐benzimidazol‐2‐yl)benzene host, an extremely high EQE of 10.19% with an emission peak of 693 nm is achieved. All these values represent the best result for NIR OLEDs based on a pure organic fluorescent emitter with similar device structure and color gamut.
A near‐infrared (NIR) thermally activated delayed fluorescence material, APDC‐DTPA, containing acenaphtho1,2‐bpyrazine‐8,9‐dicarbonitrile unit as acceptor and diphenylamine as donor unit is developed. A non‐doped device based on APDC‐DTPA exhibits a maximum external quantum efficiency (EQE) of 2.19% with an emission peak at 777 nm. A maximum EQE of up to 10.19% is achieved in a doped NIR device (λEL = 693 nm).
In this work, two novel thermally activated delayed fluorescence (TADF) emitters, 2tDMG and 3tDMG, are synthesized for high‐efficiency organic light‐emitting diodes (OLEDs), The two emitters have a ...tilted face‐to‐face alignment of donor (D)/acceptor (A) units presenting intramolecular noncovalent interactions. The two TADF materials are deposited either by an evaporation‐process or by a solution‐process, both of them leading to high OLED performance. 2tDMG used as the emitter in evaporation‐processed OLEDs achieves a high external quantum efficiency (EQE) of 30.8% with a very flat efficiency roll‐off of 7% at 1000 cd m−2. The solution‐processed OLEDs also display an interesting EQE of 16.2%. 3tDMG shows improved solubility and solution processability as compared to 2tDMG, and thus a high EQE of 20.2% in solution‐processed OLEDs is recorded. The corresponding evaporation‐processed OLEDs also reach a reasonably high EQE of 26.3%. Encouragingly, this work provides a novel strategy to address the imperious demands for OLEDs with high EQE and low roll‐off.
A thermally activated delayed fluorescence emitter, 2tDMG, is designed and synthesized based on the donor (D)/acceptor (A) spatially intramolecular noncovalent interaction. The D/A units are connected via a rigid linker, thereby confining them into a close‐packed coplanar configuration for small singlet–triplet splitting energy. 2tDMG achieves a high external quantum efficiency of 30.8% with a low efficiency roll‐off in evaporation‐processed organic light‐emitting diodes (OLEDs).
A multiple resonance thermally activated delayed fluorescence (MR‐TADF) molecule with a fused, planar architecture tends to aggregate at high doping ratios, resulting in broad full width at half ...maximum (FWHM), redshifting electroluminescence peaks, and low device efficiency. Herein, we propose a mono‐substituted design strategy by introducing spiro‐9,9′‐bifluorene (SBF) units with different substituted sites into the MR‐TADF system for the first time. As a classic steric group, SBF can hinder interchromophore interactions, leading to high device efficiency (32.2–35.9 %) and narrow‐band emission (≈27 nm). Particularly, the shield‐like molecule, SF1BN, seldom exhibits a broadened FWHM as the doping ratio rises, which differs from the C3‐substituted isomer and unhindered parent emitter. These results manifest an effective method for constructing highly efficient MR‐TADF emitters through a spiro strategy and elucidate the feasibility for steric modulation of the spiro structure in π‐framework.
By incorporating a three‐dimensional spiro unit into multiple resonance thermally activated delayed fluorescence emitters, the device efficiency is increased to nearly 1.5 times that of the unhindered emitter. Notably, the linkage pattern with spatial interaction and hindrance can maintain the narrow FWHM and curb unfavorable redshifts at a high doping ratio.
Rational manipulation of frontier orbital distribution and singlet‐triplet splitting is crucial to exploit the luminescent properties of organic molecules. To realize ultra‐blue luminescence, both ...blue‐shifted wavelength peak (λpeak) and narrow full‐width at half‐maximum (FWHM) are required. Herein, a new thermally activated delayed fluorescence (TADF) skeleton by inserting the diphenyl methylene intramolecular‐lock to adjust the torsion angles and restrict the intramolecular relaxation is developed. Two rigid emitters, incorporating phenoxazine (PXZN‐B) and acridine (DMACN‐B) as donors and mesitylboron as an acceptor, exhibit narrow FWHMs (<50 nm) with deep‐blue (0.133, 0.147) and violet‐blue emission (0.151, 0.045), respectively. In particular, the Commission Internationale de l'Eclairage (CIE) coordinates of a DMACN‐B‐based device closely approach the Rec.2020 standard (0.131, 0.046). Moreover, both of the organic light‐emitting diodes (OLEDs) based on PXZN‐B and DMACN‐B show TADF character, with high external quantum efficiencies (EQEs) exceeding 10%. Furthermore, owing to the large orbital overlap, these TADF emitters own a fast S1–S0 transition rate exceeding 108 s–1, thereby exhibiting marked amplified spontaneous emission (ASE) with low thresholds. Therefore, the intramolecular‐lock strategy provides not only innovation for realizing high‐efficiency deep‐blue TADF emission with high color purity but also an avenue for a TADF‐based ASE and lasing application.
An “intramolecular‐lock” is proposed as part of the thermally activated delayed fluorescence (TADF) molecular design for manipulating torsion angles and wave function distributions. The quasi‐planar TADF emitters lead to ultrapure violet‐blue TADF electroluminescence with CIE‐(0.151, 0.045), approaching the Rec. 2020 standard. Furthermore, a TADF‐based amplified spontaneous emission with low thresholds is triggered, which paves the way for future TADF‐based lasing application.
Rockbursts are markedly characterized by the ejection of rock fragments from host rocks at certain speeds. The rockburst process is always accompanied by acoustic signals that include acoustic ...emissions (AE) and sounds. A deep insight into the evolutionary features of AE and sound signals is important to improve the accuracy of rockburst prediction. To investigate the evolutionary features of AE and sound signals, rockburst tests on granite rock specimens under true-triaxial loading conditions were performed using an improved rockburst testing system, and the AE and sounds during rockburst development were recorded and analyzed. The results show that the evolutionary features of the AE and sound signals were obvious and similar. On the eve of a rockburst, a ‘quiescent period’ could be observed in both the evolutionary process of the AE hits and the sound waveform. Furthermore, the time-dependent fractal dimensions of the AE hits and sound amplitude both showed a tendency to continuously decrease on the eve of the rockbursts. In addition, on the eve of the rockbursts, the main frequency of the AE and sound signals both showed decreasing trends, and the frequency spectrum distributions were both characterized by low amplitudes, wide frequency bands and multiple peak shapes. Thus, the evolutionary features of sound signals on the eve of rockbursts, as well as that of AE signals, can be used as beneficial information for rockburst prediction.
Organic materials with multi‐stimulus response (MSR) properties have demonstrated many potential and practical applications. Herein, a π‐stacked thermally activated delayed fluorescence (TADF) ...material with multi‐stimulus response (MSR) properties, named SDMAC, was designed and synthesized using distorted 9,9‐dimethyl‐10‐phenyl‐9,10‐dihydroacridine as a donor. SDMAC possesses a rigid π‐stacked configuration with intramolecular through‐space interactions and exhibits aggregation‐induced emission enhancement (AIEE), solvatochromic, piezochromic, and circularly polarized luminescence (CPL) under different external stimuli. The rigid molecular structure and efficient TADF properties of SDMAC can be used in displays and lighting. Using SDMAC as an emitter, the maximum external quantum efficiency (EQE) of the fabricated organic light‐emitting diodes (OLEDs) is as high as 28.4 %, which make them the most efficient CP‐TADF OLEDs based on the through‐space charge transfer strategy. The CP organic light‐emitting diodes (CP‐OLEDs) exhibit circularly polarized electroluminescence (CPEL) signals.
An efficient thermally activated delayed fluorescence (TADF) emitter has been developed that possesses a rigid π‐stacked configuration with intramolecular through‐space interactions. This emitter exhibits solvatochromism, piezochromism, aggregation‐induced emission enhancement (AIEE), and circularly polarized luminescence (CPL) under different external stimuli.
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