Superficial Serrated Adenoma (SuSA): A New Subtype of Serrated Lesions

Superficial serrated adenoma (SuSA) is a new subtype of serrated lesions proposed in recent years, most of which are located in the sigmoid colon or rectum, with typical mixed adenoma and serrated pathological features, and its molecular features are high frequency of KRAS mutation and RSPO fusion or overexpression. At present, it is believed that SuSA has two subtypes: traditional serrated adenoma (TSA)-associated SuSA and isolated SuSA. Solitary SuSA showed faded pedicle-free protuberant lesions under endoscope and lobulated, pp (pit pattern) classification was type II and type IIIH, TSA-associated SuSA showed double-layer eminence, SuSA part showed white flat eminence, pp classification showed type II and IIIH, TSA part showed red tone high eminence, pp was IVH type. SuSA can develop into colorectal cancer through the evolution of TSA, and it can also directly develop into MSS colorectal cancer. In view of the superficial understanding of SuSA and the lack of a complete description of SuSA, this paper review the research progress of SuSA at home and abroad from the origin, endoscope features, histopathological features, molecular biology, differential diagnosis and treatment of SuSA, in order to better promote the understanding and clinical diagnosis of lesions.

原位构筑三维有序自支撑Co-N-C一体化电极并用于高效电催化氧还原反应

开发高效非贵金属氧还原反应(ORR)催化剂是降低质子交换膜燃料电池(PEMFC)成本,实现其大规模商业化应用的关键.目前,过渡金属-氮-碳(TM-N-C)被认为是最有希望替代Pt的非贵金属催化剂.然而,尽管在半池测试中展现出较好的ORR性能,但当将其组装到PEMFC核心部件膜电极(MEA)中时,其单池性能远低于Pt/C催化剂.因此,未来需要进一步优化TM-N-C在全电池环境中的性能.本文提出了一种原位策略,成功构筑了TM-N-C三维有序一体化ORR电极.通过结合碳纸亲水处理和化学气相沉积技术,在含氧官能团修饰的碳纸(OCP)上原位构建了Co,N共掺杂碳纳米管(N-CNTs@Co)自支撑三维有序一体化电极.该独特的三维有序网络结构不仅使反应物(H_(2),O_(2)和H_(2)O)和质子(H+和e–)的传输通道处于有序状态,降低了实际工况条件下的浓差极化,还避免了催化层传统制备过程(如涂覆、喷涂和流延法)引起的催化剂活性位点团聚或包埋,从而提高了催化剂的利用率.X射线光电子能谱分析表明,优化后的一体化电极试样(N-CNTs-20@Co/OCP,其中20代表CNT生长时间为20 min)具有最高的吡啶N和石墨化N含量,而吡啶N和石墨化N被普遍认为是N掺杂碳材料在电催化ORR中的活性位点.因此,该N-CNTs-20@Co/OCP一体化电极在酸性(0.1 mol L^(‒1)HClO_(4))和碱性(0.1 mol L^(‒1)KOH)介质中均展现出与商用Pt/C(20 wt%)喷涂在CP(0.2 mgPt cm^(‒2))上制备的传统电极相当的ORR性能.密度泛函理论计算进一步揭示了其性能提升的机制:Co纳米颗粒被封装在碳纳米管内部并作为电子供体,通过电子隧穿效应,强化了N-CNTs@Co/OCP催化剂表面对氧的吸附,进而提高了电催化ORR性能.此外,封装在碳纳米管内部的Co纳米颗粒避免了与电解液的直接接触,从而显著提高了催化剂的稳定性.综上,本文不仅为基于非贵金属ORR催化剂三维有序一体化电极的构筑提供了有益的理论储备和实验技术积累,而且对于降低燃料电池成本以及推动燃料电池产业化进程提供了一定的参考.

Heat exposure and hospitalizations for chronic kidney disease in China: a nationwide time series study in 261 major Chinese cities

Background:Climate change profoundly shapes the population health at the global scale.However,there was still insufficient and inconsistent evidence for the association between heat exposure and chronic kidney disease(CKD).Methods:In the present study,we studied the association of heat exposure with hospitalizations for cause-specific CKD using a national inpatient database in China during the study period of hot season from 2015 to 2018.Standard time-series regression models and random-effects Meta-analysis were developed to estimate the city-specific and national averaged associations at a 7 lag-day span,respectively.Results:A total of 768,129 hospitalizations for CKD was recorded during the study period.The results showed that higher temperature was associated with elevated risk of hospitalizations for CKD,especially in sub-tropical cities.With a 1℃ increase in daily mean temperature,the cumulative relative risks(RR)over lag 0-7 d were 1.008[95% confidence interval(CI)1.003-1.012]for nationwide.The attributable fraction of CKD hospitalizations due to high temperatures was 5.50%.Stronger associations were observed among younger patients and those with obstructive nephropathy.Our study also found that exposure to heatwaves was associated with added risk of hospitalizations for CKD compared to non-heatwave days(RR=1.116,95%CI 1.069-1.166)above the effect of daily mean temperature.Conclusions:Short-term heat exposure may increase the risk of hospitalization for CKD.Our findings provide insights into the health effects of climate change and suggest the necessity of guided protection strategies against the adverse effects of high temperatures.

Passive neutron multiplicity device for^(240)Pu measurement based on FPGA

A passive neutron multiplicity measurement device,FH-NCM/S1,based on field-programmable gate arrays(FPGAs),is developed specifically for measuring the mass of plutonium-240(^(240)Pu)in mixed oxide fuel.FH-NCM/S1 adopts an inte-grated approach,combining the shift register analysis mode with the pulse-position timestamp mode using an FPGA.The optimal effective length of the^(3)He neutron detector was determined to be 30 cm,and the thickness of the graphite reflector was ascertained to be 15 cm through MCNP simulations.After fabricating the device,calibration measurements were per-formed using a^(252)Cf neutron source;a detection efficiency of 43.07%and detector die-away time of 55.79μs were observed.Nine samples of plutonium oxide were measured under identical conditions using the FH-NCM/S1 in shift register analysis mode and a plutonium waste multiplicity counter.The obtained double rates underwent corrections for detection efficiency(ε)and double gate fraction(f_(d)),resulting in corrected double rates(D_(c)),which were used to validate the accuracy of the shift register analysis mode.Furthermore,the device exhibited fluctuations in the measurement results,and within a single 20 s measurement,these fluctuations remained below 10%.After 30 cycles,the relative error in the mass of^(240)Pu was less than 5%.Finally,correlation calculations confirmed the robust consistency of both measurement modes.This study holds specific significance for the subsequent design and development of neutron multiplicity devices.

Enhancing the Performance of Perovskite Light-Emitting Diodes via Synergistic Effect of Defect Passivation and Dielectric Screening

Metal halide perovskites,particularly the quasi-two-dimensional perovskite subclass,have exhibited considerable potential for next-generation electroluminescent materials for lighting and display.Nevertheless,the presence of defects within these perovskites has a substantial influence on the emission efficiency and durability of the devices.In this study,we revealed a synergistic passivation mechanism on perovskite films by using a dual-functional compound of potassium bromide.The dual functional potassium bromide on the one hand can passivate the defects of halide vacancies with bromine anions and,on the other hand,can screen the charged defects at the grain boundaries with potassium cations.This approach effectively reduces the probability of carriers quenching resulting from charged defects capture and consequently enhances the radiative recombination efficiency of perovskite thin films,leading to a significant enhancement of photoluminescence quantum yield to near-unity values(95%).Meanwhile,the potassium bromide treatment promoted the growth of homogeneous and smooth film,facilitating the charge carrier injection in the devices.Consequently,the perovskite light-emitting diodes based on this strategy achieve a maximum external quantum efficiency of~21%and maximum luminance of~60,000 cd m^(-2).This work provides a deeper insight into the passivation mechanism of ionic compound additives in perovskite with the solution method.

Identification of the highly active Zn-N_(4) sites with pyrrole/pyridine-N synergistic coordination by dz^(2)+s-band center for electrocatalytic H_(2)O_(2) production

Single metal atoms anchored on nitrogen-doped carbon materials(M-N_(4))have been identified as effective active sites for catalyzing the two-electron oxygen reduction reaction(2e-ORR).However,the relationship between the local atomic/electronic environments of the M-N_(4) sites(metal atoms coordinated with different types of N species)and their catalytic activity for 2e-ORR has rarely been elaborated clearly,which imposes significant ambiguity for the rational design of catalysts.Herein,guided by the comprehensive density-functional theory calculations and predictions,a series of Zn-N_(4) single-atom catalysts(SACs)are designed with pyrrole/pyridine-N(N_(Po)/N_(Pd))synergistic coordination and prepared by controlling the pyrolysis temperature(600,700,and 800℃),Among them,the dominated Zn-N_(4) configurations with rationally combined N_(Po)/N_(Pd)coordination show~*OOH adsorption strength close to the optimal value,much superior to those with mono N species.Thus,the as-prepared catalyst exhibits a high H_(2)O_(2) selectivity of over 90%both in neutral and alkaline environments,with a superb H_(2)O_(2) yield of up to 33.63 mol g^(-1)h^(-1)in an alkaline with flow cell.More importantly,a new descriptor,dz^(2)+s band center,has been proposed,which is especially feasible for predicting the activity for metal types with fully occupied s and d orbitals.This work thus presents clear guidance for the rational design of highly active SACs toward ORR and provides a complement to the d-band theory for more accurately predicting the catalytic activity of the materials.

High Efficiency Formamidinium-Cesium Perovskite-Based Radio-Photovoltaic Cells

Radio-photovoltaic cell is a micro nuclear battery for devices operating in extreme environments,which converts the decay energy of a radioisotope into electric energy by using a phosphor and a photovoltaic converter.Many phosphors with high light yield and good environmental stability have been developed,but the performance of radio-photovoltaic cells remains far behind expectations in terms of power density and power conversion efficiency,because of the poor photoelectric conversion efficiency of traditional photovoltaic converters under low-light conditions.This paper reports an radio-photovoltaic cell based on an intrinsically stable formamidinium-cesium perovskite photovoltaic converter exhibiting a wide light wavelength response from 300 to 800 nm,high open-circuit voltage(V_(oc)),and remarkable efficiency at low-light intensity.When a He ions accelerator is adopted as a mimickedαradioisotope source with an equivalent activity of 0.83 mCi cm^(-2),the formamidinium-cesium perovskite radio-photovoltaic cell achieves a V_(oc)of 0.498 V,a short-circuit current(J_(sc))of 423.94 nA cm^(-2),and a remarkable power conversion efficiency of 0.886%,which is 6.6 times that of the Si reference radio-photovoltaic cell,as well as the highest among all radio-photovoltaic cells reported so far.This work provides a theoretical basis for enhancing the performance of radio-photovoltaic cells.

OsPPG encodes a pseudouridine-5'-phosphate glycosidase and regulates rice spikelet development

Florets are the basic structural units of spikelets,and their morphogenesis determines the yield and quality of rice grains.However,whether and how pseudouridine-5’-phosphate glycosidase participates in rice spikelet development remains an open question.In this study,we identified a novel gene,OsPPG,which encodes a peroxisome-localized pseudouridine-5’-phosphate glycosidase and regulates the development of rice spikelets.osppg mutants exhibited abnormal sterile lemma,lemma,palea,lodicule,stamens,and pistils;male sterility;shorter panicles;and reduced plant height.OsPPG was found to regulate several OsMADS genes,thereby affecting the morphogenesis of rice spikelets.Furthermore,metabolomics revealed that the OsPPG gene was involved in the decomposition of pseudouridine via the pyrimidine metabolism pathway and may affect the jasmonic acid signaling pathway.These results suggest that OsPPG is a key regulator of rice spikelet development.

Accelerating the evaluation of operational lifetimes of perovskite solar cells and modules

Compared with the power conversion efficicency,the operational stability of perovskite solar cells(PsCs)remains a major challenge hampering its commercialization.However,conducting a light soaking test under 1 sun illumination to get a long lifetime is time-consuming and experimentally inefficient.Here,we report an accelerated stability test protocol by aging PsCs under high-intensity light illumination to accelerate the evaluation of their operation stability.It is found that the efficiency degradation rate of a typical inverted PsC is almost linearly dependent on the light intensity within the range of 1 to 4 suns regardless of the encapsulations.The results prove that it can save the light-soaking time by at least 4 times to predict the operation lifetime on the basis of the equivalent light irradiation dose.

Tuning Second Chern Number in a Four-Dimensional Topological Insulator by High-Frequency Time-Periodic Driving

Floquet engineering has attracted considerable attention as a promising approach for tuning topological phase transitions.We investigate the effects of high-frequency time-periodic driving in a four-dimensional(4D)topological insulator,focusing on topological phase transitions at the off-resonant quasienergy gap.The 4D topological insulator hosts gapless three-dimensional boundary states,characterized by the second Chern number C_(2).We demonstrate that the second Chern number of 4D topological insulators can be modulated by tuning the amplitude of time-periodic driving.This includes transitions from a topological phase with C_(2)=±3 to another topological phase with C_(2)=±1,or to a topological phase with an even second Chern number C_(2)=±2,which is absent in the 4D static system.Finally,the approximation theory in the high-frequency limit further confirms the numerical conclusions.

Structural and Ferroelectric Transition in Few-Layer HfO_(2) Films by First Principles Calculations

The discovery of ferroelectricity in HfO_(2)-based materials with high dielectric constant has inspired tremendous research interest for next-generation electronic devices.Importantly,films structure and strain are key factors in exploration of ferroelectricity in fluorite-type oxide HfO_(2) films.Here we investigate the structures and straininduced ferroelectric transition in different phases of few-layer HfO_(2) films(layer number𝑁=1–5).It is found that HfO_(2) films for all phases are more stable with increasing films thickness.Among them,the Pmn2_(1)(110)-oriented film is most stable,and the films of𝑁=4,5 occur with a𝑃21 ferroelectric transition under tensile strain,resulting in polarization about 11.8μC/cm^(2) along in-plane𝑎-axis.The ferroelectric transition is caused by the strain,which induces the displacement of Hf and O atoms on the surface to non-centrosymmetric positions away from the original paraelectric positions,accompanied by the change of surface Hf–O bond lengths.More importantly,three new stable HfO_(2)2D structures are discovered,together with analyses of computed electronic structures,mechanical,and dielectric properties.This work provides guidance for theoretical and experimental study of the new structures and strain-tuned ferroelectricity in freestanding HfO_(2) films.

Higher-order topological Anderson insulator on the Sierpiński lattice

Disorder effects on topological materials in integer dimensions have been extensively explored in recent years. However, its influence on topological systems in fractional dimensions remains unclear. Here, we investigate the disorder effects on a fractal system constructed on the Sierpiński lattice in fractional dimensions. The system supports the second-order topological insulator phase characterized by a quantized quadrupole moment and the normal insulator phase. We find that the second-order topological insulator phase on the Sierpiński lattice is robust against weak disorder but suppressed by strong disorder. Most interestingly, we find that disorder can transform the normal insulator phase to the second-order topological insulator phase with an emergent quantized quadrupole moment. Finally, the disorder-induced phase is further confirmed by calculating the energy spectrum and the corresponding probability distributions.

Different timing for abdominal paracentesis catheter placement and drainage in severe acute pancreatitis complicated by intraabdominal fluid accumulation

BACKGROUND Non-surgical methods such as percutaneous drainage are crucial for the treatment of patients with severe acute pancreatitis(SAP).However,there is still an ongoing debate regarding the optimal timing for abdominal paracentesis catheter place-ment and drainage.AIM To explore the influence of different timing for abdominal paracentesis catheter placement and drainage in SAP complicated by intra-abdominal fluid accumu-lation.METHODS Using a retrospective approach,184 cases of SAP complicated by intra-abdominal fluid accumulation were enrolled and categorized into three groups based on the timing of catheter placement:group A(catheter placement within 2 d of symptom onset,n=89),group B(catheter placement between days 3 and 5 after symptom onset,n=55),and group C(catheter placement between days 6 and 7 after symptom onset,n=40).The differences in progression rate,mortality rate,and the number of cases with organ dysfunction were compared among the three groups.RESULTS The progression rate of group A was significantly lower than those in groups B and groups C(2.25%vs 21.82%and 32.50%,P<0.05).Further,the proportion of patients with at least one organ dysfunction in group A was significantly lower than those in groups B and groups C(41.57%vs 70.91%and 75.00%,P<0.05).The mortality rates in group A,group B,and group C were similar(P>0.05).At postoperative day 3,the levels of C-reactive protein(55.41±19.32 mg/L vs 82.25±20.41 mg/L and 88.65±19.14 mg/L,P<0.05),procalcitonin(1.36±0.51 ng/mL vs 3.20±0.97 ng/mL and 3.41±0.98 ng/mL,P<0.05),tumor necrosis factor-alpha(15.12±6.63 pg/L vs 22.26±9.96 pg/L and 23.39±9.12 pg/L,P<0.05),interleukin-6(332.14±90.16 ng/L vs 412.20±88.50 ng/L and 420.08±87.65ng/L,P<0.05),interleukin-8(415.54±68.43 ng/L vs 505.80±66.90 ng/L and 510.43±68.23ng/L,P<0.05)and serum amyloid A(270.06±78.49 mg/L vs 344.41±81.96 mg/L and 350.60±80.42 mg/L,P<0.05)were significantly lower in group A compared to those in groups B and group C.The length of hospital stay in group A was significantly lower than those in groups B and group C(24.50±4.16 d vs 35.54±6.62 d and 38.89±7.10 d,P<0.05).The hospitalization expenses in group A were also significantly lower than those in groups B and groups C[2.70(1.20,3.55)ten-thousand-yuan vs 5.50(2.98,7.12)ten-thousand-yuan and 6.00(3.10,8.05)ten-thousand-yuan,P<0.05).The incidence of complications in group A was markedly lower than that in group C(5.62%vs 25.00%,P<0.05),and similar to group B(P>0.05).CONCLUSION Percutaneous catheter drainage for the treatment of SAP complicated by intra-abdominal fluid accumulation is most effective when performed within 2 d of onset.

现代产业学院:建设困境与思考建议

产教融合是提升人才培养质量的核心动力。现代产业学院作为深化产教融合的重要载体,能够有效衔接区域产业发展,通过校企合作,构建多元主体协同的人才培养模式,已成为深化产教融合的重要举措。通过分析现阶段产业学院建设和运营中的难点和问题,提出从加强政策保障,规范组织架构和明确各参与方的职责、权利和义务,整合各方资源,保障经费投入等方面助力现代产业学院建设。

Study on the Evolution of Plane Shape of Guangfu Ancestral Hall Buildings and the Construction of Type Genealogy in the Ming and Qing Dynasties

This paper studies the clan temples in four periods,namely,the development period(early Ming Dynasty and before),the shaping period(mid-Ming Dynasty to early Qing Dynasty),the maturity period(mid-Qing Dynasty),and the programmed period(late Qing Dynasty),analyzes and summarizes their prototypical planform features and attempts to summarize and construct a genealogy of the architectural characteristics of the plane shape of clan temples.During the Ming and Qing dynasties,Guangfu ancestral halls in general showed a journey of development from a centripetal-single-linear-multi-linear-grid pattern,forming the unique Guangsanlu classic pattern in the Guangfu area.

中医治疗失眠研究进展

在现代生活中,失眠是一种睡眠障碍疾病,严重影响人们的生活质量、情绪稳定以及工作水平。使用西药治疗失眠虽能在一定程度上改善患者的失眠症状,但仍存在明显的不良反应,如焦虑抑郁状态、药物成瘾等,因此不能进行长期口服药物治疗。而中医经历几千年的发展变化在治疗上具有独特优势,在古代就已经有医家对失眠有极具特色的辨证认识及治疗理念,包括从调节阴阳平衡、营卫协调、气血充盈等方面治疗失眠。这种认识及治疗理念发展到今天,现代医者通过不断改革创新,使用中药、针灸、推拿、穴位贴敷等方法治疗失眠。在中医治疗下,患者无明显不良反应,其经济适用性高,简便易操作,推广度更高,患者普遍接受度高。因此作者通过对近几年相关文献的梳理及归纳,为中医临床治疗失眠提供参考依据。

基于普通器件实现快1000倍的相机与机器视觉

在数码相机中,我们发现了一个重大缺陷,即从胶片相机继承的图像和视频模型阻碍了相机捕捉快速变化的光子世界。我们提出了一种新的视觉形式,称为视象(vform),这是一个比特序列阵列,其中每个比特表示光子的累积是否达到了一个阈值,从而可以记录和重建任何时刻场景的光强。仅使用消费级CMOS传感器和集成电路,开发了一种比传统相机快1000倍的脉冲相机。将视象看作生物视觉中的脉冲序列,进一步开发了基于脉冲神经网络的机器视觉系统,它可以将机器的速度和生物视觉的机理结合起来,从而实现了比人类视觉快1000倍的高速目标检测和跟踪,并通过辅助裁判和目标瞄准系统证明了脉冲相机和超级视觉系统的效用。视象模型和芯片有望从根本上改变图像和视频的概念以及摄影、电影和视觉媒体等相关行业,并开启一个全新的基于脉冲神经网络的速度自由的机器视觉时代。

Expert Consensus on Nutritional Support for Children with Congenital Heart Disease(2023 Edition)

The second edition of the expert consensus on pediatric nutrition was formed based on a global update of pedia-tric nutrition guidelines or consensus worldwide,the management of congenital heart disease,and the results of multi-center clinical nutrition research for congenital heart disease following thefirst Chinese consensus edition of 2016.The consensus was also shaped by the results of three discussion sessions and two questionnaires con-ducted by the 13-member collaboration group.This process was informed by both clinical guidelines and expert consensus.The quality of literature,both in English and Chinese,and the level of recommendations were evaluated using the Grading of Recommendations Assessment,Development,and Evaluations(GRADE)system.

Multiatom activation of single-atom electrocatalysts via remote coordination for ultrahigh-rate two-electron oxygen reduction

Electrocatalytic oxygen reduction via a two-electron pathway(2e^(-)-ORR)is a promising and eco-friendly route for producing hydrogen peroxide(H_(2)O_(2)).Single-atom catalysts(SACs)typically show excellent selectivity towards 2e^(-)-ORR due to their unique electronic structures and geometrical configurations.The very low density of single-atom active centers,however,often leads to unsatisfactory H_(2)O_(2)yield rate,significantly inhibiting their practical feasibility.Addressing this,we herein introduce fluorine as a secondary doping element into conventional SACs,which does not directly coordinate with the singleatom metal centers but synergize with them in a remote manner.This strategy effectively activates the surrounding carbon atoms and converts them into highly active sites for 2e^(-)-ORR.Consequently,a record-high H_(2)O_(2)yield rate up to 27 mol g^(-1)h^(-1)has been achieved on the Mo–F–C catalyst,with high Faradaic efficiency of 90%.Density functional theory calculations further confirm the very kinetically facile 2e^(-)-ORR over these additional active sites and the superiority of Mo as the single-atom center to others.This strategy thus not only provides a high-performance electrocatalyst for 2e^(-)-ORR but also should shed light on new strategies to significantly increase the active centers number of SACs.

Synergistic Optimization of Buried Interface by Multifunctional Organic-Inorganic Complexes for Highly Efficient Planar Perovskite Solar Cells

For the further improvement of the power conversion efficiency(PCE)and stability of perovskite solar cells(PSCs),the buried interface between the perovskite and the electron transport layer is crucial.However,it is challenging to effectively optimize this interface as it is buried beneath the perovskite film.Herein,we have designed and synthesized a series of multifunctional organic-inorganic(OI)complexes as buried interfacial material to promote electron extraction,as well as the crystal growth of the perovskite.The OI complex with BF4−group not only eliminates oxygen vacancies on the SnO_(2) surface but also balances energy level alignment between SnO_(2) and perovskite,providing a favorable environment for charge carrier extraction.Moreover,OI complex with amine(−NH_(2))functional group can regulate the crystallization of the perovskite film via interaction with PbI2,resulting in highly crystallized perovskite film with large grains and low defect density.Consequently,with rational molecular design,the PSCs with optimal OI complex buried interface layer which contains both BF4−and−NH_(2) functional groups yield a champion device efficiency of 23.69%.More importantly,the resulting unencapsulated device performs excellent ambient stability,maintaining over 90%of its initial efficiency after 2000 h storage,and excellent light stability of 91.5%remaining PCE in the maximum power point tracking measurement(under continuous 100 mW cm−2 light illumination in N2 atmosphere)after 500 h.