Online health communities (OHCs) have emerged as critical platforms for patients with type 1 diabetes (T1D) to exchange informational and emotional support. However, how stakeholder roles and disease duration jointly shape support dynamics and influence formation remains underexplored. This study aimed to examine network-based social support mechanisms in a large T1D OHC, focusing on how stakeholder diversity and disease duration are associated with social support behaviors, subnetwork structures, and user influence. This retrospective observational study analyzed digital trace data from China's largest T1D online community (January 1-May 20, 2024), comprising 43,788 posts and 145,423 comments contributed by 1393 users. We manually annotated 2000 randomly sampled posts and fine-tuned a GPT-4o-mini (OpenAI) to classify support type (informational or emotional, and seeking or providing), yielding 20,384 support-related posts and 56,953 comments from 1224 users. We constructed weighted directed informational and emotional interaction networks and modeled predictors of a composite influence metric (Relative Centrality) using a gamma log-link generalized linear model (including demographics, identity, sentiment, disease duration, posting orientation, and cyclical activity time). Analyses were conducted in Python (version 3.11; Python Software Foundation). Statistical significance was set at P<.05. Support predominantly flowed from longer-duration members (≥ y) to those at earlier stages (≤5 y). Both subnetworks exhibited multicentered, star-like structures; the informational subnetwork had broader participation (density 0.031, diameter 7), while the emotional network was denser (density 0.039, diameter 6). In the influence model, peer supporters had substantially higher influence than patients (exp(β)=34.79, 95% CI 18.94-64.08; P<.001), professionals lower (exp(β)=0.41, 95% CI 0.17-0.99; P=.055), and women higher than men (exp(β)=1.65, 95% CI 1.23-2.23; P=.001). Positive sentiment was associated with higher influence (exp(β)=1.91, 95% CI 1.22-2.97; P=.005), and negative lower (exp(β)=0.54, 95% CI 0.37-0.79; P=.001). Influence followed an inverted U-shaped trajectory over disease duration, peaking at approximately the 116th month (95% CI 43.25-188.91). This study suggests that social support patterns and user influence in a T1D OHC vary by stakeholder role and disease duration. Users with shorter disease duration more often sought support, whereas longer-duration users more often provided support, and informational and emotional exchanges formed distinct interaction subnetworks. Peer supporters were the most influential users; influence was also associated with gender, sentiment, activity timing, and a nonlinear (inverted U-shaped) relationship with disease duration. These findings may inform peer-facilitated, stage-tailored community strategies, with professionals engaged in targeted, complementary roles. A patient-centered collaborative care approach integrating peer experience with multidisciplinary clinical input could be explored in future work.
Eco-friendly waterborne optical adhesives suffer from simultaneously achieving high interfacial adhesion and high bulk cohesion, alongside poor hydrothermal resistance. Here, we address this challenge by introducing Zn2+ coordination into a covalently cross-linked acetoacetylated poly(vinyl alcohol) (AAPVA) network. This synergistic multinetwork─comprising dynamic metal-ligand bonds, PVA crystallites, and covalent cross-links─dissipates energy to alleviate cohesive brittleness while providing new interaction sites at the adhesive-substrate interface. Consequently, the average peel strength is remarkably enhanced from 2.68 × 10-2 to 9.32 × 10-2 N mm-1, achieving optimal hydrothermal aging resistance at 0.22 wt % Zn2+. Furthermore, quantitative topological analysis via time-resolved low-field NMR, DSC, and FT-IR reveals that Zn2+ accelerates the initial cross-linking kinetics. Notably, the network constraint sites peak at 0.10 wt % Zn2+, while crystallization is completely suppressed above 0.64 wt %. This work provides a robust physical paradigm for utilizing dynamic metal coordination to decouple the adhesion-cohesion conflict in soft materials for demanding environments.
This convergent mixed-methods study explores how Theater of the Oppressed (TO) fosters critical consciousness among gay, bisexual, queer, and transgender men (n = 16) in Singapore. Grounded in Freirean praxis, the study assessed pre- and post-intervention changes across four domains: perceived inequality, egalitarianism, critical motivation, and support networks. Quantitative findings showed a significant improvement in support networks and positive shifts in motivation. Qualitative insights revealed how TO's embodied and dialogic methods promoted reflection, solidarity, and agency. Furthermore, this study operationalizes support networks as a distinct, measurable component of critical consciousness within a TO framework. Findings highlight the potential of arts-based, relational interventions to advance psychosocial resilience and collective empowerment among marginalized queer communities in non-Western contexts.
Chiral polyoxometalates (cPOMs) are a class of inorganic organic hybrid materials that combine molecular chirality and metal oxygen cluster framework. They have both the chemical stability of inorganic polyoxometalates and the structural diversity of organic ligands. Unlike the traditional review which regards synthesis and application as a parallel separation field, this paper constructs a "hierarchical chiral transfer" framework to systematically explain the generation mechanism of molecular scale chirality, supramolecular scale transfer path and the amplification law of macro function. In view of the long-standing conceptual confusion in the field, this paper establishes a strict three-level classification system: type I (intrinsic chiral frameworks), type II (covalently induced chirality) and type III (chiral environment containing POM), and clearly defines the experimental diagnostic criteria and application scope of each type. This paper goes beyond the enumeration of isolated cases, systematically compares the traditional and new synthesis strategies, refines their common mechanism logic, and defines the cPOMs structure types that each method adapts to. At the application level, the quantitative performance of asymmetric catalysis, chiral recognition and separation, chiral optical materials and biomedical fields were compared, and the critical structure-activity relationship between chiral architecture parameters and functional output indicators was established. Conclusion three core bottlenecks are clearly pointed out: the chiral regulation mechanism is still at the empirical level, and the predictive correlation between reaction conditions and chiral framework is lacking; The large-scale preparation of enantiopure cPOMs has not yet been realized, and it is difficult to take into account the yield, purity and inter batch consistency; The data of operational stability and biosafety are seriously missing. Biomedical applications are still limited to in vitro proof of concept, and there is a transformation gap of 5-10 years. Four development directions are proposed, including mechanism decoding, large-scale manufacturing, stability engineering and biomedical safety integration. To sum up, this paper is not a simple literature compilation, but a research roadmap with clear mechanism foundation and clear critical guidance for the rational design of chiral inorganic organic hybrid materials.
Rapeseed (Brassica napus L.) is one of most vital oil crops in China, and its cultivation in southern regions is crucial for national edible oil security. However, delayed sowing in southern rice-rapeseed rotation systems exposes seedlings to subzero freezing events, which can cause severe foliar wilting, root injury, and mortality, thereby limiting overwintering survival and yield potential. To address this challenge, enhancing varietal cold tolerance is essential. This study evaluated two early-maturing rapeseed germplasms YLS145 (cold-sensitive) and YLS449 (cold-tolerant) under -4°C freezing treatment for 5 h at the three-leaf stage. The survival rate of the cold-tolerant germplasm YLS449 was significantly higher than that of the cold-sensitive germplasm YLS145, attributable to the rapid response of its antioxidant system. Transcriptome analysis indicated that freezing stress primarily impairs rapeseed physiology by disrupting the photosynthetic system and redox homeostasis. The YLS449 likely activates CBFs centered regulatory network through cold sensing, integrating Reactive Oxygen Species (ROS), circadian, calcium, and hormone signals (jasmonic acid (JA) and abscisic acid (ABA)) into a complex signaling network that enhances freezing tolerance. These findings establish a molecular foundation for cold adaptation mechanisms in early-maturing B. napus.
Layered metal hydroxides can be exfoliated into functional nanosheets via solvent intercalation, yet probing the atomic-level solvation processes remains challenging. Herein, we employ 79/81Br solid-state nuclear magnetic resonance (SSNMR) spectroscopy to directly probe the local environments of interlayer anions in bromide-intercalated layered yttrium hydroxide (LYH-Br). Upon treatment with a series of solvents of varying polarity, the overall spectral lineshapes remain largely unchanged in weakly interacting systems (toluene (PhMe), acetone (ACE), isopropanol (IPA)), indicating preservation of the local structural framework. Increasing solvent polarity leads to a reduction in 79Br NMR signal intensity, particularly in the case of formamide (FM). By combining complementary characterization techniques and transverse relaxation analysis, we show that this signal attenuation originates from shortened T2 relaxation times rather than structural degradation. These results reveal that polar solvent intercalation perturbs the local dynamics and solvation environment of interlayer Br- anions. Furthermore, solvent-induced effects are largely reversible for PhMe, ACE, IPA and N, N-dimethylformamide (DMF) upon vacuum drying, whereas FM remains trapped within the interlayer spaces, illustrating stronger host-guest interactions and altered local dynamics. This work demonstrates solid-state 79/81Br NMR as a powerful tool for directly distinguishing solvation-driven intercalation mechanisms in layered materials.
The rapid and precise detection of nucleic acids is critical for identifying viral mutations, yet it presents formidable difficulties for conventional diagnostics. While established techniques such as quantitative polymerase chain reaction and next-generation sequencing involve complex workflows, emerging on-chip integrated photonic biosensing techniques are often limited by inadequate specificity and sensitivity. Here, we introduce an integrated photonic biosensing platform that synergizes the programmable recognition of clustered regularly interspaced short palindromic repeats (CRISPR)-Cas12a, with the superior sensitivity of subwavelength grating microring resonators. The sensor surface is functionalized with single-stranded DNA probes conjugated to gold nanoparticles. Upon target recognition, activated Cas12a cleaves the probes, releasing the nanoparticles and generating a quantifiable resonance wavelength shift. In particular, the spectral response gets further amplified by a resonance-enhanced photothermal effect. The detection of SARS-CoV-2 variants enables discrimination between wild-type, Delta, and Omicron strains. The extracted detection limit of 0.7 fM represents a four-order-of-magnitude improvement over conventional fluorescence-based CRISPR assays. Our work establishes a generalizable platform for ultrasensitive, mutation-resolved molecular diagnostics on a CMOS-compatible photonic chip, paving the way for advanced point-of-care testing and genomic surveillance.
Marjolin ulcer lacks a disease-specific staging system, and existing cutaneous squamous cell carcinoma (cSCC) staging criteria have never been formally tested against outcomes in this disease. We retrospectively reviewed 42 consecutive Marjolin ulcer patients treated at a single tertiary center between 2010 and 2025, applied the American Joint Committee on Cancer (AJCC) 8th edition and Brigham and Women's Hospital (BWH) staging systems, and analyzed clinicopathological predictors of recurrence and survival including tumor depth of invasion (DOI) in millimeters. The cohort was predominantly male (71%) with a mean age of 54 years; burns were the leading etiology (67%), and the lower extremity was the most common site (69%). At median follow-up of 48 months, recurrence occurred in 26.2% and overall mortality in 21.4%. The AJCC system classified 71% of tumors as T3 and did not discriminate recurrence (p = 0.537) or mortality (p = 0.760). BWH staging was similarly nonsignificant. The AJCC cutaneous SCC depth threshold of 6 mm failed for recurrence (p = 0.477). When oral cavity SCC DOI thresholds were applied as an exploratory framework, patients with DOI ≤ 5 mm had no distant metastasis (0/23), whereas those with DOI > 10 mm had 80% recurrence and 60% distant metastasis (log-rank p < 0.001). Pathological nodal metastasis was the strongest independent predictor of recurrence-free survival (HR 5.91; p = 0.012). Current staging systems fail to stratify outcomes in Marjolin ulcer. Standardized reporting of DOI in millimeters alongside pathological nodal status across future series is needed for disease-specific staging and treatment algorithms.
To evaluate criterion and construct validity of field exercise tests and patient-reported questionnaires compared with cardiopulmonary exercise testing (CPET) to estimate cardiorespiratory fitness (CRF) in clinical rehabilitation. Participants were included at the start of a cardiopulmonary or oncologic rehabilitation program. All patients performed a CPET, steep ramp test (SRT), and 6-minute walk test (6-MWT) and completed the Duke activity status index (DASI), veterans-specific activity questionnaire (VSAQ), and FitMáx© questionnaire (FitMáx). Work rate at peak exercise at the SRT (SRT-WRpeak), distance walked at the 6-MWT (6-MWD), and oxygen uptake at peak exercise (VO2peak) estimated by the questionnaires were compared with measured VO2peak during CPET. Sixty-nine patients (57% female) were included, with a median (IQR) age of 58 (46-66) years. Correlations of SRT-WRpeak and 6-MWD with CPET-VO2peak were ρ=0.87 (95%-CI 0.78-0.92) and ρ=0.40 (95%-CI 0.17-0.58), respectively. Correlations of DASI-VO2peak, VSAQ-VO2peak, and FitMáx-VO2peak with CPET-VO2peak were ρ=0.37 (95%-CI 0.13-0.56), ρ=0.51 (95%-CI 0.30-0.68), and ρ=0.78 (95%-CI 0.65-0.87), respectively. SRT-WRpeak and FitMáx-VO2peak strongly correlated with CPET-VO2peak, whereas the 6-MWD, DASI-VO2peak and VSAQ-VO2peak showed a moderate correlation. Consequently, the SRT and FitMáx are considered the best alternative exercise test and questionnaire to estimate CRF when CPET is not feasible.
Decades of neuroscience research using the Drosophila model system has made enormous strides in uncovering genes that positively support the ability to form new memories or consolidate them for the long-term. However, recent research has revealed the existence of more rare but equally important memory suppressor genes whose normal function is to limit memory formation or even promote active forgetting. Here we report that RNAi targeting of Diacylglycerol kinase (Dgk), a major regulator of lipid signaling, within the mushroom body memory circuitry specifically enhances aversive olfactory memory retention while leaving learning and sensory-motor behavioural controls unaffected. Furthermore, memory retention is enhanced when targeting Dgk in these circuits with two additional RNAi lines. Finally, using in vivo functional imaging, we offer evidence that Dgk plays a role in regulating baseline synaptic transmission of memory circuits. While the exact mechanism for Dgk's synaptic effects and the implications for memory storage remain unclear, our findings implicate lipid signaling via Dgk as an important regulator of active-forgetting pathways. This work builds on our prior understanding of the importance of lipids in cognition by extended their role to memory suppression and active forgetting.
A biosynthetic gene cluster (tcr) was identified from the fungus Trichothecium crotocinigenum LC36. The encoded enzymes direct the biosynthesis of two structurally distinct shikimate-originated meroterpenoids, trichothosporon A (1) and (±)-trichothecrotocin J (2), from a common precursor. Using heterologous expression and in vitro assays, the cupin-domain enzyme TcrH and the ketoreductase enzyme TcrG sequentially catalyze the dearomatization. Biochemical characterization of TcrG revealed a previously unreported cofactor-dependent substrate specificity in a ketoreductase. This work reveals novel enzymatic strategies for diversifying shikimate-derived meroterpenoid scaffolds.
Mixed-cation mixed-halide perovskite compositions are essential for achieving the required bandgaps for high-efficiency multijunction photovoltaics, yet their stability remains limited by interfacial defects, phase segregation, and degradation. Here, we introduce spinel oxides as a new family of lattice-matched substrates that enable crystalline, phase-pure, compositionally-uniform, bromide-rich perovskite film growth. The effect of spinel oxides is two-fold: reducing defects at the bottom interface by templating film growth and inducing beneficial compressive strain through mismatch-dependent substrate-perovskite lattice coupling. Spinel oxide substrates facilitate growth of highly crystalline films and eliminate detrimental secondary phases across thicknesses. Using grazing incidence X-ray diffraction, X-ray fluorescence, cathodoluminescence-scanning electron microscopy, cryogenic photoluminescence, and density functional theory, we reveal that Mg-halide bonds at the bottom interface induce lattice mismatch-dependent compressive strain that suppresses halide segregation and further reduces defect formation. In addition, films grown on spinel oxides maintain over 87% of the perovskite phase after 12 h under 100% relative humidity, as monitored by in situ grazing incidence wide-angle X-ray scattering (GIWAXS), compared to less than 70% for control samples. This work extends lattice matching from vapor-deposited epitaxial semiconductors to solution-processed halide perovskites to establish a broadly applicable strategy for defect suppression, phase homogenization, and long-term stability. Based on the fundamental science explored here, we set the stage for the development of lattice-matched spinel oxide charge transport layers to be integrated into perovskite solar cells and other optoelectronic devices.
Globally, paediatric burns are the fifth most common non-fatal injury in children. In England and Wales annually over 30,000 children receive outpatient burn treatment. A paediatric burn can have a significant negative psychological impact on parents and children. In the UK, where parents are often asked to undertake their child's burn wound dressing changes at home, the role of clinical caregiver can provoke significant emotional labour. This study explored the emotional dimensions and support available to parents administering children's burn dressing changes at home. This qualitative study formed part of a larger experience-based co-design project to develop service guidance to support parent-administered home dressing changes in paediatric burns care. Clinic observations were conducted across three paediatric burns centres in England and Wales. In addition, semi-structured interviews were conducted with healthcare professionals and parents on the perspectives and experiences of parent-administered home dressing changes. A thematic framework analysis identified two key themes and sub-themes. Healthcare professionals typically recognised parental anxiety and regularly provided parents with comfort and reassurance in clinics. Healthcare professional perceptions of severity of anxiety displayed through parents' behaviour were used as indicators of suitability for home administered dressing changes. Whilst parents dealt with the practical elements of dressing changes, they were unprepared for the emotional impact. Parents expressed feeling negative emotions when administering dressing changes and employing strategies to supress emotions to minimise distress to their child. The emotional impact of paediatric burns is recognised by parents and healthcare professionals. However, a disparity exists between these perspectives. Currently guidance and reassurance provided to parents does not address the emotional impact of parent-administered dressing-changes. Healthcare professionals provide emotional support in clinic and task-related support for home dressing-changes. Resources to support parents to administer dressings at home should include psychological coping strategies to manage the negative impact on families.
Research on COVID-19 and people with intellectual disability has largely relied on proxy reports and early pandemic data, with limited focus on everyday policy implementation. In Sweden, where pandemic-related responses were based on recommendations rather than lockdowns, this raises questions about how participation was affected in practice. This study examined how people with intellectual disability receiving social services in Sweden experienced participation and involvement in everyday life during the COVID-19 pandemic, focusing on how national recommendations were implemented in practice. Five focus groups with 24 adults with mild to moderate intellectual disability were conducted in late 2022. Data were analysed using reflexive thematic analysis. Participants described difficulties accessing understandable information and increased reliance on staff for interpreting recommendations. At the same time, they demonstrated knowledge of the virus and described actively following protective measures. Despite this, national recommendations were frequently translated by staff and managers into binding rules within housing and daily activities, limiting opportunities to influence decisions in everyday life. This resulted in experienced participation restrictions, including constraints on work, social contact, and use of shared spaces. Several participants also described ongoing consequences of these practices beyond the pandemic period. The findings show that, even without lockdowns, local implementation of recommendations can create de facto restrictions in everyday life, despite participants' ability to understand and follow public health measures. The study underscores how translating policy into practice within social services can affect participation in ways not visible at the policy level.
American Burn Association (ABA) referral criteria help identify patients to be transferred. Limited data exist on characteristics of patients being transferred and utilization of these criteria at non-burn centers (NBC). To describe pediatric emergency department (ED) disposition practices at a non-burn center and compare these practices to ABA referral criteria. Retrospective review of electronic records of patients < 18 years old, with discharge diagnosis of burn at a non-burn healthcare system, from December 2016 to June 2022, was performed. Descriptive statistics and multivariable logistic regression was used to analyze transfer rates and determine odds ratios of different factors, comparing transferred and discharged patients. 1231 cases were identified with 35% transferred. Of the 65% of patients discharged, 52% met ABA referral criteria. For all visits, 64% met at least one ABA criterion, of which 47% were transferred. Infants had greatest odds of transfer (OR 9.62, 95% CI 4.6 - 20.1). Burns to high-risk anatomical zones (OR 5.89, 95% CI 4.1 - 8.4), those with > 20% total body surface area (OR 16.86, 95% CI 4.3 - 66.7) and full/partial thickness burns (OR 11.47, 95% CI 5.5 - 23.9) were also all associated with highest odds of transfer. The majority of visits met ABA criteria for transfer to a burn center; however, only about half those qualified were transferred. Some may have been appropriately discharged. Infants, large burns, burns to high-risk anatomic zones, or full/partial thickness burns were more often transferred indicating appropriate adherence to the established guideline. These data suggest that ABA criteria are very broad for pediatrics and do not have face validity for community physicians. Further work is needed to refine pediatric ABA referral criteria.
Hemipteran insects harbour several symbiotic partners, mainly bacteria, which play pivotal roles for hosts like dietary provision, support overall physiology, xenobiotic degradation and manipulate/regulate behaviour. Most of these symbionts usually reside and operate from the digestive tracts of the animals. Cotton is one of the major cash crops in India and Dysdercus cingulatus (D. cingulatus) though a secondary pest, is causing significant destruction of cotton bolls, poor lint quality and reduce oil content of seeds. Premature opening of cotton bolls often leads to bacterial and fungal infections, thus resulting in extensive economic loss worldwide. D. cingulatus is a hemimetabolous insect that comprises of developmental stages like egg, nymph (5 instar stages), and adult. The present work explored the ontogeny specific diversity in the associated microbiota and predicted their probable functional inputs in D. cingulatus. The data obtained using 16S rRNA gene sequencing (NovaSeq 6000) revealed presence of members of Proteobacteria (65.83%), Firmicutes (24%), Actinobacteria (10%) phyla throughout the ontogeny of D. cingulatus. Highest alpha diversity of these symbiotic bacteria was recorded in the third instar nymphs in contrast to rest of the developmental stages. Among all the observed genera, Stenotrophomonas, Hungatella and Glutamicibacter were predominant from egg to adult stages. MicFunPred, a tool used for predicting the probable functional inputs of these symbionts, hinted at their probable stage specific contribution in crucial biochemical pathways such as polyketide biosynthesis, ascorbate/aldarate metabolism, pentose phosphate and glyoxylate cycles, steroid hormone and peptidoglycan biosynthesis, and glycolysis/pyruvate metabolism. The primary investigations on the ontogenetic composition and diversity of associated microbiota, suggest dynamic shifts in D. cingulatus, concurrent with their probable functions/roles in the host development and metabolism. To the best of our knowledge, this is the first report on symbiotic microbiota variation across the developmental stages of D. cingulatus that provides preliminary descriptive observations that may guide future functional and experimental investigations into microbiota-based pest management.
The discovery of ferrielectricity, which can be termed as an antiferroelectric order with an uncompensated dipole, has created a new wonderland for exploring and coupling multiple dipolar orders. However, limited by stringent symmetry and ambiguous multiple definitions, experimental visualization of ferrielectricity is still considerably rare in crystalline solids. Herein, the distinctive noncollinear ferrielectricity has been experimentally visualized in a 2D hybrid germanium perovskite, (butylammonium)2GeI4. From polarization-electric field loops, the ferroelectric polarization in the out-of-plane direction and antiferroelectricity in the in-plane direction have been demonstrated in its single crystal. As temperature increases, (butylammonium)2GeI4 undergoes the consecutive transition of ferroelectric-ferrielectric-ferroelectric-paraelectric, involving symmetry transformation. Temperature-dependent crystal structure analysis and theoretical calculations reveal that the dynamic organic cations and ion displacement promoted by the stereoactive lone pair electrons compete, leading to the distinctive ferrielectric order. This work offers fascinating opportunities for exploring ferrielectrics integrating multiple dipolar orders, highlighting their distinctive functionalities and promising applications.
Antibody-drug conjugates (ADCs) combine the targeting specificity of monoclonal antibodies with the potent cytotoxicity of small-molecule drugs. However, ADC development using Exatecan, a potent topoisomerase I inhibitor, has been challenged by its hydrophobicity, leading to aggregation, rapid clearance, and off-target toxicity. Herein, we report the design of an intrinsically hydrophilic drug-linker platform (SMP-70067-L) that enables the construction of a homogeneous Exatecan-based HER2-targeted ADC (SMP-70067-X) with a high drug-to-antibody ratio (DAR of 7.92). Similar to Trastuzumab deruxtecan (DS-8201a), which achieves high DAR without PEG or polysarcosine chains through a hydrophilic self-immolative spacer, SMP-70067-L integrates minimal hydrophilic elements, including a glutamic acid residue and a modified aromatic self-immolative spacer, to balance hydrophilicity, stability, and efficient payload release. The resulting ADC exhibits low aggregation (<1%), favorable plasma and thermal stability, and sustained exatecan release. SMP-70067-X demonstrates potent cytotoxicity in HER2-positive tumor cells (sub-nanomolar IC50 values) and significantly enhanced antitumor efficacy compared to DS-8201a in HER2-moderate and HER2-low xenograft models. These results highlight the critical role of rational linker engineering in expanding the therapeutic window of hydrophobic topoisomerase I inhibitor-based ADCs.
The optimal surgical strategy for patients with hepatocellular carcinoma (HCC) and liver fibrosis/cirrhosis presenting with a future liver remnant to standard liver volume (FLR/SLV) ratio of 30%-40% remains a subject of clinical controversy. This study aimed to evaluate the safety and efficacy of one-stage hepatectomy (OSH) versus Associating Liver Partition and Portal Vein Ligation for Staged Hepatectomy (ALPPS) and to validate the feasibility of OSH by benchmarking it against the standard safety criterion (FLR/SLV ≥40%). We conducted a retrospective analysis of 219 patients with HBV-related HCC and liver fibrosis/cirrhosis who underwent right hemihepatectomy. Patients were stratified into three groups: the OSH group (FLR/SLV 30%-40%, n = 62), the ALPPS group (FLR/SLV 30%-40%, n = 20), and the standard control group (FLR/SLV ≥40% undergoing OSH, n = 137). Perioperative outcomes, including post-hepatectomy liver failure (PHLF) and complications, as well as long-term overall survival (OS) and disease-free survival (DFS), were compared. In the 30%-40% cohort, the incidence of severe PHLF (ISGLS Grade B or C) in the ALPPS group was comparable to that of the one-stage hepatectomy group (P = 0.128), and no 90-day mortality was observed in either group. However, in terms of severe postoperative complications (Clavien-Dindo grade ≥ IIIa), the ALPPS group demonstrated a higher incidence rate compared to the one-stage hepatectomy group, although the difference did not reach statistical significance (P = 0.082). Long-term oncological outcomes, including OS and DFS, were comparable between the OSH and ALPPS groups (p > 0.05). Furthermore, benchmarking analysis revealed preliminary observations that patients in the OSH group (30%-40%) achieved perioperative and long-term outcomes comparable to those in the standard control group (≥40%) (p > 0.05). For selected HCC patients with liver fibrosis/cirrhosis and FLR/SLV ratio of 30%-40% undergoing standardized right hemihepatectomy, one-stage hepatectomy might serve as a safe and feasible alternative to ALPPS, though large-scale prospective validation is warranted.
Janus nanostructures, named after the two-faced Roman god, represent a class of novel materials that integrate two or more distinct properties within a single micro-or nanoscale entity. In contrast to traditional homogeneous materials, Janus structures achieve the spatial segregation and integration of functionalities across distinct regions of a single particle by breaking symmetry. While numerous reviews over the past three decades have chronicled the morphological evolution of Janus particles, a comprehensive understanding bridging precise atomic-level topological engineering and multifunctional synergy remains scarce. To transcend conventional descriptive summaries, this review systematically categorizes the interactions within asymmetric architectures into series, parallel, and regulatory synergy modes. Through this lens, recent advancements in precision synthesis were critically evaluated, emphasizing the mode shift from random macroscopic segregation to programmable atomic-level control (e.g., built-in electric fields and strain engineering). Subsequently, the unique physicochemical properties emerging from structural asymmetry are explored. Based on these fundamental properties, specific application examples in frontier fields, including energy catalysis, biomedicine, environmental remediation, and intelligent sensing, are highlighted. The discussion clarifies how distinct functional components achieve synergistic enhancements superior to single-component materials through a "division of labor" mechanism. Finally, the challenges facing this field, such as large-scale low-cost fabrication and the precise characterization of dynamic behaviors, are summarized. Future trends toward more complex and intelligent designs are also prospected to provide a reference for the development of next-generation high-performance nanomaterials.