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Design strategies to achieve degradation and ideally closed-loop recycling of organic semiconductors have attracted great interest in order to minimize the electronic waste (E-waste). In this work, three ester-incorporated monomers were synthesized by the names of Thiophene-Ester-Ethylene-Thiophene (TEET), Thiophene-Ester-Methylene-Thiophene (TEMT), and Thiophene-Ester-Thiophene (TET), which were co-polymerized via Stille polycondensation with a benzodithiophene (BnDT) pi-conjugated unit to yield a series of ester-incorporated polymers: PBnDT-TEET, PBnDT-TEMT, and PBnDT-TET. While the ester-only linker can maintain some extended conjugation in PBnDT-TET, the other two ester linkers having conjugation breaking units result in isolated conjugated segments in PBnDT-TEET and PBnDT-TEMT, evidenced by UV-Vis and CV results. This yields an improved photovoltaic performance of PBnDT-TET compared to PBnDT-TEET. While all three polymers can degrade under methanolysis, the alternating co-polymer PBnDT-TEET demonstrates the highest recyclability potential with a single dimethyl ester-functionalized product with an excellent 92% isolated yield, which can then be repolymerized to obtain the repolymerized PBnDT-TEET with a 36% yield. This work provides a framework towards achieving recyclable organic semiconductors to reduce E-waste. Although the incorporation of ester linkers allowed for closed-loop recycling, the low solar cell efficiency of PBnDT-TEET highlights the significant challenges in achieving both recycling and high device performance.

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Background and objective: The rupture risk of intracranial aneurysms (IAs) is related to their arterial origin, but whether the different segments of the artery have different risks and act as independent risk factors is still unknown. Our study aimed to investigate the rupture risk of IAs in different arterial segments in a large Chinese cohort. Methods: Imaging and clinical data of consecutive patients with IAs diagnosed by Computed Tomography angiography (CTA) from January 2013 to December 2022 were collected. Two neuroradiologists independently identified ruptured and unruptured IAs based on imaging and medical records. The internal carotid artery (ICA), middle cerebral artery (MCA), anterior cerebral artery (ACA), vertebral artery (VA), and posterior cerebral artery (PCA) were segmented according to the Bouthillier and Fischer segmentation methods. Stenoses of the proximal parent vessel were evaluated and documented. The Institutional Review Board (IRB) at Beijing Tiantan Hospital approved this retrospective study. Results: A total of 3,837 aneurysms {median size 3.5 mm [interquartile range (IQR) 2.6-5.1 mm]; 532 ruptured} were included in this study from 2,968 patients [mean age: 57 years (IQR 50-64); male patients: 1,153]. Ruptured aneurysms were most commonly located in the posterior inferior cerebellar artery (PICA) (52.9%), anterior communicating artery (ACoA) (33.8%), other locations (33.3%), ACA (22.4%), and basilar artery (BA) (21.4%). The locations with the highest likelihood of rupture were the C7 ICA (21.3%), M2 MCA (24.0%), distal MCA (25.0%), and A2 ACA (28.1%). IAs originating from the C7 (p < 0.001), dM1 (p = 0.022), and dA1 (p = 0.021) segments were independent risk factors for rupture. IAs without stenosis of the proximal parent vessel were associated with a higher risk of rupture (p = 0.023). Conclusion: There are unique associations between the origins of aneurysms from various arterial segments. Aneurysms originating from the anterior communicating artery (ACoA), BA, PICA, A2, dA, C7, and M2 indicate a higher risk of rupture. Aneurysms originating from C4, C5, and C6 indicate a lower risk of rupture. C7 IAs, ACoA IAs, and PICA IAs seem to be independent risk factors.

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The model precatalyst sp3- and sp2-N dinitrogen-coordinated zinc-heteroimidazole has been used as an efficient catalyst for the ring-opening polymerization of cyclic esters. Subsequent to our exceptional active 5,6,7-trihydroquinolin-8-amine-zinc catalysts for the ring-opening polymerization (ROP) of ε-caprolactone, various pyridine-fused cycloalkanones (ring size from five to eight) are developed for the correspondent fused amine-pyridine derivatives and their zinc-heteroimidazole chloride complexes Zn1-Zn8 (LZnCl2) bearing N-diphenylphosphinoethyl pendants. Activated with two equivalents of LiN(SiMe3)2, the title zinc complexes efficiently promote the ROP of L-lactide (L-LA) in situ; among them, Zn4/2Li(NSiMe3)2 catalyzed 500 equivalent L-LA at 80 °C with 92% conversion in 5 min (TOF: 5520 h-1). Under the same conditions, the catalytic efficiency for the ROP of rac-LA by Zn1-Zn8/2Li(NSiMe3)2 was slightly lower than that for L-LA (highest TOF: 4440 h-1). In both cases, cyclooctyl-fused pyridyl-zinc complexes exhibited higher activity than others, while the cycloheptyl-fused zinc complexes showed the lowest activity. The microstructure analysis of the polymers showed they possessed a linear structure capped with CH3O as major and cyclic structure as minor. In this work, all the ligands and zinc complexes were well characterized by 1H/13C/31P NMR, FT-IR spectroscopy as well as elemental analysis.

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The nonlinear susceptibility in the terahertz region is expected to have a non-negligible imaginary part originating from the momentum-dependent scattering time of free carriers, but it has been scarcely reported. By utilizing an intense 4 THz beam from a terahertz free electron laser, we investigated the azimuth angle dependence of the third harmonic generation (THG) from semiconductors. The observed angular anisotropy of THG revealed the contribution of the imaginary part of the nonlinear susceptibility originating from the momentum-scattering time relation in addition to its real part originating from the band nonparabolicity. The results provide a deeper understanding of nonlinear optics in the terahertz region.

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BACKGROUND: Santalum album L. is an evergreen tree which is mainly distributes throughout tropical and temperate regions. And it has a great medicinal and economic value. RESULTS: In this study, the complete mitochondrial genome of S. album were assembled and annotated, which could be descried by a complex branched structure consisting of three contigs. The lengths of these three contigs are 165,122 bp, 93,430 bp and 92,491 bp. We annotated 34 genes coding for proteins (PCGs), 26 tRNA genes, and 4 rRNA genes. The analysis of repeated elements shows that there are 89 SSRs and 242 pairs of dispersed repeats in S. album mitochondrial genome. Also we found 20 MTPTs among the chloroplast and mitochondria. The 20 MTPTs sequences span a combined length of 22,353 bp, making up 15.52 % of the plastome, 6.37 % of the mitochondrial genome. Additionally, by using the Deepred-mt tool, we found 628 RNA editing sites in 34 PCGs. Moreover, significant genomic rearrangement is observed between S. album and its associated mitochondrial genomes. Finally, based on mitochondrial genome PCGs, we deduced the phylogenetic ties between S. album and other angiosperms. CONCLUSIONS: We reported the mitochondrial genome from Santalales for the first time, which provides a crucial genetic resource for our study of the evolution of mitochondrial genome.

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At present, the power conversion efficiency (PCE) of perovskite solar cells (PSCs) has reached 26.1%. Polycrystalline perovskite films prepared by sequential deposition are often accompanied by excess PbI2. Although excess PbI2 can reduce the internal defects of the perovskites and promote charge transfer, excess PbI2 is unevenly distributed in the perovskites and easily decomposed into the composite center of charge. Therefore, the growth and distribution of PbI2 crystals can be regulated by introducing 4-fluoroaniline (4-FLA) as an additive into the precursor of PbI2. We observe that the presence of an amino group in 4-FLA leads to a reduction in the strength of van der Waals forces between PbI2 layer structures, thereby facilitating the uniform dispersion of excess PbI2 within the perovskites. Additionally, 4-FLA is restricted from being embedded in the PbI2 layer due to the steric hindrance of 4-FLA and the hydrogen bond interaction between nitrogen atoms and PbI2. Therefore, it leads to better dispersion of PbI2, resulting in better passivation and device efficiency. Based on the hydrophobicity of the benzene ring, the modified perovskite film shows excellent hydrophobicity. Ultimately, we achieved 21.63% PCE and 1.16V VOC. This provides an effective strategy for regulating excess PbI2 to achieve efficient and stable PSCs.

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Fungi capable of simultaneous nitrogen and phosphorus removal from wastewater is rarely found. Here, a novel fungal strain (SNDM1) performing heterotrophic nitrification, aerobic denitrification, and phosphate removal was isolated and identified as Mucor circinelloides. The favorable nutrient removal conditions by the strain using glucose were C/N ratios of 25-30, salinities of 0 %-3 %, and pH of 7.5. Strain SNDM1 achieved ammonium, nitrite, nitrate, and phosphate removal rates of 5.23, 10.08, 4.88, and 0.97 mg/L/h. Nitrogen balance indicated that gaseous (18.60 %-24.55 %) and intracellular nitrogen (43.76 %-70.63 %) were primary fate of initial nitrogen. Enzyme activity revealed that ammonium removal occurred through heterotrophic nitrification and aerobic denitrification. Removed phosphorus was mainly transformed into cell membranes (56 %-64 %) and extracellular polymeric substances (20 %-26 %). Orthophosphate was the major intracellular phosphorus species, while polyphosphate and pyrophosphate existed extracellularly. These findings highlight the potential of this fungal strain for bioremediating polluted wastewater.

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Salinity stress severely restricts rice growth. Prohexadione calcium (Pro-Ca) modulation can effectively alleviate salt stress in rice. In this study, we explored the effects of Pro-Ca on enhancing salt tolerance in two rice varieties, IR29 and HD96-1. The results revealed that Pro-Ca markedly enhanced root and shoot morphological traits and improved plant biomass under salt stress. Chlorophyll a and b content were significantly increased, which improved photosynthetic capacity. Transcriptomic and metabolomic data showed that Pro-Ca significantly up-regulated the expression of genes involved in E3 ubiquitin ligases in IR29 and HD96-1 by 2.5-fold and 3-fold, respectively, thereby maintaining Na+ and K+ homeostasis by reducing Na+. Moreover, Pro-Ca treatment significantly down-regulated the expression of Lhcb1, Lhcb2, Lhcb3, Lhcb5, and Lhcb6 in IR29 under salt stress, which led to an increase in photosynthetic efficiency. Furthermore, salt stress + Pro-Ca significantly increased the A-AAR of IR29 and HD96-1 by 2.9-fold and 2.5-fold, respectively, and inhibited endogenous cytokinin synthesis and signal transduction, which promoted root growth. The current findings suggested that Pro-Ca effectively alleviated the harmful effects of salt stress on rice by maintaining abscisic acid content and by promoting oxylipin synthesis. This study provides a molecular basis for Pro-Ca to alleviate salt stress in rice.

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Sialadenitis is a prevalent salivary gland disease resulting in decreased salivary flow rate. To date, little is known about the exact changes and mechanism of ductal cells in sialadenitis. This study aims to establish an efficient method to identify and isolate ductal cells, thereby facilitating further research on this specific cell type. Immunofluorescence for cytokeratin 13 and cytokeratin 19 was conducted in salivary glands to confirm their specificity as ductal cell markers. The dissected ducts were assessed through PCR and Western blot of cytokeratin 19 and digested by dispase and collagenase. The functionality of the isolated ductal cells was determined by measuring intracellular calcium. Cytokeratin 19 and cytokeratin 13 were expressed in all segments of human ducts. Cytokeratin 19 was limited to ducts excluding granular convoluted tubules in rat and mouse. The purities of the obtained ductal cells were approximately 98% in humans and 93% in rats. Furthermore, intracellular free calcium increased with time and concentration of carbachol treatment. Cytokeratin 19 serves as a dependable marker for identifying ductal cells in salivary glands, except for granular convoluted tubules. Moreover, we have successfully developed an efficient method for isolating ductal cells from salivary glands.

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Fused-ring electronic acceptors (FREAs) have transformed the field of organic solar cells. However, the prevailing syntheses of FREAs suffer from low yield, difficulty in separation, and high cost. Here, we report new and streamlined syntheses with three distinctive key steps. First, a universal approach to fuse neighboring aromatic units via a single carbon atom is demonstrated with ytterbium triflate and boron trifluoride as the catalysts. This approach allows the incorporation of diverse side-chain combinations. Second, nitrogen atom fusing neighboring aromatics is realized by using oxo-molybdenum catalyst, featuring lower reaction temperatures and enhanced yields. Third, an organic catalyst, proline, is identified to catalyze the aldol condensation with high yield to afford the most typical FREAs having acceptor-donor-acceptor (ADA) configurations. Our new chemistries enable easy syntheses of a wide range of FREAs, substantially expanding the scope and availability of these coveted materials at reduced synthetic cost, particularly for organic electronics.

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Objective: This study assesses the effectiveness and safety of single-port laparoscopic myomectomy (SPLM) versus conventional laparoscopic myomectomy (CLM). Methods: We conducted a retrospective case-control study at a university tertiary hospital, involving 262 patients treated from July 2020 to December 2022. Participants were divided into two groups: 132 underwent SPLM and 130 underwent CLM. Results: The two groups were comparable in terms of age, body mass index, parity, delivery history, preoperative anemia, number of myomas, and size of the largest myoma. The SPLM group showed a significant reduction in operation time (average 93 min) and estimated blood loss (average 50 ml) compared to the CLM group (average 118.5 min and 100 ml, respectively). Subgroup analysis based on the size, location, and number of myomas further highlighted the advantages of SPLM, particularly for patients with large (diameter ≥8 cm) or multiple myomas (number ≥4). Patient satisfaction was also notably higher in the SPLM group. Conclusions: Single-port laparoscopic myomectomy offers a highly effective, safer, and patient-preferred option for the surgical management of fibroids, especially in cases of large or multiple myomas. These findings suggest that SPLM could become the preferred surgical approach for complex fibroid cases, promising less trauma and quicker recovery for patients.

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Organic-inorganic hybrid perovskite quantum wells exhibit electronic structures with properties intermediate between those of inorganic semiconductors and molecular crystals. In these systems, periodic layers of organic spacer molecules occupy the interstitial spaces between perovskite sheets, thereby confining electronic excitations to two dimensions. Here, we investigate spectroscopic line broadening mechanisms for phonons coupled to excitons in lead-iodide layered perovskites with phenyl ethyl ammonium (PEA) and azobenzene ethyl ammonium (AzoEA) spacer cations. Using a modified Elliot line shape analysis for the absorbance and photoluminescence spectra, polaron binding energies of 11.2 and 17.5 meV are calculated for (PEA)2PbI4 and (AzoEA)2PbI4, respectively. To determine whether the polaron stabilization processes influence the dephasing mechanisms of coupled phonons, five-pulse coherent Raman spectroscopies are applied to the two systems under electronically resonant conditions. The prominence of inhomogeneous line broadening mechanisms detected in (AzoEA)2PbI4 suggests that thermal fluctuations involving the deformable organic phase broaden the distributions of phonon frequencies within the quantum wells. In addition, our data indicate that polaron stabilization primarily involves photoinduced reorganization of the organic phases for both systems, whereas the impulsively excited phonons represent less than 10% of the total polaron binding energy. The signal generation mechanisms associated with our fifth-order coherent Raman experiments are explored with a perturbative model in which cumulant expansions are used to account for time-coincident vibrational dephasing and polaron stabilization processes.

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OBJECTIVES: To investigate whether negative remodeling (NR) detected by intravascular ultrasound (IVUS) of the side branch ostium (SBO) would affect in-stent neointimal hyperplasia (NIH) at the one-year follow-up and the clinical outcome of target lesion failure (TLF) at the long-term follow-up for patients with left main bifurcation (LMb) lesions treated with a two-stent strategy. METHODS: A total of 328 patients with de novo true complex LMb lesions who underwent a 2-stent strategy of percutaneous coronary intervention (PCI) treatment guided by IVUS were enrolled in this study. We divided the study into two phases. Of all the patients, 48 patients who had complete IVUS detection pre- and post-PCI and at the 1-year follow-up were enrolled in phase I analysis, which aimed to analyze the correlation between NR and in-stent NIH at SBO at the 1-year follow-up. If the correlation was confirmed, the cutoff value of the remodeling index (RI) for predicting NIH ≥ 50% was analyzed next. The phase II analysis focused on the incidence of TLF as the primary endpoint at the 1- to 5-year follow-up for all 328 patients by grouping based on the cutoff value of RI. RESULTS: In phase I: according to the results of a binary logistic regression analysis and receiver operating characteristic (ROC) analysis, the RI cutoff value predicting percent NIH ≥ 50% was 0.85 based on the ROC curve analysis, with a sensitivity of 85.7%, a specificity of 88.3%, and an AUC of 0.893 (0.778, 1.000), P = 0.002. In phase II: the TLR rate (35.8% vs. 5.3%, P < 0.0001) was significantly higher in the several NR (sNR, defined as RI ≤ 0.85) group than in the non-sNR group. CONCLUSION: The NR of LCxO is associated with more in-stent NIH post-PCI for distal LMb lesions with a 2-stent strategy, and NR with RI ≤ 0.85 is linked to percent NIH area ≥ 50% at the 1-year follow-up and more TLF at the 5-year follow-up.

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Gastric cancer is a leading cause of cancer-related deaths in China. Affecting more than 40% of the world's population, Helicobacter pylori is a major risk factor for gastric cancer. While previous clinical trials indicated that eradication of H. pylori could reduce gastric cancer risk, this remains to be shown using a population-based approach. We conducted a community-based, cluster-randomized, controlled, superiority intervention trial in Linqu County, China, with individuals who tested positive for H. pylori using a 13C-urea breath test randomly assigned to receiving either (1) a 10-day, quadruple anti-H. pylori treatment (comprising 20 mg of omeprazole, 750 mg of tetracycline, 400 mg of metronidazole and 300 mg of bismuth citrate) or (2) symptom alleviation treatment with a single daily dosage of omeprazole and bismuth citrate. H. pylori-negative individuals did not receive any treatment. We examined the incidence of gastric cancer as the primary outcome. A total of 180,284 eligible participants from 980 villages were enrolled over 11.8 years of follow-up, and a total of 1,035 cases of incident gastric cancer were documented. Individuals receiving anti-H. pylori therapy showed a modest reduction in gastric cancer incidence in intention-to-treat analyses (hazard ratio 0.86, 95% confidence interval 0.74-0.99), with a stronger effect observed for those having successful H. pylori eradication (hazard ratio 0.81, 95% confidence interval 0.69-0.96) than for those who failed treatment. Moderate adverse effects were reported in 1,345 participants during the 10-day treatment. We observed no severe intolerable adverse events during either treatment or follow-up. The findings suggest the potential for H. pylori mass screening and eradication as a public health policy for gastric cancer prevention. Chinese Clinical Trial Registry identifier: ChiCTR-TRC-10000979 .

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BACKGROUND: Bilirubin is known for its multifaceted attributes, including antioxidant, anti-inflammatory, immunomodulatory, and antiapoptotic properties. The systemic immune-inflammation index (SII) is a recent marker that reflects the balance between inflammation and immune response. Despite the wealth of information available on bilirubin's diverse functionalities, the potential correlation between the total bilirubin (TB) levels and SII has not been investigated so far. METHODS: Leveraging data from the National Health and Nutrition Examination Survey spanning 2009-2018, the TB levels were categorized using tertiles. Employing the chi-squared test with Rao and Scott's second-order correction and Spearman's rank correlation analysis, the association between TB and SII was examined. The potential nonlinearities between TB and SII were evaluated using restricted cubic spline (RCS) analysis. Weighted linear regression, adjusted for covariates, was used to explore the correlation between TB and SII, with further subgroup analyses. RESULTS: A total of 16,858 participants were included, and the findings revealed significant SII variations across TB tertiles (p < 0.001). The third tertile (Q3) exhibited the lowest SII level at 495.73 (295.00) 1000 cells/µL. Spearman rank correlation disclosed the negative association between TB and SII. RCS analysis exposed the lack of statistically significant variations in the nonlinear relationship (p > 0.05), thereby providing support for a linear relationship. Weighted linear regression analysis underscored the negative correlation between TB and SII (ß 95% CI - 3.9 [- 5.0 to - 2.9], p < 0.001). The increase in the TB levels is associated with a significant linear trend toward decreasing SII. After controlling for relative covariates, this negative correlation increased (p < 0.001). Subgroup analysis confirmed the significant negative TB-SII association. CONCLUSION: A notable negative correlation between TB and SII implies the potential protective effects of bilirubin in inflammation-related diseases.

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Objective: To discuss the effectiveness of breast reconstruction with dual plane prosthesis implantation or anterior pectoralis prosthesis implantation under endoscopy by using prospective comparative study, in order to provide a reference for clinical surgical selection. Methods: A total of 54 female patients with breast cancer admitted between January 2023 and December 2023 and met the selection criteria were selected as research subjects. According to the random number table, 54 patients were divided into trial group and control group with 27 cases in each. The patients in the trial group and control group were treated with dual plane prosthesis implantation and anterior pectoralis prosthesis implantation for breast reconstruction after glandular resection under endoscopy, respectively. There was no significant difference between the two groups ( P>0.05) in the terms of age, body mass index, affected side, breast clinical stages, molecular typing, disease duration, breast volume of healthy side, breast ptosis of affected side, and preoperative Breast-Q score (social mental health, sexual health, breast satisfaction, chest somatic health). The operation-related indicators (operation time, total volume of drainage within 7 days after operation, extubation time, and hospital stay), occurrence of complications, breast reconstruction efficacy related indicators (transverse and longitudinal distance difference), and the pre- and post-operative differences (change values) of Breast-Q scores for each item were compared between the two groups. Results: There was no significant difference in operation time, total volume of drainage within 7 days after operation, extubation time, and hospital stay between the two groups ( P>0.05). All patients of the two groups were followed up 3-12 months (mean, 6.3 months). Three patients (11.11%) in trial group and 5 patients (18.52%) in control group experienced complications, and there was no significant difference in the occurrence of complications ( P>0.05). At 7 days after operation, the transverse and longitudinal distance differences were significantly less in trial group than in control group ( P<0.05). The Breast-Q scores of the two groups at 7 days after operation were significantly higher in all items than those before operation ( P<0.05), but there was no significant difference in all change values between the two groups ( P>0.05). Conclusion: For patients with breast cancer, comparison of breast reconstruction with anterior pectoralis prosthesis implantation, breast reconstruction with dual plane prosthesis implantation has better breast reconstruction effectiveness and higher safety.

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The human vagina harbours diverse microorganisms-bacteria, viruses and fungi-with profound implications for women's health. Genome-level analysis of the vaginal microbiome across multiple kingdoms remains limited. Here we utilize metagenomic sequencing data and fungal cultivation to establish the Vaginal Microbial Genome Collection (VMGC), comprising 33,804 microbial genomes spanning 786 prokaryotic species, 11 fungal species and 4,263 viral operational taxonomic units. Notably, over 25% of prokaryotic species and 85% of viral operational taxonomic units remain uncultured. This collection significantly enriches genomic diversity, especially for prevalent vaginal pathogens such as BVAB1 (an uncultured bacterial vaginosis-associated bacterium) and Amygdalobacter spp. (BVAB2 and related species). Leveraging VMGC, we characterize functional traits of prokaryotes, notably Saccharofermentanales (an underexplored yet prevalent order), along with prokaryotic and eukaryotic viruses, offering insights into their niche adaptation and potential roles in the vagina. VMGC serves as a valuable resource for studying vaginal microbiota and its impact on vaginal health.

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Molecular sieving is an ideal separation mechanism, but controlling pore size, restricting framework flexibility, and avoiding strong adsorption are all very challenging. Here, we report a flexible adsorbent showing molecular sieving at ambient temperature and high pressure, even under high humidity. While typical guest-induced transformations are observed, a high transition pressure of 16.6 atm is observed for C2H4 at 298 K because of very weak C2H4 adsorption (~16 kJ mol-1). Also, C2H6 is completely excluded below the pore-opening pressure of 7.7 atm, giving single-component selectivity of ca. 300. Quantitative high-pressure column breakthrough experiments using 1 : 1 C2H4/C2H6 mixtures at 10 atm as input confirm molecular sieving with C2H4 adsorption of 0.73 mmol g-1 or 32 cm3(STP) cm-3 and negligible C2H6 adsorption of 0.001(2) mmol g-1, and the adsorbent can be completely regenerated by inert gas purging. Furthermore, it is highly hydrophobic with negligible water adsorption, and the C2H4/C2H6 separation performance is unaffected at high humidity.

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In this study, a novel approach for the tertiary α-alkylation of ketones using alkanes with electron-deficient C─H bonds is presented, employing a synergistic catalytic system combining inexpensive copper salts with aminocatalysis. This methodology addresses the limitations of traditional alkylation methods, such as the need for strong metallic bases, regioselectivity issues, and the risk of over alkylation, by providing a high reactivity and chemoselectivity without the necessity for pre-functionalized substrates. The dual catalytic strategy enables the direct functionalization of C(sp3)─H bonds, demonstrating remarkable selectivity in the presence of conventional C(sp3)─H bonds that are adjacent to heteroatoms or π systems, which are typically susceptible to single-electron transfer processes. The findings contribute to the advancement of alkylation techniques, offering a practical and efficient route for the construction of C(sp3)─C(sp3) bonds, and paving the way for further developments in the synthesis of complex organic molecules.

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BACKGROUND: It is currently uncertain whether the combination of a proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitor and high-intensity statin treatment can effectively reduce cardiovascular events in patients with acute coronary syndrome (ACS) who have undergone percutaneous coronary intervention (PCI) for culprit lesions. METHODS: This study protocol describes a double-blind, randomized, placebo-controlled, multicenter study aiming to investigate the efficacy and safety of combining a PCSK9 inhibitor with high-intensity statin therapy in patients with ACS following PCI. A total of 1,212 patients with ACS and multiple lesions will be enrolled and randomly assigned to receive either PCSK9 inhibitor plus high-intensity statin therapy or high-intensity statin monotherapy. The randomization process will be stratified by sites, diabetes, initial presentation and use of stable (≥4 weeks) statin treatment at presentation. PCSK 9 inhibitor or its placebo is injected within 4 hours after PCI for the culprit lesion. The primary endpoint is the composite of cardiovascular death, myocardial infarction, stroke, re-hospitalization due to ACS or heart failure, or any ischemia-driven coronary revascularization at 1-year follow-up between 2 groups. Safety endpoints mean PCSK 9 inhibitor and statin intolerance. CONCLUSION: The SHAWN study has been specifically designed to evaluate the effectiveness and safety of adding a PCSK9 inhibitor to high-intensity statin therapy in patients who have experienced ACS following PCI. The primary objective of this study is to generate new evidence regarding the potential benefits of combining a PCSK9 inhibitor with high-intensity statin treatment in reducing cardiovascular events among these patients.

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