To realize the potential of artificial intelligence in medical imaging, improvements in imaging capabilities are required, as well as advances in computing power and algorithms. Hybrid inorganic–organic metal halide perovskites, such as methylammonium lead triiodide (MAPbI3), offer strong X-ray absorption, high carrier mobilities (µ) and long carrier lifetimes (τ), and they are promising materials for use in X-ray imaging. However, their incorporation into pixelated sensing arrays remains challenging. Here we show that X-ray flat-panel detector arrays based on microcrystalline MAPbI3 can be created using a two-step manufacturing process. Our approach is based on the mechanical soft sintering of a freestanding absorber layer and the subsequent integration of this layer on a pixelated backplane. Freestanding microcrystalline MAPbI3 wafers exhibit a sensitivity of 9,300 µC Gyair–1 cm–2 with a μτ product of 4 × 10–4 cm2 V–1, and the resulting X-ray imaging detector, which has 508 pixels per inch, combines a high spatial resolution of 6 line pairs per millimetre with a low detection limit of 0.22 nGyair per frame.

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Background Cancer patients are at higher risk of developing severe COVID-19. However, safety and efficacy of COVID-19 vaccination in cancer patients undergoing treatment is unclear. Patients and Methods In this interventional prospective multi-cohort study, priming and booster doses of the BNT162b2 COVID-19 vaccine were administered 21 days apart to solid tumor patients receiving chemotherapy, immunotherapy, targeted- or hormonal therapy, and patients with a hematologic malignancy receiving rituximab or after allogeneic hematopoietic stem cell transplantation. Vaccine safety and efficacy (until three months post-booster) were assessed. Anti-SARS-CoV-2 receptor binding domain (RBD) antibody levels were followed over time (until 28 days post-booster) and in vitro SARS-CoV-2 50% neutralization titers (NT50) towards the wild-type Wuhan strain were analyzed 28 days post-booster. Results Local and systemic adverse events (AEs) were mostly mild to moderate (only 1-3% of patients experiencing severe AEs). Local, but not systemic, AEs occurred more frequently after booster dose. 28 days post-booster vaccination of 197 cancer patients, RBD-binding antibody titers and NT50 were lower in the chemotherapy group (234.05IU/mL [95%CI 122.10-448.66] and NT50 of 24.54 [95% CI 14.50-41.52]) compared to healthy individuals (1844.93IU/mL [95% CI 1383.57-2460.14] and NT50 of 122.63 [95% CI 76.85-195.67]), irrespective of timing of vaccination during chemotherapy cycles. Extremely low antibody responses were seen in hematology patients receiving rituximab, only two patients had RBD-binding antibody titers necessary for 50% protection against symptomatic SARS-CoV-2 infection (<200IU/mL) and only one had NT50 above the limit of detection. During the study period, five cancer patients tested positive for SARS-CoV-2 infection, including a case of severe COVID-19 in a patient receiving rituximab, resulting in a 2-week hospital admission. conclusion The BNT162b2 vaccine is well-tolerated in cancer patients under active treatment. However, the antibody response of immunized cancer patients was delayed and diminished, mainly in patients receiving chemotherapy or rituximab, resulting in breakthrough infections.

The integration of oral health care into day-to-day care seems to be a major problem due to a multitude of barriers. In future implementation innovations in oral health care an a priori assessment of influencing factors is recommended.

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