IMPORTANCEFor patients with large vessel occlusion strokes, it is unknown whether endovascular treatment alone compared with intravenous thrombolysis plus endovascular treatment (standard treatment) can achieve similar functional outcomes. OBJECTIVE To investigate whether endovascular thrombectomy alone is noninferior to intravenous alteplase followed by endovascular thrombectomy for achieving functional independence at 90 days among patients with large vessel occlusion stroke.DESIGN, SETTING, AND PARTICIPANTS Multicenter, randomized, noninferiority trial conducted at 33 stroke centers in China. Patients (n = 234) were 18 years or older with proximal anterior circulation intracranial occlusion strokes within 4.5 hours from symptoms onset and eligible for intravenous thrombolysis. Enrollment took place from May 20, 2018, to May 2, 2020. Patients were enrolled and followed up for 90 days (final follow-up was July 22, 2020).INTERVENTIONS A total of 116 patients were randomized to the endovascular thrombectomy alone group and 118 patients to combined intravenous thrombolysis and endovascular thrombectomy group. MAIN OUTCOMES AND MEASURESThe primary end point was the proportion of patients achieving functional independence at 90 days (defined as score 0-2 on the modified Rankin Scale; range, 0 [no symptoms] to 6 [death]). The noninferiority margin was −10%. Safety outcomes included the incidence of symptomatic intracerebral hemorrhage within 48 hours and 90-day mortality. RESULTSThe trial was stopped early because of efficacy when 234 of a planned 970 patients had undergone randomization. All 234 patients who were randomized (mean age, 68 years; 102 women [43.6%]) completed the trial. At the 90-day follow-up, 63 patients (54.3%) in the endovascular thrombectomy alone group vs 55 (46.6%) in the combined treatment group achieved functional independence at the 90-day follow-up (difference, 7.7%, 1-sided 97.5% CI, −5.1% to ϱ)P for noninferiority = .003). No significant between-group differences were detected in symptomatic intracerebral hemorrhage (6.1% vs 6.8%; difference, −0.8%; 95% CI, −7.1% to 5.6%) and 90-day mortality (17.2% vs 17.8%; difference, −0.5%; 95% CI, −10.3% to 9.2%).CONCLUSIONS AND RELEVANCE Among patients with ischemic stroke due to proximal anterior circulation occlusion within 4.5 hours from onset, endovascular treatment alone, compared with intravenous alteplase plus endovascular treatment, met the prespecified statistical threshold for noninferiority for the outcome of 90-day functional independence. These findings should be interpreted in the context of the clinical acceptability of the selected noninferiority threshold.

We demonstrated compact SnO2thin films prepared by sinter-less spin-coating processes as an electron selective contact for CH3NH3PbI3-based planar-heterojunction perovskite solar cells (PSCs).

Electron collection layer (ECL) is one of the most important fundamentals to determine the power conversion efficiency (PCE) in organometal halide-based perovskite solar cells (PSCs). Herein, we prepared ZnO-SnO 2 nanocomposites with different Zn/Sn ratios at low temperature as ECLs for CH 3 NH 3 PbI 3-based planar-structured PSCs. ZnO-SnO 2 nanocomposite with the optimal ~89 mol% of the ZnO content gives higher PCE than the ZnO for the best fabricated PSC. The photoluminescence spectroscopies measured in both steady and transient states and the electrochemical impedance spectroscopy were carried out to characterize the interface of CH 3 NH 3 PbI 3 and different ECLs, namely ZnO, ZnO-SnO 2 composite, and SnO 2. The high PCE of PSCs based on the ZnO-SnO 2 nanocomposite ECL was thus attributed to joint contributions of the high charge extraction efficiency and large charge recombination resistance both on the CH 3 NH 3 PbI 3 /ECL interface. The thermal stability of CH 3 NH 3 PbI 3 absorber and the device stability of the corresponding PSC are both dependent on the ECLs in the order: SnO 2 > ZnO-SnO 2 >ZnO, suggesting that the hydroxyl-induced degradation of CH 3 NH 3 PbI 3 may be predominant in the ambient air environment in the initial ~700 hours. The PCE of the optimized device was further improved to 15.2% by introducing the low-temperature processable Al 2 O 3 as a capping layer to the ZnO-SnO 2 composite.

Chlorophylls (Chls) are abundant, naturally occurring pigments that play key roles in light-harvesting and electron/energy transfer in natural photosynthetic apparatus. To demonstrate the idea that Chls are suitable hole transporters, we employed two Chl derivatives, Chl-1 and Chl-2, which self-assembled readily into π-stacking aggregates through a simple spincasting process, in perovskite solar cells (PSCs). The Chl aggregate films exhibit an ultra-smooth film surface, high hole mobility, appropriate energy levels, and efficient hole injection efficiencies that are all key characteristics for efficient hole transporters in PSCs. CH NH PbI Cl -based PSCs with these Chls as hole transporters were fabricated and compared with P3HT as a standard hole transporter. PSCs based on Chl-1 and Chl-2 without the use of typical additives, such as 4-tert-butylpyridine and lithium bis(trifluoromethanesulfinyl)imide, gave power conversion efficiencies of 11.44 and 8.06 %, respectively. This research provides a unique way to incorporate low-cost and environmentally friendly natural photosynthetic materials in the development of highly efficient photovoltaic devices.

Solution-processed polymer solar cells (PSCs) have attracted dramatically increasing attention over the past few decades owing to their advantages of low cost, solution processability, light weight, and excellent flexibility. Recent progress in materials synthesis and devices engineering has boosted the power conversion efficiency (PCE) of single-junction PSCs over 17%. As an emerging technology, it is still a challenge to prepare solution-processed flexible electrodes for attractive flexible PSCs. Poly(3,4-ethylenedioxythiophene): poly(styrenesulfonate) (PEDOT:PSS) is one of the most promising candidates for electrodes due to its high conductivity (>4000 S/cm), excellent transmittance (>90%), intrinsically high work function (WF > 5.0 eV), and aqueous solution processability. To date, a great number of single-junction PSCs based on PEDOT:PSS electrodes have realized a PCE over 12%. In this review, we introduce the current research on the conductive complex PEDOT:PSS as well as trace the development of PEDOT:PSS used in electrodes for high performance PSCs and perovskite solar cells. We also discuss and comment on the aspects of conductivity, transmittance, work-function adjustment, film preparing methods, and device fabrications. A perspective on the challenges and future directions in this field is be offered finally.

The electron-selective contact layer (ESL) in organometal halide-based perovskite solar cells (PSCs) determines not only the power conversion efficiency (PCE) but also the thermostability of PSCs. To improve the thermostability of ZnO-based PSCs, we developed Mg-doped ZnO [Zn Mg O (ZMO)] as a high optical transmittance ESL for the methylammonium lead trihalide perovskite absorber [CH NH PbI ]. We further investigated the optical and electrical properties of the ESL films with Mg contents of 0-30 mol % and the corresponding devices. We achieved a maximum PCE of 16.5 % with improved thermal stability of CH NH PbI on ESL with the optimal ZMO (0.4 m) containing 10 mol % Mg. Moreover, this optimized ZMO PSC exhibited significantly improved durability and photostability owing to the improved chemical/photochemical stability of the wider optical bandgap ZMO.

Previous investigations have revealed that CH3NH3PbI3-based perovskites rapidly decompose on ZnO at elevated temperature. The thermostability of a perovskite film on ZnO was substantially improved with FAPbI3owing to the robust nature of FA compared with methylammonium (MA) in CH3NH3PbI3.

Secondary infection in septic patients has received widespread attention, although clinical data are still lacking. The present study was performed on 476 patients with septic shock. Time trends for mortality were analyzed using Spearman’s rank correlation test. Risk factors for secondary infection were investigated by binary logistic regression. The extended Cox model with time-varying covariates and hazard ratios (HR) was performed to determine the impact of secondary infection on mortality. Differences in hospital length of stay (LOS) between patients with and without secondary infection were calculated using a multistate model. Thirty-nine percent of septic shock patients who survived the early phase of the disease developed secondary infection. There was a statistically significant increased odds ratio for secondary infection in older patients and patients with a longer LOS in the intensive care unit (ICU), a higher Sequential Organ Failure Assessment (SOFA) score, and endotracheal intubation. Secondary infection significantly reduced the rate of discharge (HR 5.607; CI95 3.612–8.704; P < 0.001) and was associated with an increased hospital LOS of 5.46 days. The present findings represent a direct description of secondary infection in septic shock patients and highlight the influence of this condition on septic shock outcomes.