Pediatric Anesthetic Management of a Patient with an ALG-13 Gene Mutation, a Rare Congenital Disorder of GlycosylationEsha Thakkar, PharmD,1 John A. Iasiello, MD,1 Sunny R. Cai, MD,1 Adrienne Hutton, MD11 Brody School of Medicine at East Carolina University, Greenville, NC

Life-Threatening Pulmonary Air Embolism Following Right Jugular Venous Catheter Removal Successfully Managed With Hyperbaric Oxygen: An Unusual Case ReportHaidar Barjas1 . Wisam Al Wassiti1 , Rasha Abduljabbar3 , Nagham Sadik1,21-Hamad Medical Corporation, Medical Education, Internal Medicine Department, Doha, Qatar2-Qatar University, Medical College, Doha, Qatar3-University of Nottingham, College of Medicine

Two-dimensional Ruddlesden-Popper (2D RP) layered metal-halide perovskites have garnered increasing attention due to their favorable optoelectronic properties and enhanced stability in comparison to their three-dimensional counterparts. Nevertheless, precise control over the crystal orientation of 2D RP perovskite films remains challenging, primarily due to the intricacies associated with the solvent evaporation process. In this study, we introduce a novel approach known as reverse-cool annealing (RCA) for the fabrication of 2D RP perovskite films. This method involves a sequential annealing process at high and low temperatures for wet perovskite films. The resulting RCA-based perovskite films show the smallest root-mean-square value of 23.1 nm, indicating a minimal surface roughness and a notably compact and smooth surface morphology. The low defect density in these 2D RP perovskite films with exceptional crystallinity suppresses non-radiative recombination, leading to a minimal non-radiative open-circuit voltage loss of 149 mV. Moreover, the average charge lifetime in these films is extended to 56.30 ns, thanks to their preferential growth along the out-of-plane direction. Consequently, the leading 2D RP perovskite solar cell achieves an impressive power conversion efficiency of 17.8% and an open-circuit voltage of 1.21 V. Additionally, the stability of the 2D RP perovskite solar cell, even without encapsulation, exhibits substantial improvement, retaining 97.4% of its initial efficiency after 1000 hours under a nitrogen environment. The RCA strategy presents a promising avenue for advancing the commercial prospects of 2D RP perovskite solar cells.

Many factors, including individual- and species-specific traits and resource requirements as well as landscape characteristics, influence second-order habitat selection and home range characteristics such as size, shape, stability, and overlap. By comparing home range characteristics across individuals, species, and landscapes, we can draw conclusions regarding whether and how different factors influence home range selection. Our objectives were to quantify home range characteristics of VHF- and GPS-collared coyotes and red foxes in southern Wisconsin, including home range size and shape, home range stability, and inter- and intraspecific overlap, and to review current literature on coyote and red fox home range characteristics for comparison and context. On average, urban coyotes had smaller, more circular home ranges with greater intraspecific overlap than rural coyotes; although, rural coyotes had greater home range stability. Similarly, urban red foxes had smaller, more circular home ranges with greater intraspecific overlap than urban coyotes, with no difference in stability between urban coyotes and red foxes. Our results corresponded with trends identified from literature review; however, we did find greater interspecific overlap between urban coyotes and red foxes than has been previously reported. Our results provide further evidence that intrinsic and extrinsic factors, such as body size, resource predictability and availability as well as the physical environment, influence home range selection of coyotes and red foxes.

Esophagitis in a Post-Liver Transplant Patient: A Case of Cytomegalovirus and Herpes Simplex Virus-1 CoinfectionAmmad Javaid Chaudhary MD1, Taher Jamali MD2, Abdullah Sohail MD3, Allyce Caines MD, Mazen ELatrache MD1. Internal Medicine Department, Henry Ford Hospital, Detroit, MI 48202, US2. Department of Gastroenterology and Hepatology, Henry Ford Hospital, Detroit, MI 48202, US3. The University of Iowa Hospitals and Clinics, Iowa City, IA, 52246

Non-human animal models continue to be indispensable in neuroscience research for the foreseeable future. In recent years, animal-right activists have been increasing the pressure on politicians and policymakers to phase out animal research. To address this pressure, we should adapt our communication habits, to be more open and transparent about (our) animal research and most importantly to expand the methods we use to communicate about our research and increase the extend of this outreach. In this editorial we discuss the why and how of animal research communication.

The mechanisms underlying plant species distribution and abundance have been long studied in ecology. However, the role of heterospecific pollen interference in shaping these patterns needs more attention. Species distribution and abundance are important factors determining whether a species is endangered or not, thus understanding the impact of heterospecific pollen interference on rare species could help to inform conservation strategies aimed at preserving plant communities. In this study, we conducted a multispecies experiment using eight co-occurring and co-flowering plant species with varying rarity levels in Switzerland. We performed hand-pollination experiments between all species pairs and measured seed set (whether a flower produces seed) and seed number (number of seeds per flower) as outcomes. We looked at the effects of rarity status, self-compatibility and recipient-donor relatedness on heterospecific pollen interference. Contrary to expectations, neither seed set nor seed number were affected by heterospecific pollen deposition. Self-compatible species had a higher seed set probability, but this was independent from species rarity. In our study setting, heterospecific pollen interference seems to have only minor effects on seed set and seed number, and consequently on recruitment. Thus, heterospecific pollen interference seems to play only a minor role in shaping plant species distribution and abundance. Nevertheless, the higher impact of heterospecific pollen deposition on rare and closely related species, as well as the importance of conspecific pollen loss, might need further investigation for both in-situ and ex-situ conservation strategies.

Background: Herpes Simplex Virus (HSV) infections, primarily caused by HSV-1 and HSV-2, are prevalent worldwide and carry significant health implications. The impact of tobacco use on HSV infections, however, remains underexplored. Methods: This cross-sectional study utilized the National Health and Nutrition Examination Survey (NHANES) database (2009-2016) to investigate the link between Tobacco use and HSV infections among U.S. adults. Smoking status, volume, and serum cotinine levels were analyzed, alongside demographic and behavioral factors. Propensity score matching (PSM) was employed to adjust for confounders such as sexual behavior. Results: Our study involved 5,693 participants to explore the relationship of tobacco use and HSV infection. We found that smokers, particularly current smokers, have a significantly increased risk of both HSV-1 and HSV-2 infections compared to non-smokers. Specifically, the adjusted odds ratio (OR) for HSV-1 in current smokers was 1.36 (95% CI: 1.16-1.59, p<0.001), and for HSV-2, it was 2.37 (95% CI: 1.88-3, p<0.001). The risk escalates with the intensity of smoking. Elevated serum cotinine levels correlated with an increased risk of HSV infection[HSV-1:1.13 (95% CI:1.09~1.18, p<0.001); HSV-2:1.33 (95% CI:1.25~1.41, p<0.001)]. After propensity score matching (PSM) for factors such as age, gender, sexual behavior, and condom use, these associations remained significant. Conclusion: Tobacco use is significantly associated with an increased risk of HSV infections, highlighting the importance of reducing tobacco exposure in public health strategies against HSV. Further longitudinal studies are warranted to establish causality and explore underlying mechanisms.

Key clinical Message:We present a patient who incurred strokes on two different factor Xa inhibitors and was successfully treated with a direct thrombin inhibitor and discuss the literature on switching to an anticoagulant with a different mechanism of action in case of failure. There is limited research on this common scenario.

Floating offshore wind (FOW) is a renewable energy source that is set to play an essential role in addressing climate change and the need for sustainable development. However, due to the increasing threat of climate emergency, more wind turbines are required to be deployed in deep water locations, further offshore. This presents heightened challenges for accessing the turbines and performing maintenance, leading to increased costs. Naturally, methods to reduce operational expenditure (OpEx) are highly desirable. One method that shows potential for reducing OpEx of FOW is LIDAR-assisted pitch control. This approach uses wind velocity measurements from a nacelle-mounted LIDAR to enable feedforward control of floating offshore wind turbines (FOWTs), and can result in reductions to the variations of structural loads. Results obtained from a previous study of combined feedforward collective and individual pitch control (FFCPC+FFIPC) are translated to OpEx reductions via reduced component failure rates for future FOW developments, namely in locations awarded in the recent ScotWind leasing round. The results indicate that LIDAR-assisted pitch control may allow for an up to 5% reduction in OpEx, increasing up to 11% with workability constraints included. The results varied across the three ScotWind sites considered, with sites furthest from shore reaping the greatest benefit from LIDAR-assisted control. This work highlights the potential savings and reduction in the overall levelised cost of energy for future offshore wind turbine projects deliverable through the implementation of LIDAR-assisted pitch control.

Resources play an important role in shaping the evolution of plant defensive strategies. Much research has focused on how resource availability impacts the overall concentration of specific defensive compounds, particularly among-species. Yet, how resource availability influences overall phytochemical diversity within species, and how this in-turn might affect herbivore damage is less well understood. Using Monarda fistulosa, a species that produces diverse terpene compounds and distinct chemotypes (i.e., thymol or carvacrol), we addressed three primary questions: 1) How do phytochemical components (i.e., total concentration, Shannon diversity, and chemotypes) vary between distinct populations from two large, widely separated regions that differ in climate and productivity? 2) How do these components influence attack by different herbivore species? 3) What are the growth costs of higher phytochemical levels in different chemotypes? Seeds were collected from 12 populations, six from a low-productivity/resource environment in Montana, and six from a high-productivity/resource environment in Wisconsin. Seedlings produced from these seeds were transplanted to a common garden in Wisconsin. Over two growing seasons, we analyzed terpene concentrations, quantified the number of herbivores damage, and measured plant above-ground biomass. Plants from Montana exhibited higher terpene concentrations but lower diversity, whereas those from Wisconsin displayed lower terpene concentrations but higher diversity. Total terpene concentration emerged as the primary predictor of herbivore damage, although some differences were observed between region of origin and with terpene richness. Herbivores exhibited mixed responses to phytochemistry; some herbivores were negatively affected, while one species, a specialized leaf galler, responded positively. Costs of producing defenses were evident, manifest by negative correlations between plant biomass and total terpene concentration (but not chemical richness or Shannon diversity). Our study revealed that regional differences in resource availability and productivity can influence the evolution of phytochemical concentration and diversity, which, in turn, affects plant damage and incurs growth-related costs.

SR/RS dipeptide repeats vary in both length and position and are phosphorylated by SR protein kinases (SRPKs). PIM-1L, the long isoform of PIM-1 kinase, the splicing of which has been implicated in acute myeloid leukemia, contains a domain which consists largely of repeating SR/RS and SH/HS dipeptides (SR/SH-rich). In order to extend our knowledge on the specificity and cellular functions of SRPK1, here we investigate whether PIM-1L could act as substrate of SRPK1 by a combination of biochemical and computational approaches. Our biochemical data showed that the SR/SH-rich domain of PIM-1L was able to associate with SRPK1, yet it could not act as a substrate but, instead, inactivated the kinase. In line with our biochemical data, molecular modeling followed by a microsecond-scale all-atom molecular dynamics (MD) simulation suggests that the SR/SH-rich domain acts as a pseudo-docking peptide that binds to the same acidic docking-groove used in other SRPK1 interactions and induces inactive SRPK1 conformations. Comparative community network analysis of the MD trajectories, unraveled the dynamic architecture of apo SRPK1 and notable alterations of allosteric communications upon PIM-1L peptide binding. This analysis also allowed us to identify key SRPK1 residues, including unique ones, with a pivotal role in mediating allosteric signal propagation within the kinase core. Interestingly, most of the identified amino acids correspond to cancer-associated amino acid changes, validating our results. In total, this work provides insights not only on the details of SRPK1 inhibition by the PIM-1L SR/SH-domain, but also contributes to an in-depth understanding of SRPK1 regulation.

Background: Premature ventricular contractions (PVCs) are frequently observed with left ventricular (LV) systolic dysfunction, although the prevalence of these associated conditions in the general population remains unknown. Objective: We sought to understand the prevalence of frequent PVCs (defined PVCs>5%) and high burden PVCs (defined PVCs>10%) and LV systolic dysfunction in patients receiving ambulatory Holter monitors (HM). Methods: A prospective multicenter (8 US medical centers) cross-sectional study collected demographic and PVC burden data from consecutive patients undergoing 24-hour, 48-hour, and 14-day HM (July 2018-June 2020). Left ventricle ejection fraction (LVEF) data was collected if obtained within 6 months of HM. Four PVC burden groups were analyzed (<1%, 1-5%, 5.1-10% and >10% burden) and stratified by normal LVEF (≥50%) or presence LVEF<50%. Results: The prevalence of PVC burden of 5.1-10% and >10% was 4% and 5%, respectively in the population undergoing HM (n=6,529). Age was significantly different between PVC groups (p<0.001). In those with LVEF assessment (n=3,713), the prevalence of LVEF<50% and both LVEF<50% and PVC>5% was 16.4% and 4.2%, respectively. The prevalence of PVC>5% and PVC>10% in patients with LVEF<50% was 26% and 16%, respectively. PVC>5% were more prevalent in older, male, and Caucasians (p<0.001). Females had a lower prevalence of PVC>5% than males (6% vs. 11%; p<0.001), but not among those with LVEF<50% (24% vs. 26%, p=0.10). Conclusion: PVC>5% and PVC>10% and LVEF<50% are prevalent in patients undergoing HM. PVC>5% are associated with older age. Females have a lower prevalence of PVC>5% than males but similar combined PVC>5% and LVEF<50%.

COVID-19 Vaccination and Atrial fibrillation: When Pandemics CollideJason S. Chinitz, MD1,2,3 and Laurence M. Epstein, MD1,2,41Northwell, New Hyde Park, NY2Northwell Cardiovascular Institute3South Shore University Hospital, Bay Shore, NY4North Shore University Hospital, Manhasset, NYShort title : COVID-19 Vaccination and Atrial fibrillationKey Words : Atrial Fibrillation, Atrial Arrhythmias, COVID-19, COVID-19 VaccinationFinancial support : none.Conflicts of Interest :Jason Chinitz, MD: Consultant for Boston Scientific, Biosense Webster, MedtronicLaurence Epstein, MD: none.Address for Correspondence :Jason Chinitz, MDNorthwell, 2000 Marcus Ave, Suite 300New Hyde Park, NY [email protected] the wake of the coronavirus disease 2019 (COVID-19) pandemic, accelerated research and development efforts were made to create a new class of vaccinations to mitigate the unprecedented global health burden. However, the rapid development and approval process was a factor in prompting vaccine hesitancy, based partially on concerns regarding the safety of the vaccine. Adding to the hesitancy, reports of adverse reactions became widely disseminated in medical literature, as well as in social media. However, the lack of long-term data and controlled studies have limited interpretation of the true COVID-19 vaccine risk profile, and has hampered the effort to combat misinformation.Cardiac complications are the most frequently reported adverse reaction following COVID-19 vaccination.1 Case series have attributed exacerbations of various chronic cardiac diseases to COVID-19 vaccination, including hypertension, coronary artery disease, and arrhythmias.2 In the WHO database, palpitation and tachycardia were reported frequently across all age groups and gender following vaccination, including many cases of atrial fibrillation.2 The Vaccine Adverse Event Report System (VAERS) database of the Food and Drug Administration reported over 2600 cases of atrial fibrillation following COVID-19 vaccination, only 315 of which were reported as new-onset.3 These reports, however, are generally anecdotal, denominators are not considered, and causality cannot be inferred. Any association is further confounded when evaluating the vaccine’s effects in populations in whom cardiovascular disease is the most common comorbidity, as the prevalence of heart rhythm abnormalities is already high. In this circumstance, patients and clinicians may tend to inappropriately attribute an arrhythmia occurrence to a history of vaccination. Indeed, the majority of adverse medical outcomes that occur following vaccination may have little to do with the vaccine itself, even when the temporal relationship is suggestive.Tachycardia and arrhythmias may occur as an inflammatory or stress-related response to vaccination. Inflammatory reactions such as myocarditis and pericarditis have been shown to occur at higher rates following COVID-19 vaccination.4 A potential mechanism of post-COVID-19 vaccine adverse events has been attributed to an immune response to the detection of mRNA as an antigen, particularly in genetically predisposed individuals; in these cases, immunization may activate inflammatory cascades, leading to systemic reactions including myocarditis and potentially atrial and ventricular arrhythmias.5 Atrial fibrillation and ventricular arrhythmias have been long associated with inflammatory conditions, and are relatively common in patients with pericarditis and myocarditis.6 Accordingly, an increase in arrhythmia burden after vaccination is biologically plausible, regardless of whether the vaccine itself is pro-arrhythmic.For practicing cardiologists, atrial fibrillation can reasonably be considered a disorder of pandemic proportions. Driven by both modifiable and non-modifiable risk factors, and more ubiquitous screening and detection modalities, the incidence of AF has been reported to be 31% higher in 2017 compared to 1997, and predictive models suggest AF will impact nearly 8 million Americans by 2050.7,8Furthermore, AF burden is progressive in at least 25% of patients, including progression from paroxysmal to persistent AF in 8-15% of patients per year.9 AF interventions, particular AF ablation, have been shown to reduce the rate of progression to persistent AF markedly.10Though increasing AF burden in an individual patient may be attributed to the natural history of the disease, cardiovascular risk factors are commonly implicated as drivers of AF progression. Interestingly, the pandemic itself may have also contributed to the increasing prevalence of AF, as we have reported high rates of AF, nearly two-thirds of which was new onset, in large numbers of hospitalized patients with COVID-19.11 However, in most patients with AF who have various cardiac risk factors, identification of extrinsic factors such as a novel vaccination that may contribute directly to AF onset and progression is challenging, and non-randomized studies can be misleading due to unrecognized confounders.In the study reported in this issue of the Journal of Cardiovascular Electrophysiology by Deshmukh et al,12arrhythmia burden was extracted retrospectively in large databases of patients with CIEDs, to evaluate any temporal association between COVID-19 vaccination and AF progression. Insurance claims were used to identify patients receiving COVID-19 vaccination, and long-term trends in arrhythmia burden, occurring before and after vaccination were analyzed, and compared to similar populations not undergoing vaccination. Though the AF burden was found to increase in the 3 months following vaccination, similar increases in AF burden were observed in patients who did not receive vaccination over the same time frame, and sustained increases in arrhythmia burden were noted over the course of a year, in both populations. These findings implicate disease progression, and not the vaccine itself, as the primary driver of AF events occurring following vaccination. This manuscript’s first conclusion citing an increase in the burden of arrhythmia events in the 3 months following COVID-19 vaccination, particularly in males over 70 years in whom the prevalence of AF is already highest, is therefore potentially misleading, as a subsequently reported comparison between matched vaccinated and un-vaccinated populations yielded no statistically significant difference in AF burden.There are two primary lessons to take from this research.AF is a common and progressive disease, which is best understood in populations that have devices capable of long-term arrhythmia monitoring. Beyond observed and predicted increases in AF prevalence and incidence over time, AF burden in individual patients is progressive over time. This study further demonstrates this trend in a population with underlying cardiovascular disease who have CIEDs, regardless of whether they had a vaccination or not.Exacerbations of chronic medical disease, such as atrial fibrillation, are seen following vaccinations, and may be in-part related to the vaccine\RL’s induced inflammatory response. However, in this study, arrhythmia burden did not appear to accelerate more quickly in patients who received vaccinations relative to those who did not get vaccinated, and no long-term difference in atrial or ventricular arrhythmia burdens were noted between these populations.A risk versus benefit analysis must always be performed when evaluating any therapy, including with vaccines. While this study does not report on the benefits of the vaccine, it does provide some reassurance in recommending COVID-19 vaccination to our patients at risk for arrhythmias, who are also at high risk of complications from COVID-19 infection. Furthermore, the progressive nature of AF in patients with cardiovascular disease, who are at highest risk of AF-related morbidity and mortality, further justifies current trends towards early AF intervention.

Objective: Child marriage forces a girl into adult roles before physical and psychological maturity, which can take a toll on women’s health over the life course. This paper aims to assess whether child marriage and adolescent childbearing are associated with elevated risk of gynecologic disorders leading to hysterectomy. Design: Cross-sectional and survival analysis. Setting: India, nationally representative survey. Population: 528,816 ever married women, aged 20-49 years. Methods: Women were grouped in four mutually exclusive categories – i) married adult – not an adolescent mother (reference category), ii) married adult – adolescent mother, iii) married child – not an adolescent mother, and iv) married child – adolescent mother. Multivariable logistic regressions were fitted to assess the odds of hysterectomy for these groups. Non-parametric Kaplan-Meier survivor functions were estimated to evaluate survival rates across the groups. Main outcome measures: Whether had a hysterectomy and age when hysterectomy was performed. Results: Compared to women married as adult – not an adolescent mother, women married in childhood and who gave birth in adolescence were 1.87 (95% CI: 1.78–1.96) times more likely to have a hysterectomy and had the lowest survival rate for hysterectomy. Women married as children but not an adolescent mother also had higher odds of hysterectomy (AOR = 1.40, 95% CI: 1.31–1.50). These results were robust across sub-groups including geographic regions, urban/rural residence, education, and income. Conclusions: Our results, showing a strong relationship between child marriage and hysterectomy, contribute to the literature on later-life health consequences of child marriage and call for strengthening efforts to eradicate child marriage.

Objective To evaluate costs and cost-effectiveness to the healthcare system, and costs to families, of a national prenatal exome sequencing (pES) service additional to standard testing, compared to standard testing alone. Design A cost-effectiveness analysis combining costs, outcomes, parent and professional interview and professional survey data. Setting The English National Health Service (NHS) Genomic Medicine Service. Sample 413 cases referred for pES testing from 01/10/2021 to 30/06/2022. Methods We costed the incremental resource required to deliver the pES clinical pathway, synthesising this with unit costs and outcomes data on additional cases diagnosed to analyse cost-effectiveness. We estimated the annual NHS budget requirement based on case numbers. We determined parental costs from interviews. Main Outcome Measures Incremental costs of pES to the NHS and families, incremental cost per additional diagnosis, NHS budget impact. Results Of 413 referred cases, 241 were tested, at a cost of £2,331 (95% credibility interval £1,894-£2,856) per referred case, or £3,592 (£2,959-£4,250) per case that proceeded with testing. The incremental cost per diagnosis (yield 35.3%) was £11,326 (£8,582-£15,361). At current demand levels pES costs the NHS approximately £1.7m annually. Family costs could not be separated from other pregnancy related appointments but were not considered burdensome as most appointments were concurrent or remote. Conclusions pES is more expensive than predecessor prenatal genetic testing technologies, has a higher diagnostic yield and informs pregnancy management and decision making. Further research into potential savings from the foregone diagnostic odyssey resulting from pES may be informative.

The major histocompatibility complex (MHC) plays a critical role in the immune response against pathogens. Its high polymorphism is thought to be mainly the consequence of host-pathogen co-evolution, but elucidating the mechanism(s) driving MHC evolution remains challenging for natural populations. We investigated the diversity of MHC class II genes in a wild population of pied flycatchers Ficedula hypoleuca, and tested its associations with two key components of individual fitness: lifetime reproductive success and survival. Among 180 breeding adults in our study population, we found 182 unique MHC class II exon 2 alleles. The alleles showed a strong signal of positive selection and grouped into 9 functional supertypes based on physicochemical properties at the inferred antigen-binding sites. Three supertypes were found in > 98% of the sampled individuals, indicating that they are nearly fixed in the population. We found no rare supertypes in the population, as all supertypes were present in >70% of individuals. Three supertypes were related to different components of individual fitness: two were associated with lower offspring production over time, while the third was positively associated with survival. Overall, the substantial allelic and functional diversity and the relationship between specific supertypes and fitness is in accordance with the notion that balancing selection maintains MHC class II diversity in the study population, possibly with fluctuating selection as the underlying mechanism. The absence of rare supertypes in the population suggests that the balancing selection is not driven by rare-allele advantage.

Lithium metal batteries are the most promising next-generation energy storage technologies due to their high energy density. However, their practical application is impeded by serious interfacial side reactions and dendrite growth of lithium metal anode (LMA). Herein, copper 2,4,5-trifluorophenylacetate (CuTFPAA) is synthesized and used to stabilize LMA by in-situ constructing a dense and mixed-conductive interfacial protective layer. The in-situ formed passivated layer not only significantly inhibits interfacial side reactions by avoiding direct contact between LMA and electrolyte but also effectively suppresses lithium dendrite growth due to its high mechanical strength. As a result, the CuTFPAA-treated LMAs show greatly improved cycle stability under both high current density and high areal deposition capacity. Notably, the assembled liquid symmetrical cells with CuTFPAA-treated LMAs can stably work for more than 3000, 5000, and 4800 h at 1.0 mA cm‒2‒1.0 mAh cm‒2, 2.0 mA cm‒2‒5.0 mAh cm‒2, and 10 mA cm‒2‒5.0 mAh cm‒2, respectively. Furthermore, the assembled liquid full cell with a high LiFePO4 loading (~ 16.9 mg cm‒2) shows a significantly enhanced cycle life of 250 cycles with stable Coulombic efficiencies (> 99.1%). Moreover, the assembled all-solid-state lithium metal battery with a high LiNi0.6Co0.2Mn0.2O2 loading (~ 5.0 mg cm‒2) also exhibits improved cycle stability. These findings underline that the CuTFPAA-treated LMAs show great promise for high-performance lithium metal batteries.