The PEC photodetectors based on these cascade heterostructures demonstrate the highest photoresponsivity (103 mA W−1 at −0.1 V and 3.5 mAW−1 at 0 V under 475 nm light excitation) among the previous reports based on two‐dimensional materials and related heterostructures. Furthermore, the photodetectors display a fast response (≈8 ms), a high detectivity (8.96 × 109 Jones), a high external quantum efficiency (26.17%), and a high incident photon‐to‐current efficiency (27.04%) at 475 nm. Due to the rapid charge transport and efficient light absorption, the Bi2Te3/Bi2Se3/Bi2S3 cascade heterostructure demonstrates a highly efficient hydrogen production rate , which is far superior to those of pure bismuth chalcogenides and its type‐II heterostructures. The large‐scale cascade heterostructure offers an innovative method to improve the performance of optoelectronic devices in the future.Large‐scale multi‐heterostructure and optimal band alignment are significantly challenging but vital for photoelectrochemical (PEC)‐type photodetector and water splitting. Herein, the centimeter‐scale bismuth chalcogenides‐based cascade heterostructure is successfully synthesized by a sequential vapor phase deposition method. The multi‐staggered band alignment of Bi 2Te3/Bi2Se3/Bi2S3 heterostructure photodetectors demonstrate a high photoresponsivity (103 mA W−1 at −0.1 V and 3.5 mAW−1 at 0 V) and a fast response (≈8 ms) at 475 nm. The cascade heterostructure also shows a high hydrogen production rate (0.416 mmol cm−2 h−1).The centimeter‐scale bismuth chalcogenides based cascade heterostructure are synthesized by vapor phase deposition methods. The Bi In the past few decades, n‐type semiconductors such as TiO2 and ZnO have been widely investigated as photoanodes in PEC devices due to their strong redox capability. However, the low conductivity, limited carrier lifetime, rapid carrier recombination rate, and large bandgap in UV band only have prevented the energy conversion efficiency by these wide bandgap semiconductors. In this regard, hunting for advanced materials such as visible‐light‐active two‐dimensional (2D) materials is desirable for PEC devices due to their narrow bandgap, strong light‐matter interaction, and high carrier mobility.The conversion of solar energy into electric and chemical energy by photoelectrochemical (PEC) devices has received widespread attention due to the promising prospects in solving energy‐shortage and environment‐pollution.1 The 2X3  are attractive and promising candidates for visible‐light‐driven PEC devices due to the narrow bandgap and environmental friendliness. Among them, Bi2Se3 and Bi2Te3 are the most studied topological insulators with the metallic Dirac surface states, which are advantageous to the electron interface transmission. Furthermore, both Bi2Se3 and Bi2Te3 show a superior electrical conductivity and a small bandgap as well as a high surface mobility (104 cm2 V−1 s−1). In contrast, Bi2S3 belongs to a typical n‐type semiconductor with a relatively high photon‐electron conversion efficiency (≈5%), a high absorption coefficient (104–105 cm−1), and a narrow bandgap (≈1 eV). Despite the strong and wide‐band light absorption by bismuth chalcogenides, the rapid electron‐hole pair recombination in them still slows down the interfacial kinetics and reduces the conversion efficiency in the photodetection and water splitting in PEC performance.As typical 2D materials, bismuth chalcogenides with a general structure Bie states,6 whic2X3‐based heterostructures such as Bi2X3/SnS2, Bi2S3/BiVO4, Bi2Se3/TiO2, and Bi2Se3/MoS2 have been constructed as a strategy to improve the photocatalytic activity due to the rapid carrier migration at the interface. This type‐II heterostructure with a staggered band structure can effectively reduce the severe charge recombination by the built‐in electric field, which is of great significance for PEC water splitting and PEC‐type photodetectors. However, the poor interfacial contact and charge traps at the interface seriously hinder the charge flow trajectory and decrease the charge transfer efficiency. Considering the similar crystal structure and conducting surface state, the Bi2X3 heterostructures are easy to form intimate interface and beneficial for charge transfer. As such, the heterostructure formation among 2D Bi2X3 provides an efficient strategy for realizing highly efficient PEC performance. Moreover, recent works on cascade heterostructures such as ZnO/CdS/CdSe, ZnO/CdS/PbS, and MoS2/WS2/WSe2/Si suggest that the multi‐staggered band alignment can further accelerate the electron‐hole flow fluently and improve the carrier separation efficiently. Recently, type‐II Bi2S3/Bi2Se3 heterostructure was fabricated as anode materials for hybrid capacitors due to the efficient charge transport. Bi2Te3/Bi2Se3 heterostructure was also constructed to improve the thermoelectric performance. However, despite the efficient control in size and atomic uniformity of 2D Bi2X3 films by a vapor deposition method, the synthesis of the Bi2Te3/Bi2Se3/Bi2S3 cascade heterostructure and the optimization of band alignment are still in challenge.To solve the above problems, Bi2X3/SnS2,5, 92Te3/Bi2Se3/Bi2S3 thin films with cascade band alignment. The multiple staggered bandgap has been verified by X‐ray photoelectron spectroscopy (XPS) and UV–vis absorption spectra. The PEC‐type photodetectors based on these cascade heterostructures demonstrate a broadband photoresponse with the maximum photoresponsivity of 103 and 3.5 mAW−1 at −0.1 and 0 V, respectively. Due to the high incident photon‐to‐current efficiency (IPCE ≈27.04%), the Bi2Te3/Bi2Se3/Bi2S3 cascade heterostructure also reaches unprecedented hydrogen (H2) production rates of 0.416 mmol cm−2 h−1 and 14.320 µmol cm−2 h−1 in the sacrificial agent and pure water, respectively. This study reveals the great potentials of cascade heterostructures based on 2D materials for high‐performance PEC devices.Herein, a sequential vapor phase deposition method is optimized to synthesize Bi22Se3 film in a centimeter scale  and Se 3d7/2 (≈53.8 eV) belong to the Se2− valence state. This analysis further confirms the successful formation of Bi2Se3 films. Due to the similar physical and chemical properties of Bi2Se3 and Bi2Te3, the same parameters were also used to grow Bi2Te3 film by a PVD method with the morphology shown in Figure −1 in Figure Eg2 and A1g vibration modes of Bi2Te3. The Bi 4f core‐level spectrum also exhibits four main peaks  from Bi3+ as shown in Figure 5/2 (≈572.7 and 576.4 eV) and 3d3/2 (≈583.2 and 586.8 eV) in Figure 2Te3 film with Bi and Te oxidation states may be due to the long‐term air exposure in the measurement. Compared with the PVD method, the Bi2S3 film was synthesized by a CVD method to avoid the high decomposition under high temperature . The photograph and scanning electron microscopy (SEM) characterization of Bi2S3 film suggests that the nanosheets are deposited and stacked a continuous and uniform film as shown in Figure 2S3 in Figure g vibration modes near 183.2 and 233.6 cm−1, and the B1g vibration mode near 259.2 cm−1. The XPS characterization in Figure 3+. The small peak at 159.8 eV is from Bi metal, which is caused by a bit precipitation of metal bismuth in the CVD reaction process. From the S 2p core‐level spectrum in Figure 1/2 and 2p3/2 energy levels are observed near 163.46 and 162.35 eV, respectively. Meanwhile, hexagonal phase Bi2Se3, hexagonal phase Bi2Te3, and orthorhombic phase Bi2S3 have been confirmed by X‐ray diffraction spectroscopy as shown in Figure Chemical/physical vapor deposition (CVD/PVD) is a facile strategy to fabricate large‐scale nanofilms. The uniform Bi2X3 heterostructures  were first prepared by a two‐step vapor phase deposition method. The uniform Bi2X3 heterostructure films are observed from photographs and SEM images as shown in Figure 2Te3/Bi2Se3 in Figure g (126.9 cm−1) and A1g (169.3 cm−1) from Bi2Se3 and Eg2 (105.7 cm−1) and A1g (146.7 cm−1) from Bi2Te3. Similarly, the Ag (≈186.2 and 235.2 cm−1) and B1g (≈263.7 cm−1) vibration modes from Bi2S3 are also displayed in Figure 2Se3/Bi2S3 and Bi2Te3/Bi2S3, respectively. It is worth noting that the characteristic peaks have an obvious red‐shift or blue‐shift in these heterostructures. This is due to the interlayer coupling when the heterostructure interface is formed, which is the direct evidence of van der Waals heterostructures.To optimize the heterostructure formation and confirm the band alignment, Biructures.21Ev) at the Bi2X3 interfaces. This offset is the energy difference of the Bi core levels between the heterostructure and the single component. In the Bi2Te3/Bi2Se3 heterostructure, four main peaks of Bi 4f5/2 and Bi 4f7/2 are 164.6, 163.2, 159.2, and 157.9 eV, respectively, as shown in Figure 2Se3/Bi2S3 (163.6 eV of Bi 4f5/2 and 158.3 eV of 4f7/2) and Bi2Te3/Bi2S3  heterostructures are also investigated as shown in Figure 2Te3, Bi2Se3, and Bi2S3, indicating the interfacial carrier redistribution when the heterostructure is formed.To determine the band offset parameters, high‐resolution XPS is employed to evaluate the valence band offset  of the Bi2Se3/Bi2S3, Bi2Te3/Bi2Se3, and Bi2Te3/Bi2S3 films can be calculated as follows:The valence band spectra of Bimeters ΔEV of the meters ΔEV of the EV1 value of Bi2Se3/Bi2S3 heterostructure is −0.27 eV, and the ΔEV2 value of Bi2Te3/Bi2Se3 heterostructure is −0.27 eV, and the ΔEV3 value of Bi2Te3/Bi2S3 heterostructure is −0.54 eV. In order to measure the bandgap (Eg) of Bi2X3, the Tauc plots of Bi2S3, Bi2Se3, and Bi2Te3 in Figure According to the experimental data, the Δα, h, ν, and A are the absorption coefficient, Planck's constant, optical frequency, and proportionality constant, respectively. Based on the calculation of Equation 2S3, Bi2Se3, and Bi2Te3 films are 1.00, 0.82, and 0.77 eV, respectively. Therefore, the corresponding conduction band offset parameters (ΔEc) of Bi2X3 heterostructures can be calculated by the following Equations:Here, EC1 value of Bi2Se3/Bi2S3 is −0.04 eV, and the ΔEC2 value of Bi2Te3/Bi2Se3 is ‐0.32 eV, and the ΔEC3 value of Bi2Te3/Bi2S3 is −0.36 eV. Based on these results, the schematic diagram of the band arrangement of the Bi2Te3/Bi2Se3/Bi2S3 cascade heterostructure is obtained as shown in Figure 2Te3 to Bi2Se3 and then from Bi2Se3 to Bi2S3, while the photogenerated holes can easily transfer from Bi2S3 to Bi2Se3 and then from Bi2Se3 to Bi2Te3.According to the experimental data, the Δ2Te3/Bi2Se3/Bi2S3 cascade heterostructure was realized by a sequential deposition of Bi2S3, Bi2Se3, and Bi2Te3. The morphology by SEM  and A1g (140.7 cm−1) from Bi2Te3, the Eg (121.4 cm−1) and A1g (164.8 cm−1) from Bi2Se3, and the Ag (184.2 and 236.5 cm−1) and B1g (260.3 cm−1) from Bi2S3 as shown in Figure 2Te3/Bi2Se3/Bi2S3 cascade heterostructure.The BiM Figure  and photIph) and photoresponsivity (Rph) are often used to quantitatively evaluate photodetection performance:Ilight and Idark are the current responses under light illumination and dark states, respectively. In our experiment, the illumination area (S) and light power density (λP) are 0.7 cm2 and 100 mWcm−2, respectively. It is evident from Figure 2X3 and the heterostructures increases with the bias voltage. It is worth noting that the photocurrent density of the Bi2Te3/Bi2Se3/Bi2S3 cascade heterostructure has a much higher value than those of pure Bi2X3 and their related type‐II heterostructures. To clearly evaluate the solar energy conversion efficiency, the applied bias photon‐to‐current efficiency (ABPE=Ilight×(1.23−ERHE)Pλ×100%) was calculated. As shown in Figure 2X3 and their related type‐II heterostructures. The maximum ABPE reaches 1.58% at the 0.75 V versus RHE equal to −0.1 V versus Ag/AgCl in our experiment, which is larger than those of BiVO4/CdS, ZnO/CuS, Fe2O3/NiFeOOH, CdS/TiO2, and Si/Au/TiO2. The ABPE improvement mainly comes from the high light absorption, efficient photogenerated electron‐hole separation, and fast carrier transport. As shown in Figure I–V measurement under the chopped light illumination (100 mWcm−2), the PEC photodetector demonstrates a high photocurrent density without a bias or with a small bias. This suggests that this cascade heterostructure‐based photodetector can be used as a highly sensitive self‐powered photodetector as well as a low‐bias photodetector with a low on‐set potential.Considering the well‐matched staggered bandgap Figure , the cas2X3 and heterostructures with a switching duration of 5 s as shown in Figure Iph and Rph values of Bi2S3 reach 131.5 µA cm−2 and 1315 µA W−1, which are higher than those of Bi2Se3  and Bi2Te3 . This transient photocurrent response is determined by the carrier transportation and recombination rate of samples. Correspondingly, Figure Iph values of Bi2Te3/Bi2Se3 (301.2 µA cm−2), Bi2Se3/Bi2S3 (1047.6 µA cm−2), and Bi2Te3/Bi2S3 (1469.1 µA cm−2) are better than those of pure Bi2X3. It is evident from Figure 2Te3/Bi2Se3/Bi2S3 cascade heterostructure demonstrates the highest Iph and Rph values  among these pure bismuth chalcogenides and its type‐II heterostructures. These values are 178 times larger than that of Bi2Te3, 138 times larger than that of Bi2Se3, and 17 times larger than that of Bi2S3, respectively. Compared with the Bi2X3 heterostructure, the photoresponse of the cascade heterostructure is also greatly improved. The Iph and Rph values in the cascade heterostructure are 7.3, 2.1, and 1.5 times larger than those of the type‐II Bi2Te3/Bi2Se3, Bi2Se3/Bi2S3, and Bi2Te3/Bi2S3 heterostructures, respectively. The long‐term I‐t cyclic stability tests of Bi2Te3/Bi2Se3/Bi2S3 heterostructure are measured in Figure 2Te3/Bi2Se3/Bi2S3 was maintained almost constant ≈2.24 mA cm−2 before and after one month under the illumination at −0.1 V as shown in Figure We further demonstrate the transient photocurrent response of both pure BiPE and sR as well as ct,R represent the double layer capacitance, the electrolyte and charge transfer resistances, respectively. It is evident in Figure 2Te3>Bi2Se3>Bi2S3>Bi2Te3/Bi2Se3>Bi2Se3/Bi2S3>Bi2Te3/Bi2S3>Bi2Te3/Bi2Se3/Bi2S3, which agrees well with LSV results. The results suggest that the cascade heterostructure shows a small interface resistance, due to the well‐matched band structure between Bi2X3 and ITO substrate. As such, the photoexcited electrons can transfer efficiently from Bi2Te3 to ITO substrate and generate a high photoresponse.To further investigate the carrier dynamic process at the interface of heterogeneous structures, electrochemical impedance spectroscopy (EIS) was used as shown in Figure 2X3 and their heterostructures belong to n‐type semiconductors. In addition, the flat band potential (VFB) of the sample can be obtained by the tangent of the Mott‐Schottky curve with the X‐axis in Figure VFB of Bi2Se3, Bi2Te3, and Bi2S3 is calculated to be −0.53, −0.64, and −0.41 V (vs Ag/AgCl), respectively. Based on the VFB measurement of these n‐type semiconductors, the band energy position of Bi2Te3/Bi2Se3/Bi2S3 in solution is also type‐II alignment, which agrees with the results in Figure 2Te3, the electrons in the CB of Bi2Te3 will transfer to that of Bi2Se3 and then to that of Bi2S3. Furthermore, the inverse transfer direction of holes will greatly decrease the recombination of photogenerated carriers. These processes can also be found frequently in other cascade heterostructures such as ZnO/CdS/CdSe, ZnO/CdS/PbS, and MoS2/WS2/WSe2/Si. Furthermore, the VFB of the Bi2Te3/Bi2Se3/Bi2S3 cascade heterostructure is also calculated to be −0.86 V, which is larger than those of Bi2Te3/Bi2Se3 (−0.70 V), Bi2Se3/Bi2S3 (−0.73 V), and Bi2Te3/Bi2S3 (−0.79 V) in Figure 2Te3/Bi2Se3/Bi2S3 cascade interfaces, benefiting for the charge separation due to the significantly sharp heterostructure interface, which is also found in ZnIn2S4/TiO2 and WO3/Bi2S3. The free carrier density (dN) can be obtained as follows:e = 1.6 × 10−19 C is the electron charge, and ε0 = 8.85×10−14 Fcm−1 is the vacuum permittivity; rε is the relative permittivity of Bi2X3 . The calculated carrier density of Bi2Te3/Bi2Se3/Bi2S3 (≈4.9 × 1024 cm−3) is larger than those of Bi2Te3/Bi2Se3 (≈3.5 × 1024 cm−3), Bi2Se3/Bi2S3 (≈3.6 × 1024 cm−3), Bi2Te3/Bi2S3 (≈4.2 × 1024 cm−3), Bi2Se3 (≈3.1 × 1024 cm−3), Bi2Te3 (≈2.7 × 1024 cm−3), and Bi2S3 (≈3.4 × 1024 cm−3). The larger dN values are easier to raise the Fermi‐level closer to their conduction band position and then decrease the VFB, indicating a faster charge transfer.Furthermore, Mott‐Schottky curve is also used to analyze the performance of photodetectors. As shown in Figure tential VFB of thetential VFB of thetential VFB of thetential VFB of thetential VFB of thetential VFB of the Here, the photovoltage (Vph) is defined as OCPdark−OCPlight and the Vph is caused by the Fermi‐level pinning effect. In our experiment, the cascade heterostructure shows the highest Vph value (≈0.35 eV) than those of Bi2X3 and its type‐II heterostructures. This is because heterostructure formation could eliminate the Fermi‐level pinning induced by the trap state, resulting in a high Vph and a large band bending between the photoanode and electrolyte interface. The OCP measurement agrees well with the Mott‐Schottky and EIS results as the sharp band bending in the cascade heterostructure can effectively suppress the surface carrier recombination and promote the surface charge transport ability.In addition, the OCP measurements in Figure 33 HerI–t measurement was conducted under the wavelengths ≥400 nm and ≥700 nm by adding band‐pass optical filters. Similar to LSV results, the Bi2Te3/Bi2Se3/Bi2S3 cascade heterostructure also shows the highest Iph (1.77 mA cm−2 and 373 µA cm−2) and Rph (29.5 and 18.65 mA W−1) than those of Bi2X3 and its type‐II heterostructures under the wavelengths ≥400 nm and ≥700 nm as shown in Figure Iph and Rph values of Bi2X3 and heterostructures are summarized in Table Iph at the wavelength ≥400 nm is much larger than that of ≥700 nm due to the efficient light absorption in visible region. Additionally, the efficient charge separation and transfer in the cascade heterostructure also have a synergy effect to produce high photoresponse.To investigate the effect of light absorption range on the photodetection ability, the 2Te3/Bi2Se3/Bi2S3 cascade heterostructure at −0.1 V was investigated under different visible light wavelengths as shown in Figure Iph values in Table Iph reaches the maximum value ≈1243 µA cm−2 at the wavelength of 475 nm, which may be due to the high light‐absorption at the special wavelength. To estimate the sensitivity performance of the cascade heterostructure, the Rph as a function of the wavelength is displayed in Figure Rph increases from 92 to 103 mAW−1 with the wavelength increased from 420 to 475 nm, and then it gradually decreases to 25.76 mA W−1. The Iph and Rph values are much larger than those of previously reported PEC photodetectors as shown in Table Rph value of the cascade heterostructure is approximately 103 times larger than those of 2D GeSe and SnS and ≈102 times larger than those of 2D SnS/SnSe2 and Te@Se heterostructures. This is mainly determined by the strong light absorption ability, well‐matched band alignment, and specific atomic‐level interfacial contact in the Bi2Te3/Bi2Se3/Bi2S3 cascade heterostructure. The superior photoresponse performance of the cascade heterostructure suggests a great commercial potential in the visible‐light‐driven PEC photodetectors.To deeply explore the visible‐light‐driven photodetector performance, the photoresponse of the BiIph (Rph) and wavelengths is a similar to those in Figure Iph value of 42 µAcm−2 and Rph value of 3.5 mAW−1 at 475 nm, which are better than those of previously reported 2D materials‐based PEC photodetector as shown in Table 2X3 have a strong light absorption efficiency beyond 104 cm−1 even in the infrared region due to the narrow bandgap, which can produce more photogenerated carriers compared with those of 2D nanosheets in Table 2Te3/Bi2Se3/Bi2S3 cascade heterostructure generates strong built‐in electric fields at the multiple interfaces and then promotes the photoexcited electron‐hole transportation, resulting in a high self‐powered capacity. This self‐powered photodetector meets the practical application requirement in various harsh and complicated environments with low‐energy consumption, and light weight.Further exploration of the photodetection behavior in the visible region without an applied voltage was also investigated as shown in Figure Rph, specific detectivity (D*) is another key parameter to estimate the photo‐responsiveness of photodetectors. The D* values are calculated by Equation Apart from 9 and 1.99 × 109 Jones for −0.1 V and 0 V at 475 nm) than those of other wavelengths. Additionally, the D* values of the cascade heterostructure‐based photodetectors are an order of magnitude larger than those of PEC‐type photodetectors such as Bi, Te, BP, SnS, and Te@Bi. High crystallinity and efficient light absorption as well as fast interfacial charge transportation of cascade heterostructure lead to a low dark current and a high detectivity.It is evident that the cascade heterostructure also shows the strongest detectivity  and incident photon‐to‐current efficiency (IPCE) are calculated based on the incident photon as a function of the wavelength as follows:q is 1.6 × 10−19 C; h is 6.63 × 10−34 J s; c is 3 × 108 m s−1; λ is the incident wavelength. The calculated EQE and IPCE are summarized in Figure Here, tres, response from 10% to 90%) and recovery time  are measured under the single wavelength as shown in Figure tres and trec are on a millisecond scale, which is almost not influenced by the incident wavelength. Figure tres (8 ms) and trec (6.9 ms) of the Bi2Te3/Bi2Se3/Bi2S3 cascade heterostructure at 475 nm. Even without a voltage bias voltage, the cascade heterostructure still keeps the fast response of tres (8 ms) and trec (8 ms) at different incident wavelengths as shown in Figure tres value is comparable to the trec value, suggesting that few defects and trap centers are involved in carrier separation and recombination. The rapid photoresponse characteristics in the cascade heterostructure are far superior to those of 2D materials‐based photodetectors. For instance, the response time in the cascade heterostructure is an order of magnitude faster than previously reported Bi2S3‐based photodetector (tres ≈100 ms and trec ≈100 ms). On the one hand, the rapid response could result from the internal electric field of the multi‐staggered band alignment that induces a fast charge transfer and separation efficiently. On the other hand, the rapid response could result in a strong redox reaction, which unambiguously promotes the PEC process, leading to a high photocurrent density.To evaluate the sensitivity of the photodetector, the response time  between CB of semiconductor I and VB of semiconductor II. According to the band arrangement of the Bi2Te3/Bi2Se3/Bi2S3 heterostructure, a smaller work function (higher Fermi level) of semiconductor Bi2S3 than those of Bi2Se3 and Bi2Te3, which is characterized by ultraviolet photoelectron spectroscopy measurements as shown in Figure Ecv ≈ 0.73 eV) between CB of Bi2S3 and VB of Bi2Se3 is far larger than that of ΔEc (0.07 eV). Similarly, the ΔEcv (0.5 eV) between CB of Bi2Se3 and VB of Bi2Te3 is larger than that of ΔEc (0.32 eV) as shown in Figure 2Te3/Bi2Se3/Bi2S3 heterostructure interface favors the type‐II charge transfer process. Furthermore, the enhanced photocurrent in the heterostructure is solid evidence to verify the type‐II instead of direct Z‐scheme heterostructure in Figure 2S3/Bi2Se3 and Bi2Se3/Bi2S3 (Bi2Te3/Bi2Se3 and Bi2Se3/Bi2Te3) heterostructures was also measured as shown in Figure 2S3/Bi2Se3/ITO heterostructure, much more photogenerated electrons of Bi2Se3/Bi2S3/ITO heterostructure are collected at ITO substrate and then generate a higher photocurrent as shown in Figure 2S3 is larger than that of Bi2S3/Bi2Se3/ITO heterostructure. This is because the photogenerated electrons of Bi2Se3 quickly transfer toward Bi2S3 and then participate in water reduction reaction as shown in Figure 2Se3/Bi2S3 belongs to type‐II heterostructure instead of Z‐scheme heterostructure as shown in Figure 2Te3/Bi2Se3 heterostructure also belongs to type‐II heterostructure. Under the light illumination, the photoexcited electron‐hole pairs are separated by the internal electric field. In details, the photoinduced electrons transmit from valence band (VB) to conduction band (CB) of the Bi2X3 semiconductors and the electrons in the CB of Bi2Te3 would go into the CB of the Bi2Se3 and then flow into Bi2S3 as shown in Figure To further evaluate the light sensitive properties of the photodetector, the incident light power‐dependent photoresponse is investigated with the power intensity from 50 to 100 mW cm2 due to the photogenerated electrons undergoing the redox reactions. A vacuum gas circulation system combined with a gas chromatograph was employed to detect the amount of H2 production . Under the bias voltage of −0.1 V, the H2 productions are 0.23, 0.09, and 0.34 mmol cm−2 for Bi2Se3, Bi2Te3, and Bi2S3 within 2.5 h as shown in Figure 2X3 films show strong activity under a small bias voltage as shown in Table 2S3 nanowires, our chemical vapor deposited Bi2S3 film shows the almost two‐fold increase in the PEC water splitting performance as shown in Table 2X3 film and ITO substrate can accelerate the charge transport to counter electrode for reduction reaction.Different from other photodetectors, the PEC photodetectors can work in electrolytes and the electrolytes as ion channels to complete the current loop. Under the light illumination, this PEC‐type photodetector not only can collect the photogenerated electrons to produce electric signal, but also can produce Hanowires,52 our2X3 heterostructures are investigated on the PEC hydrogen production under the same measurement conditions in Figure 2 productions of Bi2Te3/Bi2Se3, Bi2Se3/Bi2S3, and Bi2Te3/Bi2S3 films are 0.43, 0.51, and 0.83 mmol cm−2 within 2.5 h which are 4.78, 5.67, and 9.22 times larger than that of Bi2Te3 under the same conditions. Interesting, the H2 production rate of Bi2Te3/Bi2S3 is also superior to those of TiO2/Bi2Se3, Bi2Te3/V0.04‐Sb2Te3, Bi2S3/BiVO4, and Bi2S3@TiO2 heterostructures as shown in Table 2X3 heterostructures is mainly attributed to several merits. I) Two‐step vapor deposited van der Waals heterostructures can effectively avoid the alloy and defect‐center formation. II) The similar crystal structure among 2D Bi2X3 materials is beneficial for forming a good‐contact and a large‐area heterostructure interface. III) The conducting surface state facilitates the charge transfer at the large‐area interface. IV) The formed type‐II heterostructure can effectively separate electron‐hole pairs and participate the redox reaction. As a representative Bi2X3 heterostructure, the charge transfer process of Bi2Se3/Bi2S3 can be described as following. Under the visible light illumination, the photogenerated electrons transmit from VB to CB of Bi2Se3 and Bi2S3 semiconductors and the electrons in the Bi2Se3 would go into the CB of the Bi2S3. Much more accumulated electrons in the Bi2S3 would transit to the counter electrode and generate a higher H2 production rate than those of pure Bi2X3. Similarly, the interfacial charge transfer also improves the H2 production rates in the Bi2Te3/Bi2Se3 and Bi2Te3/Bi2S3 heterostructures.To further improve the water splitting performance, the Bitructures53 as 2Te3/Bi2Se3/Bi2S3 heterostructure with a multi‐staggered bandgap and multiple interfaces was designed and the H2 production can reach 1.04 mmol cm−2, which is 4.5, 11.6, and 3.06 times larger than those of Bi2Se3, Bi2Te3, and Bi2S3, respectively. Similarly, the H2 production performance of Bi2Te3/Bi2Se3/Bi2S3 is also far larger than those of Bi2X3‐based heterostructures as shown in Table 2 production in the cascade heterostructure is 17.5 times larger than the Bi2S3‐BiOBr/TiO2 heterostructures. The highest H2 production rate in the cascade heterostructure is realized among the 2D Bi2X3 materials and related heterostructures, which mainly come from the efficient charge transport and proper band alignment as shown in Figure 2Te3/Bi2Se3/Bi2S3 cascade heterostructure interfaces provides an efficient carrier highway to deliver electrons to counterpart electrode and reduce the recombination of photogenerated carriers. Under a small applied voltage, the carrier transport rate was also greatly improved due to the external electric field. Meanwhile, the holes participate in the oxidation reaction with the sacrificial agent , bismuth(III) selenide , and bismuth(III) oxide  were purchased from Alfa. Sulfur  powder was purchased from Sigma‐Aldrich. Sodium sulfide  and sodium sulfite  were purchased from Acros.Bismuth(III) telluride  was filled the furnace to drive away air and the furnace was pumped down to 100 pa. During the growth process, 5 mg Bi2Se3 powder was heated to 500 °C within 20 minutes and kept for 5 min and the vapor was carried onto the ITO substrate by 50 sccm Ar gas. The Bi2Se3 nanosheet deposits onto the ITO substrate at the distance of 10 cm from the source, where the temperature is 350 °C. Due to the similar physical and chemical properties of Bi2Se3 and Bi2Te3, the same synthesis parameters were also used to grow Bi2Te3 by the PVD method. Compared with the PVD method, the Bi2S3 film was synthesized by a CVD method. Bi2O3(5 mg) and 100 mg S powders were selected as precursors and located at 650 and 180 °C in a tube furnace with two independent temperature zones, respectively. Two independent temperature zones were heated to 650 and 180 °C within 25 minutes and the temperature was kept for 5 minutes to grow Bi2S3 film. Ar gas flow was maintained at 50  ccm and the inside pressure was controlled at 300 pa. The ITO substrate is put ≈15 cm away from the sources to deposit Bi2S3 nanosheets, where the substrate temperature is 400 °C. Bi2Te3/Bi2Se3, Bi2Se3/Bi2S3, and Bi2Te3/Bi2S3 were synthesized by a two‐step vapor phase deposition method according to the above‐mentioned growth process. To prepare Bi2Te3/Bi2Se3/Bi2S3 cascade heterostructure, Bi2S3 film was first deposited onto the ITO substrate. Subsequently, Bi2S3/ITO acts as a new substrate to continually grow Bi2Se3 to form Bi2Se3/Bi2S3/ITO heterostructure. Finally, Bi2Te3 film was deposited onto Bi2Se3/Bi2S3/ITO heterostructure to construct the Bi2Te3/Bi2Se3/Bi2S3 cascade heterostructure.In the experiment, 2D uniform Bi2X3 films. X‐Ray photoelectron spectroscopy  was used to confirm the bonding configuration and electronic structure of the samples. Scanning electron microscopy  was used to observe the morphology. The semiconductor crystal phase was confirmed by X‐ray diffraction spectroscopy . UV–vis absorption spectroscopy  was employed to confirm the light absorption.SmartRaman confocal‐micro‐Raman module  with the laser excited at 532 nm was used to characterize the vibration modes of Bi−1 Na2S and 0.02 molL−1 Na2SO3). I–V curve was measured by the cyclic linear sweep voltammetry from −1 to 0.1 V at a scan rate of 10 mVs−1. The photoresponse was investigated under the irradiation of simulated light ranging from 400 to 780 nm. The transient photocurrent response was measured with a switching duration of 5 s. The PEC photodetectors were illuminated under the visible light wavelength of 420, 450, 475, 500, 550, 600, and 650 nm. The light power intensities  were used to investigate the relationship between the photoresponse and the pump intensity. The EIS spectra were measured in the frequency range of 0.01 Hz to 100 kHz under the conditions of the dark environment and open circuit voltage.The photodetection performance of the PEC photodetectors was characterized by a traditional three‐electrode PEC system in a quartz reaction cell filled with a pH = 11 solution electrolyte (0.1 molL2) production under the irradiation of 100 mWcm−2. The hydrogen produced was then quantitatively analyzed using a gas chromatograph . The mixed solution of 0.1 molL−1 Na2S and 0.02 molL−1 Na2SO3 was selected as the sacrificial agent.All glass automatic on‐line trace gas analysis system  was used to collect and detect the hydrogen (HThe authors declare no conflict of interest.Supporting InformationClick here for additional data file.


N = 40) compared to demographically matched healthy controls (N = 40) and determined the association with depressive symptomatology. As explicit measure, we assessed the use of cognitive emotion regulation strategies via self-report. As implicit measure, performance in an ambiguous cue-conditioning task was assessed as indicator of affective bias in the processing of information. Compared to controls, patients reported more frequent use of maladaptive  and less frequent use of adaptive  emotion regulation strategies. This pattern was associated with the severity of current depressive symptoms in patients. In the implicit measure of cognitive bias, there was no significant difference in response of patients and controls and no association with depression. Our findings point to depression-related alterations in the use of cognitive emotion regulation strategies in youth with ADHD. The study suggests those alterations as a candidate risk factor for ADHD-depression comorbidity that may be used for risk assessment and prevention strategies.Youth with attention-deficit/hyperactivity disorder (ADHD) are at increased risk to develop co-morbid depression. Identifying factors that contribute to depression risk may allow early intervention and prevention. Poor emotion regulation, which is common in adolescents, is a candidate risk factor. Impaired cognitive emotion regulation is a fundamental characteristic of depression and depression risk in the general population. However, little is known about cognitive emotion regulation in youth with ADHD and its link to depression and depression risk. Using explicit and implicit measures, this study assessed cognitive emotion regulation in youth with ADHD (The online version contains supplementary material available at 10.1007/s00406-022-01382-z. Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental condition defined by a persistent and cross-situational pattern of age-inappropriate inattention and/or hyperactivity-impulsivity that leads to functional impairment . Being aPsychological factors associated with ADHD and depression may mediate the pathway(s) from ADHD to depression , 17. PooAccording to the temporal model of emotion regulation , 28, theTo address this issue, the current study focused on cognitive emotion regulation, which is largely unknown in patients with ADHD but constitutes a key determinant of the capacity to regulate negative emotions in depression and has been associated with depression risk in the general population –38. CognThere is little research on cognitive emotion regulation in patients with ADHD specifically during the potentially vulnerable phase of adolescence and early adulthood . PrelimiThe goal of this study was to better understand cognitive emotion regulation in ADHD and its role in the development of co-morbid depression during the critical developmental window of adolescence and early adulthood. To this end, we assessed cognitive emotion regulation - previously associated with depression risk - in adolescents and young adults with ADHD (14–34 years) compared to demographically matched healthy controls (HC) and determined the association with current depressive symptomatology. The study compared effects for an explicit and an implicit measure of cognitive emotion regulation. As explicit measure, we assessed the use of adaptive and maladaptive cognitive emotion regulation strategies in daily life via direct self-report using the Cognitive Emotion Regulation Questionnaire (CERQ). As implicit measure, we assessed performance in an ambiguous cue-conditioning task as a behavioural indicator of cognitive bias. Current depressive symptoms and diagnoses were determined by validated self-reports, clinician-based symptom ratings, and diagnostic interviews.We reasoned that if deficits in cognitive emotion regulation conferred risk for ADHD-depression comorbidity, youth with ADHD would use maladaptive cognitive emotion regulation strategies more often and adaptive strategies less often than HC as assessed with the explicit measure. We also expected to find a stronger bias towards negative interpretations of ambiguous information in patients compared to HC as assessed with the implicit measure. Furthermore, if poor cognitive emotion regulation was closely related to ADHD-depression comorbidity, we would expect alterations in cognitive emotion regulation as assessed with the explicit and the implicit measure to be associated with current depressive symptoms in our sample of youth with ADHD.SD = 5.60) and 40 demographically matched HC  participated in the study , anxiety disorders (N = 6), obsessive-compulsive disorder (N = 3), conduct disorder (N = 2), tic disorder (N = 1), and Borderline personality disorder (N = 1). 28 patients (70%) were currently treated with ADHD-relevant medication and eight patients received at least one antidepressant. HC had no psychiatric diagnosis, no family history of ADHD, and were medication-free [see Supplementary Information (SI1)]. The study was approved by the ethical commission of the Medical Faculty, Goethe University, Frankfurt, Germany. All participants gave written informed consent in accordance with the Declaration of Helsinki.All patients met diagnostic criteria for ADHD  according to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition ; DIVA 2.Trained experts rated the severity of ADHD symptoms based on information from the clinical interviews . Participants also completed the attention problems subscale of the Youth Self-Report (YSR) and the Adult Self-Report (ASR) , 72. Theputting into perspective, positive refocusing, positive reappraisal, acceptance, and planning) and „maladaptive strategies“  . Subsequent ANOVAs indicated a significant main effect of group for maladaptive strategies . A group effect was also found when patients with a depression diagnosis were excluded (see SI3-4). With regard to adaptive strategies, the group difference was marginally significant . There was no significant group difference in the use of adaptive strategies when patients with a depression diagnosis were excluded (see SI3-4).Patients reported more frequent use of maladaptive strategies and less frequent use of adaptive strategies compared to HC Table . A MANOVU = 471, p < 0.001, one-tailed), catastrophizing , and rumination . They also reported less frequent use of positive reappraisal . Patients did not significantly differ on any of the other subscales .None of the linear regression models yielded a significant association between either CERQ total scores for adaptive or maladaptive strategies and severity of ADHD symptomatology  and lower scores for CERQ adaptive strategies  were associated with higher scores on the IDS-C30 rating scale  = 6.45, p < 0.001). Lower CERQ total scores for adaptive strategies were also associated with higher BDI-II total scores  = 5.07, p = 0.001). The total score for CERQ maladaptive strategies did not predict BDI-II total score .Linear regression models indicated that higher scores for CERQ maladaptive strategies (SD = 3.10) and 93.83% (SD = 3.16) correct responses in the last training session for patients and HC, respectively . Patients and HC did not differ in the mean number of training sessions . Although performance dropped in the test phase when presenting additional intermediate cues , the percentage of correct responses to the reference cues was still high and did not significantly differ between groups .Participants were able to discriminate the two reference cues  as indicated by 94.67%  = 525.26, p < 0.001, ε2 = 0.87] on bias scores. The main effect of group  and the group x condition interaction  were not significant. Similarly, the robust repeated-measures ANOVA yielded a significant main effect of cue condition (p < 0.001) but no effect of group (p = 0.52) and no interaction effect between the two factors (p = 0.26). As indicated by pairwise follow-up comparisons calculated across both groups, bias scores significantly differed between NR and NN , NN and AM , AM and NP , and NP and PR . As indicated by the ANOVAs, bias scores in the AM condition did not differ between groups  . When conducting a Bayesian independent samples Mann-Whitney-U test, calculation of the Bayes factor (BF01) yielded 4.26 times stronger support for the null hypothesis of no group difference in the bias score in the AM condition over the alternative hypothesis.Figure R2-values < 0.24, all F-values < 2.1, all p-values > 0.09, Supplementary Table 3).None of the linear regression models yielded a significant association between the bias score in the AM condition and severity of ADHD symptomatology  and clinician-rated  depressive symptomatology (Supplementary Table 4).Linear regression models revealed no significant association between bias scores in the AM condition and total scores in self-rated  at an α-level of p < 0.05 with a power of 0.8 in a two-sided t-test [01 = 4.26) provided only moderate evidence for the null hypothesis of no group difference in interpretation bias. Thus, while our study does not suggest a difference in the interpretation of ambiguous information by youth with ADHD compared to HC, our findings do not rule out smaller effects that might be detected by higher-powered studies.The implicit measure of cognitive bias implemented in this study has originally been developed in the context of animal models of depression –79 and td t-test . FurtherThe following limitations need to be considered for the current study. Due to the cross-sectional nature of the study, it is not clear whether the identified differences in cognitive emotion regulation causally contribute to the development of depression. To answer this question longitudinal studies are needed that examine if alterations in cognitive emotion regulation strategies occur before a depressive episode and prospectively predict its onset in youth with ADHD. Also, we cannot exclude that group findings were influenced by sample characteristics. The patient sample was comparable to previous reports in terms of depression rate and the majority of patients was medicated. Taking medication into account by adjusting regression models for ADHD and other medication, the frequencies of adaptive and maladaptive strategies were associated with depressive symptoms in patients. However, in the light of potentially protective effects of ADHD medication against the occurrence and development of depression , and posIn conclusion, the present findings suggest that youth with ADHD have difficulties in the effective use of cognitive emotion regulation strategies, which are linked to their current depressive symptomatology. These deficits in cognitive emotion regulation may also confer a risk to develop later depression among patients with ADHD during the critical developmental window of adolescence and early adulthood. These findings highlight an important candidate risk factor for ADHD-depression comorbidity which should be integrated in future longitudinal studies on comorbidity in ADHD.For the clinical practice, these findings point to the importance of screening for the occurrence of co-morbid depression in adolescents and young adults with ADHD but also monitoring their risk to develop depression. Specifically, the assessment of cognitive emotion regulation strategies in young patients may help therapists to better detect co-morbid depression that often presents in a ruminative quality among youth with ADHD . FurtherSupplementary file1 (DOCX 139 KB)Below is the link to the electronic supplementary material.


A positive association between ADHD and obesity has been repeatedly observed, especially in adult samples[2]. However, only a few studies investigated the prevalence and correlates of ADHD in obese patients seeking bariatric treatment.Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental condition characterized by symptoms of inattention, hyperactivity, and impulsivity, which only rarely remits in adulthoodOur study was aimed to examine the prevalence of probable ADHD comorbidity in a sample of obese patients referred for bariatric surgery. Secondly, we sought to characterize differences in eating behaviour between obese subjects with and without probable ADHD.[5]. The extent of binge-eating/purging and night-eating behaviours were respectively estimated using the Bulimic Investigatory Test, Edinburgh (BITE)[6] and the Night-eating Questionnaire (NEQ)[7]. Wilcoxon test was used for statistical comparisons, with a significance level of p<0.05 set for all tests.The study sample was composed of 110 adult obese patients (BMI ≥ 30 kg/m2) consecutively referred for bariatric surgery to the Obesity Center of the Endocrinology Unit in Pisa University Hospital between November 2010 and May 2012. Probable ADHD was identified using a recently developed screening scale based on items selected from Symptom Check‐List‐90‐R (SCL-90-R)vs. 9.5±3.9, r=0.27, p=0.005).Probable ADHD was found in 14 subjects . Patients with probable ADHD showed significantly higher BITE symptom score  and NEQ total score (16.1±9.2 ADHD is a relatively common comorbidity in obese patients seeking bariatric treatment, which is positively associated with disordered eating habits, such as binge-eating/purging and night-eating behaviours.No significant relationships.


Currently, our understanding remains limited of how co-occurring bipolar disorder and attention deficit hyperactivity disorder (ADHD) should be treated.To evaluate the impact of central stimulant treatment on self-injurious behaviour in patients with a dual diagnosis of bipolar disorder or schizoaffective disorder and ADHD.Retrospective cohort study (LiSIE) into effects and side-effects of lithium as compared to other mood stabilisers. Here, using a mirror-image design, we compared suicide attempts and non-suicidal self-injury events within 6 months and 2 years before and after central stimulant treatment start.Of 1564 eligible patients, 206 patients met inclusion criteria; having a dual diagnosis of bipolar disorder or schizoaffective disorder and ADHD at first central stimulant initiation. In these, suicide attempts and non-suicidal self-injury events decreased significantly within both 6 months (p = 0.004) and 2 years (p = 0.028) after central stimulant start. After multiple adjustments, this effect was preserved 2 years after central stimulant start .Central stimulant treatment may reduce the risk of self-injurious behavior in patients with a dual diagnosis of bipolar disorder or schizoaffective disorder and ADHD. However, to reduce the risk of manic switches, concomitant mood stabilising treatment remains warranted.Michael Ott has been a scientific advisory board member of Astra Zeneca Sweden, Ursula Werneke has received funding for educational activities on behalf of Norrbotten Region : Astra


The most and second likely clusters were located in two areas: (1) the small islands in south-west Japan  and (2) the cities on the base of Mt. Fuji, stretching over three neighboring prefectures of Yamanashi, Shizuoka and Kanagawa (Relative risk = 1.10–1.55 with p < 0.001), respectively. We need to optimize the medical resource allocations based on the evidence in geographical clustering of LBW and/or PTB at specific locations in Japan.In Japan, mean birth weight has significantly decreased from 3152 g in 1979 to 3018 g in 2010 and the prevalence of preterm birth (PTB) has risen to 5.7% in the last thirty years. However, the presence and magnitude of geographical differences in low birthweight (LBW) and/or PTB in Japan is not well understood. We implemented spatial analysis to identify localized clusters and hot spots of LBW and/or PTB during 2012–2016. The Japan national birth database was used in this study. A total of 5,041,685  births were used for spatial analysis using empirical Bayes estimates of the incidence rate of LBW and/or PTB and spatial scan tests to detect hot-spot areas with  LBW is the leading cause of death in under-five children worldwide. It accounts for 80% of all neonatal deaths, of which two-thirds are preterm birth (PTB)6. Around 15 million PTB and more than 20 million LBW, which is one in seven of all births in the world, were observed globally in 2014 and 2015, respectively8. In 2012, a Comprehensive Implementation Plan on Maternal, Infant and Young Child Nutrition was introduced by the World Health Assembly and all member states committed to achieve a global nutrition target of a 30% reduction in the number of infants with LBW by 2025, relative a 2012 baseline9. Recent estimates found that the global LBW incidence has fallen slightly from 17.5% in 2000 to 14.6% in 20157, while the incidence of PTB has increased from 9.8 to 10.6% over the period8. Further, progress toward the target is quite slow in high-income countries such as the UK, Finland, France, Germany, the USA, Australia, and New Zealand8. To meet the global LBW target by the year of 2025, progress must more than double, and improved measurement and program investment to address the causes of LBW throughout the lifecycle is urgently required7.Low birth weight (LBW) is defined by the World Health Organization (WHO) as birth weight less than 2500 g (5.5 lb) irrespective of gestational age. LBW is an important global health issue, having both short- and long-term health consequences. LBW newborns who survive have a higher risk of short-term and long-term morbidities, including non-communicable diseases such as diabetes, hypertension and other cardiovascular diseases7. The mean birthweight of singleton infants in Japan has significantly decreased from 3152 g in 1979 to 3018 g in 201010. PTB prevalence has also increased to 5.7% in the last thirty years8. Several studies reported the trends and maternal risk factors, including parental socio-demographic and economic factors, for LBW and PTB in Japan17. However, there is a lack of evidence of identifying the geographical clusters of LBW and/or PTB in Japan, even though geographical disparities have been identified in other countries and may play an important role in the persistence of PTB and LBW in developed nations20. To the best of our knowledge, only one study explored spatial patterns of LBW in a single administrative area of Japan and reported some LBW prevalent clusters21. Geographical analysis for identifying geographical clusters of LBW and/or PTB helps policymakers to identify priority areas of action as well as boosting public health promotion policies for addressing health issues in those particular areas. This study explores the spatial variation in LBW and/or PTB across all areas in Japan by identifying clusters with statistically significantly elevated or reduced incidence of these events, using a robust national dataset.Despite having an advanced healthcare system, Japan has the second highest prevalence of LBW among the Organization for Economic Cooperation and Development (OECD) countries. In Japan, the prevalence of LBW has increased from 8.6% in 2000 to 9.5% in 201522. Based on the Guidelines for Statistics Law promulgated by the Ministry of Internal Affairs, our application documents for the secondary use of the Vital statistics were submitted to the MHLW and approved. Data from January 1st, 2012 to December 31st, 2016 was extracted for our analysis. In addition to the individual’s birthweight, maternal age, residential address and gestational age were extracted. We excluded multiple births to avoid the bias of a higher risk of LBW for multiple births10. Every infant was categorized as LBW (birthweight < 2500 g) or normal birthweight (NBW) group (birthweight ≥ 2500 g). In addition, they were also categorized as PTB  or term birth . Consequently, the following four groups were considered in this study: LBW, PTB, LBW and term birth (LBW term) and LBW and preterm birth (LBW pre). Since we used national data that the medical profession is required to input at birth, there are essentially no  missing values. If there were missing values, they were dropped.Birth certificate data was obtained from the Ministry of Health, Labor and Welfare in Japan vital registration statistics23. Geographical analysis in this study was conducted at the municipality level. Geographical coordinates defined as the centroid of the area (measured by latitude and longitude) were extracted from map data for each municipality . Empirical Bayes estimates of the age-standardized incidence rate (EBSIR) were used to examine how LBW and/or PTB were geographically distributed in Japan during the study period25. The age-standardization for each municipality was implemented based on the age structure of Japanese population as a reference: the age categories were ≤ 15,  for calculating the age-standardized value. We first calculated the age-standardized values using a direct method, and then the Empirical Bayes estimates was calculated. The advantage of EBSIR is that it can incorporate the information of the spatial neighborhood areas to smooth the risk of LBW and/or preterm birth toward the local  neighborhood mean, stabilizing estimates for municipalities with small numbers of births based on updated information from neighboring municipalities26. The spatial neighborhood was defined as the queen contiguity where spatial neighbors shared at least a common border. The local adjacency matrix was calculated based on the k-nearest neighborhood method with k = 8.Japan was divided into 1902 municipalities at the time of the study, organized within 47 prefecture27. Tango’s statistic for general clustering was used to globally test the existence of clusters in Japan28. Then, to identify the exact locations of geographical clusters of LBW and/or PTB in Japan, the spatial scan statistic and its associated likelihood-based test proposed by Kulldorff and Nagarwalla (1995) were implemented30. The test can identify spatial clusters of any size, located anywhere in the study region. Under the assumption of a Poisson distribution for the occurrence of LBW and/or PTB, the most/second/third likely clusters (MLC/SLC/TLC) were defined by maximum likelihood estimation31. To obtain the corresponding p values, 1000 Monte Carlo (resampling with replacement) iterations were implemented30. Data management was done by using AWK, SQL and Python and statistical analysis was performed with R version 3.6.1. In this paper, statistical significance was defined as a p value less than 0.05. This study was approved by the Ethics Committee at National Center for Child Health and Development (No. 1274). Informed consent is waived by the Ethics Committee at National Center for Child Health and Development. All methods were carried out in accordance with relevant guidelines and regulations.Spatial clusters were defined following: “a geographically bounded group of occurrences of sufficient size and concentration to be unlikely to have occurred by chance”A total of 5,041,685  births were reported in Japan from 2012 to 2016. Among them, 8.23%, 4.74%, 5.23%, and 3.00% were categorized as LBW, PTB, LBWat term, and LBWbut premature, respectively. The reported proportions of births by maternal age were 2.21%, 76.64% and 21.1% for the age of ≤ 20, . Tables p < 0.001). The second most frequently detected area was highland cities around the north-east part of Mt. Fuji . The third frequently detected area was cities around the Kanmon-Kaikyo strait that separates the main island and Kyushu island . It is noteworthy that we observed a distinctive difference in the locations of the clusters between LBW term and LBW pre: LBW infants at term were likely to be clustered around the north-east part of Mt. Fuji , while LBW and premature infants were likely to be clustered around Tohoku or the north part of the Kanto Plain .Figure 32. Previous studies have reported that residents in Area 1 have relatively higher values of risks factors for poor birth outcomes, compared with other areas, such as high smoking rates among pregnant women33 and low parental socioeconomic status (SES), including low household income34. Area 1 has the lowest percentage of students attending college or university in Japan, and these low education levels might have a significant impact on the incidence of LBW35. Finally, Area 1 is located far from the main islands of Japan. Residents of Area 1 are genetically isolated from the major island of Japan36, and thus one of the reasons for the regional difference might be a genetic issue.The study revealed the geographical distribution of LBW and/or PTB in Japan from 2012 to 2016 using population-based data. To the best of our knowledge, this is the first study to identify geographical clusters of LBW and PTB among Japanese singleton live-birth infants using spatial analytical techniques at the municipality level. In this study, we identified several characteristic areas, generally called ‘hot spots’, in an archipelago of small islands in south-west Japan (Amami and Okinawa), and a cluster of cities on the base of Mt. Fuji, stretching over three neighboring prefectures of Yamanashi, Shizuoka and Kanagawa. Although we identified more than two geographical clusters, we confine our discussion to these two areas because they were frequently identified in several sub-groups Tables , 4. In A37. Further, there is a military training ground of the Japan Ground Self-Defense Force, which is the largest training ground in the main islands of Japan. It implicates that noise and vibration from the military ground and air crafts might influence maternal health40. Additionally, Modzelewska et al. (2019) and Okubo et al. (2015) provided the association between green tea intake, which contains high caffeine, and poor birth outcomes 42. Green tea is also one of the products with high pesticide residue contain. There is a report that infants with low birth weight have higher contain of pesticide43. It is well known that residents in Area 2 have high green tea intake in Japan. The high intake of green tea might be possible epidemiological explanation for Area 2 although there was no available data about the intake of green tea in pregnant women. Our study is the first evidence that Area 2 is a geographically clustered area of LBW term. However, since our discussion here still includes speculations and not based on the specific data, further research will be needed to identify the characteristic risk factors specific to this area.In contrast, in Area 2 LBW was only highly clustered among pregnancies brought to term. Residents in Area 2, especially the eastern part of Shizuoka prefecture, which is the center of Area 2, have limited access to necessary antenatal care: the number of obstetricians and gynecologists here is relatively small (7.4 in 2012 compared to a Japanese average of 8.6), the number of hospitals or clinics for delivery has reduced from 141 to 93 between 1995 and 2010The present study is limited by the unavailability of information regarding obstetric, genetic, demographic, cultural, and socioeconomic factors of the parents and their children. Although we used a population-based birth certificate dataset that includes all live births in Japan during the study period, the number of available variables in the dataset was limited to residential addresses, the place of birth, birthweight, sex of infant, maternal age, and gestational age at birth. Therefore, further examination would be required to identify the potential risk factors and predictors that can explain the geographical clusters of LBW and/or PTB in Japan. To address this, we are collecting more detailed information such as maternal BMI, smoking status, alcohol consumption, pregnancy complication, family history, and the quality of hospitals as part of an ongoing study into geographical clustering of birth outcomes. Identification of further risk factors and predictors for the geographical clusters could encourage the future development of effective strategies to promote the prevention of LBW and/or PTB in Japan. In addition, this study excluded multiple births, which are high-risk group and requires special attention. Since these births have different pathology, they are excluded from this study, but the current geographical distribution should be also examined carefully to guarantee the optimal allocation of medical resources. It is our ongoing study.In conclusion, this spatial analysis identified several geographical clusters of term or preterm low birthweight in Japan during the year of 2012–2016. The results can provide a new insight for future genetic, environmental and epidemiological studies on LBW in Japan. It is important to carefully continue monitor the detected areas to ensure that they can receive all the benefits of Japan’s modern health system, and help infants born here to achieve the same health outcomes as the rest of Japan. Moreover, this study showed that even in Japan, a (relatively) homogeneous country, there exist geographical clusters of low birthweight. In addition to standard measures targeting known risk factors of LBW, we suggest that geographical factors should be assessed more in the future.Supplementary Information.


PubMed, Web of Science, and Scopus) and performed a narrative review of a total of 21 articles. The main conclusions of this research were (1) girls with ADHD are more at risk of substance use than boys, although there was no consensus on the prevalence of dual disorders; (2) girls are less frequently treated because of underdiagnosis and because they are more often inattentive and thereby show less disruptive behavior; (3) together with increased impairment in cognitive and executive functioning in girls, the aforementioned could be related to greater substance use and poorer functioning, especially in terms of more self-injurious behavior; and (4) early diagnosis and treatment of ADHD, especially in adolescent girls, is essential to prevent early substance use, the development of SUD, and suicidal behavior.Sex differences are poorly studied within the field of mental health, even though there is evidence of disparities  that can significantly influence the etiology and course of mental disorders. The objective of this work was to review sex differences in adolescents (aged 13–18 years) diagnosed with ADHD  in terms of substance use disorder (SUD), prevalence, pharmacological therapy and mental health. We searched three academic databases ( Sex differences in patients with mental disorders have been little studied ,2, with During puberty, there is an increase in sex hormones which results in changes in the activation and organization of the brain, leading to significant changes in its structure . One of One of the most worrying issues during adolescence is substance use. Epidemiological studies indicate that early adolescent use of alcohol, marijuana, and cocaine increases the risk of substance use disorder (SUD) in adulthood . Indeed,ADHD affects 5–10% of the child population ,18,19. AADHD frequently co-occurs with other psychiatric disorders, such as conduct disorder, obsessive–compulsive disorder, or SUD . Childhohttps://www.crd.york.ac.uk/prospero/display_record.php?RecordID=304765 (accessed on 10 March 2022). The search for relevant studies was conducted in the PubMed (28 October 2021), Web of Science (12 November 2021), and Scopus (20 November 2021) databases. We used several combinations of keywords as follows: (1) ((ADHD OR Gender differences OR Sex differences) AND (Adolescents OR Teenagers OR Teens) AND AND (Substance use OR Substance addiction)); (2) ((ADHD) AND (Gender differences OR Sex differences) AND (Substance use OR Substance addiction) AND (Adolescents OR Teenagers OR Teens)); and (3) ((ADHD) AND (Gender differences OR Sex differences) AND (Adolescents OR Teenagers OR Teens)).The search strategy of this narrative review has taken into account the PRISMA checklist (except items 12–15 and 19–22) . The proThe inclusion criteria were: (1) a diagnosis of ADHD using questionnaires or a clinical interviews according to the DSM-IV , DSM-IV-Two authors independently extracted the information from the articles included in this work by using a standardized form. Any disagreements were resolved though discussion with two of the other authors until a consensus was reached. The variables extracted from the studies were the names of the authors, publication year and country, population, sample age, cohort size, ADHD evaluation instruments used, sexual differences evaluated, substance use, study type, and study quality assessed using the Newcastle Ottawa Scale .The NOS  was usedThe article selection process, which lasted two months, is summarized in The results of these studies were summarized as sex differences in substance use and sex differences in variables that may be related to substance use and addiction: the prevalence of ADHD and pharmacological therapy, cognitive and academic functioning, and other variables. Our review synthesizes the literature on sex differences in substance use, substance use disorder, prevalence, pharmacological therapy, and mental health in adolescents with ADHD. Our results show that ADHD was associated with SUD in adolescence and that girls with ADHD were at an increased risk for some types of SUD, including tobacco, alcohol, marijuana, and cannabis ,52,55,59Yildiz et al. (2020)  found thNevertheless, the results of the study by Madsen and Dalsgaard (2013)  were oppOur study also reviewed sex differences in other variables related to substance use and SUD in adolescents with ADHD. Two of the related variables are the prevalence of ADHD and drug therapy. Our results indicated that boys with ADHD had more accentuated symptoms, and therefore, the prevalence was higher among them. We believe this would lead to an earlier diagnosis in boys than in girls ,50,54, wIndeed, the study of ADHD has long focused primarily on boys  despite Other variables analyzed in this review were sex differences in cognitive and academic functioning in adolescents with ADHD. We identified sex differences among individuals with ADHD in terms of cognitive functioning  and, within this, in impulsivity and attention deficit problems. Adolescent girls had higher levels of cognitive impulsiveness and motor impulsivity ; made moImportantly, in this review, we found that sex is related to suicidal behavior in adolescents with ADHD. Regarding girls, some studies linked the inattentive type of ADHD with an increased risk of suicidal behavior because inattention can be a particularly important deteriorating factor . As we hFinally, we must point out that our review has some limitations. The first is the age range we selected for the inclusion criteria (13 to 18 years). In most of the studies reviewed, the samples comprised children and adolescents, and the data obtained were not broken down into different age ranges to separate the childhood and adolescent periods. In other studies, the age range was much broader, encompassing childhood, adolescence, and young adulthood. However, this limitation can also be considered a strength because this is the period during which sex differences are most evident and substance use most often begins. Another relevant aspect to highlight is that most of the articles we reviewed had included more boys than girls, which could have biased their results. It is also worth noting the variability in these studies both in terms of the instruments used to assess ADHD and the variables of interest in each study. Another limitation was the small number of studies we found regarding each variable and the heterogeneity between them, which made it impossible to quantitatively synthesize the results through a meta-analysis. This meant that the PRISMA criteria  regardinIn our review, we found sex differences in adolescents with a diagnosis of ADHD in terms of prevalence, pharmacological treatment, and mental health. There is evidence that girls with ADHD may be at greater risk of for some types of SUD  than boys with this disorder, especially in mild and moderate cases, where girls present more symptoms of hyperactivity and impulsivity. Meanwhile, adolescents of both sexes who had had severe childhood ADHD showed similar risk levels for substance use. Studies regarding the evolution of adolescents with ADHD from substance use to SUD  are scarce and did not show consistent sex differences. Boys seemed to have a higher prevalence of ADHD and more pronounced symptoms but were diagnosed earlier than girls with ADHD. In contrast, persistent ADHD was less frequent in adolescent girls (partly due to underdiagnosis), and they received treatment less frequently. This was likely both because of underdiagnosis and the fact that they more often presented the inattentive ADHD phenotype, which is associated with fewer disruptive behaviors. The delay in diagnosis, underdiagnosis, and lack of treatment, together with the greater deterioration in cognitive and executive functioning in girls, have all been proposed as reasons for the greater risk of SUD consequently leading to deterioration of functioning in girls with ADHD, especially leading them towards suicidal behavior. Thus, given all the above, early diagnosis and treatment of ADHD is essential, especially in adolescent girls, to help prevent early substance use, SUD, and suicidal behaviors.


Ageratina adenophora could remain its competitive advantages over time by avoiding its autotoxicity. Our results highlighted that the autotoxicity of A. adenophora in its invaded soil was reduced by some microbes. Moreover, an autotoxic allelochemical, 2-coumaric acid glucoside, detected in the invaded soil, demonstrated distinctly autotoxic effects on its seed germination and seedling growth. However, the autotoxic effects were greatly alleviated by a bacterium Bacillus cereus, accumulated by A. adenophora. Furthermore, the allelochemical could be almost completely degraded by B. cereus within 96 h. Accordingly, we speculate that A. adenophora could aggregate B. cereus to release its autotoxicity maintaining its competitive advantages over time.Plant invasive success is attributed to invaders’ ecological advantages over their native neighbors. However, increasing evidence suggests that these advantages are expected to attenuate over time because of natural enemy accumulation, ecological evolution of native species and autotoxicity. We determined how an invasive  The iArthrobacter sp. ZS and Rhodococcus sp. BS), which are purified from the soils invaded by crofton weed (Ageratina adenophora) and from habitats of native species. Then, the observation that specific microorganisms degrade specific allelochemicals excreted by invasive plants is firstly reported. Nonetheless, we do not know whether invasive plants can actively accumulate some microorganisms to relieve their autotoxicity, which actually declines their ecological advantages after a long time of local residence .Professor Aiping Wu was supported by Data will be made available on request.The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.


Emotion dysregulation (ED) is common in attention-deficit/hyperactivity disorder (ADHD) and often results in adverse outcomes. However, ED has been suggested as a transdiagnostic construct, why the specific association between ADHD and ED when adjusting for other mental health conditions needs further investigation. It is also important to determine the aetiological basis of the association between ADHD and ED to inform the theoretical conceptualization of ADHD.This study used a co-twin control design, including a sample of dizygotic (DZ) and monozygotic (MZ) twins . ED was assessed using the dysregulation profile from the parent-rated Child Behaviour Checklist and its adult version. Regression analyses were used across individuals and within the pairs, while adjusting for diagnoses of autism, intellectual disability, other neurodevelopmental conditions and affective conditions.ADHD was significantly associated with ED, even when adjusting for age, sex, attention problems and other mental health conditions, and was the diagnosis most strongly associated with ED. Within-pair analyses revealed that twins with ADHD had higher levels of ED compared to their co-twin without ADHD. This association remained within DZ twins and was non-significant in the MZ subsample, with non-overlapping confidence intervals between the DZ and MZ estimates.ADHD is strongly and in part independently linked to ED, stressing the importance of early detection and treatment of emotional difficulties within this group. The findings from the within-pair analyses indicate a genetic influence on the association between ADHD and ED.The online version contains supplementary material available at 10.1186/s13034-022-00528-0. Attention-deficit/hyperactivity disorder (ADHD) is one of the most common neurodevelopmental conditions (NDCs), affecting  ~ 5% of children, adolescents and adults worldwide . ADHD isED has in recent years been conceptualised as a pivotal transdiagnostic construct underlying several psychiatric diagnoses –12 and hPrevious research investigating the relation between ADHD and ED are limited by a focus on male participants and by often excluding other mental health conditions, why firm conclusions about universality and specificity are hampered , 23. FurGiven the ongoing debate regarding the relation between ED and ADHD, it is of particular interest to assess the aetiological basis for this association. Genetic factors are likely to play a crucial role, since ADHD is highly heritable  and emotIn summary, while there is an established association between ED and ADHD, it remains unclear whether ED is independently related to ADHD when controlling for other mental health conditions, and the genetic and environmental influences desire clarification. It is also important to acknowledge developmental periods when studying ED since regulatory abilities have been shown to improve from age 10 up to late adolescence before tapering off . Hence, We used data from an ongoing project, the Roots of Autism and ADHD Twin Study in Sweden . Note that a substantial proportion of participants had more than one diagnosis (n = 100), thus belonging to more than one of the diagnostic group categories in the statistical analyses. Being discordant for a mental condition meant that one of the twins in a pair had a diagnosis, while their co-twin did not. This study was approved by the National Swedish Ethical Review Board and written and oral informed consent was obtained from all participants. See Table The final sample consisted of 389 twins . Zygosity was determined by single nucleotide polymorphism markers  . The DP p values  < 0.05 were considered significant.Conditional linear regression analyses within the generalized estimating equations framework using the “drgee” package (v.1.1.10) in R (v. 4.0.5) were used , 42. Alln = 11). We also re-calculated the analyses while excluding the attention subscale from our outcome measure, thus only including the summed t-scores of the aggression and anxious/depressed subscales.Because the DP includes a subscale of self-regulatory challenges in attention capacity, and symptoms of inattention are part of the diagnostic criteria for ADHD, any associations found between ADHD and ED could be attributed to this overlap of inattention symptoms. Due to this potential bias, as a post-hoc analysis, we re-calculated the analyses while excluding participants who had an ADHD diagnosis with elevated t-scores only on the attention subscale and not on the other subscales of the DP . The saThe current study extends previous research into the relation between ADHD and ED by using a co-twin control-study design in a sample of deeply phenotyped children, adolescents and adults, enriched for ADHD and other mental health conditions. Our findings suggest that ED is in part independently related to ADHD and that individuals with ADHD seem to be a particularly vulnerable group for ED. Therefore, clinically it appears crucial to address difficulties with ED as a target when developing and evaluating both behavioural and pharmacological treatments in ADHD. In addition, genetic factors seem to influence the relation between ADHD and ED. Future studies should examine the genetic association in more depth to further increase understanding of potentially shared underlying mechanisms. Finally, in order to strengthen the likelihood of early detection of ADHD and develop more stratified treatments, there is a need to further specify how different aspects of ED is characterised in ADHD across development and how this may vary depending on sex, age and ADHD symptoms.Additional file 1:Table S1. Post-hoc analysis for associations across individuals where participants with ADHD and elevated t-scores on the attention subscale only were excluded. Table S2. Post-hoc analysis for within-pairs associations where participants with ADHD and elevated t-scores on the attention subscale only were excluded. Table S3. Post-hoc analysis for associations across individuals where only items from the aggression and anxious/depressed subscales of the DP were included as the outcome measure. Table S4. Post-hoc analysis for within-pairs associations where only items from the aggression and anxious/depressed subscales of the DP were included as the outcome measure.