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Kawasaki disease (KD) is a syndrome of acute systemic vasculitis commonly observed in children. Due to its unclear pathogenesis and the lack of specific diagnostic markers, it is prone to being confused with other diseases that exhibit similar symptoms, making early and accurate diagnosis challenging. This study aimed to develop an interpretable machine learning (ML) diagnostic model for KD. We collected demographic and laboratory data from 3650 patients (2299 with KD, 1351 with similar symptoms but different diseases) and employed 10 ML algorithms to construct the diagnostic model. Diagnostic performance was evaluated using several metrics, including area under the receiver-operating characteristic curve (AUC). Additionally, the shapley additive explanations (SHAP) method was employed to select important features and explain the final model. Using the Streamlit framework, we converted the model into a user-friendly web application to enhance its practicality in clinical settings. Among the 10 ML algorithms, XGBoost demonstrates the best diagnostic performance, achieving an AUC of 0.9833. SHAP analysis revealed that features, including age in months, fibrinogen, and human interferon gamma, are important for diagnosis. When relying on the top 10 most important features, the model's AUC remains at 0.9757. The proposed model can assist clinicians in making early and accurate diagnoses of KD. Furthermore, its interpretability enhances model transparency, facilitating clinicians' understanding of prediction reliability., Competing Interests: Declarations. Competing interests: The authors declare no competing interests. Ethics declarations: This study was approved by the Medical Ethics Committee of Children’s Hospital (Approval Letter of IRB/EC, 2024-IRB-0009-P-01) and waived the need for informed consent from patients, as long as the data of the patient remained anonymous. All of the methods were carried out in accordance with the Declaration of Helsinki., (© 2025. The Author(s).)

Obesity is a chronic condition demanding effective treatment strategies, among which pharmacotherapy plays a critical role. As glucagon-like peptide-1 (GLP-1) agonist approved by the Food and Drug Administration (FDA) for long-term weight management in adults with obesity, liraglutide and semaglutide have great weight loss effect through reducing food intake and delaying gastric emptying. The emergence of unimolecular polypharmacology, which utilizes single molecules to simultaneously target multiple receptors or pathways, marked a revolutionary improvement in GLP-1-based obesity pharmacotherapy. The dual agonist tirzepatide activates both GLP-1 and glucose-dependent insulinotropic polypeptide (GIP) receptors and has shown enhanced potency for weight loss compared to conventional GLP-1 mono agonist. Furthermore, emerging data suggests that unimolecular GLP-1/glucagon (GCG) dual agonist, as well as GLP-1/GIP/GCG triple agonist, may offer superior weight loss efficacy over GLP-1 agonist. This review summarizes the comprehensive mechanisms underlying the pronounced advantages of GLP-1/GIP dual agonist, GLP-1/GCG dual agonist and GLP-1/GIP/GCG triple agonist over GLP-1 mono agonist in weight reduction in obese adults without type 2 diabetes. A deeper understanding of these unimolecular multitargeting GLP-1-based agonists will provide insights for their clinical application and guide the development of new drugs for obesity treatment., (© 2024 John Wiley & Sons Ltd.)

Chronic stress constitutes a major precipitating factor for Major Depressive Disorder (MDD), and comprehending individual differences in stress responses is crucial for the development of effective intervention strategies for MDD. Recent studies indicate that an individual's vulnerability to chronic stress is closely associated with gut microbiota composition, but the underlying mechanisms remain unclear. This study aims to investigate whether the gut microbiota and its metabolites can serve as gut-brain signaling molecules and explores how the gut microbiota affects stress sensitivity. Here, we showed that gut microbiome-derived indole-3-carboxaldehyde (I3C) can act as a gut-brain signaling molecule that links tryptophan metabolism by gut microbes to stress vulnerability in the host. First, we identified a specific reduction in gut microbiome-derived I3C levels in the hippocampus and colon through untargeted and targeted metabolomic analyses. Then, the study of gut microbiota suggested that the relative abundance of lactobacillus was reduced significantly in stress-susceptible rats, whereas fecal microbiota transplantation regulates stress vulnerability. Furthermore, supplementation with I3C and the representative I3C-producing strain, Lactobacillus reuteri, was shown to alleviate depression-like behaviors induced by chronic stress. Further research confirms that I3C can inhibit neuroinflammation and promote hippocampal neurogenesis through the aryl hydrocarbon receptors (AhR) signal pathway, thereby mitigating the host's susceptibility to stress. In conclusion, our findings elucidate that the gut microbiome-derived-I3C can help buffer the host's stress through the AhR/SOCS2/NF-κB/NLRP3 pathway, providing a gut-brain signaling basis for emotional behavior., Competing Interests: Declaration of Competing Interest The authors declare no competing financial interest., (Copyright © 2025 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Acute pancreatitis (AP) is a severe inflammatory disorder associated with metabolic reprogramming and mitochondrial dysfunction. This study investigated central carbon metabolism alterations in pancreatic acinar cells during AP, elucidated the molecular mechanisms of tricarboxylic acid (TCA) cycle disorders, and explored the role of protein hypersuccinylation in AP pathogenesis. Using in vitro and in vivo AP models, targeted metabolomics and bioinformatics analyses revealed TCA cycle dysregulation characterized by elevated succinyl-CoA and decreased succinate levels. Colorimetric assays, mass spectrometry, and site-directed mutagenesis demonstrated that SIRT5 downregulation led to SUCLA2 hypersuccinylation at K118, inhibiting succinyl-CoA synthetase activity and triggering a vicious cycle of succinyl-CoA accumulation and SUCLA2 succinylation. Adenovirus-mediated SIRT5 overexpression and SUCLA2 knockdown clarified the SIRT5-SUCLA2 pathway's role in regulating TCA cycle disorders. Protein succinylation levels positively correlated with pancreatic tissue damage and mitochondrial injury severity. Succinylome analysis identified cytochrome c1 (CYC1) as a key hypersuccinylated protein, and the SIRT5-SUCLA2 pathway regulated its succinylation level and electron transport chain complex III activity. Hypersuccinylation induced mitochondrial DNA release, activating the cGAS-STING pathway, contributing to multiple organ dysfunction syndrome. Modulating the SIRT5-SUCLA2 axis attenuated TCA cycle dysregulation, protein hypersuccinylation, mitochondrial damage, and inflammatory responses in AP. These findings reveal novel mechanisms linking the SIRT5-SUCLA2 axis, TCA cycle dysfunction, and protein hypersuccinylation in AP pathogenesis, providing potential therapeutic targets for AP treatment., Competing Interests: Declaration of competing interest No conflict of interest declared., (Copyright © 2024. Published by Elsevier B.V.)

Incorporating susceptibility genetic variants of risk factors has been reported to enhance the risk prediction of polygenic risk score (PRS). However, it remains unclear whether this approach is effective for lung cancer. Hence, we aimed to construct a meta polygenic risk score (metaPRS) of lung cancer and assess its prediction of lung cancer risk and implication for risk stratification. Here, a total of 2180 genetic variants were used to develop nine PRSs for lung cancer, three PRSs for different histopathologic subtypes, and 17 PRSs for lung cancer-related risk factors, respectively. These PRSs were then integrated into a metaPRS for lung cancer using the elastic-net Cox regression model in the UK Biobank (N = 442,508). Furthermore, the predictive effects of the metaPRS were assessed in the prostate, lung, colorectal, and ovarian (PLCO) cancer screening trial (N = 108,665). The metaPRS was associated with lung cancer risk with a hazard ratio of 1.33 (95% confidence interval: 1.27-1.39) per standard deviation increased. The metaPRS showed the highest C-index (0.580) compared with the previous nine PRSs (C-index: 0.513-0.564) in PLCO. Besides, smokers in the intermediate risk group predicted by the clinical risk model (1.34%-1.51%) with the intermediate-high genetic risk had a 6-year average absolute lung cancer risk that exceeded the clinical risk model threshold (≥1.51%). The addition of metaPRS to the clinical risk model showed continuous net reclassification improvement (continuous NRI = 6.50%) in PLCO. These findings suggest the metaPRS can improve the predictive efficiency of lung cancer compared with the previous PRSs and refine risk stratification for lung cancer., (© 2024 UICC.)

Cadmium (Cd) pollution significantly hampers cleaner production of peanut (Arachis hypogaea L.). Therefore, exploring of tolerance mechanisms to Cd stress and breeding of low-Cd peanut cultivars are urgently needed and require intense efforts. Herein, multi-omics and physiological studies reveal that multiple biological processes, including melatonin (MT) biosynthesis, are involved in the Cd tolerance in peanut plants. Exogenous MT was applied to peanut plants under Cd stress, which decreased Cd accumulation in roots, shoots and seeds for 40%-60%, and promoted the antioxidant capacity. Integrated investigation reveals that MT-mediated Cd tolerance is mainly attributed to the enhanced metabolism of linolenic acid, glutathione (GSH), and phenylpropanoid (lignin), and development of casparian strip in root cell wall. Defense genes, such as non-race-specific disease resistance gene 1/harpininduced gene 1 (NDR1/HIN1)-like in peanut (AhNHL), were also significantly upregulated by MT under Cd stress. Overexpression of the AhNHL gene in tobacco reduced Cd accumulation for 37%-46%, and alleviated photosynthesis-inhibition induced by Cd stress. Transcriptomic analysis suggested that AhNHL confers the Cd tolerance mainly through promoting phenylpropanoid biosynthesis and GSH metabolism. Additionally, exogenous GSH effectively alleviated the Cd stress through improving Cd sequestration and antioxidant capacity in peanut plants, while apply of the GSH biosynthesis inhibitor (buthionine sulfoximine) exacerbated the Cd phytotoxicity. Transcriptomic analysis reveals that exogenous GSH improves Cd tolerance through affecting the expression of genes involved in transcription regulation, and metal ion binding and transport. Our findings provide novel insights into molecular mechanisms underlying Cd tolerance in plants, which would facilitate breeding of low-Cd peanut cultivars., (© 2025 The Author(s). Journal of Pineal Research published by John Wiley & Sons Ltd.)

Purpose: To report a case series of four patients with isolated growth hormone deficiency (IGHD) type I from two Chinese pedigrees and to elucidate phenotype-genotype correlation of IGHD type I and II with GH1 gene alterations in the literature., Methods: Whole exome sequencing (WES) was performed and a literature review was conducted., Results: Four patients presented with extreme growth retardation (height -4.74 to -6.50 SDS) and undetectable peak growth hormone (GH) during GH stimulating test. WES revealed a novel homozygous nonsense mutation, c.316delC (p.L106Cfs*35), in GH1 gene in the the first pedigree. Deletions of exon 1-5 in GH1 gene were identified in the second pedigree. Ideal catch-up growth after GH treatment was achieved. 94 patients with IGHD type I and 240 patients with IGHD type II were included in literature review. Patients with IGHD type I exhibited younger age (3.2 vs 6.0 years, P < 0.001), more severe growth retardation (median height -6.50 vs -3.84 SDS, P < 0.001), lower peak GH levels (0.05 vs 1.70 ng/ml, P < 0.001) and a higher dosage of GH (0.22 vs 0.17 mg/kg/week, P = 0.012) compared to patients with IGHD type II. Gross deletions constituted 72.3% of IGHD type I cases, while splicing mutations and missense mutations comprised 54.2% and 45.0% of IGHD type II cases. In patients with IGHD type I harboring gross deletion, an early age of diagnosis correlated with both a higher height SDS at diagnosis and a better response after GH treatment. Height SDS after GH treatment in patients with IGHD type II carrying splicing mutations was negatively correlated with age at diagnosis., Conclusion: We identified two GH1 gene mutations, c.316delC (p.L106Cfs*35) and deletions of exon 1-5 in four Chinese patients with IGHD type I. They had a good response to GH treatment and gained satisfactory height improvement. Early diagnosis and initiating treatment may lead to a better prognosis., Competing Interests: Compliance with ethical standards. Conflict of interest: The authors declare no competing interests. Ethics approval: The study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the Ethics Committee of the Peking Union Medical College Hospital (I-22PJ2212). Consent to participate: Written informed consent was obtained from all parents of individual patients. Consent to publish: The authors affirm that human research participants provided informed consent for publication of the images in Fig. 1 and Fig.2., (© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Hepatitis B protein x (HBx) is considered a critical contributor to hepatitis B virus (HBV)‑associated liver cancer development. Protein regulator of cytokinesis 1 (PRC1) has been implicated in hepatocarcinogenesis. However, the clinical relevance, biological functions and related regulatory mechanisms of PRC1 in HBV‑associated liver cancer have not yet been clarified. PRC1 expression profiles in liver cancer were obtained from The Cancer Genome Atlas and Gene Expression Profiling Interactive Analysis database and through reverse transcription‑quantitative polymerase chain reaction and immunohistochemistry assays. A series of in vitro and in vivo assays were used to explore the function of the PRC1 gene and the possible mechanisms through which it affects HBV‑associated liver cancer. PRC1 was overexpressed in HBV‑positive liver cancer tissues. Functional studies in vitro demonstrated that HBx induced the expression of the PRC1 gene, which promoted cell autophagy and enhanced viability, invasion and migration. Furthermore, the knockdown of the PRC1 gene or treatment with the autophagosome inhibitor 3‑methyladenine blocked the HBx‑induced autophagic flux, disrupted the formation of autophagosomes, and promoted cell apoptosis. Liver cancer xenograft animal model experiments revealed that inhibition of autophagy by 3‑methyladenine or silencing of the PRC1 gene attenuated HBx‑induced malignant behavior in vivo . The absence of autophagy inhibited the expression of Bcl‑2, induced the expression of Bax, and regulated the levels of Th1 and Th2 cytokines. These results elucidate a mechanism wherein the PRC1 gene participates in the occurrence and development of HBV‑associated liver cancer by modulating autophagy. PRC1 could be a potential therapeutic target for liver cancer.

Background: While numerous studies have quantified the prevalence of reasons for missed care, a comprehensive synthesis of evidence across various health systems remains lacking., Aim: To estimate the pooled prevalence of the reasons reported by nurses for missed care, using data from the MISSCARE surveys., Introduction: Missed nursing care, which refers to any aspect of essential patient care that is omitted or delayed, presents substantial risks to patient safety and the quality of care., Methodology: Four databases (PubMed, Web of Science, Embase, and Scopus) were searched, without language restrictions. Study quality was assessed using Joanna Briggs Institute's critical appraisal tool. A random-effects meta-analysis was used to calculate prevalence estimates and evaluate heterogeneity via prediction intervals. Subgroup analyses were conducted to assess potential sources of heterogeneities. Time trends were estimated using linear regression modeling., Results: Twenty-eight studies (2011-2024) totaling 20768 nurses from 121 hospitals from 14 countries were included. The raw prevalence of missed care ranged from 6.8% to 98.1%, with a median of 56.4% (IQR: 41.0-75.4). The most frequently reported reasons were "unexpected rise in patient volume and/or acuity on the unit" (78.1%; 95% confidence intervals (CI) 71.5-54.1), "inadequate number of staff" (76.5%; 95% CI, 68.7-83.5), and "urgent patient situation" (73.5%; 95% CI, 66.6-79.9). Most of the investigated reasons for missed nursing care showed no significant changes over time., Conclusion: This meta-analysis provides valuable insights that can inform interventions and policies aimed at mitigating missed nursing care, ultimately improving patient safety and healthcare outcomes., Implications for Nursing and Health Policy: This study underscores the global prevalence reasons for missed nursing care. The findings call for comprehensive strategies to address this crucial challenge, regardless of geographic region and economic status of countries. However, special attention should be given to non-university hospitals and hospitals with specific demographic characteristics of nurses., (© 2025 International Council of Nurses.)

To overcome low adsorption capacity, slow adsorption rate, poor adsorption selectivity, and dissolution of peach gum polysaccharide (PGP), an amino-rich crosslinked PGP (ACPGP) was first synthesized by cross-linking highly soluble PGP. Subsequently, a cation-rich PGP (QCPGP) was prepared from ACPGP through the addition of glycidyltrimethyl ammonium chloride (GTAC) and a secondary quaternization. The step-by-step preparation process was confirmed, and the adsorption properties of PGP, ACPGP, and QCPGP were compared in detail. The adsorption of crude PGP for cationic dyes violet (MV, 135.0 mg/g) and methylene blue (MB, 121.4 mg/g) were spontaneous endothermic, following the pseudo-first-order kinetic model and D-R isotherm. Due to the presence of rich charged groups in their structure, their highly selective adsorption towards new coccine (NC) and tartrazine (TTZ) is spontaneous and endothermic, and can be described by the pseudo-first-order and pseudo-second-order kinetic models, respectively. According to the Langmuir isotherm, the Q m of ACPGP and QCPGP for NC and TTZ was calculated to be 876.2 and 1304.3 mg/g (NC), and 814.5 and 1136.7 mg/g (TTZ), respectively. QCPGP exhibited more advantages in terms of adsorption capacity, adsorption rate (equilibrium time of 10 min), environmental stability, adsorption selectivity, and regeneration efficiency, showing great potential in practical wastewater treatment applications., Competing Interests: Declaration of competing interest 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., (Copyright © 2025. Published by Elsevier B.V.)

Patients infected with SARS-CoV-2 may experience acute and long-term immune disorders. Immunological factors are thought to play an important role in Kawasaki disease. To analyze the impact of COVID-19 infection on Kawasaki disease, this study retrospectively analyzed 161 children with Kawasaki disease onset during the COVID-19 pandemic. The proportion of IVIG-Resistant individuals and the rate of corticosteroid use in the 1-7 weeks from COVID-19 infection to Kawasaki disease onset were higher than that of the noninfected group, even after excluding suspected cases of multiple system inflammatory syndrome. Compared to the noninfected group, the level of CD4 was lower, and the levels of CD3 - CD16 + CD56 + , complement C4, TNF-α, and IFN-γ were higher in the 1-7 weeks after COVID-19 infection. In conclusion, the risk of IVIG resistance was significantly increased in children with Kawasaki disease onset 1-7 weeks after COVID-19 infection, which may be related to the long-term impact of COVID-19 on immunity., Competing Interests: Declarations. Competing interests: The authors declare no competing interests. Ethics declarations: This retrospective study involving human participants was in accordance with the ethical standards of the institutional and national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. The medical ethics committee of the Children’s Hospital of Zhejiang University School of Medicine approved this study (NO.: 2023-IRB-0256-P-01). Since the information was anonymized and the submission did not include images that may identify the person, The medical ethics committee of the Children’s Hospital of Zhejiang University School of Medicine waived the need of obtaining individual informed consent forms., (© 2025. The Author(s).)

Kawasaki disease (KD) is a widely prevalent acute vasculitis in children that often leads to cardiovascular complications. Although m 6 A modification plays a crucial role in various cardiovascular diseases, m 6 A-related biomarkers for KD remain unknown. We utilized GEO datasets to perform WGCNA to identify m 6 A-related differentially expressed genes in KD. Feature genes associated with m 6 A and key immune cells were identified using RF and SVM-RFE algorithms, and CIBERSORT, and the correlation was evaluated using CytoHubba and ROC analysis. The expression of hub genes was assessed in blood from patients with KD and in mice with CAWS-induced vasculitis. Our analysis identified four m 6 A-related hub genes: SNRK, PCCB, PIGP, and PRPS1, which exhibited significant negative correlation with M2 macrophages. A total of 477 microRNAs, 22 lncRNAs, and 3 snRNAs were identified as potential regulators of these hub genes. The ROC analysis demonstrated a robust diagnostic accuracy of these hub genes for KD. The expression of these hub genes was reduced in blood from patients with KD and in mice with vasculitis. In conclusion, SNRK, PCCB, PIGP, and PRPS1 demonstrate significant diagnostic value for KD and may also be considered as potential therapeutic targets., Competing Interests: Declaration of competing interest 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., (Copyright © 2025. Published by Elsevier B.V.)

This study aimed to find the most effective PGT-M strategy for Duchenne muscular dystrophy/Becker muscular dystrophy (DMD/BMD), and to reduce misdiagnosis caused by embryo recombination in DMD. A retrospective study was performed by analyzing 158 PGT-M cycles for DMD/BMD in Reproductive and Genetic Hospital of CITIC-Xiangya between 2009 and 2023. Patients' backgrounds were collected. The effectiveness and safety for five different PGT-M strategies (1-5), including mutation testing from cleavage or trophoblast ectoderm (TE) cells and additional linkage analysis post-TE cell amplification, were analyzed. The embryonic recombination events were assessed for these cycles. Mutation analysis showed that 62.4% of the 125 families had DMD deletions, 16.0% had duplications, and 21.6% had single nucleotide variants (SNVs). Among 125 families, 104 (83.2%) had previously affected fetus or offspring. The highest diagnosis rate (99.56%) was achieved with Strategy 5, which combined mutation testing with SNP-based linkage analysis in TE cells. This strategy 5 also demonstrated an advantage in cases with recombination near the mutation. An intragenic recombination rate of 5.5% was observed in embryos, predominantly in the hotspots (exons 45-55 and exons 3-9) of DMD deletion/duplication mutations. Prenatal diagnosis for 52 families and successful outcomes in all 85 healthy deliveries (live birth rate, 65.89%, 85/129) validated the accuracy and effectiveness of PGT-M. This study provides a highly effective PGT-M strategy (Strategy 5) for DMD/BMD by comparing five different strategies, with the diagnostic yield reaching 99.56%. The results underscore the significance of monitoring intragenic recombination in DMD, which is a frequent occurrence in DMD/BMD., Competing Interests: Declarations. Conflict of interests: The authors declare no competing interests., (© 2025. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

The consumption of organophosphorus flame retardants (OPFRs) has surged significantly recent years since global banning of brominated flame retardants (BFRs). Industrial activity is an important source of OPFRs, however there are few studies on OPFRs contamination in the indoor and outdoor atmosphere of industrial areas. A study was conducted to analyze contamination of 15 OPFRs individuals in both indoor and outdoor air and PM 2.5 of living and industrial sites of the petrochemical industrial area (outdoor and indoor sites of living area was LO and LI, outdoor and indoor sites of industrial area was IO and II). The average concentrations of OPFRs in PM 2.5 of LO (16.40 ng/m 3 ) and IO (17.83 ng/m 3 ) were similar, while LI (60.46 ng/m 3 ) was higher than that in II (33.43 ng/m 3 ). The average concentrations of indoor OPFR in PM 2.5 and air in summer were 4.10 and 2.22 times higher than those in winter, respectively. This seasonal concentration variation of OPFRs may attribute to the influence of temperature that accelerated the releasing of OPFRs from materials. Source apportionment results indicated that the indoor source (material emission) was the dominant contributor of indoor OPFRs in PM 2.5 and air, and outdoor sources (industrial and traffic sources) had significant contribution to OPFRs in indoor and outdoor air and outdoor PM 2.5 . The gas-particle partitioning of OPFRs had not reached equilibrium state. The K OA absorption model has better fitting effect for OPFRs with logK OA > 10. The health risk of OPFRs for both adult and child was neglectable. While considering the high contribution of TCEP to carcinogenic risk, and high contribution of TCPP to none-carcinogenic risk, their health risk should be given special attention., Competing Interests: Declaration of competing interest 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., (Copyright © 2024. Published by Elsevier Ltd.)

Bisphenol A diglycidyl ether (BADGE) from the epoxy coating can migrate to food and react with the protein, but the safety of these adducts formed is unknown, besides, after being consumed in large quantities, BADGE may also combine with other proteins supplemented, posing a potential hazard to human health. The binding mechanism and the possible binding products of BADGE and protein were explored by a series of liquid chromatograph-tandem mass spectrometry (LC-MS) methods. Results showed BADGE can modify a variety of amino acid residues with two modification modes, of which the largest number of modifications were cysteine (Cys) and lysine (Lys). Some adducts formed had shown potential toxicity by in-silico toxicity evaluation and needed to be concerned, which provided a new perspective on the safety of epoxy coating. The molecular docking simulation revealed that hydrophobicity and hydrogen bond interactions are the main intermolecular forces in complex formation., Competing Interests: Declaration of competing interest 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., (Copyright © 2025. Published by Elsevier Ltd.)

Objective: The objective of this study is to evaluate the impact of comprehensive individualised interventions on the clinical outcomes of patients with recurrent implantation failure (RIF), as few studies have evaluated their effectiveness., Design: Retrospective cohort study., Setting: Tertiary hospital, from June 2016 to December 2022., Population: Overall, 1546 patients with RIF underwent endometrial biopsy during implantation., Methods: The comprehensive individualised interventions were conducted on the basis of the endometrial histological dating, endometrial CD138 count, endometrial immune-cell proportion and endometrial microbiota testing., Main Outcome Measures: Cumulative ongoing pregnancy rate (cOPR)., Results: The median number of failed transfer cycles was 3 (range, 2-12), and the cOPR was 58.0%. The rates of window of implantation (WOI) displacement, CD138 positivity, imbalanced endometrial immune-cell proportion, endometrial microbiota testing, multiple factors and unexplained RIF were 34.0%, 9.3%, 7.5%, 4.1%, 32.4% and 12.7%, respectively. The cOPRs of the individualised frozen embryo transfers in patients having RIF with WOI displacement, WOI CD138 positivity, imbalanced endometrial immune-cell proportion, endometrial microbiota testing, multiple factors and unexplained RIF were 64.1%, 57.6%, 55.1%, 38%, 64.2% and 34.5%, respectively. After adjusting for basic characteristics through logistic regression analysis, the cOPRs of the WOI displacement group, WOI CD138 positive group and immune-cell proportion imbalanced group remained higher than that of the unexplained RIF group. However, the cOPR was comparable between the endometrial microbiota testing and unexplained RIF groups., Conclusion: Comprehensive individualised interventions may improve clinical outcomes for patients with RIF, warranting further investigation., (© 2025 The Author(s). BJOG: An International Journal of Obstetrics and Gynaecology published by John Wiley & Sons Ltd.)

Microvascular aging, predominantly driven by endothelial cells (ECs) dysfunction, is a critical early event in cardiovascular diseases. However, the specific effects of aging on ECs across the microvascular network segments and the associated mechanisms are not fully understood. In this study, we detected a microvascular rarefaction and a decreased proportion of venular ECs in the subcutaneous adipose tissue of aged mice using light-sheet immunofluorescence microscopy and single-cell RNA sequencing. Moreover, aged ECs, especially in the venular subtype, exhibited a pseudotemporal transition to a terminal state characterized by diminished oxidative phosphorylation and strengthened cytokine signaling. Metabolic flux balance analysis predicted that among the 13 differentially expressed cytokines identified in aged EC subpopulations, Cxcl9 was strongly correlated with impaired oxidative phosphorylation in aged ECs. It was further validated using microvascular ECs treated with Cxcl9. Notably, the G protein-coupled receptor signaling pathway was subsequently suppressed, in which Aplnr suppression was also observed in aged ECs, contributing to their impaired energy metabolism and reduced angiogenesis. Based on these findings, we propose Cxcl9 as a biomarker for aging-related dysfunction of microvascular ECs, suggesting that targeting Cxcl9 signaling may help combat microvascular aging., Competing Interests: Declarations. Competing interests: The authors declare no competing interests., (© 2025. The Author(s).)

Matching ABO blood group antigens between donors and recipients is critical to prevent hyperacute rejection in kidney transplantation. Enzymatic conversion of blood group antigens to the universal O type presents a promising strategy to overcome barriers in ABO-incompatible kidney transplantation. In this study, we employ α-galactosidase from Bacteroides fragilis to convert type B kidneys to type O during hypothermic machine perfusion. After 3 hours of perfusion with enzyme, more than 95% of blood group B antigens in the kidney endothelium are effectively removed. Subsequently, enzyme-treated kidneys are protected from antibody-mediated injuries in an ex vivo simulation of ABO-incompatible kidney transplantation. Encouraged by these results, a discarded type B kidney, following enzymatic conversion, is transplanted into a type O brain-dead recipient with high titer of anti-B antibody. The allograft survives for 63 hours without hyperacute rejection. Blood group B antigens re-express within 48 hours, with histopathological analyses indicating no evidence of antibody-mediated rejection. This enzymatic conversion approach holds the potential to broaden the practice of ABO-incompatible kidney transplantation, decrease waiting times and facilitate equitable organ allocation., Competing Interests: Competing interests: The authors declare no competing interests., (© 2025. The Author(s).)

The study aimed to assess the association of five insulin resistance surrogates, namely HOMA-β (Homeostasis Model Assessment of Beta-cell Function), QUICKI (Quantitative Insulin Sensitivity Check Index), IGR (Insulin Glucose Ratio), e-IS (Estimated Insulin Sensitivity), and Bennett ISI(Bennett's insulin sensitivity index) with all-cause and cardiovascular mortality in respondents with metabolic syndrome(MetS). The prospective cohort of 6662 participants aged 18 years and older with metabolic syndrome was extracted from the National Health and Nutrition Examination Survey(NHANES 1999-2016). The multivariate Cox proportional hazards regression model, Kaplan-Meier survival curve, and log-rank tests were applied to determine the association between the five indices and all-cause mortality and cardiovascular mortality in the MetS population. Restricted cubic splines, a two-piece segmented Cox proportional hazards model, and threshold effect analyses were performed to evaluate the nonlinear relationship. Sensitivity analyses were then conducted by removing individuals with CKD, CHF, CAD, stroke, or cancer, respectively. All five insulin resistance (IR) surrogates displayed a negative association with all-cause and cardiovascular mortality in participants with metabolic syndrome. Restricted cubic spline curves showed QUICKI, IGR, and e-IS had a nonlinear relationship with statistical significance. MetS population at the highest quartile of HOMA-β or IGR exhibited lower all-cause and cardiovascular event probabilities compared with those at the lowest quartile, and e-IS had a similar correlation with cardiovascular events. Threshold effect analyses showed that there were inflection points of IGR for all-cause and cardiovascular mortality. As IGR gradually approached inflection points, the two types of mortality risks descended by 15%[HR 0.85(0.80,0.91)] and 19%[HR 0.81(0.71,0.92)], respectively. Sensitivity analysis indicated most results were robust, but Bennett ISI did not exhibit significant outcomes in participants without CKD. Our study provides evidence that HOMA-β, QUICKI, IGR, e-IS, and Bennett ISI displayed a reverse correlation with all-cause mortality and cardiovascular mortality in participants with metabolic syndrome. The five IR surrogates should be given more attention during the follow-up of MetS population., Competing Interests: Declarations. Competing interests: The authors declare no competing interests., (© 2025. The Author(s).)

Iron overload disease is characterized by the excessive accumulation of iron in the body. To better alleviate iron overload, there is an urgent need for safe and effective small molecule compounds. Rubiadin, the active ingredient derived from the Chinese herb Prismatomeris tetrandra, possesses notable anti-inflammatory and hepatoprotective properties. Nevertheless, its impact on iron metabolism remains largely unexplored. To determine the role of rubiadin on iron metabolism, Western blot analysis, real-time PCR analysis, and the measurement of serum iron were performed. Herein, we discovered that rubiadin significantly downregulated the expression of transferrin receptor 1, ferroportin 1, and ferritin light chain in ferric-ammonium-citrate-treated or -untreated HepG2 cells. Moreover, intraperitoneal administration of rubiadin remarkably decreased serum iron and duodenal iron content and upregulated expression of hepcidin mRNA in the livers of high-iron-fed mice. Mechanistically, bone morphogenetic protein 6 (BMP6) inhibitor LDN-193189 completely reversed the hepcidin upregulation and suppressor of mother against decapentaplegic 1/5/9 (SMAD1/5/9) phosphorylation induced by rubiadin. These results suggested that rubiadin increased hepcidin expression through the BMP6/SMAD1/5/9-signaling pathway. Collectively, our findings uncover a crucial mechanism through which rubiadin modulates iron metabolism and highlight it as a potential natural compound for alleviating iron-overload-related diseases.

Lipid nanoparticles (LNPs) are the most extensively validated clinical delivery vehicles for mRNA therapeutics, exemplified by their widespread use in the mRNA COVID-19 vaccines. The pace of lipid nanoparticle (LNP) development for mRNA therapeutics is restricted by the limitations of existing methods for large-scale LNP screening. To address this challenge, we developed Quantitative Analysis of Reverse Transcribed Barcodes (QuART), a novel nucleic-acid-based system for measuring LNP functional delivery in vivo. QuART uses a bacterial retron reverse transcription system to couple functional mRNA delivery into the cytoplasm with a cDNA barcode readout. Our results demonstrate that QuART can be used to identify functional mRNA delivery both in vitro in cell culture and in vivo in mice. Multiplexing of QuART could enable high-throughput screening of LNP formulations, facilitating the rapid discovery of promising LNP candidates for mRNA therapeutics., Competing Interests: The authors declare no competing financial interest., (© 2025 The Authors. Published by American Chemical Society.)

Whether surgical treatment of tubal pregnancy affects the outcomes of concomitant live normally sited (eutopic) pregnancies is unknown. The purpose of this study was to investigate the outcomes of live eutopic singleton pregnancies following surgical treatment for concomitant fallopian pregnancies. A total of 446 patients who conceived tubal heterotopic pregnancies (HPs) via in vitro fertilization-embryo transfer and underwent surgical treatment to remove ectopic pregnancies (EPs) were included. For each study patient, one matched patient who conceived a live eutopic singleton pregnancy was selected randomly as a control. The rates of early miscarriage, late miscarriage, live birth, preterm birth, low birth weight and perinatal mortality were not significantly different between the study and control groups. The birth weight were also similar between these two groups. However, the caesarean section rate was significantly higher in the study group than that in the control group(P < 0.001). Additionally, laparotomy and laparoscopy for tubal HPs yielded similar pregnancy outcomes. Compared with controls, patients who conceived tubal pregnancies and concomitant live eutopic singleton pregnancies had similar pregnancy outcomes after proper surgical treatment of EPs. These findings can be used for counselling women who have conceived tubal HPs regarding the risks associated with surgical treatment., Competing Interests: Declarations. Ethics approval and consent to participate: The study protocol was approved by the local ethics committee (LL-SC-2023-016). Owing to the retrospective nature of the study, the requirement for informed consent was waived. Competing interests: The authors declare no competing interests., (© 2025. The Author(s).)

The detection of disease-related protein biomarkers plays a crucial role in the early diagnosis, treatment, and monitoring of diseases. The concentrations of protein biomarkers can vary significantly in different diseases or stages of the same disease. However, most of the existing analytical methods cannot simultaneously meet the requirements of high sensitivity and a wide dynamic range. Herein, we developed a digital and analog immunoassay method based on submicron magnetic beads and fluorescent microspheres. The digital analysis achieves a limit of detection as low as 46 fg/mL (1.8 fM) for IL-6, and the analog analysis has a wide dynamic range spanning from 0.2 pg/mL to 10 ng/mL. Furthermore, the analog analysis can be used to quickly and roughly assess higher concentration proteins via visual detection, and the practical application potential of this method was verified by the detection of alpha-fetoprotein in serum samples from 12 healthy individuals and hepatocellular carcinoma patients. The established method does not involve the use of enzymes or costly instruments, which greatly simplifies the experimental steps, shortens the experimental time, and reduces the experimental cost. In view of those advantages, the proposed method has great application prospects in point-of-care applications.

The ionizable lipid component of lipid nanoparticle (LNP) formulations is essential for mRNA delivery by facilitating endosomal escape. Conventionally, these lipids are synthesized through complex, multistep chemical processes that are both time-consuming and require significant engineering. Furthermore, the development of new ionizable lipids is hindered by a limited understanding of the structure-activity relationships essential for effective mRNA delivery. In this work, we have developed a modular platform utilizing the Passerini reaction to rapidly generate large, chemically diverse libraries of biodegradable ionizable lipids. This high-throughput approach enables the systematic exploration of various lipid components-head groups, tails, and spacers-and their impacts on mRNA delivery efficiency. By investigating the hydrogen bonding potential between the lipid's head groups and the mRNA's ribose phosphate complex, we found that optimizing the methylene units between the lipid's head groups and linkages could enhance endosomal escape and, consequently, mRNA delivery efficiencies. Leveraging this insight, our platform has led to the identification of the biodegradable ionizable lipid A4B4-S3, which outperforms the current clinical benchmark, SM-102, in gene editing efficacy in mouse liver following systemic administration and demonstrates the promise for repeat-dose protein replacement treatments. This work not only offers a rapid, scalable method for ionizable lipid synthesis but also deepens our understanding of their structure-activity relationships, paving the way for more effective mRNA therapeutics., Competing Interests: Competing interests statement:Y.X. and B.L. have filed a patent for the development of the described lipids.

Cytotoxic CD4 + T cells (CD4 + CTLs) represent a novel subset of T cells with cytotoxic effects. They recognize target cells in an antigen-specific manner, relying on class II major histocompatibility complex (MHC-II) interactions. CD4 + CTLs exert cytotoxic effects on target cells by secreting cytotoxic molecules such as granzymes, perforin, and granulysin. Recent studies have revealed their significant roles in various autoimmune diseases. This review focuses on the differentiation, phenotypic characteristics, and roles of CD4 + CTLs in different types of autoimmune disorders, aiming to provide new insights for the prevention and treatment of these diseases.

Molybdenum diphosphide (MoP 2 ), a topological semimetal, possesses distinctive properties and applications in catalysis, energy storage, and condensed matter physics. However, synthesizing high-purity MoP 2 is complex and often results in undesired stoichiometric by-products. Additionally, the intrinsic orthorhombic crystal structure makes it difficult to synthesize MoP 2 in a 2D morphology, which is desirable for device and energy applications. Here, the robust synthesis of MoP 2 with a well-defined 2D morphology is achieved using the confined gas-solid phosphorization of a MoS 2 precursor on substrates. The use of 2D precursors and the surface confinement provided by the substrate maintain the 2D morphology and result in a thickness-dependent stoichiometry of the phosphorization products. The chemical composition and crystal structure of MoP 2 nanosheets are comprehensively characterized. At room temperature, MoP 2 nanosheets exhibit metallic transport with high conductivity over 5500 S cm -1 . Furthermore, MoP 2 nanosheets demonstrate excellent electrocatalytic activity and durability for hydrogen evolution in both neutral and acid mediums. Notably, MoP 2 nanosheets possess better durability than amorphous Pt film and commercial Pt/C, positioning MoP 2 as a promising catalyst for hydrogen evolution in neutral mediums. This work advances the synthetic chemistry of 2D MoP 2 and provides 2D semimetals with a novel member for future explorations in diverse fields., (© 2024 Wiley‐VCH GmbH.)

Obesity is a serious health threat, which has affected 16% of adults globally in 2022 and shows a trend toward youthfulness. Leptin, as a regulator of body weight, can suppress appetite and promote energy expenditure, making it potential in obesity treatment. Nevertheless, with the progress of relevant research, it is worth noting that monotherapy with leptin is not an effective strategy since most obese individuals are hyperleptinemic and resistant to leptin, where high levels of leptin fail to exert its weight-loss effects. Therefore, the potential to unlock the weight-loss properties of leptin using pharmacology to improve resistance has provided a new direction for this field. However, most synthetic medicines have retreated from the market due to their undesirable side effects, while natural products are increasingly sought after for drug development due to their minimal side effects. Indeed, natural products are ideal alternatives to oral synthetic agents since a growing body of research has demonstrated their desirable effects on improving leptin resistance through potential therapeutic targets like the JAK2/STAT3 signaling pathway, protein tyrosine phosphatase 1B, the exchange proteins directly activated by cAMP/Ras-related protein 1 signaling pathway, endoplasmic reticulum stress, pro-opiomelanocortin gene, and leptin levels. This review outlines natural products that can improve leptin resistance by inhibiting or activating these targets and evaluates their efficacy in experiments and human clinical trials, offering insights for the development of anti-obesity agents. However, more high-quality clinical research is necessary to validate these findings, as current clinical evidence is constrained by heterogeneity and small sample sizes., (© 2025 John Wiley & Sons Ltd.)

Introduction: Bullying among adolescents is a global public health issue prevalent in schools, posing significant risks to positive adolescent development. Studies have shown that bullied adolescents tend to engage in more bullying perpetration, but this underlying process of longitudinal correlation has not been fully elucidated., Methods: Based on two waves of longitudinal data collected from 347 junior and 144 senior high school students in China (M age  = 13.66 years, SD age  = 1.46, 59.27% boys) at 1-year intervals, two moderated chain-mediation models were used to explore the longitudinal correlations between bullying victimization and bullying perpetration and its underlying processes., Results: The results found a significant positive correlation between adolescents' bullying victimization experiences 1 year prior and bullying perpetration 1 year later. Furthermore, fear of negative evaluation and psychache played a longitudinal chain-mediating role in the process, with self-esteem and grade moderating this mediating pathway, either enhancing or weakening the effect., Conclusions: This study demonstrates that prior bullying victimization is longitudinally and positively associated with subsequent bullying perpetration among adolescents. This process is mediated by fear of negative evaluation and psychache, with self-esteem and grade level as moderators. Based on these conclusions, we have formulated the Threat-Motivation Model, offering a framework to understand the relationship between bullying victimization and bullying perpetration. Practical implications, including strategies to reduce bullying in youth groups, are discussed., (© 2024 Foundation for Professionals in Services to Adolescents.)

Constructing built-in electric field (BIEF) in heterojunction catalyst is an effective way to optimize adsorption/desorption of reaction intermediates, while its precise tailor to achieve efficient bifunctional electrocatalysis remains great challenge. Herein, the hollow Mo/MoS Vn nanoreactors with tunable BIEFs are elaborately prepared to simultaneously promote hydrogen evolution reaction (HER) and urea oxidation reaction (UOR) for sustainable hydrogen production. The BIEF induced by sulfur vacancies can be modulated from 0.79 to 0.57 to 0.42 mV nm -1 , and exhibits a parabola-shaped relationship with HER and UOR activities, the Mo/MoS V1 nanoreactor with moderate BIEF presents the best bifunctional activity. Theoretical calculations reveal that the moderate BIEF can evidently facilitate the hydrogen adsorption/desorption in the HER and the breakage of N─H bond in the UOR. The electrolyzer assembled with Mo/MoS V1 delivers a cell voltage of 1.49 V at 100 mA cm -2 , which is 437 mV lower than that of traditional water electrolysis, and also presents excellent durability at 200 mA cm -2 for 200 h. Life cycle assessment indicates the HER||UOR system possesses notable superiority across various environment impact and energy consumption. This work can provide theoretical and experimental direction on the rational design of advanced materials for energy-saving and eco-friendly hydrogen production., (© 2024 The Author(s). Advanced Materials published by Wiley‐VCH GmbH.)

The cGAS-STING pathway is pivotal in initiating antitumor immunity. However, tumor metabolism, particularly glycolysis, negatively regulates the activation of the cGAS-STING pathway. Herein, Mn galvanic cells (MnG) are prepared via liquid-phase exfoliation and in situ galvanic replacement to modulate tumor metabolism, thereby enhancing cGAS-STING activation for bidirectional synergistic H 2 -immunotherapy. The obtained MnG can be etched by water, enabling efficient and sustained generation of H 2 gas and Mn 2+ . MnG not only activated and amplified the cGAS-STING pathway through the sustained release of Mn 2+ but also regulated tumor glucose metabolism to inhibit the expression of three prime repair exonuclease 2 (TREX2), thereby synergistically enhancing the activation of the cGAS-STING pathway. The injection of MnG into tumors resulted in a robust immune response, thereby providing favorable support for antitumor therapy. Consequently, the combination of MnG with immune checkpoint blockade therapy resulted in significant suppression of both primary tumors and distant tumors. Furthermore, the MnG-lipiodol dispersion exhibited remarkable efficacy in combination with transarterial embolization (TAE)-gas-immunotherapy in a rabbit orthotopic liver tumor model. The present study underscores the significance of employing a metal galvanic cell strategy for enhanced immunotherapy, thereby offering a novel approach for rational design of bioactive materials to augment immunotherapeutic effectiveness., (© 2025 Wiley‐VCH GmbH.)

Gasdermin (GSDM)-mediated pyroptosis involves the induction of mitochondrial damage and the subsequent release of mitochondrial DNA (mtDNA), which is anticipated to activate the cGAS-STING pathway, thereby augmenting the antitumor immune response. However, challenges lie in effectively triggering pyroptosis in cancer cells and subsequently enhancing the cGAS-STING activation with specificity. Herein, we developed intelligent self-cascaded pyroptosis-STING initiators of cobalt fluoride (CoF 2 ) nanocatalysts for catalytic metalloimmunotherapy. CoF 2 nanocatalysts with a semiconductor structure and enzyme-like activity generated a substantial amount of reactive oxygen species (ROS) under stimulation by endogenous H 2 O 2 and exogenous ultrasound. Importantly, we discovered that Co-based nanomaterials themselves induce pyroptosis in cancer cells. Therefore, CoF 2 nanocatalysts initially acted as pyroptosis inducers, triggering caspase-1/GSDMD-dependent pyroptosis in cancer cells via Co 2+ and ROS, leading to mtDNA release. Subsequently, CoF 2 nanocatalysts were further utilized as intelligent STING agonists that were specifically capable of detecting mtDNA and augmenting the activation of the cGAS-STING pathway. These cascade events triggered a robust immune response, effectively modulating the immunosuppressive tumor microenvironment into an immune-supportive state, thereby providing favorable support for antitumor therapy. This innovative strategy not only significantly impeded the growth of the primary tumor but also elicited an immune response to further augment the efficacy of immune checkpoint inhibitors in preventing distant tumor progression. Overall, this study proposed a self-cascade strategy for activating and amplifying the cGAS-STING pathway with specificity mediated by pyroptosis, representing a valuable avenue for future cancer catalytic metalloimmunotherapy.

Objective: To test the hypothesis that a freeze-all strategy would increase the chance of live birth compared with fresh embryo transfer in women with low prognosis for in vitro fertilisation (IVF) treatment., Design: Pragmatic, multicentre, randomised controlled trial., Setting: Nine academic fertility centres in China., Participants: 838 women with a low prognosis for IVF treatment defined by ≤9 oocytes retrieved or poor ovarian reserve (antral follicle count <5 or serum anti-Müllerian hormone level <8.6 pmol/L)., Interventions: Eligible participants were randomised (1:1) to undergo either frozen embryo transfer or fresh embryo transfer on the day of oocyte retrieval. Participants in the frozen embryo transfer group had all of their embryos cryopreserved and underwent frozen embryo transfer later. Participants in the fresh embryo transfer group underwent fresh embryo transfer after oocyte retrieval., Main Outcome Measures: The primary outcome was live birth, defined as the delivery of neonates with a heartbeat and respiration at ≥28 weeks' gestation. Secondary outcomes were clinical pregnancy, singleton or twin pregnancy, pregnancy loss, ectopic pregnancy, birth weight, maternal and neonatal complications, and cumulative live birth after embryo transfers within one year after randomisation., Results: In an intention-to-treat analysis, the rate of live birth was lower in the frozen embryo transfer group than in the fresh embryo transfer group (32% (132 of 419) v 40% (168 of 419); relative ratio 0.79 (95% confidence interval 0.65 to 0.94); P=0.009). The frozen embryo group had a lower rate of clinical pregnancy than the fresh embryo group (39% (164 of 419) v 47% (197 of 419); 0.83 (0.71 to 0.97)). The cumulative live birth rate was lower in the frozen embryo transfer group compared with the fresh embryo transfer group (44% (185 of 419) v 51% (215 of 419), 0.86 (0.75 to 0.99)). No difference was observed in birth weight, incidence of obstetric complications, or risk of neonatal morbidities., Conclusions: Fresh embryo transfer may be a better choice for women with low prognosis in terms of live birth rate compared with a freeze-all strategy. The treatment strategies that prevent fresh embryo transfers, such as accumulating embryos with back-to-back cycles or performing routine preimplantation genetic testing for aneuploidy, warrant further studies in women with a low prognosis., Trial Registration: Chinese Clinical Trial Registry ChiCTR2100050168., Competing Interests: Competing interests: All authors have completed the ICMJE uniform disclosure form at www.icmje.org/disclosure-of-interest/ and declare: RSL reports consulting for Organon, Celmatix and Exeltis. All other authors declare no support from any organisation for the submitted work; no financial relationships with any organisations that might have an interest in the submitted work in the previous three years; and no other relationships or activities that could appear to have influenced the submitted work., (© Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

The advancement of green chemistry and sustainable chemical processes has been significantly facilitated by catalytic systems derived from plant roots, which also present substantial application prospects in the realm of chemical synthesis. This study utilized the roots of Rhizoma Coptidis as a support to successfully fabricate a silver-based nanocatalyst. By depositing silver nanoparticles onto the root material of Coptis chinensis and subjecting it to carbonization, a silver/carbon composite was synthesized, featuring monodisperse silver nanoparticles and a hierarchical mesoporous carbon framework. This composite exhibits robust surface activity, a well-defined pore structure, and superior mechanical properties. The catalyst achieves a catalytic yield nearing 90%, showcasing remarkable activity in terminal alkyne halogenation reactions. Its stability and recyclability are markedly enhanced; it retains 95% of its mass and remains unaltered in the reaction solvent for over 160 h after five cycles. This method simplifies the synthesis of terminal alkynes and their derivatives, rendering the process more environmentally benign and efficacious. Furthermore, it broadens the potential applications of Rhizoma Coptidis in synthetic chemistry and pioneers a novel approach for the synthesis of precious metal catalysts from renewable resources.

Acute respiratory distress syndrome (ARDS) is a clinical syndrome of acute hypoxic respiratory failure caused by diffuse lung inflammation and edema. ARDS can be precipitated by intrapulmonary factors or extrapulmonary factors, which can lead to severe hypoxemia. Patients suffering from ARDS have high mortality rates, including a 28-day mortality rate of 34.8% and an overall in-hospital mortality rate of 40.0%. The pathophysiology of ARDS is complex and involves the activation and dysregulation of multiple overlapping and interacting pathways of systemic inflammation and coagulation, including the respiratory system, circulatory system, and immune system. In general, the treatment of inflammatory injuries is a coordinated process that involves the downregulation of proinflammatory pathways and the upregulation of anti-inflammatory pathways. Given the complexity of the underlying disease, treatment needs to be tailored to the problem. Hence, we discuss the pathogenesis and treatment methods of affected organs, including 2019 coronavirus disease (COVID-19)-related pneumonia, drowning, trauma, blood transfusion, severe acute pancreatitis, and sepsis. This review is intended to provide a new perspective concerning ARDS and offer novel insight into future therapeutic interventions., Competing Interests: The authors declare no conflicts of interest., (© 2025 The Author(s). MedComm published by Sichuan International Medical Exchange & Promotion Association (SCIMEA) and John Wiley & Sons Australia, Ltd.)

Seed color is a key agronomic trait in crops such as peanut, where it is a vital indicator of both nutritional and commercial value. In recent years, peanuts with darker seed coats have gained market attention due to their high anthocyanin content. Here, we used bulk segregant analysis to identify the gene associated with the purplish-red coat trait and identified a novel gene encoding a basic/helix-loop-helix transcription factor, PURPLE RED SEED COAT1 (PSC1), which regulates the accumulation of anthocyanins in the seed coat. Specifically, we found that a 35-bp insertion in the PSC1 promoter increased the abundance of PSC1 mRNA. Transcriptomic and metabolomic analyses indicated that the purplish-red color of the seed coat was the result of decreased expression of anthocyanidin reductase (ANR), leading to increased accumulation of delphinidin, cyanidin, and pelargonidin derivatives. Further analysis revealed that PSC1 interacts with AhMYB7 to form a complex that specifically binds to the ANR promoter to suppress its expression, resulting in increased anthocyanin accumulation. Moreover, overexpression of PSC1 increased anthocyanin content in Arabidopsis thaliana and peanut callus. Our study reveals a new gene that controls seed coat color by regulating anthocyanin metabolism and provides a valuable genetic resource for breeding peanuts with a purplish-red seed coat., (© 2025 Institute of Botany, Chinese Academy of Sciences.)

An increasing number of patients utilizing in vitro fertilization (IVF) and assisted reproductive technology (ART) are characterized as impaired or poor ovarian responders (PORs). Owing to its unclear molecular etiology, the management of patients with age-related ovarian characteristics remains a controversial and complex clinical concern. Therefore, it is important to identify and understand the etiological causes behind POR to develop more effective and efficient management strategies for these patients. In this study, we report a homozygous HSD17B1 (accession number: NM&#95;000413.4) variant (c.718-1G>C) in a patient with POR from a consanguineous family. The proband, a 33-years-old woman, exhibited poor ovarian reserve prestimulation parameters (antral follicle count < 5; anti-Müllerian hormone = 0.386 ng/mL), resulting in the classification of this patient as patient oriented strategies encompassing individualized oocyte number (POSEIDON) group three according to the POSEIDON criteria. Additionally, this patient displayed impaired estradiol production and reduced 17-ketosteroids secretion and multiple ovarian cysts, which differed from previously reported POR cases. Overall, our findings provide valuable insights for researchers and clinicians into the relationships between the phenotype and genotype of POR and the HSD17B1 gene., (© 2025 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Background: Depression is a common mental disorder accompanied by gut microbiota dysbiosis, which disturbs the metabolism of the host. While diurnal oscillation of the intestinal microbiota is involved in regulating host metabolism, the characteristics of the intestinal microbial circadian rhythm in depression remain unknown. Our aim was to investigate the microbial circadian oscillation signature and related metabolic pathways in a mouse model with depression-like behaviours., Methods: Chronic restraint stress (CRS) was used to induce depressive-like behaviours in C57BL/6J mice. The open field test (OFT) and forced swimming test (FST) were used to evaluate anxiety- and depressive-like behaviours in the control and CRS groups. Afterwards, faecal samples from the two groups were collected every four hours from ZT2 (9:00 am) to ZT22 (5:00 am). Faecal 16 S rRNA gene sequencing and metabolomics analysis were performed, and the microbial circadian rhythm was analysed via the MetaCycle package in R/RStudio., Results: CRS mice exhibited depressive-like behaviours after 4 weeks of restriction. Alpha- and beta-diversity analyses revealed that the microbial composition in control and CRS mice oscillated throughout the day. The circadian rhythm analyses revealed that at the phylum level, Bacteroidota, Firmicutes, Cyanobacteria and Patescibacteria showed circadian rhythmicity in the CRS group. At the genus level, Dubosiella and Romboutsia showed circadian rhythmicity in the control group, and Dubosiella abundance was correlated with tryptophan and galactose metabolism. In the CRS group, Bacteroides, Parabacteroides, and Rikenellaceae&#95;RC9&#95;gut&#95;group showed circadian rhythmicity; among these genera, Parabacteroides was related to tryptophan metabolism, axon regeneration, phenylalanine metabolism and tyrosine metabolism., Conclusion: Our data highlight the importance of observing the diurnal oscillation of the microbiome in host with depressive-like states. Rhythmicity in the microbiome may affect the host by regulating distinct metabolic pathways during the light and dark phases. A better combination of microbiota composition and oscillation would help to offer novel insight into key genera and their potential effects on depression., Competing Interests: Declarations. Ethics approval and consent to participate: The animal experiments were approved by the Ethics Committee of Yongchuan Hospital of Chongqing Medical University (Yongchuan, Chongqing, China). Animal care and treatment adhered to the National Institutes of Health Guidelines for Animal Research. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests., (© 2025. The Author(s).)

Renewable energy-powered seawater electrolysis is a green and attractive technique for producing high-purity hydrogen. However, severe chlorideions (Cl - ) and their derivatives tend to corrode anodic catalysts at ampere-level current densities and hinder the application of seawater-to-H 2 systems. Herein, a polycalmagite (PCM)-coated NiFe layered double hydroxide is presented on Ni foam (NiFe LDH@PCM/NF) that exhibits exceptional stability in alkaline seawater. PCM not only acts as a conductive layer to reduce charge transfer resistance of the anodes but also as a polymer-based protective layer to inhibit Cl - adsorption and stabilize metal ions oxidation due to its own anions and strong adhesion, thereby increasing activity and stability during alkaline seawater. Thus, NiFe LDH@PCM/NF only needs a low overpotential of 364 mV to reach up to 1000 mA cm -2 and maintains operation for 500 h without activity degradation. Moreover, a minimal amount of hypochlorite can be detected in electrolyte after a 500-h stability test. This development affords a significant exploration in creating durable and efficient anodes, highlighting the importance of polymer coating toward anti-corrosion in alkaline seawater oxidation., (© 2025 Wiley‐VCH GmbH.)

Objective: To clarify whether intrauterine adhesions (IUAs) affect endometrial receptivity (ER) on the day of ovulation and to compare patients with mild and moderate-severe adhesions., Methods: This prospective cohort study included 592 infertile women with IUAs who underwent frozen-thawed embryo transfer (FET). Patients were divided into groups with or without IUAs; and pregnant and nonpregnant populations based on whether a clinical pregnancy was achieved. The ultrasound ER parameters on the ovulation day were compared. Patients with IUAs were then divided into mild or moderate-severe IUA subgroups according to IUA degree., Results: The proportions of patients with Type B plus Type C endometrial morphology (94% vs. 75%, P<0.001), an endometrial thickness≥8mm (97% vs. 81%, P<0.001), an endometrial volume≥2ml (94% vs. 67%, P<0.001), a frequency of endometrial peristalsis≥2 times/min (84% vs. 53%, P<0.001), low subendometrial volume (11.54 ± 2.94 vs. 9.57 ± 2.35, P<0.001) and subendometrial vascularization flow index (VFI) values (2.70 ± 3.10 vs. 2.23 ± 2.23, P=0.033) and a low live birth rate (65% vs. 56%, P=0.039) were significantly higher in the group without IUAs than in the group with IUAs. The group with moderate-severe IUAs had lower proportion of patients with an endometrial thickness≥8mm (73% vs. 89%, P=0.008) and an endometrial volume ≥2ml (58% vs. 78%, P=0.005), a lower frequency of endometrial peristalsis≥2 times/min (42% vs. 65%, P=0.003), and low subendometrial volume (9.22 ± 2.29 vs. 9.97 ± 2.36, P=0.023) and subendometrial flow index (FI) (31.48 ± 3.64 vs. 33.43 ± 4.17, P=0.002) values than the group with mild IUAs; a high antral follicle count (AFC), basal follicle-stimulating hormone (FSH), and anti-Müllerian hormone (AMH) levels and an endometrial thickness≥8mm were independent predictors of clinical pregnancy., Conclusion: IUAs can affect ER on the ovulation day and the live birth rate during natural cycles. Moderate-severe IUAs have a greater impact on ER than mild adhesions do; however, if these adhesions are treated properly, they do not have adverse effects on the clinical pregnancy rate. A high AFC, basal FSH and AMH levels and an endometrial thickness ≥8 mm were found to be independent predictors of clinical pregnancy., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2025 Ouyang, Peng, Zheng, Mao, Gong, Li, Chen and Li.)

We investigated the correlation between Triglyceride-glucose (TyG) index and cardiovascular disease (CVD) mortality in type 2 diabetes mellitus (T2DM) population across different obesity classications using a cohort study. We analyzed 7867 T2DM participants from the National Health and Nutrition Examination Survey 1999-2018, categorizing them into obese or non-obese group by body mass index (BMI) and waist circumference (WC). Cox regression models were used to estimate the correlation between TyG index and CVD mortality risk, comparing the results across the two obesity classifications. Over a 9.1-year follow-up, 691 CVD deaths occurred. Among non-obese T2DM participants (BMI-defined), the hazard ration for CVD mortality was 1.73 in the fourth quartile group of TyG index compared with the first quartile group. Conversely, among obese T2DM participants (WC-defined), the fourth quartile group of TyG index held a 1.51-fold risk of CVD mortality compared with the first quartile group. The association between obesity and higher CVD risk was observed in WC-defined obesity but not in BMI-defined obesity. A totally opposite relationship appeared between TyG index and CVD mortality based on how obesity was defined using BMI or WC in the T2DM participants, suggesting a reevaluation of BMI's accuracy in predicting mortality risk., Competing Interests: Declarations. Competing interests: The authors declare no competing interests. Ethical approval: The NCHS Ethics Review Board has approved the implementation of NHANES, and all participants have provided written informed consent. Informed consent: The written informed consent of all subjects was obtained following the Declaration of Helsinki. Registry and the registration no. of the stydy/trial: Data: Protocol #2011-17., (© 2025. The Author(s).)

Pulmonary endothelial cell (EC) activation is a key factor in acute respiratory distress syndrome (ARDS). In sepsis, increased glycolysis leads to lactate buildup, which induces lysine lactylation (Kla) on histones and other proteins. However, the role of protein lactylation in EC dysfunction during sepsis-induced ARDS remains unclear. Integrative lactylome and proteome analyses were performed to identify the global lactylome profile in the lung tissues of septic mice. Cut&Tag analysis was used to identify the transcriptional targets of histone H3 lysine 14 lactylation (H3K14la) in ECs. Septic mice presented elevated levels of lactate and H3K14la in lung tissues, particularly in pulmonary ECs. Suppressing glycolysis reduced both H3K14la and EC activation, suggesting a link between glycolysis and lactylation. Moreover, H3K14la was enriched at promoter regions of ferroptosis-related genes such as transferrin receptor (TFRC) and solute carrier family 40 member 1 (SLC40A1), which contributed to EC activation and lung injury under septic conditions. For the first time, we reported the role of lactate-dependent H3K14 lactylation in regulating EC ferroptosis to promote vascular dysfunction during sepsis-induced lung injury. Our findings suggest that manipulation of the glycolysis/H3K14la/ferroptosis axis may provide novel therapeutic approaches for sepsis-associated ARDS., Competing Interests: The authors declare no conflicts of interest., (© 2025 The Author(s). MedComm published by Sichuan International Medical Exchange & Promotion Association (SCIMEA) and John Wiley & Sons Australia, Ltd.)

Disseminated intravascular coagulation (DIC) is a complex and serious condition characterized by widespread activation of the coagulation cascade, resulting in both thrombosis and bleeding. This review aims to provide a comprehensive overview of DIC, emphasizing its clinical significance and the need for improved management strategies. We explore the primary causes of DIC, including sepsis, trauma, malignancies, and obstetric complications, which trigger an overactive coagulation response. At the molecular level, DIC is marked by excessive thrombin generation, leading to platelet and fibrinogen activation while simultaneously depleting clotting factors, creating a paradoxical bleeding tendency. Diagnosing DIC is challenging and relies on a combination of existing diagnostic criteria and laboratory tests. Treatment strategies focus on addressing the underlying causes and may involve supportive care, anticoagulation therapy, and other supportive measures. Recent advances in understanding the pathophysiology of DIC are paving the way for more targeted therapeutic approaches. This review highlights the critical need for ongoing research to enhance diagnostic accuracy and treatment efficacy, ultimately improving patient outcomes in those affected by DIC., Competing Interests: The authors have declared that no conflict of interest exists., (© 2025 The Author(s). MedComm published by Sichuan International Medical Exchange & Promotion Association (SCIMEA) and John Wiley & Sons Australia, Ltd.)

Objective: To elucidate the metabolic mechanisms by which acteoside (ACT) isolated from Cistanche tubulosa alleviates cancer-related fatigue (CRF) in a murine model of colon cancer with cachexia., Methods: BALB/c mice inoculated with C26 colon cancer cells were treated with paclitaxel (PTX, 10 mg/kg) and ACT (100 mg/kg) alone or in combination for 21 days. Fatigue-associated behaviors, tumor inhibition rate, and skeletal muscle morphology assessed by hematoxylin-eosin (H&E) staining and electron microscopy were evaluated. Finally, liquid chromatography-mass spectrometry (LC/MS) was employed to investigate alterations in the plasma metabolic profile of tumor-bearing mice with CRF in response to ACT treatment, and the affinity between metabolite-associated proteins and ACT was verified by Surface plasmon resonance (SPR) assay., Results: Our study demonstrated the presence of CRF in the colon cancer mouse model, with the severity of fatigue increasing alongside tumor growth. Administration of ACT ameliorated both tumor burden and PTX-induced muscle fatigue-like behavior. LC/MS analysis identified a panel of differentially regulated metabolites, including trans-aconitine, citric acid, 3-coumaric acid, ephedrine, thymine, cytosine, indole-3-acetic acid, and pantothenol-9. These metabolites were primarily enriched in pathways associated with valine biosynthesis, tyrosine metabolism, tryptophan metabolism, and biosynthesis of pyridine alkaloids. Furthermore, several key enzymes, including CYP3A4, CYP19A1, CYP2E1, TNF, BCL-2, RYR2, and ATP2A1, were identified as potential targets underlying the anti-CRF effects of ACT., Conclusion: This study suggests that ACT derived from C. tubulosa harbors protective properties against cancer-related fatigue mediated by tumor cells., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2025 Zhang, Gong, Liu, You, Liu, Yang and Hu.)

Background: Insulin resistance proxy indicators are significantly associated with cardiovascular disease (CVD) and diabetes. However, the correlations between the estimated glucose disposal rate (eGDR) index and CVD and its subtypes have yet to be thoroughly researched., Methods: 10,690 respondents with diabetes and prediabetes from the NHANES 1999-2016 were enrolled in the study. Three machine learning methods (SVM-RFE, XGBoost, and Boruta algorithms) were employed to select the most critical variables. Logistic regression models were established to evaluate the association between eGDR and CVD. We applied ROC curves, C-statistics, NRI, IDI, calibration curves, and DCA curves to assess model performance. Subgroup analyses were conducted to investigate the association among different subgroups., Results: Participants in the higher quartile showed a decreased prevalence of CVD. Multivariate logistic regression models and RCS curves demonstrated that eGDR had an independently negative linear correlation with the likelihood of CVD[Q4 vs. Q1: OR 0.24(0.18,0.32)], CAD[OR 0.81(0.78,0.85)], CHF[OR 0.81(0.76,0.86)], and stroke[0.85(0.80,0.90)]. Model evaluation showed better performance in fully adjusted models than basic models[C-statistics(Model 3 vs. Model 1): CVD(0.683 vs. 0.814), CAD(0.672 vs. 0.807), CHF(0.714 vs. 0.839) and stroke(0.660 vs. 0.790)]. The AUCs of eGDR were significantly higher than the values of other IR surrogates in the unadjusted models, and slightly higher in the fully adjusted models. Subgroup analyses indicated that the results were robust., Conclusion: A lower eGDR was significantly associated with a heightened likelihood of CVD and its subtypes in diabetic and prediabetic populations. And eGDR exhibited better performance in evaluating the associations compared to other IR proxies encompassing TyG, HOMA-IR, QCUIKI, METS-IR, etc., Competing Interests: Declarations. Competing interests: The authors declare no competing interests. Ethics approval and consent to participate: The protocol of NHANES was approved by National Center for Health Statistics (NCHS) Ethical Review Board and informed consent was obtained from all participants., (© 2025. The Author(s).)

Perovskite oxides have a wide variety of physical properties that make them promising candidates for versatile technological applications including nonvolatile memory and logic devices. Chemical tuning of those properties has been achieved, to the greatest extent, by cation-site substitution, while anion substitution is much less explored due to the difficulty in synthesizing high-quality, mixed-anion compounds. Here, nitrogen-incorporated BaTiO 3 thin films have been synthesized by reactive pulsed-laser deposition in a nitrogen growth atmosphere. The enhanced hybridization between titanium and nitrogen induces a large ferroelectric polarization of 70 μC/cm 2 and high Curie temperature of ~1213 K, which are ~2.8 times larger and ~810 K higher than in bulk BaTiO 3 , respectively. These results suggest great potential for anion-substituted perovskite oxides in producing emergent functionalities and device applications.

Petal size, a crucial trait in the economically important ornamental rose (Rosa hybrida), is synergistically regulated by cell division and cell expansion. Cell division primarily occurs during the early development of petals. However, the molecular mechanism underlying the regulation of petal size is far from clear. In this study, we isolated the transcription factor gene RhSCL28, which is highly expressed at the early stage of rose petal development and is induced by cytokinin. Silencing RhSCL28 resulted in a reduced final petal size and reduced cell number in rose petals. Further analysis showed that RhSCL28 participates in the regulation of cell division by positively regulating the expression of the cyclin genes RhCYCA1;1 and RhCYCB1;2. To explore the potential mechanism for cytokinin-mediated regulation of RhSCL28 expression, we investigated the cytokinin response factor RhRR1 and determined that it positively regulates RhSCL28 expression. Like RhSCL28, silencing RhRR1 also resulted in smaller petals by decreasing cell number. Taken together, these results reveal that the RhRR1-RhSCL28 module positively regulates petal size by promoting cell division in rose., (© The Author(s) 2024. Published by Oxford University Press on behalf of the Society for Experimental Biology. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.)

Background: Recent studies suggest that the anterior limb of the internal capsule may be an area of convergence for multiple compulsion loops. In this study, the role of different dopaminergic compulsion loops in the mechanism of obsessive-compulsive disorder (OCD) was investigated by selectively damaging dopaminergic neurons or fibers in the corresponding targets with 6-hydroxydopamine (6-OHDA) and depicting the anatomical map of various compulsion loops located in the anterior limb of the internal capsule., Methods: A total of 52 male Sprague Dawley (SD) rats were exposed to either saline (1 mL/kg, NS group, n = 6) or quinpirole (QNP, dopamine D2-agonist, 0.5 mg/kg, n = 46) twice weekly for 5 weeks. After each injection, the rats were placed on an open field to analyze aspects of their behaviour, including the number of home base visits (NOH), average time between each home base visit (ATBO), and total distance travelled (TDM). After model setup, 46 QNP rats were divided randomly into five groups: 6-OHDA anterior limb of internal capsule (AC) stereotactic injection group (QNP+AC group, n = 10), 6-OHDA mediodorsal thalamic nucleus (MD) stereotactic injection group (QNP+MD group, n = 10), 6-OHDA nucleus accumbens (NAC) stereotactic injection group (QNP+NAC group, n = 10), saline stereotactic injection group (QNP+NS-S group, n = 10), and non-surgical group (QNP+Non-S group, n = 6). In the NS group, rats simultaneously received a 6-OHDA stereotactic injection (NS+6-OHDA-S group, n = 6: AC2, MD2, NAC2). All QNP-treated rats were then continued to be given QNP twice a week for 4 weeks, and their behaviour was observed after each infusion. After 4 weeks, immunofluorescence staining was used to monitor the distribution of dopamine neurons and nerve fibers in different areas of the intervention nerve loops, and quantitative analysis was performed., Results: Compulsive behaviour declined gradually in the QNP+AC and QNP+NAC groups 3 and 4 weeks after surgery, with the QNP+AC group decreasing more rapidly. The QNP+MD group had decreased by 3 weeks after surgery but increased to almost the same level as pre-surgery at 4 weeks post-surgery. Postoperative fluorescence staining and quantitative analysis suggested the number of dopamine (DA) neurons or nerve fibers in the corresponding target area of the 6-OHDA injection were significantly reduced compared with the QNP+Non-S group., Conclusions: 6-OHDA selectively damages the targets of dopaminergic neurons or nerve fibers within the OCD loop, which somewhat alleviates compulsive behaviours. The results suggest that the AC might be the best target for therapeutic interventions for OCD., (© 2025 The Author(s). Published by IMR Press.)

Objective: Clinically, prostate cancer (PCa) is a common cancer among males, with the primary treatment being radical prostatectomy, which, nevertheless, has side effects. Multidisciplinary team (MDT) care, a new nursing method, could facilitate accurate diagnosis and individualized treatment. This study explored the perioperative nursing effect of MDT on patients undergoing da Vinci robot-assisted radical prostatectomy., Methods: A total of 146 patients underwent radical resection of prostate cancer in The First Affiliated Hospital, Sun Yat-sen University from January 2023 to February 2024. They were divided into the MDT group (n = 77) and conventional care group (CC group, n = 69) according to the care modes; The data collected during the nursing period were collected and compared., Results: The baseline characteristics of the two groups before care were similar, showing no significant difference ( p > 0.05). After the implementation of care, resuscitation chamber dwell time and the quality of life and anxiety scores at each stage were better in the MDT than in the CC group, and the difference was statistically significant ( p < 0.05)., Conclusions: Patients with radical resection of prostate cancer exhibit a high need for physical and psychological nursing. The implementation of a multidisciplinary nursing team led by nurses plays a major role in improving the anesthetic resuscitation effect while assisting in improving quality of life and anxiety., Competing Interests: The authors declare no conflict of interest., (© 2025 The Author(s).)

Hydrogen is an essential energy resource, playing a pivotal role in advancing a sustainable future. Electrolysis of seawater shows great potential for large-scale hydrogen production but encounters challenges such as electrode corrosion caused by chlorine evolution. Herein, a durable CoCO 3 /CoFe layered double hydroxide (LDH) electrocatalyst is presented for alkaline seawater oxidation, showcasing resistance to corrosion and stable operation exceeding 1,000 h at a high current density of 1 A cm -2 . The results indicate that CoCO 3 within the electrocatalyst undergoes conversion into CoOOH and releases CO 3 2- during electrolysis. The incorporation of CO 3 2- within its layers and the anchoring of the electrocatalyst's surface prevent the adverse adsorption of chloride ions, enhancing resistance to chloride ion corrosion, thereby protecting the active sites of the electrocatalyst effectively., (© 2024 Wiley‐VCH GmbH.)