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Background: Flood disasters are projected to increase in severity, duration, and frequency in the context of climate change, and the risks of mortality and morbidity may increase after floods, which will overwhelm health systems., Objective: This study aims to synthesize current epidemiological evidence about the impacts of floods on mortality and morbidity., Method: After performing a systematic literature search from 2000 to 2023, we included studies involving human participants, with exposures of floods, and with outcomes of mortality or morbidity., Results: In total, 37 studies were included in evidence syntheses. Meta-analyses yielded an overall relative risk of 1.26 (95% confidence interval [CI]: 1.10, 1.46), 1.10 (1.08, 1.13), 1.11 (1.04, 1.20), and 1.38 (1.18, 1.62) for all-cause mortality and morbidities of overall gastrointestinal diseases, diarrhea diseases, and dysentery, respectively. Although meta-analyses were not conducted, evidence from at least three studies consistently supported that exposure to floods was associated with increased risks of malaria and respiratory diseases. The evidence for other outcomes was reported but either limited or uncertain., Conclusion: This study suggests that exposure to floods is associated with increased risks of all-cause mortality and morbidities of overall gastrointestinal diseases, diarrhea diseases, dysentery, malaria, and respiratory diseases, while further research is urgently called., 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 The Authors. Published by Elsevier Inc. All rights reserved.)

Background: Non-optimum temperatures are associated with a considerable mortality burden. However, there is a lack of evaluation of labour productivity losses related to premature deaths due to non-optimum temperatures. This study aimed to quantify the labour productivity burden associated with premature deaths related to non-optimum temperatures and explore the potential socio-economic vulnerabilities., Methods: Daily all-cause mortality data were collected from 1,066 locations in 7 countries (Australia, Brazil, Canada, Chile, New Zealand, South Korea, and Thailand). Productivity-Adjusted Life-Year (PALY) loss due to each premature death was calculated to measure the labour productivity loss, by multiplying the years of working life lost by the proportion of the equivalent full-time (EFT) workers. A two-stage times series design and the generalized linear regression model with a quasi-Poisson family were applied to assess the association between non-optimum temperatures and the PALY loss due to premature deaths., Results: We observed a U-shaped relationship between temperature and PALY lost due to premature mortality. We estimated that 2.51% (95% eCI: 2.05%, 2.92%) of PALY losses could be attributed to non-optimal temperatures, with cold-related deaths contributing 1.26% (95% eCI: 0.94%, 1.54%) and heat-related deaths contributing 1.25% (95% eCI: 0.96%, 1.51%). Cold temperature contributed to the most PALYs lost in those aged 45-54 and 55-64, while heat-related losses predominated among the 15-44 age group. We also observed that the fractions of PALY lost attributed to extreme heat were positively associated with the relative deprivation index, while negatively associated with GDP per capita., Conclusion: This multi-country study highlights that non-optimum temperatures led to a considerable labour productivity loss and socioeconomically disadvantaged communities experience greater losses., 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 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Background: The proportion of intense tropical cyclones is expected to increase in a changing climate. However, there is currently no consistent and comprehensive assessment of infectious disease risk following tropical cyclone exposure across countries and over decades. We aimed to explore the tropical cyclone-associated hospitalisation risks and burden for cause-specific infectious diseases on a multi-country scale., Methods: Hospitalisation records for infectious diseases were collected from six countries and territories (Canada, South Korea, New Zealand, Taiwan, Thailand, and Viet Nam) during various periods between 2000 and 2019. The days with tropical cyclone-associated maximum sustained windspeeds of 34 knots or higher derived from a parametric wind field model were considered as tropical cyclone exposure days. The association of monthly infectious diseases hospitalisations and tropical cyclone exposure days was first examined at location level using a distributed lag non-linear quasi-Poisson regression model, and then pooled using a random-effects meta-analysis. The tropical cyclone-attributable number and fraction of infectious disease hospitalisations were also calculated., Findings: Overall, 2·2 million people who were hospitalised for infectious diseases in 179 locations that had at least one tropical cyclone exposure day in the six countries and territories were included in the analysis. The elevated hospitalisation risks for infectious diseases associated with tropical cyclones tended to dissipate 2 months after the tropical cyclone exposure. Overall, each additional tropical cyclone day was associated with a 9% (cumulative relative risk 1·09 [95% CI 1·05-1·14]) increase in hospitalisations for all-cause infectious diseases, 13% (1·13 [1·05-1·21]) for intestinal infectious diseases, 14% (1·14 [1·05-1·23]) for sepsis, and 22% (1·22 [1·03-1·46]) for dengue during the 2 months after a tropical cyclone. Associations of tropical cyclones with hospitalisations for tuberculosis and malaria were not significant. In total, 0·72% (95% CI 0·40-1·01) of the hospitalisations for all-cause infectious diseases, 0·33% (0·15-0·49) for intestinal infectious diseases, 1·31% (0·57-1·95) for sepsis, and 0·63% (0·10-1·04) for dengue were attributable to tropical cyclone exposures. The attributable burdens were higher among young populations (aged ≤19 years) and male individuals compared with their counterparts, especially for intestinal infectious diseases. The heterogeneous spatiotemporal pattern was further revealed at the country and territory level-tropical cyclone-attributable fractions showed a decreasing trend in South Korea during the study period but an increasing trend in Viet Nam, Taiwan, and New Zealand., Interpretation: Tropical cyclones were associated with persistent elevated hospitalisation risks of infectious diseases (particularly sepsis and intestinal infectious diseases). Targeted interventions should be formulated for different populations, regions, and causes of infectious diseases based on evidence on tropical cyclone epidemiology to respond to the increasing risk and burden., Funding: Australian Research Council, Australian National Health, and Medical Research Council., Competing Interests: Declaration of interests We declare no competing interests., (Copyright © 2024 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license. Published by Elsevier Ltd.. All rights reserved.)

Owing to extensive plastic consumption, wastewater from households, business establishments, and industrial activities have been recognised as a significant contributor to microplastics (MPs) in aquatic environments. This case study represents the first investigation of MPs in the Nakdong River, Republic of Korea, that traverses through the largest industrial complex midstream and densely populated cities of Daegu and Busan downstream before flowing into the sea. Monitoring of MP abundance in effluents discharged from three municipal, two industrial, and one livestock wastewater treatment plant (WWTP) into the Nakdong River was conducted over four seasons from August 2022 to April 2023. Identification and quantification of MPs were performed using micro-Fourier transform infrared spectrometry. Seasonal variation in MPs in the Nakdong River was found to be strongly influenced by the nearest upstream WWTPs and rivers, exhibiting a linear relationship that decreased gradually with increasing distance from the WWTPs. The average concentrations of MPs in the six effluent sources ranged from 101 ± 13 to 490 ± 240 particles/L during the yearly monitoring period, while MP concentrations in the river ranged between 79 ± 25 and 120 ± 43 particles/L. Industrial effluents contained higher amounts of discharged MPs (314 ± 78 particles/L) than municipal sources (201 ± 61 particles/L). Notably, two municipal WWTPs, located in the highly densely populated city, discharged the highest total MP amounts per day and released the greatest volumes of effluents. This study provides valuable insights into the monitoring and impact of effluents on MPs in rivers, which could inform MP treatment and management strategies for in river and marine environments., 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 Elsevier Ltd. All rights reserved.)

Objective: To evaluate associations of wildfire fine particulate matter ≤2.5 mm in diameter (PM2.5) with diabetes across multiple countries and territories., Research Design and Methods: We collected data on 3,612,135 diabetes hospitalizations from 1,008 locations in Australia, Brazil, Canada, Chile, New Zealand, Thailand, and Taiwan during 2000-2019. Daily wildfire-specific PM2.5 levels were estimated through chemical transport models and machine-learning calibration. Quasi-Poisson regression with distributed lag nonlinear models and random-effects meta-analysis were applied to estimate associations between wildfire-specific PM2.5 and diabetes hospitalization. Subgroup analyses were by age, sex, location income level, and country or territory. Diabetes hospitalizations attributable to wildfire-specific PM2.5 and nonwildfire PM2.5 were compared., Results: Each 10 µg/m3 increase in wildfire-specific PM2.5 levels over the current day and previous 3 days was associated with relative risks (95% CI) of 1.017 (1.011-1.022), 1.023 (1.011-1.035), 1.023 (1.015-1.032), 0.962 (0.823-1.032), 1.033 (1.001-1.066), and 1.013 (1.004-1.022) for all-cause, type 1, type 2, malnutrition-related, other specified, and unspecified diabetes hospitalization, respectively. Stronger associations were observed for all-cause, type 1, and type 2 diabetes in Thailand, Australia, and Brazil; unspecified diabetes in New Zealand; and type 2 diabetes in high-income locations. An estimate of 0.67% (0.16-1.18%) and 1.02% (0.20-1.81%) for all-cause and type 2 diabetes hospitalizations were attributable to wildfire-specific PM2.5. Compared with nonwildfire PM2.5, wildfire-specific PM2.5 posed greater risks of all-cause, type 1, and type 2 diabetes and were responsible for 38.7% of PM2.5-related diabetes hospitalizations., Conclusions: We show the relatively underappreciated links between diabetes and wildfire air pollution, which can lead to a nonnegligible proportion of PM2.5-related diabetes hospitalizations. Precision prevention and mitigation should be developed for those in advantaged communities and in Thailand, Australia, and Brazil., (© 2024 by the American Diabetes Association.)

Background: Exposure to floods might increase the risks of adverse birth outcomes. However, the current evidence is scarce, inconsistent, and has knowledge gaps. This study aims to estimate the associations of flood exposure before and during pregnancy with adverse birth outcomes and to identify susceptible exposure windows and effect modifiers., Methods: In this cohort study, we obtained all the birth records occurring in Greater Sydney, Australia, from Jan 1, 2001, to Dec 31, 2020, from the New South Wales Midwives Data Collection and in the Brisbane metropolitan region, Australia, from Jan 1, 1995, to Dec 31, 2014, from the Queensland Health Perinatal Data Collection. For each birth, residential address and historical flood information from the Dartmouth Flood Observatory were used to estimate the numbers of days with floods during five exposure windows (Pre-1 was defined as 13-24 weeks before the last menstrual period [LMP], Pre-2 was 0-12 weeks before the LMP, trimester 1 [Tri-1] was 0-12 weeks after the LMP, trimester 2 [Tri-2] was 13-28 weeks after the LMP, and trimester 3 [Tri-3] was ≥29 weeks after the LMP). We estimated the hazard ratios (HRs) of adverse birth outcomes (preterm births, stillbirths, term low birthweight [TLBW], and small for gestational age [SGA]) associated with flood exposures in the five exposure windows using Cox proportional hazards regression models., Findings: 1 338 314 birth records were included in our analyses, which included 91 851 (6·9%) preterm births, 9831 (0·7%) stillbirths, 25 567 (1·9%) TLBW, and 108 658 (8·1%) SGA. Flood exposure in Pre-1 was associated with increased risks of TLBW (HR 1·06 [95% CI 1·01-1·12]) and SGA (1·04 [1·01-1·06]); flood exposure during Tri-1 was associated with increased risks of preterm births (1·03 [1·002-1·05]), stillbirth (1·11 [1·03-1·20]), and SGA (1·03 [1·01-1·06]). In contrast, flood exposures during Pre-2 and Tri-3 were associated with reduced risks., Interpretation: Exposures to floods in Pre-1 and Tri-1 are both associated with increased risks of adverse birth outcomes, and the risks increase with a higher exposure. Upon planning for conception and prenatal care, individuals and health practitioners should raise awareness of the increased risks of adverse birth outcomes after experiencing floods., Funding: The Australian Research Council and the Australian National Health and Medical Research Council., Competing Interests: Declaration of interests We declare no competing interests., (Copyright © 2024 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license. Published by Elsevier Ltd.. All rights reserved.)

Background: Depression in late life has been associated with reduced quality of life and increased mortality. Whether the chronic fine particular matter (PM 2.5 ) and its components exposure are contributed to the older depression symptoms remains unclear., Method: Middle-aged and older adults (>45 years) were selected from the China Health and Retirement Longitudinal Study during the four waves of interviews. The concentrations of PM 2.5 and its major constituents were calculated using near real-time data at a spatial resolution of 10 km during the study period. The depressive symptom was evaluated by the Depression Center for Epidemiologic Studies Depression (CES-D)-10 score. The fix-effect model was applied to evaluate the association between PM 2.5 and its major constituents with depressive symptoms. Three three-step methods were used to explore the modification role of sleep duration against the depressive symptoms caused by PM 2.5 exposure., Results: In our study, a total of 52,683 observations of 16,681 middle-aged and older adults were assessed. Each interquartile range (IQR) level of PM 2.5 concentration exposure was longitudinally associated with a 2.6 % (95 % confidence interval [CI]: 1.3 %, 4.0 %) increase in the depression CES-D-10 score. Regarding the major components of PM 2.5 , OM, NO 3 - , and NH 4 + showed the leading toxicity effects, which could increase the depression CES-D-10 score by 2.2 % (95 %CI: 1.0 %, 3.4 %), 2.2 % (0.6 %, 3.9 %), and 2.0 % (95 %CI: 0.6 %, 3.4 %) correspondingly. Besides, males were more susceptible to the worse depressive symptoms caused by PM 2.5 and its major components exposure than female subpopulations. Shortened sleep duration might be the mediator of PM 2.5 -associated depressive symptoms., Conclusion: Our results suggest that long-term exposure to PM 2.5 and its major components were associated with an increased risk for depressive symptoms in middle-aged and older adults. Reducing the leading components of PM 2.5 may cost-effectively alleviate the disease burden of depression and promote healthy longevity in heavy pollutant countries., Competing Interests: Declaration of Competing Interest The authors declare no conflict of interest, (Copyright © 2024. Published by Elsevier Inc.)

On-site conversion of organic waste into biogas to satisfy consumer energy demand has the potential to realize energy equality and mitigate climate change reliably. However, existing methods ignore either real-time full supply or methane escape when supply and demand are mismatched. Here, we show an improved design of community biogas production and distribution system to overcome these and achieve full co-benefits in developing economies. We take five existing systems as empirical examples. Mechanisms of synergistic adjusting out-of-step biogas flow rates on both the plant-side and user-side are defined to obtain consumption-to-production ratios of close to 1, such that biogas demand of rural inhabitants can be met. Furthermore, carbon mitigation and its viability under universal prevailing climates are illustrated. Coupled with manure management optimization, Chinese national deployment of the proposed system would contribute a 3.77% reduction towards meeting its global 1.5 °C target. Additionally, fulfilling others' energy demands has considerable decarbonization potential., (© 2024. The Author(s).)

Toxoplasmosis is a significant global zoonosis with devastating impacts, and an effective vaccine against toxoplasmosis for humans has not yet been developed. In this study, we designed and formulated a novel DNA vaccine encoding the inhibitor of STAT1 transcriptional activity (IST) of T. gondii utilizing the eukaryotic expression vector pEGFP-N1 for the first time, with CL264 being a molecular adjuvant. Following intramuscular injection of the vaccine into mice, the levels of antibodies and cytokines were assessed to evaluate the immune response. Additionally, mice were challenged with highly virulent RH-strain tachyzoites of T. gondii , and their survival time was observed. The results show that the levels of IgG in serum, the ratio of IgG2a/IgG1 and the levels of IFN-γ in splenocytes of mice were significantly higher in the pEGFP-TgIST group and the pEGFP-TgIST + CL264 group than in the control group. In addition, the proportion of CD4+/CD8+ T cells was higher in mice immunized with either the pEGFP-TgIST group ( p < 0.001) or the pEGFP-TgIST + CL264 group ( p < 0.05) compared to the three control groups. Notably, TgIST-immunized mice exhibited prolonged survival times after T. gondii RH strain infection ( p < 0.05). Our findings collectively demonstrate that the TgIST DNA vaccine elicits a significant humoral and cellular immune response and offers partial protection against acute T. gondii infection in the immunized mice, which suggests that TgIST holds potential as a candidate for further development as a DNA vaccine.

Purpose: This study aims to explore the serial mediating effect of stigma and depression on the association between social support and medication adherence., Patients and Methods: A cross-sectional survey was undertaken in the Changning District of Shanghai using a five-part questionnaire from August to December 2023. A convenient sampling method was employed, and 35 patients with schizophrenia were invited from each of the 9 streets in Changning District to participate in the survey, resulting in a total of 305 valid questionnaires collected. The questionnaire measured social support, stigma, depression, medication adherence, and demographic characteristics. Data analysis involved descriptive statistics, independent samples t-tests, ANOVA, Pearson correlation analysis, and the bootstrap method., Results: There was a direct and significantly positive association between social support and medication adherence (β = 0.69, p < 0.001). Moreover, increased levels of stigma (β = - 0.45, p = 0.013) and depression (β = - 0.09, p = 0.017) were both associated with a decline in medication adherence. Bootstrapping analysis revealed that the association between social support and medication adherence operated indirectly through stigma (β = 0.11, 95% CI: 0.03, 0.18). Additionally, social support was indirectly associated with medication adherence through depression (β = 0.15, 95% CI: 0.04, 0.30). Further analysis indicated that social support had an indirect association with medication adherence through both stigma and depression (β = 0.04, 95% CI: 0.01, 0.07)., Conclusion: Stigma and depression serially mediate the association between social support and medication adherence among patients with schizophrenia. This serial multiple mediation model underscores the importance of integrating social support interventions with psychological interventions aimed at reducing stigma and depression, thereby effectively enhancing medication adherence in patients with schizophrenia., Competing Interests: The authors report no conflicts of interest in this work., (© 2024 Jiang et al.)

Nitrate-nitrogen pertains to the nitrogen component of the overall nitrate present in a given sample in order to reduce nitrate nitrogen pollution in water, nitrate nitrogen removal methods based on iron-carbon micro-electrolysis have become a key research focus. The process and mechanism of nitrate nitrogen removal by microbial coupling was comprehensively explored in a novel iron-carbon micro-electrolysis (ICME) system. In order to establish the transformation pathway of nitrate nitrogen in water, the transformation paths of nitrate nitrogen in water before and after coupling microorganisms in three groups of continuous flow reaction devices, namely sponge iron (s-Fe 0 ), sponge iron + biochar (s-Fe 0 /BC) and sponge iron + biochar + manganese sand (s-Fe 0 /BC/MS), were studied. The morphology and composition changes of sponge iron were analyzed by means of characterization, and the microbial population changes in the three groups were analyzed by high-throughput sequencing. Results showed that the nitrate conversion rate in the s-Fe 0 , s-Fe 0 /BC and s-Fe 0 /BC/MS systems reached 99.48%, 99.57% and 99.36%, respectively, with corresponding ammonia nitrogen generation, rates of 3.77%, 9.34% and 11.24% and nitrogen generation rates of 95.71%, 90.23% and 88.12%. Scanning electron microscopy imaging showed that in the s-Fe 0 /BC and s-Fe 0 /BC/MS systems the surface of sponge iron was highly corroded, with granular substances in the corrosion product clusters. X-ray photoelectron spectroscopy analysis found that the relative contents of Fe 2 O 3 in the surface oxides of sponge iron after microbial coupling were 38.02% and 71.27% in the s-Fe 0 /BC and s-Fe 0 /BC/MS systems, while the relative Fe 3 O 4 contents were 61.98% and 28.72%, respectively. Microbial high-throughput sequencing analysis revealed that the Chao and Ace index values in the s-Fe 0 system were 871.89 and 880.78, while in the s-Fe 0 /BC system they were 1012.05 and 1017.29, and in the s-Fe 0 /BC/MS system were 1241.09 and 1198.29, respectively. The relative proportion of Thauera in the s-Fe 0 , s-Fe 0 /BC, and s-Fe 0 /BC/MS systems was 16.76%,14.25% and 10.01%, while the proportion of Acetoanaerobium was 15.36%, 13.27% and 11.11%, and the proportion of Chloroflexi was 0%, 1.11% and 2.18%, respectively. Furthermore, FAPROTAX function annotation found that the expression levels of chemoheterotrophs in the s-Fe 0 , s-Fe 0 /BC and s-Fe 0 /BC/MS systems were 43 316 OTU, 37 289 OTU and 34 205 OTU, while nitrate respiration expression levels were 16 230 OTU, 15 483 OTU and 9149 OTU, with nitrogen respiration expression levels of 16 328 OTU, 15 493 OTU and 9154 OTU, respectively. These findings suggest that nitrate is converted into nitrogen gas and ammonia nitrogen through the actions of the coupled system of sponge iron/biochar/manganese sand and microorganisms. The catalytic effect of MnO 2 promotes the conversion of Fe 2+ to Fe 3+ , generating more electrons, allowing denitrifying bacteria to reduce more nitrate nitrogen, effectively coupling the manganese-catalyzed ICME reaction and microbial denitrification. The micro-electrolysis system and the addition of manganese sand enhanced biodiversity within the s-Fe 0 /BC/MS system. The heterotrophic bacteria Thauera and Acetoanaerobium were the dominant microorganisms in all three systems, although the micro-electrolysis system with added manganese sand significantly reduced the proportion of facultative bacteria Thauera and Acetoanaerobium and promoted the growth of autotrophic Chloroflexi bacteria. The ecological functions of the three systems were mainly nitrate respiration and nitrogen respiration. By comparing the expression levels of nitrate respiration and nitrogen respiration in s-Fe 0 /BC and s-Fe 0 /BC/MS systems, it can be seen that the addition of manganese sand reduced microbial activity., Competing Interests: There are no conflicts to declare., (This journal is © The Royal Society of Chemistry.)

Background: Long working hours are associated with an increased risk of cardiovascular disease, yet the underlying mechanism(s) remain unclear. The study examines how occupational factors like working hours, shift work, and employment status correlate with dietary choices and sodium intake, impacting hypertension risk., Methods: This study used data from the Korea National Health and Nutrition Examination Survey conducted between 2013 and 2020. The dataset included 8,471 respondents, all of whom were wage workers aged 20 or older and reported working at least 36 hours per week. Individuals who have been previously diagnosed with or are currently diagnosed with hypertension, diabetes, or dyslipidemia were excluded. The average daily sodium intake was assessed via a 24-hour dietary recall method. Average weekly working hours were categorized into 3 groups: 36-40 hours, 41-52 hours, and over 52 hours. Multiple logistic regression models were used., Results: Study findings revealed that 83.7% of participants exceeded the recommended daily sodium intake of 2 g set by the World Health Organization. After adjusting for confounding factors, a positive correlation was observed between average working hours and daily sodium intake. Among males, statistical significance was found in the group with average weekly working hours of 41-52 hours (prevalence ratio [PR]: 1.17; 95% confidence interval [CI]: 1.05-1.30) and the group exceeding 52 hours (PR: 1.22; 95% CI: 1.09-1.38) when comparing the fourth quartile of daily sodium intake to the combined quartiles of Q1, Q2, and Q3. Among females, no significance was noted., Conclusions: Long working hours were associated with increased sodium intake, primarily among male workers. This connection is likely attributed to having less time for home-cooked meals, resulting in higher fast food consumption and dining out. A workplace intervention promoting healthy eating and reducing stress is essential to lower sodium consumption and mitigate hypertension risk., Competing Interests: Competing interests: The authors declare that they have no competing interests., (Copyright © 2024 Korean Society of Occupational & Environmental Medicine.)

A novel wrist-inspired soft actuator, which is driven by a magneto-pneumatic hybrid system and based on a Kresling origami unit, is proposed. The geometric model, kinematic analysis model, and quasistatic analysis model of the Kresling origami unit are presented. A key focus is on the formulation and investigation of the variation in rotation angle using the kinematic analysis model. A wrist-inspired soft actuator is designed, and its quasistatic characteristics are validated through various experiments. The paper proposes an innovative magneto-pneumatic hybrid actuation method, capable of achieving bidirectional torsion. This actuation method is experimentally validated, demonstrating the actuator's ability to maintain 3 steady states and its capability for bidirectional torsion deformation. Furthermore, the paper highlights the potential of the Kresling origami unit in designing soft actuators capable of achieving large rotation angles. For instance, an actuator with 6 sides ( n = 6) is shown to achieve a rotation angle of 239.5°, and its rotation ratio exceeds 277°, about twice the largest one reported in other literature. The actuator offers a practical and effective solution for bidirectional torsion deformation in soft robotic applications., Competing Interests: Competing interests: The authors declare that they have no competing interests., (Copyright © 2024 Yan Xu et al.)

Background: The hospitalization rate of ambulatory care sensitive conditions (ACSCs) has been recognized as an essential indicator reflective of the overall performance of healthcare system. At present, ACSCs has been widely used in practice and research to evaluate health service quality and efficiency worldwide. The definition of ACSCs varies across countries due to different challenges posed on healthcare systems. However, China does not have its own list of ACSCs. The study aims to develop a list to meet health system monitoring, reporting and evaluation needs in China., Methods: To develop the list, we will combine the best methodological evidence available with real-world evidence, adopt a systematic and rigorous process and absorb multidisciplinary expertise. Specific steps include: (1) establishment of working groups; (2) generations of the initial list (review of already published lists, semi-structured interviews, calculations of hospitalization rate); (3) optimization of the list (evidence evaluation, Delphi consensus survey); and (4) approval of a final version of China's ACSCs list. Within each step of the process, we will calculate frequencies and proportions, use descriptive analysis to summarize and draw conclusions, discuss the results, draft a report, and refine the list., Discussion: Once completed, China's list of ACSCs can be used to comprehensively evaluate the current situation and performance of health services, identify flaws and deficiencies embedded in the healthcare system to provide evidence-based implications to inform decision-makings towards the optimization of China's healthcare system. The experiences might be broadly applicable and serve the purpose of being a prime example for nations with similar conditions., (© 2024. The Author(s).)

Background: Human nutrient intake is closely related to the conditions of their workplace., Methods: This study used data from the Korean National Health and Nutritional Examination Survey (KNHANES) conducted between 2016 and 2020. The study population comprised individuals aged 19 to 65 years who were engaged in paid work, excluding soldiers (total = 12,201, male = 5,872, female = 6,329). The primary outcome of interest was the Dietary Inflammatory Index (DII) score, which was calculated using dietary intake data. Generalized linear models were used for statistical analyses., Results: Pink-collar workers had higher DII scores, indicating a potentially higher inflammatory diet than white-collar workers (mean: 2.18 vs. 1.89, p < 0.001). Green and blue-collar workers displayed lower levels of dietary inflammation (green: 1.64 vs. 1.89, p = 0.019, blue: 1.79 vs. 1.89, p = 0.022). After adjusting for sex, age, income, education, and energy intake, the sole trend that persisted was the comparison between white-collar and pink-collar workers., Conclusions: DII scores and dietary patterns differed among occupational groups and genders., Competing Interests: Competing interests: The authors declare that they have no competing interests., (Copyright © 2024 Korean Society of Occupational & Environmental Medicine.)

The genus Bacteroides , a predominant group in the human gut microbiome, presents significant potential for microbiome engineering and the development of live biotherapeutics aimed at treating gut diseases. Despite its promising capabilities, tools for effectively engineering Bacteroides species have been limited. In our study, we have made a breakthrough by identifying novel signal peptides in Bacteroides thetaiotaomicron and Akkermansia muciniphila . These peptides facilitate efficient protein transport across cellular membranes in Bacteroides , a critical step for therapeutic applications. Additionally, we have developed an advanced episomal plasmid system. This system demonstrates superior protein secretion capabilities compared to traditional chromosomal integration plasmids, making it a vital tool for enhancing the delivery of therapeutic proteins in Bacteroides species. Initially, the stability of this episomal plasmid posed a challenge; however, we have overcome this by incorporating an essential gene-based selection system. This novel strategy not only ensures plasmid stability but also aligns with the growing need for antibiotic-free selection methods in clinical settings. Our work, therefore, not only provides a more robust secretion system for Bacteroides but also sets a new standard for the development of live biotherapeutics.

Background: More intense tropical cyclones (TCs) are expected in the future under a warming climate scenario, but little is known about their mortality effect pattern across countries and over decades. We aim to evaluate the TC-specific mortality risks, periods of concern (POC) and characterize the spatiotemporal pattern and exposure-response (ER) relationships on a multicountry scale., Methods and Findings: Daily all-cause, cardiovascular, and respiratory mortality among the general population were collected from 494 locations in 18 countries or territories during 1980 to 2019. Daily TC exposures were defined when the maximum sustained windspeed associated with a TC was ≥34 knots using a parametric wind field model at a 0.5° × 0.5° resolution. We first estimated the TC-specific mortality risks and POC using an advanced flexible statistical framework of mixed Poisson model, accounting for the population changes, natural variation, seasonal and day of the week effects. Then, a mixed meta-regression model was used to pool the TC-specific mortality risks to estimate the overall and country-specific ER relationships of TC characteristics (windspeed, rainfall, and year) with mortality. Overall, 47.7 million all-cause, 15.5 million cardiovascular, and 4.9 million respiratory deaths and 382 TCs were included in our analyses. An overall average POC of around 20 days was observed for TC-related all-cause and cardiopulmonary mortality, with relatively longer POC for the United States of America, Brazil, and Taiwan (>30 days). The TC-specific relative risks (RR) varied substantially, ranging from 1.04 to 1.42, 1.07 to 1.77, and 1.12 to 1.92 among the top 100 TCs with highest RRs for all-cause, cardiovascular, and respiratory mortality, respectively. At country level, relatively higher TC-related mortality risks were observed in Guatemala, Brazil, and New Zealand for all-cause, cardiovascular, and respiratory mortality, respectively. We found an overall monotonically increasing and approximately linear ER curve of TC-related maximum sustained windspeed and cumulative rainfall with mortality, with heterogeneous patterns across countries and regions. The TC-related mortality risks were generally decreasing from 1980 to 2019, especially for the Philippines, Taiwan, and the USA, whereas potentially increasing trends in TC-related all-cause and cardiovascular mortality risks were observed for Japan., Conclusions: The TC mortality risks and POC varied greatly across TC events, locations, and countries. To minimize the TC-related health burdens, targeted strategies are particularly needed for different countries and regions, integrating epidemiological evidence on region-specific POC and ER curves that consider across-TC variability., Competing Interests: YG is a member of the Editorial Board of PLOS Medicine. All other authors declare no competing interests., (Copyright: © 2024 Huang et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Employing porous structures is essential in high-performance electrochemical energy devices. However, obtaining uniform functional coatings on high-tortuosity structures can be challenging, even with specialized processes such as atomic layer deposition (ALD). Herein, a novel method for achieving a porous composite electrode for solid oxide fuel cells by coating La 0.6 Sr 0.4 Co 0.2 Fe 0.8 O 3 -δ (LSCF) powders with ZrO 2 using a powder ALD process is presented. Unlike conventional ALD, powder ALD can be used to fabricate extremely uniform coatings on porous electrodes with a thickness of tens of micrometers. The powder ALD ZrO 2 coating is found to effectively suppress chemical degradation of the LSCF electrodes. The cell with the powder ALD coated cathode shows a 2.2 times higher maximum power density and 60% lower thermal degradation in activation resistance than the bare LSCF cathode cell at 700-750 °C. The result demonstrated in this study is expected to have significant implications for high-performance and durable electrodes in energy conversion/storage devices., (© 2023 Wiley-VCH GmbH.)

Particle swarm optimization is implemented for the complete inverse design of multilayered optical filters. To achieve this, a model is designed to optimize the thickness and material of each layer, as well as the total number of layers, simultaneously. The performance of the model is evaluated by repeating the optimization process, enabling clarification of the effects of model parameters on the final output. The designed model is also demonstrated for the optimization of various optical filters, including bandstop filters, bandpass filters, and anti-reflection coatings. The results confirm that particle swarm optimization is capable of designing arbitrary optical filters that cannot be designed using conventional design theories.

Range adaptation refers to the representation of a stimulus value based on its relative position in the range of pre-experienced values. Altered range adaptation in value representation may be related to motivation and pleasure (MAP) deficit in schizophrenia (SCZ). This follow-up study examined the relationship between range adaptation performance and MAP symptoms in SCZ patients. We recruited 26 schizophrenia patients and followed them for 1 year. They completed an experimental task for estimating their range adaptation to outcome value (OV) and expected value (EV) at baseline and after 1 year. At baseline, we found a marginally significant and negative correlation between OV adaptation and avolition symptoms in SCZ patients. Moreover, the 1-year change of EV adaptation was significantly and negatively correlated with the change of self-report pleasure experience. Our results suggest that range adaptation may track the variations of MAP symptoms in SCZ., Competing Interests: None to be declared., (© 2023 The Authors.)

Happiness is the ultimate life goal for most people, and the pursuit of happiness serves as the fundamental motivation driving human behavior. Orientation to Happiness (OTH) represents the aspect that individuals seek when making decisions or engaging in activities, including values, priorities, motivations, ideals, and goals. Nevertheless, existing research has predominantly approached OTH from an individualistic perspective, emphasizing an individual's internal emotional state and personal goals, thereby neglecting the significant influence of a collectivist cultural background on the pursuit of happiness. To address this research gap, our study employs qualitative research methods, enabling us to delve deeply into the intricate interplay between cultural context, societal influences, and individual motivations that collectively shape OTH. Our research is dedicated to understanding the structure of OTH within the Chinese cultural context. Through semi-structured interviews with 26 Chinese adults and the utilization of an inductive style of thematic analysis, we have identified two core themes within the OTH of Chinese adults: Self-focused and Other-focused. Notably, the "Other-focused" theme emphasizes the pursuit of group harmony and the fulfillment of group responsibilities, highlighting the paramount role of "relationships" in the study of happiness within collectivist cultures. This insight forms a robust foundation for future research in this area.

C-type lectins (CTLs), a superfamily of Ca 2+ -dependent carbohydrate-recognition proteins, serve as pattern recognition receptors (PRRs) in the immune response of many species. However, little is currently known about the CTLs of the commercially and ecologically important bivalve species, blood clam (Tegillarca granosa). In this study, a CTL (designated as TgCTL-1) with a single carbohydrate-recognition domain (CRD) containing unique QPN/WDD motifs was identified in the blood clam through transcriptome and whole-genome searching. Multiple alignment and phylogenetic analysis strongly suggested that TgCTL-1 was a new member of the CTL superfamily. Expression analysis demonstrated that TgCTL-1 was highly expressed in the hemocytes and visceral mass of the clam under normal condition. In addition, the expression of TgCTL-1 was shown to be significantly up-regulated upon pathogen challenge. Moreover, the recombinant TgCTL-1 (rTgCTL-1) displayed agglutinating and binding activities against both the gram-positive and gram-negative bacteria tested in a Ca 2+ -dependent manner. Furthermore, it was found that the in vitro phagocytic activity of hemocytes was significantly enhanced by rTgCTL-1. In general, our results showed that TgCTL-1 was an inducible acute-phase secretory protein, playing crucial roles in recognizing, agglutinating, and binding to pathogenic bacteria as well as modulating phagocytic activity of hemocytes in the innate immune defense of blood clam., (Copyright © 2023 Elsevier Ltd. All rights reserved.)

Due to different understandings of happiness, people adopt different tendencies to act, which is called orientation to happiness (OTH). Our previous study found that OTH had two core themes, Self-focused and Other-focused in Chinese culture, which was different from OTH structures in Western culture. However, no corresponding measurement tool has been developed or revised. The Hedonic and Eudaimonic Motives for Activities Scale (HEMA) was the most commonly used measurement tool of OTH in recent years. The present study aimed to develop a Chinese version of the HEMA. A total of 1729 Chinese adults participated in this study. The exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were used to examine the underlying structure of the Chinese version of the HEMA. The results supported the 3-factor structure of the translation instrument, and the 15-item scale had good convergent and discriminant validity. The three dimensions were named Hedonism, Eudaimonism, and Otherism. Among them, Otherism is a new dimension, which means "the pursuit of the harmony of the group and achieving happiness by fulfilling their responsibilities in the group". The revised tool was named the Hedonic, Eudaimonic, and Otheristic Motives for Activities Scale-Chinese (HEOMA-C). The results showed that the HEOMA-C has good reliability and validity. Overall, the present study provided an effective tool to assess the OTH in Chinese culture., Competing Interests: The authors declare no conflict of interest.

The lectins are a large family of carbohydrate-binding proteins that play important roles in the innate immune response of various organisms. Although C-type lectin domain family 3 member B (CLEC3B), an important member of C-type lectin, has been well documented in humans and several other higher vertebrates, little is currently known about this molecule in economically important marine fish species. In this study, through transcriptomic and BLAST screening, a novel CLEC3B gene was identified in the golden pompano (Trachinotus ovatus). The T. ovatus CLEC3B (ToCLEC3B) was subsequently characterized by bioinformatic analysis and compared with those reported in other species. In addition, the expression patterns of ToCLEC3B in different tissues under normal condition and at different times post pathogen challenge were assessed. Furthermore, the agglutinating activity of ToCLEC3B with and without Ca 2+ against different bacteria and blood cells of donor species were verified using the recombinant T. ovatus CLEC3B (rToCLEC3B). Our results demonstrated that ToCLEC3B is a Ca 2+ -dependent galactose-binding lectin with a single copy of carbohydrate recognition domain (CRD). Similar to CLEC3B reported in other species, the CRD domain of ToCLEC3B consists of two α-helices, six β-sheets, and four loops, forming two Ca 2+ - and a galactose-binding sites. According to the phylogenetic analysis, the ToCLEC3B was highly similar (similarity at 95.00%) to that of its relative, the greater amberjack (Seriola dumerili). The expression of ToCLEC3B was detected in all tissues examined under normal condition and was significantly up-regulated by injection of pathogenic microbes. In addition, the rToCLEC3B exhibited strong agglutinating activity against different bacteria and blood cells of donor species in the presence of Ca 2+ . Our results indicate that ToCLEC3B is a constitutive and inducible acute-phase immune factor in the host's innate immune response of T. ovatus., Competing Interests: Declaration of competing interest The authors declare no competing financial interest., (Copyright © 2023 Elsevier Ltd. All rights reserved.)

Few studies have examined the causal relationship between chronic exposure to air pollutants during pregnancy and depression in adolescent offspring. In addition, it has not been investigated whether exposure is most harmful to adolescents in certain populations and at certain stages of pregnancy. A total of 1975 adolescents from 1632 families from the China Family Panel Study, a representative national longitudinal cohort, were included in this study. We used high-resolution satellite retrieval data to assess the PM 2.5 exposure of mothers during pregnancy. Specifically, we employed a two-stage instrumental variable model (IV-2SLS) within the counterfactual causal inference framework, and selected and validated appropriate instruments, thereby mitigating potentially biased results arising from bi-direction between dependent and independent variables. This approach allowed us to explore the causal relationship between maternal PM 2.5 exposure during pregnancy and adolescent depression symptoms. The endogeneity of air pollution during pregnancy and the need for a causal model were suggested by the results of the model comparisons. Using the IV-2SLS model, we found that maternal exposure to PM 2.5 during pregnancy exacerbates depressive symptoms in the offspring during adolescence (β = 0.2, 95% CI: 0.05-0.34). We also found that exposure during the first trimester may cause greater harm. Adolescents with low household income, being male, irregular exercise habits, living in rural areas, and having mothers with poorer mental status may be more vulnerable. The findings suggest that maternal exposure to PM 2.5 during pregnancy may have a negative impact on the depression symptoms of offspring in adolescence and that more attention should be paid to vulnerable populations and the window of vulnerability., 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 © 2023 Elsevier Inc. All rights reserved.)

This study investigates the impact of various sources of social support on the mental health of unaccompanied children under residential education in China. Unaccompanied children refer to those whose parents are still alive but unable to raise them due to various reasons. The study utilized self-reported questionnaires administered at two time waves, with the first wave (T1) evaluating family support, teacher support, and peer support, and the second wave (T2) evaluating depression, subjective well-being, and resilience. A total of 202 participants completed both surveys. To examine the predictive effect of different sources of social support on the mental health of these children, the study used the structural equation model with depression and subjective well-being as indicators. The results show that neither family support nor teacher support (T1) had a significant effect on the mental health (T2) of the children. However, peer support (T1) had a significant positive predictive effect on mental health (T2), indicating the unique role of peer support in promoting the mental health of unaccompanied children. The study also explored the mediating role of resilience between social support and well-being, revealing that though the direct effect of teacher support (T1) on mental health (T2) was not significant, the indirect mediating effect of resilience on the relationship between teacher support and mental health was significant. Both the direct and indirect effect of family support (T1) on mental health (T2) were not significant. These findings highlight the importance of creating a positive peer environment for unaccompanied children to promote their mental health. This study has important practical implications for the development of effective intervention programs aimed at improving the mental health of this population.

Background: Older adults experience age-related declines in physical and cognitive functions due to interactions between aging and chronic diseases. Tai Chi and Qigong (TCQ) might be beneficial in improving the physical function and delaying the cognitive decline of this population. The potential underlying mechanism was explored to determine the effects of TCQ on cognitive function via direct or indirect pathways., Purpose: The objective of this systematic review was to determine the effects of TCQ on cognitive and physical functions in older adults using meta-analysis, and to determine the impact of TCQ on cognitive function while controlling for physical function using a meta-regression approach., Methods: A systematic search of 13 electronic databases (in English, Korean, and Chinese languages) identified 10,292 potentially eligible studies published between inception and May 2022. The bias in individual studies was assessed using the Cochrane Risk of Bias (version 2.0) tool. The heterogeneity of the studies was evaluated using a 95% prediction interval, and the meta-analysis and meta-regression were implemented using the Comprehensive Meta-Analysis (version 3) software., Results: Our search identified 17 randomized studies (n = 2,365, mean age = 70.3 years). The results of the meta-analysis that used a random-effects model indicated that TCQ had significant effects on both cognitive (Hedges' g = 0.29, 95% confidence interval [CI] = 0.17 to 0.42) and physical (Hedges' g = 0.32, 95% CI = 0.19 to 0.44) functions. We used meta-regression to explore the effect size of TCQ in association with physical function level. The regression model was significant (Q = 25.01, p = .070), and 55% of the heterogeneity was explained by physical function as a moderator variable. The effects of TCQ on cognitive function remained significant in this model when controlling for the effect of physical function (β = 0.46, p = .011)., Conclusion: This meta-regression of 17 randomized studies strongly suggests that TCQ has beneficial effects on physical and cognitive functions in older adults. The effect of TCQ on cognitive function remained significant after taking into account the significant effects of physical function as a moderator. The findings imply the potential health benefits of TCQ by promoting cognitive function in older adults directly and indirectly through enhancing physical function. PROSPERO REGISTRATION NUMBER: *PROSPERO international prospective register of systematic reviews, registration ID CRD42023394358., (© 2023. The Author(s).)

Using network analysis, this study investigated how family communication patterns (Conversation and Conformity) were related to and predictive of adolescent overall depression severity and specific symptoms. A community sample of adolescents (10-17 years, n = 1327) completed the Children's Depression Inventory and the Revised Family Communication Pattern Instrument. Depressive symptoms were also re-assessed 6 months later. Results showed that Conversation orientation protected against, whereas Conformity orientation increased the risk of adolescent depression. Family communication particularly influenced the child's feeling of being unloved, and feeling unloved was the only symptom prospectively predicted by two communication orientations at baseline. These findings revealed the path linking family factors to adolescent depression and may have implications for future family-based interventions., (© 2022 Society for Research on Adolescence.)

Air pollution remains a risk factor for the global burden of disease. Middle-aged and older people are more susceptible to air pollution because of their declining physical function and are more likely to develop diseases from long-term air pollution exposure. Studies of the effects of air pollution on cognitive function in middle-aged and older adults have been inconsistent. More representative and definitive evidence is needed. This study analysed data from the Chinese Family Panel Study, an ongoing nationwide prospective cohort study, collected in waves 2014, 2016 and 2018. Rigorously tested instrument was selected for analysis and participants' PM 2.5 and instrument exposures were assessed using high-precision satellite data. The causal relationship between long-term exposure to air pollution and poor cognitive function in middle-aged and older adults was investigated using the Correlated Random Effects Control Function (CRE-CF) method within a quasi-experimental framework. This study included a total of 7042 participants aged 45 years or older. A comparison of CRE-CF with other models (OLS model, ordered probit model, and ordered probit-CRE model) demonstrated the necessity of using CRE-CF given the endogeneity of air pollution. The credibility and validity of the instrumental variable were verified. In the CRE-CF model, long-term exposure to PM 2.5 was found to accelerate cognitive decline in middle-aged and older adults (coefficients of -0.159, -0.336 and -0.244 for the total cognitive, verbal and mathematical scores, respectively). Taken together, these results suggest that chronic exposure to ambient air pollution is associated with cognitive decline in middle-aged and older adults, which highlights the need for appropriate protective policies., 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 © 2023 The Authors. Published by Elsevier Inc. All rights reserved.)

This study evaluated the biomechanical microenvironmental stimulating effect of pulsed electromagnetic field (PEMF) on the regeneration of crush-injured rat sciatic nerve, when combined with bone marrow mesenchymal stem cells (BMSCs) and recombinant human nerve growth factor (rhNGF-β), in the form of an adenoviral vector-mediated NGF. Sprague-Dawley rats were equally distributed into six groups; PBS, BMSC, NGF-Ad + BMSC, PEMF + PBS, PEMF + BMSC and PEMF + NGF-Ad + BMSC. The PBS group received PBS (volume: 10μL/rat), the BMSC group with BMSCs (1 × 10 6  cell/10 μL/rat) and NGF-Ad group with the rhNGF-β Ad infected BMSCs (1 × 10 6 cell/10 μL/rat) immediate after right sciatic nerve crush injury. The PEMF groups were exposed to PEMF of 1mT, 50 Hz, 1 h/day. The rats were observed for 3 weeks. PEMF alone did not showed the positive effect compared with negative control group. The groups transplanted with BMSCs showed higher axonal regeneration compared with the groups without transplantation of the cells whether BMSC was infected with NGF-Ad or not and whether the animals received PEMF. PEMF + NGF-Ad + BMSC group showed the significantly highest number of axons than the other groups. Functionally, all groups showed marked improvement at 3 weeks postoperatively although the difference was not statistically significant among the groups. PEMF showed the positive effect when combined with BMSC and NGF-ad in aspect of number of axons. Therefore, combining the microenvironment stimulation methods of PEMF and conventional methods such as transplantation of stem cells and growth factor could be considered for the regeneration methods in the nerve damage., Competing Interests: Conflict of interestThe authors have no relevant financial or non-financial interests to disclose., (© Korean Society of Medical and Biological Engineering 2023, Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.)

Background: There is little evidence on whether PM 2.5 and ground surface ozone have consistent effects on increased individual medical costs, and there is a lack of evidence on causality in developing countries., Methods: This study utilized balanced panel data from 2014, 2016, and 2018 waves of the Chinese Family Panel Study. The Tobit model was developed within a counterfactual causal inference framework, combined with a correlated random effects and control function approach (Tobit-CRE-CF), to explore the causal relationship between long-term exposure to air pollution and medical costs. We also explored whether different air pollutants exhibit comparable effects., Results: This study encompassed 8928 participants and assessed various benchmark models, highlighting the potential biases from failing to account for air pollution endogeneity or overlooking respondents without medical costs. Using the Tobit-CRE-CF model, significant effects of air pollutants on increased individual medical costs were identified. Specifically, margin effects for PM 2.5 and ground-level ozone signifying that a unit increase in PM 2.5 and ground-level ozone results in increased total medical costs of 199.144 and 75.145 RMB for individuals who incurred fees in the previous year, respectively., Conclusions: The results imply that long-term exposure to air pollutants contributes to increased medical costs for individuals, offering valuable insights for policymakers aiming to mitigate air pollution's consequences., (© 2023. The Author(s).)

Background: Environmental pollution may give rise to the incidence and progression of nonalcoholic fatty liver disease (NAFLD), the most common cause for chronic severe liver lesions. Although knowledge of NAFLD pathogenesis is particularly important for the development of effective prevention, the relationship between NAFLD occurrence and exposure to emerging pollutants, such as microplastics (MPs) and antibiotic residues, awaits assessment., Objectives: This study aimed to evaluate the toxicity of MPs and antibiotic residues related to NAFLD occurrence using the zebrafish model species., Methods: Taking common polystyrene MPs and oxytetracycline (OTC) as representatives, typical NAFLD symptoms, including lipid accumulation, liver inflammation, and hepatic oxidative stress, were screened after 28-d exposure to environmentally realistic concentrations of MPs ( 0.69 mg / L ) and antibiotic residue ( 3.00 μ g / L ). The impacts of MPs and OTC on gut health, the gut-liver axis, and hepatic lipid metabolism were also investigated to reveal potential affecting mechanisms underpinning the NAFLD symptoms observed., Results: Compared with the control fish, zebrafish exposed to MPs and OTC exhibited significantly higher levels of lipid accumulation, triglycerides, and cholesterol contents, as well as inflammation, in conjunction with oxidative stress in their livers. In addition, a markedly smaller proportion of Proteobacteria and higher ratios of Firmicutes/Bacteroidetes were detected by microbiome analysis of gut contents in treated samples. After the exposures, the zebrafish also experienced intestinal oxidative injury and yielded significantly fewer numbers of goblet cells. Markedly higher levels of the intestinal bacteria-sourced endotoxin lipopolysaccharide (LPS) were also detected in serum. Animals treated with MPs and OTC exhibited higher expression levels of LPS binding receptor ( LBP ) and downstream inflammation-related genes while also exhibiting lower activity and gene expression of lipase. Furthermore, MP-OTC coexposure generally exerted more severe effects compared with single MP or OTC exposure., Discussion: Our results suggested that exposure to MPs and OTC may disrupt the gut-liver axis and be associated with NAFLD occurrence. https://doi.org/10.1289/EHP11600.

Although accumulating data demonstrated that gamma-aminobutyric acid (GABA), an inhibitory neurotransmitter, plays an important regulatory role in immunity of vertebrates, its immunomodulatory function and mechanisms of action remain poorly understood in invertebrates such as bivalve mollusks. In this study, the effect of GABA on phagocytic activity of hemocytes was evaluated in a commercial bivalve species, Tegillarca granosa. Furthermore, the potential regulatory mechanism underpinning was investigated by assessing potential downstream targets. Data obtained demonstrated that in vitro GABA incubation significantly constrained the phagocytic activity of hemocytes. In addition, the GABA-induced suppression of phagocytosis was markedly relieved by blocking of GABA A and GABA B receptors using corresponding antagonists. Hemocytes incubated with lipopolysaccharides (LPS) and GABA had significant higher K + -Cl - cotransporter 2 (KCC2) content compared to the control. In addition, GABA treatment led to an elevation in intracellular Cl - , which was shown to be leveled down to normal by blocking the ionotropic GABA A receptor. Treatment with GABA A receptor antagonist also rescued the suppression of GABA A receptor-associated protein (GABARAP), KCC, TNF receptor associated factor 6 (TRAF6), inhibitor of nuclear factor kappa-B kinase subunit alpha (IKKα), and nuclear factor kappa B subunit 1 (NFκB) caused by GABA incubation. Furthermore, incubation of hemocytes with GABA resulted in a decrease in cAMP content, an increase in intracellular Ca 2+ , and downregulation of cAMP-dependent protein kinase (PKA), calmodulin kinase II (CAMK2), calmodulin (CaM), calcineurin (CaN), TRAF6, IKKα, and NFκB. All these above-mentioned changes were found to be evidently relieved by blocking the metabotropic G-protein-coupled GABA B receptor. Our results suggest GABA may play an inhibitory role on phagocytosis through binding to both GABA A and GABA B receptors, and subsequently regulating corresponding downstream pathways in bivalve invertebrates., 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 © 2023 Elsevier Ltd. All rights reserved.)

Although accumulating data demonstrate that dietary supplementation of bamboo vinegar and charcoal powder (BVC) can significantly strengthen the immunity and boost the growth of domestic animals, its application potency still awaits verification in commercial fish species such as the large-scale loach Paramisgurnus dabryanus. The impacts of 90-day dietary supplementation of 1% and 2% BVC on survival and growth performance of the loach, and on the intestinal morphological characteristics and gut microflora were analyzed. Our data show that the large-scale loach supplied with BVC at the experimental doses had significant higher survival rates and better growth performance (indicated by greater weight gain (1.13-1.14 times), higher specific growth rate (1.04 times), and lower feed conversion ratio (0.88-0.89 times)) compared to that of the control ( P <0.05). Histological examination revealed significant longer villus (3.22-5.54 times), deeper crypt (1.77-1.87 times), and thicker muscle (1.59-3.17 times) in the intestines of large-scale loach fed with BVC ( P <0.05). Furthermore, we found that the gut microflora consisted of significantly fewer proportions of potential pathogenic bacterial species ( Aeromonas veronii and Escherichia coli ), but significantly greater proportions of beneficial microbes ( Lactococus raffinolactis and Faecalibacterium prausnitzii ). Therefore, dietary intake of BVC can promote intestinal tract development and optimize gut microflora, by which the survival and growth of large-scale loach may be improved., (© Chinese Society for Oceanology and Limnology, Science Press and Springer-Verlag GmbH Germany, part of Springer Nature 2023.)

Manganese dioxide and its derivatives are widely used as promising electrode materials for supercapacitors. To achieve the environmentally friendly, simple, and effective material synthesis requirements, the laser direct writing method is utilized to pyrolyze the MnCO 3 /carboxymethylcellulose (CMC) precursors to MnO 2 /carbonized CMC (LP-MnO 2 /CCMC) in a one-step and mask-free way successfully. Here, CMC is utilized as the combustion-supporting agent to promote the conversion of MnCO 3 into MnO 2 . The selected materials have the following advantages: (1) MnCO 3 is soluble and can be converted into MnO 2 with the promotion of a combustion-supporting agent. (2) CMC is an eco-friendly and soluble carbonaceous material, which is widely used as the precursor and combustion-supporting agent; (3) the redundant part of the MnCO 3 /CMC precursor can be removed by deionized water, which is simple and convenient. The different mass ratios of MnCO 3 and CMC-induced LP-MnO 2 /CCMC(R1) and LP-MnO 2 /CCMC(R1/5) composites are investigated in the electrochemical performance toward electrodes, respectively. The LP-MnO 2 /CCMC(R1/5)-based electrode showed the high specific capacitance of 74.2 F/g (at the current density of 0.1 A/g) and good electrical durability for 1000 times charging-discharging cycles. Simultaneously, the sandwich-like supercapacitor which was assembled by LP-MnO 2 /CCMC(R1/5) electrodes presents the maximum specific capacitance of 49.7 F/g at the current density of 0.1 A/g. Moreover, the LP-MnO 2 /CCMC(R1/5)-based energy supply system is used to light a light-emitting diode, which demonstrates the great potential of LP-MnO 2 /CCMC(R1/5)-based supercapacitors for power devices., Competing Interests: The authors declare no competing financial interest., (© 2023 The Authors. Published by American Chemical Society.)

Background: Early screening of cognitive function is critical to dementia treatment and care. However, traditional tests require face-to-face administration and are often limited by implementation costs and biases., Aims: This study aimed to assess whether the Thoven Cognitive Self-Assessment (TCSA), a novel, innovative two-step touchscreen-based cognition assessment tool, could identify early cognitive impairment due to dementia in older adults., Methods: The TCSA was administered to 61 healthy controls (HCs), 46 participants with mild cognitive impairment (MCI) and 44 participants diagnosed with dementia recruited from Shanghai. Two outcome measures were generated from the TCSA test: the TCSA primary task score and the TCSA secondary task score., Results: The total average scores in the control group for the TCSA primary task and TCSA secondary task were significantly higher than those in the MCI and dementia groups (TCSA primary task : HCs vs MCI group vs dementia group, 8.58±1.76 vs 5.40±2.67 vs 2.74±2.11, F=75.40, p<0.001; TCSA secondary task : HCs vs MCI group vs dementia group, 23.02±3.31 vs 17.95±4.93 vs 11.93±5.50, F=76.46, p<0.001). Moreover, receiver operating characteristic analysis showed that a score below 7.5 for the TCSA primary task and a score below 22.5 for the TCSA secondary task were indicators of MCI., Conclusions: The TCSA appears to be efficacious for the detection of cognitive impairment in older adults. It demonstrates the potential for large-scale cognition screening in community service settings., Competing Interests: Competing interests: All authors declare no conflict of interest., (© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

In recent years, there is growing evidence that long-term exposure to fine particulate matter (PM 2.5 ) is associated with depressive symptoms. However, little is known about the individual effects of PM 2.5 components, particularly in low-income and middle-income countries. We investigated the association between long-term exposure to major components of PM 2.5 and worsening depressive symptoms in Chinese adults based on a large, long-term, nationally representative, population-based prospective cohort. Our data were derived from China Family Panel Study (CFPS) wave 2012, 2016 and 2018 and a long-term (2010-2019) high-resolution PM 2.5 components dataset covering the whole China. We assessed respondents' depressive symptoms using standardized scales and applied advanced Fixed-effect ordered logit model (FE-ologit) to capture the ordinal nature of respondents' depressive symptoms and control for individual-specific and time-invariant effects to investigate their associations with PM 2.5 components. We included 9503 respondents and the FE-ologit model results indicated that the odds ratio of increase per standard unit was 1.118 (95 % CI: 1.020, 1.225) for black carbon, 1.134 (95 % CI: 1.028, 1.252) for organic matter, 1.127 for ammonium (95 % CI: 1.011, 1.255), 1.107 for nitrate (95 % CI: 0.981, 1.248), and 1.117 for sulfate (95 % CI: 1.020, 1.224). Our study suggests that long-term exposure to PM 2.5 components is significantly associated with worsening of depressive symptoms, and that different components may have different toxicity. Reducing PM 2.5 emissions, especially the major sources of organic matter and ammonium, may reduce the burden of depressive symptoms in Chinese adults., 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 © 2022 Elsevier B.V. All rights reserved.)

Long-term exposure to air pollutants is likely to be associated with mental disorders, but relevant studies remain limited and inconsistent, and evidence to assess causality is particularly lacking, especially in developing countries. In addition, there are few studies on the role of physical activity in this relationship. We investigated the causal relationship between air pollutant exposure and mental health among Chinese adults and whether physical activity could play a positive role in this relationship. Using the balanced panel data for 2014 and 2016 from the China Family Panel Study, a representative Chinese national cohort study, we selected and validated appropriate instrumental variable to explore the causal relationship between air pollution and mental health and explored the moderating effect of physical activity using an instrumental variable fixed effects model (IVFE) in a counterfactual causal inference framework. PM 2.5 and ground surface ozone were selected as proxies for different types of air pollutants and extended the interpretability by studying them for populations with different characteristics. A total of 21,944 participants were included in this study. In the IVFE model, we found that both PM 2.5 and ground surface ozone significantly negatively affected mental health, and that habitual physical activity counteracted this negative effect regardless of different types of air pollution. We also found that the findings held for adults with different characteristics. The findings suggest that habitual physical activity may offset the deterioration of mental health in adults in developing countries due to air pollution, regardless of age, gender, income, and the presence of chronic diseases., 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 © 2022 Elsevier Inc. All rights reserved.)

Background: Stroke survivors often experience impaired mobility and physical functions. Tai Chi and Qigong have been shown to have physical and psychological benefits for stroke patients., Purpose: To summarize the evidence on Tai Chi and Qigong for improving mobility in stroke survivors, specifically the ability to walk, dynamic balance, and activities of daily living (ADL)., Methods: Independent searches of 16 electronic databases in English, Korean, and Chinese from their inception until December 2021 were conducted by two research teams. Methodological quality was assessed using Cochrane's risk of bias tool 2.0. Comprehensive Meta-Analysis 3.0 software was used to calculate effect sizes with subgroup analysis and to assess heterogeneity and publication bias., Results: The meta-analysis included 27 randomized trials (18 with Tai Chi and 9 with Qigong) on stroke survivors (N = 1,919). None of the studies were considered at high risk of bias, about 70% had some concerns, and 30% were considered low risk. Meta-analysis of 27 randomized controlled trials with random-effects models indicated that Tai Chi and Qigong effectively improved mobility, specifically on the ability to walk (Hedges'g = 0.81), dynamic balance (Hedges'g = 1.04), and ADL (Hedges'g = 0.43). The effects of Tai Chi and Qigong were significant for short-term and long-term programs (Hedges'g 0.91 vs. 0.75), and when compared with active controls and no treatment group (Hedges'g 0.81 vs. 0.73)., Conclusion: Tai Chi and Qigong performed for 12 weeks or less were effective in improving the mobility of stroke survivors. Further studies are warranted to assess whether Tai Chi and Qigong work best as an adjunct to rehabilitation, an effective alternative to rehabilitation or as a maintenance strategy, and whether the results could be further optimized by assessing different schools of Tai Chi and Qigong, different types of stroke patients, and different points in the post-stroke recovery process., Prospero Registration Number: This study has been registered on the UK National Institute for Health Research (http://www.crd.york.ac.uk/PROSPERO) PROSPERO registration number: CRD42020220277., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2022 Park et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Background: Increasing attention has been paid to the role of caregivers' burden in affecting quality of life (QoL) of schizophrenic patients. However, less is known about potential mediation mechanisms underlying this relationship. The current study aimed to explore the sequential mediating effect of expressed emotion and perceived expressed emotion on the relationship between care burden and QoL among people with schizophrenia., Methods: 135 Chinese families (one patient and one caregiver) participated in this study. Caregivers reported their care burden and expressed emotion, patients reported their perceived expressed emotion and QoL., Results: The results of the correlation analysis showed that care burden was negatively related to patients' QoL, including physical, psychological, and social relationships domains, with patients' sex, age, educational level, employment status, and medication-taking as covariates. The sequential mediating effects of criticism and perceived criticism between care burden and QoL were not significant. However, the sequential mediating effects of emotional over-involvement and perceived emotional over-involvement (EOI) between care burden and QoL (including physical and psychological domain) were significant., Conclusion: The results indicated that reducing the burden and expressed emotion of caregivers could be helpful to improve schizophrenia patients' QoL., 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 © 2022 Wei, Peng, Li, Song, Ju and Xi.)

The world is aging, posing a challenge to public health. Air pollution is increasingly recognized as an important environmental risk factor, with effects on both physical and mental health. Considering the vulnerability of older adults, they tend to have more prevalent comorbidities that may lead to broader consequences. However, evidence to comprehensively assess the causal effects of long-term air pollution exposure on the physical and mental health of older adults remains limited and inconsistent, especially in developing countries. The longitudinal data from the Chinese Family Panel Study (a representative Chinese national cohort study) for 2012, 2014, 2016, and 2018 were included in this study. The Correlated Random Effects Control Function method (CRE-CF) in a counterfactual causal inference framework was employed to explore the causal relationship between long-term exposure to air pollution and physical and mental health and self-rated health status in middle-aged and older adults, considering the ordered categorical nature of health outcomes. The appropriate instrumental variable was selected and validated. This study included 5846 participants aged >45 years in 2012. In the CRE-CF model for activities of daily living (ADLs, positively associated with physical health), subjective memory impairment (SMI, negatively associated with memory health) and self-rated health status in middle-age and older adults, the coefficient of PM 2.5 is -0.069, 0.102, and 0.106 respectively, and all statistically significant at 5% level, which suggests that chronic exposure to air pollutants had significant negative effects on ADLs, SMI and self-rated health in middle-aged and older adults. The findings suggest that long-term exposure to air pollutants can impair the health of middle-aged and older adults across the board, including physical and mental health. In the context of an aging society, the findings of this study will provide tremendous implications for the authority to protect them from damage caused by long-term exposure to air pollutants., 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 © 2022 Elsevier B.V. All rights reserved.)

The Dimensional Anhedonia Rating Scale measures state anhedonia in multiple domains, such as hobbies, food and drink, social activities, and sensory experience, and it has good reliability and validity in adult samples. However, no study has examined the psychometrical properties of this scale in adolescents. The present study examined its reliability and validity in adolescents with and without depression. In Study 1, 988 high-school students completed the Dimensional Anhedonia Rating Scale; 915 completed the second-round survey 3 months later. Confirmatory factor analysis was used to determine the factor structure. Additionally, internal consistency and test-retest reliability, and concurrent, convergent, and divergent validity were assessed in typical adolescents. In Study 2, the Dimensional Anhedonia Rating Scale was administrated to 108 patients with major depressive disorder, 108 adolescents with subthreshold depression, and 108 healthy controls. Factor structure and convergent validity were assessed in the clinical and subclinical groups. Finally, a one-way analysis of variance (ANOVA) was applied to examine the effect of depression severity on the scale scores. The results of Study 1 indicated that a four-factor model (i.e., hobbies, food and drink, social activities, and sensory experience) best fit the data. Meanwhile, the scale also yielded good concurrent, convergent, and divergent validity, as well as high internal consistency and test-retest reliability, in typical adolescents. In Study 2, goodness-of-fit statistics also suggested a good fit for the four-factor model in the two depressed groups. The one-way ANOVA revealed significant group differences in the total and factor scores, whereby the major depressive disorder group had lower scores than the subthreshold depression group, whose scores were lower than the healthy controls, indicating excellent eligibility of the scale in depressed adolescents. The Chinese version of the Dimensional Anhedonia Rating Scale is a reliable and valid instrument to comprehensively measure state anhedonia in Chinese typical and depressed adolescents., (© 2022 The Institute of Psychology, Chinese Academy of Sciences and John Wiley & Sons Australia, Ltd.)

Molluscs, the second largest animal phylum on earth, primarily rely on cellular and humoral immune responses to fight against pathogen infection. Although antimicrobial peptides (AMPs) such as big defensin play crucial roles in the humoral immune response, it remains largely unknown in the ecological and economic important blood clam (Tegillarca granosa). In this study, a novel big defensin gene (TgBD) was identified in T. granosa through transcripts and whole genome searching. Bioinformatic analyses were conducted to explore the molecular characteristics of TgBD, and comparisons of TgBD with those reported in other molluscs were performed by multiple alignments and phylogenetic analysis. In addition, the expression patterns of TgBD in various tissues and upon bacterial challenge were investigated while the antimicrobial activity of synthetic N-terminal domain of TgBD was confirmed in vitro by radial diffusion experiment. Results obtained showed TgBD had an open reading frame (ORF) of 369 bp, encoding a prepropeptide containing a signal peptide and a propeptide. Similar to big defensins reported in other species, TgBD consists of a hydrophobic N-terminal domain containing β1-α1-α2-β2 folds and a cysteine-rich cationic C-terminal domain with three disulfide bonds between C1-C5, C2-C4, and C3-C6. Phylogenetic analysis showed that TgBD shared 76.80% similarity to its close relative ark shell (Scapharca broughtoni). In addition, TgBD expression was observed in all tissues investigated under normal conditions and was significantly induced by injection of Vibrio parahaemolyticus. Furthermore, synthetic N-terminal peptide of TgBD exhibited strong antimicrobial activity against Gram-positive bacteria tested. Our results indicated that TgBD is a constitutive and inducible acute phase AMP, which provides a universal and prompt protection for T. granosa., (Copyright © 2022 Elsevier Ltd. All rights reserved.)

Azathioprine (AZA) is the preferred immunosuppressant for treating pemphigus vulgaris (PV), with discontinuation mainly attributed to hematological adverse events (AE). Reportedly, nucleoside diphosphate-linked moiety X-type motif 15 (NUDT15) polymorphisms have been strongly associated with thiopurine-induced leukopenia. To investigate hematological AE of low-dose AZA based on NUDT15 genotypes among patients with PV, a prospective cohort study was conducted in patients with PV, followed-up for the first 8 weeks after AZA administration. All patients were divided into wild homozygous and heterozygous NUDT15 groups. Both groups initiated AZA at low dose (50 mg/day) and continued with different dose-escalating approaches. Bone marrow suppression was considered the principal outcome. Overall, 62 patients with PV were enrolled (48 in the wild homozygous NUDT15 group vs. 14 in the heterozygous NUDT15 group). Except for median maintenance doses of AZA, no statistically significant differences were observed between the two groups in terms of age, sex, white blood cells, neutrophil count, platelet count, hemoglobin level, median final doses of corticosteroids (mg prednisone equivalent), pemphigus disease area index, and anti-desmoglein 1/3 autoantibodies. In both groups, patients presented similar hematological AE and treatment responses after administration of different low-dose AZA treatment strategies. Low-dose AZA based on NUDT15 genotypes can reduce the risk of early hematological AE among patients with PV., (© 2021 The Authors. The Journal of Dermatology published by John Wiley & Sons Australia, Ltd on behalf of Japanese Dermatological Association.)

The temperature/pH dual-responsive gel spheres were prepared by orthogonal experiments and response surface methodology, and finally, the optimal synthesis conditions were obtained by a composite score, including swelling, mechanical properties, mass transfer properties, and so forth. The results showed that a sodium alginate concentration of 3% (w/v), CaCl 2 concentration of 2% (w/v), gelling time of 40 h, drop height of 14 cm, NaCl concentration of 0.6% (w/v), N -isopropylacrylamide concentration of 0.03% (w/v), and acrylic acid concentration of 4.06% (w/v) were optimal synthesis conditions. The environmental change tolerance experiments showed that the nitrogen removal of the dual-response nitrifying gel spheres was better than the domesticated sludge at low temperatures (4 °C) and in alkaline (pH 9 and 10) conditions. The as-obtained gel spheres can respond intelligently to the changes in ambient temperature and pH. It is hoped that this study will provide technical parameters for the development and application of microbial immobilization carriers., Competing Interests: The authors declare no competing financial interest., (© 2022 The Authors. Published by American Chemical Society.)

The effects of air pollution on adolescents need further consideration. Although there is evidence that maternal exposure to air pollution may affect the cognitive function of offspring, relevant studies remain limited and inconsistent, with a lack of studies assessing the causal effects and evidence from developing countries. Using data from Chinese Family Panel Studies, a representative Chinese nationwide cohort study, OLS combined with instrumental variable + two-stage least square (IV+2SLS) was used to explore the causal effects of exposure to PM 2.5 concentrations during pregnancy on the cognitive function of offspring when they become adolescents. After detailed argumentation and multiple testing, Planetary Boundary Layer Height (PBLH) and Surface Pressure (SP) were selected as the instrumental variables for this study. One thousand five hundred fifty-five adolescents participated in this study, with a mean age of 13.3 years (sd = 2.3). There were 706 females (45.4%), the mean maternal PM 2.5 exposure concentration was 64.9 μg/m 3 , and recorded a mean cognitive function score of 38.1 (sd = 9.4). The OLS results found that maternal exposure to air pollution increased cognitive function in offspring adolescents, corroborating the presence of endogeneity. Multi-domain knowledge, the results of the weak instrumental variable assessments of F-tests (F = 237 > 10) and Stock-yogo tests (minimum eigenvalue statistic = 153.16 > 16.38), and the results of the Hansen J overidentification test (p > 0.05) verified the plausibility and validity of the instrumental variables. The IV+2SLS results, following causal modeling, showed that PM 2.5 exposure during pregnancy impairs the cognitive ability of offspring adolescents (β = -0.040, p < 0.05). Robustness tests also validated the results. This study provides important policy implications for developing countries on protecting their adolescents and reminds parents that the protection of adolescents from air pollution should begin from conception., (Copyright © 2021 The Authors. Published by Elsevier Ltd.. All rights reserved.)

We propose an innovative way to produce both 225 Ac and 227 Th, two precious radioisotopes enabling promising targeted alpha therapy, in a natural thorium target bombarded with a 30-90 MeV electron beam. Bremsstrahlung photons in the target are analyzed by MCNP and in-situ photonuclear transmutation of 232 Th is evaluated by using the TENDL nuclear data. In the photo-transmutation analysis, 13 nuclides including 229 Th and 231 Pa are modelled. Special procedures with chemical separations are also proposed to produce pure 225 Ac and 227 Th in separate streams. In addition, performance of the new approach is compared with conventional methods in terms of the 225 Ac and 227 Th yields. After a Th target is bombarded with a 500 kW electron beam for a year, yearly 225 Ac yield is ~ 8.47 GBq (semi-permanently) and yearly 227 Th yield is ~ 48.9 GBq over 50 years, and their yields are at least doubled in a 2-year irradiation. This work will help increase global supply of the two precious isotopes and would invariably help advance TAT-related researches and developments., (© 2022. The Author(s).)

Rapid reviews have been widely employed to support timely decision-making, and limiting the search date is the most popular approach in published rapid reviews. We assessed the accuracy and workload of search date limits on the meta-analytical results to determine the best rapid strategy. The meta-analyses data were collected from the Cochrane Database of Systematic Reviews (CDSR). We emulated the rapid reviews by limiting the search date of the original CDSR to the recent 40, 35, 30, 25, 20, 15, 10, 7, 5, and 3 years, and their results were compared to the full meta-analyses. A random sample of 10% was drawn to repeat the literature search by the same timeframe limits to measure the relative workload reduction (RWR). The relationship between accuracy and RWR was established. We identified 21,363 meta-analyses of binary outcomes and 7683 meta-analyses of continuous outcomes from 2693 CDSRs. Our results suggested that under a maximum tolerance of 5% and 10% on the bias of magnitude, a limit on the recent 20 years can achieve good accuracy and at the same time save the most workload. Under the tolerance of 15% and 20% on the bias, a limit on the recent 10 years and 15 years could be considered. Limiting the search date is a valid rapid method to produce credible evidence for timely decisions. When conducting rapid reviews, researchers should consider both the accuracy and workload to make an appropriate decision., (© 2021 The Authors. Research Synthesis Methods published by John Wiley & Sons Ltd.)

Background: An increasing number of systematic reviews assessed the safety of surgical interventions over time. How well these systematic reviews were designed and conducted determines the reliability of evidence. In this study, we aimed to assess the methodological quality of systematic reviews on the safety of surgical interventions., Methods: We searched PubMed for systematic reviews of surgical interventions with safety as the exclusive outcome from 1st-Jan, 2015 to 1st-Jan, 2020. The methodological quality of eligible systematic reviews was evaluated according to the AMSTAR 2.0 instrument. The primary outcomes were the number of methodological weaknesses and the global methodological quality. The proportion of each methodological weakness among eligible systematic reviews was compared by three pre-defined stratification variables. The absolute difference of the proportion (PD) was used as the effect estimator, with the two-tailed z-test for the significance., Results: We identified 127 systematic reviews from 18,636 records. None (n = 0, 0.00%) of them could be rated as "high" in terms of the global methodological quality; in contrast, they were either rated as "low" (n = 18, 14.17%) or as "critically low" (n = 109, 85.83%). The median number of methodological weaknesses of these systematic reviews was 8 (interquartile range, IQR: 6 to 9), in which 4 (IQR: 2 to 4) were critical weaknesses. Systematic reviews that used any reporting guideline (e.g., domain 13, PD = -0.22, 95% CI: - 0.39, - 0.06; p = 0.01) and developed a protocol in advance (e.g., domain 6, PD = -0.20, 95% CI: - 0.39, - 0.01; p = 0.04) were less likely to have methodological weakness in some domains but not for the rest (e.g., domain 8, PD = 0.04, 95% CI: - 0.14, 0.21; p = 0.68; with protocol vs. without)., Conclusions: The methodological quality of current systematic reviews of adverse events with surgical interventions was poor. Further efforts, for example, encouraging researchers to develop a protocol in advance, are needed to enhance the methodological quality of these systematic reviews., (© 2021. The Author(s).)