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Abstract Rheumatoid arthritis (RA)-associated interstitial lung disease (RA-ILD) is the most common pulmonary complication of RA, increasing morbidity and mortality. Anti-citrullinated protein antibodies have been associated with the development and progression of both RA and fibrotic lung disease; however, the role of protein citrullination in RA-ILD remains unclear. Here, we demonstrate that the expression of peptidylarginine deiminase 2 (PAD2), an enzyme that catalyzes protein citrullination, is increased in lung homogenates from subjects with RA-ILD and their lung fibroblasts. Chemical inhibition or genetic knockdown of PAD2 in RA-ILD fibroblasts attenuated their activation, marked by decreased myofibroblast differentiation, gel contraction, and extracellular matrix gene expression. Treatment of RA-ILD fibroblasts with the proteoglycan syndecan-2 (SDC2) yielded similar antifibrotic effects through regulation of PAD2 expression, phosphoinositide 3-kinase/Akt signaling, and Sp1 activation in a CD148-dependent manner. Furthermore, SDC2-transgenic mice exposed to bleomycin-induced lung injury in an inflammatory arthritis model expressed lower levels of PAD2 and were protected from the development of pulmonary fibrosis. Together, our results support a SDC2-sensitive profibrotic role for PAD2 in RA-ILD fibroblasts and identify PAD2 as a promising therapeutic target of RA-ILD.

Abstract Low testosterone level is an independent predictor of osteoporotic fracture in elderly men as well as increased fracture risk in men undergoing androgen deprivation. Androgens and androgen receptor (AR) actions are essential for bone development and homeostasis but their linkage to fracture repair remains unclear. Here we found that AR is highly expressed in the periosteum cells and is co-localized with a mesenchymal progenitor cell marker, paired-related homeobox protein 1 (Prrx1), during bone fracture repair. Mice lacking the AR gene in the periosteum expressing Prrx1-cre (AR-/Y;Prrx1::Cre) but not in the chondrocytes (AR-/Y;Col-2::Cre) exhibits reduced callus size and new bone volume. Gene expression data analysis revealed that the expression of several collagens, integrins and cell adhesion molecules were downregulated in periosteum-derived progenitor cells (PDCs) from AR-/Y;Prrx1::Cre mice. Mechanistically, androgens-AR signaling activates the AR/ARA55/FAK complex and induces the collagen-integrin α2β1 gene expression that is required for promoting the AR-mediated PDCs migration. Using mouse cortical-defect and femoral graft transplantation models, we proved that elimination of AR in periosteum of host mice impairs fracture healing, regardless of AR existence of transplanted donor graft. While testosterone implanted scaffolds failed to complete callus bridging across the fracture gap in AR-/Y;Prrx1::Cre mice, cell-based transplantation using DPCs re-expressing AR could lead to rescue bone repair. In conclusion, targeting androgen/AR axis in the periosteum may provide a novel therapy approach to improve fracture healing.

Chronic obstructive pulmonary disease is a leading cause of death worldwide, while our understanding of cell-specific mechanisms underlying its pathobiology remains incomplete. Here the authors perform scRNA-seq of human lung tissue to identify transcriptional changes in alveolar niche cells associated with the disease.

Abstract Background Sarcoidosis is an inflammatory disorder of immune dysregulation characterized by non-caseating granulomas that can affect any organ. Cardiac sarcoidosis is an under-recognized entity that has a heterogeneous presentation and may occur independently or with any severity of systemic disease. Diagnosing cardiac sarcoidosis remains problematic with endomyocardial biopsies associated with a high risk of complications. Several diagnostic algorithms are currently available that rely on histopathology or clinical and radiological measures. The dominant mode of diagnostic imaging to date for cardiac sarcoidosis has been cardiac magnetic resonance imaging with gadolinium enhancement. Case presentations We report the cases of two adult patients: case 1, a 50-year-old white man who presented with severe congestive cardiac failure; and case 2, a 37-year-old white woman who presented with complete heart block. Both patients had a background of untreated pulmonary sarcoidosis. Cardiac magnetic resonance imaging did not show evidence of sarcoidosis in either patient and both proceeded to 18F-fluorodeoxyglucose-positron emission tomography scans that were highly suggestive of cardiac sarcoidosis. Both patients were systemically immunosuppressed with orally administered prednisone and methotrexate and had subsequent improvement by clinical and nuclear medicine imaging measures. Conclusions Current consensus guidelines recommend all patients with sarcoidosis undergo screening for occult cardiac disease, with thorough history and examination, electrocardiogram, and transthoracic echocardiogram. If any abnormalities are detected, advanced cardiac imaging should follow. While cardiac magnetic resonance imaging identifies the majority of cardiac sarcoidosis, early disease may not be detected. These cases demonstrate 18F-fluorodeoxyglucose-positron emission tomography is warranted following an indeterminate or normal cardiac magnetic resonance imaging if clinical suspicion remains high. Unidentified and untreated cardiac sarcoidosis risks significant morbidity and mortality, but early detection can facilitate disease-modifying immunosuppression and cardiac-specific interventions.

Background:. Soft-tissue deficiencies pose a challenge in a variety of disease processes when the end result is exposure of underlying tissue. Although multiple surgical techniques exist, the transposition of tissue from one location to another can cause donor-site morbidity, long incisions prone to dehiscence, and poor patient outcomes as a result. Use of tissue expansion prior to grafting procedures has been shown to have success in increasing available soft tissue to aid in repairing wounds. However, the current tissue expanders have biomechanical limits to the extent and rate of expansion that usually exceeds the tissue capacity, leading to incisional dehiscence or expander extrusion. Understanding the baseline biomechanical properties of the tissue to be expanded would provide useful information regarding surgical protocol employed for a given anatomical location. Therefore, the aim of this study was to test and compare the baseline (preexpansion) biomechanical properties of different common expansion sites in dogs. Methods:. Four samples measuring approximately 20 × 15 × 1 mm were harvested from 8 dogs. The samples were collected from the hard palate, alveolar mucosa, scalp, and chest of the animal and analyzed for stress, strain, maximum tangential stiffness, maximum tangential modulus, and tensile strength using a Texture Technologies TA.XT texture analyzer with corresponding biomechanical measurement software. Samples were compared as to their baseline biomechanical properties prior to any soft-tissue expansion. Histological sections of the samples were analyzed using hematoxylin eosin in an attempt to correlate the histological description to the biomechanical properties seen during testing. Summary statistics (mean, standard deviation, standard error, range) are reported for stress, strain, maximum tangential stiffness, maximum tangential modulus, and tensile strength and for the histological parameters by intraoral site. Analysis of variance was used to compare the biomechanical and histological parameters among the 4 locations while accounting for multiple measurements from each dog. Results:. The scalp had significantly higher maximum stress (σmax) than chest, mucosa, and palate (P < 0.0001), with no differences among the other 3 locations (P > 0.63). Scalp site also had significantly higher maximum tangential modulus (ε) than chest, mucosa, and palate (P < 0.006), with no differences among the other 3 locations (P > 0.17). The locations did not have significantly different maximum tangential stiffness (k; P = 0.72). Histologically, 2 separate patterns of collagen disruption were evident. Conclusion:. Although different results were obtained than theorized, this study showed that the scalp had the greatest resiliency to expand prior to tearing, and the highest tangential modulus, with all sites having statistically similar modulus of elasticity. Based on this study, the scalp could be expanded more aggressively compared with the other sites.

The exchange coupled composite FePt/TbCo/[Co/Ni]N films have been prepared by DC magnetron sputtering. The net magnetization of ferromagnetic TbCo changes with the temperature variation, and then the magnetic configuration of FePt/TbCo/[Co/Ni]N changes. When a RE-dominated Tb32Co68 is inserted, FePt/Tb32Co68/[Co/Ni]5 has high coercivity at room temperature because of its synthesis ferrimagnetic sandwich structure, but small coercivity is obtained when the temperature is higher than 200 °C because of its graded ECC structure.

Background and Objectives: Few investigations on polycyclic aromatic hydrocarbons (PAHs) in surface sediments have reported medium to high petrogenic contamination at the southwest coasts of the Caspian Sea. The aim of this study was to investigate distribution and potential sources of 16 PAH compounds in surface sediments of the southwest coasts of the Caspian Sea (Gillan province). Materials and methods: A total of 45 sediment samples from 15 stations at coasts of the Gillan province (from Astara to Lahijan) were collected from 10, 20, and 50 meters depths. Each sample was analyzed using Gas chromatography – Mass spectrometry. Diagnostic ratios were used for source identification. Results: The main PAH compounds in the study area were phenanthrene (87.6±74.6 ng/g), pyrene (43.1±23.5 ng/g), and naphthalene (34.4±40.4 ng/g) respectively. According to the calculated diagnostic ratios such as LMW/HMW (0.25-7.75), Ant/178 (0.02-0.11), Flu/202 (0.20-0.49), and B(a)Ant/228 (0.09-0.54) the main source of PAHs is petrogenic in this study area. Conclusion: According to PAH diagnostic ratios and similarity of dominant PAH compounds in study area with dominant PAH compounds of Azerbaijan oil field, main probable source of PAH compounds in Gillan province coasts is Azerbaijan oil pollution.

Both long-term observation data and model simulations suggest an increasing chance of serious drought in the dry season and extreme flood in the wet season in southern China, yet little is known about how changes in precipitation pattern will affect soil respiration in the region. We conducted a field experiment to study the responses of soil respiration to precipitation manipulations – precipitation exclusion to mimic drought, double precipitation to simulate flood, and ambient precipitation as control (abbr. EP, DP and AP, respectively) – in three subtropical forests in southern China. The three forest sites include Masson pine forest (PF), coniferous and broad-leaved mixed forest (MF) and monsoon evergreen broad-leaved forest (BF). Our observations showed that altered precipitation strongly influenced soil respiration, not only through the well-known direct effects of soil moisture on plant and microbial activities, but also by modification of both moisture and temperature sensitivity of soil respiration. In the dry season, soil respiration and its temperature sensitivity, as well as fine root and soil microbial biomass, showed rising trends with precipitation increases in the three forest sites. Contrarily, the moisture sensitivity of soil respiration decreased with precipitation increases. In the wet season, different treatments showed different effects in three forest sites. The EP treatment decreased fine root biomass, soil microbial biomass, soil respiration and its temperature sensitivity, but enhanced soil moisture sensitivity in all three forest sites. The DP treatment significantly increased soil respiration, fine root and soil microbial biomass in the PF only, and no significant change was found for the soil temperature sensitivity. However, the DP treatment in the MF and BF reduced soil temperature sensitivity significantly in the wet season. Our results indicated that soil respiration would decrease in the three subtropical forests if soil moisture continues to decrease in the future. More rainfall in the wet season could have limited effect on the response of soil respiration to the rising of temperature in the BF and MF.

Objective: To compare the incidence of acute otitis media among children aged 2 to 6 months old in Sampaloc, Manila who were previously given 3 doses of pneumococcal conjugate vaccine (Non-Typeable Haemophilus influenzae (NTHi) protein D, diphtheria or tetanus toxoid conjugates) and those who did not receive the vaccine, over a period of one year. Methods: Study Design: Cohort Study Setting: Primary Health Center in Sampaloc, Manila, Philippines Participants: Medical records of well children aged 2 to 6 months were reviewed for inclusion. Participants were categorized into vaccinated and unvaccinated groups. Both groups underwent baseline history and physical examination including otoscopy and any signs and symptoms of active ear infection were noted. Subjects were followed up for a period of 1 year on a monthly basis for signs or symptoms of acute otitis media. Results: A total of 176 subjects participated in the study. The overall incidence of AOM among participants was 5.11% (9 out of 176). An AOM incidence of 3.75% (3 out of 80) and 6.25% (6 out of 96) was found among the exposed and unexposed groups, respectively. Fisher’s exact test (one-tailed) p value =.34, relative risk (RR) .6 (95 percent CI 0.155, 2.323). Conclusion: The results of this study showed no difference in the development of AOM in the two groups. However, based on the relative risk, Pneumococcal conjugate vaccine is still beneficial in preventing AOM in children. Keywords: Pneumococcal Conjugate Vaccine; Acute Otitis Media

Epithelial cell death is a major contributor to fibrogenesis in the lung. In this study, we sought to determine the function of mitochondria and their clearance (mitophagy) in alveolar epithelial cell death and fibrosis.We studied markers of mitochondrial injury and the mitophagy marker, PTEN-induced putative kinase 1 (PINK1), in IPF lung tissues by Western blotting, transmission electron microscopy (TEM), and immunofluorescence. In vitro experiments were carried out in lung epithelial cells stimulated with transforming growth factor-β1 (TGF-β1). Changes in cell function were measured by Western blotting, flow cytometry and immunofluorescence. In vivo experiments were performed using the murine bleomycin model of lung fibrosis.Evaluation of IPF lung tissue demonstrated increased PINK1 expression by Western blotting and immunofluorescence and increased numbers of damaged mitochondria by TEM. In lung epithelial cells, TGF-β1 induced mitochondrial depolarization, mitochondrial ROS, and PINK1 expression; all were abrogated by mitochondrial ROS scavenging. Finally, Pink1-/- mice were more susceptible than control mice to bleomycin induced lung fibrosis.TGF-β1 induces lung epithelial cell mitochondrial ROS and depolarization and stabilizes the key mitophagy initiating protein, PINK1. PINK1 ameliorates epithelial cell death and may be necessary to limit fibrogenesis.

Background: The aim of the study was to probe the morphological features of the proximal segment (V1) of vertebral artery (VA) in a sample of Chinese cadavers.Materials and Methods: The origin, course and outer diameter at origin of the pre-vertebral part of the VAs were evaluated in 119 adult cadavers.Results: It was found that 94.12% of the VAs originated from the subclavian arteries, bilaterally. The variant origins were present in 5.88% of the cadavers and all originated directly from the arch of the aorta. All the variations were observed on the left side of male cadavers. The average outer diameters at origin of the normal and variation groups were 4.35 ± 1.00 mm and 4.82 ± ± 1.42 mm, respectively, p = 0.035. In the normal group, but not in the variation group, the average diameter in the males was significantly larger than that in the females (4.50 ± 0.99 mm, 3.92 ± 0.92 mm, respectively, p = 0.000). In addition, only 5 cadavers in the normal group had hypoplastic VAs (4.20%, 4 males, 3 right-sided). Vertebral artery dominance (VAD) was present in 91 (69 males) out of 112 cadavers and more common on the left (n = 48). In addition, 3 cadavers satisfied conditions for coexistence of VAD and vertebral artery hypoplasia. All 7 cadavers in the variation group exhibited VAD, which was more common on the right side (n = 5).Conclusions: The morphologic variations and frequencies described above have implications for the early prevention, abnormal anatomy detection, accurate diagnosis, safe surgery and endovascular treatment of cardiovascular and neurological disease. [ABSTRACT FROM AUTHOR]

Background. HIV/AIDS remains a leading cause of death in adolescents (aged 15 - 25 years), and in sub-Saharan Africa HIV-related deaths continue to rise in this age group despite a decline in both adult and paediatric populations. This is attributable in part to high adolescent infection rates and supports the urgent need for more efficacious prevention strategies. In particular, an even partially effective HIV vaccine, given prior to sexual debut, is predicted to significantly curb adolescent infection rates. While adolescents have indicated willingness to participate in HIV vaccine trials, there are concerns around safety, uptake, adherence, and ethical and logistic issues.Objectives. To initiate a national, multisite project with the aim of identifying obstacles to conducting adolescent HIV vaccine trials in South Africa (SA).Method. A simulated HIV vaccine trial was conducted in adolescents aged 12 - 17 years across five SA research sites, using the already licensed Merck human papillomavirus vaccine Gardasil as a proxy for an HIV vaccine. Adolescents were recruited at community venues and, following a vaccine discussion group, invited to participate in the trial. Consent for trial enrolment was obtained from a parent or legal guardian, and participants aged 16 - 17 years were eligible only if sexually active. Typical vaccine trial procedures were applied during the five study visits, including the administration of vaccination injections at study visits 2, 3 and 4.Results. The median age of participants was 14 years (interquartile range 13 - 15), with 81% between the ages of 12 and 15 years at enrolment. Overall, 98% of screened participants opted to receive the vaccine, 588 participants enrolled, and 524 (89%) attended the final visit.Conclusions. This trial showed that adolescents can be recruited, enrolled and retained in clinical prevention trials with parental support. While promising, these results were tempered by the coupling of sexual-risk eligibility criteria and the requirement for parental/guardian consent, which was probably a barrier to the enrolment of high-risk older adolescents. Further debate around appropriate consent approaches for such adolescents in HIV prevention studies is required.

Stagonospora nodorum, causal agent of Stagonospora nodorum blotch (SNB), is a destructive pathogen of wheat worldwide. As is true for many necrotrophic host–pathogen systems, the wheat- S. nodorum system is complex and resistance to SNB is usually quantitatively inherited. We recently showed that S. nodorum produces at least four proteinaceous host-selective toxins that interact with dominant host sensitivity/susceptibility gene products to induce SNB in seedlings. Here, we evaluated a population of wheat recombinant inbred lines that segregates for Tsn1, Snn2, and Snn3, which confer sensitivity to the toxins SnToxA, SnTox2, and SnTox3, respectively, to determine if compatible host–toxin interactions are associated with adult plant susceptibility to SNB foliar disease under field conditions. Artificial inoculation of the population in 2 years and two locations with a fungal isolate known to produce SnToxA and SnTox2 indicated that compatible SnToxA– Tsn1 and SnTox2– Snn2 interactions accounted for as much as 18 and 15% of the variation in disease severity on the flag leaf, respectively. As previously reported for seedlings, the effects of these two interactions in conferring adult plant susceptibility were largely additive. Additional adult plant resistance QTLs were identified on chromosomes 1B, 4B, and 5A, of which, the 1B and 5A QTLs were previously reported to be associated with seedling resistance to SNB. Therefore, in this population, some of the same QTLs are responsible for seedling and adult plant resistance/susceptibility. This is the first report showing that host-selective toxins confer susceptibility of adult plants to SNB, further substantiating the importance of compatible toxin–host interactions in the wheat- S. nodorum pathosystem. [ABSTRACT FROM AUTHOR]

The magnetic and electronic transport properties of the compound Pr5Ge4 were investigated by means of magnetic and electrical resistivity measurements. The results indicate that for the compound Pr5Ge4 there are two magnetic transitions at TIC = 25 K and TIIC = 41 K in a low field of 500 Oe. In analogy to Nd5Ge4 compound, the magnetic structure of Pr5Ge4 may be a canted one, which can be induced by a competition between nearest-neighbor Pr–Pr ferromagnetic (FM) and Pr–Pr antiferromagnetic (AFM) exchange interactions. The main contribution to the electrical resistivity of Pr5Ge4 is the scattering of conduction electrons on localized magnetic moments. A large magnetoresistance (Δρ/ρ) was observed (about 25% at 24 K and 15% at 40 K) in the presence of a magnetic field of 50 kOe. [ABSTRACT FROM AUTHOR]

Presents a study which evaluated how wet-dry cycling with water affects the plasticity and swelling of bentonite and the hydraulic conductivity of geosynthetic clay liners. Properties of bentonite; Materials and methods used; Results; Conclusions.

Executive summary 1. Democracy assessment in Mongolia was a state-led exercise conducted as part of the follow-up activities to the 5th International Conference of New or Restored Democracies and involved the active participation of the Government, Parliament, and Civil Society. 2. The process of democracy assessment itself provided a unique opportunity for critical self-reflection within Mongolia about the quality of democracy, the performance of democratic institutions, and elite and mass perceptions of democracy. 3. The follow-up activities successfully generated methods for assessing democracy in the particular context of Mongolia using comparable concepts and measures employed in the measurement and assessment of democracy in other developed and developing democracies around the world, as well as a series of ‘satellite’ indicators that captured aspects of democracy particular to the Mongolian national context. 4. Mongolia has built on the assessment process by institutionalising a democratic reform agenda through the passage of the 9th Millennium Development Goal on democracy, human rights, and zero tolerance of corruption. DOI: http://dx.doi.org/10.5564/mjia.v0i18.73 Mongolian Journal of International Affairs No.18 2013: 105-117

Rainfall redistribution through the vegetation canopy plays a key role in the hydrological cycle. Although there have been studies on the heterogeneous patterns of rainfall redistribution in some ecosystems, the understanding of this process in different stages of forest succession remains insufficient. Therefore, this study investigated the change tendency in rainfall redistribution and rainwater chemistry in a subtropical forest succession in South China, based on 22 years (2001–2022) of rainfall monitoring (740 valid events). Results showed that, at the event scale, both the throughfall ratio and the stemflow ratio in pine forest (PF) were higher than in mixed forest (MF) and broadleaf forest (BF). At the interannual scale, throughfall and stemflow of forests experienced an initial decrease followed by a subsequent increase over the entire measurement period (except stemflow of the pine forest), which reflects the trend in open rainfall. The variability in throughfall showed an increase from MF to PF to BF, and the variability in stemflow likewise showed an increase from MF to PF to BF. Changes in throughfall and stemflow in the BF are thus higher than those in the MF and PF over time. Furthermore, important differences in rainwater chemistry fluxes among the three forest types were found, changing in varying order over time. On average, total nitrogen (TN) and total phosphorus (TP) fluxes of throughfall increased from BF to MF to PF, while the potassium (K+) flux of throughfall showed a decrease from BF to MF to PF. Stemflow chemical fluxes varied less among forest types and over time, although tree species most importantly affected varying stemflow chemistry. These results show important changes in patterns of rainfall redistribution over time and that characteristic variations are driven by rainfall and forest factors. Therefore, this study provides insight into long-term rainfall redistribution processes by linking changes in rainfall spectra with a typical subtropical forest succession sequence.

Core samples taken from the bottom sediments of the glacial Lake Kucherla (Gorny Altai, Russia) clearly show annual layers represented by glacial clays. In our study, age-depth modeling is based the varve chronology and Cs-137, Pb-210 and C-14 isotope data. Our model is a highly accurate and reliable demonstration of the annual sedimentation history within the past 1400 years. The time series of geochemical indicators of climate change were obtained by synchrotron radiation micro X-ray fluorescence (SR-μXRF) core scanning. Instrumental meteorological observations from 1940 to 2016 were used to construct transfer functions for the average annual temperatures and atmospheric precipitation amounts. A geochemical trace of a catastrophic seismic event, the Mongolian earthquake of 1761, was found in the cross-section of the bottom sediments.

Loss of large bone segments due to fracture resulting from trauma or tumor removal is a common clinical problem. The goal of this study was to evaluate the use of scaffolds containing testosterone, bone morphogenetic protein-2 (BMP-2), or a combination of both for treatment of critical-size segmental bone defects in mice. A 2.5-mm wide osteotomy was created on the left femur of wildtype and androgen receptor knockout (ARKO) mice. Testosterone, BMP-2, or both were delivered locally using a scaffold that bridged the fracture. Results of X-ray imaging showed that in both wildtype and ARKO mice, BMP-2 treatment induced callus formation within 14 days after initiation of the treatment. Testosterone treatment also induced callus formation within 14 days in wildtype but not in ARKO mice. Micro-computed tomography and histological examinations revealed that testosterone treatment caused similar degrees of callus formation as BMP-2 treatment in wildtype mice, but had no such effect in ARKO mice, suggesting that the androgen receptor is required for testosterone to initiate fracture healing. These results demonstrate that testosterone is as effective as BMP-2 in promoting the healing of critical-size segmental defects and that combination therapy with testosterone and BMP-2 is superior to single therapy. Results of this study may provide a foundation to develop a cost effective and efficient therapeutic modality for treatment of bone fractures with segmental defects.

The demand for flexible composite films with electromagnetic interference (EMI) shielding capabilities is rapidly increasing. Balancing high EMI performance with flexibility and portability has become a critical research focus in practical applications. In this study, an optimized strategy for aramid nanofibers (ANF) films was developed using spin-coating and sol-gel techniques. The resulting film features a smooth surface and excellent mechanical properties. ANF, initially an insulator, was transformed into a conductor through the in-situ polymerization of ion-doped polypyrrole (PPy). Leveraging a multilayer structural strategy, we prepared a symmetric composite film, ANF@PPy-(TA-MXene)-AgNWs-(TA-MXene)-ANF@PPy (PMA), using vacuum-assisted filtration and lamination hot pressing. This film, composed of ANF@PPy (PA) as the matrix, tannic acid (TA) modified MXene, and silver nanowires (AgNWs) as fillers, exhibited multiple shielding mechanisms as electromagnetic wave (EMW) passed through its various layers. This multilayer configuration provides significant flexibility in EMW shielding. Moreover, TA-modified MXene expands the lamellar spacing, enhancing the scattering efficiency of EMWs within the film, and serves as a medium connecting the upper and lower layers. This results in the efficient integration of the multilayer structure, synergistically improving both EMI shielding performance and mechanical properties. When the ratio of PA/MXene/AgNWs was 1:3:1, the film demonstrated optimal properties, including an EMI shielding effectiveness of 70.2 dB, thermal conductivity of 4.62 W/(m•K), and tensile strength of 50.2 MPa. Due to the exceptional EMI shielding and thermal properties of the PMA composite film, it holds great potential for applications in artificial intelligence, wearable heaters, and military equipment., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024. Published by Elsevier Inc.)

Background: The emergence of telesurgery has received global interest, with secure network transmission identified as a crucial determinant of its success. This study aimed to evaluate the safety and viability of employing quantum cryptography communication in remote partial nephrectomy., Methods: The surgeon operated on the patient from a distance of over 260 km using remote control of a surgical robot. Key evaluation metrics for the telesurgery procedure included success rate, incidence of complications, network latency, and packet loss., Results: The average BMI of these patients was 29.4 kg/m 2 , the average warm ischaemia time was 26 min, and the packet loss rate was 0%. Postoperative patient recovery, as indicated by follow-up results, was favourable., Conclusions: We introduced a novel telesurgical paradigm for partial nephrectomy based on quantum cryptography communication. The application of pioneering technology provides patients with a safer choice for telemedical treatment and promotes the application of telesurgery., (© 2025 John Wiley & Sons Ltd.)

An algal-bacterial symbiosis (ABS) system was developed on a rotating biological contactor treating mariculture wastewater, and its nitrogen removal, enzymatic activity and metabolic pathways were investigated under different light intensities. The nitrogen removal efficiency increased when light intensities ranged from 20 to 80 μE/(m 2 ·s) but declined under 100 μE/(m 2 ·s). Higher enzymatic activities under 80 μE/(m 2 ·s) facilitated nitrogen conversion, light utilization, ATP supply and photosynthesis. Reactive oxygen species accumulation activated antioxidant pathways under 20 and 100 μE/(m 2 ·s). Functional bacteria including Sedimentitalea, Thauera and Dechloromonas as well as Chlorella sorokinian, Dunaliella, Pleurosira laevis and Microcystis were enriched under 80 μE/(m 2 ·s). Abundant photosynthesis-related genes (petC, Lca3/4 and atpH/A) supported energy supply and electron transport. Conversely, lower proportions of IDH3, gltB, and acnA/B under 20 and 100 μE/(m 2 ·s) hindered tricarboxylic acid cycle, reducing NADPH and energy production. These results enhance the understanding on the effect of light intensity on ABS system treating mariculture wastewater., 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.)

Characterized by a cascade of profound changes in nucleus pulposus (NP) cells, extracellular matrix (ECM), and biomechanics, intervertebral disc degeneration is a common multifactorial condition that may lead to various degenerative lumbar disorders. Therapeutic strategies targeting a single factor have shown limited efficacy in treating disc degeneration, and approaches that address multiple pathological ingredients are barely reported. In this study, engineered cell membrane-encapsulated keratin nanoparticles are developed to simultaneously alleviate NP cell senescence and promote ECM remodeling. To achieve this, salivary acid glycoengineered adipose mesenchymal stem cell membranes are used to coat keratin, a core protein for structural support and cellular protection. The synthesized cell membrane-coated keratin nanoparticles (MKNs) effectively protected mitochondrial integrity in NP cells from oxidative stress-induced damage. Moreover, MKNs modulate mitochondrial metabolism and attenuate NP cell senescence. In addition, MKNs activate integrins at the cell membrane and enhance the interactions between NP cells and ECM, resulting in increased ECM anabolism and decreased catabolism. The proposed multi-targeted strategy to block the degenerative cycle inside the disc is efficacious for treating disc degeneration and may have the potential for clinical application., (© 2025 Wiley‐VCH GmbH.)

Seawater electrolysis is an ideal technology for obtaining clean energy-green hydrogen. Developing efficient bifunctional catalysts is crucial for hydrogen production through direct seawater electrolysis. Currently, metal substrates loaded with active catalysts are widely employed as electrodes for seawater electrolysis. However, the challenge of metal corrosion cannot be ignored. In this work, the boron-doped diamond (BDD) with excellent corrosion resistance was explored as a substrate for loading active catalysts in seawater electrolysis. A step-by-step electrodeposition method was used to fabricate the FeCoS/Ni/BDD electrode, effectively addressing the poor adhesion of the FeCoS active layer to the BDD substrate. The resulting electrode demonstrated interesting bifunctional catalytic performance, achieving oxygen evolution reaction (OER) and hydrogen evolution reaction (HER) overpotentials of 425 mV and 360 mV, respectively, in alkaline simulated seawater (1 M KOH and 3.5 wt% NaCl) at a current density of 100 mA cm - 2 . Furthermore, by increasing the KOH concentration in the alkaline simulated seawater to 3 M, the OER and HER overpotentials of the electrode significantly decreased to 383 and 300 mV, respectively. This work offers a novel approach for utilizing BDD substrates in the design of corrosion-resistant electrodes for alkaline seawater electrolysis., Competing Interests: Declarations. Competing interests: The authors declare no competing interests., (© 2025. The Author(s).)

The nitrogen removal performance, enzymatic activity, antioxidant response and metabolic pathway of Chlorella pyrenoidosa (C. pyrenoidosa) under different salinities have been investigated during the treatment of aquaculture wastewater. The growth, chlorophyll content and photosynthetic activity of C. pyrenoidosa were negatively correlated with the salinity from 1% to 3%. The removal performance of chemical oxygen demand (COD) and nitrogen compounds for C. pyrenoidosa decreased with the increase of salinity from 1% to 3%, which was due to the decrease of their corresponding metabolism enzymatic activities. The equilibrium between the reactive oxygen species production and antioxidant defensive system in C. pyrenoidosa was destroyed under high salinity stress and then caused an irreversible damage, which decreased the nitrogen assimilation of C. pyrenoidosa. The metabolic pathway of C. pyrenoidosa under 3% salinity had some obvious variation by comparison with 1% salinity, which led to the discrepancy in the microalgae activity and nitrogen transformation performance. Additionally, high salinity could inhibit the expression of gene associated with the chlorophyll synthesis and damaged the photosystem II reaction center. This study can provide an insight into the effect of salinity on the nitrogen removal from aquaculture wastewater by microalgae., 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 Inc. All rights reserved.)

The development of advanced electrocatalysts for the abiotic direct glucose fuel cells (ADGFCs) is critical in the implantable devices in living organisms. The ligand effect in the Pt shell-alloy core nanocatalysts is known to influence the electrocatalytic reaction in interfacial structure. Herein, we reported the synthesis of ternary Pt@PdRu nanoalloy aerogels with ligand effect of PdRu on Pt-enriched surface through electrochemical cycling. Pt@PdRu aerogels with optimized Pt surface electronic structure exhibited high mass activity and specific activity of Pt@PdRu about 450 mA mg Pt -1 and 1.09 mA cm -2 , which were 1.4 and 1.6 times than that of commercial Pt/C. Meanwhile, Pt@PdRu aerogels have higher electrochemical stability comparable to commercial Pt/C. In-situ FTIR spectra results proved that the glucose oxidation reaction on Pt@PdRu aerogels followed the CO-free direct pathway reaction mechanism and part of the products are CO 2 by completed oxidation. Furthermore, the ADGFC with Pt@PdRu ultrathin anode catalyst layer showed a much higher power density of 6.2 mW cm -2 than commercial Pt/C (3.8 Mw cm -2 ). To simulate the blood fuel cell, the Pt@PdRu integrated membrane electrode assembly was exposed to glucose solution and a steady-state open circuit of approximately 0.6 V was achieved by optimizing the glucose concentration in cell system., (© 2024 Wiley-VCH GmbH.)

Addressing the urgent need for effective fracture treatments, this study investigates the efficacy of a 3D bioprinted biomimetic hydrogel, enriched with bone marrow mesenchymal stem cells (BMSCs) and targeted hypoxia-inducible factor 1 alpha (Hif1a) gene activation, in enhancing fracture healing. A photocross-linkable bioink, gelatin methacryloyl bone matrix anhydride (GBMA) is developed, and selected its 5% concentration for bioink formulation. Rat BMSCs are isolated and combined with GBMA to create the GBMA@BMSCs bioink. This bioink is then used in 3D bioprinting to fabricate a hydrogel for application in a rat femoral fracture model. Through transcriptome sequencing, WGCNA, and Venn analysis, the hypoxia-inducible factor Hif1a is identified as a critical gene in the fracture healing process. In vitro studies showed that Hif1a promoted BMSC proliferation, chondrogenic differentiation, and cartilage matrix stability. The in vivo application of the GBMA@BMSCs hydrogel with Hif1a overexpression significantly accelerated fracture healing, evidenced by early and enhanced cartilage callus formation. The study demonstrates that 3D bioprinting of GBMA@BMSCs hydrogel, particularly with Hif1a-enhanced BMSCs, offers a promising approach for rapid and effective fracture repair., (© 2024 Wiley‐VCH GmbH.)

Abstract: Low-dose methotrexate has been proposed as therapy for patients with severely disabling psoriasis and psoriatic arthritis. However, it can be associated with severe toxicity, such as pancytopenia, characterized by anemia (hemoglobin level <13 g/dL in men), thrombocytopenia (platelet count <150 × 109/L), and neutropenia or agranulocytosis (neutrophil count <1.5 × 109/L and 0.5 × 109/L, respectively). Here, we report a challenging clinical scenario characterized by pancytopenia and acute renal failure to inform clinicians about potential drug-drug interactions and subclinical renal insufficiency., Competing Interests: The authors declare no conflict of interest., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)

Study Design: Retrospective analysis., Objective: Kümmell's disease is an uncommon and complicated spinal condition first described in 1891. Treatment of this disease must be individualized according to the stage of disease and the experience and preference of the surgeon. Nevertheless, the surgical option in Stage III Kümmell's disease without neurological deficits remains controversial. The purpose of this study is to determine whether PKP or pedicle subtraction osteotomy (PSO) combined with long-segment fixation (LSF) is more effective in treating Kümmell's disease at Stage III without neurological impairments., Methods: Between January 2017 and June 2020, 89 patients were treated with PKP or PSO + LSF. The outcomes, including operative time, blood loss, Oswestry Disability Indexes (ODIs), heights of fractured vertebrae, visual analog scale (VAS) scores, and kyphosis Cobb angles, were measured at the follow-up time for the PKP group and PSO + LSF group. Fisher's exact test or chi-square test for number and percentage data was employed to compare statistical analyses between two groups., Results: Forty-six patients underwent PKP and 43 patients who treated by PSO + LSF. Postoperative measurements showed substantial improvements in kyphosis Cobb angle and vertebral height in the PKP group compared to preoperative measurements. Operating time, estimated blood loss, and duration of stay were all reduced in the PKP group compared to the PSO + LSF group. The PSO + LSF group had better correction of a kyphotic Cobb angle than the PKP group. Short-term monitoring showed that the PKP group had fewer ODI and VAS scores than the PSO + LSF group. In addition, no significant neurological symptoms were found after operation in both groups. The complication rates of PKP and PSO + LSF groups were 10.87% and 9.30%, respectively., Conclusions: Kümmell's disease in Stage III without neurological symptoms responded to both PKP and PSO + LSF as safe and efficient treatments. Despite limited correction of kyphotic Cobb angle, PKP patients had better early clinical outcomes, increased fractured vertebral height, decreased blood loss, and less surgical trauma compared with the PSO + LSF group., (© 2024 The Author(s). Orthopaedic Surgery published by Tianjin Hospital and John Wiley & Sons Australia, Ltd.)

Background: Designing effective health interventions and evaluating their impact is crucial to improving the health of the population. To ensure interventions are of high quality and effective, evidence-based research is essential, particularly studies that use randomised controlled trials (RCTs) or systematic reviews. However, RCTs may not be feasible or ethical in certain situations, such as in intensive care units. Cluster or stepped-wedge RCTs are alternative ways to assess interventions that also address these ethical concerns., Aim: To explain the stepped-wedge design and its main features as well as how to use it to evaluate nursing interventions., Discussion: Understanding stepped-wedge designs empowers nurses to implement evidence-based interventions and improve patient outcomes. The use of stepped-wedge designs has increased in nursing research over the past two decades, indicating growing recognition of its advantages: efficient evaluation of healthcare interventions, ensuring all clusters receive treatment over time; smaller sample sizes; ethical considerations; and time control. However, challenges remain: ensuring nurse researchers' understanding and application of it is consistent, extended duration and logistical complexities. Methodological rigour, collaboration and understanding of secular trends are crucial, and nurses' involvement in RCTs enhances cluster selection, data collection and dissemination., Conclusion: The stepped-wedge design offers an ethical and adaptable method for studying interventions, considering healthcare complexities and allocating resources. Its versatility assists the advancement of nursing care delivery and in promoting evidence-based practice., Implications for Practice: Understanding stepped-wedge designs in nursing practice enhances evidence-based care, decision-making, collaboration and professional development, benefiting patient outcomes., Competing Interests: None declared, (© 2024 RCN Publishing Company Ltd. All rights reserved. Not to be copied, transmitted or recorded in any way, in whole or part, without prior permission of the publishers.)

Nanoscale material systems are central to next-generation optoelectronic and quantum technologies, yet their development remains hindered by limited characterization tools, particularly at terahertz (THz) frequencies. Far-field THz spectroscopy techniques lack the sensitivity for investigating individual nanoscale systems, whereas in near-field THz nanoscopy, surface states, disorder, and sample-tip interactions often mask the response of the entire nanoscale system. Here, we present a THz resonance-amplified near-field spectroscopy technique that can detect subtle conductivity changes in isolated nanoscale systems─such as a single InAs nanowire─under ultrafast photoexcitation. By exploiting the spatial localization and resonant field enhancement in the gap of a bowtie antenna, our approach enables precise measurements of the nanostructures through shifts in the antenna resonant frequency, offering a direct means of extracting the system response, and unlocking investigations of ultrafast charge-carrier dynamics in isolated nanoscale and microscale systems.

Small colony variant (SCV) is strongly linked to antibiotic resistance and the persistence of osteomyelitis. However, the intrinsic phenotypic instability of SCV has hindered a thorough investigation of its pathogenic mechanisms. In this study, phenotypically stable SCV strains are successfully recovered from clinical specimens, characterized by elevated drug resistance and reduced immunogenicity. Multi-omics analysis revealed that the acquired high drug resistance is associated with altered flux in the purine metabolism pathway, attributable to mutations in the hypoxanthine phosphoribosyltransferase (hpt) gene. Furthermore, this study innovatively discovered that lonidamine, an inhibitor of cellular energy metabolism, can effectively mitigate SCV resistance to β-lactam antibiotics, thereby facilitating its eradication. The underlying mechanism involves the reprogramming of purine metabolism. Therefore, a co-delivery system for lonidamine and oxacillin is constructed with amino-modified dendritic mesoporous silica as a carrier, which showed high efficacy and safety in combating SCV both in vitro and in vivo experiments. Overall, this study elucidated the pathogenic mechanisms of a class of clinically isolated SCV isolates with hpt mutations and provided a paradigm for treating SCV-associated osteomyelitis by reprogramming purine metabolism., (© 2024 The Author(s). Advanced Science published by Wiley‐VCH GmbH.)

Cellulose nanocrystals (CNC) have been significantly developed as a building block material for the design of novel functional materials in many fields such as biomedicine, nanotechnology, and materials science due to their excellent optical properties, biocompatibility, and sustainability. Improving the redispersibility of CNC in the sustainable processing of nanocellulose has been a challenge because intense hydrogen bond interaction leads to irreversible aggregation, making CNC difficult to redisperse and increasing the cost of storage and transportation of CNC. Hydroxypropyl cellulose (HPC) is an important hydroxy propylated cellulose ether. As a water-soluble cellulose derivative, HPC has a polyhydroxy structure similar to that of CNC, which leads to good compatibility and high affinity between HPC and CNC. In this work, HPC of different molecular weights was comixed with CNC of different contents, which was then dried using different methods, and the dried samples were redispersed in water. The addition of HPC improved the redispersibility of the CNC. Finally, the redispersed suspension was also redried to form a film, which was found to retain its structure color. These results provide an important avenue for the redispersion of dried CNC and for the development of functional materials from redispersed CNC.

Background: While structured compassion training programs have shown promise for increasing compassion among medical trainees, a major challenge is applying the concepts and practices taught during the program into the complex, dynamic, time-pressured, and often hectic hospital workplace., Objective: The purpose of this pilot study was to examine the feasibility, acceptability, and preliminary effects of Compassion Coach, a mobile health (mHealth) smartphone app designed to bolster a 6-week mindfulness and self-compassion training program for medical trainees., Methods: In Compassion Coach, notifications to remind, encourage, and measure the perceived impact of informal mindfulness and compassion practices taught during the program were delivered at 7 AM, 12 PM, and 7 PM, respectively, 3 times per week over the course of the training program. The app also contained a library of guided audio formal mindfulness and compassion practices to allow quick and easy access. In this pilot study, we collected data from 29 medical students and residents who downloaded Compassion Coach and completed surveys assessing perceived effectiveness and acceptability. Engagement with the Compassion Coach app was passively tracked through notification response rate and library resource access over time., Results: The average response rate to notifications was 58% (SD 29%; range 12%-98%), with a significant decline over time (P=.009; odds ratio 0.98, 95% CI 0.96-0.99). Across all participants and occasions, the majority agreed the informal practices prompted by Compassion Coach helped them feel grounded and centered (110/150, 73%), improved compassion (29/41, 71%), reduced burnout (106/191, 56%), and improved their mood (133/191, 70%). In total, 16 (55%) of the 29 participants accessed guided audio recordings on average 3 (SD 3.4) times throughout the program. At the posttreatment time point, most participants (13/18, 72%) indicated that Compassion Coach helped them engage in compassion practices in daily life, and half (9/18, 50%) indicated that Compassion Coach helped improve interactions with patients., Conclusions: Overall, preliminary results of Compassion Coach are encouraging and suggest the integration of a smartphone app with an ongoing mindfulness and self-compassion training program may bolster the effects of the program on medical trainees. However, there was variability in engagement with Compassion Coach and perceived helpfulness. Additional research is indicated to optimize this novel mHealth approach and conduct a study powered to formally evaluate effects., (©Jennalee S Wooldridge, Emily C Soriano, Gage Chu, Anaheed Shirazi, Desiree Shapiro, Marta Patterson, Hyun-Chung Kim, Matthew S Herbert. Originally published in JMIR Formative Research (https://formative.jmir.org), 26.11.2024.)

Background: Approximately 70% of patients in intensive care units (ICUs) experience untreated pain, often due to severe patient conditions and communication barriers., Aim: The aim of this study was to implement the Critical-Care Pain Observation Tool (CPOT) to improve pain assessment in patients unable to self-report pain in the ICU., Method: A stepped-wedge trial was conducted in six adult ICUs in Saudi Arabia between February and June 2022. The sequential transition of ICU clusters occurred in February 2022, from control to intervention, until all ICUs were exposed to the intervention. The primary outcome was the number of pain assessments, whereas the secondary outcomes were reassessments. Other outcomes were length of stay, mechanical ventilation duration, and administered doses of sedatives and analgesic agents. Statistical analyses were performed using the Statistical Analysis Software v9.4., Results: A total of 725 patients unable to self-report pain were included; 65% (n = 469) were male with an average age of 55 years. Implementing CPOT showed a significant increase in the number of pain assessments (rate ratio: 1.77, 95% confidence interval: 1.45, 2.16, p < 0.001) and reassessments (rate ratio: 13.99, 95% confidence interval: 8.14, 24.02, p < 0.001) between intervention and control conditions. There was no significant effect on the ICU length of stay, mechanical ventilation duration, and the amount of sedation (midazolam, propofol, and ketamine) and analgesia (fentanyl) administered., Conclusion: The study indicates that the implementation of the CPOT increased the frequency of pain assessment and reassessment. However, the impact on patient outcomes remains inconclusive. Further investigations focussing on CPOT as the primary pain scale are necessary to determine its holistic impact on patient outcomes over the long term., Trial Registration: NCT05488834., Clinical Trial Registration Number: This study was registered with the U.S. National Library of Medicine (ClinicalTrial.gov, NCT05488834)., Competing Interests: Conflict of interest The authors declare no conflicts of interest related to this manuscript., (Copyright © 2024 Australian College of Critical Care Nurses Ltd. Published by Elsevier Ltd. All rights reserved.)

Study Design: Retrospective study., Objectives: To demonstrate that repeat Percutaneous vertebroplasty (PVP) performed for the same cemented vertebrae in Kümmell's disease can offer therapeutic benefit for patients with recurrent symptoms after initial percutaneous kyphoplasty (PKP) treatment., Methods: From January 2019 to December 2021, we investigated 2932 patients with PKP. Among them, 191 patients were diagnosed Kümmell's disease. 33 patients upon presentation of recurrent symptoms underwent repeat PVP procedure. Radiologic outcomes and clinic indices were investigated., Results: Bone cement reperfusion surgery was successfully completed in 33 patients. The average age was 73.5 ± 8.2 years old. The kyphosis angle showed significant correction from pre-operation to the final follow-up, descending from pre-operation (20.6 ± 11.1°) to final follow-up (15.4 ± 7.9°). The vertebral heights at different follow-up appointments were significantly higher than the pre-operative appointments. The VAS and ODI scores at final follow-up were respectively 1.2 ± .8 and 27.3 ± 5.4%, which were both significantly lower than those before operation. No complications such as cement leakage into the spinal canal or cement displacement occurred during follow-up., Conclusions: Bone cement reperfusion surgery can ameliorate kyphosis and restore vertebral height to some extent. Repeat PVP is a minimally invasive surgery that provides superior long-term results in clinical and radiological outcomes but is technically more difficult to perform., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Background: Xerostomia is a distressing symptom experienced by patients undergoing dialysis. We sought to compare and rank the efficacy of different non-pharmacological interventions on xerostomia and salivary flow rate among dialysis patients., Methods: A systematic search was conducted in six English-language databases: PubMed, CINAHL, Scopus, Web of Science, Embase and Cochrane Central Register of Controlled Trials, in April 2023. Screening, quality appraisal and data extraction were undertaken by two independent reviewers. A network meta-analysis was performed to assess the relative efficacy of different non-pharmacological interventions., Results: The analysis included 11 randomized controlled trials involving 739 patients and eight non-pharmacological interventions. The pairwise analysis indicated that compared with the control group, sugarless candy, chewing sugarless gum, acupressure auricular and licorice mouthwash had a significant positive effect on reducing the severity of xerostomia; also, transcutaneous electrical nerve stimulation (TENS), licorice mouthwash, sugarless chewing gum, photobiomodulation and pure water mouthwash significantly improved the saliva flow rate. The network analysis indicated that sugarless chewing gum significantly reduced the symptoms of xerostomia, while TENS and sugarless chewing gum were effective in improving the unstimulated whole salivary rate. Among dialysis patients, chewing sugarless gum and using TENS were the top-ranked interventions for relieving xerostomia and enhancing saliva flow rate, respectively., Conclusions: Several non-pharmacological interventions have demonstrated effectiveness in relieving xerostomia and enhancing saliva flow rate. While further research may be needed to confirm and refine these findings, the interventions used in this review offer promising results and should be incorporated into the standard care of dialysis patients experiencing these symptoms to enhance their quality of life and oral health., Competing Interests: The authors declare no conflicts of interest., (© The Author(s) 2024. Published by Oxford University Press on behalf of the ERA.)

Competing Interests: The authors declare no conflict of interest.

Background: The case study discusses a complex scenario involving the use of amoxicillin in a critically ill patient undergoing intermittent renal replacement therapy.Severe infections are complicated by septic shock and organ failure, requiring urgent and effective antibiotic treatment., Methods: The patient's comorbidities, including obesity and acute kidney injury, required careful consideration of the amoxicillin dosing strategies., Results: Therapeutic drug monitoring is critical for dose adjustment during treatment., Conclusions: This case highlights the importance of a collaborative approach between clinicians and therapeutic drug monitoring consultants to optimize antibiotic therapy for critically ill patients with renal impairment., Competing Interests: The authors declare no conflict of interest., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)