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目的 评估普罗布考与阿托伐他汀钙联合治疗急性脑梗死（acute cerebral infarction，ACI）的疗效，以提供ACI的治疗参考方案。 方法 回顾性收集2018年1月—2023年9月在重庆市急救医疗中心就诊，发病24 h内住院的ACI患者资料。纳入患者需满足：接受了阿托伐他汀钙（20 mg，每晚1次）单药或联用普罗布考（0.5 mg，每日2次）调节血脂治疗，且治疗周期为3个月以上。根据是否联用普罗布考分为联合治疗组和对照组，比较两组治疗后神经功能（使用NIHSS评估）、神经功能结局（使用mRS评估）、生活能力（使用Barthel指数评估）以及血脂水平的差异。 结果 研究共入组102例患者，其中联合治疗组56例，对照组46例。两组的基线资料差异无统计学意义。治疗后14 d两组的NIHSS评分和血脂水平、治疗3个月后的血脂水平均较本组治疗前显著改善（均P

The cordierite–belite core-shell lightweight aggregate (CSLWA) effectively improves the performance of the interfacial transition zone (ITZ) in lightweight aggregate concrete; however, the underlying fracture behavior still needs to be revealed. This study characterized the reinforced mechanical properties of ITZ by CSLWA through nanoindentation and interfacial fracture tests and the reinforcement mechanism was further explained using finite element analysis. The results showed that the continuous hydration of the belite shell of CSLWA enhanced the yield stress and improved the failure strain during fracture. Energy dissipation was observed during the fracture of CSLWA concrete, improving the brittleness of the lightweight aggregate concrete. Finite element analysis showed that the core strength of CSLWA changed the energy dissipation model and affected the toughness of CSLWA concrete, and a suitable composition of 6:4 was proposed for the "cordierite–anorthite" core constitution in CSLWA depending on the strength order between the cement matrix and core of the CSLWA. [ABSTRACT FROM AUTHOR]

Planting oat forage in fallow fields during winter and producing total mixed ration (TMR) silage can effectively address issues of land wastage and forage shortages while maintaining forage quality. This study used oats and common vetch grown in winter fields in southern China as base materials, with additives including corn flour, soybean meal, corn lees, cottonseed meal, and premixes to formulate mixed feeds with roughage-to-concentrate ratios of 75:25, 70:30, and 65:35 on a dry matter basis. TMR silage was inoculated with a customized mixed lactic acid bacteria (LAB) additive composed of Lactobacillus plantarum 160 (patent number ZL202210218695.5), Lactobacillus pentosus 260 (patent number ZL202210204293), and Lactobacillus buchneri 225 (patent number ZL202210204293), at a ratio of 2:1:1, with addition rates of 4 × 106, 2 × 106, and 2 × 106 cfu/g, respectively (IN), while sterile distilled water served as the control (CK). After a 60-day fermentation, the cornell net carbohydrate protein system (CNCPS) and in vitro digestion analysis were used to assess the effects of different roughage-to-concentrate ratios on the carbohydrate and protein components and ruminal degradation rate of fermented TMR (FTMR) silage, as well as to evaluate the impact of mixed LAB inoculation on FTMR nutritional quality, fermentation quality, and aerobic stability. The results indicated the following: (1) Regardless of the LAB addition, dry matter (DM), ether extract (EE), crude protein (CP), and Ash contents significantly decreased (p < 0.05) as the concentrate level decreased. In the IN group, as the concentrate level decreased, the water-soluble carbohydrate (WSC) content significantly increased (p < 0.05), the pH significantly decreased (p < 0.05), and the NH3-N/TN significantly decreased (p < 0.05), with LAB counts significantly higher at a 65:35 roughage-to-concentrate ratio than in the other two groups. In the CK group, no significant changes (p > 0.05) were observed in the WSC content, pH, or LAB counts. (2) CNCPS analysis showed that in the IN group, the carbohydrate (CHO) content at a 75:25 roughage-to-concentrate ratio was significantly higher than in the other two groups (p < 0.05), while the non-utilizable carbohydrate (CC) content was significantly lower (p < 0.05). As the concentrate levels decreased, the non-protein nitrogen (PA) and moderately degradable true protein (PB2) content significantly increased (p < 0.05), whereas the rapidly degradable true protein (PB1) and slowly degradable true protein (PB3) content significantly decreased (p < 0.05). In the CK group, the CHO, PA, PB2, and PC content significantly increased (p < 0.05) as concentrate levels decreased, while the PB1 and PB3 content significantly decreased (p < 0.05). (3) In vitro digestibility characteristics indicated that gas production (GP) in the IN group was significantly lower than in the CK group (p < 0.05), with crude protein degradability increasing as concentrate levels decreased, regardless of the LAB addition. (4) At a 65:35 roughage-to-concentrate ratio, aerobic stability in the IN group was significantly higher than in the CK group (p < 0.05). In conclusion, higher concentrate ratios in total mixed rations (TMRs) with varying roughage-to-concentrate proportions improve the nutritional quality and promote the ruminal degradation of the FTMR. LAB inoculant addition could be an effective approach for addressing FTMR feed challenges. [ABSTRACT FROM AUTHOR]

Introduction: Weak aerobic stability is a notable challenge for whole-plant corn silage, particularly in hot and humid regions. Acetobacter is commonly regarded as an indicator of aerobic deterioration in silage, yet its precise role in fermentation and during aerobic exposure, as well as the factors that promote its growth, remain insufficiently understood. Methods: In this study, whole-plant corn silage was prepared using a bagged method with controlled dry matter (DM) content at 20%, 25%, and 30%, and initial concentrations of A. pasteurianus at 40%, 50%, and 60%. The silage was stored for 60 days under varying temperatures (20°C, 30°C, and 40°C). Following the anaerobic storage phase, the silage was exposed to air at room temperature (20-25°C) for 7 days, both with and without A. pasteurianus inoculation. Results: The results demonstrated that A. pasteurianus did not impact the nutritional value of the silage during anaerobic fermentation, maintaining a low pH (< 3.80). However, during aerobic exposure, the presence of A. pasteurianus significantly reduced the aerobic stability of the silage. The microbial community shifted from primarily Klebsiella species initially to Lactobacillus and Acetobacter species post-ensiling. During the aerobic exposure phase, A. pasteurianus and A. fabarum became the dominant species. Response Surface Methodology (RSM) analysis identified optimal conditions for the proliferation of A. pasteurianus during the aerobic phase, which occurred at 28°C, 25% DM, and 52% initial concentration at 3 ml/kg. Discussion: These findings confirm that A. pasteurianus plays a critical role in reducing the aerobic stability of whole-plant corn silage. Additionally, the study identifies the optimal conditions that favor the proliferation of A. pasteurianus , offering valuable insights for the development of strategies to prevent and control this bacterium, thereby improving the aerobic stability of silage in hot and humid regions. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to investigate the current state of empathy for pain among clinical nurses, analyze the relationship between resilience and empathy for pain, and explore the mediating effects of coping styles. Methods: This was a multicenter cross-sectional study conducted among 1601 clinical nurses in Guangdong Province, China. The convenience sampling method was used to collect data from Sociodemographic information, the 14-Item Resilience Scale, the Simplified Coping Style Questionnaire, and the Chinese version of the Empathy for Pain Scale from June to September 2023. To analyze the relationship between resilience, coping styles, and empathy for pain among clinical nurses with descriptive statistics, Spearman correlation analysis, and mediation analysis. Results: The empathy for pain score among Chinese clinical nurses was 2.92 ± 0.79, with the empathy reactions dimension at 3.56 ± 0.74, and the body and mind discomfort reactions dimension at 2.70 ± 0.89. Clinical nurses' resilience was positively related to the coping styles and the empathy reactions dimension, whereas negatively associated with the body and mind discomfort reactions dimension. Coping styles were negatively related to the empathy for pain and the body and mind discomfort reactions dimension, whereas positive with the empathy reactions dimension. Coping styles partially mediated between resilience and empathy reactions dimension (β=0.127, 95% CI: 0.070~0.183), accounting for 56.19% of the total effect. There were suppressing effects of coping styles between resilience and empathy for pain (β=− 0.157, 95% CI: − 0.189~-0.126), the body and mind discomfort reactions dimension (β=− 0.172, 95% CI: − 0.203~-0.142). Conclusion: The effects of resilience on clinical nurses' empathy for pain were partially mediated and suppressed by coping styles. During clinical pain management, nursing administrators should focus on developing clinical nurses' resilience and positive coping strategies to improve nurses' physical and mental health, optimize pain management, and foster a heightened sense of empathy for pain. [ABSTRACT FROM AUTHOR]

Background Cardiac blunt trauma clinically presents as a spectrum of injuries of varying severity. However, the diagnosis of complications of remote myocardial trauma is often challenging, especially if the patient forgets to mention a remote history of chest trauma. Case summary In this study, we present a patient who recently experienced traumatic myocardial dissection and interventricular septal rupture, alongside three patients exhibiting a mimic double-chambered left ventricle, indicative of prior remote myocardial trauma potentially associated with myocardial dissecting tear. Discussion Patients with recent severe myocardial injury are detectable through cardiac imaging. However, forgotten remote myocardial trauma can lead to adverse myocardial remodelling, heart failure, and arrhythmias. Long-term myocardial remodelling can obscure initial myocardial imaging characteristics, posing challenges in interpretation. Our case series suggests that remote myocardial trauma may be more prevalent than commonly thought of in clinical practice. [ABSTRACT FROM AUTHOR]

Simple Summary: The yak (Bos grunniens) is a multi-tasking grazing ruminant species playing vital roles for Tibetan nomads living in the Hindu Kush-Himalayan region and the Qinghai-Tibetan Plateau. Yaks are subjected to undernutrition in traditional pasture management systems during long winters due to inadequate forage intakes. This results in animals losing 25.7~30.2% of their live weight. Large ruminant animals have high intakes of feed and water. The utilization of dietary nitrogen efficiency of yaks is only about 25.9%, and a large amount of nitrogen is excreted in their feces and urine. Changes in nutritional measurement could improve the utilization of dietary nutrients and regulate the synthesis of proteins in yaks. Methionine and lysine are the first two limiting amino acids in a corn–soybean-meal-based diet for ruminants; therefore, we added rumen-protected methionine and lysine to low- and high-protein diets and found that the low-protein diet supplemented with rumen-protected methionine and lysine is beneficial for rumen and body health, physiological response, and metabolic status in yaks. This study investigated the effects of the dietary protein level and rumen-protected methionine and lysine (RPML) on the growth performance, rumen fermentation, and serum indexes of yaks. Thirty-six male yaks were randomly assigned to a two by three factorial experiment with two protein levels, 15.05% and 16.51%, and three RPML levels: 0% RPML; 0.05% RPMet and 0.15% RPLys; and 0.1% RPMet and 0.3% RPLys. The trial lasted for sixty days. The results showed that the low-protein diet increased the DMI and feed conversion ratio of yaks. The diet supplemented with RPML increased the activities of IGF1 and INS and nutrient digestibility. The high-protein diet decreased the rumen butyrate concentration and increased the rumen isovalerate concentration. The low-protein diet supplemented with RPML increased the rumen pH and the concentrations of total volatile fatty acids, butyrate and NH3-N; the high-protein diet supplemented with a high level of RPML decreased the rumen pH and the concentrations of isobutyrate, isovalerate, propionate and NH3-N. The low-protein diet supplemented with RPML increased the total antioxidant capacity and glutathione peroxidase activity, along with the concentrations of malondialdehyde and amino acids such as aspartic acid, lysine, cysteine, etc. In conclusion, a low-protein diet supplemented with RPML is beneficial for rumen and body health, physiological response, and metabolic status in yaks. [ABSTRACT FROM AUTHOR]

Polymer‐based magnetic particles have been widely used for the separation of biological samples including nucleic acids, proteins, virus, and cells. Existing magnetic particles are almost prepared by coating polymers on magnetic nanoparticles (NPs). However, this strategy usually encounters the problem of poor magnetic NPs loading capacity. Here, a series of nanofractal magnetic particles (nanoFMPs) synthesized by a strategy of mediator monomer regulated emulsion interfacial polymerization is presented, which allows effective magnetic NPs loading and show efficient nucleic acid separation performance. The mediator monomers facilitate the dispersion of magnetic NPs in internal phase to achieve higher loading, and the hydrophilic monomers use electrostatic interactions to form surface nanofractal structures with functional groups. Compared with magnetic particles without nanofractal structure, nanoFMPs exhibit a higher nucleic acid extraction capability. This strategy offers an effective and versatile way for the synthesis of nanoFMPs toward efficient separation in various fields from clinical diagnosis to food safety and environmental monitoring. [ABSTRACT FROM AUTHOR]