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Background: The prognosis of initially unresectable hepatocellular carcinoma (iuHCC) has been improved by TACE with TKIs and PD-1 inhibitors (TTP). However, the role of timing of tumor progression and and early salvage surgery during TTP therapy remains unclear. Patients and Methods: The data of 151 patients who received TTP for iuHCC consecutively between November 2019 and December 2022 were retrospectively analyzed. The X-Tile software was used to determine the optimal threshold of progression timing to differentiate the post-progression survival (PPS) for patients with tumor progression, ultimately yielding 9 months as the optimal cut-off time. Early tumor progression was defined as patients with tumor recurrence (surgical patients) or progressive disease by mRECIST (nonsurgical patients) within 9 months of initial treatment. Accordingly, early salvage surgery was defined as salvage surgery performed within 9 months of the initial treatment. Results: Out of all the patients, 55 (36.4%) patients showed early tumor progression, 33 (34.4%) showed late tumor progression, and 63 (41.7%) showed non-progression. Patients who experienced early tumor progression had a median PPS of 5.2 months, while those with late tumor progression had a median PPS of 16.8 months (P < 0.001). Multivariable analysis revealed a robust independent correlation between early tumor progression and PPS (HR = 3.279, 95% CI: 1.591– 6.756; P = 0.001). Patients who received early salvage surgery showed a considerably lower early tumor progression rate when compared with patients who did not receive early surgery (12.5% vs 42.9%, P = 0.002). The multivariable analysis revealed that early salvage surgery was an independent factor influencing early tumor progression (OR = 0.246; 95% CI: 0.078– 0.773; P = 0.016). Conclusion: Early tumor progression is associated with worse PPS in patients with iuHCC receiving TTP therapy. Early salvage surgery can further improve patient outcomes by lowering the incidence of early progression. [ABSTRACT FROM AUTHOR]

Cognitive impairment induced by postoperative pain severely deteriorates the rehabilitation outcomes in elderly patients. The present study focused on the relationship between microglial exosome miR‐124‐3p in hippocampus and cognitive impairment induced by postoperative pain. Cognitive impairment model induced by postoperative pain was constructed by intramedullary nail fixation after tibial fracture. Morphine intraperitoneally was carried out for postoperative analgesia. Morris water maze tests were carried out to evaluate the cognitive impairment, while mRNA levels of neurotrophic factors (BDNF, NG) and neurodegenerative biomarker (VILIP‐1) in hippocampus were tested by q‐PCR. Transmission electron microscope was used to observe the axon degeneration in hippocampus. The levels of pro‐inflammatory factors (TNF‐α, IL‐1β, IL‐6), the levels of anti‐inflammatory factors (Ym, Arg‐1, IL‐10) and microglia proliferation marker cyclin D1 in hippocampus were measured to evaluate microglia polarization. Bioinformatics analysis was conducted to identify key exosomes while BV‐2 microglia overexpressing exosome miR‐124‐3p was constructed to observe microglia polarization in vitro experiments. Exogenous miR‐124‐3p‐loaded exosomes were injected into hippocampus in vivo. Postoperative pain induced by intramedullary fixation after tibial fracture was confirmed by decreased mechanical and thermal pain thresholds. Postoperative pain induced cognitive impairment, promoted axon demyelination, decreased BDNF, NG and increased VILIP‐1 expressions in hippocampus. Postoperative pain also increased pro‐inflammatory factors, cyclin D1 and decreased anti‐inflammatory factors in hippocampus. However, these changes were all reversed by morphine analgesia. Bioinformatics analysis identified the critical role of exosome miR‐124‐3p in cognitive impairment, which was confirmed to be down‐regulated in hippocampus of postoperative pain mice. BV‐2 microglia overexpressing exosome miR‐124‐3p showed decreased pro‐inflammatory factors, cyclin D1 and increased anti‐inflammatory factors. In vivo, stereotactic injection of exogenous miR‐124‐3p into hippocampus decreased pro‐inflammatory factors, cyclin D1 and increased anti‐inflammatory factors. The cognitive impairment, axon demyelination, decreased BDNF, NG and increased VILIP‐1 expressions in hippocampus were all alleviated by exogenous exosome miR‐124‐3p. Microglial exosome miR‐124‐3p in hippocampus alleviates cognitive impairment induced by postoperative pain through microglia polarization in elderly mice. [ABSTRACT FROM AUTHOR]

Herein, a novel technology named coaxial electro‐spraying/electrospinning was successfully introduced, which can simultaneously prepare nanofibers and nanoparticles. First, the device contains an outer nozzle and an inner nozzle, which combine electrospinning with electro‐spraying technology. Then, the polyamide 6 (PA6) was spun to prepare the nanofibers from the inner nozzle, and the silver nanoparticles (Ag NPs) into the PA6 solution were sprayed to prepare the nanoparticles from the outer nozzle. PA6 nanofibers (NFs)/Ag nanoparticles (NPs) antibacterial composite membranes for the filtration of fine particulate pollutants were successfully prepared using coaxial electro‐spraying/electrospinning. The microstructure, physical properties, and antibacterial properties of the composite membrane were investigated. The results show that Ag NPs are successfully loaded in situ onto PA6 NFs of approximately 100 nm to form a three‐dimensional (3D) structure. The filtration efficiency of the 3D structured filtration membrane reaches 90.98%, compared to only 12.78% for the melt‐blown cloth mask filter material when tested with polystyrene microspheres (PS) of 200 nm. The contact angle of the composite membrane decreased from 145.47° to 44.11°, indicating a significant improvement in the hydrophilicity of the membrane. Furthermore, depositing Ag on the surface fibers resulted in an impressive antibacterial rate of 99.75% against Penicillium. [ABSTRACT FROM AUTHOR]

Metal fluorides (MFs) are regarded as high‐capacity conversion cathode materials for next‐generation lithium‐ion batteries with high energy density. However, these cathodes suffer from poor electronic conductivity, sluggish reaction kinetics, and deleterious cathode solid electrolyte interface (CEI) formation, which may cause rapid cell degradation upon cycling. Herein, a low temperature chemical vapor deposition (CVD) carbon coating technology is successfully achieved to coat MFs‐FeF2 with a thin amorphous carbon layer, which promotes the formation of a stable CEI with improved electronic and ionic transport property. Consequently, a discharge capacity higher than 450 mAh g−1 of the CVD coated FeF2 is achieved with a capacity retention at about 75% after 2500 cycles in a saturated electrolyte. Moreover, an unprecedented cycling performance with the discharge capacity of 350 mAh g−1 after 500 cycles in a super diluted electrolyte is also achieved. Advanced cryo‐electron microscopy reveals that the carbon coating significantly suppresses the undesirable CEI formation and promotes the formation of a thin CEI with excellent chemo‐mechanical property. This work provides a feasible technology to stabilize the important interface on MFs and offers a new strategy to accelerate the commercial adoption of such cathodes. [ABSTRACT FROM AUTHOR]

Diabetes mellitus and lipid metabolism disorders are increasingly recognized as key contributors to the development of chronic kidney disease (CKD). The lipid accumulation product (LAP) index, a novel marker of lipid accumulation, has potential implications for CKD risk assessment. The present meta-analysis aimed to assess the association between LAP index and CKD, with an emphasis on varying impacts in diabetic and non-diabetic populations. A comprehensive search for relevant publications was performed using PubMed/MEDLINE, Scopus, Cochrane Library, ScienceDirect and Google Scholar databases, and a meta-analysis of 17 studies was performed to investigate the relationship between LAP index and CKD. The random-effects inverse-variance model employing the DerSimonian-Laird estimator for τ² was utilized to calculate pooled odds ratios (ORs). Diagnostic accuracy was assessed using summary receiver operating characteristic (ROC) curves, with calculations of the area under the ROC curve (AUROC), sensitivity, specificity, likelihood ratios and diagnostic OR. The pooled OR for the association between higher quintiles or tertiles of LAP index and CKD was 1.098 (95% CI: 1.043-1.152), with substantial heterogeneity (I²=91.2%) and evidence of publication bias. Subgroup analysis revealed a stronger association in non-diabetic (OR=2.422, 95% CI: 1.802-3.042) compared with diabetic patients (OR=1.018, 95% CI: 0.993-1.043). The diagnostic accuracy of LAP index for CKD was moderate (AUROC=0.64), with sensitivity and specificity estimates of 0.58 and 0.63, respectively. In conclusion, in the present study, LAP index demonstrated a modest but significant association with CKD, particularly in non-diabetic patients. Despite its moderate diagnostic accuracy, the LAP index could serve as a valuable tool in CKD risk stratification, particularly when integrated with other clinical markers. [ABSTRACT FROM AUTHOR]

Competing Interests: Competing interests statement:The authors declare no competing interest.

The matching of poly(ethylene oxide) (PEO)-based electrolytes with ultrahigh-nickel cathode materials is crucial for designing new-generation high-energy-density solid-state lithium metal batteries (SLMBs), but it is limited by serious interfacial side reactions between PEO and ultrahigh-nickel materials. Here, a high-concentration electrolyte (HCE) interface with a customized Li + solvation sheath is constructed between the cathode and the electrolyte. It induces the formation of an anion-regulated robust cathode/electrolyte interface (CEI), reduces the unstable free-state solvent, and finally achieves the compatibility of PEO-based electrolytes with ultrahigh-nickel cathode materials. Meanwhile, the corrosion of the Al current collector caused by lithium bis(trifluoromethanesulfonyl)imide (LiTFSI) ions is prevented by lithium difluoro(oxalato)borate (LiDFOB) ions. The synergistic effect of the double lithium salt is achieved by a well-tailored ratio of TFSI - and DFOB - in the first solvation sheath of Li + . Compared with reported PEO-based SLMBs matched with ultrahigh-nickel (Ni ≥ 90%) cathodes, the SLMB in this work delivers a high discharge specific capacity of 216.4 mAh g -1 (0.1C) even at room temperature. This work points out a direction to optimize the cathode/electrolyte interface.

Objective: To compare the detection rates of hepatic artery digital subtraction angiography (HA-DSA) and magnetic resonance imaging (MRI) gadolinium diethylenetriaminepentaacetic acid (MRI-Gd-DTPA) and MRI gadolinium diethylenetriaminepentaacetic acid (MRI-Gd-EOB-DTPA) for small (diameter ≤2 cm) hepatocellular carcinoma (HCC) lesions., Methods: A prospective analysis of patients admitted to the Tumor Hospital of Guangxi Medical University between January 1, 2015, and December 30, 2016, was conducted. The detection rates of the three methods were analyzed. The diameter of small HCC lesions detected using HA-DSA and MRI-Gd-EOB-DTPA were evaluated. The diagnostic value of HCC Barcelona staging for HA-DSA was analyzed., Results: For 107 small lesions detected in 57 patients, the detection rates of HA-DSA and MRI-Gd-DTPA were 86.0% (92/107) and 71.0% (76/107), respectively (p < .05). Of 77 small lesions detected in 42 patients using MRI-Gd-EOB-DTPA and HA-DSA, 67 were detected using HA-DSA, all of which had a rich blood supply, and 72 were detected using MRI-Gd-EOB-DTPA. The minimum diameter of lesions detected using MRI-Gd-EOB-DTPA was approximately 0.4 cm, whereas that of lesions detected using HA-DSA was approximately 0.5 cm. After HA-DSA, a change in the Barcelona staging occurred in 33.3% (62/186) of cases but not after MRI-Gd-DTPA; HA-DSA was significantly better than MRI-Gd-DTPA for staging (p = .03)., Conclusion: HA-DSA and MRI-Gd-EOB-DTPA have high diagnostic values for the detection of small HCC lesions, which is helpful for accurate staging of HCC and provides the most valuable information for patient treatment and prognosis., (© 2024 Wiley Periodicals LLC.)

Cobalt-free (Co-free) and nickel-rich (Ni-rich) cathode materials have attracted significant attention and undergone extensive studies due to their affordability and superior energy density. However, the commercialization of these Co-free materials is hindered by challenges such as cation disorder, irreversible phase changes, and inadequate high-voltage performance. To overcome these challenges, a Co-free ternary cathode material of Mg/Al double-pillared LiNiO 2 (NMA) synthesized via a wet-coating and lithiation-sintering technique is proposed. Fundamental studies reveal that Mg and Al have the potential to form a distinctive double-pillar structure within the layered cathode, enhancing its structural stability. To be specific, the strategic placement of Mg and Al in Li and Ni layers, respectively, effectively reduces Li + /Ni 2+ disorder and prevents irreversible phase transitions. Additionally, the inclusion of Mg and Al refines the primary grains and compacts the secondary grains in the cathode material, reducing stress from cyclic usage and preventing material cracking, thereby mitigating electrolyte erosion. As a result, NMA demonstrates exceptional electrochemical performance under a high charge cutoff voltage of 4.6 V. It maintains 70% of initial specific capacity after 500 cycles at 1 C and exhibits excellent rate performance, with a capacity of 162 mAh g -1 at 5 C and 149 mAh g -1 at 10 C. As a whole, the produced NMA achieves a high structural stability in cases of excessive delithiation, providing a groundbreaking solution for the development of cost-effective and high-energy-density cathode materials for lithium-ion batteries.

The narrow electrochemical stability window, deleterious side reactions, and zinc dendrites prevent the use of aqueous zinc-ion batteries. Here, aqueous "soggy-sand" electrolytes (synergistic electrolyte-insulator dispersions) are developed for achieving high-voltage Zn-ion batteries. How these electrolytes bring a unique combination of benefits, synergizing the advantages of solid and liquid electrolytes is revealed. The oxide additions adsorb water molecules and trap anions, causing a network of space charge layers with increased Zn 2+ transference number and reduced interfacial resistance. They beneficially modify the hydrogen bond network and solvation structures, thereby influencing the mechanical and electrochemical properties, and causing the Mn 2+ in the solution to be oxidized. As a result, the best performing Al 2 O 3 -based "soggy-sand" electrolyte exhibits a long life of 2500 h in Zn||Zn cells. Furthermore, it increases the charging cut-off voltage for Zn/MnO 2 cells to 2 V, achieving higher specific capacities. Even with amass loading of 10 mg MnO2 cm -2 , it yields a promising specific capacity of 189 mAh g -1 at 1 A g -1 after 500 cycles. The concept of "soggy-sand" chemistry provides a new approach to design powerful and universal electrolytes for aqueous batteries., (© 2023 Wiley-VCH GmbH.)

The phylogeny and divergence timing of the Neoavian radiation remain controversial despite recent progress. We analyzed the genomes of 124 species across all Neoavian orders, using data from 25,460 loci spanning four DNA classes, including 5,756 coding sequences, 12,449 conserved nonexonic elements, 4,871 introns, and 2,384 intergenic segments. We conducted a comprehensive sensitivity analysis to account for the heterogeneity across different DNA classes, leading to an optimal tree of Neoaves with high resolution. This phylogeny features a novel Neoavian dichotomy comprising two monophyletic clades: a previously recognized Telluraves (land birds) and a newly circumscribed Aquaterraves (waterbirds and relatives). Molecular dating analyses with 20 fossil calibrations indicate that the diversification of modern birds began in the Late Cretaceous and underwent a constant and steady radiation across the KPg boundary, concurrent with the rise of angiosperms as well as other major Cenozoic animal groups including placental and multituberculate mammals. The KPg catastrophe had a limited impact on avian evolution compared to the Paleocene-Eocene Thermal Maximum, which triggered a rapid diversification of seabirds. Our findings suggest that the evolution of modern birds followed a slow process of gradualism rather than a rapid process of punctuated equilibrium, with limited interruption by the KPg catastrophe. This study places bird evolution into a new context within vertebrates, with ramifications for the evolution of the Earth's biota., Competing Interests: Competing interests statement:The authors declare no competing interest.

Planar gliding along with anisotropic lattice strain of single-crystalline nickel-rich cathodes (SCNRC) at highly delithiated states will induce severe delamination cracking that seriously deteriorates LIBs' cyclability. To address these issues, a novel lattice-matched MgTiO 3 (MTO) layer, which exhibits same lattice structure as Ni-rich cathodes, is rationally constructed on single-crystalline LiNi 0.9 Co 0.05 Mn 0.05 O 2 (SC90) for ultrastable mechanical integrity. Intensive in/ex situ characterizations combined with theoretical calculations and finite element analysis suggest that the uniform MTO coating layer prevents direct contact between SC90 and organic electrolytes and enables rapid Li-ion diffusion with depressed Li-deficiency, thereby stabilizing the interfacial structure and accommodating the mechanical stress of SC90. More importantly, a superstructure is simultaneously formed in SC90, which can effectively alleviate the anisotropic lattice changes and decrease cation mobility during successive high-voltage de/intercalation processes. Therefore, the as-acquired MTO-modified SC90 cathode displays desirable capacity retention and high-voltage stability. When paired with commercial graphite anodes, the pouch-type cells with the MTO-modified SC90 can deliver a high capacity of 175.2 mAh g -1 with 89.8% capacity retention after 500 cycles. This lattice-matching coating strategy demonstrate a highly effective pathway to maintain the structural and interfacial stability in electrode materials, which can be a pioneering breakthrough in commercialization of Ni-rich cathodes., (© 2023 Wiley-VCH GmbH.)