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Background: The management of patients with disorders of consciousness (DOC) presents substantial challenges in clinical practice. Deep brain stimulation (DBS) has emerged as a potential therapeutic approach, but the lack of standardized regulatory parameters for DBS in DOC hinders definitive conclusions. Objective: This comprehensive review aims to provide a detailed summary of the current issues concerning patient selection, target setting, and modulation parameters in clinical studies investigating the application of DBS for DOC patients. Methods: A meticulous systematic analysis of the literatures was conducted, encompassing articles published from 1968 to April 2023, retrieved from reputable databases (PubMed, Embase, Medline, and Web of Science). Results: The systematic analysis of 21 eligible articles, involving 146 patients with DOC resulting from acquired brain injury or other disorders, revealed significant insights. The most frequently targeted regions were the Centromedian‐parafascicular complex (CM‐pf) nuclei and central thalamus (CT), both recognized for their role in regulating consciousness. However, other targets have also been explored in different studies. The stimulation frequency was predominantly set at 25 or 100 Hz, with pulse width of 120 μs, and voltages ranged from 0 to 4 V. These parameters were customized based on individual patient responses and evaluations. The overall clinical efficacy rate in all included studies was 39.7%, indicating a positive effect of DBS in a subset of DOC patients. Nonetheless, the assessment methods, follow‐up durations, and outcome measures varied across studies, potentially contributing to the variability in reported efficacy rates. Conclusion: Despite the challenges arising from the lack of standardized parameters, DBS shows promising potential as a therapeutic option for patients with DOC. However, there still remains the need for standardized protocols and assessment methods, which are crucial to deepen the understanding and optimizing the therapeutic potential of DBS in this specific patient population. [ABSTRACT FROM AUTHOR]

Open in new tab Download slide OBJECTIVES To evaluate the impact of antiplatelet therapy on the long-term descending thoracic aorta (DTA) fate and prognosis of extensive repaired type A aortic dissection (TAAD). METHODS 1147 eligible TAAD patients from January 2010 to December 2019 were stratified into non-antiplatelet (n  = 754) and antiplatelet groups (n  = 393). The primary end points were overall survival, and DTA remodelling, including false lumen (FL) thrombosis and aortic redilation. The secondary end points were DTA reintervention or rupture and major bleeding events (MBEs). RESULTS The 5-year overall survival rates were 95.6% and 94.3% in the non-antiplatelet and antiplatelet groups (P  = 0.53), respectively. In the stent covering segment, the 1-year FL complete thrombosis rates were 92.1% and 92.4% in the non-antiplatelet and antiplatelet groups (P  = 0.27), respectively, while in the stent uncovering segment, the 5-year FL complete thrombosis rates were 47.1% and 56.5% in the non-antiplatelet and antiplatelet groups (P  = 0.12), respectively. Antiplatelet therapy was not an independent predictor of aortic redilation at the pulmonary artery bifurcation (β±SE = –0.128 ± 0.203, P  = 0.53), diaphragm (β±SE = 0.143 ± 0.152, P  = 0.35) or coeliac artery (β±SE = 0.049 ± 0.136, P  = 0.72) levels. With death as a competing risk, the cumulative incidences of DTA reintervention or rupture at 5 years were 4.6% and 4.0% in the non-antiplatelet and antiplatelet groups (sHR = 0.85, 95% CI, 0.49∼1.19; P  = 0.58), respectively, and the 5-year cumulative incidences of MBEs were 2.1% and 2.3% in the non-antiplatelet and antiplatelet groups (sHR = 0.82, 95% CI, 0.56∼2.67; P  = 0.62), respectively. CONCLUSIONS Antiplatelet therapy did not impact long-term DTA FL thrombosis, redilation, reintervention or rupture, MBEs or overall survival on extensive repaired TAAD. Thus, antiplatelet therapy can be administered as indicated on extensive repaired TAAD. [ABSTRACT FROM AUTHOR]

A new alternative calculation procedure is developed to quantify the effect of yarn distortion characteristics on the mechanical properties of three-dimensional (3D) braided carbon/resin composites. Firstly, the multi-type yarn distortion characteristics factors including path, cross-section shape and cross-section torsion effects are described based on the stochastic theory. Then, the multiphase finite element method is employed to overcome the complex discretization in traditional numerical analysis, and the parametric studies including multi-type yarn distortion and different braided geometrical parameters on the resulting mechanical properties are performed. It is shown that the proposed procedure can simultaneously capture the yarn path and cross-section distortion characteristics caused by the mutual squeeze of component materials, which is difficult to characterize by experimental methods. In addition, it is found that even small distortions of yarn may significantly affect the mechanical properties for 3D braided composites, and the 3D braided composites with different braiding geometric parameters will show different sensitivity to the distortion characteristics factors of yarn. The procedure, which could be implemented into commercial finite element codes, is an efficient tool for the design and structural optimization analysis of a heterogeneous material with anisotropic properties or complex geometries. [ABSTRACT FROM AUTHOR]

It remains controversial to choose anesthesia for transcatheter aortic valve implantation (TAVI). A meta-analysis of cohort studies was conducted to assess the efficacy and safety of local anesthesia (LA) compared to general anesthesia (GA) in TAVI. All relevant studies published from 1 January 2002, to 31 June 2022, were searched in Ovid, PubMed, Embase, Web of Science, and Cochrane Library. A total of 34 studies involving 23,480 patients were included in the meta-analysis. TAVI with LA was associated with a significant reduction in hospital stay [WMD = −2.48, 95% CI (−2.80, −2.16), p < 0.00001], operative [WMD = −12.25, 95% CI (−13.73, −10.78), p < 0.00001] and fluoroscopy time [WMD = −3.30, 95% CI (−5.40, −1.19), p = 0.002], and an increased risk of acute kidney injury [OR = 1.31, 95% CI (1.01, 1.69), p = 0.04] and a reduced incidence of major bleeding [OR = 0.59, 95% CI (0.46, 0.75), p < 0.0001] and the use of cardiovascular drugs [OR = 0.17, 95% CI (0.05, 0.57), p = 0.004]. No differences were found between LA and GA for 30-day mortality, procedural success rate, myocardial infarction, permanent pacemaker implantation, paravalvular leak, shock, and cerebrovascular events. Overall, 4.4% of LA converted to GA. Based on current evidence, our results suggested that LA strategies reduced hospital stay, operative time, fluoroscopy time, cardiovascular drug consumption, and major bleeding rates in patients undergoing TAVI but led to increased acute kidney injury rates. Further studies and randomized trials are required to verify the presented findings and to identify patients who might benefit from LA. [ABSTRACT FROM AUTHOR]

Currently, there is a lack of expert consensus and clinical guidelines about the treatment strategy for aortic roots in patients with acute Stanford type A aortic dissection with aortic sinuses less than 45 mm in diameter and without combined connective tissue disorder. The physiological aortic sinus plays a key role in the protection of the aortic valve and cardiac function. Thus, we invented a "watching without dealing with" technique of aortic root repair to preserve the aortic sinus as much as possible. This technique could simplify the operation and improve the patient's prognosis, which is worth learning and promoting. [ABSTRACT FROM AUTHOR]

As two environmental pollutants of great concern, polystyrene microplastics (PS-MPs) and nonylphenol (NP) often coexist in the environment and cause combined pollution. Batch adsorption experiments were carried out by varying parameters such as pH, the particle sizes of the PS-MPs, the initial concentration of NP, and metal ion content. The results showed that the particle size of the PS-MPs in the range tested (0.1, 1, 10, 50, and 100 μm) had a significant effect on their NP adsorption capacity. The NP adsorption process of the PS-MPs was best described by the pseudo-second-order kinetic model and the Langmuir isotherm model, while the intraparticle diffusion and Bangham models were also involved in determining the NP adsorption process of 0.1 μm PS-MPs. Both PS-MPs and NP significantly affected cell proliferation, which had been confirmed by reduced cell viability, a blocked cell cycle G1 phase, and elevated apoptosis by affecting the basic cell functions. Furthermore, the negative effects of 0.1 μm PS-MPs on cell proliferation and function were aggravated after the adsorption of NP. Further research on the potential health risks of PS-MPs combined with NP or other environmental contaminants is needed. [ABSTRACT FROM AUTHOR]

This article, published in the European Heart Journal Case Reports, presents a case report of a 71-year-old male patient with an extensive aortic arch aneurysm. The patient underwent a type III hybrid arch repair, which involved ascending aortic and total arch replacement with frozen elephant trunk, and subsequent thoracic endovascular aortic repair. The surgical team utilized multimodality neuroimaging, including computed tomographic angiography (CTA) and transcranial Doppler (TCD) monitoring, to guide the procedure and mitigate neurological risks. The surgery was successful, with stable cerebral blood flow and no significant post-operative neurological complications. The case highlights the importance of individualized neuroimaging and targeted cerebral perfusion strategies in complex cardiac surgeries. [Extracted from the article]

Objective. To observe the effect of carboxypeptidase E (CPE) on the ischemia and hypoxia (I/H) injury of primary cardiomyocytes. Methods. Quantitative real-time polymerase chain reaction (qRT-PCR) technology was used to detect the expression of CPE in sham and myocardial infarction (MI) rat heart tissue, and the plasmid was transferred into primary cardiomyocytes by transfection technology. The apoptosis rate of cardiomyocytes was detected by terminal deoxynucleotidyl transferase-mediated dUTP-biotin nick end labeling (TUNEL) staining, Annexin V-PI staining, and Cell Counting Kit-8 (CCK-8) assay. In addition, Caspase kit and qRT-PCR technology were used to detect the expression of apoptosis-related factors. The cell proliferation was detected by 5-ethynyl-2'-deoxyuridine (EdU) staining, flow cytometry, and qRT-PCR technology. In addition, Western blotting (WB) and qRT-PCR techniques were used to detect the Wnt/β-catenin pathway. Results. First, we found that the expression of CPE in the marginal zone of MI was obviously reduced. Overexpression of CPE in primary cardiomyocytes can effectively inhibit ischemia/hypoxia (I/H)-induced apoptosis and decreased cell activity. In addition, CPE can promote cell proliferation and relieve the inhibitory effect of I/H on cardiomyocytes. At the same time, CPE can promote the expression of β-catenin and c-myc. Conclusion. Overexpression of CPE in primary cardiomyocytes can effectively alleviate the decreased cell activity, increased apoptosis, and decreased proliferation caused by I/H and regulated by Wnt/β-catenin pathway. [ABSTRACT FROM AUTHOR]

The purpose of the present study was to investigate the expression of matrix metalloproteinase-9 (MMP-9) and interleukin-6 (IL-6) in patients with subarachnoid hemorrhage (SAH) and the clinical significance thereof. Forty-three patients with SAH and 23 healthy individuals were enrolled in this study. Patients were divided into the cerebral vasospasm (CVS) and non-cerebral vasospasm (non-CVS) groups, or the good and poor prognosis groups. Serum levels of MMP-9 and IL-6 were detected by ELISA. Expression levels of MMP-9 and IL-6 mRNAs were detected by RT-qPCR. Expression levels of MMP-9 and IL-6 were elevated with the increase of grades as determined by the Hunt-Hess grading method. Serum levels of MMP-9 and IL-6 in the CVS and poor prognosis groups were significantly higher than those in the control group. Expression levels of MMP-9 and IL-6 in the CVS group were significantly higher than those in the non-CVS group (P<0.05). Compared with the good prognosis group, the expression levels of MMP-9 and IL-6 were significantly increased in the poor prognosis group at 1, 4, 7 and 10 days after SAH (P<0.05). Additionally, the expression level of MMP-9 was significantly positively correlated with that of IL-6 (P<0.05). Expression levels of MMP-9 and IL-6 were significantly increased in patients with SAH, and the expression level of MMP-9 was positively correlated with that of IL-6. Thus, MMP-9 and IL-6 are involved in the development of SAH. [ABSTRACT FROM AUTHOR]

Groundwater is a prominent resource of drinking and domestic water in the world. In this context, a feasible water resources management plan necessitates acceptable predictions of groundwater table depth fluctuations, which can help ensure the sustainable use of a watershed's aquifers for urban and rural water supply. Due to the difficulties of identifying non-linear model structure and estimating the associated parameters, in this study radial basis function neural network (RBFNN) and GM (1, 1) models are used for the prediction of monthly groundwater level fluctuations in the city of Longyan, Fujian Province (South China). The monthly groundwater level data monitored from January 2003 to December 2011 are used in both models. The error criteria are estimated using the coefficient of determination ( R ), mean absolute error (E) and root mean squared error (RMSE). The results show that both the models can forecast the groundwater level with fairly high accuracy, but the RBFN network model can be a promising tool to simulate and forecast groundwater level since it has a relatively smaller RMSE and MAE. [ABSTRACT FROM AUTHOR]

Insufficient understanding of the hydrogeochemistry of aquifers makes it necessary to conduct a preliminary water quality assessment in the southern region of Ordos Basin, an arid area in the world. In this paper, the major ions of groundwater have been studied aiming at evaluating the hydrogeochemical processes that probably affect the groundwater quality using 150 samples collected in 2015. The two prevalent hydrochemical facies, HCO 3 Mg·Na·Ca and HCO 3 Mg·Ca·Na type water, have been identified based on the hydrochemical analysis from Piper trilinear diagram. Compositional relations have been used to assess the origin of solutes and confirm the predominant hydrogeochemical processes responsible for the various ions in the groundwater. The results show that the ions are derived from leaching effect, evaporation and condensation, cation exchange, mixing effect and human activities. Finally groundwater quality was assessed with single factor and set pair methods, the results indicate that groundwater quality in the study region is generally poor in terms of standard of national groundwater quality. The results obtained in this study will be useful to understand the groundwater quality status for effective management and utilization of the groundwater resource. [ABSTRACT FROM AUTHOR]

Ordos Basin is located in an arid and semi-arid region of northwestern China, which is the most important energy source bases in China. Salawusu Formation (Q 3 s) is one of the most important aquifer systems of Ordos Basin, which is adjacent to Jurassic coalfield areas. A large-scale exploitation of Jurassic coal resources over ten years results in series of influences to the coal minerals, such as exposed to the oxidation process and dissolution into the groundwater due to the precipitation infiltration. Therefore, how these processes impact groundwater quality is of great concerns. In this paper, the descriptive statistical method, Piper trilinear diagram, ratios of major ions and canonical correspondence analysis are employed to investigate the hydrochemical evolution, determine the possible sources of pollution processes, and assess the controls on groundwater compositions using the monitored data in 2004 and 2014 (before and after large-scale coal mining). Results showed that long-term exploration of coal resources do not result in serious groundwater pollution. The hydrochemical types changed from HCO 3 − - CO 3 2 − facies to SO 4 2 − -Cl facies during 10 years. Groundwater hardness, nitrate and sulfate pollution were identified in 2014, which was most likely caused by agricultural activities. [ABSTRACT FROM AUTHOR]

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• AAA and normal samples have different immune infiltration statuses. • FOS, IL-6 and IL2RB are identified as AAA immune-related hub genes. • IL2RB is an immune-related hub gene and a potential hub gene with significant diagnostic value in AAA. Abdominal aortic aneurysm (AAA) is potentially life threatening and characterized by immune-inflammatory cell infiltration and extracellular matrix degradation. Currently, pharmacotherapy mainly aims to control risk factors without reversion of the dilated aorta. This study analyzed the immune-inflammatory response and identified the immune-related hub genes of AAA. Gene Expression Omnibus datasets (GSE57691, GSE47472 and GSE7084) were downloaded. After identification of GSE57691 differentially expressed genes (DEGs), weighted gene co-expression network analysis of the DEGs was performed. Through enrichment analysis of each module and screening in Immunology Database and Analysis Portal, immune-related hub genes were identified via protein–protein interaction (PPI) network construction and lasso regression. CIBERSORT was utilized to analyze AAA immune infiltration. The correlations between the immune-related hub genes and infiltrating immune cells were investigated. Receiver operating characteristic (ROC) curve analysis was performed to determine immune-related hub gene cutoff values, which were validated in GSE47472 and GSE7084. In GSE57691, 1,018 DEGs were identified. Five modules were identified in the co-expression network. The blue and green modules were found to be related to immune-inflammatory responses, and 61 immune-related genes were identified. PPI and lasso regression analyses identified FOS, IL-6 and IL2RB as AAA immune-related hub genes. CIBERSORT analysis indicated significantly increased infiltration of naive B cells, memory activated CD4 T cells, follicular helper T cells, monocytes and M1 macrophages and significantly decreased infiltration of M2 macrophages in AAA compared with normal samples. IL2RB was more strongly associated with immune infiltration in AAA than were FOS and IL6. The IL2RB area under the ROC curve (AUC) value was > 0.9 in both the training and validation set, demonstrating its strong, stable diagnostic value in AAA. AAA and normal samples had different immune infiltration statuses. IL2RB was identified as an immune-related hub gene and a potential hub gene with significant diagnostic value in AAA. [ABSTRACT FROM AUTHOR]

AT2Rs [AngII (angiotensin II) type 2 receptors] contribute to the cardioprotective effects of angiotensin II receptor blockers, possibly via kinins acting on the B1R (B1 receptor) and B2R (B2 receptor). Recent studies have shown that a lack of B2R up-regulates B1R and AT2R; however, the pathophysiological relevance of such an event remains unclear. We hypothesized that up-regulation of AT2R and B1R compensates for the loss of B2R. Blockade of AT2R and/or B1R worsens cardiac remodelling and dysfunction following MI (myocardial infarction) in B2R-/- (B2-receptor-knockout mice). B2R-/- mice and WT (wild-type) controls were subjected to sham MI or MI and treated for 4 weeks with (i) vehicle, (ii) a B1R-ant (B1R antagonist; 300 µg/kg of body weight per day), (iii) an AT2R-ant [AT2 receptor antagonist (PD123319); 20 mg/kg of body weight per day], or (iv) B1R-ant+AT2R-ant. B2R-/- mice had a greater MCSA (myocyte cross-sectional area) and ICF (interstitial collagen fraction) at baseline and after MI compared with WT controls. Cardiac function and increase in macrophage infiltration, TGFß1 (transforming growth factor ß1) expression and ERK1/2 (extracellular-signal-regulated kinase 1/2) phosphorylation post-MI were similar in both strains. Blockade of AT2R or B1R worsened cardiac remodelling, hypertrophy and dysfunction associated with increased inflammation and ERK1/2 phosphorylation and decreased NO excretion in B2R-/- mice, which were exacerbated by dual blockade of B1R and AT2R. No such effects were seen in WT mice. Our results suggest that, in the absence of B2R, both B1R and AT2R play important compensatory roles in preventing deterioration of cardiac function and remodelling post-MI possibly via suppression of inflammation, TGFß1 and ERK1/2 signalling. [ABSTRACT FROM AUTHOR]

• A new type of BFRP-SWSSC beam with TRE tension zone cover was proposed. • Effects of various factors were revealed (such as number of textile layers). • The composite layer can promote the serviceability and ductility of the beam. • A method for predicting the bearing capacity of composite beams was proposed. To improve the service behavior of basalt fiber reinforced polymer (BFRP) reinforced seawater sea-sand concrete (BFRP-SWSSC) beams, textile reinforced ECC (TRE) are utilized in the tensile zone to replace the traditional SWSSC. The experimental parameters of TRE included the number of textile layers, the matrix thickness, and the matrix type. The results showed that the failure mode of the composite beams transitioned from tensile failure to balanced failure with the increase in the matrix thickness and the number of textile layers. The composite layer can promote the ultimate capacity to some extent. Compared with engineered cementitious composites (ECC) and textile reinforced concrete (TRC), TRE can more effectively reduce the deflection and crack width, as well as improve the ductility, at the service stage. The improvement was more significant when the matrix thickness and the number of textile layers increased. Compared with those of the control beams, the deflection and crack width were reduced by 63.2% and 71.3% under the service loads, respectively, while the ductility index was improved by 29.1% for the TRE composite beam with three textile layers. Furthermore, the formulas for the ultimate capacity of the composite beams were developed and verified by the experiments. [ABSTRACT FROM AUTHOR]

Groundwater evapotranspiration (ETG) estimation is an important issue in semiarid areas for groundwater resources management and environmental protection. It is widely estimated by diurnal water table fluctuations. In this study, the ETG at four sites with different plants was estimated using both diurnal water table and soil moisture fluctuations in the northeastern Mu Us sandy region, in order to identify the groundwater utilization strategy by different dominant phreatophytes. Groundwater level was monitored by ventilatory pressure transducers (Solinst LevelVent, Solinst Canada Ltd.; accuracy ±3 mm), while soil moisture was monitored using EM50 loggers (Decagon Devices Inc., Pullman, USA) in K1 and K14 and simulated by Hydrus-1D in other observation wells. A significant spatial variation of ETG was found within a limited area, indicating a poor representativeness of site ETG for regional estimation. The mean values of ETG are 4.01 mm/d, 6.03 mm/d, 8.96 mm/d, and 12.26 mm/d at the Achnatherum splendens site, Carex stenophylla site, Salix psammophila site and Populus alba site, respectively, for the whole growing season. ETG is more sensitive to depth to water table (DWT) in the Carex stenophylla site than in the Achnatherum splendens site for grass-dominated areas and more sensitive to DWT in the Populus alba site than in Salix psammophila site for tree-dominated areas. Groundwater extinction depths are estimated at 4.1 m, 2.4 m, 7.1 m, and 2.9 m in the Achnatherum splendens site, Carex stenophylla site, Salix psammophila site and Populus alba site, respectively. [ABSTRACT FROM AUTHOR]

Membrane separation technologies have attracted great attentions in chemical engineering, food science, analytical science, and environmental science. Compared to traditional membrane separation techniques like reverse osmosis (RO), ultrafiltration (UF), electrodialysis (ED) and others, pervaporation (PV)-based membrane separation shows not only mutual advantages such as small floor area, simplicity, and flexibility, but also unique characteristics including low cost as well as high energy and separation efficiency. Recently, different polymer, ceramic and composite membranes have shown promising separation applications through the PV-based techniques. To show the importance of PV for membrane separation applications, we present recent advances in the fabrication, properties and performances of polymeric membranes for PV separation of various chemicals in petrochemical, desalination, medicine, food, environmental protection, and other industrial fields. To promote the easy understanding of readers, the preparation methods and the PV separation mechanisms of various polymer membranes are introduced and discussed in detail. This work will be helpful for developing novel functional polymer-based membranes and facile techniques to promote the applications of PV techniques in different fields. [ABSTRACT FROM AUTHOR]

Many irrigated plains in arid and semi-arid regions have groundwater quality issues due to both intensive human activity and natural processes. Comprehensive studies are urgently needed to explore hydrogeochemical evolutions, investigate possible pollution sources, and understand the controls on groundwater compositions in such regions. Here, we combine geostatistical techniques and hydrogeochemical assessments to characterize groundwater quality over time in the Yinchuan Plain (a typical irrigated plain in China), using 12 physicochemical variables derived from sampling in 600 and 602 wells in 2004 and 2014, respectively. Our results show that groundwater-rock interactions and evaporation are the key natural factors controlling groundwater compositions. Hydrogeochemical water types in both 2004 and 2014 were Ca-HCO3, Na-Cl, and mixed Ca·Mg-Cl. Along with the hydrogeochemical compositions, we used ionic ratios and the saturation index to delineate mineral solution reactions and weathering processes. Dissolution of gypsum, halite, fluorite, and mirabilite, along with silicate weathering and cation exchange, were identified in the study area. Our results indicated rising ion concentrations in groundwater, which could be the result of anthropogenic influences. Increasing total hardness and nitrates over the study period were most likely caused by agricultural activity and the discharge of waste water from human residential areas. [ABSTRACT FROM AUTHOR]