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Abstract The purpose of this study was to evaluate the diagnostic utility of treadmill exercise stress echocardiography (TESE) combined with left ventricular (LV) layer‐specific strain (LSS) in subclinical myocardial and reserve function of hypertensive patients. A total of 55 hypertensive patients and 51 controls were evaluated during rest and exercise. Two‐dimensional speckle tracking (2DST) and LSS technique was used to measure longitudinal and circumferential strains at rest and peak exercise, strain difference characteristics were then evaluated. Compared to the control subjects, both longitudinal and circumferential LSS showed different degrees of reduction in hypertensive group, which was more pronounced at peak exercise. The global longitudinal endocardium strain (GLSendo) at rest was 24.4% ± 1.5% in the control group versus 20.4% ± 2.3% in the hypertensive group, while the difference was more obvious at peak state (control vs. hypertensive group, 30.8% ± 2.8% and 22.8% ± 2.9%, respectively). In particular, endocardial strain under exercise can be used as a sensitive indicator where the LV contractile reserve (CR) function of the three layers are all impaired. TESE combined with LSS might increase diagnostic accuracy of myocardial performance in hypertension patients.

Background and purpose: There are many anastomoses between stomach and esophagus in esophageal cancer surgery, each of which has its own advantages and disadvantages. The aim of this study was to investigate the safety and feasibility of end-to-end double-layer esophagogastric anastomosis and gastric fundus embedding during minimally invasive esophagectomy for esophageal cancer. Methods: The clinicopathological data of 129 patients who underwent minimally invasive esophagectomy from April 2019 to April 2021 in Zigong Fourth People’s Hospital were retrospectively reviewed. All patients were treated with thoracoscopy and laparoscopy combined with minimally invasive cervicothoracic and abdominal tri-incision (McKeown procedure) esophageal cancer resection. The thoracic procedure was performed with thoracoscopy, and the abdominal procedure with laparoscopy. The patients were divided into end-to-end double-layer esophagogastric anastomosis and gastric fundus embedding group (87 cases) and end-to-side anastomosis group (42 cases). Patients were followed up for evaluation of associated complications, of which anastomotic leakage, anastomotic stenosis and gastroesophageal reflux were the primary objectives of this study. Results: All the 129 patients underwent esophagectomy. Neoadjuvant therapy was more common in the end-to-end doubled anastomosis group (12.0% vs 2.3%, P = 0.037). There was no statistically significant difference in other basic clinical data between the two groups (P>0.05). There was no significant difference in the mean operation time between the two groups. The anastomosis time was less in end-to-side stapling group than in end-to-end stapling group[(32.0±6.8) min vs (15.0±5.4) min, P = 0.021]. The differences in the incidences of anastomotic leakage (1.1% vs 11.9%, P = 0.023), gastroesophageal reflux (9.1% vs 26.1%, P = 0.012), pneumonia (12.6% vs 30.9%, P = 0.023) and arrhythmia (10.3% vs 26.1.%, P = 0.020) were statistically significant between the two groups. Conclusion: The method of end-to-end double-layer anastomosis and gastric fundus embedding is safe and stable in esophagectomy. It can effectively prevent anastomotic leakage and gastroesophageal reflux.

Potassium‐ion hybrid capacitors (PIHCs) are highly promising as an energy‐storage system. However, the rate performance and cycling performance of most materials with high capacity cannot simultaneously meet the requirements of PIHCs. In this work, a composite material of Bi2S3 nanoparticles in situ confined within a sulfur‐doped covalent organic framework (COF) and combined with graphene (Bi2S3@SCOF/G) is synthesized. Due to the synergistic effect of the stability of COF to buffer large mechanical stresses and the high electronic conductivity of graphene, the Bi2S3@SCOF/G anode reveals a high reversible capacity (503.8 mAh g−1 at 100 mA g−1 after 100 cycles) and favorable rate performance (223.9 mAh g−1 even at 5000 mA g−1). Furthermore, the PIHCs assembled with activated carbon show excellent energy density and cycling performance, indicating their potential for practical applications. [ABSTRACT FROM AUTHOR]

Background: Neoadjuvant (NE), adjuvant (AD), and perioperative (PE) immunotherapies have gained validation in early-stage non-small cell lung cancer (NSCLC) trials. However, a comprehensive assessment of their comparative efficacy and safety is lacking. Objectives: To compare the efficacy and safety of NE, AD, and PE immunotherapies in early-stage NSCLC. Design: A systematic review and network meta-analysis using a Bayesian framework. Data sources and methods: We searched PubMed, Embase, and Cochrane databases for randomized controlled trials (RCTs) of immune checkpoint inhibitors plus chemotherapy (CT) for early-stage NSCLC. Hazard ratios (HRs) and odds ratios (ORs) for binary endpoints with 95% confidence intervals (CIs) were calculated. Results: We included 10 RCTs involving 5569 NSCLC patients, categorized as NE, PE, or AD immunotherapy. Indirect comparisons highlighted differences in efficacy between PE and AD immunotherapy, specifically in event-free survival (EFS)/disease-free survival (DFS) (HR = 0.72, 95% CI: 0.53–0.96). NE/PE immunotherapies improved pathologic complete response (pCR) (OR = 7.56, 95% CI: 5.24–10.92), major pathologic response (MPR) (OR = 5.46, 95% CI: 3.97–7.51), and EFS (HR = 0.58, 95% CI: 0.52–0.65), while AD immunotherapy enhanced DFS (HR = 0.78, 95% CI: 0.69–0.90). Overall survival (OS) benefits were seen only with PE immunotherapy (HR = 0.66, 95% CI: 0.55–0.81). PE treatment improved EFS across various subgroups (PD-L1 < 1%, IIIB, squamous, female, without MPR/pCR, epidermal growth factor receptor (EGFR) mutant-negative), except EGFR mutant-positive NSCLC (HR = 0.54, 95% CI: 0.21–1.43). AD (OR = 1.81, 95% CI: 1.20–2.73) and PE (OR = 1.28, 95% CI: 1.10–1.50) immunotherapies were associated with higher grade ⩾3 adverse events. Conclusion: In the three treatment modalities, PE immunotherapy appears to be more effective than AD immunotherapy, with PE showing significant advantages in certain subgroups that NE does not. NE and PE immunotherapy significantly improved pCR, MPR, and EFS, while AD immunotherapy significantly improved DFS in NSCLC patients compared to the control group. However, only PE immunotherapy significantly improved OS. Differences in efficacy between NE and PE across the entire population of resectable NSCLC remain to be explored in additional studies. [ABSTRACT FROM AUTHOR]

Social media greatly facilitates people's access to information; however, it can also lead to information overload and exposure to uncomfortable content that may cause individuals to avoid it. As a result, two types of influencing mechanisms emerge: information exposure and information avoidance, which may impact users' behaviors. Currently, there is limited understanding of the simultaneous effects of social media information exposure and avoidance on individuals' behavioral intentions towards climate change mitigation. Using survey data for 1056 Chinese Gen-Z undergraduates and based on the extended theory of planned behavior, this paper utilizes a partial least squares structural equation model to examine the effects of social media information exposure and information avoidance on individual low-carbon behavioral intention. The results show that information exposure on social media has a positive relationship with behavioral attitude, subjective norm, and perceived behavioral control, and then increasing the low-carbon behavioral intention. Information avoidance has a negative association with three factors, respectively, and decreases the low-carbon behavioral intention. Additionally, exposure to social media information has the greatest impact on the subjective norm and the least impact on behavioral attitude; information avoidance has the greatest impact on behavioral attitude, whereas perceived behavioral control is the least affected. Drawing from the results, we propose policy recommendations that facilitate information exposure while addressing avoidance in shaping low-carbon behavioral intentions. Those implications would help reconcile the two opposing effects while promoting public engagement in climate activities. [ABSTRACT FROM AUTHOR]

High‐speed wide‐angle radio detection is crucial for intelligent wireless systems, autonomous vehicles, rescue operations in urgent situations, and security in various fields. This can be achieved through diverse controls of electromagnetic waves. Currently, multidimensional manipulations of electromagnetic waves are determined by dynamic antennas like phased arrays, mechanical beam‐steering radars, and programmable metasurface imagers. However, these methods face challenges in achieving rapid responses and large data collection intervals for high‐speed sensing and imaging, due to limitations in the speedy explication of analog‐to‐digital (AD) converters, electronic switches, phase shifters, and stepped motors for radiation beam reconfigurations. To address these challenges, advanced microwave‐to‐millimeter‐wave metasurfaces are introduced, designed to offer joint frequency, polarization, and spatial diversities. The metasurface with a disordered atom permutation enables wide‐angle sensing for accurate trajectory tracking of moving objects. On the other hand, a dispersion‐engineered atom arrangement allows the metasurfaces to facilitate wide‐angle through‐wall imaging, effective in detecting objects of varied shapes and positions. The experiments reveal that these metasurfaces can reconstruct objects at 100 frames per second (fps) from a single‐shot measurement, allowing 0.3x speed playback for detailed analysis. This demonstrates their potential in high‐speed sensing and imaging. Such a breakthrough is pivotal in unveiling new modalities and expanding possibilities in real‐time radio applications, including smart transportation, all‐condition surveillance, perspective radio, and integrated sensing and communication (ISAC) systems, especially relevant to technologies of 6G and beyond. [ABSTRACT FROM AUTHOR]