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Abstract Covalent organic frameworks have emerged as a thriving family in the realm of photocatalysis recently, yet with concerns about their high exciton dissociation energy and sluggish charge transfer. Herein, a strategy to enhance the built-in electric field of series β-keto-enamine-based covalent organic frameworks by ionic polarization method is proposed. The ionic polarization is achieved through a distinctive post-synthetic quaternization reaction which can endow the covalent organic frameworks with separated charge centers comprising cationic skeleton and iodide counter-anions. The stronger built-in electric field generated between their cationic framework and iodide anions promotes charge transfer and exciton dissociation efficiency. Moreover, the introduced iodide anions not only serve as reaction centers with lowered H* formation energy barrier, but also act as electron extractant suppressing the recombination of electron-hole pairs. Therefore, the photocatalytic performance of the covalent organic frameworks shows notable improvement, among which the CH3I-TpPa-1 can deliver an high H2 production rate up to 9.21 mmol g−1 h−1 without any co-catalysts, representing a 42-fold increase compared to TpPa-1, being comparable to or possibly exceeding the current covalent organic framework photocatalysts with the addition of Pt co-catalysts.

Abstract With the aging process of the global population and the development of medical technology, the cases of postoperative cognitive dysfunction (POCD) are also increasing. Due to the complexity of the pathogenesis, urgent treatment has been sought. Neuroinflammation induced by the accumulation of lipid droplets (LDs) in microglia has been closely watched in recent years and is also considered to be an important cause of nerve damage. Our study found that derived from Withania somnifera, Withaferin A (WA) could reduce the accumulation of LDs in the hippocampus of POCD mice, inhibit the expression of inflammatory factor interleukin-1β (IL-1β), and improve the cognitive ability of mice. Further in vitro experimental studies showed that WA increased the autophagy level of microglia, promoted the degradation of LDs, and reduced the production of inflammatory factors. In this regard, our comprehensive research endeavor holds the potential to furnish novel insights into therapeutic strategies aimed at addressing POCD and its associated neural impairments.

Abstract Background Gastrointestinal mesenchymal stromal tumors (GISTs) are a group of intramural tumors that exhibit a wide range of morphologies. Dysfunction or loss of interstitial cells of Cajal (ICCs) is correlated with the disorders of gastrointestinal motility. At present, the characterization and molecular mechanisms underlying the role of ICCs in GIST are still not clear. Methods The GSE162115 dataset from Gene Expression Omnibus database was processed using Seurat package for quality control, data normalization, and cell clustering. Differential expression and functional enrichment analyses were performed using the FindAllMarkers function and clusterProfiler package. Cellular heterogeneity was assessed by CytoTRACE and potential regulatory mechanisms of ICCs in GISTs were investigated using SCENIC. Cellular communication was inferred and analyzed applying the CellChat package. Results Eight clusters were identified based on 34,861 cells. Intra-tumor samples had a higher proportion of ICCs than peri-tumor. ICCs were related to cell cycle and glycolytic activity in intra-tumor samples, while those in peri-tumor samples were involved in immune response. Further analysis identified four ICC subgroups (subcluster 1–4), of which subcluster 3 showed the most typical stem cell properties and interacted with the rest of the cells through the MIF-CD74 (CD44) protein. Conclusion This study analyzed the heterogeneity and stem cell properties of ICCs in GISTs, revealing the molecular mechanisms and potential therapeutic targets for GISTs.

IntroductionSevere fever with thrombocytopenia syndrome (SFTS) is an emerging infectious disease discovered in China in 2009. SFTS monitoring has been carried out since 2010 in mainland China. In recent years, human infection with SFTS virus (SFTSV) has frequently been detected in Jiujiang of Jiangxi Province, Central China.MethodsSera of SFTS surveillance cases and samples collected from humans, animals and ticks surrounding the cases were used to detect SFTSV RNA by real-time RT-PCR. SFTSV-positive samples were further subjected to sequencing and analysis of the S, M, and L segments of SFTSV.ResultsFour patients were positive for SFTSV infection. However, the subjects like humans, animals and ticks around the cases were all detected as negative for the virus infection. Phylogenetic analysis of the partial segments revealed that SFTSVs in three patients from Jiujiang were clustered with genotype C4 and C5 on the L and M segment-established phylogenetic tree; however, phylogenetic analysis of the S segment showed that the strains were grouped into genotype J1. These results suggested that the S, M, and L segments of these strains underwent segmental reassortment, which was later supported by recombination signal detection. The reassortment event was detected by at least four methods with a significance level of p value

Systemic treatment, commonly referred to as chemotherapy, is a fundamental approach for treating muscle-invasive bladder cancer (MIBC) and metastatic bladder cancer. Neoadjuvant chemotherapy has recently become a standard treatment for MIBC, significantly reducing tumor recurrence rates and improving patient outcomes. Patients may receive adjuvant chemotherapy involving various drug combinations to improve prognosis following surgery. MIBC patients who are unwilling or unable to undergo radical cystectomy and instead opt for bladder-sparing surgery may benefit from systemic chemotherapy combined with radiotherapy, wherein chemotherapy proves more impactful than radiotherapy. Over the past 30 years, cisplatin-based chemotherapy has been the main approach for treating metastatic bladder cancer. Recent advancements in the molecular understanding of bladder cancer have led to the use of targeted therapies, which have shown promising results. Immunotherapy for MIBC has only recently emerged, with clinical trial results indicating that immunotherapy offers better efficacy and fewer side effects for metastatic bladder cancer. In recent years, basic research on bladder cancer has been burgeoning, and clinical treatment methods have been improving accordingly. This article reviews the development of systemic treatment for bladder cancer.

Biochar application to soil has proven to be an excellent approach for decreasing the concentration of auto-toxic compounds and promoting plant growth in continuous-cropping fields. However, the mechanisms underlying the action pathway among biochars, auto-toxic compounds and tobacco remain unknown. In this study, we conducted an experiment tracking the incidence rate of black rot and auto-toxic compounds for a 3-year continuous-cropping tobacco pot trial in response to biochar treatment intensity compared with that of non-biochar treatment. Biochar inhibited the incidence of black rot. Using ultra-high-performance liquid chromatography–mass spectrometry (UPLC‒MS/MS), we revealed that biochar can effectively decrease the concentration of p-hydroxybenzoic acid (PHA), which is associated with the incidence rate of black rot (R2 = 0.890, p

Abstract Owing to the need for regenerant and self‐reduction problem, the hydrogen performance of sub‐nano‐sized trinuclear iron‐oxo complexes is still far from satisfied with affordability and practicality. Herein, two binary photocatalytic systems based on trinuclear metal‐oxo complexes have been first constructed and experimentally confirmed to be competent for seawater hydrogen evolution (715.4 and 271.9 μmol of hydrogen can be found, respectively, after 48 h). Notably, chloride ions act as the hole catcher and move into the gas phase in the stable form of chlorine. Similar to heterogeneous structures, homogeneous systems not only enhance the hydrogen performance while ensuring the stability of metal‐oxo complexes, but also shorten the consumption of photogenerated carriers by dissolved impurities in the seawater. This new attempt of building pluralistic sub‐nanometric systems may offer novel design strategies with noble‐metal‐free catalysts and low‐cost candidates for traditional semiconductor materials in enhancing photocatalytic efficiency and performing chlorine evolution from seawater splitting.

PurposeThe pain caused by spinal cord injury (SCI) poses a major burden on patients, and pain management is becoming a focus of treatment. Few reports have described changes in the brain after SCI. Particularly, the exact mechanism through which brain regions affect post-injury pain remains unclear. In this study, we aimed to determine the potential therapeutic mechanisms of pain. A mouse model of spinal cord contusion was established, and molecular expression in the anterior cingulate cortex (ACC) and periaqueductal gray (PAG) in the brain and animal behavior was observed after local injection of human umbilical cord mesenchymal stem cells (HU-MSCs) at the site of SCI.MethodSixty-three female C57BL/6J mice were divided into four groups: a sham operation group (n = 15); a spinal injury group (SCI, n = 16); an SCI + HU-MSCs group (n = 16) and an SCI + PBS group (n = 16), in which the SCI site was injected with HU-MSCs/phosphate buffer. The BMS score was determined, and the von Frey test and Hargreaves test were used to assess behavior every week after surgery. Mice were sacrificed in the fourth week after operation, and samples were collected. The expression of CGRP, Substance P, C-Fos and KCC2 in the ACC and PAG were observed with immunohistochemistry. Chromic cyanine staining was used to observe transverse sections of the injured spinal cord.ResultIn the ACC and PAG after SCI, the expression of CGRP, SP and C-Fos increased, and the expression of KCC2 decreased, whereas after HU-MSC injection, the expression of CGRP, SP and C-Fos decreased, and the expression of KCC2 increased. The SCI + HU-MSC group showed better exercise ability from 2 to 4 weeks after surgery than the SCI/SCI + PBS groups (P < 0.001). Local injection of HU-MSCs significantly improved the mechanical hyperalgesia caused by SCI in the fourth week after surgery (P < 0.0001), and sensation was significantly recovered 2 weeks after surgery (P < 0.0001); no improvement in thermal hypersensitivity was observed (P > 0.05). The HU-MSC group retained more white matter than the SCI/SCI + PBS groups (P < 0.0001).ConclusionLocal transplantation of HU-MSCs at the site of SCI partially relieves the neuropathic pain and promotes recovery of motor function. These findings suggest a feasible direction for the future treatment of SCI.

Biomedical microgels are a novel type of materials with promising perspectives for repair and regeneration of multi-types of tissues and organs due to their highly hydrated nature, tunable microporous structure, ability to encapsulate bioactive factors, and tailorable properties such as stiffness and composition. In particular, the reversible bonding in supramolecular microgels leads to their ease of injectability and self-healing ability, which are essential for therapeutic delivery of cells and drugs, assembly to generate scaffolds, and bioinks for 3D printing. In vivo studies of microgels have pioneered the clinical relevance of these novel and innovative materials for regenerative medicine. In this review, the important supramolecular interactions such as hydrogen bonding, ionic bonding, and host-guest and hydrophobic interactions, and metal coordination are summarized with respect to the formation of supramolecular microgels for biomedical applications, highlighting their advantages over the traditional bulk ones. The applications of supramolecular microgels in the fields of cardiac tissue repair, osteoarthritis therapy, and bone and neuronal tissue engineering are discussed.

Image inpainting is one of the most important problems in the field of image algorithm, and it is also an effective preprocessing method for many other image applications. In this paper, we suggest an image decontamination method which is mainly used to remove mesh stains and also provide a data set for this task. To our knowledge, this work is the first attempt to solve this kind of problem. Specifically, the proposed method is composed of two phases: we first remove the mesh stains with an Improved Conditional Generative Adversarial Network, and then utilize a Semantic Network to fine tune the details. Experiments demonstrated that this two-stage model can remove the mesh stains. Results show that our method significantly out-performs existing methods and achieves superior inpainting results on challenging cases.

Postharvest deterioration of ginger rhizome caused by microorganisms or wound infections causes significant economic losses. Fusarium solani is one of the important causal agents of prevalent ginger disease soft rot across the world. The massive and continuous use of chemical fungicides in postharvest preservation pose risks to human health and produce environmental contamination. Hence, new alternative tools are required to reduce postharvest deterioration and extend the postharvest life of ginger. In this study, the use of silicon nanoparticles (SiNPs) on the storability of ginger rhizomes during postharvest storage and their resistance to Fusarium solani was investigated. The results showed that 50, 100, and 150 mg L−1 of SiNPs increased the firmness of the ginger rhizome during storage but decreased the decay severity, water loss, total color difference, and the reactive oxygen species (ROS; H2O2 and superoxide anion) accumulation. Specifically, 100 mg L−1 (SiNP100) demonstrated the best effect in the extension of postharvest life and improved the quality of the ginger rhizomes. SiNP100 application increased the activities of antioxidant enzymes (SOD and CAT) and the total phenolics and flavonoid contents, thereby reducing the ROS accumulation and malondialdehyde (MDA) content. Meanwhile, SiNP100 treatment negatively impacts the peroxidase (POD) and polyphenol oxidase (PPO) activities, which may have contributed to the lower level of lignin and decreased total color difference. SiNP100 likely decreased water loss and the transfer of water by altering the expression of aquaporin genes. Moreover, SiNP100 modulated the expression of lignin synthesis and phytopathogenic responses genes including MYB and LysM genes. Furthermore, SiNP100 inhibited Fusarium solani by preventing the penetration of hyphae into cells, thus decreasing the severity of postharvest pathogenic decay. In summary, this study revealed the physiology and molecular mechanisms of SiNPs-induced tolerance to postharvest deterioration and resistance to disease, which provides a foundation for using SiNPs resources as a promising alternative tool to maintain ginger quality and control postharvest diseases.

Semiconductor photocatalytic hydrogen production technology is a pollution‐free and low‐cost technology, which is principal to alleviate the energy crisis. The metal–organic frameworks (MOFs)‐based materials have been widely used in this field because of their regular and controllable pore structure and high specific surface area. Accordingly, the recent progress of MOFs‐based materials in the production of hydrogen through water splitting is reviewed. First, the mechanism of photocatalytic hydrogen production and the existing problems are proposed and then their advantages in photocatalytic hydrogen production and various photocatalytic hydrogen production catalysts based on MOFs are summarized. Subsequently, several methods to improve their photocatalytic hydrogen production property are summarized. Finally, some views on the prospects and challenges of the use of MOFs‐based catalysts for photocatalytic hydrolysis are expounded. Although some reviews associated with MOFs for solar‐driven H2 production have been published, most of them focus on the classification of MOFs photocatalysts. This is the first comprehensive review concentrating on the strategies for optimizing the photocatalytic activity of MOFs‐based materials for H2 production. It is believed that the suggestions provided here can help to study MOFs‐based photocatalytic reactions and to further promote the development of this research direction in the future.

Cotton is the most important fiber crop and provides indispensable natural fibers for the textile industry. Micronaire (MIC) is determined by fiber fineness and maturity and is an important component of fiber quality. Gossypium barbadense L. possesses long, strong and fine fibers, while upland cotton (Gossypium hirsutum L.) is high yielding with high MIC and widely cultivated worldwide. To identify quantitative trait loci (QTLs) and candidate genes for MIC in G. barbadense, a population of 250 backcross inbred lines (BILs), developed from an interspecific cross of upland cotton CRI36 × Egyptian cotton (G. barbadense) Hai7124, was evaluated in 9 replicated field tests. Based on a high-density genetic map with 7709 genotyping-by-sequencing (GBS)-based single-nucleotide polymorphism (SNP) markers, 25 MIC QTLs were identified, including 12 previously described QTLs and 13 new QTLs. Importantly, two stable MIC QTLs (qMIC-D03-2 on D03 and qMIC-D08-1 on D08) were identified. Of a total of 338 genes identified within the two QTL regions, eight candidate genes with differential expression between TM-1 and Hai7124 were identified. Our research provides valuable information for improving MIC in cotton breeding.

The demands for model accuracy and computing efficiency in fault warning scenarios are increasing as high-speed railway train technology continues to advance. The black box model is difficult to interpret, making it impossible for this technology to be widely adopted in the railway industry, which has strict safety regulations. This paper proposes a fault early warning machine learning model based on feature contribution and causal inference. First, the contributions of the features are calculated through the Shapley additive explanations model. Then, causal relationships are discovered through causal inference models. Finally, data from causal and high-contribution time series are applied to the model. Ablation tests are conducted with the Naïve Bayes, Gradient Boosting Decision Tree, eXtreme Gradient Boosting, and other models in order to confirm the efficiency of the method based on early warning data regarding the on-site high-speed train traction equipment circuit board failure. The findings indicate that the strategy improves the evaluation markers, including the early warning accuracy, precision, recall, and F1 score, by an average of more than 10%. There is a 35% improvement in the computing efficiency, and the model can provide feature causal graph verification for expert product decision-making.

In this paper, by taking full consideration of demographics, transfer from infectious to susceptible and contact heterogeneity of the individuals, we construct an improved Susceptible-Infected-Removed-Susceptible (SIRS) epidemic model on complex heterogeneous networks. Using the next generation matrix method, we obtain the basic reproduction number $\mathcal{R}_0$ which is a critical value and used to measure the dynamics of epidemic diseases. More specifically, if $\mathcal{R}_0 < 1$, then the disease-free equilibrium is globally asymptotically stable; if $\mathcal{R}_0>1$, then there exists a unique endemic equilibrium and the permanence of the disease is shown in detail. By constructing an appropriate Lyapunov function, the global stability of the endemic equilibrium is proved as well under some conditions. Moreover, the effects of three major immunization strategies are investigated. Finally, some numerical simulations are carried out to demonstrate the correctness and validness of the theoretical results.

While the proximal dentatothalamocortical tracts are considered pivotal in the occurrence of cerebellar mutism syndrome (CMS) after medulloblastoma resection, how the cerebellum participates in motor–speech networks through direct structural connectivity is still unclear. Via tractography, we provide evidence of cerebellar streamlines projecting into the left inferior frontal gyrus majorly connecting Broca’s complex and the bilateral Crus lobes. The streamlines, named Crus–Broca tracts, originated from the bilateral Crus lobes, synapsed onto the dentate nucleus, ascended into the superior cerebellar peduncle (where these streamlines were closely superior to the superior border of the supratonsillar cleft and the superolateral roof of the fourth ventricle), surprisingly bypassed the left red nucleus and the left thalamus, and ended at the subregions of Broca’s complex. The streamlines, named Broca–Crus tracts, originated from the subregions of Broca’s complex and ended predominantly at the right Crus lobes. If verified, the existence of these connections would support the notion of the bilateral cerebellums’ participation in motor–speech planning, and the anatomical relationship of Broca–Crus tracts with the supratonsillar cleft would merit consideration for further studies aimed at further elucidating CMS mechanisms.

This study investigated the corrosion resistance of graphene/waterborne epoxy composite coatings in CO2-satarated NaCl solution. The coatings were prepared by dispersing graphene in waterborne epoxy with the addition of carboxymethylcellulose sodium. The structure and composition of the coatings were characterized by scanning electron microscopy, transmission electron microscopy, Fourier-transform infrared and Raman spectroscopies. The corrosion resistance of the composite coatings was investigated by potentiodynamic polarization measurements and electrochemical impedance spectroscopy. Composite coatings with more uniform surfaces and far fewer defects than blank waterborne epoxy coatings were obtained on 1020 steel. The 0.5 wt% graphene/waterborne epoxy composite coating exhibited a much lower corrosion rate and provided better water resistance properties and long-term protection than those of the blank epoxy coating in CO2-satarated NaCl solution.

To get the knowledge of local corrosion, thinning is useful for developing targeted inspection plans for pipe components in the oil/gas industry. Aiming at this object, this work presents a computer fluid dynamics (CFD) method to predict CO2 aqueous corrosion in complex fluid domains. The processes involved in CO2 aqueous corrosion, including flow dynamics, mass transfer, chemical reactions, and electrochemical reactions, are modeled and simulated by a commercial CFD software of Fluent V15.0 (Version, manufacturer, city, country). Mass transfer in the straight pipe flow and jet impinging flow are simulated using three low-Reynolds-number turbulent models (Abe⁻Kondoh⁻Nagano k − ε model, Change⁻Hsieh⁻Chenk k − ε model, and k − ε shear stress transport model). The flow domains are meshed by grids with the first near-wall node at the position at y+ = 0.1. Comparisons between simulations and experimental data show the Abe⁻Kondoh⁻Nagano model provides the best predictions of near-wall flow and mass transfer. Thus, it is used to predict CO2 aqueous corrosion. Corrosion rates of dissolved CO2 in straight pipes and a jet impinging are predicted. The predicted corrosion rates are compared with experimental data and results derived from commercial software, Multicorp V5.2.105. The results show that predicted corrosion rates are reasonable. The locations of the highest corrosion rate for a jet impinging system are revealed.

Alpha-glucosidase inhibitors currently form an important basis for developing novel drugs for diabetes treatment. In our preliminary tests, the ethyl acetate fraction of Phlomis tuberosa extracts showed significant α-glucosidase inhibitory activity (IC₅₀ = 100 μg/mL). In the present study, a combined method using Sepbox chromatography and thin-layer chromatography (TLC) bioautography was developed to probe α-glucosidase inhibitors further. The ethyl acetate fraction of P. tuberosa extracts was separated into 150 individual subfractions within 20 h using Sepbox chromatography. Then, under the guidance of TLC bioautography, 20 compounds were successfully isolated from these fractions, including four new diterpenoids [14-hydroxyabieta-8,11,13-triene-11-carbaldehyde-18-oic-12-carboxy-13-(1-hydroxy-1-methylethyl)-lactone (1), 14-hydroxyabieta-8,11,13-triene-17-oic-12-carboxy-13-(1-hydroxy-1-methylethyl)-lactone (2), 14,16-dihydroxyabieta-8,11,13-triene-15,17-dioic acid (3), and phlomisol (15,16-eposy-8,13(16),14-labdatrien-19-ol) (4)], and 16 known compounds. Activity estimation indicated that 15 compounds showed more potent α-glucosidase inhibitory effects (with IC50 values in the range 0.067-1.203 mM) than the positive control, acarbose (IC50 = 3.72 ± 0.113 mM). This is the first report of separation of α-glucosidase inhibitors from P. tuberosa.

A coupled system of nine identical cells with delays and 𝔻3×𝔻3-symmetry is considered. The individual cells are modelled by a scalar delay differential equation which includes linear decay and nonlinear delayed feedback. By analyzing the corresponding characteristic equations, the linear stability of the equilibrium is given. We also investigate the simultaneous occurrence of multiple periodic solutions and spatiotemporal patterns of the bifurcating periodic oscillations by using the equivariant bifurcation theory of delay differential equations combined with representation theory of Lie groups. Numerical simulations are carried out to illustrate our theoretical results.

This paper aims at studying the problem of the dynamics of switched Cohen-Grossberg neural networks with mixed delays by using Lyapunov functional method, average dwell time (ADT) method, and linear matrix inequalities (LMIs) technique. Some conditions on the uniformly ultimate boundedness, the existence of an attractors, the globally exponential stability of the switched Cohen-Grossberg neural networks are developed. Our results extend and complement some earlier publications.

Introduction. Liposarcoma constitutes a prevalent subtype of soft tissue sarcoma, represents approximately 20% of all sarcomas. However, conventional chemotherapeutic agents have shown restricted effectiveness in treating liposarcoma patients. Accumulating evidence indicates that mesenchymal stem cells (MSCs) have the characteristic of migration to tumor site, promote or suppress tumors. How human bone marrow mesenchymal stem cells (BMSCs) contribute to liposarcoma phenotype remains poorly understood. This study aims to investigate the effects of human bone marrow mesenchymal stem cell-conditioned medium (BMSC-CM) on the proliferation and migration of liposarcoma cell lines 93T449 and SW872, as well as explore potential underlying mechanisms of BMSC-CM action on these cells. Materials and methods. We transfected BMSCs with lentiviral constructs to knock down the transcriptional co- -activator Yes-associated protein 1 (YAP1), conditioned medium (CM) obtained from BMSCs and shYAP1-BMSC, respectively. Liposarcoma cell lines 93T449 and SW872 were co-cultured with BMSC-CM or shYAP1-BMSC-CM. Cell proliferation ability was assessed by 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay. Cell apoptosis was evaluated using flow cytometric assay. A wound healing assay was used to analyze cell migration. The expression levels of YAP1, Bcl-2, and matrix metalloproteinase-2 (MMP-2) were determined by western blot assay. Results. Co-culturing liposarcoma cell lines 93T449 and SW872 with BMSC-CM promoted tumor cell proliferation, while shYAP1-BMSC-CM significantly inhibited cell viability and migration, induced apoptosis, and downregulated Bcl-2 and MMP-2 expression. Conclusions. These findings provide new insights into the impact of BMSC-CM on liposarcoma and suggest its possible involvement in liposarcoma cell growth. [ABSTRACT FROM AUTHOR]

Abstract Background Hepatic encephalopathy (HE) represents a critical complications of end-stage liver disease, serving as an independent predictor of mortality among patients with cirrhosis. Despite effective treatment with rifaximin, some patients with HE still progress to recurrent episodes, posing a significant therapeutic challenge. Recurrent HE is defined as experiencing two or more episodes within a 6-month period. Previous research has suggested that FMT may emerge as a promising treatment for recurrent HE. However, there remains a critical need to explore the optimal dosage. This trial aims to abscess the efficacy and safety of two FMT dosages: 800 ml or 400 ml total bacterial count, including mortality and quality of life. Methods This multicenter, prospective, randomized controlled trial will enroll 100 eligible patients from 31 hospitals in China. Participants will be randomly assigned in a 1:1 ratio to either the high-dose group (800 ml total bacterial count) or the low-dose group (400 ml total bacterial count). The primary objective is to assess the efficacy and safety of both dosages on outcomes at 24 and 48 weeks, including mortality and quality of life. Discussion If either or both dosages of FMT demonstrate safe and effective treatment of recurrent HE, leading to improve quality of life and survival at 24 and 48 weeks, this trial would address a significant gap in the management of recurrent HE, carrying innovative and clinically significant implications. Trial registration NCT05669651 on ClinicalTrials.gov. Registered on 29 December 2022. CHiCTR2200067135 on China Registered Clinical Trial Registration Center. Registered on 27 December 2022.

Abstract Background The ability of bronchial amylase level for predicting ventilator associated pneumonia (VAP) has been extensively studied with conflicting results. This meta-analysis aimed to explore the value of bronchial amylase for predicting VAP in intubated adults. Methods PubMed, Embase, and Cochrane Central Register of Controlled Trials were searched up to November 2023. The diagnostic odds ratio (DOR), sensitivity, and specificity were calculated. The summary receiver operating characteristic curve was estimated, and the area under the curve (AUROC) was calculated. Results Overall, six studies including 769 patients were included in this review, of whom 273 (36%) were developed VAP. The cutoff values of bronchial amylase level were ranged from 8.1 U/L to 4681.5U/L. Heterogeneity between studies was assessed with an overall Q = 1.99, I 2 = 0, and P = 0.185, The pooled sensitivity and specificity for the overall population were 0.78 [95% confidence interval (CI) 0.67–0.86] and 0.75(95% CI 0.56–0.88) respectively. The DOR was 11(95% CI 3.0–40.0). The pooled AUROC was 0.83 (95%CI 0.80–0.86). Conclusions The bronchial amylase is a helpful marker for predicting VAP in intubated adults. However, it cannot be recommended as the single definitive test for VAP, but rather it must be interpreted in context with information from careful medical history, physical examination, and when feasible, microbiological assessment.