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AIM: To evaluate the clinical effect of a new surgery technique (covering corneal stromal lenticule, CSL) for macular hole (MH) in pathological myopia. METHODS: This was a prospective non-randomized series case study. Fourteen eyes of 14 patients whose axial length were more than 29 mm and suffered from MH and macular hole retinal detachment (MHRD) were included in this study. All cases were treated with 25-gauge pars plana vitrectomy (PPV) with internal limiting membrane (ILM) peeling, covering CSL and C3F8 gas tamponade. These cases were followed for 6mo, and the best-corrected visual acuity (BCVA), healing status of MH, the reattached rate of retinal detachment (RD), and reoperation rate were analyzed. RESULTS: All cases were successfully performed the surgery and the postoperative follow-up was completed. After surgery, MHs were healed in all 14 eyes (100%, 14/14) after assessed by optical coherence tomography. The reattachment of retina was achieved in all 6 eyes (100%, 6/6) with MHRD. BCVA was improved in 12 eyes (85.71%, 12/14), and had no significant change in 2 eyes (14.29%, 2/14). The overall mean BCVA was improved from 1.80±0.77 to 0.82±0.46 logMAR (F=10.46, P

Abstract Background The relationship between human gut microbiota and high-altitude hypoxia acclimatization remains highly controversial. This stems primarily from uncertainties regarding both the potential temporal changes in the microbiota under such conditions and the existence of any dominant or core bacteria that may assist in host acclimatization. Results To address these issues, and to control for variables commonly present in previous studies which significantly impact the results obtained, namely genetic background, ethnicity, lifestyle, and diet, we conducted a 108-day longitudinal study on the same cohort comprising 45 healthy Han adults who traveled from lowland Chongqing, 243 masl, to high-altitude plateau Lhasa, Xizang, 3658 masl, and back. Using shotgun metagenomic profiling, we study temporal changes in gut microbiota composition at different timepoints. The results show a significant reduction in the species and functional diversity of the gut microbiota, along with a marked increase in functional redundancy. These changes are primarily driven by the overgrowth of Blautia A, a genus that is also abundant in six independent Han cohorts with long-term duration in lower hypoxia environment in Shigatse, Xizang, at 4700 masl. Further animal experiments indicate that Blautia A-fed mice exhibit enhanced intestinal health and a better acclimatization phenotype to sustained hypoxic stress. Conclusions Our study underscores the importance of Blautia A species in the gut microbiota’s rapid response to high-altitude hypoxia and its potential role in maintaining intestinal health and aiding host adaptation to extreme environments, likely via anti-inflammation and intestinal barrier protection.

Abstract Constructing a ocean Internet of Things requires an essential ocean environment monitoring system. However, the widely distributed existing ocean monitoring sensors make it impractical to provide power and transmit monitored information through cables. Therefore, ocean environment monitoring systems particularly need a continuous power supply and wireless transmission capability for monitoring information. Consequently, a high-strength, environmentally multi-compatible, floatable metamaterial energy harvesting device has been designed through integrated dynamic matching optimization of materials, structures, and signal transmission. The self-powered monitoring system breaks through the limitations of cables and batteries in the ultra-low-frequency wave environment (1 to 2 Hz), enabling real-time monitoring of various ocean parameters and wirelessly transmitting the data to the cloud for post-processing. Compared with solar and wind energy in the ocean environment, the energy harvesting device based on the defective state characteristics of metamaterials achieves a high-energy density (99 W/m3). For the first time, a stable power supply for the monitoring system has been realized in various weather conditions (24 h).

Abstract The enhancement of regional comprehensive development ability is significantly impacted by the study on the implementation effect of regional integration strategies. The integration strategy’s impact on urban development during COVID-19 in the Yangtze River Delta(YRD) is unclear. According to prior industrial transfer theory, Hefei, Anhui’s capital, is difficult to transfer industries, and other YRD cities push industry integration in Anhui. This study employs the theory of economic and land resource use to examine the resilience of the industrial economy during an epidemic by using industrial land as a representation of industrial economic development. The three cities in Anhui—Wuhu, Maanshan, and Chuzhou (Wu-ma-Chu) were selected as the research area. The study employed the UNet deep learning method to detect the land use types in Wu-ma-Chu. The land transfer matrix and the standard deviation ellipse were utilised to research the alterations in industrial land use and the spatial distribution of industrial output value, respectively. The results showed that the industrial land in Machu continued to grow during the outbreak, highlighting the resilience of the region’s industrial economy. During 2019–2022, the elliptical ring of industrial output value is distributed in Nanjing, revealing the radiating role of Nanjing in integrating into the integration of the YRD. This confirms China’s YRD integration strategy, strengthens regional economic resilience, and encourages coordinated regional economic development.

Abstract This paper presents a novel bolt looseness detection method for power transmission towers based on vibration signal analysis. The proposed method utilizes pulse excitation to extract the vibration signal of the tower, which is then adaptively decomposed using the Variational Mode Decomposition of Spider Wasp optimizer (SWVMD). This overcomes limitations of traditional Variational Mode Decomposition methods by leveraging bio‐inspired optimization to improve signal decomposition. Simulated signals processed with different optimization methods verify the superiority of the SWO approach. Field tests on a 110‐kV transmission tower further demonstrate the effectiveness of the proposed SWVMD technique for analyzing on‐site vibration data. A new improved intrinsic multiscale sample entropy feature is also introduced for bolt state characterization. A Spider Wasp Support Vector Machine classifier is developed to realize accurate bolt loosening monitoring using the extracted features. Dynamic response tests under varying bolt conditions show that the method can identify early loosening and reduce tower damage risks compared to conventional techniques. This novel vibration‐based detection framework presents an innovative application of nature‐inspired computing for power infrastructure health monitoring.

Abstract Electrochemical urea oxidation offers a sustainable avenue for H2 production and wastewater denitrification within the water-energy nexus; however, its wide application is limited by detrimental cyanate or nitrite production instead of innocuous N2. Herein we demonstrate that atomically isolated asymmetric Ni–O–Ti sites on Ti foam anode achieve a N2 selectivity of 99%, surpassing the connected symmetric Ni–O–Ni counterparts in documented Ni-based electrocatalysts with N2 selectivity below 55%, and also deliver a H2 evolution rate of 22.0 mL h–1 when coupled to a Pt counter cathode under 213 mA cm–2 at 1.40 VRHE. These asymmetric sites, featuring oxygenophilic Ti adjacent to Ni, favor interaction with the carbonyl over amino groups in urea, thus preventing premature resonant C⎓N bond breakage before intramolecular N–N coupling towards N2 evolution. A prototype device powered by a commercial Si photovoltaic cell is further developed for solar-powered on-site urine processing and decentralized H2 production.

Abstract Diabetic nephropathy (DN) is a common complication of diabetes mellitus (DM), and cell death plays an important role. Ferroptosis is a recently discovered type of iron‐dependent cell death and one that is different from other kinds of cell death including apoptosis and necrosis. However, ferroptosis has not been described in the context of DN. This study explored the role of ferroptosis in DN pathophysiology and aimed to confirm the efficacy of the ferroptosis inhibitor SRS 16‐86 on DN. Streptozotocin injection was used to establish the DM and DN animal models. To investigate the presence or occurrence of ferroptosis in DN, we assessed the concentrations of iron, reactive oxygen species and specific markers associated with ferroptosis in a rat model of DN. Additionally, we performed haematoxylin–eosin staining, blood biochemistry, urine biochemistry and kidney function analysis to evaluate the efficacy of the ferroptosis inhibitor SRS 16‐86 in ameliorating DN. We found that SRS 16‐86 could improve the recovery of renal function after DN by upregulating glutathione peroxidase 4, glutathione and system xc−light chain and by downregulating the lipid peroxidation markers and 4‐hydroxynonenal. SRS 16‐86 treatment could improve renal organization after DN. The inflammatory cytokines interleukin 1β and tumour necrosis factor α and intercellular adhesion molecule 1 were significantly decreased following SRS 16‐86 treatment after DN. The results indicate that there is a strong connection between ferroptosis and the pathological mechanism of DN. The efficacy of the ferroptosis inhibitor SRS 16‐86 in DN repair supports its use as a new therapeutic treatment for DN.

Precipitation strengthening is a crucial method for enhancing the mechanical properties of steel. The bridgman directional solidification furnace, optical microscope (OM), scanning electron microscope (SEM), electron probe analyzer (EPMA) and transmission electron microscope (TEM) were used to investigate the effect of solidification cooling rate on the solidification microstructure, microsegregation, and nanoprecipitates in medium carbon CrMo cast steel. The results indicate that as the cooling rate increases, the solidification microstructure is significantly refined. The relationship between the cooling rate (CA) and primary dendrite arm spacing (PDAS, λ1) and secondary dendrite arm spacing (SDAS, λ2) are given by λ1 = 123.74 × C-0.4088A, λ2 = 66.63 × C-0.6532 A. Solute elements like Cr, Mo, and V exhibit noticeable positive segregation in the inter-dendritic. When the cooling rate does not exceed 0.47 °C/s, the solute concentrations in the inter-dendritic increase with higher cooling rate, leading to a decrease in the effective solute partition coefficient. This phenomenon is primarily attributed to the back diffusion of solute elements during solidification. Following heat treatment, precipitation of M6C, V(C,N), and M23C6 occurs within the inter-dendritic regions. If the solidification cooling rate does not exceed 0.47 °C/s, the density and volume fraction of nanoprecipitates increase with higher cooling rate. This trend primarily results from the reduction in critical nucleation radius and critical nucleation energy, facilitating easier nucleation of nanoprecipitates.

AbstractContext Diabetic kidney disease (DKD) affects nearly 40% of diabetic patients, often leading to end-stage renal disease that requires renal replacement therapies, such as dialysis and transplantation. The gut microbiota, an integral aspect of human evolution, plays a crucial role in this condition. Traditional Chinese medicine (TCM) has shown promising outcomes in ameliorating DKD by addressing the gut microbiota.Objective This review elucidates the modifications in gut microbiota observed in DKD and explores the impact of TCM interventions on correcting microbial dysregulation.Methods We searched relevant articles from databases including Web of Science, PubMed, ScienceDirect, Wiley, and Springer Nature. The following keywords were used: diabetic kidney disease, diabetic nephropathy, gut microbiota, natural product, TCM, Chinese herbal medicine, and Chinese medicinal herbs. Rigorous criteria were applied to identify high-quality studies on TCM interventions against DKD.Results Dysregulation of the gut microbiota, including Lactobacillus, Streptococcus, and Clostridium, has been observed in individuals with DKD. Key indicators of microbial dysregulation include increased uremic solutes and decreased short-chain fatty acids. Various TCM therapies, such as formulas, tablets, granules, capsules, and decoctions, exhibit unique advantages in regulating the disordered microbiota to treat DKD.Conclusion This review highlights the importance of targeting the gut-kidney axis to regulate microbial disorders, their metabolites, and associated signaling pathways in DKD. The Qing-Re-Xiao-Zheng formula, the Shenyan Kangfu tablet, the Huangkui capsule, and the Bekhogainsam decoction are potential candidates to address the gut-kidney axis. TCM interventions offer a significant therapeutic approach by targeting microbial dysregulation in patients with DKD.

This study established a circulating system to control the concentration of substances and temperature in the aqueous solution. Simultaneously, sensors were used to continuously monitor the corrosion of three pipe materials: ductile iron (DI), surface-treated ductile iron (SDI), and carbon steel (CS). A corrosion decision model based on a machine learning framework was developed for data mining. The results show that the developed model provides accurate corrosion prediction strategies. Analysis revealed that high temperature is the primary factor accelerating corrosion in water systems. SDI accelerates at 60 °C, reaching its peak at 90 °C, while DI and CS peak at 80 °C. The superior corrosion resistance of SDI is attributed to its ability to withstand accelerated corrosion under high temperatures and environmental coupling, making it more stable when immersed in water.

Abstract The fusion rules and operator product expansion (OPE) serve as crucial tools in the study of operator algebras within conformal field theory (CFT). Building upon the vision of using entanglement to explore the connections between fusion coefficients and OPE coefficients, we employ the replica method and Schmidt decomposition method to investigate the time evolution of entanglement entropy (EE) and pseudo entropy (PE) for linear combinations of operators in rational conformal field theory (RCFT). We obtain a formula that links fusion coefficients, quantum dimensions, and OPE coefficients. We also identify two definition schemes for linear combination operators. Under one scheme, the EE captures information solely for the heaviest operators, while the PE retains information for all operators, reflecting the phenomenon of pseudo entropy amplification. Irrespective of the scheme employed, the EE demonstrates a step-like evolution, illustrating the effectiveness of the quasiparticle propagation picture for the general superposition of locally excited states in RCFT. From the perspective of quasiparticle propagation, we observe spontaneous block-diagonalization of the reduced density matrix of a subsystem when quasiparticles enter the subsystem.

Abstract In this study, we analyzed the factors influencing the development of delayed encephalopathy in patients with acute carbon monoxide poisoning (ACOP) (DEACMP) following conventional treatment such as hyperbaric oxygen therapy (HBOT). Between January 2012 and January 2022, we retrospectively analyzed 775 patients with ACOP, who were admitted to the Second Department of Rehabilitation Medicine and received HBOT in the Second Hospital of Hebei Medical University. These patients were divided into the non-DEACMP and DEACMP groups based on their follow-up; we then compared the general data, clinical characteristics, admission examination, and treatment between the two groups to identify risk factors for the development of DEACMP. The DEACMP group comprised of 168 cases, while the non-DEACMP group consisted of 607 cases. Univariate analysis showed that there were 20 possible prognostic factors in the non-DEACMP and DEACMP groups. The results of multivariable regression analyses suggested that the occurrence of DEACMP was significantly correlated with advanced age, the combination of multiple medical histories, the duration of CO exposure, the duration of coma, poisoning degree, the Interval between ACOP and the first HBOT, the total number of HBOTs, and the combination with rehabilitation treatment. DEACMP patients who are older, have more comorbidities, prolonged CO exposure, prolonged coma, severe intoxication, long intervals between ACOP and the first HBOT, fewer HBOT treatments, and who are not treated with a combination of rehabilitative therapies have a poor prognosis.

Abstract Background Research into the acute kidney disease (AKD) after acute ischemic stroke (AIS) is rare, and how clinical features influence its prognosis remain unknown. We aim to employ interpretable machine learning (ML) models to study AIS and clarify its decision-making process in identifying the risk of mortality. Methods We conducted a retrospective cohort study involving AIS patients from January 2020 to June 2021. Patient data were randomly divided into training and test sets. Eight ML algorithms were employed to construct predictive models for mortality. The performance of the best model was evaluated using various metrics. Furthermore, we created an artificial intelligence (AI)-driven web application that leveraged the top ten most crucial features for mortality prediction. Results The study cohort consisted of 1633 AIS patients, among whom 257 (15.74%) developed subacute AKD, 173 (10.59%) experienced AKI recovery, and 65 (3.98%) met criteria for both AKI and AKD. The mortality rate stood at 4.84%. The LightGBM model displayed superior performance, boasting an AUROC of 0.96 for mortality prediction. The top five features linked to mortality were ACEI/ARE, renal function trajectories, neutrophil count, diuretics, and serum creatinine. Moreover, we designed a web application using the LightGBM model to estimate mortality risk. Conclusions Complete renal function trajectories, including AKI and AKD, are vital for fitting mortality in AIS patients. An interpretable ML model effectively clarified its decision-making process for identifying AIS patients at risk of mortality. The AI-driven web application has the potential to contribute to the development of personalized early mortality prevention.

Abstract The paper presents a fault region identification method for the active distribution network (ADN) with limited PMU. First, PMU configuration and region division strategies are proposed based on the network topology. Next, the difference in three-phase current variations between the normal and fault regions of the ADN is analyzed. A multi-dimensional state monitoring matrix is built using the measured current data. The spectral norm ratio coefficient is constructed based on the 2-norm to lower the complexity of the multi-dimensional state monitoring matrix and quantify the difference in state changes before and after the fault occurs in each region. Then, the fault region is identified by combining each region’s spectral norm ratio coefficient and the change of the current phase. Finally, an IEEE 33-node simulation model is created to simulate faults under different working conditions. According to the simulation results, the suggested approach is less impacted by fault type, neutral point grounding mode, and transition resistance. Furthermore, even if the communication does not match the rigorous synchronization requirements, the proposed method can still complete the fault identification of the distribution network correctly and has high robustness.

With the increase in the depth and intensity of coal mining, some coal mines encounter the dual disaster threat of gas outburst and rockburst, and the composite gas-rockburst disaster has become a scientific and engineering problem that deserves more attention, and the distribution of abutment stress is of great significance for revealing the mechanism of composite dynamic disasters. This paper focuses on the influence of gas pressure on the abutment stress, establishes a theoretical model of a circular roadway and obtains the influence of gas pressure changes on the tangential stress and the radius of the plastic zone. The influence characteristic of gas pressure on the front abutment of a longwall working face is simulated based on the typical engineering geological conditions of an outburst-rockburst mine. The results show that as the gas pressure decreases, the tangential stress around the roadway increases, and the radius of the plastic zone decreases, meaning that the peak tangential stress is closer to the roadway. The peak abutment stress is negatively correlated with the gas pressure, while the distance of the peak from working face is opposite, both showing a quadratic relationship. On-site monitoring shows that as gas extraction proceeds, the frequency of mining-induced tremors increases significantly. When there is a sharp upward trend of the mining-induced tremors along with the continuous decrease of gas pressure, the risk of rockburst is high. A gas-rockburst coordination prevention and control technology system is established in Haishiwan Coal Mine based on the relationship of gas pressure changes and rockburst danger. During the gas control process, the gas pressure-microseismicity frequency is used to predict the rockburst risk and optimize the starting position and strength of destress engineering to achieve collaborative prevention and control of outburst-rockburst.

Abstract Michelia alba DC is a highly valuable ornamental plant of the Magnoliaceae family. This evergreen tropical tree commonly grows in Southeast Asia and is adored for its delightful fragrance. Our study assembled the M. alba haplotype genome MC and MM by utilizing Nanopore ultralong reads, Pacbio Hifi long reads and parental second-generation data. Moreover, the first methylation map of Magnoliaceae was constructed based on the methylation site data obtained using Nanopore data. Metabolomic datasets were generated from the flowers of three different species to assess variations in pigment and volatile compound accumulation. Finally, transcriptome data were generated to link genomic, methylation, and morphological patterns to reveal the reasons underlying the differences between M. alba and its parental lines in petal color, flower shape, and fragrance. We found that the AP1 and AP2 genes are crucial in M. alba petal formation, while the 4CL, PAL, and C4H genes control petal color. The data generated in this study serve as a foundation for future physiological and biochemical research on M. alba, facilitate the targeted improvement of M. alba varieties, and offer a theoretical basis for molecular research on Michelia L.

The exponential proliferation of renewable energy has resulted in a significant mismatch between power supply and demand, especially during extreme events. This incongruity presents challenges in efficiently harnessing renewable energy and enhancing the resilience of the power grid. To address this issue, this paper proposes shared energy storage (SES) planning based on the adaptive alternating direction method of multipliers (AADMM). The objective is to fully leverage SES, enhance the local consumption level of renewable energy, ensure power grid resilience, and reduce operational costs. First, to ensure the effective utilization of SES while minimizing initial investment and construction costs, a planning model for SES is formulated. Secondly, to maximize the benefits for multiple prosumers within the renewable energy and SES station, a profit maximization model for multiple prosumers is established. Lastly, to guarantee the privacy security of SES and multi-prosumers while optimizing computational efficiency, a distributed computing model for SES based on AADMM is developed. The results of the example show that the proposed model can not only reduce the cost of 47.96 CNY, but also increase the power self-sufficiency rate by 21.86%. In addition, compared with the traditional distributed optimization, the number of iterations of AADMM is increased by 47.05%, and the computational efficiency is increased by 54.67%. In addition, market prices have a great impact on energy trading, and the impact of market pricing on the operation of the park is not considered in our current research. In this case, our future research aims to consider how to price reasonably between prosumers and between prosumers and SES, so as to realize the stable participation of each subject in the energy market.

Prior research has indicated that bisphosphonates (BPs) can improve periodontal disease because of their anti-osteoporosis properties. In vitro studies have shown that BPs induce cytotoxicity, inhibit wound healing, and thus affect periodontal disease. Denosumab and BPs have alternative indications. BP and denosumab are not known to correlate with gingival disorders. We assessed such a relationship by applying Bayesian and nonproportional analyses to data in the US FDA Adverse Event Reporting System (FAERS) database. The study analyzed BPs and denosumab-reported incidents with preferred terms found in the narrow Standardized MedDRA Queries for gingival disorders. A total of 5863 reported cases of gingival disorders were associated with five BPs (alendronate, pamidronate, ibandronate, risedronate, and zoledronate) and denosumab. More than 15% of patients with gingival disorders related to BPs and denosumab other than denosumab were hospitalized over short- or long-term periods. Our findings indicated BPs and denosumab had significant reporting odds ratios (ROR), proportional reporting ratios (PRR), and information components (IC) with respect to gingival disorders. Pamidronate had the highest association (ROR = 64.58, PRR = 57.99, IC = 5.71), while the weakest association was found with denosumab (ROR = 3.61, PRR = 3.60, IC = 1.77). Significant associations were found between the six drugs and gingival pain, gingival recession, gingivitis, periodontal disease, and periodontitis. In conclusion, our comprehensive overview of the correlations, clinical characteristics, and prognoses of BPs and denosumab-related gingival disorders suggests that these issues deserve continued surveillance and appropriate management.

IntroductionMesenchymal stromal cells (MSCs) have been extensively studied as a potential treatment for steroid refractory acute graft-versus-host disease (aGVHD). However, the majority of clinical trials have focused on bone marrow-derived MSCs.MethodsIn this study, we report the outcomes of 86 patients with grade III-IV (82.6% grade IV) steroid refractory aGVHD who were treated with human umbilical cord-derived mesenchymal stromal cells (UC-MSCs). The patient cohort included 17 children and 69 adults. All patients received intravenous infusions of UC-MSCs at a dose of 1 × 106 cells per kg body weight, with a median of 4 infusions (ranging from 1 to 16).ResultsThe median time between the onset of aGVHD and the first infusion of UC-MSCs was 7 days (ranging from 3 to 88 days). At day 28, the overall response (OR) rate was 52.3%. Specifically, 24 patients (27.9%) achieved complete remission, while 21 (24.4%) exhibited partial remission. The estimated survival probability at 100 days was 43.7%. Following a median follow-up of 108 months (ranging from 61 to 159 months), the survival rate was approximately 11.6% (10/86). Patients who developed acute lower GI tract and liver GVHD exhibited poorer OR rates at day 28 compared to those with only acute lower GI tract GVHD (22.2% vs. 58.8%; p= 0.049). No patient experienced serious adverse events.DiscussionThese finding suggest that UC-MSCs are safe and effective in both children and adults with steroid refractory aGVHD. UC-MSCs could be considered as a feasible treatment option for this challenging conditon. (NCT01754454).

Chronic pain is a prevalent and persistent ailment that affects individuals worldwide. Conventional medications employed in the treatment of chronic pain typically demonstrate limited analgesic effectiveness and frequently give rise to debilitating side effects, such as tolerance and addiction, thereby diminishing patient compliance with medication. Consequently, there is an urgent need for the development of efficacious novel analgesics and innovative methodologies to address chronic pain. Recently, a growing body of evidence has suggested that multireceptor ligands targeting opioid receptors (ORs) are favorable for improving analgesic efficacy, decreasing the risk of adverse effects, and occasionally yielding additional advantages. In this study, the intrathecal injection of a recently developed peptide (VYWEMEDKN) at nanomolar concentrations decreased pain sensitivity in naïve mice and effectively reduced pain-related behaviors in nociceptive pain model mice with minimal opioid-related side effects. Importantly, the compound exerted significant rapid-acting antidepressant effects in both the forced swim test and tail suspension test. It is possible that the rapid antihyperalgesic and antidepressant effects of the peptide are mediated through the OR pathway. Overall, this peptide could both effectively provide pain relief and alleviate depression with fewer side effects, suggesting that it is a potential agent for chronic pain and depression comorbidities from the perspective of pharmaceutical development.

Abstract Objective To analyze the efficacy and associated factors affecting the prognosis in patients with disturbance of consciousness after hyperbaric oxygen (HBO) treatment. Methods A retrospective study was carried out on patients with disorders of consciousness (DOC) receiving HBO treatment from January to January 2022 in the Second Department of Rehabilitation Medicine of the Second Hospital of Hebei Medical University, China. Results HBO therapy improved the Glasgow Coma Scale (GCS) and Chinese Nanjing Persistent Vegetative State Scale (CNPVSS), as well as the clinical efficacy in patients with DOC. The comparison of GCS and CNPVSS scores in patients with DOC before and after HBO treatment was all statistically significant, with 325 patients (67.1%) showing effective results and 159 patients (32.9%) having unchanged outcomes. Univariate analysis indicated that there were statistically significant differences in age, HBO intervention time, HBO treatment times, pre‐treatment GCS score, and etiology and underlying diseases between the good and poor prognoses groups. Multivariate regression analysis showed that HBO intervention time ≤7 days, HBO treatment ＞ times, high GCS score before HBO treatment, and brain trauma were independent influencing factors in achieving a good prognosis for patients with DOC. Low pre‐treatment GCS scores were an independent risk factor for a poor prognosis in patients with brain trauma while being male, late HBO intervention time, fewer HBO treatment times, and low pre‐treatment GCS scores were independent risk factors for a poor prognosis in patients with DOC after a stroke. Being ≥50 years of age, late HBO intervention time, and low pre‐treatment GCS scores were independent risk factors for a poor prognosis in patients with DOC after hypoxic‐ischaemic encephalopathy. Conclusion HBO therapy can improve the GCS, CNPVSS scores and clinical efficacy in patients with DOC, and the timing of HBO intervention ≤7 days, times of HBO treatment, high pre‐treatment GCS score, and brain trauma were the independent influencing factors of good prognosis in patients with DOC.

IntroductionLiuweizhiji Gegen-Sangshen beverage (LGS) is popular in China, which has been used for alleviating alcohol-mediated discomfort and preventing alcoholic liver disease (ALD). This beverage is consisted of six herbal components that are known as functional foods and fruits. LGS is rich in polysaccharides, however, the activity and quality evaluation of LGS-derived polysaccharides remain unexplored. The purpose of this study is thus to establish a comprehensive quality control methodology for the assessment of LGS polysaccharides (LGSP) and to further explore the anti-oxidant, anti-inflammatory as well as prebiotic effect of LGSP.MethodsLGSP was extracted, followed by analysis of molecular weight distribution, monosaccharide content and structural characterization via integrating the application of high-performance size exclusion chromatography (HPSEC), 1-phenyl-3-methyl-5-pyrazolone-HPLC (PMP-HPLC), fourier transform infrared spectroscopy (FT-IR) as well as nuclear magnetic resonance spectroscopy (NMR) techniques. The anti-oxidation activity of LGSP was determined by DPPH, ABTS, hydroxyl radical scavenging capacity and total antioxidant capacity. The anti-inflammation of LGSP were assessed on the RAW 264.7 cells. The effect of LGSP on growth of Lactobacillus, Bifidobacterium bifidum and Bifidobacterium adolescentis was evaluated.ResultsThe results demonstrated that LGSP had two molecular weight distribution peaks, with the average molecular weights of (6.569 ± 0.12) × 104 Da and (4.641 ± 0.30) × 104 Da. LGSP was composed of 8 monosaccharides, with galacturonic acid, glucose rhamnose and galactose representing the highest molar ratios. Homogalacturonic acid (HG) type and rhamnosegalacturonic acid glycans I (RG-I) type and α-1,4-glucan were present in LGSP. LGSP concentration in LGS was 17.94 ± 0.28 mg/mL. Furthermore, fingerprint analysis combined with composition quantification of 10 batches of LGSP demonstrated that there was a high similarity among batches. Notably, LGSP exhibited anti-oxidant effect and inhibited expressions of pro-inflammatory factors (TNF-α and IL-6) in LPS-stimulated RAW 264.7 cells. In addition, LGSP remarkably promoted the proliferation of probiotics Lactobacillus, Bifidobacterium bifidum and Bifidobacterium adolescentis, showing good prebiotic activity.DiscussionThe results of present study would be of help to gain the understanding of structure–activity relationship of LGSP, provide a reference for quality evaluation of bioactive LGSP, and facilitate development of unique health and functional products in the future.

This study focused on addressing the heat generation issue in Lithium-Ion battery packs (LIBPs). By simulating three LIBPs arranged in series within a duct, the momentum and energy conservation equations were solved using Computational Fluid Dynamics (CFD) to investigate cooling performance on the LIBPs' temperature. To enhance cooling, copper oxide nanoparticles were added to pure water to improve the thermal conductivity of the working fluid. Various cases were simulated to examine the effects of Reynolds number at inlet and volume fraction of copper oxide nanoparticles on flow parameters (streamlines, vortices, pressure drop) and heat transfer parameters (temperature distribution, maximum and average temperature of each LIBP) within the duct. Also, this study analyzed exergoeconomics by considering exergies and initial investment. The results demonstrate that increasing the volume fraction from 0 to 4 % at Re = 60 reduced the maximum temperature of LIBP 1, 2, and 3 by 2.19 °C, 2.26 °C, and 2.64 °C, respectively, while it had no remarkable impact on the maximum temperature of LIBPs for bigger Reynolds numbers.

Abstract The efficacy of administering high doses of vitamin D to patients diagnosed with COVID‐19 remains uncertain. We conducted a comprehensive search across multiple databases (PubMed, EMBASE, Cochrane Library, and ISI Web of Science) from inception until August 2022, with no limitations on language, to locate randomized controlled trials (RCTs) that investigated the impact of high‐dose vitamin D supplementation (defined as a single dose of ≥100,000 IU or daily dose of ≥10,000 IU reaching a total dose of ≥100,000 IU) on COVID‐19 patients. Risk ratios (RR) with 95% confidence intervals (CI) and weighted mean differences (WMD) with 95% CI were calculated. Our meta‐analysis included 5 RCTs with a total of 834 patients. High‐dose vitamin D supplementation did not show any significant benefits for mortality (I2 = 0.0%, p = .670; RR 1.092, 95% CI 0.685–1.742, p = .711) or intensive care unit (ICU) admission (I2 = 0.0%, p = .519; RR 0.707, 95% CI 0.454–1.102, p = .126) in COVID‐19 patients compared to the control group. However, it was found to be safe and well‐tolerated (I2 = 0.0%, p = .887; RR 1.218, 95% CI 0.930–1.594, p = .151). Subgroup analysis also showed no benefits in overall mortality, including for patients with vitamin D deficiency (I2 = 0.0%, p = .452; RR 2.441, 95% CI 0.448–13.312, p = .303) or compared to the placebo (I2 = 0.0%, p = .673; RR 1.666, 95% CI 0.711–3.902, p = .240). Our research indicates that there is no evidence to support the efficacy of high‐dose vitamin D supplementation in improving clinical outcomes among individuals with COVID‐19, in line with previous studies focused on contexts including rickets. Considering the limitations of the study, additional research may be required.

1,3-Diacylglycerol (DAG) has been well recognized as a safe food component. The metabolic pathway of DAG in the body is different from that of triacylglycerol, and DAG has been demonstrated to contribute to improving metabolism and preventing obesity and cardiovascular diseases. However, the mass fraction of natural DAG in edible oils and fats is less than 10%, so the preparation of high-purity DAG has received widespread attention in recent years. Enzymatic synthesis is the method of choice for the industrial preparation of DAG due to the advantages of eco-friendliness, safety and desirable selectivity over chemical synthesis. Edible livestock and poultry fats, as by-products of slaughter and processing, have a special flavor and nutritional value. However, their undesirable physicochemical properties, especially high melting points and high levels of saturated fatty acids and cholesterols, highly limit their applications in the food industry. In light of this, the synthesis of DAG from edible livestock and poultry fats is a promising approach for their high-value utilization. The current status of the enzymatic synthesis and the potential application of DAG from livestock and poultry fats are reviewed in this article. It is anticipated that this review will provide new ideas for researchers interested in the enzymatic preparation and high-value utilization of DAG from livestock and poultry fats.

Abstract Background Continuous and noninvasive hemoglobin (Hb) monitoring during surgery is essential for anesthesiologists to make transfusions decisions. The aim of this study was to investigate the feasibility and accuracy of noninvasive and continuous Hb monitoring using transesophageal descending aortic photoplethysmography (dPPG) in porcine model. Methods Nineteen landrace pigs, aged 3 to 5 months and weighing 30 to 50 kg, were enrolled in this study. A homemade oximetry sensor, including red (660 nm) and infrared (940 nm) lights, was placed in the esophagus for dPPG signal detection to pair with the corresponding reference Hb values (Hbi−STAT) measured by blood gas analysis. The decrease and increase changes in Hb concentration were achieved by hemodilution and transfusion. Metrics, including alternating current (AC), direct current (DC), and AC/DC for both red and infrared light were extracted from the dPPG signal. A receiver operating characteristic (ROC) curve was built to evaluate the performance of dPPG metrics in predicting the Hb “trigger threshold” of transfusion (Hb 100 g/L). Agreement and trending ability between Hb measured by dPPG (HbdPPG) and by blood gas analysis were analyzed by Bland-Altman method and polar plot graph. Error grid analysis was also performed to evaluate clinical significance of HbdPPG measurement. Results The dPPG signal was successfully detected in all of the enrolled experimental pigs, without the occurrence of a continuous loss of dPPG signal for 2 min during the entire measurement. A total of 376 pairs of dPPG signal and Hbi−STAT were acquired. ACred/DCred and ACinf/DCinf had moderate correlations with Hbi−STAT, and the correlation coefficients were 0.790 and 0.782, respectively. The areas under the ROC curve for ACred/DCred and ACinf/DCinf in predicting Hbi−STAT < 60 g/L were 0.85 and 0.75, in predicting Hbi−STAT > 100 g/L were 0.90 and 0.83, respectively. Bland-Altman analysis and polar plot showed a small bias (1.69 g/L) but a wide limit of agreement (-26.02–29.40 g/L) and a poor trend ability between HbdPPG and Hbi−STAT. Clinical significance analysis showed that 82% of the data lay within the Zone A, 18% within the Zone B, and 0% within the Zone C. Conclusion It is feasible to establish a noninvasive and continuous Hb monitoring by transesophageal dPPG signal. The ACred/DCred extracted from the dPPG signal could provide a sensitive prediction of the Hb threshold for transfusion. The Hb concentration measured by dPPG signal has a moderate correlation with that measured by blood gas analysis. This animal study may provide an experimental basis for the development of bedside HbdPPG monitoring in the future.

Abstract Electrochemical nitrate reduction to ammonia offers an attractive solution to environmental sustainability and clean energy production but suffers from the sluggish *NO hydrogenation with the spin–state transitions. Herein, we report that the manipulation of oxygen vacancies can contrive spin−polarized Fe1−Ti pairs on monolithic titanium electrode that exhibits an attractive NH3 yield rate of 272,000 μg h−1 mgFe −1 and a high NH3 Faradic efficiency of 95.2% at −0.4 V vs. RHE, far superior to the counterpart with spin−depressed Fe1−Ti pairs (51000 μg h–1 mgFe –1) and the mostly reported electrocatalysts. The unpaired spin electrons of Fe and Ti atoms can effectively interact with the key intermediates, facilitating the *NO hydrogenation. Coupling a flow−through electrolyzer with a membrane-based NH3 recovery unit, the simultaneous nitrate reduction and NH3 recovery was realized. This work offers a pioneering strategy for manipulating spin polarization of electrocatalysts within pair sites for nitrate wastewater treatment.

Highlights Novel double-network (DN) ion-conducting hydrogel (ICH) based on a poly(ionic liquid)/MXene/poly(vinyl alcohol) system (named PMP DN ICH) was synthesized using freeze–thawing and ionizing radiation technology. The PMP DN ICH possesses a multiple cross-linking mechanism and exhibits outstanding ionic conductivity (63.89 mS cm−1), excellent temperature resistance (−60–80 °C) and decent mechanical performance. The well-designed PMP DN ICH shows considerable potential in wearable sensing, energy storage, and energy harvesting.

Objective Thermal ablation (TA) is a safe and effective treatment for benign thyroid nodules (BTNs). However, there has been no consensus on the optimal maximum diameter (MD) of BTNs for TA. This study aimed to identify the optimal MD of BTNs for TA based on complete disappearance rate after TA.Materials and methods This retrospective study included 639 BTNs treated with TA from June 2014 to January 2022. The complete disappearance rate of BTNs after TA was summarized, related influencing factors were explored, and the optimal MD of BTNs for TA was identified.Results At the final follow-up (median: 40 months, range: 24–95 months), the overall volume reduction rate was 95.4 ± 9.0%, and 50.5% of the BTNs (323/639) completely disappeared. The MD was significantly negatively correlated with complete disappearance (odds ratio 0.89, 95% confidence interval 0.87–0.92; p 25.0 mm had a greater complication rate (6.5% vs. 2.4%, p = 0.012).Conclusions The MD of BTNs was negatively correlated with complete disappearance after TA; an MD > 25.0 mm indicated a reduced likelihood of complete disappearance compared with an MD ≤ 25.0 mm. An MD of 25.0 mm is an appropriate threshold of BTNs for TA on the basis of complete disappearance rate.

Background Primary myelofibrosis (PMF) is the most advanced subtype among the classic Philadelphia chromosomenegative myeloproliferative neoplasms (MPNs). A majority of patients carry one of three mutually-exclusive somatic driver mutations: JAK2 (60–65%), CALR (20–25%), or MPL (5%). Co-occurrence of these mutations is rarely reported. Here we report a case with a triple positive combination of JAK2, CALR and MPL driver mutations.Case presentation A 69-year-old male was admitted to hospital for acute exacerbation of chronic obstructive pulmonary disease (COPD) and was found to have splenomegaly and leukocytosis. Nextgeneration revealed JAK2, CALR, MPL mutations, and additional variants in SF3B1, SRSF2, and STAG2. The patient was diagnosed with PMF and treated with ruxolitinib and COPD therapy. Due to nausea, the ruxolitinib dose was reduced. After therapy, spleen volume decreased and hematologic responses were poor. Another genetic mutation of ASXL1 was later found. After adjusting the medication and adding antiemetics, the patient's condition improved.Conclusions The rare coexistence of JAK2, CALR, and MPL mutations challenges the assumption of their mutual exclusivity. Further study of these mutations is essential for developing better treatment strategies.

Objective To assess the feasibility, efficacy, and safety of microwave ablation in treating follicular thyroid neoplasms and suspicious follicular thyroid neoplasms.Methods In this retrospective study, the data of patients treated with microwave ablation for follicular neoplasms from December 2016 to January 2024 were summarized. The changes in nodule size, volume, technical success rate, disease progression, complete tumor resolution, thyroid function, and complications post-ablation were evaluated.Results Seventy-four patients (15 men, 59 women; mean age 46.3 ± 15.2 years) with follicular neoplasms were included. Over a median follow-up of 13 months, complete ablation was achieved, giving a 100% technical success rate. At the first month post-ablation, the maximum diameter of nodules showed no significant change (p = 0.287). From the third month, both maximum diameter and volume significantly decreased (p 0.05). The complication and side effect rates were 8.1% and 4.1%, respectively.Conclusions Initial findings suggest microwave ablation is an effective and safe treatment for follicular neoplasms, with low incidences of disease progression and complications, while maintaining thyroid function.

Influenza virus infection poses a continual menace to public health. Here, we developed soluble trimeric HA ectodomain vaccines by establishing interprotomer disulfide bonds in the stem region, which effectively preserve the native antigenicity of stem epitopes. The stable trimeric H1 ectodomain proteins exhibited higher thermal stabilities in comparison with unmodified HAs and showed strong binding activities towards a panel of anti-stem cross-reactive antibodies that recognize either interprotomer or intraprotomer epitopes. Negative stain transmission electron microscopy (TEM) analysis revealed the stable trimer architecture of the interprotomer disulfide-stapled WA11#5, NC99#2, and FLD#1 proteins as well as the irregular aggregation of unmodified HA molecules. Immunizations of mice with those trimeric HA ectodomain vaccines formulated with incomplete Freund’s adjuvant elicited significantly more potent cross-neutralizing antibody responses and offered broader immuno-protection against lethal infections with heterologous influenza strains compared to unmodified HA proteins. Additionally, the findings of our study indicate that elevated levels of HA stem-specific antibody responses correlate with strengthened cross-protections. Our design strategy has proven effective in trimerizing HA ectodomains derived from both influenza A and B viruses, thereby providing a valuable reference for designing future influenza HA immunogens.

AbstractObjective To evaluate the complications associated with microwave ablation (MWA) in treating persistent/recurrent hyperparathyroidism (HPT) post-surgical or ablative treatments.Materials and methods From January 2015 to December 2022, 87 persistent/recurrent HPT patients (primary HPT [PHPT]: secondary HPT [SHPT] = 13:74) who underwent MWA after surgical or ablative treatment were studied. Grouping was based on ablation order (initial vs. re-MWA), prior treatment (parathyroidectomy [PTX] vs. MWA), and etiology (PHPT vs. SHPT). The study focused on documenting and comparing treatment complications and analyzing major complication risk factors.Result Among the 87 patients, the overall complication rate was 17.6% (15/87), with major complications at 13.8% (12/87) and minor complications at 3.4% (3/87). Major complications included recurrent laryngeal nerve (RLN) palsy (12.6%) and Horner syndrome (1.1%), while minor complications were limited to hematoma (3.4%). Severe hypocalcemia noted in 21.6% of SHPT patients. No significant differences in major complication rates were observed between initial and re-MWA groups (10.7% vs. 13.8%, p = 0.455), PTX and MWA groups (12.5% vs. 15.4%, p = 0.770), or PHPT and SHPT groups (15.4% vs. 13.5%, p > 0.999). Risk factors for RLN palsy included ablation of superior and large parathyroid glands (>1.7 cm). All patients recovered spontaneously except for one with permanent RLN palsy in the PTX group (2.1%).Conclusion Complication rates for MWA post-surgical or ablative treatments were comparable to initial MWA rates. Most complications were transient, indicating MWA as a viable and safe treatment option for persistent/recurrent HPT patients.

AbstractIn this study, seventeen isobavachalcone (IBC) derivatives (1–17) were synthesised, and evaluated for their cytotoxic activity against three human lung cancer cell lines. Among these derivatives, compound 16 displayed the most potent cytotoxic activity against H1975 and A549 cells, with IC50 values of 4.35 and 14.21 μM, respectively. Compared with IBC, compound 16 exhibited up to 4.11-fold enhancement of cytotoxic activity on human non-small cell lung cancer H1975 cells. In addition, we found that compound 16 suppressed H1975 cells via inducing apoptosis and necroptosis. The initial mechanism of compound 16 induced cell death in H1975 cells involves the increasing of Bax/Bcl-2 ratio and Cyt C protein level, down-regulating of Akt protein level, and cleaving caspase-9 and -3 induced apoptosis; the up-regulation of RIP3, p-RIP3, MLKL, and p-MLKL levels induced necroptosis. Moreover, compound 16 also caused mitochondrial dysfunction, thereby decreasing cellular ATP levels, and resulting in excessive reactive oxygen species (ROS) accumulation.