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Abstract Background Hip fractures in the elderly are a common traumatic injury. Due to factors such as age and underlying diseases, these patients exhibit a high incidence of acute heart failure prior to surgery, severely impacting surgical outcomes and prognosis. Objective This study aims to explore the potential risk factors for acute heart failure before surgery in elderly patients with hip fractures and to establish an effective clinical prediction model. Methods This study employed a retrospective cohort study design and collected baseline and preoperative variables of elderly patients with hip fractures. Strict inclusion and exclusion criteria were adopted to ensure sample consistency. Statistical analyses were carried out using SPSS 24.0 and R software. A prediction model was developed using least absolute shrinkage and selection operator (LASSO) regression and multivariate logistic regression. The accuracy of the model was evaluated by analyzing the area under the receiver operating characteristic (ROC) curve (AUC) and a calibration curve was plotted to assess the model’s calibration. Results Between 2018 and 2019, 1962 elderly fracture patients were included in the study. After filtering, 1273 were analyzed. Approximately 25.7% of the patients experienced acute heart failure preoperatively. Through LASSO and logistic regression analyses, predictors for preoperative acute heart failure in elderly patients with hip fractures were identified as Gender was male (OR = 0.529, 95% CI: 0.381–0.734, P

Abstract Introduction This article mainly studies the risk factors for postoperative acute myocardial infarction (AMI) in elderly hip fracture patients combined with coronary heart disease (CHD), constructs a prediction model, and evaluates the prognosis of all the patients. Methods This article retrospectively collected elderly patients with hip fracture and CHD who underwent hip fracture surgery at the Third Hospital of Hebei Medical University from January 2019 to December 2021. Demographic data, laboratory indicators, and imaging examination results were collected from the medical case system. The risk factors of postoperative AMI were determined by univariate and multivariate logistic regression, and a nomogram prediction model was established. The ROC curve, calibration curve and DCA decision curve were plotted by R language software. The patients in the training set were followed up for 2 years to evaluate their survival situation. Results 1094 eligible patients were divided into a training set (n = 824 from January 1, 2019 to September 31, 2021) and a validation set (n = 270 from October 1, 2021 to December 31, 2022). In the training set, women accounted for 58.6%; The average age of the patients was 79.45 years old; The main type of fracture was intertrochanteric fracture. There were 64.7% patients taken B receptor blockers; A total of 166 (20.1%) patients underwent percutaneous coronary intervention (PCI); Hypertension accounted for 55.5%; 520 (63.1%) patients had a preoperative waiting time greater than 3 days; The average hemoglobin value upon admission was 101.36 g/L; The average intraoperative bleeding volume was 212.42 ml; The average surgical time was 2.5 ± 0.3 h; Reginal anesthesia accounted for 29.7%; 63 (68.5%) AMI patients had no obvious clinical symptoms; 68 (73.9%) AMI patients did not show ST-segment elevation in ECG; The risk factors of postoperative AMI were age, hemoglobin at admission, diabetes, chronic kidney disease, intraoperative bleeding, and reginal anesthesia. The AUC of the nomogram prediction model was 0.729. The AUC in the validation set was 0.783. Survival analysis showed a significant statistical difference in 2-year mortality between patients with AMI and without AMI, among all the patients with AMI, patients with ECG ST-segment elevation has higher mortality than patients without ECG ST-segment elevation. Conclusion Our research results found that the incidence of postoperative AMI in elderly patients with hip fractures and CHD was 11.1%. Age, diabetes, hemoglobin at admission, regional anesthesia, chronic kidney disease, and intraoperative bleeding are risk factors. The AUC of the nomogram in training set is 0.729. The 2-year mortality rate of the patients with AMI is higher than that of patients without AMI.

Abstract Background Hip fractures are a serious health concern among the elderly, particularly in patients with hypertension, where the incidence of acute heart failure preoperatively is high, significantly affecting surgical outcomes and prognosis. This study aims to assess the risk of preoperative acute heart failure in elderly patients with hypertension and hip fractures by constructing a predictive model using machine learning on potential risk factors. Methods A retrospective study design was employed, collecting preoperative data from January 2018 to December 2019 of elderly hypertensive patients with hip fractures at the Third Hospital of Hebei Medical University. Using SPSS 24.0 and R software, predictive models were established through LASSO regression and multivariable logistic regression analysis. The models' predictive performance was evaluated using metrics such as the concordance index (C-index), receiver operating characteristic curve (ROC curve), and decision curve analysis (DCA), providing insights into the nomogram's predictive accuracy and clinical utility. Results Out of 1038 patients screened, factors such as gender, age, history of stroke, arrhythmias, anemia, and complications were identified as independent risk factors for preoperative acute heart failure in the study population. Notable predictors included Sex (OR 0.463, 95% CI 0.299–0.7184, P = 0.001), Age (OR 1.737, 95% CI 1.213–2.488, P = 0.003), Stroke (OR 1.627, 95% CI 1.137–2.327, P = 0.008), Arrhythmia (OR 2.727, 95% CI 1.490–4.990, P = 0.001), Complications (OR 2.733, 95% CI 1.850–4.036, P

Abstract Background Elderly patients with hip fracture who develop perioperative acute heart failure (AHF) have a poor prognosis. The aim of the present study is to investigate the potential risks of AHF in elderly hip-fracture patients in the postoperative period and to evaluate the prognostic significance of AHF. Methods A retrospective analysis was conducted on hip fracture patients at the Third Hospital of Hebei Medical University, who were continuously in hospital from September 2018 to August 2020. To identify independent risk factors for AHF in elderly patients with hip fracture, univariate and multivariate Logistic regression analysis was employed. The Kaplan-Meier survival curve illustrated the relationship between all-cause mortality in the AHF and non-AHF groups. An assessment of the correlation between baseline factors and all-cause mortality was conducted by means of univariable and multivariable Cox proportional hazards analysis. Results We eventually recruited 492 patients,318 of whom were in the AHF group. Statistical significance was found between the two groups for age group, concomitant coronary heart disease, COPD, haemoglobin level below 100 g/L on admission, albumin level below 40 g/L on admission, and increased intraoperative blood loss. Age over 75, concomitant coronary artery disease, hemoglobin level below 100 g/L and albumin level below 40 g/L on admission were independent risk factors for AHF in older hip fracture patients. The AHF group exhibited a higher incidence of perioperative complications, such as anemia, cardiovascular issues, and stress hyperglycemia, as well as all-cause mortality. Based on our COX regression analysis, we have identified that the main risk factors for all-cause mortality in AHF patients are concomitant coronary heart disease, absence of pulmonary infection, absence of diabetes, absence of cancer, and absence of urinary tract infection. Conclusion Enhancing hip fracture prevention for AHF is particularly important. It is crucial to make informed decisions to avoid poor prognoses. Patients whose age over 75 years old, concomitant coronary heart disease, hemoglobin

Mercury, particularly in its methylated form, poses a significant environmental and health risk in aquatic ecosystems. While the toxicity and bioaccumulation of mercury are well documented, there remains a critical gap in our understanding of the mechanisms governing mercury methylation and demethylation in aquatic environments. This review systematically examines the complex interplay of chemical, biological, and physical factors that influence mercury speciation and transformation in natural water systems. We provide a comprehensive analysis of methylation and demethylation processes, specifically focusing on the dominant role of methanogenic bacteria. Our study highlights the crucial function of hgcAB genes in facilitating mercury methylation by anaerobic microorganisms, an area that represents a frontier in current research. By synthesizing the existing knowledge and identifying key research priorities, this review offers novel insights into the intricate dynamics of mercury cycling in aquatic ecosystems. Our findings provide a theoretical framework to inform future studies and guide pollution management strategies for mercury and its compounds in aquatic environments.

Abstract Magnetic liquid metal (LM) soft robots attract considerable attentions because of distinctive immiscibility, deformability and maneuverability. However, conventional LM composites relying on alloying between LM and metallic magnetic powders suffer from diminished magnetism over time and potential safety risk upon leakage of metallic components. Herein, we report a strategy to composite inert and biocompatible iron oxide (Fe3O4) magnetic nanoparticles into eutectic gallium indium LM via reactive wetting mechanism. To address the intrinsic interfacial non-wettability between Fe3O4 and LM, a silver intermediate layer was introduced to fuse with indium component into Ag x In y intermetallic compounds, facilitating the anchoring of Fe3O4 nanoparticles inside LM with improved magnetic stability. Subsequently, a miniature soft robot was constructed to perform various controllable deformation and locomotion behaviors under actuation of external magnetic field. Finally, practical feasibility of applying LM soft robot in an ex vivo porcine stomach was validated under in-situ monitoring by endoscope and X-ray imaging.

Abstract Understanding the distribution of soil organic carbon and nitrogen (OC(N)) content, cation exchange capacity (CEC), and specific surface area (SSA) in different soil particle sizes is crucial for studying soil fertility and properties. In this study, we investigated the distribution characteristics of the OC(N), CECand SSA in different particles of yellow–brown soil under different methods. The result revealed that as the particle size decreased, the soil OC(N), SSA and CEC content gradually increase. The content of OC and ON different soil particles ranged from 1.50–28.16 g·kg−1 to 0.18–3.78 g·kg−1, respectively, and exhibited significant differences between different particles. We observed good linear relationships between OC and ON in different particle sizes of yellow–brown soil under different utilization methods, with correlation coefficients ranging from 0.86 to 0.98, reaching a very significant level (n = 12, p

Abstract Introduction Atrial fibrillation is the most common atrial arrhythmia in the perioperative period and is associated with prolonged hospital stay, increased costs, and increased mortality. However, there are few data on the predictors and incidence of preoperative atrial fibrillation in hip fracture patients. Our aim was to identify predictors of preoperative atrial fibrillation and to propose a valid clinical prediction model. Methods Predictor variables included demographic and clinical variables. LASSO regression analyzes were performed to identify predictors of preoperative atrial fibrillation, and models were constructed and presented as nomograms. Area under the curve, calibration curve, and decision curve analysis (DCA) were used to examine the discriminative power, calibration, and clinical efficacy of the predictive models. Bootstrapping was used for validation. Results A total of 1415 elderly patients with hip fractures were analyzed. Overall, 7.1% of patients had preoperative atrial fibrillation, and they were at significant risk for thromboembolic events. Patients with preoperative AF had a significantly longer delay in surgery than those without preoperative atrial fibrillation (p

In this paper, a novel functional magnetic nano-demulsifier with efficient oil–water separation and recyclability was prepared by one-pot method. Magnetic fluorinated polyether composite demulsifier (Fe3O4@C-F) was prepared by combining Fe3O4 as magnetic matrix with carbon nanospheres and grafting fluorinated polyether. The morphology and structure of the composites were analyzed by scanning electron microscopy (SEM), Fourier transform infrared spectroscopy (FTIR) and transmission electron microscopy (TEM). The results showed that carbon nanospheres and fluorinated polyether were successfully compounded on Fe3O4, and the crystallinity of the composites was improved. The demulsification experiment and recovery performance test were carried out with the self-made crude oil emulsion. The main factors affecting the demulsification performance of demulsifier and its demulsification mechanism were discussed. The results showed that the demulsification effect of Fe3O4@C-F was the best when the dosage was 600 ppm, 65 °C, 120 min and pH value was 6. The demulsification rate could reach 96.68%, and the oil–water interface was clear. Fe3O4@C-F had magnetic response, and could be recycled and reused 5 times from two-phase system under external magnetic field. The application of carbon materials in the field of oil–water separation has injected a new power source for the application of carbon nanomaterials in the field of demulsifiers.

Abstract Background Due to concomitant factors like frailty and comorbidity, super elderly (≥90 years) patients with hip fracture differ from patients aged 65–89 years in perioperative complications and mortality. The integrated management bundle referred to bundled application of multiple clinical measures. The aim of this study was to analyze effect of integrated management bundle on 1-year overall survival and perioperative outcomes in super elderly patients with hip fracture, with multidisciplinary management group serving as the control group. Methods In this retrospective cohort study, super elderly patients with hip fracture were included from Jan 2017 to Nov 2020. Patients were retrospectively divided to multidisciplinary management group and integrated management bundle group. The primary outcome was 1- year overall survival, and the secondary outcome was perioperative outcomes. Kaplan-Meier methods was used to compare survival probability. Multivariable Cox’s modeling was used to explain the effect of integrated bundle on 1-year overall survival adjusted for confounders. The perioperative outcomes including complications and in-hospital data of two groups were compared. The multivariable logistic regression was used to explain the effect of integrated bundle on the occurrence of perioperative complications adjusted for confounders. Prognostic factors related to survival was identified by multivariable Cox’s regression analysis. Results Ninety-seven patients comprised multidisciplinary management group, and 83 comprised integrated management bundle group. The Kaplan–Meier plots showed that the survival probability of integrated management bundle group was significantly better than multidisciplinary management group (HR:0.435, 95%CI:0.207–0.914, P = 0.039). Multivariable analysis after adjustment for confounders showed a 42.8% lower incidence of mortality integrated management bundle group than multidisciplinary management group (HR:0.428, 95%CI:0.186–0.986, P = 0.046). Incidence of hypoproteinemia, and electrolyte disturbance in integrated management bundle group was significantly lower than multidisciplinary management group (all P 2 were independent risk factors of overall survival (HR: 1.940, 95%CI: 1.067–3.525,P = 0.030; HR: 2.281, 95%CI: 1.113–4.678,P = 0.024). Conclusions The integrated management bundle improved 1-year overall survival and played positive effects in improving perioperative outcomes. It might be a more suitable management modality for super elderly patients with hip fracture.

Abstract Background The aim of this study was to analyze the clinical characteristics of older fracture patients with chronic kidney disease (CKD) and to determine the risk factors of perioperative cardiovascular complications. Methods We retrospectively reviewed clinical data of older fracture patients with CKD admitted to the Third Hospital of Hebei Medical University from January 2016 to October 2021. The data we collected included baseline characteristics and complications. We finally determined the risk factors of perioperative cardiovascular complications by using logistic regression. Results We ended up enrolling 224 patients, and there were 91 (40.6%) males and 133 (59.4%) females, with a median age of 79 years. 80–84 years old was the age group with high incidence of fracture. The majority of fracture occurred indoors (130 cases, 58.0%) and morning (98 cases, 43.8%). Hip fracture was most common (183 cases, 81.7%), of which femoral neck fracture (101 cases, 45.0%) was the most prevalent. The most common comorbid condition was hypertension (171 cases, 76.3%), and anemia was the most common complication (148 cases, 66.1%). Age ≥ 80 years (OR = 2.023, 95% CI 1.110–3.688), previously combined with cardiovascular calcification (OR = 1.901, 95% CI 1.047–3.451) and admission hemoglobin level

Abstract Single crystalline BaMnSb2 is considered as a 3D Weyl semimetal with the 2D electronic structure containing Dirac cones from the Sb sheet. We report experimental investigation of low-temperature cleaved BaMnSb2 surfaces using scanning tunneling microscopy/spectroscopy and low energy electron diffraction. By natural cleavage, we find two terminations: one is Ba (above the orthorhombically distorted Sb sheet) and another Sb2 (at the surface of the Sb/Mn/Sb sandwich layer). Both terminations show the 2 × 1 surface reconstructions, with drastically different morphologies and electronic properties, however. The reconstructed structures, defect types and nature of the electronic structures of the two terminations are extensively studied. The quasiparticle interference (QPI) analysis is conducted at the energy range between −2 V and 2 V, although no interesting states are observed near the Fermi level, the surface-projected electronic band structures strongly depend on the surface termination above 1.6 V. The existence of defects can greatly modify the local density of states to create electronic phase separations on the surface in the order of tens of nm scale. Our observation on the atomic structures of the terminations and the corresponding electronic structures provides critical information towards an understanding of topological properties of BaMnSb2.

Abstract Background Patients with acute ischemic stroke (AIS) after hip fracture in the elderly have worse prognosis. We aimed to describe the characteristics and complications of hip fracture with AIS in the elderly. Methods This cross-sectional study selected patients with hip fracture (age ≥65 years) from January 2018 to September 2020. The collected data included age, sex, fracture types, comorbidities. In above screened patients, we further collected cerebral infarction related information of AIS patients. The least absolute shrinkage and selection operator (LASSO) logistic regression was performed to identify the strongest predictors of AIS after hip fracture. Multivariate logistic regression analysis was conducted to find independent risk factors for AIS after hip fracture. Results Sixty patients (mean age 79.7 years;female 56.7%) occurred AIS after hip fracture in 1577 cases. The most common infarction type was partial anterior circulation infarction (PACI) (70.0%). The majority of these infarction lesions were single (76.7%) and most infarction lesions(65.0%) were located in the left side. 81.7% of AIS patients had mild (Health stroke scale NIHSS

Abstract The electronic inhomogeneities in Co, Ni, and Cr doped BaFe2As2 single crystals are compared within three bulk property regions: a pure superconducting (SC) dome region, a coexisting SC and antiferromagnetic (AFM) region, and a non-SC region. Machine learning is utilized to categorize the inhomogeneous electronic states: in-gap, L-shape, and S-shape states. Although the relative percentages of the states vary in the three samples, the total volume fraction of the three electronic states is quite similar. This is coincident with the number of electrons (Ni0.04 and Co0.08) and holes (Cr0.04) doped into the compounds. The in-gap state is confirmed as a magnetic impurity state from the Co or Ni dopants, the L-shape state is identified as a spin density wave which competes with the SC phase, and the S-shape state is found to be another form of magnetic order which constructively cooperates with the SC phase, rather than competing with it.

We have investigated the effective utilization potential of carbon nanomaterials in the field of pour point depressants, and reported three kind of carbon-based hybrid nano-pour-point depressants with different dimensions. In this paper, poly-α-olefins-acrylate high-carbon ester pour point depressant (PAA-18) was prepared by esterification and polymerization as the basic pour point depressant. Then, the basic pour point depressant PAA18 was modified by solvothermal method with graphene oxide (GO), carbon nanospheres (Cna) and carbon nanotubes (OCNTs). The morphology and structure of the composites were analyzed by SEM, FTIR and XRD. The results showed that PAA18 was successfully in situ polymerized on GO, Cna and OCNTs. We took the simulated oil as the experimental object, and evaluated its pour point, rheological properties and wax crystal morphology, and achieved excellent results. In the three carbon-based hybrid nano-pour-point depressants with different carbon contents, the oxidation carbon nanotubes composite pour point depressant (PAA18-1 % OCNTs) with carbon content of 1 % had the best pour point and viscosity reduction effect when the dosage was 1250 ppm, which could make the pour point of the simulated oil containing wax decrease by 16 °C. PAA18-1 % OCNTs reduced the pour point by 5 °C more than PAA18. This paper provides reference for the application of carbon nanomaterials in the field of pour point depressant.

We previously identified a lipopeptide, EK1C4, by linking cholesterol to EK1, a pan-CoV fusion inhibitory peptide via a polyethylene glycol (PEG) linker, which showed potent pan-CoV fusion inhibitory activity. However, PEG can elicit antibodies to PEG in vivo, which will attenuate its antiviral activity. Therefore, we designed and synthesized a dePEGylated lipopeptide, EKL1C, by replacing the PEG linker in EK1C4 with a short peptide. Similar to EK1C4, EKL1C displayed potent inhibitory activity against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and other coronaviruses. In this study, we found that EKL1C also exhibited broad-spectrum fusion inhibitory activity against human immunodeficiency virus type 1 (HIV-1) infection by interacting with the N-terminal heptad repeat 1 (HR1) of viral gp41 to block six-helix bundle (6-HB) formation. These results suggest that HR1 is a common target for the development of broad-spectrum viral fusion inhibitors and EKL1C has potential clinical application as a candidate therapeutic or preventive agent against infection by coronavirus, HIV-1, and possibly other class I enveloped viruses.

Abstract Two-dimensional Janus materials have great potential for the applications in spintronic devices due to their particular structures and novel characteristics. However, they are usually non-magnetic in nature. Here, different transition metals (TMs: Co, Fe, Mn, Cr, and V) adsorbed WSSe frameworks are constructed, and their structures and magnetic properties are comprehensively investigated by first-principles calculations. The results show that the top of W atom is the most stable absorption site for all the TM atoms, and all the systems exhibit magnetism. Moreover, their magnetic properties significantly depend on the adsorbed elements and the adsorbent chalcogens. A maximal total magnetic moment of 6 μB is obtained in the Cr-adsorbed system. The induced magnetism from S-surface-adsorption is always stronger than that for the Se-surface-adsorption due to its larger electrostatic potential. Interestingly, the easy magnetization axis in the Fe-adsorbed system switches from the in-plane to the out-of-plane when the adsorption surface changes from Se to S surface. The mechanism is analyzed in detail by Fe-3d orbital-decomposed density of states. This work provides a guidance for the modification of magnetism in low-dimensional systems.

Abstract Background Medical and clinical question answering (QA) is highly concerned by researchers recently. Though there are remarkable advances in this field, the development in Chinese medical domain is relatively backward. It can be attributed to the difficulty of Chinese text processing and the lack of large-scale datasets. To bridge the gap, this paper introduces a Chinese medical QA dataset and proposes effective methods for the task. Methods We first construct a large scale Chinese medical QA dataset. Then we leverage deep matching neural networks to capture semantic interaction between words in questions and answers. Considering that Chinese Word Segmentation (CWS) tools may fail to identify clinical terms, we design a module to merge the word segments and produce a new representation. It learns the common compositions of words or segments by using convolutional kernels and selects the strongest signals by windowed pooling. Results The best performer among popular CWS tools on our dataset is found. In our experiments, deep matching models substantially outperform existing methods. Results also show that our proposed semantic clustered representation module improves the performance of models by up to 5.5% Precision at 1 and 4.9% Mean Average Precision. Conclusions In this paper, we introduce a large scale Chinese medical QA dataset and cast the task into a semantic matching problem. We also compare different CWS tools and input units. Among the two state-of-the-art deep matching neural networks, MatchPyramid performs better. Results also show the effectiveness of the proposed semantic clustered representation module.

Nowadays, most end-to-end task-oriented dialog systems are based on sequence-to-sequence (Seq2seq), which is an encoder-decoder framework. These systems sometimes produce grammatically correct, but logically incorrect responses. This phenomenon is usually due to information mismatching. To solve this problem, we introduce hierarchical attention and knowledge matching networks with information enhancement (HAMI) for task-oriented dialog systems. It contains a hierarchical attention dialog encoder (HADE) that models dialogs at the word and sentence level separately. HADE can focus on important words in a dialog history and generate context-aware representations. HAMI also contains a unique knowledge matching module to detect entities and interact with a knowledge base (KB). Then, dialog history and KB result representations serve as guidance for system response generation. Finally, HAMI's loss function is designed with an information regularization term to emphasize the importance of entities. The experimental results show that HAMI improves 9.8% in entity F1 compared with vanilla Seq2seq. HAMI also outperforms state-of-the-art models in both the entity F1 and dialog accuracy metrics.

Abstract We investigate the electric-field-dependent optical properties and electronic behaviors of GaS monolayer by using the first-principles calculations. A reversal of the dipole transition from E//c to E⊥c anisotropy is found with a critical external electric field of about 5 V/nm. Decomposed projected band contributions exhibit asymmetric electronic structures in GaS interlayers under the external electric field, which explains the evolution of the absorption preference. Spatial distribution of the partial charge and charge density difference reveal that the strikingly reversed optical anisotropy in GaS ML is closely linked to the additional crystal field originated from the external electric field. These results pave the way for experimental research and provide a new perspective for the application of the monolayer GaS-based two-dimensional electronic and optoelectronic devices.

The low-temperature scanning tunneling microscope and spectroscopy (STM/STS) are used to visualize superconducting states in the cleaved single crystal of 9% praseodymium-doped CaFe2As2 (Pr-Ca122) with Tc ≈ 30 K. The spectroscopy shows strong spatial variations in the density of states (DOS), and the superconducting map constructed from spectroscopy discloses a localized superconducting phase, as small as a single unit cell. The comparison of the spectra taken at 4.2 K and 22 K (below vs. close to the bulk superconducting transition temperature) from the exact same area confirms the superconducting behavior. Nanoscale superconducting states have been found near Pr dopants, which can be identified using dI/dV conductance maps at +300 mV. There is no correlation of the local superconductivity to the surface reconstruction domain and surface defects, which reflects its intrinsic bulk behavior. We, therefore, suggest that the local strain of Pr dopants is competing with defects induced local magnetic moments; this competition is responsible for the local superconducting states observed in this Fe-based filamentary superconductor.