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Abstract Background As a new type of intravenous anesthetic, ciprofol has the advantages of fast onset of action, fast recovery and high clearance rate. This study aimed to investigate the effectiveness and safety of ciprofol versus traditional propofol for anesthesia and sedation in and out of the operating room. Methods We searched the literature in PubMed, Web of Science, Cochrane Library, and Embase databases from January 2021 to December 2023. All clinical studies comparing the sedative effects of propofol and ciprofol, both inside and outside the operating room, were included in our trial. The main outcome measures were induction time and incidence of injection-site pain. Data are merged using risk ratio and standardized mean difference with 95% confidence interval. Subgroup analysis, meta-regression, sensitivity analysis, and publication bias were performed. The study protocol was prospectively registered with PROSPERO (CRD42023447747). Results A total of 15 randomized, controlled trials involving 2002 patients were included in this study. Compared with propofol, ciprofol has a longer induction time in the operating room but a shorter induction time in non-operating room settings. Ciprofol can effectively reduce the risk of injection-site pain and respiratory depression both inside and outside the operating room. In addition, the risk of drug-related hypotension induced with ciprofol in the operating room is lower, but the awakening time is also longer. Meta-regression analysis showed that neither age nor BMI were potential sources of heterogeneity. Funnel plot, egger and begg tests showed no significant publication bias. Sensitivity analyzes indicate that our results are robust and reliable. Conclusion Ciprofol has absolute advantages in reducing the risk of injection-site pain and respiratory depression, both in and outside operating room. Intraoperative use of ciprofol reduces the risk of drug-related hypotension and may also reduce the risk of intraoperative physical movements. However, ciprofol may have longer induction and awakening time than propofol.

Abstract Background This study aimed to develop a novel six-gene expression biomarker panel to enhance the early detection and risk stratification of peritoneal recurrence and micrometastasis in locally advanced gastric cancer (LAGC). Methods We used genome-wide transcriptome profiling and rigorous bioinformatics to identify a six-gene expression biomarker panel. This panel was validated across multiple clinical cohorts using both tissue and liquid biopsy samples to predict peritoneal recurrence and micrometastasis in patients with LAGC. Results Through genome-wide expression profiling, we identified six mRNAs and developed a risk prediction model using 196 samples from a surgical specimen training cohort. This model, incorporating a 6-mRNA panel with clinical features, demonstrated high predictive accuracy for peritoneal recurrence in gastric cancer patients, with an AUC of 0.966 (95% CI: 0.944–0.988). Transitioning from invasive surgical or endoscopic biopsy to noninvasive liquid biopsy, the model retained its predictive efficacy (AUC = 0.963; 95% CI: 0.926–1.000). Additionally, the 6-mRNA panel effectively differentiated patients with or without peritoneal metastasis in 95 peripheral blood specimens (AUC = 0.970; 95% CI: 0.936–1.000) and identified peritoneal micrometastases with a high efficiency (AUC = 0.941; 95% CI: 0.874–1.000). Conclusions Our study provides a novel gene expression biomarker panel that significantly enhances early detection of peritoneal recurrence and micrometastasis in patients with LAGC. The RSA model's predictive capability offers a promising tool for tailored treatment strategies, underscoring the importance of integrating molecular biomarkers with clinical parameters in precision oncology.

Radix Rehmanniae (RR) has three processing forms in clinical practice, including fresh Radix Rehmanniae (FRR), raw Radix Rehmanniae (RRR), and processed Radix Rehmanniae (PRR). However, the sensory criterion, “black as lacquer and sweetness as candy”, which was traditionally used to evaluate the quality of PRR, have not been fully elucidated. In this study, the mechanism of chemical transformation based on oligosaccharide hydrolysis, crosslinking coloring, and Maillard reactions was explored to clarify the observed changes in appearance and flavor. The physicochemical properties of different processed RR products were characterized. Besides, “sweetness as candy” was explained by oligosaccharides hydrolysis, and “black as lacquer” can attribute to crosslinking coloring and Maillard reactions. Importantly, this study provided the first evidence for the existence of crosslinking coloring reaction during the processing of RR. In conclusion, our results unveiled the scientific basis of the sensory attributes “black as lacquer and sweetness as candy” in PRR, offering valuable insights for enhancing quality control of PRR.

Abstract Patients with multiple myeloma (MM) are likely to achieve poor therapeutic response when organs are involved. We produced anti‐B‐cell maturation antigen (BCMA) chimeric antigen receptor (CAR)‐T cells, which are in a trial for patients with relapsed/refractory MM. One enrolled patient developed severe heart failure, highly suspected as light chain cardiac amyloidosis. He exhibited increased N‐terminal pro‐brain natriuretic peptide with a peak of 32 299 ng/mL and heart failure with an ejection fraction of 30%. Anti‐BCMA CAR‐T cells were administered following lymphodepletion. The patient achieved cardiac response within 1 week with a decrease in N‐terminal pro‐brain natriuretic peptide by 80%, an increase in ejection fraction from 30% to 56%, and a haematological response with negative minimal residual disease at 1 month and a complete response at 1 year. To date, this patient has maintained good health without heart failure or haematological relapse. Herein, we show the efficacy of anti‐BCMA CAR‐T cells in patients with MM and severe heart failure.

Objective: In view of the problems of large size and low heating uniformity of the existing cooking machine, a miniaturized drum-type automatic cooking machine with electromagnetic heating was designed to reduce the equipment volume and improve the cooking effect. Methods: The modular design method oriented to function and structure was adopted to design each module mechanism of the frying machine. Then, based on Biot-Savart law, the relationship between the magnetic field generated by the coil in space and the current and distance is obtained, and the distribution curves of magnetic field intensity and temperature on the surface of the cooker under three coil arrangements are obtained by Ansys-Maxwell joint simulation. Secondly, the modal analysis of the sliding rail mechanism is carried out by Ansys software, and the frequency band of improper deformation of the mechanism is obtained. Finally, a prototype was developed and compared with three cooking methods to verify the cooking effect of the proto type. Results: Compared with the existing cooking machine, the heating uniformity was greatly improved, and the structural design and actual cooking effect met the use requirements. Conclusion: The research and design of automatic cooking machine has high feasibility and practicability.

ObjectiveThe Da Vinci Robot is the most advanced micro-control system in endoscopic surgical instruments and has gained a lot of valuable experience today. However, the technical feasibility and oncological safety of the robot over open surgery are still uncertain. This work is to systematically evaluate the efficacy of the unilateral axillary approach for robotic surgery compared to open surgery for differentiated thyroid carcinoma.MethodsPubMed, Embase, Cochrane Library, and Web of Science databases were utilized to search for relevant literatures of robotic thyroid surgery using unilateral axillary approach compared to open thyroid surgery, and a meta-analysis was performed using RevMan software version 5.3. Statistical analysis was performed through Mantle-Haenszel and inverse variance methods.ResultsTwelve studies with a total of 2660 patients were included in the meta-analysis. The results showed that compared with the open group, the robotic group had a longer total thyroidectomy time, shorter hospital stay, less intraoperative bleeding, more postoperative drainage, fewer retrieved central lymph nodes, and higher cosmetic satisfaction (all P < 0.05). In contrast, temporary and permanent laryngeal recurrent nerve injury, temporary and permanent hypoparathyroidism or hypocalcemia, brachial plexus nerve injury, number of retrieved central lymph nodes, number of retrieved lymph nodes in the lateral cervical region, number of lymph node metastases in the lateral cervical region, hematoma, seroma, lymphatic leak, stimulated thyroglobulin (sTg) and unstimulated thyroglobulin (uTg), and the number and recurrence rate of patients with sTg 0.05).ConclusionsThe unilateral axillary approach for robotic thyroid surgery may achieve outcomes similar to those of open surgery. Further validation is required in a prospective randomized controlled trial.

According to the orthopedic principle based on the three-point force system, this study aimed to reveal the orthopedic effect and patterns of the orthopedic based on this system in 3 patients with strephenopodia through the weight-bearing stance phase experiment and numerical simulation analysis of ankle-foot orthoses (AFOs). After the correction with AFOs, Under the pressure tolerance of human skin, different three correction forces were applied to the medial heel, above the medial ankle, below the lateral ankle and the first metatarsal bone,the weight-bearing region of the affected foot gradually shifted to the normal region of the first metatarsal bone, the fifth metatarsal bone, and the heel. The weight-bearing capacity of the affected foot increased by 11.4 %. After the three-point force was adjusted for the AFO, the distribution of the plantar weight-bearing region became more uniform, and the supporting force of the affected foot increased significantly, the weight-bearing capacity of the affected foot increased to 15.19 %, which approached the theoretical value. When the three-point force of was over-adjusted to exceed the pain threshold, the weight-bearing capacity of the affected foot decreased by 2.79 % compared with the theoretical value. It was confirmed that the foot varus angle was attenuated significantly 8 weeks after the orthopedic with three-point force system. Further, the strephenopodia with 10° was corrected with the finite element method based on the three-point force principle, and orthopedic angle and the plantar weight-bearing region before and after the correction were also obtained, The visualization of orthopedic effects and the orthotic principle is clear contributes to clinicians provide important scientific reference for the formulation of scientific and accurate orthopedic regimens.

Objective: Aiming at the problems of unstable 3D printing quality and low printing efficiency of adipose tissue part of artificial meat based on plant raw materials, studied and improve the intelligent 3D printing trajectory motion algorithm matching with food materials, to reduce the accumulation and corners in the printing path. Methods: A trajectory planning method adapted to the characteristics of artificial meat adipose tissue raw materials was proposed. The complex section layer of the sliced model was divided into several simple polygon sub-partition contours using Bayesian algorithm, and an improved nearest neighbor method was used to determine the optimal motion starting point of each contour. At the same time, the genetic algorithm was integrated into the ant colony algorithm was applied to solve the optimal printing path of the partition contour, and finally the interior of the contour was filled with the improved zigzag scanning algorithm. Results: For the artificial meat adipose tissue in this study, through experimental verification, comparing the existing trajectory planning methods of Cura and Prusa, the established model was printed on a single-layer cross-section, and the printing time and motion path length were reduced, and the quality was good. Conclusion: The proposed trajectory planning algorithm for 3D printing of artificial meat adipose tissue has high feasibility and effectiveness.

This research adopted the D-galactose induced senility mice as the research object, under the condition of constant energy control, different protein content of feeding groups was designed. Mice were under dietary intervention for 8 weeks, by analyzing the Morris water maze data, brain tissue slice and liver tissue antioxidant capacity to explore the anti-aging effect of protein nutrition in Guangxi longevity dietary patterns. The results showed that: Compared with the high (P/C=1/2), medium (P/C=1/3) and low (P/C=1/5) protein diet groups, the escape latency of mice in P/C=1/4 (protein/carbohydrate) group significantly decreased (P P/C=1/5 group > P/C=1/3 group > young control group > P/C=1/2 group > aging control group. In summary, mice in P/C=1/4 low-protein diet group can effectively resist the senior-induced injury of D-galactose, and maintain strong learning and memory ability and antioxidant ability, thus showing strong anti-aging effect. The results of this study would provide a theoretical basis for the relationship between dietary protein nutrition and health as well as longevity.

In the context of intensive network construction, how to realize automatic, intelligent, and experienceguaranteed base station energy consumption management has become a pain point for current operators in operation management.A 3G/4G/5G smart base station power saving solution with full intelligent detection, full-scenario modeling, and full-process self-service was innovatively proposed.The coverage scene was distinguished by a dynamic time warping algorithm, and the SARIMA model was used to predict the time frame to build the model dynamically.Monitoring indicators ensured quality of experience, automatically issue power-saving strategies, and promptly raise SMS alerts.In the case that the user had no perception, the energy consumption of the base station was saved to the greatest extent at the cell granularity level.This method had been implemented on a pilot study in a province.The average annual power saving efficiency of a single station in the pilot area can reach 9.24% per day per station, which can be put in actual production.

The activity of probiotic products would reduce to a certain extent during storage and in the gastrointestinal tract, resulting in weakened potential probiotic properties, in this study, Lactobacillus fermentum LTP1332 from the feces of centenarians in Bama, Guangxi was microencapsulated. In this experiment, gelatin (GEL) and chitosan (CS) were introduced for compounding based on sodium alginate (SA) and CaCl2 as the main wall materials. The key factors affecting the embedding rate were found by single-factor test, the radial basis function (RBF) was constructed by using Box-Behnken design (BBD), and the encapsulation process of Lactobacillus fermentum LTP1332 microcapsules was optimized by using genetic algorithms (GA). The optimized capsules were characterized using SEM scanning electron microscopy and other methods, and the in vitro simulated digestion tests was carried out. Results showed that, the optimum preparation parameters of the microcapsule were as follows: 2.210% sodium alginate, 4.451% CaCl2, 0.1% gelatin, 13.529 min curing time. Under such conditions, the measured average embedding rate was 95.08%±0.25%. The cell survival rate of CS-GEL-SA microcapsule under the optimized processing conditions could still reach 22.48%±0.78% after being treated with simulated gastric juice for 120 min. The maximum rate of probiotic release could be reached at 90 min of digestion with simulated intestinal juice, which had good intestinal solubility. Therefore, it is considered that the long-lived elderly source probiotic microcapsule prepared under this processing condition would have a good bacterial protection effect and good prospects in development and application.

Mental health problems in nurses are prevalent and impairing. To date, no literature has comprehensively synthesised cohort evidence on mental health among nurses. This scoping review aimed to synthesise the existing literature on the risk factors and consequences of mental health problems in nurses. A systematic search was conducted on PubMed, EMBASE, Epistemonikos database, Web of Science, CINAHL, and PsycINFO from inception to March 2023. We identified 171 cohort studies from 16 countries, mostly (95.3%) from high‐income economies. This review indicated that nurses worldwide encountered significant mental health challenges, including depression, cognitive impairment, anxiety, trauma/post‐traumatic stress disorder, burnout, sleep disorder, and other negative mental health problems. These problems were closely related to various modifiable risk factors such as nurses' behaviours and lifestyles, social support, workplace bullying and violence, shift work, job demands, and job resources. Moreover, nurses' mental health problems have negative effects on their physical health, behaviour and lifestyle, occupation and organisation, and intrapersonal factors. These findings provided an enhanced understanding of mental health complexities among nurses, and shed light on policy enactment to alleviate the negative impact of mental health problems on nurses. Addressing mental health among nurses should be a top priority. [ABSTRACT FROM AUTHOR]

Over the past few decades, the transportation sector has been the largest contributor to CO2 emissions in China. Research and Development spending leads to technological innovation in the country and could affect the CO2 emission in the country. Therefore, this study analyzes the nexus between CO2 emissions, transport infrastructure and R&D spending in China. A QARDL approach was used for the data analysis, which revealed Research and Development and Transport infrastructure has a positive impact on CO2 emissions. R&D was only significant in the first 25% quantile, while transportation was significant in almost all quantiles. These results suggest that R&D spending in China is mainly allocated to the sectors that emit the CO2 emission. It is recommended that government should allocate more R&D to carbon-reducing sectors. Furthermore, the government should consider green transportation investments and renewable energy projects in the transportation sector to reduce CO2 emissions in the country.

IntroductionRecent evidence supports a role for the gut microbe-metabolites in longevity. However, the phenomenon of hypertension is more common in the longevity area and whether hypertension is associated with longevity remains unclear. Here, we hypothesize that the levels of gut microbiota, SCFAs, and urine metabolites were different between hypertension elderly and hypertension longevity.MethodsWe recruited 46 elderly volunteers from Donglan County, Guangxi, and 32 were selected and included in the experiment. The subjects with hypertension were divided into two groups according to age, Hypertension Elderly (HTE, aged 70.5 ± 8.59, n = 19) and Hypertension Longevity (HTL, aged 100 ± 5.72, n = 13). The gut microbiota, SCFAs, and urine metabolites were determined by three-generation 16S rRNA full-length sequencing, GC-MS, and 1H-NMR, respectively.ResultsCompared with the HTL group, the HTE group had higher levels of hypertension-related genera Klebsiella and Streptococcus, while having lower levels of the SCFA-producing genera Bacteroides, Faecalibacterium, and Alistipes. Based on LEFse analysis, Klebsiella pneumoniae, Lactobacillus gasseri, Streptococcus salivarius, Ruminococcus, Actinomyces, Rikenellaceae, f_Saccharimonadaceae, Clostridium perfringens, and Bacteroids, Faecalibacterium prausnitzii, Parabacteroides, Alistipes were biomarkers that showed significant differences between the groups. In addition, the microbial pathways associated with K. pneumoniae and E. coli may promote hypertension, while A. muciniphila may play a role in reversing the development of hypertension in long-lived elderly. Metabolomics revealed that HTL contained a lower concentration of fecal acetate and propionate than HTE, while it contained a higher concentration of serum acetate and urine acetate. Furthermore, their immune cells exhibited no significant changes in SCFAs receptors.ConclusionAlthough long-lived elderly have extremely high systolic blood pressure, their unique gut microbiota composition and efficient acetate absorption in the colon may offset the damages caused by hypertension and maintain healthy homeostasis.