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BackgroundThe left subclavian artery (LSA) can be intentionally covered by a stent graft to acquire adequate landing zones for a proximal entry tear near the LSA during thoracic endovascular aortic repair (TEVAR). The Castor single-branched stent graft is designed to treat type B aortic dissection (TBAD) to retain the LSA during TEVAR. This study investigates clinical outcomes, aortic remodeling, and abdominal aortic perfusion patterns after TEVAR with the novel Castor device.MethodsFrom November 2020 to June 2023, 29 patients with TBAD involving the LSA were treated with the Castor single-branched stent graft. In-hospital clinical outcome and aortic computed tomography angiography (CTA) data were analyzed. CTA was performed preoperatively and at follow-up to observe stent morphology; branch patency; endoleak; change in true lumen (TL), false lumen (FL), and transaortic diameters; and abdominal aortic branch perfusion pattern.ResultsThe technical success rate was 96.6%. One failure was that the branch section did not completely enter the LSA and the main body migrated distally. No in-hospital mortality, paraplegia, or stroke occurred. During follow-up, one type Ib endoleak, four distal new entry tears, and one recurrent type A dissection arose from a new entry tear at the ascending aorta, no stent migration was observed, and the branch patency rate was 100%. At the thoracic aorta, TL diameters significantly increased, FL diameters markedly decreased, and FL was partially or completely thrombosed in most patients at follow-up. At the abdominal aorta, we observed 33.3% of TL growth and 66.7% of TL stabilization or shrinkage. The initial TL ratio at iliac bifurcation negatively predicted abdominal TL growth after TEVAR with a cutoff of 21.0%. Of the 102 abdominal aortic branches, 94.1% of the branches showed no change in perfusion pattern, 3.9% of the branches had an increased TL perfusion, and 2.0% of the branches had an increased FL contribution.ConclusionThe Castor unibody single-branched stent graft offers an efficient endovascular treatment for TBAD involving the LSA. TEVAR with the Castor device effectively induced thoracic FL thrombosis and thoracic TL enlargement and resulted in abdominal TL growth when the initial TL ratio at iliac bifurcation is less than 21.0%. Abdominal aortic branch perfusion patterns remain relatively stable after TEVAR with the Castor stent graft.

While online gaming has become a choice for relaxation and entertainment in today’s digital age, Internet Gaming Disorder (IGD) has also become a widely concerning mental disorder. Nature connectedness has been found to effectively reduce addiction-related risks and alleviate symptoms of addictive behaviors. It is a relatively lacking but very important factor influencing psychological recovery and regulation in the digital society. This study aims to explore the relationship between nature connectedness and IGD, and the mediating roles of intolerance of uncertainty and desire thinking. A total of 571 young people voluntarily participated in the questionnaire survey. The results showed that: (1) nature connectedness was negatively correlated with IGD; (2) intolerance of uncertainty plays a mediating role between nature connectedness and IGD; and (3) intolerance of uncertainty and desire thinking plays a chain mediating role between nature connectedness and IGD. Analysis of the research results indicates that nature connectedness can effectively reduce IGD and reveal its mechanism of action. The findings provide new insights for the study and intervention of IGD in the digital age.

ObjectiveTo monitor the radiological courses of symptomatic spontaneous isolated superior mesenteric artery dissection (SISMAD) after conservation, clarify the relationship between its morphological change and initial imaging classification, and identify these factors that affect dissection remodeling.MethodsEighty-nine conservative patients with SISMAD who underwent periodic follow-up of computed tomography angiography (CTA) were enrolled. Initial morphologic classification, imaging features and dissection remodeling were analyzed retrospectively. Logistic regression was used to identify predictors for remodeling. Receiver operating characteristics were performed for cutoff threshold.ResultsZerbib classification was adapted and initial CT appearance divided eighty-nine patients into: type I (15.7%), patent false lumen (FL) with both entry and re-entry; type II (37.1%), “cul-de-sac” shaped FL without re-entry; type III (27.0%), thrombosed FL with ulcer-like-projection (ULP); type IV (18%), intramural hematoma; type V (0%), dissecting aneurysm; and type VI (2.2%), total or partial occlusion of superior mesenteric artery (SMA). Follow-up CTA revealed complete remodeling (33.7%), partial remodeling (16.9%), no change (25.8%), type change (13.5%) and dissection progression (10.1%). There was no dissection-related mortality. Type I (92.9%) sustained patent FL and no angiographic change. Type II showed partial remodeling (42.4%), no change (27.3%) and dissection progression (27.3%), and the length of FL enhancement positively predicted dissection progression with the cutoff of 40.3 millimeters. Type III achieved complete remodeling (58.3%) or evolved into type II (41.7%), and the distance between SMA orifice and ULP negatively predicted type change with the cutoff of 23.5 millimeters. Type IV (87.5%) achieved complete remodeling due to hematoma absorption. One patient underwent stent placement for the evolution of ULP into an enlarged blind-ending FL 2 months after conservation.ConclusionAfter conservation, patent FL with a distal re-entry is no morphological change, FL thrombosis tends to be resolved, and the “cul-de-sac” shaped FL without re-entry is partially shortened, no change or progressively dilated. FL enhancement length ≥ 40.3 millimeters is a predictor for the blinding-end FL enlargement. Thrombosed FL with ULP evolves into a patent “cul-de-sac” shaped FL when the distance between SMA orifice to ULP is less than 23.5 millimeters. A careful follow-up is necessary for the lesions with demonstrated predictors.

Background: During the COVID-19 pandemic, depressive symptoms, a common emotional problem among adolescents, have become more prominent. Regarding the influencing factors of adolescent depressive symptoms, it is widely accepted that parents’ problematic cellphone use around the family (specifically parental phubbing) is a strong predictive factor for the development of depressive symptoms among adolescents. Notably, the COVID-19 pandemic caused a sharp increase in the number of individuals with depressive symptoms, and the negative consequences of parental phubbing and depressive symptoms might have been exacerbated. Accordingly, this study aimed to examine the association between parental phubbing and adolescent depressive symptoms as well as their underlying mechanism. Method: To test our hypotheses, we conducted an offline/online survey with 614 adolescents in Central China from May to June 2022, which corresponded to a period of strict lockdowns in some areas due to the outbreak of the Omicron variant. The participants completed a set of measures, including a technology interference questionnaire, a parent–child relationship scale, a self-concept clarity scale, and the depressive symptoms scale. Results: Parental phubbing was positively associated with adolescent depressive symptoms; the parent–child relationship and self-concept clarity could independently mediate this relationship; and the parent–child relationship and self-concept clarity were also serial mediators in this association. These findings extend previous research by highlighting the impact of parental technology use on their children and the underlying mechanism explaining adolescent depressive symptoms. They provide practical recommendations for parents to prioritize fostering a positive family environment and minimizing phubbing behaviors to enhance adolescent development, particularly in the context of the COVID-19 pandemic.

Objective. The homing of adipose-derived stem cells (ASCs) to infarcted myocardium, which is important for improved cardiac function, has been investigated previously, but with poor efficiency. Substantial improvements in engraftments are required to optimize ASC treatment. Stromal derived factor-1α (SDF-1α) is upregulated early after MI, and its endogenous receptor, chemokine receptor 4 (CXCR4), is pivotal in stem cell survival, migration, and engraftment. We examined whether CXCR4+ ASCs enhance their efficacy of migration and engraftment posttransplantation and improve heart function following myocardial infarction (MI). Methods and Results. CXCR4+ ASC subpopulations were sorted by fluorescence-activated cell sorting. CXCR4+ sorted ASCs exhibited the stronger cell viability, the faster proliferation rate, and the better migration capability in comparison with unfractionated ASCs. CXCR4+ sorted ASCs secreted a higher level of angiogenic growth factors including VEGF, HGF, and IGF-1 relative to unfractionated ASCs. Fewer apoptotic cells under oxygen-glucose deprivation were detected in CXCR4+ sorted ASCs than in unfractionated ASCs. Osteogenic and angiogenic differentiation were more pronounced in CXCR4+ sorted ASCs than in unfractionated ASCs. At 3 days after acute MI, rats were randomly allocated to receive intramyocardial injection of cell culture medium, CXCR4+ sorted ASCs, and unfractionated ASCs. Left ventricular function was assessed echocardiographically 4 weeks thereafter. Explanted hearts were then processed for the immunofluorescence detection of survived cells, quantification of angiogenesis, and cell engraftment. CXCR4+ sorted ASCs more obviously engrafted into infarcted myocardium, more markedly inhibited collagen remodeling, and more effectively improved heart function and promoted capillary formation than did unfractionated ASCs. Conclusion. CXCR4+ sorted ASCs are superior to unfractionated ASCs due to better viability, faster proliferation, more cytokine secretion, and stronger migration. CXCR4+ sorted ASCs provide better curative benefits on MI than do unfractionated ASCs and can be efficiently harvested and purified from adipose tissue, they may serve as a promising candidate for MI.

In recent years, the scarcity of pure water resources has received a lot of attention from society because of the increasing amount of pollution from industrial waste. It is very important to use low-cost adsorbents with high-adsorption performance to reduce water pollution. In this work, a gel adsorbent with a high-adsorption performance on methylene blue (MB) and Cu(II) was prepared from bamboo nanocellulose (BCNF) (derived from waste bamboo paper) and montmorillonite nanosheet (MMTNS) cross-linked by polyethyleneimine (PEI). The resulting gel adsorbent was characterized by Fourier transform infrared spectroscopy (FTIR), field emission scanning electron microscopy (SEM), X-ray photoelectron spectroscopic (XPS), etc. The results indicated that the MB and Cu(II) adsorption capacities of the resulting gel adsorbent increased with the solution pH, contact time, initial concentration, and temperature before equilibrium. The adsorption processes of MB and Cu(II) fitted well with the fractal-like pseudo-second-order model. The maximal adsorption capacities on MB and Cu(II) calculated by the Sips model were 361.9 and 254.6 mg/g, respectively. The removal of MB and Cu(II) from aqueous solutions mainly included electrostatic attraction, ion exchange, hydrogen bonding interaction, etc. These results suggest that the resulting gel adsorbent is an ideal material for the removal of MB and Cu(II) from aqueous solutions.

Background: Thoracic endovascular aortic repair (TEVAR) for type B aortic dissection (TBAD) induces false lumen (FL) thrombosis, promotes favorable aortic remodeling, and makes an impact on abdominal aortic branch perfusion patterns. However, little is known about the long-term fate of aortic remodeling and abdominal aortic branch perfusion after TEVAR for TBAD and the effect of FL thrombosis status on these changes.Materials and methods: Between January 2014 and May 2021, 59 enrolled patients with acute TBAD were treated with TEVAR and had post-operative or follow-up images. Pre-operative, post-operative, and latest follow-up CT angiography (CTA) data were analyzed for the largest diameter of true lumen (TL), FL, and transaorta and for the FL thrombosis status on the stented thoracic aorta, unstented thoracic aorta, and abdominal aorta. Abdominal aorta perfusion patterns were characterized.Results: The mean follow-up period was 17.1 months. In the stented thoracic aorta, average TL diameters increased, average FL diameters decreased, and average transaortic diameters did not change; 82.6% of the patients had either a stable or shrinking transaortic size and 87% of the patients achieved total FL thrombosis. In the unstented thoracic aorta, average TL diameters increased, transaortic growth and no changes occurred in 39.1 and 45.7% of the patients, respectively, and complete FL thrombosis was present in 50% of the patients. In the abdominal aorta, average FL and transaortic diameters increased, aorta was expanded in 52.2% of the patients, and FL remained patent in 65.2% of the patients. Of the 354 branches, 37 branches (10.5%) exhibited changes in perfusion patterns, 22 branches (6.2%) demonstrated an increased TL perfusion, and 15 branches (4.2%) had an increased FL contribution. Compared with patent or partially thrombosed FL, complete FL thrombosis was accompanied by a bigger decrease in FL diameters, a larger increase in TL diameters, and a higher percentage of abdominal branch TL perfusion.Conclusions: In majority of the patients, TEVAR stabilized the size of the stented thoracic aorta, namely TL expansion and FL obliteration. However, abdominal aortic FL remained patent FL, and it was expanded with the resultant transaortic growth over a long follow-up period. Abdominal aortic branch perfusion patterns remained largely stable after TEVAR. The failure to achieve FL thrombosis negatively affects the remodeling of a contagious abdominal aortic dissection.