The electromagnetic wave absorption of silicon carbide nanowires is improved by their uniform and diverse cross-structures.This study introduces a sustainable and high value-added method for synthesizing silicon carbi...The electromagnetic wave absorption of silicon carbide nanowires is improved by their uniform and diverse cross-structures.This study introduces a sustainable and high value-added method for synthesizing silicon carbide nanowires using lignite and waste silicon powder as raw materials through carbothermal reduction.The staggered structure of nanowires promotes the creation of interfacial polarization,impedance matching,and multiple loss mechanisms,leading to enhanced electromagnetic absorption performance.The silicon carbide nanowires demonstrate outstanding electromagnetic absorption capabilities with the minimum reflection loss of-48.09 d B at10.08 GHz and an effective absorption bandwidth(the reflection loss less than-10 d B)ranging from 8.54 to 16.68 GHz with a thickness of 2.17 mm.This research presents an innovative approach for utilizing solid waste in an environmentally friendly manner to produce broadband silicon carbide composite absorbers.展开更多
Small extracellular vesicles(sEVs)membrane protein profile(sEVpp)is a novel biomarker for cancer,and it can reveal the in-depth phenotype information.The point-of-care testing(POCT)of sEVpp holds great significance fo...Small extracellular vesicles(sEVs)membrane protein profile(sEVpp)is a novel biomarker for cancer,and it can reveal the in-depth phenotype information.The point-of-care testing(POCT)of sEVpp holds great significance for mass screening of cancer,so the cost-effective and simple detection methods of sEVpp are urgently demanded.Herein,we constructed a paper-based multichannel sEVpp POCT device(sEVpp-PAD)enabled by functional DNA probes and metal-organic framework(MOF).The core components are aptamer/MOF-modified paper chips.The modified aptamers can immunocapture the sEV expressing corresponding proteins,while the modified MOF can provide abundant sites for aptamer-modification,reduce the nonspecific protein absorption,and act as reference for ratiometric detection.Simply powered by two syringes,the sEVpp-PAD can efficiently capture sEVs expressing corresponding protein from cell culture media and sera.Furthermore,a detection probe(DP)consisted of CD63 aptamer and G-quadruplex was developed for the colorimetric detection of captured sEVs.Utilizing this device,the sEVpp in various hepatocellular carcinoma cell culture medium and,more importantly,in human sera can be accurately determined,only with$2 device,$0.2 detection reagents and 1.8 h procedure.This simple strategy for sEVpp detection can innovatively promote the POCT and subtyping of cancer based on sEV-related liquid biopsy.展开更多
The treatment of severe diabetic foot remains a clinical challenge.While it is established that bone can exert systemic effects through the secretion of osteokines on other organs,whether this endocrine function can b...The treatment of severe diabetic foot remains a clinical challenge.While it is established that bone can exert systemic effects through the secretion of osteokines on other organs,whether this endocrine function can be harnessed to promote diabetic wound healing remains unexplored.Here,we investigate the impact of a bone injury strategy on diabetic wound healing,leveraging the body's innate regenerative capacity to stimulate osteokine release and influence remote skin wound repair.This study demonstrates that the tibial defect significantly accelerates ipsilateral diabetic foot skin wound healing.Mechanistically,we identify osteokines,platelet-derived growth factor-BB(PDGF-BB),as the key to initiating this process.Bone defect triggers a substantial release of PDGF-BB,which reaches the skin wound site via peripheral circulation.At the skin wound site,PDGF-BB mediates the secretion of keratinocyte growth factor(KGF)from fibroblasts via the PDGFRβsignaling pathway,thereby promoting the rapid reepithelialization of epidermal cells through a paracrine pathway.Additionally,elevated PDGF-BB levels enhance the regeneration of CD31^(h i)Emcn^(h i)blood vessels within the wound.Importantly,we demonstrate the therapeutic potential of osteokines by showing that a collagen hydrogel loaded with osteokines promotes wound healing in diabetic mice.Our findings reveal a clear link between bone and skin wound healing,providing a therapeutic inspiration for chronic wounds that are difficult to treat locally.展开更多
Iron-based Prussian white(PW)materials have attracted considerable attention as promising cathodes for potassium-ion batteries(PIBs)due to their high capacity,easy preparation,and economic merits.However,the intrinsic...Iron-based Prussian white(PW)materials have attracted considerable attention as promising cathodes for potassium-ion batteries(PIBs)due to their high capacity,easy preparation,and economic merits.However,the intrinsic iron dissolution and uncontrollable cathode-electrolyte interface(CEI)formation in conventional organic electrolytes severely hinder their long-term cycling stability.Herein,we employ succinonitrile(SN),a bifunctional electrolyte additive,to suppress the iron dissolution and promote thin,uniform,and stable CEI formation of the PW cathode,thus improving its structural stability.Benefited from the coordination between the cyano groups in SN and iron atoms,this molecule can preferentially adsorb on the surface of PW to mitigate iron dissolution.SN also facilitates the decomposition of anions in potassium salt rather than organic solvents in electrolyte due to the attractive reaction between SN and anions.Consequently,the PW cathode with SN additive provides better electrochemical reversibility,showing capacity retention of 93.6%after 3000 cycles at 5C.In comparison,without SN,the capacity retention is only 87.4%after 1000 cycles under the same conditions.Moreover,the full cells of PW matched with commercial graphite(Gr)achieve stable cycling for 3500 cycles at a high rate of 20C,with an exceptional capacity decay of only 0.005%per cycle,surpassing the majority of recently reported results in literature.展开更多
Background:Inflatable Penile Prosthesis(IPP)is the treatment for erectile dysfunction(ED)refractory to pharmacological therapies.Long-term data on factors associated with prosthesis survival remain unclear.This study ...Background:Inflatable Penile Prosthesis(IPP)is the treatment for erectile dysfunction(ED)refractory to pharmacological therapies.Long-term data on factors associated with prosthesis survival remain unclear.This study aimed to analyze the long-term survival of penile prostheses and identify risk factors associated with survival without reintervention.Methods:This is a retrospective,single-center study of patients who underwent IPP implantation between January 2014 and December 2022.Preoperative data related to the patient and the etiology of ED,as well as perioperative data,were collected.The primary outcome was survival without reintervention,defined as prosthesis revision or explantation due to mechanical dysfunction or infection.We conducted survival analyses without reintervention and searched for risk factors using a multivariate Cox model.Results:In total,33 out of 137 patients underwent reintervention(24.1%),including 24(17.5%)prosthesis revisions and 9(6.6%)had explantations.Median follow-up was 39 months with an interquartile range(IQR)of 9.00 to 62.00.Median survival without reintervention was 7 years.In univariate analysis,downsizing(p=0.046)was associated with reintervention.Smoking(p=0.003)and age(p=0.034)were associated with prosthesis explantation.The number of implantations(p=0.009)was associated with prosthesis revision.Multivariate analysis by the Cox model did not identify any independent predictive factors for reintervention.Conclusion:Smoking may play a role in infection post-IPP implantation.Primary implantations seem to be associated with better survival.Adjusting cylinder size,known as downsizing,is likely to be a proxy for the complexity of the procedure and thus linked to earlier reintervention.展开更多
Background Heat shock proteins(HSPs)are key molecular chaperones that help maintain protein homeostasis by stabilizing or removing damaged proteins during cellular stress.Aging weakens these stress–response systems,d...Background Heat shock proteins(HSPs)are key molecular chaperones that help maintain protein homeostasis by stabilizing or removing damaged proteins during cellular stress.Aging weakens these stress–response systems,disrupting proteostasis and increasing vulnerability to sarcopenia.High-intensity training(HIT)can counteract these declines by activating protective pathways such as the HSP response.HSPs are highly responsive to stress,examining their regulation during aging is important,as altered HSP activity is linked to the progressive loss of muscle mass.Methods This study investigated the abundance and phosphorylation of HSPs in skeletal muscle from healthy,active young and older adults(n=7 per group),assessed at baseline and again in the older group following 12 weeks of HIT.Using calibrated Western blotting on both whole-muscle homogenates and pooled single muscle fibres,we quantified HSP content and phosphorylation to determine how aging and exercise influence stress–responsive protein regulation at both the tissue and cellular levels.Results In whole muscle homogenates,HSPs(HSP72,HSP27,andαB-crystallin)did not differ between young and older adults,while higher phosphorylation of small HSPs(sHSPs):phospho-HSP27 at Serine15(pHSP27 Ser15)and phospho-αB-crystallin at Serine59(pαB-crystallin Ser59)(∼1.8-fold and∼2.9-fold,respectively)were found in muscle from older adults,indicating higher cellular stress associated with aging.A 12-week HIT intervention in older adults reduced homogenate pHSP27 Ser15 and pαB-crystallin Ser59 abundances to similar levels found in young adults.Total HSPs typically displayed a distinct fiber-type profile in both age groups,with more in type I compared to type II fibers,distinguished by the presence of myosin heavy chain I(MHCI)or MHCII.Phosphorylation at pHSP27 Ser15 and pαB-crystallin Ser59 was not different between type I and type II fibers.The HIT in older adults decreased total and phosphorylated sHSPs in both type I and type II fibers but increased HSP72 in type I fibers.Conclusion HIT has the potential to mitigate age-related cellular stress and modulate protein expression patterns in aging skeletal muscle and,perhaps,has the potential to delay age-related muscle decline,thereby improving muscle health in older adults.展开更多
At inference time,deep neural networks are susceptible to backdoor attacks,which can produce attackercontrolled outputs when inputs contain carefully crafted triggers.Existing defense methods often focus on specific a...At inference time,deep neural networks are susceptible to backdoor attacks,which can produce attackercontrolled outputs when inputs contain carefully crafted triggers.Existing defense methods often focus on specific attack types or incur high costs,such as data cleaning or model fine-tuning.In contrast,we argue that it is possible to achieve effective and generalizable defense without removing triggers or incurring high model-cleaning costs.Fromthe attacker’s perspective and based on characteristics of vulnerable neuron activation anomalies,we propose an Adaptive Feature Injection(AFI)method for black-box backdoor detection.AFI employs a pre-trained image encoder to extract multi-level deep features and constructs a dynamic weight fusionmechanism for precise identification and interception of poisoned samples.Specifically,we select the control samples with the largest feature differences fromthe clean dataset via feature-space analysis,and generate blended sample pairs with the test sample using dynamic linear interpolation.The detection statistic is computed by measuring the divergence G(x)in model output responses.We systematically evaluate the effectiveness of AFI against representative backdoor attacks,including BadNets,Blend,WaNet,and IAB,on three benchmark datasets:MNIST,CIFAR-10,and ImageNet.Experimental results show that AFI can effectively detect poisoned samples,achieving average detection rates of 95.20%,94.15%,and 86.49%on these datasets,respectively.Compared with existing methods,AFI demonstrates strong cross-domain generalization ability and robustness to unknown attacks.展开更多
The treatment of severe diabetic foot remains a clinical challenge.While it is established that bone can exert systemic effects through the secretion of osteokines on other organs,whether this endocrine function can b...The treatment of severe diabetic foot remains a clinical challenge.While it is established that bone can exert systemic effects through the secretion of osteokines on other organs,whether this endocrine function can be harnessed to promote diabetic wound healing remains unexplored.Here,we investigate the impact of a bone injury strategy on diabetic wound healing,leveraging the body’s innate regenerative capacity to stimulate osteokine release and influence remote skin wound repair.This study demonstrates that the tibial defect significantly accelerates ipsilateral diabetic foot skin wound healing.Mechanistically,we identify osteokines,platelet-derived growth factor-BB(PDGF-BB),as the key to initiating this process.Bone defect triggers a substantial release of PDGF-BB,which reaches the skin wound site via peripheral circulation.At the skin wound site,PDGF-BB mediates the secretion of keratinocyte growth factor(KGF)from fibroblasts via the PDGFRβsignaling pathway,thereby promoting the rapid re-epithelialization of epidermal cells through a paracrine pathway.Additionally,elevated PDGF-BB levels enhance the regeneration of CD31hi Emcnhi blood vessels within the wound.展开更多
BACKGROUND The persistent burden of cardiovascular(CV)disease in the United States requires innovative and cost-effective prognostic markers that can be relied upon.AIM To provide insights into how adiponectin can pre...BACKGROUND The persistent burden of cardiovascular(CV)disease in the United States requires innovative and cost-effective prognostic markers that can be relied upon.AIM To provide insights into how adiponectin can predict all-cause mortality and major adverse CV events(MACE)in patients with coronary artery disease(CAD)and to determine the prognostic value of adiponectin in predicting all-cause mortality and MACE in patients with stable CAD.METHODS We conducted a systematic search on PubMed,Scopus,and Google Scholar to find relevant studies published through June 2023 evaluating the long-term prognostic role of adiponectin in patients with stable CAD.Using a random effects model with 95%CI,we estimated the odds ratio(OR)while assessing heterogeneity through I^(2)statistics.To ensure robustness,we performed a sensitivity analysis using the leave-one-out approach.RESULTS After screening,we included five prospective studies involving 3225 patients who were followed up for a median duration of 3.8 years.Within the study population,prevalent risk factors included hypertension,diabetes,hyperlipidemia,and smoking.The commonly prescribed medications were angiotensin-converting enzyme inhibitors,beta blockers,and statins.The combined adjusted OR for all-cause mortality was found to be 2.51(95%CI:1.36–4.62),showing heterogeneity(I^(2)=65.51%,P=0.03).On the other hand,the combined adjusted OR for MACE was determined to be 1.04(95%CI:1.02–1.06)with no significant heterogeneity observed(I^(2)=0%,P=0.68).Through a sensitivity analysis,it was discovered that none of the studies significantly impacted the overall results of the meta-analysis,thus indicating their robustness.CONCLUSION Higher levels of adiponectin were found to be associated with an increased risk of long-term mortality and MACE in patients with CAD,which highlights its potential as a cost-effective marker for risk assessment and guiding treatment strategies.Further research on the role of adiponectin could greatly influence decision-making and resource allocation in CV care.展开更多
BACKGROUND Knowledge-based systems(KBS)are software applications based on a knowledge database and an inference engine.Various experimental KBS for computerassisted medical diagnosis and treatment were started to be u...BACKGROUND Knowledge-based systems(KBS)are software applications based on a knowledge database and an inference engine.Various experimental KBS for computerassisted medical diagnosis and treatment were started to be used since 70s(VisualDx,GIDEON,DXPlain,CADUCEUS,Internist-I,Mycin etc.).AIM To present in detail the“Electronic Pediatrician(EPed)”,a medical non-machine learning artificial intelligence(nml-AI)KBS in its prototype version created by the corresponding author(with database written in Romanian)that offers a physiopathology-based differential and positive diagnosis and treatment of ill children.METHODS EPed specifically focuses on the physiopathological reasoning of pediatric clinical cases.EPed has currently reached its prototype version 2.0,being able to diagnose 302 physiopathological macro-links(briefly named“clusters”)and 269 pediatric diseases:Some examples of diagnosis and a previous testing of EPed on a group of 34 patients are also presented in this paper.RESULTS The prototype EPed can currently diagnose 269 pediatric infectious and noninfectious diseases(based on 302 clusters),including the most frequent respiratory/digestive/renal/central nervous system infections,but also many other noninfectious pediatric diseases like autoimmune,oncological,genetical diseases and even intoxications,plus some important surgical pathologies.CONCLUSION EPed is the first and only physiopathology-based nml-AI KBS focused on general pediatrics and is the first and only pediatric Romanian KBS addressed to medical professionals.Furthermore,EPed is the first and only nml-AI KBS that offers not only both a physiopathology-based differential and positive disease diagnosis,but also identifies possible physiopathological“clusters”that may explain the signs and symptoms of any child-patient and may help treating that patient physiopathologically(until a final diagnosis is found),thus encouraging and developing the physiopathological reasoning of any clinician.展开更多
Decision support systems(DSS)based on physically based numerical models are standard tools used by water services and utilities.However,few DSS based on holistic approaches combining distributed hydrological,hydraulic...Decision support systems(DSS)based on physically based numerical models are standard tools used by water services and utilities.However,few DSS based on holistic approaches combining distributed hydrological,hydraulic,and hydrogeological models are operationally exploited.This holistic approach was adopted for the development of the AquaVar DSS,used for water resource management in the French Mediterranean Var watershed.The year 2019 marked the initial use of the DSS in its operational environment.Over the next 5 years,multiple hydrological events allowed to test the performance of the DSS.The results show that the tool is capable of simulating peak flows associated with two extreme rainfall events(storms Alex and Aline).For a moderate flood,the real-time functionality was able to simulate forecast discharges 26 h before the flood peak,with a maximum local error of 30%.Finally,simulations for the drought period 2022-2023 highlighted the essential need for DSS to evolve in line with changing climatic conditions,which give rise to unprecedented hydrological processes.The lessons learned from these first 5 years of AquaVar use under operational conditions are synthesized,addressing various topics such as DSS modularity,evolution,data positioning,technology,and governance.展开更多
BACKGROUND Steroids remain the primary treatment for severe alcohol-associated hepatitis(AAH),though there is little available tools to predict patient response to steroids.It was hypothesized that phosphatidylethanol...BACKGROUND Steroids remain the primary treatment for severe alcohol-associated hepatitis(AAH),though there is little available tools to predict patient response to steroids.It was hypothesized that phosphatidylethanol(PEth)value will inversely corre-late with response to steroid therapy based on Lille score in AAH.AIM To assess the relationship of patient factors,focusing on pre-steroid therapy PEth value,to steroid therapy response in AAH.METHODS A retrospective case control study was performed on patients who received≥4 days of steroid therapy for AAH at our hospital between July 1,2019 and June 30,2022.A total of 2087 patients were screened for AAH and those treated with steroids were included for statistical analysis utilizing independent sample t-test and for categorical variables using the χ^(2) test.RESULTS No correlation was found between PEth value,pre-steroids abstinence length,or number of drinks per week pre-steroids and response to steroids.Non-responder status significantly correlated with older age(P=0.024),lower albumin(P=0.003),and higher bilirubin(P=0.010)pre-steroids.Our study suggests that age,pre-steroid albumin,and pre-steroid bilirubin levels may predict nonresponse to steroid therapy.Non-responders have increased incidence of death and higher medical costs.CONCLUSION Identifying non-responders through these identified factors should prompt early referral for liver transplantation.Future prospective studies with larger population size are needed to assess the efficacy of combined pre-steroid age,albumin,bilirubin and other biochemical markers as predictors of steroid response.展开更多
Insomnia disorder negatively affects the quality of life of patients.Phototherapy has proven effective in treating sleep problems.This study aimed to summarize the impact of phototherapy on sleep quality in patients w...Insomnia disorder negatively affects the quality of life of patients.Phototherapy has proven effective in treating sleep problems.This study aimed to summarize the impact of phototherapy on sleep quality in patients with insomnia disorder and the factors influencing its effectiveness.We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses(PRISMA)guidelines and registered experiments on the PROSPERO website,retrieving 12 randomized controlled trials that included at least one sleep quality outcome measure available for analysis from the four databases.Meta-analysis was conducted using the RevMan software,using Mean Differences(MD)and its 95% Confidence Interval(CI)to evaluate treatment efficacy and the Cochrane bias risk assessment tool to assess bias risk.The results showed that phototherapy prolonged the total sleep time of patients,with the subgroup analysis indicating that this was related to the choice of phototherapy time and light intensity.Using high-intensity(≥2000l×)light in the morning may be more effective in improving sleep-related indicators.In summary,phototherapy improved the sleep quality of patients with insomnia disorder.However,owing to the limited sample size and heterogeneity of the included studies,more comprehensive experiments are needed to explore phototherapy conditions.展开更多
BACKGROUND The use of intravascular ultrasound(iUS)has been shown in multiple singlecenter retrospective studies to decrease procedure time,radiation exposure,and needle passes compared to conventional fluoroscopic gu...BACKGROUND The use of intravascular ultrasound(iUS)has been shown in multiple singlecenter retrospective studies to decrease procedure time,radiation exposure,and needle passes compared to conventional fluoroscopic guidance in the creation of a transjugular intrahepatic portosystemic shunt(TIPS).However,there are few data regarding the impact of imaging guidance modality choice on clinical outcomes.AIM To determine the impact of iUS vs fluoroscopic guidance during creation of a TIPS on procedural metrics,liver injury,shunt patency and mortality.METHODS The retrospective study cohort consisted of 66 patients who underwent TIPS creation using iUS[“iUS-guided TIPS(iTIPS)group”]and 135 patients who underwent TIPS creation using fluoroscopic guidance[“conventional fluoroscopic-guided TIPS(cTIPS)group”]at 2 tertiary academic medical centers from 2015-2019.TIPS that required variceal embolization or portal vein recanalization were excluded.RESULTS The technical success rate was 100%in the iTIPS group and 96%in the cTIPS group(P=0.17).The iTIPS group had an air kerma(266±254 mGy vs 1235±1049 mGy,P<0.00001),dose area product(5728±6518 uGy×m^(2) vs 28969±19067 uGy×m^(2),P<0.00001),fluoroscopy time(18.7±9.6 minutes vs 32.3±19.0 minutes,P<0.00001),and total procedure time(93±40 minutes vs 110±51 minutes,P=0.01)which were significantly lower than the cTIPS group.There was no significant difference in liver function test adverse event grade at 1 month.With a median follow-up of 26 months(inter quartile range:6-61 months),there was no difference between the two groups in terms of thrombosis-free survival(P=0.23),intervention-free survival(P=0.29),or patient mortality(P=0.61).CONCLUSION The use of iUS in the creation of TIPS reduces radiation exposure and procedure time compared with fluoroscopic guidance.At midterm follow-up,the imaging guidance modality did not affect shunt patency or mortality.展开更多
Background Regular physical training induces adaptive effects across multiple organ systems,highlighting the existence of inter-organ communication networks.However,the molecular mechanisms underlying both exercise-in...Background Regular physical training induces adaptive effects across multiple organ systems,highlighting the existence of inter-organ communication networks.However,the molecular mechanisms underlying both exercise-induced adaptations and organ-to-organ signaling are not fully characterized.Circulating extracellular vesicles(EVs),including exosomes,carry molecules like microRNAs(miRNAs)that may mediate tissue crosstalk.This study aimed to identify specific exercise training-responsive miRNAs that affect skeletal muscle function.Methods miRNA expression profiles of serum-derived EVs were analyzed in healthy young individuals before and after 3 weeks endurance exercise training.Exercise training-responsive miRNAs were then validated for a functional role in cellular metabolic processes in human myotubes.Results We identified several exercise training-responsive miRNAs within exosome-rich EVs in serum,including miR-136-3p.In human myotubes,miR-136-3p enhanced glucose uptake and targeted the nardilysin convertase(NRDC)gene.Transfection of miR-136-3p or silencing of NRDC induced a shift towards glycolytic metabolism in mitochondria and modulated gene expressions related to myogenesis.Pancreatic islets were identified as a potential source of miR-136-3p based on in silico analysis of gene expression and a molecular analysis of conditioned media from isolated pancreatic islets.Conclusion MiR-136-3p is an endurance training-responsive molecular transducer that modulates glucose metabolism and cellular proliferation in myocytes.Associated with EVs,extracellular miR-136-3p may serve as a molecular messenger to communicate islet–skeletal muscle crosstalk after exercise.Extracellular miR-136-3p may serve as a molecular messenger to communicate islet–skeletal muscle crosstalk.Our results highlight a miRNA-mediated mechanism that participates in inter-organ communication to fine tune the metabolic adaptations to exercise.展开更多
BACKGROUND Parental presence in neonatal units(NUs)is essential for infant development and family well-being.A deeper understanding of the factors influencing parental presence is vital and will contribute to the deve...BACKGROUND Parental presence in neonatal units(NUs)is essential for infant development and family well-being.A deeper understanding of the factors influencing parental presence is vital and will contribute to the development of targeted interventions and policies that enhance parental engagement in neonatal care,thereby improving outcomes for infants and their families.AIM To identify and analyze primary factors influencing parental involvement in their child’s care in a neonatal intensive care unit(NICU).METHODS A literature search was conducted using the PubMed,MEDLINE,and Cochrane Library for systematic reviews databases,with the following search terms:“parental presence neonatology”,“couplet care”,“zero separation neonatal care”,“family integrated care”,“couplet care intervention”,“mother-child separation”,“parents newborn togetherness”,“mother-baby care”,“closeness and separation NICU”,“mother-infant interaction NICU”,“kangaroo care”,“dyad mother-infant”,and“newborn integrated care”.The database search for this literature review began on December 10,2024,with the final search conducted on April 10,2025.RESULTS The literature search yielded 281 articles,out of which 23 were selected for a detailed review.The factors associated with parental presence in NUs were grouped into five main categories:Parents’socio-demographic and cultural traits;the physical layout and care model of the NUs;the quality of parents’relationships with the healthcare staff;their active involvement in neonatal care;and the newborn’s health status.CONCLUSION The identification of factors that affect parental presence in NUs is critical for developing effective strategies aimed at encouraging increased parental involvement and ultimately improving neonatal and family outcomes.展开更多
Background:Investigators from low-,middle-,and high-income countries representing 6 continents contributed to the development of the Global Adolescent and Child Physical Activity Questionnaire(GAC-PAQ).The GAC-PAQ is ...Background:Investigators from low-,middle-,and high-income countries representing 6 continents contributed to the development of the Global Adolescent and Child Physical Activity Questionnaire(GAC-PAQ).The GAC-PAQ is designed to assess physical activity(PA)across all key domains(i.e.,school,chores,work/volunteering,transport,free time,outdoor time).It aimed to address multiple gaps in global PA surveillance(e.g.,omission of important PA domains,insufficient cultural adaptation,underrepresentation of rural areas in questionnaire validation studies).The purpose of this study was to assess the content validity of the GAC-PAQ among PA experts,8-to 17-year-olds,and one of their parents/guardians,and to discuss changes made to the questionnaire based on participants'feedback.Methods:Sixty-two experts in PA measurement and/or surveillance from 24 countries completed an online survey that included both closed-and open-ended questions about the content validity of the GAC-PAQ.The proportion of experts who agreed or strongly agreed with the items was calculated.Child-parent/guardian dyads from 15 countries(n=250;10-40 per country)participated in a structured cognitive interview to assess the clarity of the questions and response options,and they were encouraged to provide suggestions to improve clarity and facilitate completion of the questionnaire.Participating countries are:Aotearoa New Zealand,Brazil,Canada,China,Colombia,Czech Republic,India,Malawi,Mexico,Nepal,Nigeria,Spain,Sweden,Thailand,and the United Arab Emirates.Interviews were conducted in 13 different languages and structured by PA domain.Generic images were included to help participants in answering questions about PA intensity.Results:Expert agreement with the items for each domain exceeded 75%,and their qualitative feedback was used to revise the questionnaire before cognitive interviews.In general,participants found the questionnaire to be comprehensive.Adolescents(12-17 years)found it easier than children(8-11 years)to answer the questions.Several children struggled to answer questions about the duration and intensity of activities and/or concepts related to travel modes,active trips,and organized activities.Many parents/guardians were unsure about the frequency,duration,and intensity of their children's or adolescents'PA at school and/or recommended using more culturally relevant and appropriate images.Some participants misunderstood the concept of activities that“make you stronger”(intended to assess resistance activities)and/or struggled to differentiate between work,volunteering,and chores.Conclusion:Participants'feedback was used to develop a revised,simplified,and culturally adapted GAC-PAQ,which will be pilot-tested in all15 countries in an App that will include country-specific images and narration in local languages.Further research is needed to assess the reliability and validity of the revised GAC-PAQ.展开更多
Characterized by special morphologic,geographic,hydrologic,and societal behaviors,the water resources management of the Mediterranean catchment often shows a higher level of complexity including security issues of wat...Characterized by special morphologic,geographic,hydrologic,and societal behaviors,the water resources management of the Mediterranean catchment often shows a higher level of complexity including security issues of water supply,inundation risks,and environment management under the perspective of climate change.To have a comprehensive understanding of the Mediterranean water-cycle system,a deterministic distributed hydrologic modeling approach has been developed and presented in this study based on an application in the Var catchment(2800 km^(2))located at the French Mediterranean region.A 1D and 2D coupled model of MIKE SHE and MIKE 11 has been set up under a series of hypotheses to represent the whole hydrologic and hydrodynamic processes including rainfall-runoff,snow-melting,channel flow,overland flow,and the water exchange between land surface and unsaturated/saturated zones.The developed model was first calibrated with 4 years daily records from 2008 to 2011,then to be validated and further run within hourly time interval to produce detailed representation of the catchment water-cycle from 2012 to 2014.The deterministic distributed modeling approach presented in this study is able to represent its complicated water-cycle and used for supporting the decision‐making process of the water resources management of the catchment.展开更多
Robotic distal pancreatectomy(RDP)is being increasingly used in centres with access to the robot and offers technological improvements over conventional laparoscopy.Some studies have also shown superior outcomes compa...Robotic distal pancreatectomy(RDP)is being increasingly used in centres with access to the robot and offers technological improvements over conventional laparoscopy.Some studies have also shown superior outcomes compared with laparoscopic and open approaches.However,robotic technology is not widely available currently.This review aims to compare RDP with open and laparoscopic distal pancreatectomy,covering the basics of the RDP technique and highlighting the current nuances of the evidence pertaining to RDP with respect to clinical effectiveness and cost‒benefit analysis.展开更多
BACKGROUND The global prevalence of diabetes among adults aged 29-79 years was found to be 10.5%.It is a global public health threat with a rising trend in morbidity and mortality.Poor glycemic control(GC)among patien...BACKGROUND The global prevalence of diabetes among adults aged 29-79 years was found to be 10.5%.It is a global public health threat with a rising trend in morbidity and mortality.Poor glycemic control(GC)among patients with type 2 diabetes mellitus(T2DM)is a major determinant of diabetes-related complications.There are limited data on GC and associated factors among patients with T2DM in South West Region,Cameroon.AIM To assess GC and identify contributing factors among patients with T2DM in a regional hospital in South West Region,Cameroon.METHODS A cross-sectional study was conducted from February 2022 to July 2022 among 131 participants in Limbe Regional Hospital who were selected by convenience.Glycated hemoglobin(HbA1c)was measured by ion-exchange chromatography.Sociodemographic,clinical,and lifestyle data were collected,entered into Excel,and exported to Statistical Package for Social Sciences version 22 for analysis.A multivariate logistic regression analysis was conducted to assess the association between explanatory variables and GC.The level of significance was set at P<0.05.RESULTS The mean age was 56±5.1 years.Eighty-eight(67.2%)patients were female.The mean HbA1c was 8.8%±1.8%.Poor GC(HbA1c≥7%)was registered in 106(80.9%;95%confidence interval:73.1%-87.3%)participants.Lack of self-monitoring of blood glucose at home was associated with poor GC(adjusted odds ratio:3.858,95%confidence interval:1.262-11.800;P=0.018).CONCLUSION The majority of patients with T2DM had poor GC.Absence of self-monitoring of blood glucose at home was the main contributing factor for poor GC.展开更多
基金supported by the National Natural Science Foundation of China(No.52436008)the Inner Mongolia Science and Technology Projects,China(Nos.JMRHZX20210003 and 2023YFCY0009)+3 种基金the Huaneng Group Co Ltd.,China(No.HNKJ23-H50)the National Natural Science Foundation of China(No.22408044)the China Postdoctoral Science Foundation(No.2024M761877)the National Key R&D Program of China(No.SQ2024YFD2200039)。
文摘The electromagnetic wave absorption of silicon carbide nanowires is improved by their uniform and diverse cross-structures.This study introduces a sustainable and high value-added method for synthesizing silicon carbide nanowires using lignite and waste silicon powder as raw materials through carbothermal reduction.The staggered structure of nanowires promotes the creation of interfacial polarization,impedance matching,and multiple loss mechanisms,leading to enhanced electromagnetic absorption performance.The silicon carbide nanowires demonstrate outstanding electromagnetic absorption capabilities with the minimum reflection loss of-48.09 d B at10.08 GHz and an effective absorption bandwidth(the reflection loss less than-10 d B)ranging from 8.54 to 16.68 GHz with a thickness of 2.17 mm.This research presents an innovative approach for utilizing solid waste in an environmentally friendly manner to produce broadband silicon carbide composite absorbers.
基金supported by the National Key Research and Development Program of China(No.2022YFE0201800)the National Natural Science Foundation of China(Nos.22274169 and 22474161)+5 种基金Guangdong Basic and Applied Basic Research Foundation(No.2024A1515030160)the Science and Technology Program of Guangzhou City(No.2023B03J1380)Shenzhen Science and Technology Innovation Commission(No.GJHZ20210705142200001)the Scientific Technology Project of Guangzhou City(No.202103000003)the Guangdong Science and Technology Plan Project(No.2020B1212060077)the Open Research Fund of State Key Laboratory of Analytical Chemistry for Life Science,School of Chemistry and Chemical Engineering,Nanjing University.
文摘Small extracellular vesicles(sEVs)membrane protein profile(sEVpp)is a novel biomarker for cancer,and it can reveal the in-depth phenotype information.The point-of-care testing(POCT)of sEVpp holds great significance for mass screening of cancer,so the cost-effective and simple detection methods of sEVpp are urgently demanded.Herein,we constructed a paper-based multichannel sEVpp POCT device(sEVpp-PAD)enabled by functional DNA probes and metal-organic framework(MOF).The core components are aptamer/MOF-modified paper chips.The modified aptamers can immunocapture the sEV expressing corresponding proteins,while the modified MOF can provide abundant sites for aptamer-modification,reduce the nonspecific protein absorption,and act as reference for ratiometric detection.Simply powered by two syringes,the sEVpp-PAD can efficiently capture sEVs expressing corresponding protein from cell culture media and sera.Furthermore,a detection probe(DP)consisted of CD63 aptamer and G-quadruplex was developed for the colorimetric detection of captured sEVs.Utilizing this device,the sEVpp in various hepatocellular carcinoma cell culture medium and,more importantly,in human sera can be accurately determined,only with$2 device,$0.2 detection reagents and 1.8 h procedure.This simple strategy for sEVpp detection can innovatively promote the POCT and subtyping of cancer based on sEV-related liquid biopsy.
基金supported by the Key Program of the National Natural Science Foundation of China grants 32230059the Basic Science Center Program T2288102,the National Natural Science Foundation of China grants 32301123the Foundation of Frontiers Science Center for Materiobiology and Dynamic Chemistry JKVD1211002。
文摘The treatment of severe diabetic foot remains a clinical challenge.While it is established that bone can exert systemic effects through the secretion of osteokines on other organs,whether this endocrine function can be harnessed to promote diabetic wound healing remains unexplored.Here,we investigate the impact of a bone injury strategy on diabetic wound healing,leveraging the body's innate regenerative capacity to stimulate osteokine release and influence remote skin wound repair.This study demonstrates that the tibial defect significantly accelerates ipsilateral diabetic foot skin wound healing.Mechanistically,we identify osteokines,platelet-derived growth factor-BB(PDGF-BB),as the key to initiating this process.Bone defect triggers a substantial release of PDGF-BB,which reaches the skin wound site via peripheral circulation.At the skin wound site,PDGF-BB mediates the secretion of keratinocyte growth factor(KGF)from fibroblasts via the PDGFRβsignaling pathway,thereby promoting the rapid reepithelialization of epidermal cells through a paracrine pathway.Additionally,elevated PDGF-BB levels enhance the regeneration of CD31^(h i)Emcn^(h i)blood vessels within the wound.Importantly,we demonstrate the therapeutic potential of osteokines by showing that a collagen hydrogel loaded with osteokines promotes wound healing in diabetic mice.Our findings reveal a clear link between bone and skin wound healing,providing a therapeutic inspiration for chronic wounds that are difficult to treat locally.
基金funding support from the Macao Science and Technology Development Fund(0013/2021/AMJ and 0082/2022/A2)support from the Multi-Year Research Grants(MYRG2022-00266-IAPME,and MYRG-GRG2023-00224-IAPME)provided by the Research&Development Office at the University of Macao+2 种基金the National Natural Science Foundation of China(52202328)the Shanghai Sailing Program(22YF1455500)the Shanghai Magnolia Talent Plan Pujiang Project(24PJD128)for their financial support。
文摘Iron-based Prussian white(PW)materials have attracted considerable attention as promising cathodes for potassium-ion batteries(PIBs)due to their high capacity,easy preparation,and economic merits.However,the intrinsic iron dissolution and uncontrollable cathode-electrolyte interface(CEI)formation in conventional organic electrolytes severely hinder their long-term cycling stability.Herein,we employ succinonitrile(SN),a bifunctional electrolyte additive,to suppress the iron dissolution and promote thin,uniform,and stable CEI formation of the PW cathode,thus improving its structural stability.Benefited from the coordination between the cyano groups in SN and iron atoms,this molecule can preferentially adsorb on the surface of PW to mitigate iron dissolution.SN also facilitates the decomposition of anions in potassium salt rather than organic solvents in electrolyte due to the attractive reaction between SN and anions.Consequently,the PW cathode with SN additive provides better electrochemical reversibility,showing capacity retention of 93.6%after 3000 cycles at 5C.In comparison,without SN,the capacity retention is only 87.4%after 1000 cycles under the same conditions.Moreover,the full cells of PW matched with commercial graphite(Gr)achieve stable cycling for 3500 cycles at a high rate of 20C,with an exceptional capacity decay of only 0.005%per cycle,surpassing the majority of recently reported results in literature.
文摘Background:Inflatable Penile Prosthesis(IPP)is the treatment for erectile dysfunction(ED)refractory to pharmacological therapies.Long-term data on factors associated with prosthesis survival remain unclear.This study aimed to analyze the long-term survival of penile prostheses and identify risk factors associated with survival without reintervention.Methods:This is a retrospective,single-center study of patients who underwent IPP implantation between January 2014 and December 2022.Preoperative data related to the patient and the etiology of ED,as well as perioperative data,were collected.The primary outcome was survival without reintervention,defined as prosthesis revision or explantation due to mechanical dysfunction or infection.We conducted survival analyses without reintervention and searched for risk factors using a multivariate Cox model.Results:In total,33 out of 137 patients underwent reintervention(24.1%),including 24(17.5%)prosthesis revisions and 9(6.6%)had explantations.Median follow-up was 39 months with an interquartile range(IQR)of 9.00 to 62.00.Median survival without reintervention was 7 years.In univariate analysis,downsizing(p=0.046)was associated with reintervention.Smoking(p=0.003)and age(p=0.034)were associated with prosthesis explantation.The number of implantations(p=0.009)was associated with prosthesis revision.Multivariate analysis by the Cox model did not identify any independent predictive factors for reintervention.Conclusion:Smoking may play a role in infection post-IPP implantation.Primary implantations seem to be associated with better survival.Adjusting cylinder size,known as downsizing,is likely to be a proxy for the complexity of the procedure and thus linked to earlier reintervention.
文摘Background Heat shock proteins(HSPs)are key molecular chaperones that help maintain protein homeostasis by stabilizing or removing damaged proteins during cellular stress.Aging weakens these stress–response systems,disrupting proteostasis and increasing vulnerability to sarcopenia.High-intensity training(HIT)can counteract these declines by activating protective pathways such as the HSP response.HSPs are highly responsive to stress,examining their regulation during aging is important,as altered HSP activity is linked to the progressive loss of muscle mass.Methods This study investigated the abundance and phosphorylation of HSPs in skeletal muscle from healthy,active young and older adults(n=7 per group),assessed at baseline and again in the older group following 12 weeks of HIT.Using calibrated Western blotting on both whole-muscle homogenates and pooled single muscle fibres,we quantified HSP content and phosphorylation to determine how aging and exercise influence stress–responsive protein regulation at both the tissue and cellular levels.Results In whole muscle homogenates,HSPs(HSP72,HSP27,andαB-crystallin)did not differ between young and older adults,while higher phosphorylation of small HSPs(sHSPs):phospho-HSP27 at Serine15(pHSP27 Ser15)and phospho-αB-crystallin at Serine59(pαB-crystallin Ser59)(∼1.8-fold and∼2.9-fold,respectively)were found in muscle from older adults,indicating higher cellular stress associated with aging.A 12-week HIT intervention in older adults reduced homogenate pHSP27 Ser15 and pαB-crystallin Ser59 abundances to similar levels found in young adults.Total HSPs typically displayed a distinct fiber-type profile in both age groups,with more in type I compared to type II fibers,distinguished by the presence of myosin heavy chain I(MHCI)or MHCII.Phosphorylation at pHSP27 Ser15 and pαB-crystallin Ser59 was not different between type I and type II fibers.The HIT in older adults decreased total and phosphorylated sHSPs in both type I and type II fibers but increased HSP72 in type I fibers.Conclusion HIT has the potential to mitigate age-related cellular stress and modulate protein expression patterns in aging skeletal muscle and,perhaps,has the potential to delay age-related muscle decline,thereby improving muscle health in older adults.
基金supported by the National Natural Science Foundation of China Grant(No.61972133)Project of Leading Talents in Science and Technology Innovation for Thousands of People Plan in Henan Province Grant(No.204200510021)the Key Research and Development Plan Special Project of Henan Province Grant(No.241111211400).
文摘At inference time,deep neural networks are susceptible to backdoor attacks,which can produce attackercontrolled outputs when inputs contain carefully crafted triggers.Existing defense methods often focus on specific attack types or incur high costs,such as data cleaning or model fine-tuning.In contrast,we argue that it is possible to achieve effective and generalizable defense without removing triggers or incurring high model-cleaning costs.Fromthe attacker’s perspective and based on characteristics of vulnerable neuron activation anomalies,we propose an Adaptive Feature Injection(AFI)method for black-box backdoor detection.AFI employs a pre-trained image encoder to extract multi-level deep features and constructs a dynamic weight fusionmechanism for precise identification and interception of poisoned samples.Specifically,we select the control samples with the largest feature differences fromthe clean dataset via feature-space analysis,and generate blended sample pairs with the test sample using dynamic linear interpolation.The detection statistic is computed by measuring the divergence G(x)in model output responses.We systematically evaluate the effectiveness of AFI against representative backdoor attacks,including BadNets,Blend,WaNet,and IAB,on three benchmark datasets:MNIST,CIFAR-10,and ImageNet.Experimental results show that AFI can effectively detect poisoned samples,achieving average detection rates of 95.20%,94.15%,and 86.49%on these datasets,respectively.Compared with existing methods,AFI demonstrates strong cross-domain generalization ability and robustness to unknown attacks.
基金supported by the Key Program of the National Natural Science Foundation of China grants 32230059the Basic Science Center Program T2288102+1 种基金the National Natural Science Foundation of China grants 32301123the Foundation of Frontiers Science Center for Materiobiology and Dynamic Chemistry JKVD1211002.
文摘The treatment of severe diabetic foot remains a clinical challenge.While it is established that bone can exert systemic effects through the secretion of osteokines on other organs,whether this endocrine function can be harnessed to promote diabetic wound healing remains unexplored.Here,we investigate the impact of a bone injury strategy on diabetic wound healing,leveraging the body’s innate regenerative capacity to stimulate osteokine release and influence remote skin wound repair.This study demonstrates that the tibial defect significantly accelerates ipsilateral diabetic foot skin wound healing.Mechanistically,we identify osteokines,platelet-derived growth factor-BB(PDGF-BB),as the key to initiating this process.Bone defect triggers a substantial release of PDGF-BB,which reaches the skin wound site via peripheral circulation.At the skin wound site,PDGF-BB mediates the secretion of keratinocyte growth factor(KGF)from fibroblasts via the PDGFRβsignaling pathway,thereby promoting the rapid re-epithelialization of epidermal cells through a paracrine pathway.Additionally,elevated PDGF-BB levels enhance the regeneration of CD31hi Emcnhi blood vessels within the wound.
文摘BACKGROUND The persistent burden of cardiovascular(CV)disease in the United States requires innovative and cost-effective prognostic markers that can be relied upon.AIM To provide insights into how adiponectin can predict all-cause mortality and major adverse CV events(MACE)in patients with coronary artery disease(CAD)and to determine the prognostic value of adiponectin in predicting all-cause mortality and MACE in patients with stable CAD.METHODS We conducted a systematic search on PubMed,Scopus,and Google Scholar to find relevant studies published through June 2023 evaluating the long-term prognostic role of adiponectin in patients with stable CAD.Using a random effects model with 95%CI,we estimated the odds ratio(OR)while assessing heterogeneity through I^(2)statistics.To ensure robustness,we performed a sensitivity analysis using the leave-one-out approach.RESULTS After screening,we included five prospective studies involving 3225 patients who were followed up for a median duration of 3.8 years.Within the study population,prevalent risk factors included hypertension,diabetes,hyperlipidemia,and smoking.The commonly prescribed medications were angiotensin-converting enzyme inhibitors,beta blockers,and statins.The combined adjusted OR for all-cause mortality was found to be 2.51(95%CI:1.36–4.62),showing heterogeneity(I^(2)=65.51%,P=0.03).On the other hand,the combined adjusted OR for MACE was determined to be 1.04(95%CI:1.02–1.06)with no significant heterogeneity observed(I^(2)=0%,P=0.68).Through a sensitivity analysis,it was discovered that none of the studies significantly impacted the overall results of the meta-analysis,thus indicating their robustness.CONCLUSION Higher levels of adiponectin were found to be associated with an increased risk of long-term mortality and MACE in patients with CAD,which highlights its potential as a cost-effective marker for risk assessment and guiding treatment strategies.Further research on the role of adiponectin could greatly influence decision-making and resource allocation in CV care.
文摘BACKGROUND Knowledge-based systems(KBS)are software applications based on a knowledge database and an inference engine.Various experimental KBS for computerassisted medical diagnosis and treatment were started to be used since 70s(VisualDx,GIDEON,DXPlain,CADUCEUS,Internist-I,Mycin etc.).AIM To present in detail the“Electronic Pediatrician(EPed)”,a medical non-machine learning artificial intelligence(nml-AI)KBS in its prototype version created by the corresponding author(with database written in Romanian)that offers a physiopathology-based differential and positive diagnosis and treatment of ill children.METHODS EPed specifically focuses on the physiopathological reasoning of pediatric clinical cases.EPed has currently reached its prototype version 2.0,being able to diagnose 302 physiopathological macro-links(briefly named“clusters”)and 269 pediatric diseases:Some examples of diagnosis and a previous testing of EPed on a group of 34 patients are also presented in this paper.RESULTS The prototype EPed can currently diagnose 269 pediatric infectious and noninfectious diseases(based on 302 clusters),including the most frequent respiratory/digestive/renal/central nervous system infections,but also many other noninfectious pediatric diseases like autoimmune,oncological,genetical diseases and even intoxications,plus some important surgical pathologies.CONCLUSION EPed is the first and only physiopathology-based nml-AI KBS focused on general pediatrics and is the first and only pediatric Romanian KBS addressed to medical professionals.Furthermore,EPed is the first and only nml-AI KBS that offers not only both a physiopathology-based differential and positive disease diagnosis,but also identifies possible physiopathological“clusters”that may explain the signs and symptoms of any child-patient and may help treating that patient physiopathologically(until a final diagnosis is found),thus encouraging and developing the physiopathological reasoning of any clinician.
文摘Decision support systems(DSS)based on physically based numerical models are standard tools used by water services and utilities.However,few DSS based on holistic approaches combining distributed hydrological,hydraulic,and hydrogeological models are operationally exploited.This holistic approach was adopted for the development of the AquaVar DSS,used for water resource management in the French Mediterranean Var watershed.The year 2019 marked the initial use of the DSS in its operational environment.Over the next 5 years,multiple hydrological events allowed to test the performance of the DSS.The results show that the tool is capable of simulating peak flows associated with two extreme rainfall events(storms Alex and Aline).For a moderate flood,the real-time functionality was able to simulate forecast discharges 26 h before the flood peak,with a maximum local error of 30%.Finally,simulations for the drought period 2022-2023 highlighted the essential need for DSS to evolve in line with changing climatic conditions,which give rise to unprecedented hydrological processes.The lessons learned from these first 5 years of AquaVar use under operational conditions are synthesized,addressing various topics such as DSS modularity,evolution,data positioning,technology,and governance.
文摘BACKGROUND Steroids remain the primary treatment for severe alcohol-associated hepatitis(AAH),though there is little available tools to predict patient response to steroids.It was hypothesized that phosphatidylethanol(PEth)value will inversely corre-late with response to steroid therapy based on Lille score in AAH.AIM To assess the relationship of patient factors,focusing on pre-steroid therapy PEth value,to steroid therapy response in AAH.METHODS A retrospective case control study was performed on patients who received≥4 days of steroid therapy for AAH at our hospital between July 1,2019 and June 30,2022.A total of 2087 patients were screened for AAH and those treated with steroids were included for statistical analysis utilizing independent sample t-test and for categorical variables using the χ^(2) test.RESULTS No correlation was found between PEth value,pre-steroids abstinence length,or number of drinks per week pre-steroids and response to steroids.Non-responder status significantly correlated with older age(P=0.024),lower albumin(P=0.003),and higher bilirubin(P=0.010)pre-steroids.Our study suggests that age,pre-steroid albumin,and pre-steroid bilirubin levels may predict nonresponse to steroid therapy.Non-responders have increased incidence of death and higher medical costs.CONCLUSION Identifying non-responders through these identified factors should prompt early referral for liver transplantation.Future prospective studies with larger population size are needed to assess the efficacy of combined pre-steroid age,albumin,bilirubin and other biochemical markers as predictors of steroid response.
基金supported by the National Key R&D Program of China(No.2024YFC3505503)the Joint Fund of Tianjin Natural Science Foundation(No.25JCLMJC00370)the Chinese Academy of Medical Sciences Innovation Fund for Medical Sciences(No.2022-I2M-3-002).
文摘Insomnia disorder negatively affects the quality of life of patients.Phototherapy has proven effective in treating sleep problems.This study aimed to summarize the impact of phototherapy on sleep quality in patients with insomnia disorder and the factors influencing its effectiveness.We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses(PRISMA)guidelines and registered experiments on the PROSPERO website,retrieving 12 randomized controlled trials that included at least one sleep quality outcome measure available for analysis from the four databases.Meta-analysis was conducted using the RevMan software,using Mean Differences(MD)and its 95% Confidence Interval(CI)to evaluate treatment efficacy and the Cochrane bias risk assessment tool to assess bias risk.The results showed that phototherapy prolonged the total sleep time of patients,with the subgroup analysis indicating that this was related to the choice of phototherapy time and light intensity.Using high-intensity(≥2000l×)light in the morning may be more effective in improving sleep-related indicators.In summary,phototherapy improved the sleep quality of patients with insomnia disorder.However,owing to the limited sample size and heterogeneity of the included studies,more comprehensive experiments are needed to explore phototherapy conditions.
文摘BACKGROUND The use of intravascular ultrasound(iUS)has been shown in multiple singlecenter retrospective studies to decrease procedure time,radiation exposure,and needle passes compared to conventional fluoroscopic guidance in the creation of a transjugular intrahepatic portosystemic shunt(TIPS).However,there are few data regarding the impact of imaging guidance modality choice on clinical outcomes.AIM To determine the impact of iUS vs fluoroscopic guidance during creation of a TIPS on procedural metrics,liver injury,shunt patency and mortality.METHODS The retrospective study cohort consisted of 66 patients who underwent TIPS creation using iUS[“iUS-guided TIPS(iTIPS)group”]and 135 patients who underwent TIPS creation using fluoroscopic guidance[“conventional fluoroscopic-guided TIPS(cTIPS)group”]at 2 tertiary academic medical centers from 2015-2019.TIPS that required variceal embolization or portal vein recanalization were excluded.RESULTS The technical success rate was 100%in the iTIPS group and 96%in the cTIPS group(P=0.17).The iTIPS group had an air kerma(266±254 mGy vs 1235±1049 mGy,P<0.00001),dose area product(5728±6518 uGy×m^(2) vs 28969±19067 uGy×m^(2),P<0.00001),fluoroscopy time(18.7±9.6 minutes vs 32.3±19.0 minutes,P<0.00001),and total procedure time(93±40 minutes vs 110±51 minutes,P=0.01)which were significantly lower than the cTIPS group.There was no significant difference in liver function test adverse event grade at 1 month.With a median follow-up of 26 months(inter quartile range:6-61 months),there was no difference between the two groups in terms of thrombosis-free survival(P=0.23),intervention-free survival(P=0.29),or patient mortality(P=0.61).CONCLUSION The use of iUS in the creation of TIPS reduces radiation exposure and procedure time compared with fluoroscopic guidance.At midterm follow-up,the imaging guidance modality did not affect shunt patency or mortality.
基金supported by grants from the Knut and Alice Wallenberg foundation(P-OB,JRZ,and AK)the Swedish Research Council(JRZ and AK),Centrum för idrottsforskning(AK and JRZ)+7 种基金the NovoNordisk Foundation Metabolic Stress Associated Molecules(MSAM)consortium NNF15SA0018346 and Metabolite-related Inflammation and Disease(MeRIAD)consortium Grant number 0064142(AK)the Swedish Diabetes Foundation(AK and JRZ)the European Foundation for the Study of Diabetes(JRZ and AK)the Region Stockholm(ALF project)(JRZ and KC)the Strategic Research Program in Diabetes at Karolinska Institutet(JRZ and AK)supported by the Strategic Research Programme in Diabetes(SRP Diabetes)for use of the Seahorse flux analyzer.Human islets were made possible through the Juvenile Diabetes Research Foundation(JDRF)award 31-2008-416(European Coordinating Infrastructure for Islet Transplantation(ECIT),Islet for Basic Research program)AK holds a Distinguished Investigator Grant within Endocrinology and Metabolism from the Novo Nordisk Foundation(NNF24OC0088739)JRZ received the 2024 European Association for the Study of Diabetes(ESAD)-Novo Nordisk Foundation Diabetes Prize for Excellence(NNF24SA0092609).
文摘Background Regular physical training induces adaptive effects across multiple organ systems,highlighting the existence of inter-organ communication networks.However,the molecular mechanisms underlying both exercise-induced adaptations and organ-to-organ signaling are not fully characterized.Circulating extracellular vesicles(EVs),including exosomes,carry molecules like microRNAs(miRNAs)that may mediate tissue crosstalk.This study aimed to identify specific exercise training-responsive miRNAs that affect skeletal muscle function.Methods miRNA expression profiles of serum-derived EVs were analyzed in healthy young individuals before and after 3 weeks endurance exercise training.Exercise training-responsive miRNAs were then validated for a functional role in cellular metabolic processes in human myotubes.Results We identified several exercise training-responsive miRNAs within exosome-rich EVs in serum,including miR-136-3p.In human myotubes,miR-136-3p enhanced glucose uptake and targeted the nardilysin convertase(NRDC)gene.Transfection of miR-136-3p or silencing of NRDC induced a shift towards glycolytic metabolism in mitochondria and modulated gene expressions related to myogenesis.Pancreatic islets were identified as a potential source of miR-136-3p based on in silico analysis of gene expression and a molecular analysis of conditioned media from isolated pancreatic islets.Conclusion MiR-136-3p is an endurance training-responsive molecular transducer that modulates glucose metabolism and cellular proliferation in myocytes.Associated with EVs,extracellular miR-136-3p may serve as a molecular messenger to communicate islet–skeletal muscle crosstalk after exercise.Extracellular miR-136-3p may serve as a molecular messenger to communicate islet–skeletal muscle crosstalk.Our results highlight a miRNA-mediated mechanism that participates in inter-organ communication to fine tune the metabolic adaptations to exercise.
文摘BACKGROUND Parental presence in neonatal units(NUs)is essential for infant development and family well-being.A deeper understanding of the factors influencing parental presence is vital and will contribute to the development of targeted interventions and policies that enhance parental engagement in neonatal care,thereby improving outcomes for infants and their families.AIM To identify and analyze primary factors influencing parental involvement in their child’s care in a neonatal intensive care unit(NICU).METHODS A literature search was conducted using the PubMed,MEDLINE,and Cochrane Library for systematic reviews databases,with the following search terms:“parental presence neonatology”,“couplet care”,“zero separation neonatal care”,“family integrated care”,“couplet care intervention”,“mother-child separation”,“parents newborn togetherness”,“mother-baby care”,“closeness and separation NICU”,“mother-infant interaction NICU”,“kangaroo care”,“dyad mother-infant”,and“newborn integrated care”.The database search for this literature review began on December 10,2024,with the final search conducted on April 10,2025.RESULTS The literature search yielded 281 articles,out of which 23 were selected for a detailed review.The factors associated with parental presence in NUs were grouped into five main categories:Parents’socio-demographic and cultural traits;the physical layout and care model of the NUs;the quality of parents’relationships with the healthcare staff;their active involvement in neonatal care;and the newborn’s health status.CONCLUSION The identification of factors that affect parental presence in NUs is critical for developing effective strategies aimed at encouraging increased parental involvement and ultimately improving neonatal and family outcomes.
基金supported by a Project Grant(Grant No.PJT183705)an Early Career Investigator Prize(Grant No.ECP 184184)from the Canadian Institutes of Health Research+7 种基金a Prentice Institute Research Affiliate Fund Grant from the Prentice Institute for Global Population and Economy(Grant No.G00004116)a Te Herenga Waka Victoria University of Wellington Division of Science Health Engineering Architecture and Design Innovation Faculty Strategic Research Grant(Grant No.FSRG-SHEADI-10724)The Thailand Physical Activity Knowledge Development Centre(TPAK)/Thai Health Promotion Foundation provided funding for the cognitive interviews and pilot study in Thailand(Grant No.66-P1-0473)The University Pablo de Olavide provided a scholarship for 2 undergraduate students working on the project(codes PPI2207 and PPI2308)In the Czech Republicthe study was supported by Palacky University IGA(Grant No.IGA_FTK_2023_017)supported by the Division of Intramural Research at the National Institute on Minority Health and Health Disparities of the National Institutes of Healthsupported by the Key Project of the National Philosophy and Social Science Foundation of China(23&ZD197)。
文摘Background:Investigators from low-,middle-,and high-income countries representing 6 continents contributed to the development of the Global Adolescent and Child Physical Activity Questionnaire(GAC-PAQ).The GAC-PAQ is designed to assess physical activity(PA)across all key domains(i.e.,school,chores,work/volunteering,transport,free time,outdoor time).It aimed to address multiple gaps in global PA surveillance(e.g.,omission of important PA domains,insufficient cultural adaptation,underrepresentation of rural areas in questionnaire validation studies).The purpose of this study was to assess the content validity of the GAC-PAQ among PA experts,8-to 17-year-olds,and one of their parents/guardians,and to discuss changes made to the questionnaire based on participants'feedback.Methods:Sixty-two experts in PA measurement and/or surveillance from 24 countries completed an online survey that included both closed-and open-ended questions about the content validity of the GAC-PAQ.The proportion of experts who agreed or strongly agreed with the items was calculated.Child-parent/guardian dyads from 15 countries(n=250;10-40 per country)participated in a structured cognitive interview to assess the clarity of the questions and response options,and they were encouraged to provide suggestions to improve clarity and facilitate completion of the questionnaire.Participating countries are:Aotearoa New Zealand,Brazil,Canada,China,Colombia,Czech Republic,India,Malawi,Mexico,Nepal,Nigeria,Spain,Sweden,Thailand,and the United Arab Emirates.Interviews were conducted in 13 different languages and structured by PA domain.Generic images were included to help participants in answering questions about PA intensity.Results:Expert agreement with the items for each domain exceeded 75%,and their qualitative feedback was used to revise the questionnaire before cognitive interviews.In general,participants found the questionnaire to be comprehensive.Adolescents(12-17 years)found it easier than children(8-11 years)to answer the questions.Several children struggled to answer questions about the duration and intensity of activities and/or concepts related to travel modes,active trips,and organized activities.Many parents/guardians were unsure about the frequency,duration,and intensity of their children's or adolescents'PA at school and/or recommended using more culturally relevant and appropriate images.Some participants misunderstood the concept of activities that“make you stronger”(intended to assess resistance activities)and/or struggled to differentiate between work,volunteering,and chores.Conclusion:Participants'feedback was used to develop a revised,simplified,and culturally adapted GAC-PAQ,which will be pilot-tested in all15 countries in an App that will include country-specific images and narration in local languages.Further research is needed to assess the reliability and validity of the revised GAC-PAQ.
基金supported by the National Key R&D Program of China(No.2023YFC3006702)the Natural Science Foundation of Beijing Municipality(IS23117).
文摘Characterized by special morphologic,geographic,hydrologic,and societal behaviors,the water resources management of the Mediterranean catchment often shows a higher level of complexity including security issues of water supply,inundation risks,and environment management under the perspective of climate change.To have a comprehensive understanding of the Mediterranean water-cycle system,a deterministic distributed hydrologic modeling approach has been developed and presented in this study based on an application in the Var catchment(2800 km^(2))located at the French Mediterranean region.A 1D and 2D coupled model of MIKE SHE and MIKE 11 has been set up under a series of hypotheses to represent the whole hydrologic and hydrodynamic processes including rainfall-runoff,snow-melting,channel flow,overland flow,and the water exchange between land surface and unsaturated/saturated zones.The developed model was first calibrated with 4 years daily records from 2008 to 2011,then to be validated and further run within hourly time interval to produce detailed representation of the catchment water-cycle from 2012 to 2014.The deterministic distributed modeling approach presented in this study is able to represent its complicated water-cycle and used for supporting the decision‐making process of the water resources management of the catchment.
文摘Robotic distal pancreatectomy(RDP)is being increasingly used in centres with access to the robot and offers technological improvements over conventional laparoscopy.Some studies have also shown superior outcomes compared with laparoscopic and open approaches.However,robotic technology is not widely available currently.This review aims to compare RDP with open and laparoscopic distal pancreatectomy,covering the basics of the RDP technique and highlighting the current nuances of the evidence pertaining to RDP with respect to clinical effectiveness and cost‒benefit analysis.
文摘BACKGROUND The global prevalence of diabetes among adults aged 29-79 years was found to be 10.5%.It is a global public health threat with a rising trend in morbidity and mortality.Poor glycemic control(GC)among patients with type 2 diabetes mellitus(T2DM)is a major determinant of diabetes-related complications.There are limited data on GC and associated factors among patients with T2DM in South West Region,Cameroon.AIM To assess GC and identify contributing factors among patients with T2DM in a regional hospital in South West Region,Cameroon.METHODS A cross-sectional study was conducted from February 2022 to July 2022 among 131 participants in Limbe Regional Hospital who were selected by convenience.Glycated hemoglobin(HbA1c)was measured by ion-exchange chromatography.Sociodemographic,clinical,and lifestyle data were collected,entered into Excel,and exported to Statistical Package for Social Sciences version 22 for analysis.A multivariate logistic regression analysis was conducted to assess the association between explanatory variables and GC.The level of significance was set at P<0.05.RESULTS The mean age was 56±5.1 years.Eighty-eight(67.2%)patients were female.The mean HbA1c was 8.8%±1.8%.Poor GC(HbA1c≥7%)was registered in 106(80.9%;95%confidence interval:73.1%-87.3%)participants.Lack of self-monitoring of blood glucose at home was associated with poor GC(adjusted odds ratio:3.858,95%confidence interval:1.262-11.800;P=0.018).CONCLUSION The majority of patients with T2DM had poor GC.Absence of self-monitoring of blood glucose at home was the main contributing factor for poor GC.
