Automatic measurement of anatomical parameters of the lumbar vertebral body and the intervertebral disc on radiographs by deep learning.

Background: Lumbar spine disorders are one of the common causes of low back pain (LBP). Objective and reliable measurement of anatomical parameters of the lumbar spine is essential in the clinical diagnosis and evaluation of lumbar disorders. However, manual measurements are time-consuming and laborious, with poor consistency and repeatability. Here, we aim to develop and evaluate an automatic measurement model for measuring the anatomical parameters of the vertebral body and intervertebral disc based on lateral lumbar radiographs and deep learning (DL). Methods: A model based on DL was developed with a dataset consisting of 1,318 lateral lumbar radiographs for the prediction of anatomical parameters, including vertebral body heights (VBH), intervertebral disc heights (IDH), and intervertebral disc angles (IDA). The mean of the values obtained by 3 radiologists was used as a reference standard. Statistical analysis was performed in terms of standard deviation (SD), mean absolute error (MAE), Percentage of correct keypoints (PCK), intraclass correlation coefficient (ICC), regression analysis, and Bland-Altman plot to evaluate the performance of the model compared with the reference standard. Results: The percentage of intra-observer landmark distance within the 3 mm threshold was 96%. The percentage of inter-observer landmark distance within the 3 mm threshold was 94% (R1 and R2), 92% (R1 and R3), and 93% (R2 and R3), respectively. The PCK of the model within the 3 mm distance threshold was 94-99%. The model-predicted values were 30.22±3.01 mm, 10.40±3.91 mm, and 10.63°±4.74° for VBH, IDH, and IDA, respectively. There were good correlation and consistency in anatomical parameters of the lumbar vertebral body and disc between the model and the reference standard in most cases (R2=0.89-0.95, ICC =0.93-0.98, MAE =0.61-1.15, and SD =0.89-1.64). Conclusions: The newly proposed model based on a DL algorithm can accurately measure various anatomical parameters on lateral lumbar radiographs. This could provide an accurate and efficient measurement tool for the quantitative evaluation of spinal disorders.

Deep learning-based quantitative morphological study of anteroposterior digital radiographs of the lumbar spine.

Background: Morphological parameters of the lumbar spine are valuable in assessing lumbar spine diseases. However, manual measurement of lumbar morphological parameters is time-consuming. Deep learning has automatic quantitative and qualitative analysis capabilities. To develop a deep learning-based model for the automatic quantitative measurement of morphological parameters from anteroposterior digital radiographs of the lumbar spine and to evaluate its performance. Methods: This study used 1,368 anteroposterior digital radiographs of the lumbar spine to train a deep learning model to measure the quantitative morphological indicators, including L1 to L5 vertebral body height (VBH) and L1-L2 to L4-L5 intervertebral disc height (IDH). The means of the manual measurements by three radiologists were used as the reference standard. The parameters predicted by the model were analyzed against the manual measurements using paired t-tests. Percentage of correct key points (PCK), intra-class correlation coefficient (ICC), Pearson correlation coefficient (r), mean absolute error (MAE), root mean square error (RMSE), and Bland-Altman plots were performed to assess the performance of the model. Results: Within the 3-mm distance threshold, the model had a PCK range of 99.77-99.46% for the L1 to L4 vertebrae and 77.37% for the L5 vertebrae. Except for VBH-L5 and IDH_L3-L4, IDH_L4-L5 (P<0.05), the estimated values of the model in the remaining parameters were not statistically significant compared with the reference standard (P>0.05). Except for VBH-L5 and IDH_L4-L5, the model showed good correlation and consistency with the reference standard (ICC =0.84-0.96, r=0.85-0.97, MAE =0.5-0.66, RMSE =0.66-0.95). The model outperformed other models (EfficientDet + Unet, EfficientDet + DarkPose, HRNet, and Unet) in predicting landmarks within a distance threshold of 1.5 to 5 mm. Conclusions: The model developed in this study can automatically measure the morphological parameters of the L1 to L4 vertebrae from anteroposterior digital radiographs of the lumbar spine. Its performance is close to the level of radiologists.

Association of non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio (NHHR) and gallstones among US adults aged ≤ 50 years: a cross-sectional study from NHANES 2017-2020.

BACKGROUND: The chronic digestive condition gallstones is quite common around the world, the development of which is closely related to oxidative stress, inflammatory response and abnormalities of lipid metabolism. In the last few years, as a novel biomarker of lipid metabolism, the non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio (NHHR) has garnered significant interest. However, its relationship with gallstones has not been studied yet. METHODS: 3,772 people, all under 50, were included in this study, and their full data came from the National Health and Nutrition Examination Survey (NHANES) database for the years 2017-2020. Information on gallstones was obtained through self-reported questionnaires. Smoothed curve fitting multifactorial logistic regression was utilized to evaluate the connection of NHHR with gallstone formation incidence. Subsequently, subgroup analysis and interaction tests were applied. Finally, to create a prediction model, logistic regression and feature screening by last absolute shrinkage and selection operator (LASSO) were used. The resulting model was displayed using a nomogram. RESULTS: In multivariate logistic regression that accounted for all factors, there was a 77% increase in the likelihood of gallstones for every unit rise in lnNHHR (OR 1.77 [CI 1.11-2.83]). Following NHHR stratification, the Q4 NHHR level was substantially more linked to the risk of gallstones than the Q1 level (OR 1.86 [CI 1.04-3.32]). This correlation was stronger in women, people under 35, smokers, abstainers from alcohol, non-Hispanic White people, those with excessively high cholesterol, people with COPD, and people without diabetes. After feature screening, a predictive model and visualized nomogram for gallstones were constructed with an AUC of 0.785 (CI 0.745-0.819), which was assessed by DCA to be clinically important. CONCLUSION: In the group of people ≤ 50 years of age, elevated NHHR levels were substantially linked to a higher incidence of gallstones. This correlation was stronger in several specific groups such as females, under 35 years of age, smokers, and so on. Predictive models constructed using the NHHR have potential clinical value in assessing gallstone formation.

The tripartite motif-containing 24 is a multifunctional player in human cancer.

Tripartite motif-containing 24 (TRIM24), also known as transcriptional intermediary factor 1α (TIF1α), is the founding member of TIF1 family. Recent evidence indicates that aberrant expression of TRIM24, functions as an oncogene, is associated with poor prognosis across various cancer types. TRIM24 exhibits a multifaceted structure comprising an N-terminal TRIM region with a RING domain, B-box type 1 and type 2 domains, and a coiled-coil region, as well as a C-terminal plant-homeodomain (PHD)-bromodomain. The bromodomain serves as a 'reader' of epigenetic histone marks, regulating chromatin structure and gene expression by linking associated proteins to acetylated nucleosomal targets, thereby controlling transcription of genes. Notably, bromodomains have emerged as compelling targets for cancer therapeutic development. In addition, TRIM24 plays specialized roles as a signal transduction molecule, orchestrating various cellular signaling cascades in cancer cells. Herein, we review the recent advancements in understanding the functions of TRIM24, and demonstrate the research progress in utilizing TRIM24 as a target for cancer therapy.

Preparation of multi-modified/carbonized/gelatinized starch and its de-risking effect on Cd(II) and hymexazol in wastewater.

In this study, starch (S) was gelatinized and carbonized to prepare carbonized/gelatinized S (CGS) as the research material. Then, peat extract (Pe) and surfactants with different ratios were single- and multi-modified on CGS, respectively, to prepare Pe-modified CGS (Pe-CGS) and multi-modified CGS, respectively. The microscopic morphology of multi-modified CGS was studied using various testing methods. The de-risking effect on Cd(II) and hymexazol in wastewater was investigated, and the effects of temperature, pH, and ionic strength were compared. The spheroidal structure of S was destroyed after carbonization, and Pe and surfactants were modified on the surface and changed the surface properties of CGS. The adsorption processes of Cd(II) and hymexazol were suitable to be described by the Langmuir and Freundlich models, respectively. The maximum adsorption capacities (qm) of Cd(II) and adsorption capacity parameter (k) of hymexazol on different modified CGSs presented the peak value at BS/Pe-CGS. With the increase in the modification ratio of Pe, BS, and SDS, qm and k increased, which showed a high value at 100 % modification. Increases in temperature and pH were beneficial to Cd(II) adsorption but were not conducive to hymexazol adsorption. The adsorption amount decreased for Cd(II) and increased first and then reduced for hymexazol with the rise in ionic strength. The adsorption process exhibited spontaneity, endothermic behavior for Cd(II), exothermic behavior for hymexazol, and an entropy-increasing reaction. The adsorption amount of Cd(II) and hymexazol by multi-modified CGS maintained approximately 81 % of the original sample after three rounds of regeneration.

Genome-Wide Analyses of MADS-Box Genes Reveal Their Involvement in Seed Development and Oil Accumulation of Tea-Oil Tree (Camellia oleifera).

The seeds of Camellia oleifera produce high amount of oil, which can be broadly used in the fields of food, industry, and medicine. However, the molecular regulation mechanisms of seed development and oil accumulation in C. oleifera are unclear. In this study, evolutionary and expression analyses of the MADS-box gene family were performed across the C. oleifera genome for the first time. A total of 86 MADS-box genes (ColMADS) were identified, including 60 M-type and 26 MIKC members. More gene duplication events occurred in M-type subfamily (6) than that in MIKC subfamily (2), and SEP-like genes were lost from the MIKCC clade. Furthermore, 8, 15, and 17 differentially expressed ColMADS genes (DEGs) were detected between three developmental stages of seed (S1/S2, S2/S3, and S1/S3), respectively. Among these DEGs, the STK-like ColMADS12 and TT16-like ColMADS17 were highly expressed during the seed formation (S1 and S2), agreeing with their predicted functions to positively regulate the seed organogenesis and oil accumulation. While ColMADS57 and ColMADS07 showed increasing expression level with the seed maturation (S2 and S3), conforming to their potential roles in promoting the seed ripening. In all, these results revealed a critical role of MADS-box genes in the C. oleifera seed development and oil accumulation, which will contribute to the future molecular breeding of C. oleifera.

Screening Strategy Identifies an Overlooked Deep-Ultraviolet Transparent Nonlinear Optical Crystal.

In the deep-ultraviolet (DUV) region, nonlinear optical (NLO) crystals must meet stringent requirements, including a large optical band gap and sufficient second harmonic generation (SHG) response. Typically, these criteria are fulfilled by borates, carbonates and nitrates containing π-conjugated groups. In contrast, sulfates and phosphates, with polarizabilities significantly smaller than those of π-conjugated groups, struggle to achieve similar performance. Here, we present the discovery of Mg2PO4Cl, a magnesium-based phosphate, identified from over 10,000 phosphates based on a polar-axial-symmetry screening strategy, which exhibits the highest SHG response (5.2 × KH2PO4 (KDP)) with phase-matching ability among non-π-conjugated DUV transparent NLO crystals. This compound belongs to the Pna21 space group, with [PO4] units consistently aligned along the 21 screw axis and glide planes throughout its crystal structure. Theoretical calculations attribute its remarkable SHG effect to the orderly arrangement of heteroanionic [MgO5Cl] and [MgO4Cl2] polyhedra alongside isolated [PO4] tetrahedra, supported by Berry phase analysis. Furthermore, a crystallographic structure analysis of phosphates and sulfates with significant SHG effects validates the effectiveness of our screening strategy. These findings offer valuable insights into the origins of NLO effects in non-π-conjugated compounds from both a material design and structural chemistry perspective, inspiring future efforts to revitalize DUV phosphates.

Development and IND-enabling studies of a novel Cas9 genome-edited autologous CD34+ cell therapy to induce fetal hemoglobin for sickle cell disease.

Sickle cell disease (SCD) is a common, severe genetic blood disorder. Current pharmacotherapies are partially effective and allogeneic hematopoietic stem cell transplantation (HSCT) is associated with immune toxicities. Genome editing of patient hematopoietic stem cells (HSCs) to reactivate fetal hemoglobin (HbF) in erythroid progeny offers an alternative potentially curative approach to treat SCD. Although the FDA released guidelines for evaluating genome editing risks, it remains unclear how best to approach pre-clinical assessment of genome-edited cell products. Here we describe rigorous pre-clinical development of a therapeutic γ-globin gene promoter editing strategy that supported an investigational new drug (IND) application cleared by the FDA. We compared γ-globin promoter and BCL11A enhancer targets, identified a potent HbF-inducing lead candidate, and tested our approach in mobilized CD34+ HSPCs from SCD patients. We observed efficient editing, HbF induction to predicted therapeutic levels, and reduced sickling. With single-cell analyses, we defined the heterogeneity of HbF induction and HBG1/HBG2 transcription. With CHANGE-seq for sensitive and unbiased off-target discovery followed by targeted sequencing, we did not detect off-target activity in edited HSPCs. Our study provides a blueprint for translating new ex vivo HSC genome editing strategies towards clinical trials for treating SCD and other blood disorders.

Ergonomics of Various Modalities for Ear Surgery.

Objective: Evaluate ergonomic differences of various modalities for performing middle ear surgery. Study Design: Observational study. Setting: Two academic tertiary care centers. Methods: Attending physicians and residents performing middle ear surgery were photographed intraoperatively. Intraoperative photographs were analyzed using the validated Rapid Upper Limb Assessment (RULA) tool to measure musculoskeletal disease (MSD) risk. Descriptive statistics and significance testing were used to characterize and compare ergonomic differences between surgical modalities. Multivariable ordinal regression was performed to assess factors associated with increased MSD risk, as determined by the final RULA score. Results: Most of our 110 intraoperative photos featured attendings (82.7%) performing combined middle ear surgery and mastoidectomy (60.0%). Body angles and the final RULA score varied significantly among modalities. On subset analysis, microscopic surgery exhibited significantly worse wrist, trunk, and neck angles compared to endoscopic and exoscopic surgery. Exoscopic surgery had significantly lower final RULA scores than both endoscopic and microscopic surgery, indicating significantly lower MSD risk. Microscopic and endoscopic surgery final scores did not vary significantly. In a multivariable ordinal regression of factors associated with increased RULA score, exoscopic surgery had statistically significantly less ergonomic risk relative to microscopic surgery (odds ratio = 0.12, 95% confidence interval = [0.03-0.43]). Conclusion: Exoscopic, endoscopic, and microscopic surgery all featured low ergonomic risk, although exoscopic middle ear surgery demonstrated the lowest risk profile among studied surgical modalities. This demonstrates the importance of using each modality in combination with other ergonomic interventions to provide meaningful musculoskeletal benefits.

AgriGAN: unpaired image dehazing via a cycle-consistent generative adversarial network for the agricultural plant phenotype.

Artificially extracted agricultural phenotype information exhibits high subjectivity and low accuracy, while the utilization of image extraction information is susceptible to interference from haze. Furthermore, the effectiveness of the agricultural image dehazing method used for extracting such information is limited due to unclear texture details and color representation in the images. To address these limitations, we propose AgriGAN (unpaired image dehazing via a cycle-consistent generative adversarial network) for enhancing the dehazing performance in agricultural plant phenotyping. The algorithm incorporates an atmospheric scattering model to improve the discriminator model and employs a whole-detail consistent discrimination approach to enhance discriminator efficiency, thereby accelerating convergence towards Nash equilibrium state within the adversarial network. Finally, by training with network adversarial loss + cycle consistent loss, clear images are obtained after dehazing process. Experimental evaluations and comparative analysis were conducted to assess this algorithm's performance, demonstrating improved accuracy in dehazing agricultural images while preserving detailed texture information and mitigating color deviation issues.

Assessing Transition Pathways of Hydrogen Production in China with a Probabilistic Framework.

The transition of China's hydrogen production system to meeting carbon neutrality is considerably uncertain. This study uses a probabilistic framework to assess the transition pathways of hydrogen production in China to meet the goal of carbon neutrality and reveals the key technology selection mechanism. Three strategies for hydrogen production transition were considered: delayed, orderly, and radical, corresponding to the green hydrogen shares between 70 and 95% in 2060. More ambitious strategies tended to result in greater uncertainty of green hydrogen production and introduce higher system costs and cost uncertainty. The different strategies showed notable differences in carbon dioxide (CO2) reduction pathways. The cumulative CO2 emissions of the delayed strategy may reach 3 times that of the radical strategy, and the CO2 reduction uncertainty of the orderly strategy may be twice that of the other strategies. Alkaline electrolyzers were predicted to dominate green hydrogen production until being surpassed by proton exchange membrane electrolyzers (PEM) after 2060. The synergy of the solar-energy storage-PEM technology combination was notable because expensive electrolyzers tended to increase utilization, thereby diluting fixed costs. Our results underscore the importance of studying the impact of uncertainty and technology selection mechanisms on transition pathways.

Divergence of Phyllosphere Microbial Community Assemblies and Components of Volatile Organic Compounds between the Invasive Sphagneticola trilobata, the Native Sphagneticola calendulacea and Their Hybrids, and Its Implications for Invasiveness.

Closely-related plant groups with distinct microbiomes, chemistries and ecological characteristics represent tractable models to explore mechanisms shaping species spread, competitive dynamics and community assembly at the interface of native and introduced ranges. We investigated phyllosphere microbial communities, volatile organic compound (VOC) compositions, and potential interactions among introduced S. trilobata, native S. calendulacea and their hybrid in South China. S. trilobata exhibited higher α diversity but significantly different community composition compared to the native and hybrid groups. However, S. calendulacea and the hybrid shared certain microbial taxa, suggesting potential gene flow or co-existence. The potent antimicrobial VOC profile of S. trilobata, including unique compounds like p-cymene (13.33%), likely contributes to its invasion success. The hybrid's intermediate microbial and VOC profiles suggest possible consequences for species distribution, genetic exchange, and community assembly in heterogeneous environments. This hybrid deserves further study as both an opportunity for and threat to diversity maintenance. These differentiating yet connected plant groups provide insight into ecological and evolutionary dynamics shaping microbiome structure, species co-occurrence and competitive outcomes during biological exchange and habitat transformation. An interdisciplinary approach combining chemical and microbial ecology may reveal mechanisms underlying community stability and change, informing management of species spread in a globalized world.

MXene Supported Surface Plasmon Polaritons for Optical Microfiber Ammonia Sensing.

The properties of surface plasmons are notoriously dependent on the supporting materials system. However, new capabilities cannot be obtained until the technique of surface plasmon enabled by advanced two-dimensional materials is well understood. Herein, we present the experimental demonstration of surface plasmon polaritons (SPPs) supported by single-layered MXene flakes (Ti3C2Tx) coating on an optical microfiber and its application as an ammonia gas sensor. Enabled by its high controllability of chemical composition, unique atomistically thin layered structure, and metallic-level conductivity, MXene is capable of supporting not only plasmon resonances across a wide range of wavelengths but also a selective sensing mechanism through frequency modulation. Theoretical modeling and optics experiments reveal that, upon adsorbing ammonia molecules, the free electron motion at the interface between the SiO2 microfiber and the MXene coating is modulated (i.e., the modulation of the SPPs under applied light), thus inducing a variation in the evanescent field. Consequently, a wavelength shift is produced, effectively realizing a selective and highly sensitive ammonia sensor with a 100 ppm detection limit. The MXene supported SPPs open a promising path for the application of advanced optical techniques toward gas and chemical analysis.

New geographical records and molecular investigation of the ciliate Spirostomum.

Spirostomum is a genus of large ciliates, and its species are distributed worldwide. However, there has been limited research conducted on their geographical distribution and genomics. We obtained nine samples of ciliates from eight regions in Liaoning Province, China, and conducted a study on their geographical distribution and characteristics. Morphological and second-generation high-throughput sequencing methods were applied to identify the species, and a phylogenetic tree was established to gain a deeper understanding of the geographical distribution and evolutionary relationships of Spirostomum in Northeast China. The results identified Spirostomum yagiui and Spirostomum subtilis as a newly recorded species in Northeast China region. There are now five species of Spirostomum that have been recorded in China, and new details on the genomic characteristics of Spirostomum yagiui were provided. In addition, this study also identified the main branches of Spirostomum teres and Spirostomum minus in northern China, and provided a theoretical basis for the existence of hidden species. Spirostomum yagiui is the first species in the family Spirostomidae to have undergone mitochondrial genome sequencing.

Quantification and forecast of GHG emissions from municipal solid wastes by multi-expression programming method.

The municipal solid waste (MSW) management is significantly contributing to global greenhouse gas (GHG) emissions. Analyzing the emission pattern of GHGs from MSW is essential for formulating appropriate carbon mitigation policies. Based on IPCC Models, GHG emissions from MSW were calculated in Chinese provinces from 2004 to 2021 by landfilling and incineration operations, separately. Landfilling and incineration generated approximately 1271 MtCO2-eq and 198 MtCO2-eq from 2004 to 2021, respectively. GHG emissions from landfilling increased from 2004 to 2020 and declined in 2021, while GHG emissions from incineration demonstrated an increasing trend with three distinct growth stages. A panel regression model was then employed to identify the key factors influencing GHG emissions. GDP and population are positively related to GHG emissions from landfills, while PCCE is negatively related to GHG emissions from landfills. GDP and PCCE have a positive impact on GHG emissions from incineration, while population showed no significant impact. Multi-expression programming was used to develop an explicit model, forecasting GHG emissions from MSW by 2030. From 2022 to 2024, GHG emissions from landfills will quickly decrease, while GHG emissions from incineration will rapidly increase. Subsequently, the GHG emission rate of incineration will slow down, and GHGs from landfilling will slowly decrease due to no MSW for landfill disposal. The methods and results provide insightful information for policy-makers and waste management sector.

Research trends in lipid-lowering therapies for coronary heart disease combined with hyperlipidemia: a bibliometric study and visual analysis.

Background: Cardiovascular disease (CVD) poses a significant global health and economic challenge, with atherosclerosis being a primary cause. Over the past 40 years, substantial research has been conducted into the prevention and reversal of atherosclerosis, resulting in the development of lipid-lowering agents such as statins and fibrates. Despite the extensive literature and formulation of numerous therapeutic guidelines in this domain, a comprehensive bibliometric analysis of the current research landscape and trends has not been performed. This study aimed to elucidate the evolution and milestones of research into lipid-lowering treatments for coronary heart disease (CHD) in conjunction with hyperlipidemia through bibliometric analysis, offering insights into future directions for treatment strategies. Methods: This study examined publications from 1986 to 2023 retrieved from the Web of Science database (Core Collection). Utilizing tools such as VOSviewer, Pajek, and CiteSpace, we analyzed publication and citation numbers, H-indexes, contributions by countries and institutions, authorship, journal sources, and keyword usage to uncover research trajectories and areas of focus. Results: Our analysis of 587 publications revealed a recent surge in research output, particularly post-2003. The American Journal of Cardiology published the highest number of studies, with 40 articles, whereas Circulation received the highest number of citations (6,266). Key contributors included the United States, Japan, and China, with the United States leading in citation numbers and the H-index. Harvard University and Leiden University emerged as pivotal institutions, and Professors J. Wouter Jukema and Robert P. Giugliano were identified as leading experts. Keyword analysis disclosed five thematic clusters, indicating a shift in research towards new drug combinations and strategies, signaling future research directions. Conclusion: The last 4 decades have seen a notable rise in publications on lipid-lowering therapies for CHD and hyperlipidemia, with the United States retaining world-leading status. The increase in international collaboration aids the shift towards research into innovative lipid-lowering agents and therapeutic approaches. PCSK9 inhibitors and innovative combination therapies, including antisense oligonucleotides and angiopoietin-like protein 3 inhibitors, provide avenues for future research, intending to maximize the safety and efficacy of treatment approaches.

Correlation of fluid-attenuated inversion recovery sequence vascular hyperintensity in magnetic resonance with collateral circulation and short-term clinical prognosis in acute ischemic stroke.

Background: Accurately assessing the prognosis of patient with large-scale cerebral infarction caused by acute middle cerebral artery (MCA) occlusion in the early stages of onset can help clinicians to actively and effectively intervene, thus reducing mortality and disability rates. This study set out to investigate the predictive value of fluid-attenuated inversion recovery vascular hyperintensity (FVH) on collateral circulation and clinical prognosis. Methods: The clinical data of 70 patients admitted to The First People's Hospital of Lianyungang from January 2018 to December 2021 with acute cerebral infarction due to occlusion of the proximal end of the M1 segment in the MCA were retrospectively collected. All patients had their first onset of disease and did not receive thrombolytic therapy at the time of onset. Subsequently, they underwent endovascular thrombectomy for treatment. The FVH and collateral vessel scores were derived according to patients' fluid-attenuated in version recovery (FLAIR) sequence and time-of-flight magnetic resonance angiography images. Based on the 90-day Modified Rankin Scale (mRS), patients were allocated to a good prognosis group (mRS ≤2) and a poor prognosis group (mRS =3-6). The correlation between the FVH and collateral vessel scores was assessed using the Spearman rank correlation test. Pearson correlation coefficient analysis was used to assess the correlation between FVH and the 90-day mRS together with the infarct size. Univariate analysis, multivariate binary logistic regression analysis, and receiver operating characteristic (ROC) curve analysis were adopted to identify those factors potentially. associated with the prognosis of patients with acute ischemic stroke (AIS). Results: Out of 70 patients with acute unilateral MCA occlusion (MCAO) who met the inclusion criteria, 62 showed positive FVH sign. These 62 patients were divided into a good prognosis group (n=32) and a poor prognosis group (n=30) based on the mRS score 90 days after discharge. The Spearman rank correlation test indicated that FVH was positively correlated with collateral vessel grade (Spearman rho =0.865; P<0.001); meanwhile, Pearson correlation coefficient analysis indicated that FVH score had moderate negative correlation with 90-day mRS score (r=-0.605; P<0.001). The results of multivariate binary logistic regression analysis indicated that collateral vessel grade and FVH score may be associated with the prognosis of patients with AIS, and the area under the curve (AUC) of FVH score was larger than collateral vessel grade (AUC =0.738). Conclusions: There was a positive correlation between FVH score and collateral vessel grade, and FVH score could indicate collateral circulation. FVH score was negatively correlated with 90-day mRS score and infarct volume and thus can predict clinical prognosis.

The physicochemical interacting mechanisms and real-time spectral induced polarization monitoring of lead remediation by an aeolian soil.

Compared to traditional lead-remediating materials, natural-occurring paleosol is ubiquitous and could be a promising alternative due to its rich content in calcite, a substance known for its lead-removal ability via carbonate dissolution-PbCO3 precipitation process. Yet, the capability of paleosol to remediate aqueous solutions polluted with heavy metals, lead included, has rarely been assessed. To fill this gap, a series of column permeation experiments with influent Pb2+ concentrations of 2000, 200, and 20 mg/L were conducted and monitored by the spectral induced polarization technique. Meanwhile, the SEM-EDS, XRD, XPS, FTIR and MIP tests were carried out to unveil the underlying remediation mechanisms. The Pb-retention capacity of paleosol was 1.03 mmol/g. The increasing abundance of Pb in the newly-formed crystals was confirmed to be PbCO3 by XRD, SEM-EDS and XPS. Concurrently, after Pb2+ permeation, the decreasing calcite content in paleosol sample from XRD test, and the appearance of Ca2+ in the effluent confirmed that the dissolution of CaCO3 followed by the precipitation of PbCO3 was the major mechanism. The accumulated Pb (i.e., the diminished Ca) in paleosol was inversely proportional (R2 >0.82) to the normalized chargeability (mn), an SIP parameter denoting the quantity of polarizable units (primarily calcite).

PCSK9 Inhibitor Added to High-Intensity Statin Therapy to Prevent Cardiovascular Events in Patients with Acute Coronary Syndrome after Percutaneous Coronary Intervention: A Randomized, Double- Blind, Placebo-Controlled, Multicenter SHAWN Study.

BACKGROUND: It is currently uncertain whether the combination of a proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitor and high-intensity statin treatment can effectively reduce cardiovascular events in patients with acute coronary syndrome (ACS) who have undergone percutaneous coronary intervention (PCI) for culprit lesions. METHODS: This study protocol describes a double-blind, randomized, placebo-controlled, multicenter study aiming to investigate the efficacy and safety of combining a PCSK9 inhibitor with high-intensity statin therapy in patients with ACS following PCI. A total of 1212 patients with ACS and multiple lesions will be enrolled and randomly assigned to receive either PCSK9 inhibitor plus high-intensity statin therapy or high-intensity statin monotherapy. The randomization process will be stratified by sites, diabetes, initial presentation and use of stable (≥4 weeks) statin treatment at presentation. PCSK 9 inhibitor or its placebo is injected within 4 hours after PCI for the culprit lesion. The primary endpoint is the composite of cardiovascular death, myocardial infarction, stroke, re-hospitalization due to ACS or heart failure, or any ischemia-driven coronary revascularization at one-year follow-up between two groups. Safety endpoints mean PCSK 9 inhibitor and statin intolerance. CONCLUSION: The SHAWN study has been specifically designed to evaluate the effectiveness and safety of adding a PCSK9 inhibitor to high-intensity statin therapy in patients who have experienced ACS following PCI. The primary objective of this study is to generate new evidence regarding the potential benefits of combining a PCSK9 inhibitor with high-intensity statin treatment in reducing cardiovascular events among these patients.

Bioinspired Nanolayered Structure Tuned by Extensional Stress: A Scalable Way to High-Performance Biodegradable Polyesters.

The nacre-inspired multi-nanolayer structure offers a unique combination of advanced mechanical properties, such as strength and crack tolerance, making them highly versatile for various applications. Nevertheless, a significant challenge lies in the current fabrication methods, which is difficult to create a scalable manufacturing process with precise control of hierarchical structure. In this work, a novel strategy is presented to regulate nacre-like multi-nanolayer films with the balance mechanical properties of stiffness and toughness. By utilizing a co-continuous phase structure and an extensional stress field, the hierarchical nanolayers is successfully constructed with tunable sizes using a scalable processing technique. This strategic modification allows the robust phase to function as nacre-like platelets, while the soft phase acts as a ductile connection layer, resulting in exceptional comprehensive properties. The nanolayer-structured films demonstrate excellent isotropic properties, including a tensile strength of 113.5 MPa in the machine direction and 106.3 MPa in a transverse direction. More interestingly, these films unprecedentedly exhibit a remarkable puncture resistance at the same time, up to 324.8 N mm-1, surpassing the performance of other biodegradable films. The scalable fabrication strategy holds significant promise in designing advanced bioinspired materials for diverse applications.