Associations between 25 hydroxyvitamin D concentration and spontaneous abortion.

BACKGROUND: Spontaneous abortion is a common complication of pregnancy that can lead to adverse physical and psychological outcomes for women. Vitamin D is reported to be associated with reproductive functions, whereas its casual effects on abortion remains unclear. MATERIALS AND METHODS: In this study, a two-sample Mendelian randomization (MR) analysis was performed to systematically assess the causal relationships between serum 25 hydroxyvitamin D [25(OH)D] concentration and the risk of spontaneous abortion. GWAS summary data of 25(OH)D were used as exposure, and data of spontaneous abortion was considered as outcome. A retrospective study was additionally conducted to verify the MR results. RESULTS: MR estimates showed that a higher 25(OH)D level was potentially associated with decreased risk of spontaneous abortion (IVW, OR = 0.98, 95%CI = 0.90-1.06; MR Egger, OR = 0.94, 95%CI = 0.84-1.05; Weighted median, OR = 0.93, 95%CI = 0.82-1.06; Weighted mode, OR = 0.93, 95%CI = 0.84-1.03), though the P-value was not statistically significant. The retrospective study also produced consistent result of Vitamin D's protective role to spontaneous abortion. The P-value was very close to statistical significance (P = 0.053). CONCLUSIONS: This study reports the potential protective role of serum 25(OH)D concentration to spontaneous abortion, suggesting that increased vitamin D levels may decrease the risk of abortion. Further larger prospective studies and/or even randomized controlled trials are needed to confirm causal relationship between vitamin D and abortion.

People-centered Primary Care Measures (PCPCM) and health equity: a perspective of urban-rural comparison in Beijing, China.

BACKGROUND: Person-centered primary care measures (PCPCM) facilitate high-quality and culturally appropriate primary care. Access to PCPCM remains unequal between rural and urban areas, and the available evidence on rural PCPCM is still lacking. METHODS: A cross-sectional survey was conducted with stratified sampling by regions, and four districts (Xicheng, Fengtai, Huairou, and Daxing) in Beijing were selected to test the performance of PCPCM in both urban and rural areas. Descriptive statistical methods were used to compare the urban-rural differences in the demographic characteristics of PCPCM. Correlation and regression analyses were performed to determine the associations between PCPCM in demographics and utilization of primary care. RESULTS: The PCPCM showed good reliability and validity in both urban and rural areas (P< 0.001), slightly lower in rural areas, but scores of rural PCPCM (R-PCPCM) in all items were lower than urban PCPCM (U-PCPCM). The PCPCM score for preferring CHCs (U-PCPCM=3.31) or RHCs (R-PCPCM=3.10) was the highest. Patients in urban areas were more likely to receive higher-quality primary care than in rural areas (P < 0.001). Patients who preferred hospitals (ß=2.61, p<0.001) or CHCs (ß=0.71, p=0.003) as providers was a significant positive predictor of U-PCPCM, but it was the preference for hospitals (ß=2.95, p<0.001) for R-PCPCM. CONCLUSIONS: Urban-rural differences existed in the performance of PCPCM, with rural areas typically more difficult to access better PCPCM. To promote health equity in rural areas, healthcare providers should strive to minimize urban-rural differences in the quality and utilization of primary care services as much as feasible.

Diabetes specialist nurses' knowledge, skills, and personal attributes for providing competent health education practice, and its influencing factors: A cross-sectional survey.

BACKGROUND: The number of diabetes specialist nurse as well as their knowledge and skills have increased in Gansu Province since 2017. However, China has not fully addressed how to improve their professional skills to deliver effective health education. AIMS: To investigate the knowledge, skills, and personal attributes of competent health education practices among diabetes specialist nurses in Gansu Province, western China, and the potential influencing factors. DESIGN: Cross-sectional study. METHODS: In total, 178 diabetes specialist nurses from 45 hospitals participated in this study. Data were collected between December 2022 and April 2023 using the Nurse Health Education Competence Instrument (I-CepSE) and a self-report questionnaire. Descriptive and inferential statistics, including univariate and multiple linear regression analyses, were used to analyze data. RESULTS: The mean scores of overall I-CepSE, knowledge, skills, and personal attributes were 218.77 ± 31.65, 77.80 ± 18.27, 103.95 ± 13.75 and 37.02 ± 4.73, respectively. A shortage of nursing staff and heavy workload (81.4 %), lack of cooperation from patients (56.5 %), lack of access to educational resources during work placement (54.2 %), and nurses' lack of knowledge/skills in health education (53.1 %) were common barriers to health education implementation. The regression models for the overall health education competence domain were significant (P < 0.001) with R2 values ranging from 31.9 % to 50.5 %. Education level and years of experience in diabetes-related care were found to be significant on all knowledge, skills, and personal attitude scales (P < 0.05), and age was associated with diabetes specialist nurses' skills and personal attitude scores (P < 0.05). CONCLUSION: Diabetes specialist nurses demonstrated moderate to high levels of health education knowledge, skills, and attitudes. However, they lacked knowledge of pedagogical techniques and resources, with inadequate educational skills. This study suggests that reasonable nursing human resource allocation and continuous education and training are crucial for improving health education competence.

Multifunctional Lithium Phytate/Carbon Nanotube Double-Layer-Modified Separators for High-Performance Lithium-Sulfur Batteries.

Li dendrite and the shuttle effect are the two primary hindrances to the commercial application of lithium-sulfur batteries (LSBs). Here, a multifunctional separator has been fabricated via successively coating carbon nanotubes (CNTs) and lithium phytate (LP) onto a commercial polypropylene (PP) separator to improve the performance of LSBs. The LP coating layer with abundant electronegative phosphate group as permselective ion sieve not only reduces the polysulfide shuttle but also facilitates uniform Li+ flux through the PP separator. And the highly conductive CNTs on the second layer act as a second collector to accelerate the reversible conversion of sulfide species. The synergistic effect of LP and CNTs further increases the electrolyte wettability and reaction kinetics of cells with a modified separator and suppresses the shuttle effect and growth of Li dendrite. Consequently, the LSBs present much enhanced rate performance and cyclic performance. It is expected that this study may generate an executable tactic for interface engineering of separator to accelerate the industrial application process of LSBs.

The chemokine CCL14 is a potential biomarker associated with immune cell infiltration in lung adenocarcinoma.

BACKGROUND: Chemokine ligand 14, which has a C-C motif (CCL14), mediates the immunological milieu around tumors. However, its role in the progression of lung adenocarcinoma (LUAD) is still unknown. Our objectives were to study the association between CCL14 and tumor-infiltrating immune cells (TIICs) as well as the predictive significance of CCL14 in LUAD. METHODS: The expression of CCL14 in LUAD was examined by using the Oncomine, The Cancer Genome Atlas (TCGA), The University of Alabama at Birmingham CANcer data analysis Portal (UALCAN), and Human Protein Atlas databases. To determine the prognostic significance of CCL14 in LUAD, researchers used the Kaplan‒Meier plotter and Gene Expression Profiling Interactive Analysis (GEPIA, version 2). We utilized TIMER and GEPIA2 to investigate the connection between CCL14 and TIICs. Gene set enrichment analysis (GSEA) was used to test for functional enrichment of genes. We used RT‒qPCR to measure CCL14 expression and Cell Counting Kit-8, Transwell, and wound healing assays to investigate the biological role of CCL14. RESULTS: The prognosis of patients with LUAD was worse when CCL14 expression was low. Statistical analysis revealed that CCL14 mRNA expression was significantly greater in lung epithelial cells than in LUAD cell lines in vitro. Enhancing CCL14 expression reduced cell migration, invasion, and proliferation. The results of the immune infiltration research showed that CCL14 and TIICs were positively correlated. Different immune infiltration patterns associated with CCL14 were also shown by TIIC markers. According to GSEA, histone deacetylases, G2/M checkpoints, and Notch signaling pathways were associated with low CCL14 expression. CONCLUSIONS: CCL14 is anticipated to emerge as a prognostic marker and therapeutic target for LUAD due to its role in regulating TIICs, suggesting that it may be an antioncogene.

Advanced nitrogen removal of sulfur-driven autotrophic denitrification from landfill leachate after partial nitrification and denitrification pretreatment.

Sulfur-driven autotrophic denitrification (S0dAD) was employed to remove residual nitrogen from the biological effluent of landfill leachate after partial nitrification and denitrification pretreatment. The performance of S0dAD were assessed with various NOx--N (NO2--N and NO3--N) loadings over a 185-day operational period. The results demonstrated that a notable NOx--N removal efficiency of 97.8 ± 2.0% was achieved under nitrogen removal rates of 0.12 ± 0.02 kg N/(m3· d), leading to total nitrogen concentrations of 8.6 ± 3.8 mg/L in the effluent. Batch experiments revealed competitive utilization of nitrogenous electron acceptors, with NO2--N demonstrating 2-4 times higher denitrification rates than NO3--N under coexistence conditions. Genus-level microbial community identified that Thiobacillus and Sulfurovum was highly enriched with as key denitrifying bacteria in the S0dAD system. These findings provide insights for advanced nitrogen removal coupling S0dAD with partial nitrification and denitrification process for landfill leachate treatment.

Efficacy of mesenchymal stem cells in treating tracheoesophageal fistula via the TLR4/NF-κb pathway in beagle macrophages.

Background: Tracheoesophageal fistula (TEF) remains a rare but significant clinical challenge, mainly due to the absence of established, effective treatment approaches. The current focus of therapeutic strategy is mainly on fistula closure. However, this approach often misses important factors, such as accelerating fistula contraction and fostering healing processes, which significantly increases the risk of disease recurrence. Methods: In order to investigate if Mesenchymal Stem Cells (MSCs) can enhance fistula repair, developed a TEF model in beagles. Dynamic changes in fistula diameter were monitored by endoscopy. Concurrently, we created a model of LPS-induced macrophage to replicate the inflammatory milieu typical in TEF. In addition, the effect of MSC supernatant on inflammation mitigation was evaluated. Furthermore, we looked at the role of TLR4/NF-κB pathway plays in the healing process. Results: Our research revealed that the local administration of MSCs significantly accelerated the fistula's healing process. This was demonstrated by a decline in TEF apoptosis and decrease in the production of pro-inflammatory cytokines. Furthermore, in vivo experiments demonstrated that the MSC supernatant was effective in suppressing pro-inflammatory cytokine expression and alleviating apoptosis in LPS-induced macrophages. These therapeutic effects were mainly caused by the suppression of TLR4/NF-κB pathway. Conclusion: According to this study, MSCs can significantly improve TEF recovery. They achieve this via modulating apoptosis and inflammatory responses, mainly by selectively inhibiting the TLR4/NF-κB pathway.

Development and Evaluation of a Retrieval-Augmented Large Language Model Framework for Ophthalmology.

Importance: Although augmenting large language models (LLMs) with knowledge bases may improve medical domain-specific performance, practical methods are needed for local implementation of LLMs that address privacy concerns and enhance accessibility for health care professionals. Objective: To develop an accurate, cost-effective local implementation of an LLM to mitigate privacy concerns and support their practical deployment in health care settings. Design, Setting, and Participants: ChatZOC (Sun Yat-Sen University Zhongshan Ophthalmology Center), a retrieval-augmented LLM framework, was developed by enhancing a baseline LLM with a comprehensive ophthalmic dataset and evaluation framework (CODE), which includes over 30 000 pieces of ophthalmic knowledge. This LLM was benchmarked against 10 representative LLMs, including GPT-4 and GPT-3.5 Turbo (OpenAI), across 300 clinical questions in ophthalmology. The evaluation, involving a panel of medical experts and biomedical researchers, focused on accuracy, utility, and safety. A double-masked approach was used to try to minimize bias assessment across all models. The study used a comprehensive knowledge base derived from ophthalmic clinical practice, without directly involving clinical patients. Exposures: LLM response to clinical questions. Main Outcomes and Measures: Accuracy, utility, and safety of LLMs in responding to clinical questions. Results: The baseline model achieved a human ranking score of 0.48. The retrieval-augmented LLM had a score of 0.60, a difference of 0.12 (95% CI, 0.02-0.22; P = .02) from baseline and not different from GPT-4 with a score of 0.61 (difference = 0.01; 95% CI, -0.11 to 0.13; P = .89). For scientific consensus, the retrieval-augmented LLM was 84.0% compared with the baseline model of 46.5% (difference = 37.5%; 95% CI, 29.0%-46.0%; P < .001) and not different from GPT-4 with a value of 79.2% (difference = 4.8%; 95% CI, -0.3% to 10.0%; P = .06). Conclusions and Relevance: Results of this quality improvement study suggest that the integration of high-quality knowledge bases improved the LLM's performance in medical domains. This study highlights the transformative potential of augmented LLMs in clinical practice by providing reliable, safe, and practical clinical information. Further research is needed to explore the broader application of such frameworks in the real world.

Effect of dry- and moist-heat treatment processes on the structure, solubility, and in vitro digestion of macadamia protein isolate.

This study aimed to enhance the solubility and digestibility of macadamia protein isolate (MPI) for potential utilization in the food industry. The impact of dry- and moist-heat treatments at various temperatures (80, 90, and 100°C) and durations (15 and 30 min) on macadamia protein's microstructure, solubility, molecular weight, secondary and tertiary structure, thermal stability, and digestibility were investigated and evaluated. The heating degree was found to cause roughening of the MPI surface. The solubility of MPI after dry-heat treatment for 15 min at 100°C reached 290.96 ± 2.80% relative to that of untreated protein. Following heat treatment, the bands of protein macromolecules disappeared, while MPI was stretched by vibrations of free and hydrogen-bonded hydroxyl groups. Additionally, an increase in thermal stability was observed. After heat treatment, hydrophobic groups inside the protein are exposed. Heat treatment significantly improved the in vitro digestibility of MPI, reaching twice that of untreated protein. The results also demonstrated that dry- and moist-heat treatments have distinct impacts on MPI, while heating temperature and duration affect the degree of modification. With a decreased ordered structure and increased random coil content, the dry-heat treatment significantly enhanced the in vitro digestibility of MPI. The digestibility of MPI after dry-heat treatment for 30 min at 90°C increased by 77.82 ± 2.80% compared to untreated protein. Consequently, compared to moist-heat treatment, dry-heat treatment was more effective in modifying macadamia protein. Dry-heat treatment of 30 min at 90°C was determined as the optimal condition. PRACTICAL APPLICATION: Heat treatment enhances MPI characteristics, potentially advancing macadamia-derived food production, including plant-based beverages and protein supplements.

A double-blind pilot study of oral baricitinib in adult patients with lupus erythematosus panniculitis.

Lupus erythematosus panniculitis (LEP) is a chronic inflammatory skin disease with a significant impact on the overall well-being of patients. The safety and efficacy of oral baricitinib for the treatment of LEP have not been studied. This study aimed to explore the efficacy of oral baricitinib in patients with LEP who are recalcitrant or intolerant to conventional therapies. Patients (aged ≥18 years) with active LEP (with a revised cutaneous lupus erythematosus disease area and severity index [RCLASI]-active score ≥4] were randomly assigned 2:1 to baricitinib (4 mg) or placebo (once daily for 20 weeks). The placebo group was switched to baricitinib (4 mg) at week 13, and the final evaluation was conducted at week 24. The primary endpoint was the proportion of patients with an RCLASI-A score decreased by 20% at week 12. The secondary endpoints included the changes in the Cutaneous Lupus Erythematosus Disease Area and Severity Index active-(CLASI-A) score, the Dermatology Life Quality Index (DLQI), the Physician's Global Assessment (PGA) score, and safety. Five patients were enrolled. Three patients received baricitinib (4 mg), and two patients were treated with placebo. Two patients in the baricitinib treatment group showed a significant RCLASI-A decrease at week 12 and week 24. Two patients in the placebo group had no change in RCLASI-A at week 12 and a significant decrease at week 24. No new safety events were observed. Treatment with baricitinib was effective and well tolerated in patients with LEP.

Amelioration of Oxidative Stress in Rats with Chronic Obstructive Pulmonary Disease through Shenqi Huatan Decoction Activation of Peroxisome Proliferator-Activated Receptor Gamma-Mediated Activated Protein Kinase/Forkhead Transcription Factor O3a Signaling Pathway.

Background: Chronic obstructive pulmonary disease (COPD) is a common respiratory disease. Currently, no specific treatment strategy has been established; therefore, finding new treatment methods is essential. Clinically, Shenqi Huatan Decoction (SQHT) is a traditional Chinese medicinal formula for COPD treatment; however, its mechanism of action in treatment needs to be clarified. Methods: The COPD rat model was replicated by cigarette smoking and tracheal injection using the LPS method. The control group and the SQHT groups were treated with dexamethasone and SQHT by gavage, respectively. After treatment, superoxide dismutase (SOD) serum levels, total antioxidant capacity (TAOC), lipid peroxidation, and malondialdehyde (MDA) were detected by enzyme-linked immunosorbent assay (ELISA). Activated protein kinase alpha (AMPK-α), forkhead transcription factor O3a (FOXO3a), manganese SOD (MnSOD), and peroxisome proliferator-activated receptor gamma (PPARγ) were detected using reverse transcriptase quantitative polymerase chain reaction (RT-qPCR) and Western blot. Microribonucleic acid and protein expression levels were measured, and pathological changes in lung tissue were observed using hematoxylin and eosin staining. Results: The pathological findings suggested that SQHT substantially affects COPD treatment by enhancing alveolar fusion and reducing emphysema. ELISA results showed that SQHT could lower the blood levels of MDA and lipid peroxide and raise SOD and TAOC levels, suggesting that it could lessen oxidative stress. In the lung tissue of rats with COPD, large doses of SQHT intervention dramatically increased AMPK protein expression, AMPK-α, FOXO3a, MnSOD, and PPARγ, indicating that SQHT may reduce oxidative stress by activating the PPARγ-mediated AMPK/FOXO3a signaling pathway. Similar results were obtained using RT-qPCR. Conclusion: SQHT is effective for COPD treatment. The mechanism of action may be related to the activation of the PPARγ-mediated AMPK/FOXO3a signaling pathway to improve oxidative stress in lung tissue.

5-aminolevulinic acid photodynamic therapy inhibits the viability, invasion, and migration of cervical cancer SiHa cells by regulating the miR-152-3p/JAK1/STAT1 axis.

BACKGROUND: Cervical cancer ranks the fourth most prevalent type of cancer worldwide, characterized by a notably low survival rate, particularly in its metastatic stage. Despite 5-aminolevulinic acid photodynamic therapy (ALA-PDT) demonstrating potential anti-tumor effects against cervical cancer, the intricate mechanisms underlying its efficacy necessitate further investigation. Here, the study aims to elucidate the impact of ALA-PDT on the cancer cell viability, invasion and migration, alongside delineating the underlying molecular mechanisms. METHODS: Cervical cancer SiHa cells were subjected to ALA and red light irradiation, and we then measured the ALA-PDT's effects on cell functions using various assays. The potential interaction between miR-152-3p and JAK1 was explored through bioinformatics analyses and validated by dual-luciferase reporter assays. Post-transfection with miR-152-3p and JAK1 vectors, cellular functions were re-evaluated. The efficacy of ALA-PDT in tumor suppression was further investigated through tumor transplantation experiment in vivo. RESULTS: ALA-PDT markedly suppressed SiHa cell viability, invasion and migration, impacting critical markers of proliferation, apoptosis, and epithelial-mesenchymal transition(EMT). And these effects were echoed by the inhibition of miR-152-3p. JAK1 was identified as a direct target of miR-152-3p, and ALA-PDT was found to regulate the expression levels of miR-152-3p, consequently influencing the JAK1/STAT1 signaling pathway. Augmentation of miR-152-3p expression and inhibition of the JAK1/STAT1 pathway mitigated the anti-cancer effects of ALA-PDT, whereas JAK1 overexpression diminished these effects. In vivo analyses demonstrated that ALA-PDT suppressed tumor growth and modulated the miR-152-3p/JAK1/STAT1 pathway expression. CONCLUSIONS: ALA-PDT inhibits the viability, invasion, and migration of cervical cancer SiHa cells by modulating the miR-152-3p/JAK1/STAT1 axis, offering a promising therapeutic avenue for combating invasive cervical cancer.

The interplay among EFL teachers' emotional intelligence and self-efficacy and burnout.

Considering the essential role of teachers and their characteristics in language education, their emotions are the main focus of recent studies. Emotions such as burnout which usually happens due to stress, can hinder their career progress so it needs to be addressed as it affects both learners and teachers respectively. Another construct is self-efficacy which contemplates the teachers' confidence in their aptitudes and it may reduce the probability of burnout and prevent job stress. Also, Emotional intelligence (EI) is an eminent variable in this field that is a significant predictor of job performance. Therefore, this study attempted to address English as a foreign language (EFL) teachers' burnout by associating the effects of these factors such as EI and self-efficacy. Accordingly, 400 EFL teachers agreed to participate and were given three relevant questionnaires. Structural equation modeling (SEM) was utilized and the findings indicated that both teacher self-efficacy (ß = -0.123, p < .05) and emotional intelligence (ß = -0.14, p < .05) are significant predictors of burnout. The two variables jointly could explain 4.3 % of variances in teacher burnout. Teacher self-efficacy has a significant direct effect on burnout with standard estimate of -0.123 (p = .03). It also has a positive effect on emotional intelligence with standardized estimate of 0.245 (p = .000). Emotional intelligence, in turn, has a negative effect on burnout with standardized estimate of 0.14 (p = .16). The mediation analysis showed that the indirect effect of teacher self-efficacy is 0.034 (p = .017). Finally, some implications and recommendations for EFL stakeholders are presented.

Fc-null anti-CTLA-4 antibody: a novel strategy to facilitate cancer immunotherapy by ridding the colitis-inducing mishap.

Writing recently in Science, Lo and coworkers characterized a critical role of the gut microbiota in CTLA-4 blockade-induced colitis, revealing that an Fc domain deficient anti-CTLA-4 antibody can elicit antitumor responses effectively while avoiding the induction of colitis-like disease.1 This research opens up novel avenues for employing anti-CTLA-4 antibody therapy to circumvent the onset of colitis, which is often considered the Achilles' heel of what is arguably the most efficacious treatment for certain blood cancers and/or solid tumors.

[Ischemic stroke infarct segmentation model based on depthwise separable convolution for multimodal magnetic resonance imaging].

Magnetic resonance imaging (MRI) plays a crucial role in the diagnosis of ischemic stroke. Accurate segmentation of the infarct is of great significance for selecting intervention treatment methods and evaluating the prognosis of patients. To address the issue of poor segmentation accuracy of existing methods for multiscale stroke lesions, a novel encoder-decoder architecture network based on depthwise separable convolution is proposed. Firstly, this network replaces the convolutional layer modules of the U-Net with redesigned depthwise separable convolution modules. Secondly, an modified Atrous spatial pyramid pooling (MASPP) is introduced to enlarge the receptive field and enhance the extraction of multiscale features. Thirdly, an attention gate (AG) structure is incorporated at the skip connections of the network to further enhance the segmentation accuracy of multiscale targets. Finally, Experimental evaluations are conducted using the ischemic stroke lesion segmentation 2022 challenge (ISLES2022) dataset. The proposed algorithm in this paper achieves Dice similarity coefficient (DSC), Hausdorff distance (HD), sensitivity (SEN), and precision (PRE) scores of 0.816 5, 3.668 1, 0.889 2, and 0.894 6, respectively, outperforming other mainstream segmentation algorithms. The experimental results demonstrate that the method in this paper effectively improves the segmentation of infarct lesions, and is expected to provide a reliable support for clinical diagnosis and treatment.

Impact of age-related gut microbiota dysbiosis and reduced short-chain fatty acids on the autonomic nervous system and atrial fibrillation in rats.

Objective: Aging is the most significant contributor to the increasing prevalence of atrial fibrillation (AF). Dysbiosis of gut microbiota has been implicated in age-related diseases, but its role in AF development remains unclear. This study aimed to investigate the correlations between changes in the autonomic nervous system, short-chain fatty acids (SCFAs), and alterations in gut microbiota in aged rats with AF. Methods: Electrophysiological experiments were conducted to assess AF induction rates and heart rate variability in rats. 16S rRNA gene sequences extracted from fecal samples were used to assess the gut microbial composition. Gas and liquid chromatography-mass spectroscopy was used to identify SCFAs in fecal samples. Results: The study found that aged rats exhibited a higher incidence of AF and reduced heart rate variability compared to young rats. Omics research revealed disrupted gut microbiota in aged rats, specifically a decreased Firmicutes to Bacteroidetes ratio. Additionally, fecal SCFA levels were significantly lower in aged rats. Importantly, correlation analysis indicated a significant association between decreased SCFAs and declining heart rate variability in aged rats. Conclusions: These findings suggest that SCFAs, as metabolites of gut microbiota, may play a regulatory role in autonomic nervous function and potentially influence the onset and progression of AF in aged rats. These results provide novel insights into the involvement of SCFAs and autonomic nervous system function in the pathogenesis of AF. These results provide novel insights into the involvement of SCFAs and autonomic nervous system function in the pathogenesis of AF.

Establishing stable and highly osteogenic hiPSC-derived MSCs for 3D-printed bone graft through microenvironment modulation by CHIR99021-treated osteocytes.

Human induced pluripotent stem cell (hiPSC)-derived mesenchymal stem cells (iMSCs) are ideal candidates for the production of standardised and scalable bioengineered bone grafts. However, stable induction and osteogenic differentiation of iMSCs pose challenges in the industry. We developed a precise differentiation method to produce homogeneous and fully differentiated iMSCs. In this study, we established a standardised system to prepare iMSCs with increased osteogenic potential and improved bioactivity by introducing a CHIR99021 (C91)-treated osteogenic microenvironment (COOME). COOME enhances the osteogenic differentiation and mineralisation of iMSCs via canonical Wnt signalling. Global transcriptome analysis and co-culturing experiments indicated that COOME increased the pro-angiogenesis/neurogenesis activity of iMSCs. The superior osteogenic differentiation and mineralisation abilities of COOME-treated iMSCs were also confirmed in a Bio3D module generated using a polycaprolactone (PCL) and cell-integrated 3D printing (PCI3D) system, which is the closest model to in vivo research. This COOME-treated iMSCs differentiation system offers a new perspective for generating highly osteogenic, bioactive, and anatomically matched grafts for clinical applications. Statement of significance: Although human induced pluripotent stem cell-derived MSCs (iMSCs) are ideal seed cells for synthetic bone implants, the challenges of stable induction and osteogenic differentiation hinder their clinical application. This study established a standardised system for the scalable preparation of iMSCs with improved osteogenic potential by combining our precise iMSC differentiation method with the CHIR99021 (C91)-treated osteocyte osteogenic microenvironment (COOME) through the activation of canonical Wnt signalling. Moreover, COOME upregulated the pro-angiogenic and pro-neurogenic capacities of iMSCs, which are crucial for the integration of implanted bone grafts. The superior osteogenic ability of COOME-treated iMSCs was confirmed in Bio3D modules generated using PCL and cell-integrated 3D printing systems, highlighting their functional potential in vivo. This study contributes to tissue engineering by providing insights into the functional differentiation of iMSCs for bone regeneration.

Community-dwelling older adults' perspectives on health risks: a qualitative study exploring anxieties, priorities, and expectations in ageing.

BACKGROUND: With the conflict between the promise of ageing in health and longevity and the limited availability of health resources and social support, older adults in China inevitably experience anxieties surrounding health risks. This study aims to investigate how older adults perceive the health risks that come with getting older, explore the degree to which health risks affect older adults, and advocate for active engagement in practices for managing health risks. METHODS: Using purposive sampling, three districts of Beijing (Xicheng District, Fengtai District, and Daxing District, respectively) were selected for the research. Qualitative semi-structured and in-depth interviews were conducted with 70 community-dwelling older adults who participated in the study. Data were extracted and analyzed based on a thematic framework approach. RESULTS: Three main themes were identified: (i) the anxieties of older adults concerning health risks in ageing; (ii) the priorities of older adults for health risk management in ageing; (iii) the expectations of older adults for health risk management in ageing. The primary health concerns among older adults included disease incidence and function decline. It was found that basic health management emerged as a critical need for older adults to mitigate health risks. Moreover, it was observed that healthcare support for older adults from familial, institutional, and governmental levels exhibited varying degrees of inadequacy. CONCLUSIONS: The primary source of anxieties among older adults regarding health risks predominantly stems from a perceived sense of health deprivation. It is often compounded by persistent barriers to primary care of priorities in managing health risks among older adults. In addition, the expectations of older adults for health risk management emphasize the necessity for integrated care approaches. Therefore, further research should give priority to the prevention and management of health risks, aim to reduce anxieties, provide integrated care to meet the primary needs and expectations of older adults, and ultimately strive toward the overarching goal of promoting health and longevity.

Soft-in-Rigid Strategy Promoting Rapid and High-Capacity Lithium Storage by Chemical Scissoring.

Large and rapid lithium storage is hugely demanded for high-energy/power lithium-ion batteries; however, it is difficult to achieve these two indicators simultaneously. Sn-based materials with a (de)alloying mechanism show low working potential and high theoretical capacity, but the huge volume expansion and particle agglomeration of Sn restrict cyclic stability and rate capability. Herein, a soft-in-rigid concept was proposed and achieved by chemical scissoring where a soft Sn-S bond was chosen as chemical tailor to break the Ti-S bond to obtain a loose stacking structure of 1D chain-like Sn1.2Ti0.8S3. The in situ and ex situ (micro)structural characterizations demonstrate that the Sn-S bonds are reduced into Sn domains and such Sn disperses in the rigid Ti-S framework, thus relieving the volume expansion and particle agglomeration by chemical and physical shielding. Benefiting from the merits of large-capacity Sn with an alloying mechanism and high-rate TiS2 with an intercalation mechanism, the Sn1.2Ti0.8S3 anode offers a high specific capacity of 963.2 mA h g-1 at 0.1 A g-1 after 100 cycles and a reversible capacity of 250 mA h g-1 at 10 A g-1 after 3900 cycles. Such a strategy realized by chemical tailoring at the structural unit level would broaden the prospects for constructing joint high-capacity and high-rate LIB anodes.

Investigations on cavitation flow and vorticity transport in a jet pump cavitation reactor with variable area ratios.

Hydrodynamic cavitation (HC) has emerged as a promising technology for water disinfection. Interestingly, when subjected to specific cavitation pressures, jet pump cavitation reactors (JPCRs) exhibit effective water treatment capabilities. This study investigated the cavitation flow and vorticty transport in a JPCR with various area ratios by utilizing computational fluid dynamics. The results reveal that cavitation is more likely to occur within the JPCR as the area ratio becomes smaller. While as the area ratio decreases, the limit flow ratio also decreases, leading to a reduced operational range for the JPCR. During the cavitation inception stage, only a few bubbles with limited travel distances are generated at the throat inlet. A stable cavitation layer developed between the throat and downstream wall during the limited cavitation stage. In this phase, the primary flow carried the bubbles towards the outlet. In addition, it was found that the vortex stretching, compression expansion, and baroclinic torque terms primarily influence the vorticity transport equation in this context. This work may provide a reference value to the design of JPCRs for water treatment.