Effects of 4.9 GHz Radiofrequency Field Exposure on Brain Metabolomic and Proteomic Characterization in Mice.

Electromagnetic exposure has become increasingly widespread, and its biological effects have received extensive attention. The purpose of this study was to explore changes in the metabolism profile of the brain and serum and to identify differentially expressed proteins in the brain after exposure to the 4.9 GHz radiofrequency (RF) field. C57BL/6 mice were randomly divided into a Sham group and an RF group, which were sham-exposed and continuously exposed to a 4.9 RF field for 35 d, 1 h/d, at an average power density (PD) of 50 W/m2. After exposure, untargeted metabolomics and Tandem Mass Tags (TMT) quantitative proteomics were performed. We found 104 and 153 up- and down-regulated differentially expressed metabolites (DEMs) in the RF_Brain group and RF_Serum group, and the DEMs were significantly enriched in glycerophospholipid metabolism. Moreover, 10 up-regulated and 51 down-regulated differentially expressed proteins (DEPs) were discovered in the RF group. Functional correlation analysis showed that most DEMs and DEPs showed a significant correlation. These results suggested that 4.9 GHz exposure induced disturbance of metabolism in the brain and serum, and caused deregulation of proteins in the brain.

Causal Associations Between Sleep Traits and Low Grip Strength: A Bidirectional Mendelian Randomization Study.

Background: Sleep disorders and low grip strength often co-occur clinically and are geriatric symptoms that cause significant socioeconomic burden. Previous observational studies have found an association between sleep behaviors and grip strength, but the causal relationship remains unclear. Purpose: With the Mendelian randomization (MR) approach, the study aimed to determine the causal association between sleep traits (sleep duration, insomnia, daytime napping, sleep-wake disorders, chronotype) and low grip strength. Methods: The study used genetic variants from the genome-wide association study (GWAS) archived in UK Biobank and FinnGen. We assessed the potential causal relationship between sleep behaviors and grip strength using inverse variance weighting (IVW), weighted median (WM), and MR-Egger. Additionally, we performed sensitivity analyses using Cochran's Q test, MR Egger Intercept test, funnel plots, and leave-one-out method. Results: We found that sleep duration is causally negatively associated with low grip strength (OR = 0.618, 95% CI = 0.424-0.900, P = 0.012). Sleep-wake disorders have a positive association with low grip strength (OR = 1.018, 95% CI = 1.002-1.034, P = 0.029). Reversely, high low grip strength risk was causally associated with increased daytime napping (OR = 1.018, 95% CI = 1.004-1.032, P = 0.011). Conclusion: The study revealed causal associations between sleep duration, sleep-wake disorders, and low grip strength. Understanding their relationship helps in early clinical intervention to improve the life quality of the elderly.

Induced Necroptosis and Its Role in Cancer Immunotherapy.

Necroptosis is a type of regulated cell death (RCD) that is triggered by changes in the extracellular or intracellular milieu that are picked up by certain death receptors. Thanks to its potent capacity to induce immunological responses and overcome apoptotic resistance, it has garnered significant attention as a potential cancer treatment. Basic information for the creation of nano-biomedical treatments is provided by studies on the mechanisms underlying tumor necroptosis. Receptor-interacting protein kinase 1 (RIPK1)-RIPK3-mediated necroptosis, Toll-like receptor domain-containing adapter-inducing interferon (IFN)-ß (TRIF)-RIPK3-mediated necroptosis, Z-DNA-binding protein 1 (ZBP1)-RIPK3-mediated necroptosis, and IFNR-mediated necroptosis are the four signaling pathways that collectively account for triggered necroptosis in this review. Necroptosis has garnered significant interest as a possible cancer treatment strategy because, in contrast to apoptosis, it elicits immunological responses that are relevant to therapy. Thus, a thorough discussion is held on the connections between tumor cell necroptosis and the immune environment, cancer immunosurveillance, and cells such as dendritic cells (DCs), cytotoxic T cells, natural killer (NK) cells, natural killer T (NKT) cells, and their respective cytokines. Lastly, a summary of the most recent nanomedicines that cause necroptosis in order to cause immunogenic cell death is provided in order to emphasize their promise for cancer immunotherapy.

Infraclavicular versus supraclavicular nerve block for upper limb surgeries: A meta-analysis.

BACKGROUND: The impact of infraclavicular versus supraclavicular nerve block on the analgesia for upper limb surgeries is unclear. This meta-analysis and systematic review aims to study the analgesic efficacy of infraclavicular versus supraclavicular nerve block for upper limb surgeries. METHODS: We searched several databases including PubMed, EMbase, Web of science, EBSCO and Cochrane library databases from inception to December 2023, and randomized controlled trials (RCTs) assessing the effect of infraclavicular versus supraclavicular nerve block for upper limb surgeries were included. We excluded studies reporting other nerve block approaches. The methodological quality of the included studies was evaluated by the modified Jadad scale. Standard mean difference with 95% confidence interval (CI) was used to assess continuous outcomes. This meta-analysis was conducted by the fixed-effect model or random-effect model based on the heterogeneity. RESULTS: Eight RCTs and 725 patients were included in this meta-analysis. Compared with supraclavicular nerve block for upper limb surgeries, infraclavicular nerve block was able to significantly increase duration of motor block (SMD = 0.34; 95% CI = 0.12 to 0.56) and decrease readiness for surgery (SMD = -0.43; 95% CI = -0.77 to -0.10), but showed similar duration of sensory block (SMD = 0.17; 95% CI = -0.05 to 0.39), block performance time (SMD = -0.14; 95% CI = -0.51 to 0.22), onset of sensory blockade (SMD = -0.13; 95% CI = -0.59 to 0.33) and onset of motor blockade (SMD = -0.17; 95% CI = -0.26 to 0.12). No high heterogeneity was seen among the included studies. CONCLUSION: Infraclavicular nerve block may be superior to control the analgesia for upper limb surgeries than supraclavicular nerve block.

GlandSAM: Injecting Morphology Knowledge into Segment Anything Model for Label-free Gland Segmentation.

This paper presents a label-free gland segmentation, GlandSAM, which achieves comparable performance with supervised methods while no label is required during its training or inference phase. We observe that the Segment Anything model produces sub-optimal results on gland dataset: It either over-segments a gland into many fractions or under-segments the gland regions by confusing many of them with the background, due to the complex morphology of glands and lack of sufficient labels. To address this challenge, our GlandSAM innovatively injects two clues about gland morphology into SAM to guide the segmentation process: (1) Heterogeneity within glands and (2) Similarity with the background. Initially, we leverage the clues to decompose the intricate glands by selectively extracting a proposal for each gland sub-region of heterogeneous appearances. Then, we inject the morphology clues into SAM in a fine-tuning manner with a novel morphology-aware semantic grouping module that explicitly groups the high-level semantics of gland sub-regions. In this way, our GlandSAM could capture comprehensive knowledge about gland morphology, and produce well-delineated and complete segmentation results. Extensive experiments conducted on the GlaS dataset and the CRAG dataset reveal that GlandSAM outperforms state-of-the-art label-free methods by a significant margin. Notably, our GlandSAM even surpasses several fully-supervised methods that require pixel-wise labels for training, which highlights the remarkable performance and potential of GlandSAM in the realm of gland segmentation.

"Partner" cellulose gel with "dialysis" function: Achieve the integration of filtration-enrichment-SERS detection.

Hydrogel and aerogel materials have garnered significant attention in constructing effective surface-enhanced Raman spectroscopy (SERS) substrates due to their excellent adsorption capabilities, high specific surface area, and abundant chemical groups. However, in liquids with complex compositions, non-specific adsorption of macromolecules can lead to surface scaling and pore clogging of the substrate material, limiting the selective enrichment and SERS detection of target molecules. To address this, an innovative aerogel-chimeric hydrogel material (CH@S-CNF/SA/Ag NPs) was developed. The aerogel component, with its high specific surface area and electronegative properties, functions as a SERS "chip" for adsorption and detection of target molecules. Simultaneously, the mesoporous structure of the hydrogel "shell" effectively filters macromolecules from the solution. These CH@S-CNF/SA/Ag NPs were utilized as SERS substrate materials for detecting urine from healthy individuals and patients with chronic kidney disease stage 5 (CKD5). When combined with machine learning algorithms, the detection accuracy reached 99.50%. This work represents a significant advancement in the specific adsorption and SERS detection of small molecules in complex biological samples such as urine and blood.

Hexafluoropropylene oxide trimer acid (HFPO-TA) disrupts sex differentiation of zebrafish (Danio rerio) via an epigenetic mechanism of DNA methylation.

Hexafluoropropylene oxide trimer acid (HFPO-TA), an alternative to perfluorooctanoic acid, has been shown to have estrogenic effects. However, its potential to disrupt fish sex differentiation during gonadal development remains unknown. Therefore, this study exposed zebrafish to HFPO-TA from approximately 2 hours post fertilization (hpf) to 60 days post fertilization (dpf) to investigate its effects on sex differentiation. Results indicated that HFPO-TA disrupted steroid hormone homeostasis, delayed gonadal development in both sexes, and resulted in a female-skewed sex ratio in zebrafish. HFPO-TA exposure up-regulated gene expressions of cyp19a1a, esr1, vtg1 and foxl2, while down-regulated those of amh, sox9a and dmrt1. These suggested that HFPO-TA dysregulated the expressions of key genes related to sex differentiation of zebrafish, promoted the production and activation of estrogen, and further induced the feminization. Interestingly, we observed promoter hypomethylation of cyp19a1a and promoter hypermethylation of amh in male zebrafish, which were negatively associated with their gene expressions. These suggested that HFPO-TA dysregulated these key genes through DNA methylation in their promoters. Therefore, the HFPO-TA disrupted the sex differentiation of zebrafish through an epigenetic mechanism involving DNA methylation, ultimately skewing the sex ratio towards females. Overall, this study demonstrated adverse effects of HFPO-TA on fish sex differentiation and provided novel insights into the underlying epigenetic mechanism.

Myocardial Blood Flow Quantification Using Stress Cardiac Magnetic Resonance Improves Detection of Coronary Artery Disease.

BACKGROUND: Myocardial blood flow (MBF) and myocardial perfusion reserve (MPR) using stress cardiovascular magnetic resonance (CMR) have been shown to identify epicardial coronary artery disease. However, comparative analysis between quantitative perfusion and conventional qualitative assessment (QA) remains limited. OBJECTIVES: The aim of this multicenter study was to test the hypothesis that quantitative stress MBF (sMBF) and MPR analysis can identify obstructive coronary artery disease (obCAD) with comparable performance as QA of stress CMR performed by experienced physicians in interpretation. METHODS: The analysis included 127 individuals (mean age 62 ± 16 years, 84 men [67%]) who underwent stress CMR. obCAD was defined as the presence of stenosis ≥50% in the left main coronary artery or ≥70% in a major vessel. Each patient, coronary territory, and myocardial segment was categorized as having either obCAD or no obCAD (noCAD). Global, per coronary territory, and segmental MBF and MPR values were calculated. QA was performed by 4 CMR experts. RESULTS: At the patient level, global sMBF and MPR were significantly lower in subjects with obCAD than in those with noCAD, with median values of sMBF of 1.5 mL/g/min (Q1-Q3: 1.2-1.8 mL/g/min) vs 2.4 mL/g/min (Q1-Q3: 2.1-2.7 mL/g/min) (P < 0.001) and median values of MPR of 1.3 (Q1-Q3: 1.0-1.6) vs 2.1 (Q1-Q3: 1.6-2.7) (P < 0.001). At the coronary artery level, sMBF and MPR were also significantly lower in vessels with obCAD compared with those with noCAD. Global sMBF and MPR had areas under the curve (AUCs) of 0.90 (95% CI: 0.84-0.96) and 0.86 (95% CI: 0.80-0.93). The AUCs for QA by 4 physicians ranged between 0.69 and 0.88. The AUC for global sMBF and MPR was significantly better than the average AUC for QA. CONCLUSIONS: This study demonstrates that sMBF and MPR using dual-sequence stress CMR can identify obCAD more accurately than qualitative analysis by experienced CMR readers.

Partially Bio-Based and Biodegradable Poly(Propylene Terephthalate-Co-Adipate) Copolymers: Synthesis, Thermal Properties, and Enzymatic Degradation Behavior.

A series of partially bio-based and biodegradable poly(propylene terephthalate-co-adipate) (PPTA) random copolymers with different components were prepared by the melt polycondensation of petro-based adipic acid and terephthalic acid with bio-based 1,3-propanediol. The microstructure, crystallization behavior, thermal properties, and enzymatic degradation properties were further investigated. The thermal decomposition kinetics was deeply analyzed using Friedman's method, with the thermal degradation activation energy ranging from 297.8 to 302.1 kJ/mol. The crystallinity and wettability of the copolymers decreased with the increase in the content of the third unit, but they were lower than those of the homopolymer. The thermal degradation activation energy E, carbon residue, and reaction level n all showed a decreasing trend. Meanwhile, the initial thermal decomposition temperature (Td) was higher than 350 °C, which can meet the requirements for processing and use. The PPTA copolymer material still showed excellent thermal stability. Adding PA units could regulate the crystallinity, wettability, and degradation rate of PPTA copolymers. The composition of PPTA copolymers in different degradation cycles was characterized by 1H NMR analysis. Further, the copolymers' surface morphology during the process of enzymatic degradation also was observed by scanning electron microscopy (SEM). The copolymers' enzymatic degradation accorded with the surface degradation mechanism. The copolymers showed significant degradation behavior within 30 days, and the rate increased with increasing PA content when the PA content exceeded 45.36%.

Study on the Structural Features of Eight Dendrobium Polysaccharides and Their Protective Effects on Gastric Mucosa.

This study aimed to analyze the structure of polysaccharides from eight different Dendrobium species and their protective effects on gastric mucosa. Ultraviolet (UV) analysis showed that the contents of eight polysaccharides ranged from 51.89 ± 6.91% to 80.57 ± 11.63%; the degree of acetylation ranged from 0.17 ± 0.03 to 0.48 ± 0.03. High-performance liquid chromatography (HPLC) results showed that these polysaccharides were mainly composed of mannose (Man) and glucose (Glc) with a small amount of galactose (Gal) and arabinose (Ara), and the monosaccharide ratios of different Dendrobium species were different. High-performance size exclusion chromatography-multi angle light scattering-refractive index detector (HPSEC-MALS-RID) showed that the molecular weight (Mw) of all Dendrobium polysaccharides was >1 × 105 Da; D. huoshanense had the lowest molecular weight. Subsequently, an ethanol injured GES-1 cell model was constructed to evaluate the gastric mucosal protective potential of polysaccharides from eight different Dendrobium species. The results showed that the protective effect of the low concentration 50 µg/mL DHP treatment group was similar to that of the control group (p > 0.05), and the cell viability could reach 97.32% of that of the control group. Based on the polysaccharide composition, different kinds of Dendrobium have different degrees of migration and repair effects on GES-1 damaged cells, and the effect of DHP is slightly better than that of other varieties (83.13 ± 1.05%). Additionally, Dendrobium polysaccharides alleviated ethanol-induced oxidative stress and inflammatory response in gastric mucosal cells by enhancing the activity of antioxidant enzymes (superoxide dismutase, glutathione peroxidase, catalase) and reducing the levels of malondialdehyde and reactive oxygen species. Overall, DHP can most effectively protect gastric mucosa. These findings enhance our understanding of the relationship between the structure and biological activity of Dendrobium polysaccharides, providing a foundation for the quality control of Dendrobium. Furthermore, these findings offer theoretical support for the development of Dendrobium polysaccharides as nutraceuticals to treat digestive system diseases.

Effectiveness of Internet-Based Telehealth Programs in Patients With Hip or Knee Osteoarthritis: Systematic Review and Meta-Analysis.

BACKGROUND: Osteoarthritis (OA) is a chronic musculoskeletal disease that causes pain, functional disability, and an economic burden. Nonpharmacological treatments are at the core of OA management. However, limited access to these services due to uneven regional local availability has been highlighted. Internet-based telehealth (IBTH) programs, providing digital access to abundant health care resources, offer advantages, such as convenience and cost-effectiveness. These characteristics make them promising strategies for the management of patients with OA. OBJECTIVE: This study aimed to evaluate the effectiveness of IBTH programs in the management of patients with hip or knee OA. METHODS: We systematically searched 6 electronic databases to identify trials comparing IBTH programs with conventional interventions for hip and knee OA. Studies were selected based on inclusion and exclusion criteria, focusing on outcomes related to function, pain, and self-efficacy. Standardized mean differences (SMDs) with 95% CIs were calculated to compare outcome measures. Heterogeneity was assessed using I² and χ² tests. The methodological quality of the selected studies and the quality of evidence were also evaluated. RESULTS: A total of 21 studies with low-to-high risk of bias were included in this meta-analysis. The pooled results showed that IBTH has a superior effect on increasing function (SMD 0.30, 95% CI 0.23-0.37, P<.001), relieving pain (SMD -0.27, 95% CI -0.34 to -0.19, P<.001), and improving self-efficacy for pain (SMD 0.21, 95% CI 0.08-0.34, P<.001) compared to the conventional intervention group. Subgroup analysis revealed that IBTH with exercise can significantly alleviate pain and improve function and self-efficacy, but IBTH with cognitive-behavioral therapy only had the effect of reducing pain. CONCLUSIONS: The meta-analysis provides moderate-quality evidence that IBTH programs have a beneficial effect on improving function, relieving pain, and improving self-efficacy compared to conventional interventions in patients with hip or knee OA. Limited evidence suggests that the inclusion of exercise regimens in IBTH programs is recommended. TRIAL REGISTRATION: PROSPERO CRD42024541111; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=541111.

Discovery and characterization of naturally occurring covalent inhibitors of SARS-CoV-2 Mpro from the antiviral herb Ephedra.

The Chinese herb Ephedra (also known as Mahuang) has been extensively utilized for the prevention and treatment of coronavirus-induced diseases, including coronavirus disease 2019 (COVID-19). However, the specific anti-SARS-CoV-2 compounds and mechanisms have not been fully elucidated. The main protease (Mpro) of SARS-CoV-2 is a highly conserved enzyme responsible for proteolytic processing during the viral life cycle, making it a critical target for the development of antiviral therapies. This study aimed to identify naturally occurring covalent inhibitors of SARS-CoV-2 Mpro from Ephedra and to investigate their covalent binding sites. The results demonstrated that the non-alkaloid fraction of Ephedra (ENA) exhibited a potent inhibitory effect against the SARS-CoV-2 Mpro effect, whereas the alkaloid fraction did not. Subsequently, the chemical constituents in ENA were identified, and the major constituents' anti-SARS-CoV-2 Mpro effects were evaluated. Among the tested constituents, herbacetin (HE) and gallic acid (GA) were found to inhibit SARS-CoV-2 Mpro in a time- and dose-dependent manner. Their combination displayed a significant synergistic effect on this key enzyme. Additionally, various techniques, including inhibition kinetic assays, chemoproteomic methods, and molecular dynamics simulations, were employed to further elucidate the synergistic anti-Mpro mechanisms of the combination of HE and GA. Overall, this study deciphers the naturally occurring covalent inhibitors of SARS-CoV-2 Mpro from Ephedra and characterizes their synergistic anti-Mpro synergistic effect, providing robust evidence to support the anti-coronavirus efficacy of Ephedra.

Comparison of dual-bolus versus dual-sequence techniques for determining myocardial blood flow and myocardial perfusion reserve by cardiac magnetic resonance stress perfusion: From the Automated Quantitative analysis of myocardial perfusion cardiac Magnetic Resonance Consortium.

BACKGROUND: Quantitative stress cardiac magnetic resonance (CMR) can be performed using the dual-sequence (DS) technique or dual-bolus (DB) method. It is unknown if DS and DB produce similar results for myocardial blood flow (MBF) and myocardial perfusion reserve (MPR). The study objective is to investigate if there are any differences between DB- and DS-derived MBF and MPR. METHODS: Retrospective observational study with 168 patients who underwent stress CMR. DB and DS methods were simultaneously performed on each patient on the same day. Global and segmental stress MBF and rest MBF values were collected. RESULTS: Using Bland-Altman analysis, segmental and global stress MBF values were higher in DB than DS (0.22 ± 0.60 mL/g/min, p < 0.001 and 0.20 ± 0.48 mL/g/min, p = 0.005, respectively) with strong correlation (r = 0.81, p < 0.001 for segmental and r = 0.82, p < 0.001 for global). In rest MBF, segmental and global DB values were higher than by DS (0.15 ± 0.51 mL/g/min, p < 0.001 and 0.14 ± 0.36 mL/g/min, p = 0.011, respectively) with strong correlation (r = 0.81, p < 0.001 and r = 0.77, p < 0.001). Mean difference between MPR by DB and DS was -0.02 ± 0.68 mL/g/min (p = 0.758) for segmental values and -0.01 ± 0.49 mL/g/min (p = 0.773) for global values. MPR values correlated strongly as well in both segmental and global, both (r = 0.74, p < 0.001) and (r = 0.75, p < 0.001), respectively. CONCLUSION: There is a very good correlation between DB- and DS-derived MBF and MPR values. However, there are significant differences between DB- and DS-derived global stress and rest MBF. While MPR values did not show statistically significant differences between DB and DS methods.

Causal associations of physical activity and leisure sedentary behaviors with age at onset of Huntington's disease: A mendelian randomization study.

BACKGROUND: Huntington's disease (HD) is a neurodegenerative disorder for which effective therapies are currently lacking. Studies suggest that increasing physical activity (PA) and reducing leisure sedentary behavior (LSB) mitigate the progression of HD, but their causal relationship with the age at onset (AAO) of HD remains uncertain. To investigate this, we conducted the Two-sample Mendelian Randomization (MR). METHODS: Exposure were retrieved from the UK BioBank's (UKB) Genome-Wide Association Study (GWAS). PA included accelerometer-based average PA, vigorous PA, self-reported moderate-to-vigorous PA (MVPA), and light do-it-yourself activity. LSB included television (TV) time, computer time, and driving time. Outcome came from the GWAS of the GEM-HD Consortium. We applied several MR methods such as inverse variance weighted (IVW), MR-Egger regression, weighted median (WM) for sensitivity analysis. RESULTS: Increases in light PA (ß = 8.53 years, 95 % CI = 10.64 to 44.09, P = 0.001) and accelerometer-based vigorous PA (ß = 5.18, 95 % CI = 0.92 to 9.43, P = 0.017) delayed AAO of HD, while longer TV time was associated with earlier AAO of HD (ß = -2.88 years, 95 % CI = -4.99 to -0.77, P = 0.007). However, other PA and LSB phenotypes did not significantly affect AAO of HD. CONCLUSION: The study revealed a unidirectional causality between PA, LSB and the AAO of HD. Increasing PA and reducing TV time delay HD onset. Therefore, we recommend increasing physical activity and reducing sedentary behavior to delay the occurrence of motor symptoms for premanifest HD individuals.

Manipulating Photogalvanic Effects in Two-Dimensional Multiferroic Breathing Kagome Materials.

Multiferroic materials, known for their multiple tunable orders, present an exceptional opportunity to manipulate nonlinear optical responses that are sensitive to symmetry. In this study, we propose leveraging electric and magnetic fields to selectively control and switch specific types of photogalvanic effects in two-dimensional multiferroic breathing kagome materials. Taking monolayer Nb3I8 as an example, we demonstrate that the shift current, characterized by the real-space shift of electrons and holes, is predominantly unaffected by magnetic order. In contrast, injection current, featured by quantum metric dipole in momentum space, is closely related to valley polarization, which can be controlled by a magnetic field. Furthermore, both photocurrents can be reversed by an out-of-plane electric field via lattice breathing. Our findings reveal the potential of multiferroic breathing kagome structures for multifunctional optoelectronic applications and sensors.

Integrating socio-psychological factors in the SEIR model optimized by a genetic algorithm for COVID-19 trend analysis.

The global spread of COVID-19 has profoundly affected health and economies, highlighting the need for precise epidemic trend predictions for effective interventions. In this study, we used infectious disease models to simulate and predict the trajectory of COVID-19. An SEIR (susceptible, exposed, infected, removed) model was established using Wuhan data to reflect the pandemic. We then trained a genetic algorithm-based SEIR (GA-SEIR) model using data from a specific U.S. region and focused on individual susceptibility and infection dynamics. By integrating socio-psychological factors, we achieved a significant enhancement to the GA-SEIR model, leading to the development of an optimized version. This refined GA-SEIR model significantly improved our ability to simulate the spread and control of the epidemic and to effectively track trends. Remarkably, it successfully predicted the resurgence of COVID-19 in mainland China in April 2023, demonstrating its robustness and reliability. The refined GA-SEIR model provides crucial insights for public health authorities, enabling them to design and implement proactive strategies for outbreak containment and mitigation. Its substantial contributions to epidemic modelling and public health planning are invaluable, particularly in managing and controlling respiratory infectious diseases such as COVID-19.

Ultrahigh Energy Storage Performance of BiFeO3-BaTiO3 Flexible Film Capacitor with High-Temperature Stability via Defect Design.

Nanoengineering polar oxide films have attracted great attention in energy storage due to their high energy density. However, most of them are deposited on thick and rigid substrates, which is not conducive to the integration of capacitors and applications in flexible electronics. Here, an alternative strategy using van der Waals epitaxial oxide dielectrics on ultra-thin flexible mica substrates is developed and increased the disorder within the system through high laser flux. The introduction of defects can efficiently weaken or destroy the long-range ferroelectric ordering, ultimately leading to the emergence of a large numbers of weak-coupling regions. Such polarization configuration ensures fast polarization response and significantly improves energy storage characteristics. A flexible BiFeO3-BaTiO3 (BF-BT) capacitor exhibits a total energy density of 43.5 J cm-3 and an efficiency of 66.7% and maintains good energy storage performance over a wide temperature range (20-200 °C) and under large bending deformation (bending radii ≈ 2 mm). This study provides a feasible approach to improve the energy storage characteristics of dielectric oxide films and paves the way for their practical application in high-energy density capacitors.

Narrowing the semantic gaps in U-Net with learnable skip connections: The case of medical image segmentation.

Current state-of-the-art medical image segmentation techniques predominantly employ the encoder-decoder architecture. Despite its widespread use, this U-shaped framework exhibits limitations in effectively capturing multi-scale features through simple skip connections. In this study, we made a thorough analysis to investigate the potential weaknesses of connections across various segmentation tasks, and suggest two key aspects of potential semantic gaps crucial to be considered: the semantic gap among multi-scale features in different encoding stages and the semantic gap between the encoder and the decoder. To bridge these semantic gaps, we introduce a novel segmentation framework, which incorporates a Dual Attention Transformer module for capturing channel-wise and spatial-wise relationships, and a Decoder-guided Recalibration Attention module for fusing DAT tokens and decoder features. These modules establish a principle of learnable connection that resolves the semantic gaps, leading to a high-performance segmentation model for medical images. Furthermore, it provides a new paradigm for effectively incorporating the attention mechanism into the traditional convolution-based architecture. Comprehensive experimental results demonstrate that our model achieves consistent, significant gains and outperforms state-of-the-art methods with relatively fewer parameters. This study contributes to the advancement of medical image segmentation by offering a more effective and efficient framework for addressing the limitations of current encoder-decoder architectures. Code: https://github.com/McGregorWwww/UDTransNet.

Single-stage correction of severe scoliosis with syringomyelia: performed with traction assistance without prophylactic neurosurgical decompression.

OBJECTIVE: There is still controversy about whether it is necessary to perform prophylactic neurosurgical decompression for severe scoliosis (SS) with syringomyelia (SM) to reduce the risk of neurological complications during subsequent spinal correction. This study aimed to explore the safety and effectiveness of using traction-assisted single-stage spinal correction as a treatment for patients who had SS with SM (SS-SM). METHODS: The patients who had SS-SM without previous neurosurgical intervention and who underwent traction-assisted single-stage posterior spinal correction at a single center were included, and the initial, posttraction, and postoperative clinical data were reviewed. Based on preoperative MRI, the included patients were divided into two categories: those with versus those without Chiari malformation type I (CM-I-related SM [CS] vs idiopathic SM [IS]), and those with a moderate syrinx (MS) versus those with a large syrinx (LS). Different groups' traction and operation contributions were calculated for comparisons (CS vs IS, MS vs LS). RESULTS: A total of 28 patients were included. The initial mean major scoliosis was 101.0° with a mean flexibility of 21.4%. After the operation, the mean total correction rate for scoliosis was 63.9%. The mean traction and operation contributions were 61.5% and 38.5%, respectively. Most of the patients (75%) underwent spinal corrections without 3-column osteotomies, and only 1 patient reported postoperative regional numbness without motor deficits. No differences were found in the mean total correction rates, traction, and operation contributions when comparing CS versus IS and MS versus LS with the comparable initial clinical data (p > 0.05). More than 50% of the total corrections were achieved by preoperative traction in all groups. CONCLUSIONS: Traction-assisted single-stage spinal correction can safely and effectively correct SS-SM without prophylactic neurosurgical decompression under strict patient selection. Additionally, traction can achieve more than half of the final spinal correction, even for patients with varying sizes of SMs.