Associations between sensory impairment and functional limitations among older Chinese adults: mediating roles of social isolation and cognition.

BACKGROUND: The high prevalence of sensory impairment and functional limitations in older adults is a significant concern, yet there is limited understanding of the relationship between these two conditions. Therefore, the objective of this study was to investigate the pathways connecting sensory impairment and functional limitations by examining serial multiple mediating effects of social isolation and cognition in older adults. METHODS: Using the China Health and Retirement Longitudinal Study dataset, a sample of 4871 older adults was selected. The study variables included sensory impairment, functional limitations, social isolation and cognition, and other covariates. A hierarchical multiple linear regression model was used to assess the association between sensory impairment and functional limitations. Mediation analysis was conducted to explore the sequential multiple mediating effects of social isolation and cognitive function in the relationship between sensory impairment and functional limitations. RESULTS: Our findings revealed a significant and positive association between sensory impairment and functional limitations (B = 0.615, 95% CI: 0.397, 0.834). After adjusting for social isolation and cognitive function, the impact of sensory impairment on functional limitations accounted for 87.19% of the total effect. Additionally, approximately 12.81% of the significant relationship between dual sensory impairment and functional limitations was mediated by social isolation and cognitive function. A serial multiple mediating pathway (sensory impairment → social isolation → cognition → functional limitations) was identified, with a coefficient of 0.013 (95% CI: 0.006, 0.020). CONCLUSIONS: Our study provides evidence for the mediating effects of social isolation and cognition in the relationship between sensory impairment and functional limitations. Given the prevalence of functional limitations among older adults with sensory impairment, it is crucial to consider social isolation and cognitive function in efforts to reduce the burden of disability care. Future validation of these findings through longitudinal studies is necessary.

Understanding attendance patterns and determinants in cardiac, pulmonary, and ICU Rehabilitation/Recovery programs: A systematic review and meta-analysis.

BACKGROUND: Cardiac, pulmonary, and intensive care unit (ICU) rehabilitation/recovery programs are health promotion interventions designed to improve physical recovery, psychological well-being, and quality of life after acute illness while reducing the risk of adverse events. OBJECTIVE: Identify the difference in attendance rates for patients invited to a cardiac rehabilitation, pulmonary rehabilitation, or ICU recovery program and factors influencing attendance. METHODS: We conducted a systematic review and meta-analysis by searching PubMed, EMBASE, CINAHL, Web of Science, and manual reference lists from inception to June 3, 2024. We included studies reporting patient attendance rates in eligible programs following acute illness hospitalization. Two team members independently screened articles and extracted data, with a third member reviewing and achieving consensus when necessary. Our main outcomes focused on the proportion of attendance in eligible programs among patients referred. RESULTS: Of 3,446 studies screened, 179 studies (N = 4,779,012 patients) were included across cardiac rehabilitation (n = 153 studies), pulmonary rehabilitation (n = 11 studies), and ICU recovery (n = 15 studies) programs. Pooled attendance rates were 53 % (95 % CI: 48-57 %) for cardiac rehabilitation, 56 % (95 % CI: 42-70 %) for pulmonary rehabilitation, and 61 % (95 % CI: 51-70 %) for ICU recovery programs. Significant attendance heterogeneity was present (cardiac I2=100 %, p < 0.001; pulmonary I2=100 %, p < 0.001; ICU I2=94 %, p < 0.01). Barriers to attendance included transportation, distance, work conflicts, and patient factors (e.g., comorbidities, older age). Facilitators included male gender, younger age, higher education, income, provider recommendations, and flexible scheduling. Individual factors represented the primary domain affecting attendance. CONCLUSIONS: The results indicate comparable attendance rates and factors shaping attendance across acute illness rehabilitation/recovery programs, with ICU recovery programs being the most well-attended on average. REGISTRATION: PROSPERO CRD42022357261.

Mendelian Randomization Study Supports Genetic Liability to Obsessive-Compulsive Disorder Associated With the Risk of Alzheimer's Disease.

BACKGROUND: Observational studies have suggested that obsessive-compulsive disorder (OCD) may be associated with Alzheimer's disease (AD). However, whether OCD is a causal risk factor for AD remains unclear. This study aimed to assess the causal effect of OCD on AD risk by performing a two-sample Mendelian randomization (MR) analysis. METHODS: Genome-wide association summary statistics were obtained for OCD, comprising 2688 cases and 7037 controls, as well as for AD, including 21,982 cases and 41,944 controls from Kunkle et al.'s study, and 39,918 cases and 358,140 controls from Wightman et al.'s study. On the basis of two diverse thresholds, OCD-associated genetic variants were screened as instrumental variables (IVs) for subsequent MR analyses. Inverse variance weighed was the primary MR method. MR-Egger, weighted median, and weighted mode were used as supplementary MR methods. Various sensitivity tests assessed the reliability of MR results. RESULTS: On the basis of strict IV selecting thresholds, inverse-variance weighted (IVW) identified significant causal associations between genetic liability to OCD and increased risk of AD in two different sources ((i) Kunkle et al.: odds ratio [OR] = 1.070, 95% confidence interval [CI]: 1.015-1.127, p = 0.012; (ii) Wightman et al. 0.012; (iii) Wightman et al.: OR = 1.051, 95% CI: 1.014-1.090, p = 0.007). Three other supplementary MR methods yielded similar results to IVWs (OR > 1). Furthermore, all results were replicated in MR analyses based on lenient IV selecting thresholds. The sensitivity tests indicated that MR results were stable and not affected by significant horizontal pleiotropy. CONCLUSIONS: This comprehensive MR study suggests that genetic liability to OCD is a causal risk factor for AD. Early intervention in patients with OCD may be beneficial in preventing future AD progression.

Hematopoietic stem cell transplantation for CTLA-4 insufficiency across Europe: A European Society for Blood and Marrow Transplantation Inborn Errors Working Party study.

BACKGROUND: Cytotoxic T-lymphocyte antigen 4 (CTLA-4) insufficiency causes a primary immune regulatory disorder characterized by lymphoproliferation, dysgammaglobulinemia, and multiorgan autoimmunity including cytopenias and colitis. OBJECTIVE: We examined the outcome of hematopoietic stem cell transplantation (HSCT) for CTLA-4 insufficiency and study the impact of pre-HSCT CTLA-4 fusion protein (CTLA-4-Ig) therapy and pre-HSCT immune dysregulation on survival and immunologic outcome. METHODS: This was a retrospective study of HSCT for CTLA-4 insufficiency and 2q33.2-3 deletion from the European Society for Blood and Marrow Transplantation Inborn Errors Working Party. Primary end points were overall survival (OS) and disease- and chronic graft-versus-host disease-free survival (DFS). Secondary end point was immunologic outcome assessed by immune dysregulation disease activity (IDDA) score. RESULTS: Forty patients were included over a 25-year period. Before HSCT, 60% received CTLA-4-Ig, and median (range) IDDA score was 23.3 (3.9-84.0). Median (range) age at HSCT was 14.2 (1.3-56.0) years. Patients received peripheral blood stem cell (58%) or marrow (43%) from a matched unrelated donor (75%), mismatched unrelated donor (12.5%), or matched family donor (12.5%). Median (range) follow-up was 3 (0.6-15) years, and 3-year OS was 76.7% (58-87%) and DFS was 74.4% (54.9-86.0%). At latest follow-up, disease of 28 of 30 surviving patients was in disease-free remission with median IDDA reduction of 16. Probability of OS and DFS was greater in patients with lower disease activity before HSCT (IDDA < 23, P = .002 and P = .006, respectively). CTLA-4-Ig receipt did not influence OS or DFS. Cause of death was transplant related in 7 of 8 patients. CONCLUSION: HSCT is an effective therapy to prevent ongoing disease progression and morbidity, with improving survival rates over time and in patients with lower pre-HSCT disease activity.

IKKε-deficient macrophages impede cardiac repair after myocardial infarction by enhancing the macrophage-myofibroblast transition.

The regulatory role of the inhibitor of NF-kB kinase ε (IKKε) in postmyocardial infarction (MI) inflammation remains uncertain. Using an MI mouse model, we examined the cardiac outcomes of IKKε knockout (KO) mice and wild-type mice. We employed single-cell RNA sequencing (scRNA-seq) and phosphorylated protein array techniques to profile cardiac macrophages. IKKε KO mice exhibited compromised survival, heightened inflammation, pronounced cardiac fibrosis, and a reduced ejection fraction. A distinct cardiac macrophage subset in IKKε KO mice exhibited increased fibrotic marker expression and decreased phosphorylated p38 (p-p38) levels, indicating an enhanced macrophage-myofibroblast transition (MMT) post-MI. While cardiac inflammation is crucial for initiating compensatory pathways, the timely resolution of inflammation was impaired in the IKKε KO group, while the MMT in macrophages accelerated post-MI, leading to cardiac failure. Additionally, our study highlighted the potential of 5-azacytidine (5-Aza), known for its anti-inflammatory and cardioprotective effects, in restoring p-p38 levels in stimulated macrophages. The administration of 5-Aza significantly reduced the MMT in cardiac macrophages from the IKKε KO group. These findings underscore the regulation of the inflammatory response and macrophage transition by the IKKε-p38 axis, indicating that the MMT is a promising therapeutic target for ischemic heart disease.

Comparative analysis of financial toxicity between SARS-CoV-2 infection and common comorbidities.

Financial toxicity is common in individuals with COVID-19 and Long COVID. However, the extent of financial toxicity experienced, in comparison to other common comorbidities, is uncertain. Contributing factors exacerbating financial challenges in Long COVID are also unclear. These knowledge gaps are addressed via a cross-sectional analysis utilizing data from the 2022 National Health Interview Survey (NHIS), a representative sample drawn from the United States. COVID-19 cases were identified through self-reported positive testing or physician diagnoses. Long COVID was defined as experiencing COVID-19-related symptoms for more than three months. Comorbidity was assessed based on self-reported diagnoses of ten doctor-diagnosed conditions (Yes/No). Financial toxicity was defined as having difficulty paying medical bills, cost-related medication nonadherence, delaying healthcare due to cost, and/or not obtained healthcare due to cost. A total of 27,492 NHIS 2022 respondents were included in our analysis, representing 253 million U.S. adults. In multivariable logistic regression models, adults with Long COVID (excluding respondents with COVID-19 but not Long COVID), showed increased financial toxicity compared to those with other comorbidities, such as epilepsy (OR [95% CI]: 1.69 [1.22, 2.33]), dementia (1.51 [1.01, 2.25]), cancer (1.43 [1.19, 1.71]) or respiratory/cardiovascular conditions (1.18 [1.00, 1.40]/1.23 [1.02, 1.47]). Long COVID-related financial toxicity was associated with female sex, age <65 years, lack of medical insurance, current paid employment, residence region, food insecurity, fatigue, mild to severe depression symptoms experienced during the survey completion, visits to hospital emergency rooms, presence of arthritis, cardiovascular or respiratory conditions, and social activity limitations. In conclusion, American adults with Long COVID, but not those who had prior COVID-19 infection without Long COVID, exhibited a higher prevalence of financial toxicity compared to individuals with common comorbidities. Vulnerable populations were at greater risk for financial toxicity. These findings emphasize the importance of evaluating strategies to reduce economic burden and increase awareness of the effect of Long COVID-related financial toxicity on patient's healthcare and health status.

Applications of Single-Cell Omics Technologies for Induced Pluripotent Stem Cell-Based Cardiovascular Research.

Single-cell omics technologies have transformed our investigation of genomic, transcriptomic, and proteomic landscapes at the individual cell level. In particular, the application of single-cell RNA sequencing has unveiled the complex transcriptional variations inherent in cardiac cells, offering valuable perspectives into their dynamics. This review focuses on the integration of single-cell omics with induced pluripotent stem cells (iPSCs) in the context of cardiovascular research, offering a unique avenue to deepen our understanding of cardiac biology. By synthesizing insights from various single-cell technologies, we aim to elucidate the molecular intricacies of heart health and diseases. Beyond current methodologies, we explore the potential of emerging paradigms such as single-cell/spatial omics, delving into their capacity to reveal the spatial organization of cellular components within cardiac tissues. Furthermore, we anticipate their transformative role in shaping the future of cardiovascular research. This review aims to contribute to the advancement of knowledge in the field, offering a comprehensive perspective on the synergistic potential of transcriptomic analyses, iPSC applications, and the evolving frontier of spatial omics.

Effects of aquatic versus land-based exercise on irisin and fibroblast growth factor 21 expression and triiodothyronine and free fatty acid levels in elderly women.

BACKGROUND: This study investigated the impacts of exercise on irisin and fibroblast growth factor 21 (FGF-21) expression, as well as triiodothyronine (T3 ) and free fatty acid (FFA) levels in elderly women. METHODS: Thirty women aged 65 to 70 years (10 per group) were randomly assigned to aquatic exercise, land exercise, and control groups. The aquatic and land groups engaged in 3 exercise sessions per week (60 min/session) for 16 weeks. The intensity was progressively increased every 4 weeks. RESULTS: Irisin and FGF-21 levels significantly increased in the aquatic exercise group. In the posttest, the aquatic exercise group had the highest irisin levels. Significant findings were observed for irisin and FGF-21 for the main effect between aquatic and band exercise groups (p<0.05 for both), the main effect between measurement times (p<0.01 and p<0.001, respectively), and the interaction effect (p<0.05 and p<0.001, respectively). The irisin level was significantly higher in the aquatic than in the land group 30 minutes after the last session (p<0.05). In both exercise groups, T3 levels were significantly higher 30 minutes after the final session (p<0.05) than before the program. The FFA level was significantly higher in the aquatic exercise group than the others. In the aquatic group, FFA levels were significantly higher 30 minutes after both the first (p<0.01) and the last (p<0.001) session compared to pre-program values. CONCLUSION: Differences in exercise type and environment can promote fat metabolism by stimulating hormonal changes that induce brown fat activity and browning.

Endothelial Cell-Specific Prolyl Hydroxylase-2 Deficiency Augments Angiotensin II-Induced Arterial Stiffness and Cardiac Pericyte Recruitment in Mice.

BACKGROUND: Endothelial prolyl hydroxylase-2 (PHD2) is essential for pulmonary remodeling and hypertension. In the present study, we investigated the role of endothelial PHD2 in angiotensin II-mediated arterial stiffness, pericyte recruitment, and cardiac fibrosis. METHODS AND RESULTS: Chondroitin sulfate proteoglycan 4 tracing reporter chondroitin sulfate proteoglycan 4- red fluorescent protein (DsRed) transgenic mice were crossed with PHD2flox/flox (PHD2f/f) mice and endothelial-specific knockout of PHD2 (PHD2ECKO) mice. Transgenic PHD2f/f (TgPHD2f/f) mice and TgPHD2ECKO mice were infused with angiotensin II for 4 weeks. Arterial thickness, stiffness, and histological and immunofluorescence of pericytes and fibrosis were measured. Infusion of TgPHD2f/f mice with angiotensin II resulted in a time-dependent increase in pulse-wave velocity. Angiotensin II-induced pulse-wave velocity was further elevated in the TgPHD2ECKO mice. TgPHD2ECKO also reduced coronary flow reserve compared with TgPHD2f/f mice infused with angiotensin II. Mechanistically, knockout of endothelial PHD2 promoted aortic arginase activity and angiotensin II-induced aortic thickness together with increased transforming growth factor-ß1 and ICAM-1/VCAM-1 expression in coronary arteries. TgPHD2f/f mice infused with angiotensin II for 4 weeks exhibited a significant increase in cardiac fibrosis and hypertrophy, which was further developed in the TgPHD2ECKO mice. Chondroitin sulfate proteoglycan 4 pericyte was traced by DsRed+ staining and angiotensin II infusion displayed a significant increase of DsRed+ pericytes in the heart, as well as a deficiency of endothelial PHD2, which further promoted angiotensin II-induced pericyte increase. DsRed+ pericytes were costained with fibroblast-specific protein 1 and α-smooth muscle actin for measuring pericyte-myofibroblast cell transition. The knockout of endothelial PHD2 increased the amount of DsRed+/fibroblast-specific protein 1+ and DsRed+/α-smooth muscle actin+ cells induced by angiotensin II infusion. CONCLUSIONS: Knockout of endothelial PHD2 enhanced angiotensin II-induced cardiac fibrosis by mechanisms involving increasing arterial stiffness and pericyte-myofibroblast cell transitions.

Outcomes of hematopoietic stem cell transplantation in 813 pediatric patients with Fanconi anemia.

ABSTRACT: Allogeneic hematopoietic stem cell transplantation (HSCT) is the only established curative option for Fanconi anemia (FA)-associated bone marrow failure (BMF)/aplastic anemia (AA) and acute myeloid leukemia (AML)/myelodysplastic syndrome (MDS). We performed a retrospective multicenter study on 813 children with FA undergoing first HSCT between 2010 and 2018. Median duration of follow-up was 3.7 years. Median age at transplant was 8.8 years (IQR, 6.5-18.1). Five-year overall survival (OS), event-free survival (EFS), and graft-versus-host disease (GVHD)-free, relapse-free survival (GRFS) were 83% (95% confidence interval [CI], 80-86), 78% (95% CI, 75-81), and 70% (95% CI, 67-74), respectively. OS was comparable between matched family donor (MFD; n = 441, 88%) and matched unrelated donor (MUD; n = 162, 86%) and was superior to that of mismatched family donor (MMFD) or mismatched unrelated donor (MMUD; n = 144, 72%) and haploidentical donor (HID; n = 66, 70%; P < .001). In multivariable analysis, a transplant indication of AML/MDS (vs AA/BMF), use of MMFD/MMUD and HID (vs MFD), and fludarabine-cyclophosphamide (FluCy) plus other conditioning (vs FluCy) independently predicted inferior OS, whereas alemtuzumab vs antithymocyte globulin was associated with better OS. Age ≥10 years was associated with worse EFS and GRFS. Cumulative incidences (CINs) of primary and secondary graft failure were 2% and 3% respectively. CINs of grade 3 to 4 acute GVHD and chronic GVHD were 12% and 8% respectively. The 5-year CIN of secondary malignancy was 2%. These data suggest that HSCT should be offered to patients with FA with AA/BMF at a younger age in the presence of a well-matched donor.

Microbial communities assembly in wastewater treatment plants in China.

Community assembly processes determine community structure. Deterministic processes are essential for optimizing activated sludge (AS) bioreactor performance. However, the debate regarding the relative importance of determinism versus stochasticity remains contentious, and the influencing factors are indistinct. This study used large-scale 16S rRNA gene data derived from 252 AS samples collected from 28 cities across China to explore the mechanism of AS community assembly. Results showed that the northern communities possessed lower spatial turnover and more significant dispersal limitation than those in the south, whereas the latter had more substantial deterministic processes than the former (14.46 % v.s. 9.12 %). Meanwhile, the communities in the south exhibited lower network complexity and stability. We utilized a structural equation model to explore the drivers of deterministic processes. Results revealed that low network complexity (r = -0.56, P < 0.05) and high quorum sensing bacteria abundance (r = 0.25, P < 0.001) promoted deterministic assembly, which clarifies why determinism was stronger in southern communities than northern ones. Furthermore, total phosphorus and hydraulic retention time were found to be the primary abiotic drivers. These findings provide evidence to understand the community deterministic assembly, which is crucial for resolving community structure and improving bioreactor performance.

Facilitators and barriers to employment for people with physical disabilities: A cross-sectional study.

BACKGROUND: There is increasing evidence that employment, or the lack thereof, affects an individual's health. Consequently, employment provides people with physical disabilities (PWPD) with financial independence, enhances their well-being and self-worth, and facilitates a sense of purpose. People with physical disabilities often retain job skills and motivation to return to work after acquiring a disability. Their vocational rehabilitation and job accommodation needs likely differ from people with disabilities resulting from developmental, sensory, cognitive, and mental health conditions. To better target the needs of PWPD and improve vocational rehabilitation services, it is crucial to identify the modifiable factors that influence their employment outcomes. OBJECTIVE: This research aimed to examine systematically the client-, employer-, and context-related facilitators and barriers to employment experienced by PWPD. METHODS: We recruited to this cross-sectional study, PWPD from the Midwestern United States who returned to work after injury or illness. An online survey collected data on demographic characteristics and educational history; disability and functional status; supports, facilitators and barriers to employment; and job information and accommodations. RESULTS: 347 working-age PWPD completed the survey; at the time of survey completion, 270 were working and 77 were not. People with physical disabilities who reported social support and encouragement at work were more likely to be working than respondents who did not. Negative attitudes of supervisors and colleagues, inaccessible work environments, and inflexible work schedules were barriers to employment. Important reasons for working included financial needs, a sense of purpose, and self-worth. CONCLUSIONS: Results provide insights into the importance of social supports in the work environment. Novel approaches are needed to develop supportive relationships with supervisors and coworkers.

Endovascular treatment for brain arteriovenous malformations via the anterior choroidal artery for casting Onyx-18.

Background: Few studies have investigated the safety of endovascular treatment (EVT) for brain arteriovenous malformations (BAVMs) via the anterior choroidal artery (AchA); therefore, this topic is worth studying further. Materials and methods: This was a retrospective study of 18 consecutive patients with BAVMs that were treated via the AchA with Onyx casting. Clinical and angiographic data were collected from the patients and analyzed. Results: The ages of the 18 patients ranged from 13 to 67 years (mean 39.2 ± 14.7 years), and eight patients were male (44.4%, 8/18). All patients had intracranial hemorrhages, including 2 with previous hemorrhages. All 18 BAVMs were mainly fed by the AchA and were treated via the AchA as the route for casting Onyx-18. Of the 13 single-trunk AchAs, after EVT, all proximal segments were preserved. For the 5 double-trunk AchAs, EVT was performed via the lower trunk; the proximal segments of the lower trunk were occluded for 2 of these AchAs. Among the 18 BAVMs, 16 niduses were embolized to different degrees, as were twelve associated aneurysms. Five (27.8%, 5/18) of the 18 patients experienced complications, and appropriate management was provided. During long-term follow-up, 14 (77.8%, 14/18) patients achieved good outcomes. Conclusion: EVT for BAVMs via the AchA has significant risks, but overall, good long-term outcomes were achieved in approximal 80% of the patients. This study highlights the potential of this technique for embolizing BAVMs via the AchA.

Meta-Analysis on the Recovery Effect of Acupuncture Combined With Rehabilitation Therapy in Spinal Cord Injury Patients.

Objective: To explore the recovery effect of acupuncture combined with rehabilitation therapy on muscle spasms in patients with spinal cord injury through a systematic review of meta-analysis methods. Methods: Use "acupuncture," "electronic-acupuncture," "spinal cord," "spasm," and "paraplegia" as keywords, CNKI, Google, Wanfang, VIP, sci-hub, Web of Science, PubMed, and other Chinese or English databases were searched. To collect the domestic and foreign research on acupuncture combined with rehabilitation for muscle spasms in patients with spinal cord injury. Preliminary screening was conducted, and data extraction and quality evaluation were carried out on the included literature, including publication time, sample size, treatment methods, recovery effects, etc. According to the literature, the influence of acupuncture combined with rehabilitation therapy on muscle spasms in patients with spinal cord injury and related indices was analyzed. The search period was from January 2018 to June 2023, and the selected research results were tested by RevMan5.3 software and data consolidation for consistency. The methodological quality of the included studies was assessed using the Newcastle-Ottawa Scale (NOS). Results: A preliminary literature search yielded 172 papers. 53 papers from sci-hub, 71 papers from HowNet, 36 papers from Wanfang, and 12 papers from VIP. Finally, 10 articles that met the criteria were included, including 594 patients. According to different treatment methods, the literature about acupuncture combined with rehabilitation therapy for muscle spasms in patients with spinal cord injury was analyzed for consistency, and data were merged. It was concluded that acupuncture combined with rehabilitation The clinical curative effect of the experimental group of patients is higher than that of the control group MD=5.31, 95%CI (2.94, 7.81), Z=5.64, P < .001; the clinical effective rate of the experimental group is higher than that of the control group. The improvement of the clinical spasticity index (CSI) score index of the patients in the experimental group was better than that of the control group MD = -3.09, 95%CI (-4.51, -1.67), Z =4.28, P < .001; the MAS score of the patients in the experimental group The improvement was better than that of the control group MD =-0.76, 95%CI (-1.16, -0.38), Z=8.13, P < .001; the improvement of Barthel index (BI) in the experimental group was better than that of the control group MD=9.81, 95%CI (7.84,11.71), Z=12.71, P < .001; no adverse events were reported in the experimental group and the control group. Conclusion: This study shows that acupuncture and rehabilitation are more effective than other therapeutic methods in the treatment of muscle spasms after spinal cord injury, and more randomized controlled trials are needed to verify this in the future.

Plasma Coupled Electrolyte Additive Strategy for Construction of High-Performance Solid Electrolyte Interphase on Li Metal Anodes.

High-performance lithium metal anodes are crucial for the development of advanced Li metal batteries. Herein, this work reports a novel plasma coupled electrolyte additive strategy to prepare high-quality composite solid electrolyte interphase (SEI) on Li metal to achieve enhanced performance and stability. With the guidance of calculations, this work selects diethyl dibromomalonate (DB) as an additive to optimize the solvation structure of electrolytes to modify the SEI. Meanwhile, this work groundbreakingly develops DB plasma technology coupled with DB electrolyte additive to construct a combinatorial SEI: inner plasma-induced SEI layer composed of LiBr and Li2CO3 plus additive-reduced SEI containing LiBr/Li2CO3/organic lithium compounds as an outer compatible layer. The optimized hybrid SEI has strong affinity toward Li+ and good mechanical properties, thereby inducing horizontal dispersion and uniform deposition of Li+ and keep structure stable. Accordingly, the symmetrical cells exhibit enhanced cycling stability for 1200 h at an overpotential of 23.8 mV with average coulombic efficiency (99.51%). Additionally, the full cells with LiNi0.8Co0.1Mn0.1O2 cathode deliver a capacity retention of 81.7% after 300 cycles at 0.5 C, and the pouch cell achieves a volumetric specific energy of ≈664 Wh L‒1. This work provides new enlightenment on plasma technology for fabrication of advanced metal anodes for energy storage.

Dissolved trace elements in the Ganges-Brahmaputra-Meghna River Basin: A new approach for estimating trace element flux inputs from rivers into the world's oceans.

Understanding the changes in the chemical compositions of dissolved trace elements from source to sink is important for determining their spatiotemporal variations and the contributions from each sub-catchment in the Ganges, Brahmaputra, and Meghna Rivers. To estimate weathering and matter transfer in these Rivers and the Ganges-Brahmaputra-Meghna (G-B-M) Estuary, we measured 15 dissolved trace element concentrations from surface and bottom water samples and exchangeable trace metals from suspended particulate matter (SPM). From December 2019 to January 2020, post-monsoon samples were collected from the upstream of the three rivers and the G-B-M Estuary. Dissolved trace elements in the Ganges and Meghna Rivers exhibited remarkable spatial variations, whereas those in the Brahmaputra River and the G-B-M Estuary were uniform. The dissolved trace elements, basic information (river length and drainage area), and physicochemical parameters (pH, dissolved oxygen, and conductivity) of the three rivers were inconsistent. The sample sites near urban areas and industrial centers had high concentrations of dissolved trace elements. In the G-B-M Estuary, iron and lead concentrations decreased along the salinity gradient, whereas selenium levels gradually increased, which may have been released by the SPM owing to its highly exchangeable trace metals. Compared with historical concentrations, trace elements that entered the G-B Estuary from the Ganges and Brahmaputra Rivers exhibited either decreased or increased metal fluxes due to additional terrigenous sources, suggesting that the inputs of trace element flux from the Ganges and Brahmaputra Rivers into the oceans may need to be re-evaluated. Furthermore, Fe and Pb concentrations and river fluxes in the Ganges and Changjiang have decreased in recent years. Hence, the fluxes of certain trace elements that enter the oceans from large rivers may require re-evaluation.

A scalable Li-Al-Cl stratified structure for stable all-solid-state lithium metal batteries.

Sulfides are promising electrolyte materials for all-solid-state Li metal batteries due to their high ionic conductivity and machinability. However, compatibility issues at the negative electrode/sulfide electrolyte interface hinder their practical implementation. Despite previous studies have proposed considerable strategies to improve the negative electrode/sulfide electrolyte interfacial stability, industrial-scale engineering solutions remain elusive. Here, we introduce a scalable Li-Al-Cl stratified structure, formed through the strain-activated separating behavior of thermodynamically unfavorable Li/Li9Al4 and Li/LiCl interfaces, to stabilize the negative electrode/sulfide electrolyte interface. In the Li-Al-Cl stratified structure, Li9Al4 and LiCl are enriched at the surface to serve as a robust solid electrolyte interphase and are diluted in bulk by Li metal to construct a skeleton. Enabled by its unique structural characteristic, the Li-Al-Cl stratified structure significantly enhances the stability of negative electrode/sulfide electrolyte interface. This work reports a strain-activated phase separation phenomenon and proposes a practical pathway for negative electrode/sulfide electrolyte interface engineering.

Effect of moyamoya disease on the basilar artery and adjacent arteries on CTA.

Background: Computed tomographic angiography (CTA) is rarely used to explore the effect of moyamoya disease (MMD) on the basilar artery (BA) and its adjacent arteries. Methods: Participants were divided into a control group and an MMD group. The relevant parameters were measured. Statistical analyses included the t-test, chi-squared test, and linear regression analysis. Results: In the control group of 100 healthy people, the average age was 54.51 ± 13.40 years, and the ratio of males to females was 0.89:1. In the MMD group of 100 patients, the average age was 53.95 ± 11.31 years, and the ratio of males to females was 1.13:1. In the MMD group, the CTA score of the anterior circulation of the bilateral hemispheres was 7.57 ± 2.36. According to the statistical analyses, (1) in the control group, the BA apex tended to lean to the right in healthy participants; (2) in the MMD group, the BA was closer to the midline, and the angle between the BA and anterior inferior cerebellar artery was reduced, indicating that the BA was relatively elevated; (3) in the MMD group, the diameters of the BA, PCA and vertebral artery were larger than those in the control group; and (4) MMD patients with posterior cerebral atery (PCA) involvement had higher CTA scores of the anterior circulation. Conclusions: MMD can cause the BA to move toward the midline and upward and enlarge major vessels of the posterior circulation. The PCA tends to be involved in MMD patients with higher CTA scores in the anterior circulation.