Regulating the pore structure and heteroatom doping of soybean straw carbon based on a bifunctional template method for the high-performance carbon supercapacitor.

The previous research addressed the waste problem of agriculture and forestry residues by exploring the efficient utilization of liquefied soybean straw in supercapacitor. The structures of the liquefied soybean straw were controlled by coupling microwave hydrothermal treatment with carbonization under the influence of a C3N4 bifunctional template. What's more, C3N4 could effectively regulate the pore structures and provide an effective N active site of carbon materials C3N4. The obtained N-SLR Carbon-700 possess a specific surface area of up to 1593.7 m2 g-1, and the pore size is mainly concentrated in the range of 1.8-2.5 nm, providing efficient ions transmission channels and storage space. Its specific capacitance is up to 261.5F g-1 (current density of 0.5A g-1), and the capacity retention is 74.04% when the current density is expanded by 20 times. In the two-electrode system, the energy density of N-SLR Carbon-700 could reach to 31.3 W h kg-1 at a power density of 360 W kg-1, as well as the energy surface density is maintained at 69% when the power density is increased by a factor of 20. This work enhances effectively the charging and discharging stability and capacitance value of carbon-based supercapacitor.

Genome-Wide Identification of APX Gene Family in Citrus maxima and Expression Analysis at Different Postharvest Preservation Times.

Ascorbate peroxidase (APX) is a crucial enzyme involved in cellular antioxidant defense and plays a pivotal role in modulating reactive oxygen species (ROS) levels under various environmental stresses in plants. This study utilized bioinformatics methods to identify and analyze the APX gene family of pomelo, while quantitative real-time PCR (qRT-PCR) was employed to validate and analyze the expression of CmAPXs at different stages of fruit postharvest. This study identified 96 members of the CmAPX family in the entire pomelo genome, with uneven distribution across nine chromosomes and occurrences of gene fragment replication. The subcellular localization includes peroxisome, cytoplasm, chloroplasts, and mitochondria. The CmAPX family exhibits a similar gene structure, predominantly consisting of two exons. An analysis of the upstream promoter regions revealed a significant presence of cis-acting elements associated with light (Box 4, G-Box), hormones (ABRE, TCA-element), and stress-related (MBS, LTR, ARE) responses. Phylogenetic and collinearity analyses revealed that the CmAPX gene family can be classified into three subclasses, with seven collinear gene pairs. Furthermore, CmAPXs are closely related to citrus, pomelo, and lemon, followed by Arabidopsis, and exhibit low homology with rice. Additionally, the transcriptomic heat map and qPCR results revealed that the expression levels of CmAPX57, CmAPX34, CmAPX50, CmAPX4, CmAPX5, and CmAPX81 were positively correlated with granulation degree, indicating the activation of the endogenous stress resistance system in pomelo cells by these genes, thereby conferring resistance to ROS. This finding is consistent with the results of GO enrichment analysis. Furthermore, 38 miRNAs were identified as potential regulators targeting the CmAPX family for post-transcriptional regulation. Thus, this study has preliminarily characterized members of the APX gene family in pomelo and provided valuable insights for further research on their antioxidant function and molecular mechanism.

Symmetry of constellation diagram-based intelligent SNR estimation for visible light communications.

Visible light communication (VLC) technology with rich spectrum resources is thought of as an essential component in the future ubiquitous communication networks. Accurately monitoring its transmission impairments is important for improving the stability of high-speed communication networks. Existing research on intelligently monitoring the signal-to-noise ratio (SNR) performance of VLC focuses primarily on the application of neural networks but neglects the physical nature of communication systems. In this work, we propose an intelligent SNR estimation scheme for VLC systems, which is based on the symmetry of constellation diagrams with classical deep learning frameworks. In order to increase the accuracy of the SNR estimation scheme, we introduce two data augmentation methods (DA): point normalization and quadrant normalization. The results of extensive simulations demonstrate that the proposed point normalization method is capable of improving accuracy by about 5, 10, 14, and 26%, respectively, for 16-, 64-, 256-, and 1024-quadrature amplitude modulation compared with the same network frameworks without DA. The effect of accuracy improvement can be further superimposed with traditional DA methods. Additionally, the extensive number of constellation points (e.g., 32, 64, 128, 256, 512, 1024, and 2048) on the accuracy of SNR estimation is also investigated.

The Effects of Four Different Thawing Methods on Quality Indicators of Amphioctopus neglectus.

Amphioctopus neglectus is a species of octopus that is favored by consumers due to its rich nutrient profile. To investigate the influence of different thawing methods on the quality of octopus meat, we employed four distinct thawing methods: air thawing (AT), hydrostatic thawing (HT), flowing water thawing (FWT), and microwave thawing (MT). We then explored the differences in texture, color, water retention, pH, total volatile basic nitrogen (TVB-N), total sulfhydryl content, Ca2+-ATPase activity, and myofibrillar protein, among other quality indicators in response to these methods, and used a low-field nuclear magnetic resonance analyzer to assess the water migration that occurred during the thawing process. The results revealed that AT had the longest thawing time, leading to oxidation-induced protein denaturation, myofibrillar protein damage, and a significant decrease in water retention. Additionally, when this method was utilized, the content of TVB-N was significantly higher than in the other three groups. HT, to a certain extent, isolated the oxygen in the meat and thus alleviated protein oxidation, allowing higher levels of Ca2+-ATPase activity, sulfhydryl content, and springiness to be maintained. However, HT had a longer duration: 2.95 times that of FWT, resulting in a 9.84% higher cooking loss and a 28.21% higher TVB-N content compared to FWT. MT had the shortest thawing time, yielding the lowest content of TVB-N. However, uneven heating and in some cases overcooking occurred, severely damaging the protein structure, with a concurrent increase in thawing loss, W value, hardness, and shear force. Meanwhile, FWT improved the L*, W* and b* values of octopus meat, enhancing its color and water retention. The myofibrillar protein (MP) concentration was also the highest after FWT, with clearer subunit bands in SDS-PAGE electrophoresis, indicating that less degradation occurred and allowing greater springiness, increased Ca2+-ATPase activity, and a higher sulfhydryl content to be maintained. This suggests that FWT has an inhibitory effect on oxidation, alleviating protein oxidation degradation and preserving the quality of the meat. In conclusion, FWT outperformed the other three thawing methods, effectively minimizing adverse changes during thawing and successfully maintaining the quality of octopus meat.

Construction of self-enhanced luminescence probes based on Ti3C2 reducibility for ultrasensitive PNK analysis.

Au nano-clusters (Au NCs) were promising electrochemiluminescence (ECL) nano-materials. However, the small size of Au NCs presented a challenge in terms of their immobilization during the construction of an ECL biosensing platform. This limitation significantly hindered the wider application of Au NCs in the ECL field. In this work, we successfully used the reducibility of Ti3C2 to fabricate in situ a self-enhanced nano-probe Ti3C2-TiO2-Au NCs. The strategy of in situ generation not only improved the immobilization of Au NCs on the probe but also eliminated the requirement of adding reducing agents during preparation. In addition, in situ generated TiO2 could serve as a co-reaction accelerator, shortening the electron transfer distance between S2O82- and Au NCs, thereby improving the utilization of intermediates and enhancing the ECL response of Au NCs. The constructed ECL sensing platform could achieve sensitive detection of polynucleotide kinase (PNK). At the same time, the 5'-end phosphate group of DNA phosphorylation could chelate with a large amount of Ti on the surface of Ti3C2, thereby achieving the goal of specific detection of PNK. The sensor based on self-enhanced ECL probes had a broad dynamic range spanning for PNK detection from 10.0 to 1.0 × 107 µU mL-1, with a limit of detection of 1.6 µU mL-1. Moreover, the ECL sensor showed satisfactory detection performance in HeLa cell lysate and serum. This study not only provided insights for addressing the issue of ECL luminescence efficiency in Au NCs but also presented novel concepts for ECL self-enhancement strategies.

Dynamic Luminescence of Lead-Doped Calcium Zinc Germanate Clinopyroxene for Multimode Anticounterfeiting.

Anticounterfeiting plays an essential role in authenticating genuine documents and combating forged products. To further advance the anticounterfeiting technology, there is a strong demand to design new functional materials with unique properties that will be appropriate for making multimode complex security labels. Recently, dynamic security labels have emerged as a new type of advanced anticounterfeiting method as they can hold a much higher security level than the traditional static ones. In this work, we report that calcium zinc germanate (CZGO) clinopyroxenes doped with lead ions have several interesting optical properties, such as dynamic fluorescence, long persistent luminescence, and photochromism. We find that the concentration of lead dopants can significantly impact the reaction kinetics as well as the crystallinity and luminescence properties of CZGO phosphors. By fully utilizing these unique properties, we have successfully fabricated several security labels with multilevel information encoding and dynamic optical performance. The combination of multimode and dynamic luminescence makes these labels extremely challenging to illegally duplicate. With further optimization, this lead-doped CZGO clinopyroxene can be well-integrated into modern anticounterfeiting techniques that will generate highly secure anticounterfeiting labels to combat fake products.

Enhancing electrochemiluminescence for chloramphenicol detection based on the synergistic effect of doped Ti3C2 with ultrasound.

Chloramphenicol (CAP) is known to be harmful to the environment and food, posing a threat to human health. Developing an effective and convenient method for detecting CAP is crucial. An electrochemiluminescence (ECL) biosensor has been designed for sensitive detection of CAP. The improved ECL behavior was attributed to the synergistic effect of N and P co-doped Ti3C2-Apt1 (N, P-Ti3C2-Apt1) nanoprobes and high intensity focused ultrasound (HIFU) pretreatment. The doping of N and P could improve the electrochemical performance of Ti3C2. HIFU pretreatment generated more reactive oxygen species (ROS) in the luminol-O2 system. N, P-Ti3C2 could aggregate and catalyze ROS, causing an increase in ECL intensity. Furthermore, N, P-Ti3C2 as a carrier loaded more aptamer, which could recognize CAP with high specificity. The detection limit was 0.01 ng/mL. This biosensor has been successfully applied in milk and environmental water samples, highlighting its potential in the field of food and environmental analysis.

Exosomes from Hypoxia-treated Mesenchymal Stem Cells: Promoting Neuroprotection in Ischemic Stroke Through miR-214-3p/PTEN Mechanism.

Stroke stands as the second leading cause of death globally, surpassed only by ischemic heart disease. It accounts for 9% of total worldwide deaths. Given the swiftly evolving landscape, medical professionals and researchers are devoting increased attention to identifying more effective and safer treatments. Recent years have witnessed a focus on exosomes derived from mesenchymal stem cells cultivated under hypoxic conditions, referred to as Hypo-Exo. These specialized exosomes contain an abundance of components that facilitate the restoration of ischemic tissue, surpassing the content found in normal exosomes. Despite advancements, the precise role of Hypo-Exo in cases of cerebral ischemia remains enigmatic. Therefore, this study was designed to shed light on the potential efficacy of Hypo-Exo in stroke treatment. Our investigations unveiled promising outcomes, as the administration of Hypo-Exo led to improved behavioral deficits and reduced infarct areas in mice affected by ischemic conditions. Notably, these positive effects were hindered when Hypo-Exo loaded with anti-miR-214-3p were introduced, implying that the neuroprotective attributes of Hypo-Exo are reliant on miR-214-3p. This conclusion was substantiated by the high levels of miR-214-3p detected within Hypo-Exo. Furthermore, our examination of the ischemic penumbra zone revealed a gradual and sustained escalation in PTEN expression, a phenomenon effectively countered by Hypo-Exo treatment. Collectively, our findings suggest the existence of a regulatory pathway centered on miR-214-3p within Hypo-Exo. This pathway exerts a downregulating influence on the PTEN/Akt signaling pathway, thereby contributing to the amelioration of neurological function subsequent to ischemia-reperfusion events.

Effect of Rhodotorula mucilaginosa inoculation on the aroma development of a fermented vegetables simulated system.

Fermented vegetables are known for their unique flavors and aromas, which are influenced by the complex microbial processes that occur during fermentation. Rhodotorula mucilaginosa is a red yeast strain that is frequently isolated from fermented vegetables. However, the specific mechanisms underlying their effects on aroma production remain unclear. In this study, a simulated system of vegetables fermented using vegetable juices was used to investigate the effects of R. mucilaginosa inoculation on aroma development. The results demonstrated that this red yeast strain could utilize the nutrients present in the vegetable juices to support its growth and reproduction. Moreover, the inoculation of fermented vegetable juices with this yeast strain led to an increase in the levels of umami amino acids and sweet amino acids. Furthermore, this yeast strain was found able to significantly reduce the content of sulfur-containing compounds, which may decrease the unpleasant odor of fermented vegetables. Additionally, the yeast strain was capable of producing high concentrations of aromatic compounds such as phenylethyl alcohol, methyl 2-methylbutyrate, methyl butyrate, and nonanoic acid in a minimum medium. However, only phenylethyl alcohol has been identified as a core aromatic compound in fermented vegetable juice. The three fermented vegetable juices exhibited significantly different flavor profiles according to comparative analysis. Therefore, the core flavor compounds found in fermented vegetables are primarily derived from the release and modification of endogenous flavors naturally present in the vegetables, facilitated by the yeast during fermentation.

Diagnosing and Managing Uveitis Associated with Immune Checkpoint Inhibitors: A Review.

This review aims to provide an understanding of the diagnostic and therapeutic challenges of uveitis associated with immune checkpoint inhibitors (ICI). In the wake of these molecules being increasingly employed as a treatment against different cancers, cases of uveitis post-ICI therapy have also been increasingly reported in the literature, warranting an extensive exploration of the clinical presentations, risk factors, and pathophysiological mechanisms of ICI-induced uveitis. This review further provides an understanding of the association between ICIs and uveitis, and assesses the efficacy of current diagnostic tools, underscoring the need for advanced techniques to enable early detection and accurate assessment. Further, it investigates the therapeutic strategies for ICI-related uveitis, weighing the benefits and limitations of existing treatment regimens, and discussing current challenges and emerging therapies in the context of their potential efficacy and side effects. Through an overview of the short-term and long-term outcomes, this article suggests recommendations and emphasizes the importance of multidisciplinary collaboration between ophthalmologists and oncologists. Finally, the review highlights promising avenues for future research and development in the field, potentially informing transformative approaches in the ocular assessment of patients under immunotherapy and the management of uveitis following ICI therapy.

An electrochemiluminescence aptasensor based on Ti3C2 QDs-1T/2H MoS2 nano-hybrid material for the highly sensitive detection of lincomycin.

Developing a highly selective and sensitive analysis strategy for lincomycin (LIN) is of great significance for environmental protection and food safety. Herein, we reported a novel electrochemiluminescence (ECL) aptasensor based on Ti3C2 QDs-1T/2H MoS2 nano-hybrid luminophore for detection of LIN. The hybridization of Ti3C2 QDs and 1T/2H MoS2 endowed nanocomposite with structural and compositional advantages for boosting the ECL performance of QDs by about three times. This enhancement could be attributed to the remarkable electrocatalytic activity and high conductivity exhibited by 1T/2H MoS2. Secondly, the great surface area of 1T/2H MoS2 is conducive to the high dispersion of Ti3C2 QDs, and its good conductivity could promote charge transfer. On the other hand, the excellent catalytic performance of 1T/2H MoS2 could facilitate the reduction of S2O82- to produce more radical, which significantly enhance the ECL signal of Ti3C2 QDs. Given these features, a sensor for detection of LIN was established based on specific recognition between target and aptamer. The sensor showed a good linear relationship (0.05 ng mL-1 ∼100 µg mL-1) with a detection limit as low as 0.02 ng mL-1. It is worth noting that this work has been validated in testing milk samples, exhibiting great potential application prospects in food analysis.

Comparison of complications and indwelling time of midline catheter at different tip locations: A systematic review and meta-analysis.

This review was performed to determine whether different tip locations of a midline catheter can cause differences in the incidence of complications and the catheter indwelling time. PubMed, Embase, Web of Science, the Cochrane Library, Cumulative Index to Nursing and Allied Health Literature (CINAHL), China National Knowledge Infrastructure (CNKI), and Wanfang were systematically searched. RevMan 5.3 software was used for the meta-analysis. Heterogeneity was evaluated, and the mean differences or odds ratios with 95% confidence intervals were calculated. Eight studies met the inclusion criteria. The meta-analysis showed statistically significant differences in the complication rates (OR = 0.53; 95% CI = 0.34-0.84; p = 0.006) and incidence of catheter-related thrombosis (OR = 0.29; 95% CI = 0.11-0.76; p = 0.01) between midline catheter tip positioning in the subclavian vein and axillary vein. There were no significant differences in the catheter indwelling time or other complications such as phlebitis, catheter-related occlusion, catheter-related infiltration, pain, and catheter dislodgement between midline catheter tip positioning in the subclavian vein and axillary vein. There were statistically significant differences in the complication rates (OR = 0.23; 95% CI = 0.36-0.57; p < 0.001), incidence of catheter-related occlusion (OR = 0.29; 95% CI = 0.10-0.83; p = 0.02), and incidence of catheter-related infiltration (OR = 0.33; 95% CI = 0.17-0.63; p < 0.001) between midline catheter tip positioning in the proximal and distal axillary vein. Placement of the midline catheter tip in the subclavian vein was superior to that in the axillary vein in terms of complication rates and the incidence of catheter-related thrombosis. Whether different midline catheter tip locations lead to differences in the catheter indwelling time or the rates of other complications remains unclear. More high-quality studies incorporating relevant outcomes are needed for confirmation.

Barriers and facilitators of implementing the practice programme for upright positions in the second stage of labour: A mixed-method study.

OBJECTIVE: To explore the possible barriers and facilitators to implementing the Upright Positions in the Second Stage of Labour (UPSSL) programme in Chinese healthcare settings. DESIGN: A mixed-method convergent design with the guidance of Consolidated Framework for Implementation Research (CFIR). METHODS: An online survey study and semi-structured interviews were conducted between March and May 2023. Healthcare professionals were recruited from four hospitals in Shijiazhuang, China. One hundred and thirty-one participants completed the survey study, and 23 of them were interviewed individually. Descriptive statistics evaluated the possible barriers and facilitators of implementing the UPSSL programme within the CFIR framework quantitatively. Guided by the CFIR framework, qualitative data were analysed using directed content analysis to summarize healthcare professionals' perspectives on barriers and facilitators of the UPSSL programme. RESULTS: Multiple intersectional barriers and facilitators were identified from the survey and semi-interviews. Healthcare professionals believed that the UPSSL programme has a scientific evidence base, systematic contents, and possible benefits for women. However, various barriers existed at individual, system, and organizational levels. Major barriers included healthcare professionals and women's safety concerns towards the use of upright positions during childbirth, the healthcare professionals' unfamiliarity with assisting an upright position birth, poor adaptability of the programme protocol, inadequate facilities and staffing, and a lack of readiness to change in the clinical setting. CONCLUSIONS: To facilitate the implementation of the UPSSL programme in China, tailored antenatal education on upright positions, especially addressing safety-related issues, should be provided to pregnant women, their families, or peers to enhance their understanding of and familiarity with such positions. Healthcare professionals should also be offered adequate training opportunities and necessary facilities. Furthermore, national-level policy changes might be required to address midwifery workforce shortages. Additionally, further research is warranted to select, adapt, and test effective implementation strategies for programme adoption. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE: What problem did the study address? The adoption of upright positions during the second stage of labour could promote better maternal and neonatal outcomes and a positive childbirth experience. However, the adoption of upright positions during the second stage of labour is suboptimal in healthcare settings in China. Barriers and facilitators of implementing upright positions during childbirth are unclear. What were the main findings? A range of barriers and facilitators within the CFIR framework to promote upright positions during childbirth from healthcare professionals' perspectives were identified, and the major barriers included safety concerns towards and unfamiliarity with an upright position birth, inadequate facilities and staffing, and a lack of readiness to change in the clinical setting. Where and on whom will the research have an impact? This study will enable a better understanding of the barriers and facilitators to promoting upright positions in the second stage of labour in China. The smooth and effective implementation of the UPSSL programme could help to promote better maternal and neonatal outcomes and improve women's childbirth experiences. REPORTING METHOD: The reporting of this study followed the Consolidated Criteria for Reporting Qualitative Research (COREQ) and Good Reporting of A Mixed Methods Study (GRAMMS) guidelines. PATIENT OR PUBLIC CONTRIBUTION: In this study, healthcare professionals were involved in refining the topic guides and survey questions. Additionally, findings from the interviews were returned to them for comments and corrections.

Effects of Persimmon (Diospyros kaki L. cv. Mopan) Polysaccharide and Their Carboxymethylated Derivatives on Lactobacillus Strains Proliferation and Gut Microbiota: A Comparative Study.

Persimmon is a fruit that contains sugars, vitamins, phenolic compounds, and various other nutrients. The aim of this study was to explore the structure of carboxymethylated persimmon polysaccharide (CM-PFP) and its interaction with the human gut microbiota. Carboxymethyl modification of the persimmon polysaccharide (PFP) increased both the Mw and Mn, enhanced dispersion stability, and decreased thermal stability. Both PFP and CM-PFP promoted the proliferation of Lactobacillus while inhibiting the proliferation of Staphylococcus aureus and Escherichia coli. In the simulated fecal fermentation, the pH of PFP- and CM-PFP-containing media decreased, the content of short-chain fatty acids increased, and the abundance of intestinal flora at the phylum and genus levels changed. The relative abundance of harmful intestinal bacteria was significantly reduced in both PFP and CM-PFP groups. Furthermore, it was found that CM-PFP was more easily metabolized than PFP, glucose, and fructo-oligosaccharide (FOS) and had a proliferation increase effect on Lactobacillus. Therefore, CM-PFP has a significant positive effect on both Lactobacillus proliferation and the human gut microbiota.

[Matrine inhibits inflammatory response induced by TNF-α in human umbilical vein endothelial cells through miR-25-3p-mediated Klf4 pathway].

This study aimed to analyze the effect of matrine on tumor necrosis factor-α(TNF-α)-induced inflammatory response in human umbilical vein endothelial cells(HUVECs) and explore whether the underlying mechanism was related to the miR-25-3p-mediated Krüppel-like factor 4(Klf4) pathway. The HUVEC cell inflammation model was induced by TNF-α stimulation. After 24 or 48 hours of incubation with different concentrations of matrine(0.625, 1.25, and 2.5 mmol·L~(-1)), CCK-8 assay was used to detect cell proliferation. After treatment with 2.5 mmol·L~(-1) matrine for 48 h, the expression of TNF-α, interleukin-6(IL-6), interleukin-1ß(IL-1ß), and Klf4 mRNA and miR-25-3p was detected by real-time fluorescence-based quantitative PCR, and the protein expression of TNF-α, IL-6, IL-1ß, and Klf4 was detected by Western blot. The anti-miR-25-3p was transfected into HUVECs, and the effect of anti-miR-25-3p on TNF-α-induced cell proliferation and inflammatory factors was detected by the above method. The cells were further transfected with miR-25-3p and incubated with matrine to detect the changes in proliferation and expression of related inflammatory factors, miR-25-3p, and Klf4. The targeting relationship between miR-25-3p and Klf4 was verified by bioinformatics analysis and dual luciferase reporter gene assay. The results displayed that matrine could inhibit TNF-α-induced HUVEC proliferation, decrease the mRNA and protein expression of TNF-α, IL-6, and IL-1ß, increase the mRNA and protein expression of Klf4, and reduce the expression of miR-25-3p. Bioinformatics analysis showed that there were specific complementary binding sites between miR-25-3p and Klf4 sequences. Dual luciferase reporter gene assay confirmed that miR-25-3p negatively regulated Klf4 expression in HUVECs by targeting. The inhibition of miR-25-3p expression can reduce TNF-α-induced cell proliferation and mRNA and protein expression of TNF-α, IL-6, and IL-1ß. MiR-25-3p overexpression could reverse the effect of matrine on TNF-α-induced cell proliferation and the mRNA and protein expression of TNF-α, IL-6, IL-1ß, and Klf4. This study shows that matrine inhibits the inflammatory response induced by TNF-α in HUVECs through miR-25-3p-mediated Klf4 pathway.

Implementation of the Practice Programme for Upright Positions in the Second Stage of Labour and the birth experience of Chinese women: A qualitative study.

OBJECTIVE: Upright positions in the second stage of labour are recommended by many international organizations. However, they have not been widely used worldwide, especially in China. One of the important factors is the absence of a practice programme based on the best available evidence. We thus developed a Practice Programme for Upright Positions in the Second Stage of Labour following the UK Medical Research Council framework. Under the guidance of the programme, whether the use of upright positions can improve the maternal birth experience is a question of great concern. This study aimed to explore the birth experience of Chinese women who adopted upright positions in the second stage of labour. DESIGN: This qualitative descriptive study was conducted as part of an implementation study that developed an evidence-based intervention and used strategies to integrate the evidence-based intervention into routine obstetric clinical practice. SETTING: The maternity department of a tertiary comprehensive hospital in Hebei Province, China. PARTICIPANTS: Semi-structured interviews with twelve eligible women who adopted upright positions in the second stage of labour were conducted between March and April 2022. Qualitative data were analyzed by using conventional content analysis. FINDINGS: The average age of included women was 26.5 ± 3.5 years, and ten of them were primiparous women. Eight women adopted epidural analgesia during labour to relieve labour pain. All women gave birth in at least one type of upright position in the passive second stage of labour and adopted the semi-recumbent position in the active second stage of labour. Through conventional content analysis, we found that the use of upright positions in the second stage of labour could possibly promote an overall positive birth experience. Women giving birth in upright positions generally perceived they were more involved in their birthing process, and had greater physical and mental capacity to cope with childbirth. KEY CONCLUSIONS: Women have a positive birth experience when using upright positions in the second stage of labour. IMPLICATIONS FOR PRACTICE: This study suggests upright positions could improve women's birth experience and have the potential to be widely applied in clinical practice.

Effect of excessive gestational weight gain before and after 28 weeks on trial of labor after cesarean stratified by pre-pregnancy body mass index: a retrospective cohort study.

This study aimed to assess the effect of excessive gestational weight gain (GWG) before and after 28 weeks on the mode of delivery in women who attempted a trial of labor after cesarean (TOLAC), stratified by pre-pregnancy BMI. A retrospective analysis of the outcomes of eligible women who attempted trial of labor after cesarean (TOLAC) in a Chinese hospital from January 2016 to October 2022 was performed. GWG before and after 28 weeks was categorized as 'excessive' or 'non-excessive' based on the guideline of Institute of Medicine (IOM). Multivariable logistic regression analyses were used to estimate the effect of excessive GWG before and after 28 weeks on mode of delivery in women who underwent TOLAC, stratified by pre-pregnancy BMI. Of the 512 women who underwent term trial of labor, 71.1% achieved a vaginal birth. No correlation was found between excessive GWG before 28 weeks and the rate of vaginal birth after cesarean (VBAC). Among women with or without excessive GWG before 28 weeks, excessive GWG after 28 weeks was significantly associated with a reduced rate of VBAC. When stratified by pre-pregnancy BMI, women who had excessive gestational weight gain after 28 weeks gestation had lower rates of VBAC than those who did not, regardless of being underweight, normal or overweight (aOR 0.23, 95% CI 0.06-0.88; aOR 0.42, 95% CI 0.25, 0.70; and aOR 0.12, 95% CI 0.04-0.36; respectively). Excessive weight gain after 28 weeks of pregnancy was related to decreased rates of VBAC, irrespective of pre-pregnancy weight status and weight gain before 28 weeks.

Mid-trimester cervical length and prediction of vaginal birth after cesarean delivery in Chinese parturients: A retrospective study.

BACKGROUND: A successful trial of labor after cesarean (TOLAC) is linked with the best maternal/neonatal outcomes and is more cost-effective than elective repeat cesarean section (ERCS). Predictive models of vaginal birth after cesarean (VBAC) have been established worldwide to improve the success rate of TOLAC. OBJECTIVE: To validate a VBAC prediction model (the updated Grobman's predictive model without ethnicity) and identify whether mid-trimester cervical lengths (MCL) improve the prediction of VBAC among Chinese women undergoing a TOLAC. METHODS: In this retrospective cohort study, the inclusion criteria were a previous history of cesarean delivery (CD) as well as a singleton gestation in the vertex position with routine CL measurements between 20 and 24 weeks and the experience of a TOLAC. MCL as well as identifiable characteristics in early prenatal care that have been used in updated Grobman's predictive model (maternal age, height, pre-pregnancy weight, vaginal delivery history, VBAC history, arrest disorder in previous CD, and treated chronic hypertension) were obtained from the medical records. Associations of maternal characteristics and MCL with VBAC were evaluated using multivariate logistic regression. Two multivariable regression models with and without MCL as one of the risk factors were established and their predictive accuracy for VBAC was critically compared based on receiver-operating characteristic (ROC) curves. RESULTS: This study involved 409 women, among which, 347 (84.8%) achieved a VBAC. The mean MCL was significantly shorter in women who had a successful VBAC than in those who required an intrapartum CD (4.16±0.49 cm vs. 4.35±0.46 cm, P=0.007). Multivariable logistic regression revealed that a longer MCL (cm) was significantly related to a lower success rate of TOLAC [adjusted odds ratio (aOR), 0.48; 95% confidence interval (CI), 0.26-0.88]. The areas under the ROCs of Grobman's model with and without MCL as one of the risk factors were 0.785 (95% CI, 0.725-0.844) and 0.774 (95% CI, 0.710-0.837), respectively, but not significantly different (Z = -0.968, P = 0.333). CONCLUSIONS: We first evaluated the efficiency of the updated Grobman's model (without race and ethnicity) in the Chinese population. The area under the curve is relatively high, indicating that the model can be used efficiently in China. The shorter MCL was associated with a greater chance of VBAC and MCL was the independent factor from the factors of Grobman's model. However, the predictive capacity of the modified model by adding MCL as one of the risk factors did not improve significantly.

High-Performance Surface Electromyography Armband Design for Gesture Recognition.

Wearable surface electromyography (sEMG) signal-acquisition devices have considerable potential for medical applications. Signals obtained from sEMG armbands can be used to identify a person's intentions using machine learning. However, the performance and recognition capabilities of commercially available sEMG armbands are generally limited. This paper presents the design of a wireless high-performance sEMG armband (hereinafter referred to as the α Armband), which has 16 channels and a 16-bit analog-to-digital converter and can reach 2000 samples per second per channel (adjustable) with a bandwidth of 0.1-20 kHz (adjustable). The α Armband can configure parameters and interact with sEMG data through low-power Bluetooth. We collected sEMG data from the forearms of 30 subjects using the α Armband and extracted three different image samples from the time-frequency domain for training and testing convolutional neural networks. The average recognition accuracy for 10 hand gestures was as high as 98.6%, indicating that the α Armband is highly practical and robust, with excellent development potential.