The Efficacy of Acupuncture Therapy in the Management of Dyspnea and Other Symptoms Associated with Heart Failure: A Consolidated Review of Trial Data.

Background Acupuncture has been used for pain management for thousands of years. However, it is largely unclear whether this therapeutic approach can effectively reduce heart failure-associated symptoms, including dyspnea. Summary The hypothesis posited in this study was that acupuncture does indeed aid in management of such symptoms and was motivated by the following statistics that establish a requisite need for efficient management of dyspnea to improve patient outcomes with heart failure: In 2020, an estimated 6.2 million adults in the USA had a heart failure diagnosis; in 2018, 379,800 death certificates reported heart failure; and the national cost of heart failure in 2012 was approximately $30.7 billion. The methodology employed to conduct this study involved review of trial data extracted from review of papers pertaining to acupuncture, symptoms of heart failure and dyspnea, from academic and clinical data repositories subject to various inclusion and exclusion criteria. Of the initial set of 293 studies identified, the resulting inclusion set comprised 30 studies. The analysis conducted revealed that the highest frequency of combined acupuncture points prescribed for the foregoing search criteria were as follow: BL13, BL23, LU9, LU5, Dingchuan, LI4, PC6 and HT7. A meta-analysis of combined pooled p-values for the studies revealed that acupuncture does aid in the management of symptoms of dyspnea and heart failure, subject to various limitations including but not limited to heterogeneity inherent between the studies in the inclusion set that was analyzed. Such limitations underscore the need to restrict generalizations from the conclusions of this study. Key messages The impact and novelty of this research study is its attempt to target the apparent paucity of literature that focuses on the management of dyspnea specifically in the context of heart failure with acupuncture, and to bridge the gap of the application of acupuncture research on dyspnea to the cardiovascular context of heart failure. Further statistical analysis and a pilot study are warranted to consolidate or nullify the results of the research undertaken under this review study.

Optimizing auxiliary laser heating for Kerr soliton microcomb generation.

Auxiliary laser heating has become a widely adopted method for Kerr soliton frequency comb generation in optical microcavities, thanks to its reliable and easy-to-achieve merits for solving the thermal instability during the formation of dissipative Kerr solitons. Here, we conduct optimization of auxiliary laser heating by leveraging the distinct loss and absorption characteristics of different longitudinal and polarization cavity modes. We show that even if the auxiliary and pump lasers enter orthogonal polarization modes, their mutual photothermal balance can be efficient enough to maintain a cavity thermal equilibrium as the pump laser enters the red-detuning soliton regime, and by choosing the most suitable resonance for the auxiliary and pump lasers, the auxiliary laser power can be reduced to 20% of the pump laser and still be capable of warranting soliton generation. Moreover, we demonstrate soliton comb generation using integrated laser modules with a few milliwatt on-chip pump and auxiliary powers, showcasing the potential for further chip integration of the auxiliary laser heating method.

Tunable templating of photonic microparticles via liquid crystal order-guided adsorption of amphiphilic polymers in emulsions.

Multiple emulsions are usually stabilized by amphiphilic molecules that combine the chemical characteristics of the different phases in contact. When one phase is a liquid crystal (LC), the choice of stabilizer also determines its configuration, but conventional wisdom assumes that the orientational order of the LC has no impact on the stabilizer. Here we show that, for the case of amphiphilic polymer stabilizers, this impact can be considerable. The mode of interaction between stabilizer and LC changes if the latter is heated close to its isotropic state, initiating a feedback loop that reverberates on the LC in form of a complete structural rearrangement. We utilize this phenomenon to dynamically tune the configuration of cholesteric LC shells from one with radial helix and spherically symmetric Bragg diffraction to a focal conic domain configuration with highly complex optics. Moreover, we template photonic microparticles from the LC shells by photopolymerizing them into solids, retaining any selected LC-derived structure. Our study places LC emulsions in a new light, calling for a reevaluation of the behavior of stabilizer molecules in contact with long-range ordered phases, while also enabling highly interesting photonic elements with application opportunities across vast fields.

Coherently parallel fiber-optic distributed acoustic sensing using dual Kerr soliton microcombs.

Fiber-optic distributed acoustic sensing (DAS) has proven to be a revolutionary technology for the detection of seismic and acoustic waves with ultralarge scale and ultrahigh sensitivity, and is widely used in oil/gas industry and intrusion monitoring. Nowadays, the single-frequency laser source in DAS becomes one of the bottlenecks limiting its advance. Here, we report a dual-comb-based coherently parallel DAS concept, enabling linear superposition of sensing signals scaling with the comb-line number to result in unprecedented sensitivity enhancement, straightforward fading suppression, and high-power Brillouin-free transmission that can extend the detection distance considerably. Leveraging 10-line comb pairs, a world-class detection limit of 560 fε/√Hz@1 kHz with 5 m spatial resolution is achieved. Such a combination of dual-comb metrology and DAS technology may open an era of extremely sensitive DAS at the fε/√Hz level, leading to the creation of next-generation distributed geophones and sonars.

Cholesteric Spherical Reflectors with Tunable Color from Single-Domain Cellulose Nanocrystal Microshells.

The wavelength- and polarization-selective Bragg reflection of visible light exhibited by films produced by drying cholesteric liquid crystal (CLC) suspensions of cellulose nanocrystals (CNCs) render these biosourced nanoparticles highly potent for many optical applications. While the conventionally produced films are flat, the CLC-derived helical CNC arrangement would acquire new powerful features if given spherical curvature. Drying CNC suspension droplets does not work, because the onset of kinetic arrest in droplets of anisotropic colloids leads to severe buckling and loss of spherical shape. Here, these problems are avoided by confining the CNC suspension in a spherical microshell surrounding an incompressible oil droplet. This prevents buckling, ensures strong helix pitch compression, and produces single-domain cholesteric spherical reflector particles with distinct visible color. Interestingly, the constrained shrinkage leads to spontaneous puncturing, leaving every particle with a single hole through which the inner oil phase can be extracted for recycling. By mixing two different CNC types at varying fractions, the retroreflection color is tuned throughout the visible spectrum. The new approach adds a versatile tool in the quest to utilize bioderived CLCs, enabling spherically curved particles with the same excellent optical quality and smooth surface as previously obtained only in flat films.

Nanobodies as negative allosteric modulators for human calcium sensing receptor.

Human calcium sensing receptor (CaSR) senses calcium ion concentrations in vivo and is an important class of drug targets. Mutations in the receptor can lead to disorders of calcium homeostasis, including hypercalcemia and hypocalcemia. Here, 127 CaSR-targeted nanobodies were generated from camels, and four nanobodies with inhibitory function were further identified. Among these nanobodies, NB32 can effectively inhibit the mobilization of intracellular calcium ions (Ca2+i) and suppress the G12/13 and ERK1/2 signaling pathways downstream of CaSR. Moreover, it enhanced the inhibitory effect of the calcilytics as a negative allosteric modulator (NAM). We determined the structure of complex and found NB32 bound to LB2 (Ligand-binding 2) domain of CaSR to prevent the interaction of LB2 domains of two protomers to stabilize the inactive state of CaSR.

Ultra-low time jitter transform-limited dissipative Kerr soliton microcomb.

Microresonator soliton frequency combs offer unique flexibility in synthesizing microwaves over a wide range of frequencies. Therefore, it is very important to study the time jitter of soliton microcombs. Here, we fabricate optical microresonators with perfect transmission spectrum that characterizes highly uniform extinction ratio and absence of mode interactions by laser machining high-purity silica fiber preforms. Based on such perfect whispering-gallery-mode cavity, We demonstrate that K-band microwave with ultra-low phase noise (-83 dBc/Hz@100 Hz; -112 dBc/Hz@1kHz; -133 dBc/Hz@10kHz) can be generated by photo-detecting the repetition rate of a soliton microcomb. Also, with the Raman scattering and dispersive wave emission largely restricted, we show that ultra-low time jitter soliton has a wide existence range. Our work illuminates a pathway toward low-noise photonic microwave generation as well as the quantum regime of soliton microcombs.

Clean energy transitions and health.

Clean energy can lead to significant health benefits. Making it accessible throughout the world can address many ills. We delve deeply into one example-the transition toward clean residential heating and its relationship to health benefits-in China. We find that the health benefits can outweigh costs from energy expenses in northern provinces. Low-income households enjoy larger health benefits but also experience a higher expense increase, suggesting that extra subsidies or stimuli are needed to help them benefit from clean energy. Our findings suggest that clean energy transitions should be promoted in developing economies due to improved social health, lessened medical costs, and significant environmental improvements.

Combining LCA-MFA models to identify China's plastic value chain environmental impact mitigation pathways.

Characterizing material flows and environmental impacts of plastic value chain is crucial for sustainable plastic management. Here, we combine material flow analysis and life cycle assessment methods to map the flows of eight major plastics and investigate the multiple environmental impacts of China's plastic value chain. We find that packaging and textile sectors dominate plastic consumption and are responsible for the value chain environmental burdens, but with low recycling rates. Major environmental impacts are generated in plastic production and product manufacturing stages because of the consumption of coal-based feedstocks and electricity. We therefore set up six scenarios by considering carbon neutrality energy pathway, plastic recycling improvement, and technology updating, finding that the value chain environmental impact can be reduced by 14%-57% in 2060 under combined scenario. Particularly, carbon neutrality renewable energy pathway plays an important role. These findings provide valuable insights to identify key mitigation pathways for plastic value chain.

The anthropogenic cycles of palladium in China during 2001-2020.

Palladium (Pd) is a strategic metal and can help reduce environmental pollution, especially from vehicle exhausts. China is the world's largest Pd consumer, but with very limited reserves. However, Pd anthropogenic cycles remain unclear in China. This study aims to uncover the dynamic Pd flows and stocks in China for the period of 2001-2020 by conducting dynamic material flow analysis. The results show that the demand for Pd had increased by 10 folds during the study period due to stricter vehicle emissions policies. Also, China mainly imported such resource from the United States, Western Europe, and East Asia, with a share of 88.8 %. However, due to insufficient end-of-life vehicle (ELV) recycling system, the total recycled Pd was only 12.3 tons although the end-of-life Pd flow increased from 3.7 tons in 2001 to 30.8 tons in 2020. This implies a great Pd recycling potential. Therefore, it is urgent to promote Pd recycling by establishing an effective Pd recycling system. In addition, other policy recommendations, such as diversifying Pd import partners, increasing Pd emergency reserves, and economic instruments, are raised by considering the Chinese realities so that the overall Pd resource efficiency can be improved.

Towards a photonic integrated all-optical phase regenerator.

All-optical phase regeneration aims at restoring the phase information of coherently encoded data signals directly in the optical domain so as to compensate for phase distortions caused by transceiver imperfections and nonlinear impairments along the transmission link. Although it was proposed two decades ago, all-optical phase regeneration has not been seen in realistic networks to date, mainly because this technique entails complex bulk modules and relies on high-precision phase sensitive nonlinear dynamics, both of which are adverse to field deployment. Here, we demonstrate a new, to the best of our knowledge, architecture to implement all-optical phase regeneration using integrated photonic devices. In particular, we realize quadrature phase quantization by exploring the phase-sensitive parametric wave mixing within on-chip silicon waveguides, while multiple coherent pump laser tones are provided by a chip-scale micro-cavity Kerr frequency comb. Multi-channel all-optical phase regeneration is experimentally demonstrated for 40 Gbps QPSK data, achieving the best SNR improvement of more than 6 dB. Our study showcases a promising avenue to enable the practical implementation of all-optical phase regeneration in realistic long-distance fiber transmission networks.

Exergy analysis of natural resources embodied in China's interregional trade and its implication for regional imbalance.

Large-scaled interregional trade is based upon massive exchanges of natural resources, leading to more environmental emissions and economic imbalance. China is the largest trade country in the world and has to face such challenges since different Chinese provinces are in different development stages with different resource endowments. By using the latest multi-regional input-output (MRIO) tables and exergy accounting, this study aims to investigate natural resources and added values embodied in interregional trade in China for years of 2012, 2015, and 2017. Regional environmental inequality (REI) index and logarithmic mean Divisia index (LMDI) were applied to measure the imbalance states and uncover corresponding driving factors. Results show that the total trade volumes in the middle Yellow River and eastern coastal regions were generally higher than those in other regions, together accounting for 41.50 ~ 41.78% of the total trade volume during the study period. The major flows of embodied natural resources shifted from the middle Yellow River region to western coastal, eastern coastal, and southern coastal regions. The northern coastal and eastern coastal regions were the major exporters of embodied added value. Less developed regions had higher REI values, indicating more environmental and economic losses than developed regions. Natural resources intensity was the major impact factor on the trade imbalances in most provinces. This study provides valuable insights for alleviating trade imbalance and promoting sustainable natural resources management based on cross-regional collaboration.

Structure basis of two nanobodies neutralizing SARS-CoV-2 Omicron variant by targeting ultra-conservative epitopes.

The evolving SARS-CoV-2 Omicron strain has repeatedly caused widespread disease epidemics, and effective antibody drugs continue to be in short supply. Here, we identified a batch of nanobodies with high affinity for receptor binding domain (RBD) of SARS-CoV-2 spike protein, separated them into three classes using high performance liquid chromatography (HPLC), and then resolved the crystal structure of the ternary complexes of two non-competing nanobodies (NB1C6 and NB1B5) with RBD using X-ray crystallography. The structures showed that NB1B5 and NB1C6 bind to the left and right flank of the RBD, respectively, and that the binding epitopes are highly conserved cryptic sites in all SARS-CoV-2 mutant strains, as well as that NB1B5 can effectively block the ACE2. These two nanobodies were covalently linked into multivalent and bi-paratopic formats, and have a high affinity and neutralization potency for omicron, potentially inhibiting viral escape. The binding sites of these two nanobodies are relatively conserved, which help guide the structural design of antibodies targeting future variants of SARS-CoV-2 to combat COVID-19 epidemics and pandemics.

Multiresponsive Cylindrically Symmetric Cholesteric Liquid Crystal Elastomer Fibers Templated by Tubular Confinement.

Cylindrically symmetric cholesteric liquid crystal elastomer (CLCE) fibers templated by tubular confinement are reported, displaying mechanochromic, thermochromic, and thermomechanical responses. The synthesis inside a sacrificial tube secures radial orientation of the cholesteric helix, and the ground state retroreflection wavelength is easily tuned throughout the visible spectrum or into the near-infrared by varying the concentration of a chiral dopant. The fibers display continuous, repeatable, and quantitatively predictable mechanochromic response, reaching a blue shift of more than -220 nm for 180% elongation. The cylindrical symmetry renders the response identical in all directions perpendicular to the fiber axis, making them exceptionally useful for monitoring complex strains, as demonstrated in revealing local strain during tying of different knots. The CLCE reflection color can be revealed with high contrast against any background by taking advantage of the circularly polarized reflection. Upon heating, the fibers respond-fully reversibly-with red shift and radial expansion/axial contraction. However, there is no transition to an isotropic state, confirming a largely forgotten theoretical prediction by de Gennes. These fibers and the easy way of making them may open new windows for large-scale application in advanced wearable technology and beyond.

Understanding the greenhouse gas emissions from China's wastewater treatment plants: Based on life cycle assessment coupled with statistical data.

Wastewater treatment plants (WWTPs) are significant contributors to energy consumption and anthropogenic greenhouse gas (GHG) emissions. For achieving carbon reduction in the wastewater treatment industry, the direct and indirect GHG emissions generated by WWTPs need to be understood from a holistic perspective. This study estimated GHG emissions from WWTPs at the country scale by integrating process-based life cycle assessment and statistical data. On-site data were collected from 17 WWTPs of various regions in China. Uncertainty analysis based on Monte Carlo was also performed, so as to provide more reliable results. The results show that life cycle GHG emissions generated from the wastewater treatment process vary from 0.29 kg CO2 eq/m3 to 1.18 kg CO2 eq/m3 based on 17 sample WWTPs. The key factors contributing to overall GHG emissions are also identified as carbon dioxide (fossil) and methane (fossil) to air mainly generated from electricity generation, and methane (biogenic) and nitrous oxide (biogenic) to air mainly generated from wastewater treatment. National average GHG emissions was evaluated with the value of 0.88 kg CO2 eq/m3, with on-site GHG emissions and off-site electricity-based GHG emissions accounting for 32% and 34%, respectively. The total GHG emissions generated from wastewater treatment are 56.46 billion kg CO2 eq in 2020, with Guangdong province having the dominant contribution. Policy suggestions (e.g., further adjusting the electricity grid toward a low carbon structure, improving technology to promote treatment efficiency and energy recovery) were highly recommended so that national GHG emissions of WWTPs can be reduced. In order to achieve the synergy of pollutant removal and GHG emission reduction, policy-making on wastewater treatment should be tailored to specific local conditions.

Measuring the anthropogenic cycles of light rare earths in China: Implications for the imbalance problem.

Light rare earth elements (LREEs) are of strategic importance for low carbon transition and decarbonization. However, the imbalance between LREEs exists and a systematic understanding of their flows and stocks is lacking, which impedes the attainment of resources efficiency and exacerbates the environmental burdens. This study examines the anthropogenic cycles and the imbalance problem of three representative LREEs in China, the largest LREEs producer in the world, including cerium (the most abundant), neodymium and praseodymium (the fastest demand-growing). We find that 1) from 2011 to 2020, the total consumption of Nd and Pr increased by 228 % and 223 %, respectively, mainly attributed to the increasing demand of NdFeB, whereas that of Ce increased by 157 %; 2) the supply insufficiency of Nd and Pr under the current quota system accumulated to 138,086 tons and 35,549 tons, respectively, while the oversupply of Ce reached 63,523 tons; and 3) China has become a net importer of LREEs concentrates, and a net exporter of LREEs in the form of intermediate and final products, imposing further burdens to the domestic environment. It is clear that the imbalance of LREEs occurred during the study period, raising urgent needs to adjust the LREEs production quotas, seek other Ce applications, and eliminate illegal mining.

A procedure for producing an anti-AXL nanobody in E. coli.

As one of the receptors of the TAM family, AXL plays a vital role in stem cell maintenance, angiogenesis, immune escape of viruses and drug resistance against tumors. In this study, the truncated extracellular segment containing two immunoglobulin-like domains of human AXL (AXL-IG), which has been confirmed to bind growth arrest specific 6 (GAS6) by structural studies [1], was expressed in a prokaryotic expression system and then purified. Immunizing camelid with the purified AXL-IG as antigen could lead to the production of unique nanobodies composed of only variable domain of heavy chain of heavy-chain antibody (VHH), which are around 15 kD and stable. We screened out a nanobody A-LY01 specific binding to AXL-IG. We further determined the affinity of A-LY01 to AXL-IG and revealed that A-LY01 could specifically recognize full-length AXL on the surface of HEK 293T/17 cells. Our study provides appropriate support for the development of diagnostic reagents and antibody therapeutics targeting AXL.

Preparation and characterization of nanobodies targeting SARS-CoV-2 papain-like protease.

Coronavirus Papain-like protease (PLpro) mediates the cleavage of viral polyproteins and assists the virus escaping from innate immune response. Thus, PLpro is an attractive target for the development of broad-spectrum drugs as it has a conserved structure across different coronaviruses. In this study, we purified SARS-CoV-2 PLpro as an immune antigen, constructed a nanobody phage display library, and identified a set of nanobodies with high affinity for SARS-CoV-2. In addition, enzyme activity experiments demonstrated that two nanobodies had a significant inhibitory effect on the PLpro. These nanobodies should therefore be investigated as candidates for the treatment of coronaviruses.

Sensitivity-enhanced nanoplasmonic biosensor using direct immobilization of two engineered nanobodies for SARS-CoV-2 spike receptor-binding domain detection.

Sensitive, rapid, and easy-to-implement biosensors are critical in responding to highly contagious and fast-spreading severe acute respiratory syndrome coronavirus (SARS-CoV-2) mutations, enabling early infection screening for appropriate isolation and treatment measures to prevent the spread of the virus. Based on the sensing principle of localized surface plasmon resonance (LSPR) and nanobody immunological techniques, an enhanced sensitivity nanoplasmonic biosensor was developed to quantify the SARS-CoV-2 spike receptor-binding domain (RBD) in serum within 30 min. The lowest concentration in the linear range can be detected down to 0.01 ng/mL by direct immobilization of two engineered nanobodies. Both the sensor fabrication process and immune strategy are facile and inexpensive, with the potential for large-scale application. The designed nanoplasmonic biosensor achieved excellent specificity and sensitivity for SARS-CoV-2 spike RBD, providing a potential option for accurate early screening of the novel coronavirus disease 2019 (COVID-19).