Maternal Serum Folate During Pregnancy and Congenital Heart Disease in Offspring.

Importance: The association of folate supplementation with congenital heart disease (CHD) prevention is controversial. Objective: To examine the association of maternal serum folate levels at early to midpregnancy with CHD risk in offspring. Design, Setting, and Participants: This case-control study recruited participants from one of China's largest cardiac referral centers between 2015 and 2018. CHD cases and non-CHD controls were matched according to maternal age at a ratio of 1:4. Data were analyzed from May to August 2023. Exposures: Maternal serum levels of folate, vitamin B12, and homocysteine were measured around the gestational age of 16 weeks. Main Outcomes and Measures: The primary outcome was CHD, which was confirmed using echocardiography. The association between CHD risk in offspring with maternal folate levels was measured using adjusted odds ratios (aORs) with 95% CIs in conditional logistic regression analyses. Interactions between folate, vitamin B12, and homocysteine and CHD were estimated on a multiplicative scale. Results: A total of 129 CHD cases with ventricular septal defect as the most common phenotype and 516 matched controls were included. The mean (SD) maternal age at pregnancy was 31.6 (5.3) years. There was a U-shaped association between maternal serum folate levels at early to midpregnancy and CHD risk in offspring. Compared with the offspring in the second and third quartiles of maternal folate, those in the lowest (aOR, 3.09; 95% CI, 1.88-5.08) and highest quartiles (OR, 1.81; 95% CI, 1.07-3.06) had increased odds of CHD. The ORs were higher when applying the World Health Organization criteria to determine the normal range for serum folate levels. Interaction analyses suggested that the adverse associations between low and high maternal folate and CHD risk might be further magnified by vitamin B12 deficiency or elevated homocysteine. Conclusions and relevance: In this case-control study of CHD, low maternal serum folate levels in early to midpregnancy were associated with an increased CHD risk in offspring, and excessively high folate levels were also associated with an elevated CHD risk. Further investigation is needed to make causal inferences for the observed associations and elucidate the underlying mechanisms.

Main-Chain Azobenzene Poly(ether ester) Multiblock Copolymers for Strong and Tough Light-Driven Actuators.

The stimulus-responsive polymeric materials have attracted great research interest, especially those remotely manipulated materials with potential applications in actuators and soft robotics. Here we report a photoresponsive main-chain actuator based on azobenzene poly(ether ester) multiblock copolymer (mBCP) thermoplastic elastomers, (PTAD-b-PTMO-b-PTAD)n, which were synthesized by a cascade polycondensation-coupling ring-opening polymerization method using poly(tetramethylene oxide) (PTMO) and azobenzene-containing cyclic oligoesters (COTADs) as monomers. The thermal, mechanical, and microphase separation behaviors of mBCPs could be flexibly tuned by altering the ratios of soft-to-hard segments and block number (n). The oriented azobenzene mBCP fibers were prepared by melt spinning, showing reversible photoresponsive properties with remarkably high strength (∼1000 MPa) and high elongation at break comparable to spider silks. Fast photoinduced bending and contraction were successfully achieved in these fibers with high work and power densities and energy conversion efficiency, enabling it to lift up about 250 times of its own weight. Moreover, it can take out materials inside the tube by UV-light control. These fibers could be applied in light-driven actuators or telecontrolled robot arms.

Electrodeposition and optimisation of amorphous NixSy catalyst for hydrogen evolution reaction in alkaline environment.

Anion exchange membrane (AEM) water electrolyser has shown its potential in green hydrogen production. One of the crucial tasks is discover novel cost-effective and sustainable electrocatalyst materials. In this study, a low-cost Ni-S-based catalyst for hydrogen evolution reaction was prepared via a simple electrodeposition process from a modified Watts bath recipe. Physical characterisation methods suggest this deposit film to be amorphous. Optimisation of the electrodeposition parameters of the NixSy catalyst was carried out using a rotating disk electrode setup. The optimised catalyst exhibited excellent catalytical performance in 1 M KOH on a microelectrode, with overpotentials of 41 mV, 111 mV and 202 mV at 10, 100 and 1000 mA cm-2 with Tafel slope of 67.9 mV dec-1 recorded at 333 K. Long-term testing of the catalyst demonstrated steady performance over a 24 h period on microelectrode at 100 mA cm-2 with only 71 mV and 37 mV overpotential increase at 293 K and 333 K respectively. Full cell testing with the optimised NixSy as cathode and NiFe(OH-)2 as anode showed 1.88 V after 1 h electrolysis at 500 mA cm-2 in 1 M KOH under 333 K with FAA-3-30 membrane.

Novel sodium tauroursodeoxycholate-based multifunctional liposomal delivery system for encapsulation of oleanolic acid and combination therapy of type 2 diabetes mellitus.

Liposomes have demonstrated great potential for drug delivery and diabetes treatment. However, hydrolysis by enzymes and emulsification by endogenous bile salts make liposomes unstable in the gastrointestinal tract. In this study, sodium tauroursodeoxycholate (TUDCNa)-based multifunctional bilosomes were designed to address the deficiencies of conventional liposomes. In the designed bilosomes, cholesterol was replaced by TUDCNa, which served as both a membrane stabilizer and an antidiabetic drug. Oleanolic acid (OA) was encapsulated in both conventional liposomes (OA-Ch-Lip) and bilosomes (OA-Tu-Bil) to compare their properties. Firstly, OA-Tu-Bil exhibited similar encapsulation efficiency and drug loading compared to OA-Ch-Lip, but with a smaller particle size. Secondly, OA-Tu-Bil showed better stability than OA-Ch-Lip. Thirdly, bilosomes exhibited prolonged intestinal retention time and improved permeability and oral bioavailability. Fourthly, in type 2 diabetes mellitus (T2DM) mice model, TUDCNa synergized with OA to exhibit the strongest therapeutic effect. In conclusion, TUDCNa have demonstrated the ability to substitute cholesterol in conventional liposomes, it provided a new approach for oral delivery of hypoglycemic drugs, and offered an innovative strategy for combination therapy.

Development and validation of Parents' Health Literacy Scale on Preventing Road Traffic Injuries for children aged 0-6 years in China.

BACKGROUND: Road traffic injuries are the leading cause of death in children. Parents' health literacy (HL) is closely related to child safety, especially for the young children. This study aimed to develop an intervention-oriented parent HL scale: Parents' Health Literacy Scale on Preventing Road Traffic Injuries (PHLS-PRTIs). METHODS: We developed the scale including four parts: (1) definition and conceptualisation of PHLS-PRTIs; (2) domain and item development; (3) instrument construction; and (4) psychometric property validation. 685 parents participated in process of development (n=333) and validation (n=352). Cronbach's α and test-retest correlation were used to assess reliability. Content validity and construct validity were used to assess validity. RESULTS: The scale consisted of five domains (access, understand, belief, communication and use) and 16 subdomains. The Cronbach's α for each domain and the whole scale was 0.85, 0.70, 0.87, 0.80, 0.79 and 0.85, respectively. The test-retest reliability was acceptable (intraclass correlations >0.70). Content validity was good (item-level content validity index >0.79, average of the scale-level content validity index >0.80, kappa >0.74). For construct validity for domain understand, χ2/df=1.723, p=0.009, standardised root mean square residual (SRMR)=0.0404, root mean square error of approximation (RMSEA)=0.045, Comparative Fit Index (CFI)=0.942, Tucker-Lewis Index (TLI)=0.910; and for the other four domains, χ2/df=1.840, p<0.001, SRMR=0.043, RMSEA=0.049, CFI=0.958, TLI=0.952. CONCLUSIONS: PHLS-PRTIs was developed and validated by a rigorous process, providing a tool for community doctors to measure parents' HL on child road traffic safety and develop targeted health education interventions.

Validation of the Patient Activation Measure (PAM-13) among individuals with chronic spinal cord injury in mainland China.

CONTEXT/OBJECTIVE: The 13-item Patient Activation Measure (PAM-13) is the most widely used generic patient activation measure, but spinal cord injury (SCI) related psychometric evaluation of PAM-13 has not been explored globally. This study aimed to assess the validity of the Chinese version of the PAM-13 (PAM-13-C) for individuals with chronic spinal cord injury (CSCI). DESIGN: Cross-sectional study. SETTING: Shanghai Sunshine Rehabilitation Center, and some participants were recruited in a WeChat group (the most commonly used social media platform in China). PARTICIPANTS: 284 individuals with spinal cord injury who had lived with the injury for ≥0.5 year. INTERVENTIONS: NA. OUTCOME MEASURES: The PAM-13-C, global QoL, seven-item generalized anxiety disorder scale (GAD-7) and nine-item patient health questionnaire (PHQ-9), and General Self-Efficacy Scale (GSES) were used. RESULTS: The mean (SD) PAM-13-C score was 57.4 (16.5). The highest percentage of NA could be observed in item 9 (12.0%). Floor and ceiling effects of the total scores of PAM-13-C were small (0.7% and 6.7%), but a ceiling effect could be observed among all items. Exploratory Factor Analysis supported a one-factor model of the PAM-13-C (CFI = 0.97; RMSEA = 0.07). Construct validity was established through correlation analysis among the PAM-13-C, GAD-7/PHQ-9, global QoL, and GSES. The PAM-13-C demonstrated excellent internal consistency (Cronbach's α = 0.95) and acceptable test-retest reliability. CONCLUSION: The PAM-13-C is a reliable and valid measure of patient activation for individuals with CSCI in China.

Case report: Malignant epithelioid angiosarcoma in a Chinese female patient.

Perivascular epithelioid cell tumors (PEComas) are mesenchymal tumors that exhibit characteristic epithelioid or spindle cell morphology and typically grow around blood vessels. These tumors are characterized by the expression of melanocytic and smooth muscle markers, such as HMB-45, Melan-A, and smooth muscle actin, indicating a dual differentiation phenotype. PEComas are extremely rare diseases, and patients typically have a very poor prognosis. Here, we report a case of malignant cutaneous PEComa with pulmonary metastasis in a Chinese female and review relevant literature. The patient underwent surgical resection of a soft tissue tumor in the left upper arm under general anesthesia, and the subsequent pathological findings suggested a tumor with perivascular epithelioid cell differentiation (PEComa). The patient received adjuvant chemotherapy and radiotherapy after surgical resection, along with monitoring through computed tomography (CT) scans. Three months later, pulmonary metastasis was detected, but both the cutaneous PEComa in the left upper limb and the pulmonary metastatic lesions were stably controlled under active management and treatment. This is a rare case worth reporting and studying, and therefore, we conducted a long-term follow-up, and we hope to provide help for the clinical treatment of PEComa.

Bibliometric and visual analyses of research on the links between stroke and exosomes from 2008 to 2023.

Exosomes, which are extracellular vesicles secreted and released from specific cells, exist widely in cell culture supernatants and various body fluids. This study aimed to analyze the research status of exosomes in stroke, and predict developmental trends via bibliometric analyses. The related literature from January 1, 2008 to January 1, 2024 was searched in the Web of Science Core Collection and 943 articles were retrieved. VOSviewer was used to visualize national cooperation and institutional cooperation. Cluster analysis of keywords and Citespace were applied for mutation analysis. Results: The analysis of 943 works of literature showed that the number of published articles has been steadily increasing since 2015. It is predicted that nearly 211 articles will be published in 2024 and 220 annually by 2028. China has the largest number of publications (473), followed by the United States (234), and Germany (61). The institution with the most publications is Henry Ford Hospital (Detroit, MI). In the keyword cluster "Exosomes and the Mechanism of Stroke: Inflammation and Apoptosis," exosomes and inflammation were identified as hotspots. "Functional recovery" was a new trend in the keyword cluster of "Angiogenesis and Functional Recovery after Stroke." China and the United States are the main forces in this field, and both countries focusing on drug treatments. The studies have been published mainly in China and United States. The findings of our bibliometric analyses of the literature may enable researchers to choose appropriate institutions, collaborators, and journals.

The effects of lead (Pb) and pest damage on soil enzyme activities, pakchoi and Spodoptera litura performance.

Plant-soil interactions have bottom-up and top-down effects within a plant community. Heavy metal pollution can change plant-soil interactions, directly influence bottom-up effects and indirectly affect herbivores within the community. In turn, herbivores can affect plant-soil interactions through top-down effects. However, the combined effects of heavy metals and herbivores on soil enzymes, plants and herbivores have rarely been reported. Therefore, the effects of lead (Pb), Spodoptera litura and their combined effects on soil enzyme activities, pakchoi nutrition, defence compounds and S. litura fitness were examined here. Results showed that Pb, S. litura and their combined effects significantly affected soil enzymes, pakchoi and S. litura. Specifically, exposure to double stress (Pb and S. litura) decreased soil urease, phosphatase and sucrase activities compared with controls. Furthermore, the soluble protein and sugar contents of pakchoi decreased, and the trypsin inhibitor content and antioxidant enzyme activity increased. Finally, the S. litura development period was extended, and survival, emergence rates and body weight decreased after exposure to double stress. The combined stress of Pb and S. litura significantly decreased soil enzyme activities. Heavy metal accumulation in plants may create a superposition or synergistic effect with heavy metal-mediated plant chemical defence, further suppressing herbivore development. Pb, S. litura and their combined effects inhibited soil enzyme activities, improved pakchoi resistance and reduced S. litura development. The results reveal details of soil-plant-herbivore interactions and provide a reference for crop pest control management in the presence of heavy metal pollution.

Cross-domain visual prompting with spatial proximity knowledge distillation for histological image classification.

OBJECTIVE: Histological classification is a challenging task due to the diverse appearances, unpredictable variations, and blurry edges of histological tissues. Recently, many approaches based on large networks have achieved satisfactory performance. However, most of these methods rely heavily on substantial computational resources and large high-quality datasets, limiting their practical application. Knowledge Distillation (KD) offers a promising solution by enabling smaller networks to achieve performance comparable to that of larger networks. Nonetheless, KD is hindered by the problem of high-dimensional characteristics, which makes it difficult to capture tiny scattered features and often leads to the loss of edge feature relationships. METHODS: A novel cross-domain visual prompting distillation approach is proposed, compelling the teacher network to facilitate the extraction of significant high-dimensional features into low-dimensional feature maps, thereby aiding the student network in achieving superior performance. Additionally, a dynamic learnable temperature module based on novel vector-based spatial proximity is introduced to further encourage the student to imitate the teacher. RESULTS: Experiments conducted on widely accepted histological datasets, NCT-CRC-HE-100K and LC25000, demonstrate the effectiveness of the proposed method and validate its robustness on the popular dermoscopic dataset ISIC-2019. Compared to state-of-the-art knowledge distillation methods, the proposed method achieves better performance and greater robustness with optimal domain adaptation. CONCLUSION: A novel distillation architecture, termed VPSP, tailored for histological classification, is proposed. This architecture achieves superior performance with optimal domain adaptation, enhancing the clinical application of histological classification. The source code will be released at https://github.com/xiaohongji/VPSP.

Prevalence and correlates of non-suicidal self-injury among patients with bipolar disorder: A multicenter study across China.

BACKGROUND: Non-suicidal self-injury (NSSI) is increasingly prevalent among patients with bipolar disorder (BD), raising concerns in psychology and mental health. Investigating the incidence and factors associated with NSSI is crucial for developing prevention and intervention strategies. METHODS: NSSI behaviors were identified using the Ottawa Self-injury Inventory. The Clinically Useful Depression Outcome Scale supplemented with questions for the DSM-5 specifier of mixed features (CUDOS-M) and the Mini International Neuropsychiatric Interview (Hypo-)Manic Episode with Mixed Features-DSM-5 Module (MINI-M) were used to evaluate clinical symptoms. Non-parametric tests, chi-square tests, point-biserial correlation and logistic regression analyses were employed for the purposes of data analysis. RESULTS: The enrolled sample comprised 1044 patients with BD from 20 research centers across China. Out of 1044 individuals, 446 exhibited NSSI behaviors, with 101 of them being adolescents, leading to a prevalence of 78.3 % among adolescent patients. The most common methods for females and males were "cutting" (41.2 %) and "hitting" (34.7 %), respectively. By binary logistic regression analysis, young age, female, bipolar type II disorder, with suicidal ideation and mixed states, depressive symptoms and without family history of mental disorder were correlates of NSSI in patients with BD (P < 0.05). LIMITATIONS: As a cross-sectional study, causality between NSSI behaviors and associated factors cannot be established. Reporting and recall biases may occur due to self-rating scales and retrospective reports. CONCLUSION: Our study indicates a concerning prevalence of NSSI, particularly among young patients with BD in China. Future research should focus on understanding NSSI behaviors in this population and developing effective interventions.

α-Synuclein species in plasma neuron-derived extracellular vesicles as biomarkers for iRBD.

OBJECTIVE: Isolated REM sleep behavior disorder (iRBD) is considered as the strongest predictor of Parkinson's disease (PD). Reliable and accurate biomarkers for iRBD detection and the prediction of phenoconversion are in urgent need. This study aimed to investigate whether α-Synuclein (α-Syn) species in plasma neuron-derived extracellular vesicles (NDEVs) could differentiate between iRBD patients and healthy controls (HCs). METHODS: Nanoscale flow cytometry was used to detect α-Syn-containing NDEVs in plasma. RESULTS: A total of 54 iRBD patients and 53 HCs were recruited. The concentrations of total α-Syn, α-Syn aggregates, and phosphorylated α-Syn at Ser129 (pS129)-containing NDEVs in plasma of iRBD individuals were significantly higher than those in HCs (p < 0.0001 for all). In distinguishing between iRBD and HCs, the area under the receiver operating characteristic (ROC) curve (AUC) for an integrative model incorporating the levels of α-Syn, pS129, and α-Syn aggregate-containing NDEVs in plasma was 0.965. This model achieved a sensitivity of 94.3% and a specificity of 88.9%. In iRBD group, the concentrations of α-Syn aggregate-containing NDEVs exhibited a negative correlation with Sniffin' Sticks olfactory scores (r = -0.351, p = 0.039). Smokers with iRBD exhibited lower levels of α-Syn aggregates and pS129-containing NDEVs in plasma compared to nonsmokers (pα-Syn aggregates = 0.014; ppS129 = 0.003). INTERPRETATION: The current study demonstrated that the levels of total α-Syn, α-Syn aggregates, and pS129-containing NDEVs in the plasma of individuals with iRBD were significantly higher compared to HCs. The levels of α-Syn species-containing NDEVs in plasma may serve as biomarkers for iRBD.

Multi-Chambered Core/Shell Supraparticles for Real-Time, Full-Time Diagnosis and Treatment Integration of Tumors.

To a certain extent, theranostic nanoplatforms promote tumor treatment efficiency. However, timely monitoring of the critical stages and signal sustainability of the entire process is challenging. In this study, multi-chambered core/shell magnetic nanoparticles (MC-MNPs) as drug and imaging agent multi-loaded nanocarriers with a synergistic release function are reported. Supraparticles with stable chambers are formed by the supercooling self-assembly of several core/shell magnetic nanoparticles composed of amphiphilic copolymers as the core and hydrophilic magnetic iron oxide nanoparticles as the shell. Desalinized doxorubicin and coumarin 6 are stored in different cavities of nanocarriers, and chitosan is used as an outer encapsulation layer. Based on their construction properties, MC-MNPs can exhibit gradient-degraded and steady-released controllability in the tumor environment. Furthermore, real-time accumulation situations and full-time diagnostic signals of nanocarriers are thoroughly demonstrated using fluorescence imaging and T2-weighted magnetic resonance imaging before and after magnetic hyperthermia in targeted tumors under an alternating magnetic field. Thus, MC-MNPs as theranostic nanocarriers exhibit great potential for the timely monitoring and full-time guidance of tumor treatment.

Brain organoid maturation and implantation integration based on electrical signals input.

INTRODUCTION: Brain organoids are believed to be able to regenerate impaired neural circuits and reinstate brain functionality. The neuronal activity of organoids is considered a crucial factor for restoring host function after implantation. However, the optimal stage of brain organoid post-transplantation has not yet been established. External electrical signal plays a crucial role in the physiology and development of a majority of human tissues. However, whether electrical input modulates the development of brain organoids, making them ideal transplant donors, is elusive. METHODS: Bioelectricity was input into cortical organoids by electrical stimulation (ES) with a multi-electrode array (MEA) to obtain a better-transplanted candidate with better viability and maturity, realizing structural-functional integration with the host brain. RESULTS: We found that electrical stimulation facilitated the differentiation and maturation of organoids, displaying well-defined cortical plates and robust functional electrophysiology, which was probably mediated via the pathway of calcium-calmodulin (CaM) dependent protein kinase II (CAMK II)-protein kinase A (PKA)-cyclic-AMP response binding protein (pCREB). The ES-pretreated D40 organoids displayed superior cell viability and higher cell maturity, and were selected to transplant into the damaged primary sensory cortex (S1) of host. The enhanced maturation was exhibited within grafts after transplantation, including synapses and complex functional activities. Moreover, structural-functional integration between grafts and host was observed, conducive to strengthening functional connectivity and restoring the function of the host injury. CONCLUSION: Our findings supported that electrical stimulation could promote the development of cortical organoids. ES-pretreated organoids were better-transplanted donors for strengthening connectivity between grafts and host. Our work presented a new physical approach to regulating organoids, potentially providing a novel translational strategy for functional recovery after brain injury. In the future, the development of 3D flexible electrodes is anticipated to overcome the drawbacks of 2D planar MEA, promisingly achieving multimodal stimulation and long-term recordings of brain organoids.

Sepsis induced dysfunction of liver type 1 innate lymphoid cells.

BACKGROUND: Sepsis is a life-threatening condition triggered by uncontrolled immune responses to infection, leading to widespread inflammation, tissue damage, organ dysfunction, and potentially death. The liver plays a crucial role in the immune response during sepsis, serving as a major site for immune cell activation and cytokine production. Liver type 1 innate lymphoid cells (ILCs) consist of NK cells and ILC1s. They maintain the local immune microenvironment by directly eliminating target cells and secreting cytokines. However, the specific roles and pathological changes of liver-resident NK cells and ILC1s during sepsis remain poorly understood. RESULTS: This study aims to investigate the pathological changes of NK cells and ILC1s, which might contribute the dysfunction of liver. Sepsis mouse model was established by cecal ligation and puncture (CLP). Mouse immune cells from liver were isolated, and the surface makers, gene expression profiles, cytokine response and secretion, and mitochondrial function of NK (Natural Killer) cells and ILC1s (Innate Lymphoid Cell 1) were analyzed. A significant decrease in the number of mature NK cells was observed in the liver after CLP. Furthermore, the secretion of interferon-gamma (IFN-γ) was found to be reduced in spleen and liver NK cells when stimulated by IL-18. Mitochondrial activities in both liver NK cells and ILC1 were found to be increased during sepsis, suggesting an enhanced metabolic response in these cells to combat the infection. However, despite this heightened activity, liver NK cells exhibited a decreased level of cytotoxicity, which might impact their ability to target infected cells effectively. RNA sequencing supported and provided the potential mechanisms for the proinflammatory effects and exhaustion like phenotypes of liver NK cells. CONCLUSIONS: Sepsis induces dysfunction and exhaustion-like phenotypes in liver NK cells and ILC1, which might further impair other immune cells and represent a potential therapeutic target for sepsis.

Regulating the electronic properties, quantum capacitance and photocatalytic activity of Sc2CO2 based on Y doping and strain.

The doping of transition metals can effectively modulate the electronic structures and enhance the photocatalytic activity of MXenes. The electronic and photocatalytic properties, as well as the quantum capacitance of Sc2CO2-Y under biaxial strain, were studied by density functional theory. Sc2CO2-Y is a direct semiconductor and keeps its semiconductor character under strain. Sc2CO2-Y under tensile strain has higher photocatalytic activity than under compressive strain. In particular, Sc2CO2-Y at 2% strain has the slowest recombination rate of electrons and holes because of the largest . Sc2CO2-Y under strain is a potential cathode material. Its large potential keeps the character of cathode materials for Sc2CO2-Y under strain. Sc2CO2-Y under tensile strain has better conductivity, especially under 5% strain, due to having the largest Re (ε0). Sc2CO2-Y under strain can perform the HER, but fails to perform the OER at pH = 0, and tensile strain increases the reduction capacity of Sc2CO2-Y. Under strains from -2% to 2%, Sc2CO2-Y can perform the OER in an alkaline environment. Sc2CO2-Y is a good CO2 photocatalyst in acidic environments; the increase of pH value weakens the N2 reducing capacity of Sc2CO2-Y under strain. Its work function, charge transfer and optical properties are also explored.