Longitudinal assessment of plasma biomarkers for early detection of cognitive changes in subjective cognitive decline.

Background: Individuals experiencing subjective cognitive decline (SCD) are at an increased risk of developing mild cognitive impairment and dementia. Early identification of SCD and neurodegenerative diseases using biomarkers may help clinical decision-making and improve prognosis. However, few cross-sectional and longitudinal studies have explored plasma biomarkers in individuals with SCD using immunomagnetic reduction. Objective: To identify plasma biomarkers for SCD. Methods: Fifty-two participants [38 with SCD, 14 healthy controls (HCs)] underwent baseline assessments, including measurements of plasma Aß42, Aß40, t-tau, p-tau, and α-synuclein using immunomagnetic reduction (IMR) assays, cognitive tests and the Mini-Mental State Examination (MMSE). Following initial cross-sectional analysis, 39 individuals (29 with SCD, 10 HCs) entered a longitudinal phase for reassessment of these biomarkers and the MMSE. Biomarker outcomes across different individual categories were primarily assessed using the area under the receiver operating characteristic (ROC) curve. The SCD subgroup with an MMSE decline over one point was compared to those without such a decline. Results: Higher baseline plasma Aß1-42 levels significantly discriminated participants with SCD from HCs, with an acceptable area under the ROC curve (AUC) of 67.5% [95% confidence interval (CI), 52.7-80.0%]. However, follow-up and changes in MMSE and IMR data did not significantly differ between the SCD and HC groups (p > 0.05). Furthermore, lower baseline plasma Aß1-42 levels were able to discriminate SCD subgroups with and without cognitive decline with a satisfied performance (AUC, 75.0%; 95% CI, 55.6-89.1%). At last, the changes in t-tau and Aß42 × t-tau could differentiate between the two SCD subgroups (p < 0.05). Conclusion: Baseline plasma Aß42 may help identify people with SCD and predict SCD progression. The role of plasma Aß42 levels as well as their upward trends from baseline in cases of SCD that progress to mild cognitive impairment and Alzheimer's disease require further investigation.

Coagulating blood into adhesive gel by hybrid powder based on oppositely charged polysaccharide/tannic acid-modified mesoporous bioactive glass.

Hemostatic powder is widely utilized in emergency situations to control bleeding due to its ability to work well on wounds with irregular shapes, ease of application, and long-term stability. However, traditional powder often suffers from limited tissue adhesion and insufficient support for blood clot formation, leaving it susceptible to displacement by the flow of blood. This study introduces a hemostatic powder composed of tannic modified mesoporous bioactive glass (TMBG), cationic quaternized chitosan (QCS), and anionic hyaluronic acid modified with catechol group (HADA). The resulting TMBG/QCS/HADA based hemostatic powder (TMQH) rapidly absorbs plasma, concentrating blood coagulation factors. Simultaneously, the water-soluble QCS and HADA interact to form a 3D network structure, which can be strengthened by crosslinking with TMBG. This network effectively captures clustered blood coagulation factors, leading to a strong and adhesive thrombus that resists disruption from blood flow. TMQH exhibits superior efficacy in promoting hemostasis compared to Celox™ both in rat arterial injuries and non-compressible liver puncture wounds. TMQH demonstrates excellent antibacterial activity, cytocompatibility, and blood compatibility. These outstanding superiorities in blood clotting capability, wet tissue adhesion, antibacterial activity, safety for living organisms, ease of application, and long-term stability, make TMQH highly suitable for emergency hemostasis.

Clotting Blood into an Adhesive Gel by Hemostatic Powder Based on Cationic/Anionic Polysaccharides and Laponite.

Hemostatic powder is widely employed for emergency bleeding control due to its ability to conform to irregularly shaped wounds, ease of use, and stable storage. However, current powders exhibit limited tissue adhesion and insufficient support for thrombus formation, making them easily washed away by blood. In this study, a hybrid powder (QAL) was produced by mixing quaternized chitosan (QCS) powder, catechol-modified alginate (Cat-SA) powder, and laponite (Lap) powder. Upon addition of QAL, the blood quickly transformed to a robust and adhesive blood gel. The adhesion strength of the blood gel was up to 31.33 ± 1.56 kPa. When compared with Celox, QAL showed superior performance in promoting hemostasis. Additionally, QAL exhibited effectiveness in eliminating bacteria while also demonstrating outstanding biocompatibility with cells and blood. These favorable properties, including strong coagulation, adhesion to wet tissue, antibacterial activity, biosafety, ease of use, and stable storage, make QAL a promising emergency hemostatic agent.

Interfacial ice sprouting during salty water droplet freezing.

Icing of seawater droplets is capable of causing catastrophic damage to vessels, buildings, and human life, yet it also holds great potential for enhancing applications such as droplet-based freeze desalination and anti-icing of sea sprays. While large-scale sea ice growth has been investigated for decades, the icing features of small salty droplets remain poorly understood. Here, we demonstrate that salty droplet icing is governed by salt rejection-accompanied ice crystal growth, resulting in freezing dynamics different from pure water. Aided by the observation of brine films emerging on top of frozen salty droplets, we propose a universal definition of freezing duration to quantify the icing rate of droplets having varying salt concentrations. Furthermore, we show that the morphology of frozen salty droplets is governed by ice crystals that sprout from the bottom of the brine film. These crystals grow until they pierce the free interface, which we term ice sprouting. We reveal that ice sprouting is controlled by condensation at the brine film free interface, a mechanism validated through molecular dynamics simulations. Our findings shed light on the distinct physics that govern salty droplet icing, knowledge that is essential for the development of related technologies.

Gluing blood into adhesive gel by oppositely charged polysaccharide dry powder inspired by fibrin fibers coagulation mediator.

Hemostatic powders that adapt to irregularly shaped wounds, allowing for easy application and stable storage, have gained popularity for first-aid hemorrhage control. However, traditional powders often provide weak thrombus support and exhibit limited tissue adhesion, making them susceptible to dislodgment by the bloodstream. Inspired by fibrin fibers coagulation mediator, we have developed a bi-component hemostatic powder composed of positively charged quaternized chitosan (QCS) and negatively charged catechol-modified alginate (Cat-SA). Upon application to the wound, the bi-component powders (QCS/Cat-SA) rapidly absorb plasma and dissolve into chains. These chains interact with each other to form a network, which can effectively bind and entraps clustered red blood cells and platelets, ultimately leading to the creation of a durable and robust thrombus. Significantly, these interconnected polymers adhere to the injury site, offering protection against thrombus disruption caused by the bloodstream. Benefiting from these synthetic properties, QCS/Cat-SA demonstrates superior hemostatic performance compared to commercial hemostatic powders like Celox™ in both arterial injuries and non-compressible liver puncture wounds. Importantly, QCS/Cat-SA exhibits excellent antibacterial activity, cytocompatibility, and hemocompatibility. These advantages of QCS/Cat-SA, including strong blood clotting, wet tissue adherence, antibacterial activity, biosafety, ease of use, and stable storage, make it a promising hemostatic agent for emergency situations.

FGF17 protects cerebral ischemia reperfusion-induced blood-brain barrier disruption via FGF receptor 3-mediated PI3K/AKT signaling pathway.

Maintaining blood-brain barrier (BBB) integrity is critical components of therapeutic approach for ischemic stroke. Fibroblast growth factor 17 (FGF17), a member of FGF8 superfamily, exhibits the strongest expression throughout the wall of all major arteries during development. However, its molecular action and potential protective role on brain endothelial cells after stroke remains unclear. Here, we observed reduced levels of FGF17 in the serum of patients with ischemic stroke, as well as in the brains of mice subjected to middle cerebral artery occlusion (MCAO) injury and oxygen-glucose deprivation/reoxygenation (OGD/R)-induced brain microvascular endothelial cells (bEnd.3) cells. Moreover, treatment with exogenous recombinant human FGF17 (rhFGF17) decreased infarct volume, improved neurological deficits, reduced Evans Blue leakage and upregulated the expression of tight junctions in MCAO-injured mice. Meanwhile, rhFGF17 increased cell viability, enhanced trans-endothelial electrical resistance, reduced sodium fluorescein leakage, and alleviated reactive oxygen species (ROS) generation in OGD/R-induced bEnd.3 cells. Mechanistically, the treatment with rhFGF17 resulted in nuclear factor erythroid 2-related factor 2 (Nrf2) nuclear accumulation and upregulation of heme oxygenase-1 (HO-1) expression. Additionally, based on in-vivo and in-vitro research, rhFGF17 exerted protective effects against ischemia/reperfusion (I/R) -induced BBB disruption and endothelial cell apoptosis through the activation of the FGF receptor 3/PI3K/AKT signaling pathway. Overall, our findings indicated that FGF17 may hold promise as a novel therapeutic strategy for ischemic stroke patients.

A system for fluid pumping by liquid metal multi-droplets.

The transportation and control of microfluidics have an important influence on the fields of biology, chemistry, and medicine. Pump systems based on the electrocapillary effect and room-temperature liquid metal droplets have attracted extensive attention. Flow rate is an important parameter that reflects the delivery performance of the pump systems. In the systems of previous studies, cylindrical structures are mostly used to constrain the droplet. The analysis and quantitative description of the influence of voltage frequency, alternating voltage, direct current voltage bias, and solution concentration on the flow rate are not yet comprehensive. Furthermore, the systems are driven by only one droplet, which limits the increase in flow rate. Therefore, a pump with a cuboid structure is designed and the droplet is bound by pillars, and the flow rate of the pump is increased by more than 200% compared with the cylindrical pump. For this structure, the mechanism of various factors on the flow rate is analyzed. To further enhance the flow rate, a pump system with multi-droplets is proposed. Moreover, the expression of flow velocity of the solution on the surface of each droplet and the relationship between the flow rate, alternating voltage, and the number of droplets are deduced. Finally, the potential of applying the multi-droplet cuboid pump system in drug delivery and analytical chemistry is demonstrated. Additionally, the core of the pump, the droplet area, is modularized, which breaks the overall structural limitations of the liquid metal pump and provides ideas for pump design.

Cohering Plasma into Adhesive Gel by Natural Biopolymer-Nanoparticle Hybrid Powder for Efficient Hemostasis and Wound Healing.

Hemostatic powder is commonly used in emergency bleeding control due to its suitability for irregularly shaped wounds, ease of use, and stable storage. However, traditional powder often has limited tissue adhesion and weak thrombus support, which makes it vulnerable to displacement by blood flow. Herein, we have developed a tricomponent hemostatic powder (MQS) composed of mesoporous bioactive glass nanoparticle (MBG), positively charged quaternized chitosan (QCS), and negatively charged catechol-modified alginate (SADA). Upon application to the wound, MBG with its high specific surface area quickly absorbs plasma, concentrating the blood coagulation factor. Simultaneously, the water-soluble QCS and SADA interact with each other and form a net, which can be further cross-linked by MBG. This network efficiently binds and entraps clustered blood coagulation factors, ultimately resulting in the formation of a durable and robust thrombus. Furthermore, the formed net adheres to the injury site, offering protection against thrombus disruption caused by the bloodstream. Benefiting from the synergistic effect of these three components, MQS demonstrates superior hemostatic performance compared to commercial hemostatic powders like Celox in both arterial injuries and noncompressible liver puncture wounds. Furthermore, MQS can effectively accelerate wound healing. In addition, MQS exhibits excellent antibacterial activity, cytocompatibility, and hemocompatibility. These advantages of MQS, including strong blood clotting, wet tissue adherence, antibacterial activity, wound healing ability, biosafety, ease of use, and stable storage, make it a promising hemostatic agent for emergency situations.

A carboxymethyl chitosan/oxidized hyaluronic acid composite hydrogel dressing loading with stem cell exosome for chronic inflammation wounds healing.

Stem cell exosomes (Exo) play an important role in the transformation of macrophages, but the rapid clearance of Exo in vivo limits their therapeutic effects for chronic inflammation wounds healing. Here, stem cell Exo was isolated and introduced to a composite hydrogel including carboxymethyl chitosan (CMCS) and oxidized hyaluronic acid (OHA) through chemical cross-linking, which formed an Exo-loaded (CMCS/OHA/Exo) hydrogel. The CMCS/OHA/Exo hydrogel exhibited a function of Exo sustained release and an Exo protection within 6 days. This CMCS/OHA/Exo hydrogel was much better than CMCS/OHA hydrogel or Exo solution in macrophage cell phagocytosis, proliferation and migration in vitro, especially, played an obviously positive role in the transformation of macrophages compared with the reference groups. For the treatment of the chronic inflammation wounds in vivo, the CMCS/OHA/Exo hydrogel had the best results at wound heal rate and inhibiting the secretion of inflammatory factors, and it was far superior to reference groups in wound re-epithelization and collagen production. CMCS/OHA/Exo hydrogels can promote Exo release based on hydrogel degradation to regulate macrophages transformation and accelerate chronic wound healing. The study offers a method for preparing Exo-loaded hydrogels that effectively promote the transformation of macrophages and accelerate chronic inflammatory wound healing.

Antibacterial and hemostatic chitin sponge directly constructed from Pleurotus Eryngii via top-down approach.

Chitin, the second most abundant polysaccharide on earth, possesses unique characteristics, including biosafety, biodegradability, and procoagulant activity, making it an attractive material for hemostasis. However, the conventional bottom-up construction of chitin-based materials is intricate and time-consuming. In this study, we have developed a top-down strategy to prepare a 3D porous chitin-based hemostatic sponge with exceptional hemostatic properties and antibacterial activity, directly from the spongy Pleurotus eryngii. The top-down method involves deproteinization, in situ quaternization, and tannin acid crosslinking. The obtained sponge has an interconnected microporous structure with high porosity (89.7 ± 3.2 %), endowing it with high water absorption (2047 ± 105 %) and rapid water-triggered shape-memory behavior (< 2 s). The sponge exhibits superior blood coagulant activity and outperforms standard medical gauze, gelatin sponge, and chitosan sponge in both topical artery and non-compressive liver puncture wound. In addition, the sponge exhibited significant antibacterial activity against both gram-positive Staphylococcus aureus and gram-negative Escherichia coli. In summary, this study provides a straightforward and practical approach for constructing an antibacterial and hemostatic chitin sponge that could be a valuable option for treating bleeding wounds.

Construction and functional evaluation of oral long-acting insulin hydrogel microparticles based on physical and chemical double crosslinking.

The objective of this study was to enhance the convenience and effectiveness of diabetes treatment by developing hydrogel microparticles as an oral insulin delivery system, aiming to reduce the necessity for frequent treatments. The hydrogel microparticles were prepared with polysaccharides through a combination of physical and chemical crosslinking method, they achieved good results in insulin loading efficiency (70 %), insulin release efficiency (98 %) and sustained release time (>20 h). The effective transmembrane transport was validated using an intestinal epithelial cell model, which demonstrated a continuous hypoglycemic effect lasting from 6 to 26 h in a type 2 diabetes mouse model. Additionally, the relative bioavailability of insulin reached 30.14 ± 2.62 %, representing a significant breakthrough in the field of oral insulin delivery carriers. Furthermore, oral insulin hydrogel exhibited a substantial improvement in insulin resistance, organ damage, and diabetes-related complications stemming from hyperglycemia. These compelling findings underscore the potential of hydrogel microparticles as a cost-effective and valuable strategy for oral drug delivery in diabetes treatment.

Experimental and Numerical Investigation of the Mechanical Properties of a Fiber-Reinforced Geopolymer Mortar Blast Resistant Panel.

Geopolymer materials have excellent properties such as high strength, low thermal conductivity, fire resistance, acid and alkali resistance, and low carbon emissions. They can be used as protective engineering materials in places with explosion risks. At present, the common composite blast resistant panel is in the form of a sandwich: the outer layer isgalvanized steel plate, and fiber cement board or calcium carbonate board is used as the inner layer material, as these boards have the advantages of easy installation, good fire resistance, and explosion resistance. This study investigates the effect of adding different types of fibers to geopolymer mortar on the mortar's basic mechanical properties, such as compression strength, bending strength, and impact resistance. The explosive resistance of the fiber-reinforced geopolymer mortar blast resistant panels was evaluated through free-air explosion. In this paper, experimental procedures and numerical simulation have been performed to study the failure modes, maximum deflection, and dynamic response of the fiber-reinforced geopolymer mortar blast resistant panel under free-air explosion. The research results can provide a reference for the design and production of blast resistant panels.

Risk factors of portal vein system thrombosis after splenectomy: a meta-analysis.

BACKGROUND: The primary aim of the present study was to explore risk factors for portal vein system thrombosis following splenectomy. METHODS: A systematic search of PubMed, Embase and Cochrane libraries was conducted to identify original studies that fulfilled the inclusion criteria. Raw data on potential risk factors for portal vein system thrombosis after splenectomy were extracted for meta-analysis. Subsequently, a sensitivity analysis was conducted to verify the stability of the results. RESULTS: Eighteen studies with 626 thrombosis events from 1807 splenectomy met the inclusion criteria. Larger spleen volume (SMD 0.44, P = 0.000), broader splenic vein diameter (WMD 2.30, P = 0.000), broader portal vein diameter (WMD 2.08, P = 0.000), a lower velocity of portal blood flow (WMD -0.91, P = 0.001), decreased platelet count (WMD -5.14, P = 0.007), decreased white blood cell (WMD -0.40, P = 0.027), decreased haemoglobin (WMD -9.14, P = 0.002), ascites (OR 1.81, P = 0.003) and bleeding history before surgery (OR 1.88, P = 0.002) were identified to be factors that exacerbated the risk of portal vein system thrombosis after splenectomy. Sex, age, preoperative prothrombin time, postoperative platelet count, postoperative D-dimer, operation time and intraoperative blood loss, did not increase the risk of thrombosis. CONCLUSION: Larger spleen volume, broader splenic vein diameter, broader portal vein diameter, a lower velocity of portal blood flow, ascites, bleeding history before surgery, decreased platelet count, white blood cell and haemoglobin may increase the risk of portal vein system thrombosis.

Leidenfrost droplet jet engine by bubble ejection.

HYPOTHESIS: Despite the flourishing studies of Leidenfrost droplet motion in its boiling regime, the droplet motion across different boiling regimes has rarely been focused on, where bubbles are generated at the solid-liquid interface. These bubbles are probable to dramatically alter the dynamics of Leidenfrost droplets, creating some intriguing phenomena of droplet motion. EXPERIMENTS: Hydrophilic, hydrophobic, and superhydrophobic substrates with a temperature gradient are designed, and Leidenfrost droplets with diverse fluid types, volumes, and velocities travel from the hot end to the cold end of the substrate. The behaviors of droplet motion across different boiling regimes are recorded and depicted in a phase diagram. FINDINGS: A special phenomenon of Leidenfrost droplets that resembles a jet engine is witnessed on a hydrophilic substrate with a temperature gradient: the droplet traveling across boiling regimes repulsing itself backward. The mechanism of repulsive motion is the reverse thrust from fierce bubble ejection when droplets meet nucleate boiling regime, which cannot take place on hydrophobic and superhydrophobic substrates. We further demonstrate that conflicting droplet motions can occur in similar conditions, and a model is developed to predict the occurring criteria of this phenomenon for droplets in diverse working conditions, which agrees well with the experimental data.

Shared alterations in hippocampal structural covariance in subjective cognitive decline and migraine.

Introduction: Subjective cognitive decline (SCD) and migraine are often comorbid. Hippocampal structural abnormalities have been observed in individuals with both SCD and migraine. Given the known structural and functional heterogeneity along the long axis (anterior to posterior) of the hippocampus, we aimed to identify altered patterns of structural covariance within hippocampal subdivisions associated with SCD and migraine comorbidities. Methods: A seed-based structural covariance network analysis was applied to examine large-scale anatomical network changes of the anterior and posterior hippocampus in individuals with SCD, migraine and healthy controls. Conjunction analyses were used to identify shared network-level alterations in the hippocampal subdivisions in individuals with both SCD and migraine. Results: Altered structural covariance integrity of the anterior and posterior hippocampus was observed in the temporal, frontal, occipital, cingulate, precentral, and postcentral areas in individuals with SCD and migraine compared with healthy controls. Conjunction analysis revealed that, in both SCD and migraine, altered structural covariance integrity was shared between the anterior hippocampus and inferior temporal gyri and between the posterior hippocampus and precentral gyrus. Additionally, the structural covariance integrity of the posterior hippocampus-cerebellum axis was associated with the duration of SCD. Conclusion: This study highlighted the specific role of hippocampal subdivisions and specific structural covariance alterations within these subdivisions in the pathophysiology of SCD and migraine. These network-level changes in structural covariance may serve as potential imaging signatures for individuals who have both SCD and migraine.

An Oscillation System Based on a Liquid Metal Droplet and Pillars under a Direct Current Electric Field.

Gallium-based liquid metal is a new class of material that has attracted extensive attention due to its excellent deformation characteristics and great potential in applications. Based on the deformation characteristics of liquid metal droplets, researchers have developed many oscillation systems composed of gallium indium tin alloy (GaInSn) droplet and graphite, or aluminum-doped gallium indium alloy (Al-GaIn24.5) droplet and iron, and so on. Rather than the oxidation and deoxidation mechanisms used in previous systems, an oscillation system that can achieve gallium indium alloy (EGaIn) droplet oscillation with the frequency of 0-29 Hz is designed depending on the interactions between the electric field, pillars, sodium hydroxide, and the droplet. The forces on the droplet are analyzed specifically, which have a great influence on droplet deformation. Additionally, the effects of factors such as voltage, the concentration of sodium hydroxide (NaOH) solution, and droplet size on the droplet oscillation are elucidated based on the force analysis, enabling the flexible control of the oscillation frequency and amplitude of the droplet. This work provides a new perspective on the design of oscillation systems and further enhances our understanding of the deformation of gallium-based liquid metal droplets.

Risk of neurodegenerative diseases in patients with sleep disorders: A nationwide population-based case-control study.

OBJECTIVE: Our study aimed to explore the associative relationship between neurodegenerative diseases and sleep disorders. PATIENTS: This 15-year retrospective longitudinal nationwide population-based matched case-control study used data extracted from the National Health Insurance Research Database. We evaluated 25,589 patients diagnosed with neurodegenerative diseases between 2000 and 2015 and a matched control of 102,356 patients without neurodegenerative diseases. RESULTS: Sleep disorders were an independent risk factor for the development of neurodegenerative diseases (adjusted odds ratio (OR): 1.794, 95% confidence interval (CI): 1.235-2.268, P < 0.001), with a positive dose-effect relationship (adjusted OR (95% CI): <1 year: 1.638 (1.093-2.872), P < 0.001; 1-5 years: 1.897 (1.260-3.135), P < 0.001; >5 years: 2.381 (1.467-3.681), P < 0.001. Moreover, patients with sleep disorder and comorbid depression had a significantly higher risk of neurodegenerative disorders (adjusted OR: 5.874). Subgroup analysis showed that insomnia was associated with Alzheimer's disease, Pick's disease and essential tremor (adjusted OR (95% CI): 1.555 (1.069-1.965), 1.934 (1.331-2.445) and 2.089 (1.439-2.648), respectively). Obstructive sleep apnea was associated with Parkinson's disease, essential tremor, and primary dystonia (adjusted OR (95% CI): 1.801 (1.239-2.275), 5.523 (3.802-6.977), and 4.892 (3.365-6.178), respectively). Other specific sleep disorders were associated with Pick's disease, Parkinson's disease, essential tremor, and primary dystonia (adjusted OR (95% CI): 8.901 (6.101-11.010), 1.549 (1.075-1.986), 2.791 (1.924-3.531), and 9.114 (6.283-10.506), respectively). CONCLUSION: Sleep disorders are associated with the subsequent development of neurodegenerative disorders. Moreover, sleep disorder patients with comorbid depression have a higher risk of neurodegenerative diseases.

High-speed directional transport of condensate droplets on superhydrophobic saw-tooth surfaces.

HYPOTHESIS: Most droplets on high-efficiency condensing surfaces have radii of less than 100 µm, but conventional droplet transport methods (such as wettability-gradient surfaces and structural-curvature-gradient surfaces) that rely on the unbalanced force of three-phase lines can only transport millimeter-sized droplets efficiently. Regulating high-speed directional transport of condensate droplets is still challenging. Therefore, we present a method for condensate droplet transportation, based on the reaction force of the superhydrophobic saw-tooth surfaces to the liquid bridge, the condensate droplets could be transported at high speed and over long distances. EXPERIMENTS: The superhydrophobic saw-tooth surfaces are fabricated by femtosecond laser ablation and chemical etching. Condensation experiments and luminescent particle characterization experiments on different surfaces are conducted. Aided by the theoretical analysis, we illustrate the remarkable performance of condensate droplet transportation on saw-tooth surfaces. FINDINGS: Compared with conventional methods, our method improves the transport velocity and relative transport distance by 1-2 orders of magnitude and achieves directional transport of the smallest condensate droplet of about 2 µm. Furthermore, the superhydrophobic saw-tooth surfaces enable multi-hop directional jumping of condensate droplets, leading to cross-scale increases in transport distances from microns to decimeters.

Case Report: Severe rebound after withdrawal of fingolimod in a patient with neuromyelitis optica spectrum disorder.

Purpose: Fingolimod, an oral treatment for relapsing-remitting multiple sclerosis (RRMS), has been associated with a significant rebound in disease activity after therapy cessation. We described a patient with neuromyelitis optica spectrum disorder (NMOSD) who was previously diagnosed with RRMS and experienced fatal rebound syndrome after cessation of fingolimod. Case report: A 54-year-old woman, previously diagnosed with RRMS, experienced relapse after orthopedic surgery. The diagnosis was later revised to NMOSD based on a positive aquaporin-4 antibody. Three weeks after converting the immunomodulator from fingolimod to azathioprine, severe disease reactivation was observed. Considering the multiple new and enlarging magnetic resonance imaging lesions, the temporal relationship between fingolimod cessation and symptom onset, and the relatively low possibility of disease reactivation within a short time, the diagnosis of fingolimod withdrawal syndrome was proposed. Although immediate steroid pulse therapy and plasma exchange were performed, the patient eventually died owing to a fulminant clinical course. Conclusion: Fingolimod withdrawal syndrome is well known in patients with multiple sclerosis (MS). It can also occur in patients with NMOSD. Recognizing patients with NMOSD who present with MS-like manifestations, and avoiding drugs that may be harmful to patients with NMOSD, are important.

The lens of Yin-Yang philosophy: the influence of paradoxical leadership and emotional intelligence on nurses' organizational identification and turnover intention.

PURPOSE: This study aims to use "both-and" thinking of Yin-Yang philosophy to extend the field of leadership literatures and explore the influences of paradoxical leadership and emotional intelligence on organizational identification and turnover intentions of nurses. DESIGN/METHODOLOGY/APPROACH: The authors adopted a cross-sectional survey completed by 285 nurses in Taiwan. SPSS 22, PROCESS and AMOS 21 were used for data analysis. FINDINGS: The results reveal that paradoxical leadership has a significant positive relationship with nurses' organizational identification and a significant negatively relationship with their turnover intentions, and organizational identification partially mediated the relationship between paradoxical leadership and turnover intentions. The results further show that emotional intelligence strengthens the effect of paradoxical leadership on organizational identification, and paradoxical leadership had a stronger indirect effect on turnover intentions through organizational identification under strong emotional intelligence. ORIGINALITY/VALUE: Paradoxical leadership can strengthen managers' abilities in dealing with interrelated and substantial issues and correspond to organizing and belonging paradoxes in holistic thinking processes. Health-care organizations must shape a coordinated institution and offer training initiatives to increase managers' ability and attitude to control organizational rules and procedures while allowing employees' flexibility and autonomy according to the requirements of the situation, which will maintain both organizational short-term benefits and long-term growth.