Associations of Amyloid Burden, White Matter Hyperintensities, and Hippocampal Volume With Cognitive Trajectories in the 90+ Study.

BACKGROUND AND OBJECTIVES: Amyloid pathology, vascular disease pathology, and pathologies affecting the medial temporal lobe are associated with cognitive trajectories in older adults. However, only limited evidence exists on how these pathologies influence cognition in the oldest old. We evaluated whether amyloid burden, white matter hyperintensity (WMH) volume, and hippocampal volume (HV) are associated with cognitive level and decline in the oldest old. METHODS: This was a longitudinal, observational community-based cohort study. We included participants with 18F-florbetapir PET and MRI data from the 90+ Study. Amyloid load was measured using the standardized uptake value ratio in the precuneus/posterior cingulate with eroded white matter mask as reference. WMH volume was log-transformed. All imaging measures were standardized using sample means and SDs. HV and log-WMH volume were normalized by total intracranial volume using the residual approach. Global cognitive performance was measured by the Mini-Mental State Examination (MMSE) and modified MMSE (3MS) tests, repeated every 6 months. We used linear mixed-effects models with random intercepts; random slopes; and interaction between time, time squared, and imaging variables to estimate the associations of imaging variables with cognitive level and cognitive decline. Models were adjusted for demographics, APOE genotype, and health behaviors. RESULTS: The sample included 192 participants. The mean age was 92.9 years, 125 (65.1%) were female, 71 (37.0%) achieved a degree beyond college, and the median follow-up time was 3.0 years. A higher amyloid load was associated with a lower cognitive level (ßMMSE = -0.82, 95% CI -1.17 to -0.46; ß3MS = -2.77, 95% CI -3.69 to -1.84). A 1-SD decrease in HV was associated with a 0.70-point decrease in the MMSE score (95% CI -1.14 to -0.27) and a 2.27-point decrease in the 3MS score (95% CI -3.40 to -1.14). Clear nonlinear cognitive trajectories were detected. A higher amyloid burden and smaller HV were associated with faster cognitive decline. WMH volume was not significantly associated with cognitive level or decline. DISCUSSION: Amyloid burden and hippocampal atrophy are associated with both cognitive level and cognitive decline in the oldest old. Our findings shed light on how different pathologies contributed to driving cognitive function in the oldest old.

Individualized dynamic frailty-tailored therapy (DynaFiT) in elderly patients with newly diagnosed multiple myeloma: a prospective study.

It remains a substantial challenge to balance treatment efficacy and toxicity in geriatric patients with multiple myeloma (MM), primarily due to the dynamic nature of frailty. Here, we conducted a prospective study to evaluate the feasibility and benefits of dynamic frailty-tailored therapy (DynaFiT) in elderly patients. Patients with newly diagnosed MM (aged ≥ 65 years) received eight induction cycles of bortezomib, lenalidomide, and dexamethasone (daratumumab was recommended for frail patients), with treatment intensity adjusted according to longitudinal changes in the frailty category (IMWG-FI) at each cycle. Of 90 patients, 33 (37%), 16 (18%), and 41 (45%) were fit, intermediate fit, and frail at baseline, respectively. Of 75 patients who had geriatric assessment at least twice, 28 (37%) experienced frailty category changes at least once. At analysis, 15/26 (58%) frail patients improved (27% became fit and 31% became intermediate fit), 4/15 (27%) intermediate fit patients either improved or deteriorated (two for each), and 6/30 (20%) fit patients deteriorated. During induction, 34/90 (38%) patients discontinued treatment, including 10/33 (30%) fit, 4/16 (25%) intermediate fit, and 20/41 (49%) frail; 14/40 (35%) frail patients discontinued treatment within the first two cycles, mainly because of non-hematologic toxicity (mostly infections). For fit, intermediate-fit, and frail patients, the overall response rate was 100%, 93%, and 73%, respectively; one-year overall survival was 90%, 75%, and 54%, respectively. Therefore, the individualized DynaFiT is feasible and promising for heterogeneous elderly patients.

Transient temperature measurement of silicon carbide Schottky barrier diode based on thermal reflection.

In this article, we present a transient temperature detection device for silicon carbide (SiC) Schottky barrier diodes (SBDs) based on thermal reflection theory. We constructed a thermal reflection temperature measurement device based on a 530-nm green laser. This device is more suitable for transient temperature measurement of SiC SBDs than previous thermal reflection equipment. The accuracy of temperature measurement by our device was confirmed by comparison with the results of infrared thermal imaging. The high temporal resolution characteristics of the thermal reflection technology allowed the detection of millisecond-level transient temperature changes in SiC SBDs. In addition, we investigated the complementarity of transient temperature change curves during heating and cooling processes, as well as the reasons for the differences between these curves. Finally, we used the structural function method combined with the Bayesian deconvolution algorithm to obtain the thermal resistance along the heat flow path of the device and validated the results using an established thermal resistance testing method.

Colonization by the endophytic fungus Phyllosticta fallopiae combined with the element Si promotes the growth of Dendrobium nobile.

Endophytic fungi can promote plant growth and development, particularly of Orchidaceae species. Previously, we found that the endophytic fungus Phyllosticta fallopiae DN14, collected from Dendrobium nobile growing on rocks in a wild habitat, significantly promoted growth of its host plant D. nobile, an important herb in Chinese traditional medicine that contains the bioactive component dendrobine. Phyllosticta was positively correlated with FW and dendrobine content of D. nobile and with Si content of the epiphytic matrix. Si is also highly beneficial for the growth and productivity of many plants. Here, we co-cultured D. nobile with P. fallopiae DN14 in half-strength Murashige and Skoog medium with and without various concentrations of Si to investigate the effects of DN14 and Si on plant fresh weight and dendrobine content. We also explored the effects of DN14 infection and colonization on host plant growth, Si accumulation and transport, and expression of key genes, as well as the interaction between DN14 and Si. The combination of DN14 and Si promoted the lignification of D. nobile roots, stems, and leaves and markedly increased the thickening of xylem cell walls. Co-culture with DN14 increased transport of Si from roots to stems and from stems to leaves. Transcriptome sequencing and qRT-PCR analyses showed that enhancement of D. nobile growth by DN14 and Si may involve upregulation of plant hormone-related genes (AUX/IAA and MYC) and lignin biosynthesis genes (HCT, PAL1, and PAL2). Insoluble Si promoted the growth of DN14, perhaps through downregulation of genes (e.g., FBP, MPI, RPIAD) related to carbohydrate metabolism, and DN14 in turn promoted the transformation of insoluble Si into soluble Si for plant uptake. These findings demonstrate that endophytic fungi and Si can improve the growth of D. nobile and therefore show promise as organic amendments for commercial cultivation.

Relationship between parental acceptance of the COVID-19 vaccine and attitudes towards measles vaccination for children: A cross-sectional study.

BACKGROUND: The COVID-19 pandemic has led to decreased measles vaccination rates globally, exacerbating vaccine hesitancy. This study examines the relationship between COVID-19 vaccine acceptance and childhood measles vaccination among parents in Hong Kong. METHODS: A cross-sectional online survey was conducted in Hong Kong from March to September 2022. Parents were recruited via the Qualtrics panel, and a total of 588 parents were invited via email or social media account to participate in the survey. We used the adjusted Measles-containing Vaccine Hesitancy Scale for the assessment of parental vaccine hesitancy for children. A multiple linear regression analysis was conducted to examine the association between parental acceptance of the COVID-19 vaccine and their attitudes towards childhood measles vaccination. RESULTS: Of the 588 participants, parents who have been vaccinated against COVID-19 exhibited significantly less measles-containing vaccine hesitancy comparing to those unvaccinated (ß = -2.96, 95% confidence interval [CI]: -5.10 to -0.83, p = 0.007). Mothers exhibited more hesitancy compared to fathers (ß = 1.64, 95% CI: 0.60 to 2.68, p = 0.002). Parents with a higher self-rated health (ß = -2.20, 95% CI: -3.21 to -1.20, p < 0.001), or who have received advice from health professionals to offer measles, influenza, or COVID-19 vaccines for kids (ß = -2.41, 95% CI: -3.49 to -1.32, p < 0.001) had lower levels of hesitancy. CONCLUSION: COVID-19 vaccine status of parents was associated with reduced hesitancy towards measles vaccines for their children. Addressing vaccine hesitancy effectively requires targeted communication strategies, particularly focusing on those unvaccinated and leveraging the influence of healthcare professionals.

Prognostic value of the systemic immune-inflammation index in critically ill elderly patients with hip fracture: evidence from MIMIC (2008-2019).

Background: The systemic immune-inflammation index (SII) showed an extensive link between immunological dysfunction and the activation of systemic inflammation. Several studies have confirmed the application of SII to orthopedic diseases. However, the significance of SII in critically ill elderly individuals with hip fracture who require intensive care unit (ICU) admission is not yet known. This study centered on exploring the relationship between SII and clinical outcomes among critically ill elderly hip fracture individuals. Methods: The study centered around elderly patients experiencing severe illness following hip fractures and requiring admission to the ICU. These patients from the MIMIC-IV database formed the basis of this study's cohort. We stratified them into quartiles according to their SII levels. The results involved the mortality at 30 days and 1 year post-admission. Then we employ Cox proportional hazards regression analysis as well as restricted cubic splines to explore the association between the SII and clinical results in critically ill elderly patients with hip fracture. Results: The study encompassed 991 participants, among whom 63.98% identified as females. Notably, the mortality rates attributed to any cause within 30 days and 1 year after hospitalization stood at 19.68 and 33.40%, respectively. The multivariate Cox proportional hazards model disclosed a significant correlation between an elevated SII and all-cause mortality. Following adjustments for confounding variables, individuals with a high SII showed a notable correlation with 30-day mortality [adjusted hazard ratio (HR), 1.065; 95% confidence interval (CI), 1.044-1.087; p < 0.001] and 1-year mortality (adjusted HR, 1.051; 95% CI, 1.029-1.074; p < 0.001). Furthermore, the analysis of restricted cubic splines demonstrated a progressive increase in the risk of all-cause death as the SII value rose. Conclusion: Among critically ill elderly patients with hip fracture, the SII exhibits a non-linear association that positively correlates with both 30-day and 1-year all-cause mortality rates. The revelation indicates that the SII may play a vital role in identifying patients with hip fractures who face an escalated risk of mortality due to any cause.

Proteomic, single-cell and bulk transcriptomic analysis of plasma and tumor tissues unveil core proteins in response to anti-PD-L1 immunotherapy in triple negative breast cancer.

BACKGROUND: Anti-PD-1/PD-L1 treatment has achieved durable responses in TNBC patients, whereas a fraction of them showed non-sensitivity to the treatment and the mechanism is still unclear. METHODS: Pre- and post-treatment plasma samples from triple negative breast cancer (TNBC) patients treated with immunotherapy were measured by tandem mass tag (TMT) mass spectrometry. Public proteome data of lung cancer and melanoma treated with immunotherapy were employed to validate the findings. Blood and tissue single-cell RNA sequencing (scRNA-seq) data of TNBC patients treated with or without immunotherapy were analyzed to identify the derivations of plasma proteins. RNA-seq data from IMvigor210 and other cancer types were used to validate plasma proteins in predicting response to immunotherapy. RESULTS: A random forest model constructed by FAP, LRG1, LBP and COMP could well predict the response to immunotherapy. The activation of complement cascade was observed in responders, whereas FAP and COMP showed a higher abundance in non-responders and negative correlated with the activation of complements. scRNA-seq and bulk RNA-seq analysis suggested that FAP, COMP and complements were derived from fibroblasts of tumor tissues. CONCLUSIONS: We constructe an effective plasma proteomic model in predicting response to immunotherapy, and find that FAP+ and COMP+ fibroblasts are potential targets for reversing immunotherapy resistance.

Long Propagating Polaritonic Heat Transfer: Shaping Radiation to Conduction.

Surface phonon polaritons (SPhPs) originate from the coupling of mid-IR photons and optical phonons, generating evanescent waves along the polar dielectric surface. The emergence of SPhPs gives rise to a phase of quantum matter that facilitates long-range energy transfer (100s µm-scale). Albeit of the recent experimental progress to observe the enhanced thermal conductivity of polar dielectric nanostructures mediated by SPhPs, the potential mechanism to present the high thermal conductivity beyond the Landauer limit has not been addressed. Here, we revisit the comprehensive theoretical framework to unify the distinct pictures of two heat transfer mechanisms by conduction and radiation. We first designed our experimental platform to distinguish contributions of two distinct fundamental modes of SPhPs, resulting in far-field radiation and long propagating conduction, respectively, by tuning the configuration of a nanostructured heat channel integrated into the thermometer. We could effectively control the transmission of long-propagating SPhPs to influence the apparent thermal conductivity of the nanostructure. This study reveals the high thermal conductance of 1.63 nW/K by a fast SPhP mode comparable to that by classical phonons, with measurements showing apparent conductivity values of up to 2 W/m·K at 515 K. The origin of the enhanced thermal conductivity was exploited by observing the interference of dispersive evanescent waves by double heat channels. Furthermore, our experimental observations of length-dependent thermal conductance by SPhPs are in good agreement with the revisited Landauer formula to illustrate a polaritonic mode of heat conduction, considering the dispersive nature of radiation not limited to the physical boundaries of a solid object yet directionally guided along the surface.

MicroRNA-451 Regulates Angiogenesis in Intracerebral Hemorrhage by Targeting Macrophage Migration Inhibitory Factor.

Intracerebral hemorrhage (ICH) is a subtype of stroke with the highest fatality and disability rate. Up to now, commonly used first-line therapies have limited value in improving prognosis. Angiogenesis is essential to neurological recovery after ICH. Recent studies have shown that microRNA-451(miR-451) plays an important role in angiogenesis by regulating the function of vascular endothelial cells. We found miR-451 was significantly decreased in the peripheral blood of ICH patients in the acute stage. Based on the clinical findings, we conducted this study to investigate the potential regulatory effect of miR-451 on angiogenesis after ICH. The expression of miR-451 in ICH mouse model and in a hemin toxicity model of human brain microvascular endothelial cells (hBMECs) was decreased the same as in ICH patients. MiR-451 negatively regulated the proliferation, migration, and tube formation of hBMECs in vitro. MiR-451 negatively regulated the microvessel density in the perihematoma tissue and affected neural functional recovery of ICH mouse model. Knockdown of miR-451 could recovered tight junction and protect the integrity of blood-brain barrier after ICH. Based on bioinformatic programs, macrophage migration inhibitory factor (MIF) was predicted to be the target gene and identified to be regulated by miR-451 inhibiting the protein translation. And p-AKT and p-ERK were verified to be downstream of MIF in angiogenesis. These results all suggest that miR-451 will be a potential target for regulating angiogenesis in ICH.

Evaluating the impact of sugar-sweetened beverages tax on overweight, obesity, and type 2 diabetes in an affluent Asian setting: A willingness-to-pay survey and simulation analysis.

BACKGROUND: The potential health effects of taxing sugar-sweetened beverages (SSBs) has been insufficiently examined in Asian contexts. This study aimed to assess the impact of SSB taxation on the prevalence of obesity/overweight and type 2 diabetes mellitus (T2DM) in Hong Kong using a willingness-to-pay (WTP) survey and simulation analysis. METHODS: A random telephone survey was conducted with 1000 adults from May to June 2020. We used a contingent valuation approach to assess individuals' WTP for SSBs under four tax payment scenarios (5%, 10%, 40%, and 50% of the current market price). Based on the WTP, a simulation analysis was conducted to project changes in SSB purchase and associated reductions in the prevalence of obesity/overweight and T2DM over a 10-year simulation period. FINDINGS: When 5% and 10% taxation rates were introduced, approximately one-third of the population were unwilling to maintain their SSB purchase. Our simulation demonstrated a gradual decline in the prevalence of obesity/overweight and diabetes with a more pronounced decrease when higher taxation rates were introduced. 10% taxation resulted in a mean reduction of 1532.7 cases of overweight/obesity per 100 thousand population at the sixth year, while T2DM prevalence decreased by 267.1 (0.3%). CONCLUSIONS: This study underscores the effects of an SSB tax on purchase behaviors and health outcomes in an affluent Asia setting, with a more pronounced influence on adult population. These findings are expected to inform policymakers in making decisions regarding an effective and equitable tax rate on SSBs.

Expression of GCaMP6s in the dentate gyrus induces tonic-clonic seizures.

GCaMP is a genetically encoded calcium indicator (GECI) widely used in neuroscience research. It measures intracellular Ca2+ level by fluorescence changes as it directly binds to Ca2+. In this process, the effect of this calcium buffer on the intracellular calcium signaling and cell physiology is often not taken into consideration. However, growing evidence from calcium imaging studies shows GCaMP expression under certain conditions can generate aberrant activity, such as seizures. In this study, we examined the effect of GCaMP6 expression in the dentate gyrus (DG) on epileptogenesis. We found that viral expression of GCaMP6s but not GCaMP6f in the DG induces tonic-clonic seizures several weeks after viral injection. Cell-type specific expression of GCaMP6s revealed the granule cells (GCs) as the key player in GCaMP6s-induced epilepsy. Finally, by using slice electrophysiology, we demonstrated that GCaMP6s expression increases neuronal excitability in the GCs. Together, this study highlights the ability of GCaMP6s in DG-associated epileptogenesis.

Textural formation of instant controlled pressure drop-dried peach chips: Investigation of the electrical, thermal, and textural properties of predried peach slices with osmotic dehydration pretreatment.

In this study, the effect of osmotic dehydration (OD) pretreatment with various sugar (erythritol, glucose, and trehalose) on the quality of hot-air-predried peach slices was investigated, particularly focusing on electrical properties, texture, thermal stability, and cell wall strength. Furthermore, the correlation between the properties of predried peach slices and the texture of the instant controlled pressure drop (DIC) dried peach chips was explored. OD pretreatments improved the stability and integrity of the cell wall and cell membrane of pre-dried peach slices, which inhibited the excessive expansion of samples during DIC drying. Especially, peach chips with trehalose-OD exhibited the highest crispiness (1.05 mm), the highest hardness (101.34 N) was obtained in erythritol-OD samples. Overall, the type of osmotic agents affected the texture of DIC peach chips with OD pretreatments. It should be noted that trehalose is a promising osmotic agent for controlling and regulating the quality of DIC peach chips.

Association between air pollution and male sexual function: A nationwide observational study in China.

This study aimed to explore the associations between air pollution and male sexual function. A total of 5047 male subjects in China were included in this study. The average air pollution exposure (PM2.5, PM10, SO2, CO, NO2, and O3) for the preceding 1, 3, 6, and 12 months before the participants' response was assessed. Male sexual function was evaluated using the International Index of Erectile Function-5 (IIEF-5) and the Premature Ejaculation Diagnostic Tool (PEDT). Generalized linear models were utilized to explore the associations between air pollution and male sexual function. K-prototype algorithm was conducted to identify the association among specific populations. Significant adverse effects on the IIEF-5 score were observed with NO2 exposure during the preceding 1, 3, and 6 months (1 m: ß = -5.26E-05; 3 m: ß = -4.83E-05; 6 m: ß = -4.23E-05, P < 0.05). PM2.5 exposure during the preceding 12 months was found to significantly negatively affect the PEDT after adjusting for confounding variables. Our research indicated negative correlations between air pollutant exposures and male sexual function for the first time. Furthermore, these associations were more pronounced among specific participants who maintain a normal BMI, exhibit extroverted traits, and currently engage in smoking and alcohol consumption.

Zein-Based Triple-Drug Nanoparticles to Promote Anti-Inflammatory Responses for Nerve Regeneration after Spinal Cord Injury.

Defects in autophagy contribute to neurological deficits and motor dysfunction after spinal cord injury. Here a nanosystem is developed to deliver autophagy-promoting, anti-inflammatory drugs to nerve cells in the injured spinal cord. Celastrol, metformin, and everolimus as the mTOR inhibitor are combined into the zein-based nanoparticles, aiming to solubilize the drugs and prolong their circulation. The nanoparticles are internalized by BV2 microglia and SH-SY5Y neuron-like cells in culture; they inhibit the secretion of inflammatory factors by BV2 cells after insult with lipopolysaccharide, and they protect SH-SY5Y cells from the toxicity of H2O2. In a rat model of spinal cord injury, the nanoparticles mitigate inflammation and promote spinal cord repair. In the in vitro and in vivo experiments, the complete nanoparticles function better than the free drugs or nanoparticles containing only one or two drugs. These results suggest that the triple-drug nanoparticles show promise for treating spinal cord injury.

Comparison of approaches to control for intracranial volume in research on the association of brain volumes with cognitive outcomes.

Most neuroimaging studies linking regional brain volumes with cognition correct for total intracranial volume (ICV), but methods used for this correction differ across studies. It is unknown whether different ICV correction methods yield consistent results. Using a brain-wide association approach in the MRI substudy of UK Biobank (N = 41,964; mean age = 64.5 years), we used regression models to estimate the associations of 58 regional brain volumetric measures with eight cognitive outcomes, comparing no correction and four ICV correction approaches. Approaches evaluated included: no correction; dividing regional volumes by ICV (proportional approach); including ICV as a covariate in the regression (adjustment approach); and regressing the regional volumes against ICV in different normative samples and using calculated residuals to determine associations (residual approach). We used Spearman-rank correlations and two consistency measures to quantify the extent to which associations were inconsistent across ICV correction approaches for each possible brain region and cognitive outcome pair across 2320 regression models. When the association between brain volume and cognitive performance was close to null, all approaches produced similar estimates close to the null. When associations between a regional volume and cognitive test were not null, the adjustment and residual approaches typically produced similar estimates, but these estimates were inconsistent with results from the crude and proportional approaches. For example, when using the crude approach, an increase of 0.114 (95% confidence interval [CI]: 0.103-0.125) in fluid intelligence was associated with each unit increase in hippocampal volume. However, when using the adjustment approach, the increase was 0.055 (95% CI: 0.043-0.068), while the proportional approach showed a decrease of -0.025 (95% CI: -0.035 to -0.014). Different commonly used methods to correct for ICV yielded inconsistent results. The proportional method diverges notably from other methods and results were sometimes biologically implausible. A simple regression adjustment for ICV produced biologically plausible associations.

Rare Sagittal Compensatory Balance in Neuromuscular Scoliosis Complicated by Hydrocephalus: A Case Report.

Objective: This case report aims to present a rare case of thoracic lordosis and lumbar kyphosis and describe the posterior instrumented scoliosis correction performed. Case presentation: A 59-year-old female presented with low back pain. She had undergone ventriculoperitoneal shunt placement 8 years ago. I scored 76 on the Wechsler Adult Intelligence Scale. MRI of the lumbar spine showed spinal canal stenosis at L3/4, L4/5, and L5/S1. Full spine X-ray revealed thoracic lordosis and lumbar kyphoscoliosis， the coronal imbalance, and the sagittal compensatory balance. In order to avoid the risk of brain swelling and paraplegia, pedicle subtraction osteotomies (PSO) in the L2 and lumbar posterior instrumented scoliosis correction were performed under electroencephalogram and neuro electrophysiological monitoring. Shoulder imbalance was observed 1 year after surgery, but there was no loss of lumbar correction. Conclusion: In future cases of complex spinal deformity, it is important to observe whether there is cerebral ventricular dilatation on MRI before the operation. If severe thoracic lordosis is combined with lumbar scoliosis, over-correcting the lumbar scoliosis should be avoided to prevent shoulder imbalance.

Injectable Hydrogel To Deliver Bone Mesenchymal Stem Cells Preloaded with Azithromycin To Promote Spinal Cord Repair.

Spinal cord injury is a disease that causes severe damage to the central nervous system. Currently, there is no cure for spinal cord injury. Azithromycin is commonly used as an antibiotic, but it can also exert anti-inflammatory effects by down-regulating M1-type macrophage genes and up-regulating M2-type macrophage genes, which may make it effective for treating spinal cord injury. Bone mesenchymal stem cells possess tissue regenerative capabilities that may help promote the repair of the injured spinal cord. In this study, our objective was to explore the potential of promoting repair in the injured spinal cord by delivering bone mesenchymal stem cells that had internalized nanoparticles preloaded with azithromycin. To achieve this objective, we formulated azithromycin into nanoparticles along with a trans-activating transcriptional activator, which should enhance nanoparticle uptake by bone mesenchymal stem cells. These stem cells were then incorporated into an injectable hydrogel. The therapeutic effects of this formulation were analyzed in vitro using a mouse microglial cell line and a human neuroblastoma cell line, as well as in vivo using a rat model of spinal cord injury. The results showed that the formulation exhibited anti-inflammatory and neuroprotective effects in vitro as well as therapeutic effects in vivo. These results highlight the potential of a hydrogel containing bone mesenchymal stem cells preloaded with azithromycin and trans-activating transcriptional activator to mitigate spinal cord injury and promote tissue repair.

Prognosis of LSPD versus TIPS for the treatment of esophagogastric variceal bleeding in cirrhosis.

BACKGROUND: This study aimed to compare postoperative complications in patients with esophagogastric variceal bleeding (EVB) who underwent laparoscopic splenectomy combined with pericardial devascularization (LSPD) versus transjugular intrahepatic portosystemic shunt (TIPS) procedures. METHODS: A retrospective collection of medical records was conducted from January 2014 to May 2020 at Union Hospital, Tongji Medical College, Huazhong University of Science and Technology. The study included patients from the departments of trauma surgery, interventional radiology, and general surgery who were diagnosed with EVB caused by portal hypertension and treated with LSPD or TIPS. Follow-up data were obtained to assess the occurrence of postoperative complications in both groups. RESULTS: A total of 201 patients were included in the study, with 104 cases in the LSPD group and 97 cases in the TIPS group. There was no significant difference in the 1-year and 3-year post-surgery survival rates between the TIPS and LSPD groups (P = 0.669, 0.066). The 3-year survival rate of Child-Pugh B patients in the LSPD group was higher than TIPS group (P = 0.041). The LSPD group also had a significantly higher rate of freedom from rebleeding at 3-year post-surgery compared to the TIPS group (P = 0.038). Stratified analysis showed no statistically significant difference in the rebleeding rate between the two groups. Furthermore, the LSPD group had a higher rate of freedom from overt hepatic encephalopathy at 1-year and 3-year post-surgery compared to the TIPS group (P = 0.007, < 0.001). The LSPD group also had a lower rate of severe complications at 3-year post-surgery compared to the TIPS group (P = 0.020). CONCLUSION: Compared to TIPS, LSPD does not increase the risk of mortality and rebleeding, while demonstrating fewer complications. In patients classified as Child-Pugh A and B, the use of LSPD for treating EVB is both safe and effective.

Climate change, ambient air pollution, and students' mental health.

The impact of global climate change and air pollution on mental health has become a crucial public health issue. Increased public awareness of health, advancements in medical diagnosis and treatment, the way media outlets report environmental changes and the variation in social resources affect psychological responses and adaptation methods to climate change and air pollution. In the context of climate change, extreme weather events seriously disrupt people's living environments, and unstable educational environments lead to an increase in mental health issues for students. Air pollution affects students' mental health by increasing the incidence of diseases while decreasing contact with nature, leading to problems such as anxiety, depression, and decreased cognitive function. We call for joint efforts to reduce pollutant emissions at the source, improve energy structures, strengthen environmental monitoring and gover-nance, increase attention to the mental health issues of students, and help student groups build resilience; by establishing public policies, enhancing social support and adjusting lifestyles and habits, we can help students cope with the constantly changing environment and maintain a good level of mental health. Through these comprehensive measures, we can more effectively address the challenges of global climate change and air pollution and promote the achievement of the United Nations Sustainable Development Goals.