Surgical outcomes of sacrospinous hysteropexy and hysteropreservation for pelvic organ prolapse: a systematic review of randomized controlled trials.

Objective: In several randomized controlled trials (RCTs), sacrospinous hysteropexy and other forms of hysteropreservation have been compared. Nevertheless, there is no definitively best treatment. This study summarized RCT evidence for various uterine preservation surgical procedures. Methods: From each database inception to August 2023, we searched PubMed, Embase, Cochrane Library, and Web of Science for eligible RCTs. A comparison was made between sacrospinous hysteropexy and other hysteropreservation, including vaginal and abdominal surgery. For categorical and continuous variables, relative risks (RRs) and mean differences (MDs) were calculated using random-effects models. Results: We reviewed a total 1,398 studies and ultimately included five RCTs that met all inclusion criteria. These five studies included a total of 1,372 uterine POP cases all of whom received transvaginal surgery and had a follow-up period for assessment of recurrence from 12 months to 5 years. There were no significant differences between sacrospinous hysteropexy and other hysteropreservation for the incidences of recurrence (RR,1.24; 95% CI, 0.58 to 2.63; p = 0.58) or hematoma (RR,0.70; 95% CI, 0.17 to 2.92; p = 0.62). Moreover, neither sacrospinous hysteropexy nor hysteropreservation had any significant effect on the risk of mesh exposure (RR,0.34; 95% CI, 0.03 to 4.31; p = 0.41), dyspareunia (RR,0.45; 95% CI, 0.13 to1.6; p = 0.22), urinary tract infection (RR,0.66; 95% CI, 0.38 to 1.15; p = 0.15), bothersome bulge symptoms (RR,0.03; 95% CI, -0.02 to 0.08; p = 0.24), operative time (MD, -4.53; 95% CI, -12.08 to 3.01; p = 0.24), and blood loss (MD, -25.69; 95% CI, -62.28 to 10.91; p = 0.17). However, sacrospinous hysteropexy was associated with a lower probability of pain (RR,4.8; 95% CI, 0.79 to 29.26; p = 0.09) compared with other hysteropreservation. Conclusion: There was no difference between sacrospinous hysteropexy and hysteropreservation in terms of recurrence, hematoma, mesh exposure, dyspareunia, urinary tract infection, bothersome bulge symptoms, operative time, pain, and blood loss. Systematic Review Registration: PROSPERO [CRD42023470025].

Reprogramming exosomes for immunity-remodeled photodynamic therapy against non-small cell lung cancer.

Traditional treatments against advanced non-small cell lung cancer (NSCLC) with high morbidity and mortality continue to be dissatisfactory. Given this situation, there is an urgent requirement for alternative modalities that provide lower invasiveness, superior clinical effectiveness, and minimal adverse effects. The combination of photodynamic therapy (PDT) and immunotherapy gradually become a promising approach for high-grade malignant NSCLC. Nevertheless, owing to the absence of precise drug delivery techniques as well as the hypoxic and immunosuppressive characteristics of the tumor microenvironment (TME), the efficacy of this combination therapy approach is less than ideal. In this study, we construct a novel nanoplatform that indocyanine green (ICG), a photosensitizer, loads into hollow manganese dioxide (MnO2) nanospheres (NPs) (ICG@MnO2), and then encapsulated in PD-L1 monoclonal antibodies (anti-PD-L1) reprogrammed exosomes (named ICG@MnO2@Exo-anti-PD-L1), to effectively modulate the TME to oppose NSCLC by the synergy of PDT and immunotherapy modalities. The ICG@MnO2@Exo-anti-PD-L1 NPs are precisely delivered to the tumor sites by targeting specially PD-L1 highly expressed cancer cells to controllably release anti-PD-L1 in the acidic TME, thereby activating T cell response. Subsequently, upon endocytic uptake by cancer cells, MnO2 catalyzes the conversion of H2O2 to O2, thereby alleviating tumor hypoxia. Meanwhile, ICG further utilizes O2 to produce singlet oxygen (1O2) to kill tumor cells under 808 nm near-infrared (NIR) irradiation. Furthermore, a high level of intratumoral H2O2 reduces MnO2 to Mn2+, which remodels the immune microenvironment by polarizing macrophages from M2 to M1, further driving T cells. Taken together, the current study suggests that the ICG@MnO2@Exo-anti-PD-L1 NPs could act as a novel drug delivery platform for achieving multimodal therapy in treating NSCLC.

Contributions of repeated learning to memory in humans: insights from single-neuron recordings in the hippocampus and amygdala.

Despite the well-established phenomenon of improved memory performance through repeated learning, studies investigating the associated neural mechanisms have yielded complex and sometimes contradictory findings, and direct evidence from human neuronal recordings has been lacking. This study employs single-neuron recordings with exceptional spatial-temporal resolution, combined with representational similarity analysis, to explore the neural dynamics within the hippocampus and amygdala during repeated learning. Our results demonstrate that in the hippocampus, repetition enhances both representational specificity and fidelity, with these features predicting learning times. Conversely, the amygdala exhibits heightened representational specificity and fidelity during initial learning but does not show improvement with repetition, suggesting functional specialization of the hippocampus and amygdala during different stages of the learning repetition. Specifically, the hippocampus appears to contribute to sustained engagement necessary for benefiting from repeated learning, while the amygdala may play a role in the representation of novel items. These findings contribute to a comprehensive understanding of the intricate interplay between these brain regions in memory processes. Significance statement  For over a century, understanding how repetition contributes to memory enhancement has captivated researchers, yet direct neuronal evidence has been lacking, with a primary focus on the hippocampus and a neglect of the neighboring amygdala. Employing advanced single-neuron recordings and analytical techniques, this study unveils a nuanced functional specialization within the amygdala-hippocampal circuit during various learning repetition. The results highlight the hippocampus's role in sustaining engagement for improved memory with repetition, contrasting with the amygdala's superior ability in representing novel items. This exploration not only deepens our comprehension of memory enhancement intricacies but also sheds light on potential interventions to optimize learning and memory processes.

Lignin-modified graphitic carbon nitride nanotubes for photocatalytic H2O2 production and degradation of brilliant black BN.

As a renewable aromatic compound with enormous production potential, lignin has various potential high-value utilization pathways, but the success achieved in the field of photocatalysis is limited. Herein, this work prepares a new type of photocatalyst by modifying Graphitic Carbon Nitride Nanotubes (CNT) with self-assembled lignin nanospheres for the photocatalytic production of H2O2 and the degradation of azo dyes. Under light conditions, lignin enhances the production of H2O2 through oxygen reduction and collaborates with carbon nitride tubes to generate O2- and 1O2. Furthermore, carbon nitride tubes form electron-rich regions with lignin, promoting the transfer of electrons from adsorbed aromatic pollutants to this region, thereby facilitating their degradation. The experimental results indicate that the addition of 5 % lignin significantly enhances the photocatalytic degradation efficiency of azo dyes, with a degradation rate 1.87 times higher than that of the original carbon nitride tubes. Furthermore, CNL also have excellent degradation ability to pollutants in actual wastewater. This study provides new insights and prospects for the high-value utilization of lignin, enabling it to be used as a photocatalytic co-catalyst to participate in the photocatalytic degradation of environmental pollutants.

Unsupervised Modality-Transferable Video Highlight Detection With Representation Activation Sequence Learning.

Identifying highlight moments of raw video materials is crucial for improving the efficiency of editing videos that are pervasive on internet platforms. However, the extensive work of manually labeling footage has created obstacles to applying supervised methods to videos of unseen categories. The absence of an audio modality that contains valuable cues for highlight detection in many videos also makes it difficult to use multimodal strategies. In this paper, we propose a novel model with cross-modal perception for unsupervised highlight detection. The proposed model learns representations with visual-audio level semantics from image-audio pair data via a self-reconstruction task. To achieve unsupervised highlight detection, we investigate the latent representations of the network and propose the representation activation sequence learning (RASL) module with k-point contrastive learning to learn significant representation activations. To connect the visual modality with the audio modality, we use the symmetric contrastive learning (SCL) module to learn the paired visual and audio representations. Furthermore, an auxiliary task of masked feature vector sequence (FVS) reconstruction is simultaneously conducted during pretraining for representation enhancement. During inference, the cross-modal pretrained model can generate representations with paired visual-audio semantics given only the visual modality. The RASL module is used to output the highlight scores. The experimental results show that the proposed framework achieves superior performance compared to other state-of-the-art approaches.

Genetic insights into the gut microbiota and risk of facial skin aging: A Mendelian randomization study.

BACKGROUND: A growing number of experimental studies have shown an association between the gut microbiota (GM) and facial skin aging. However, the causal relationship between GM and facial skin aging remains unclear to date. METHODS: We conducted a two-sample Mendelian randomization (MR) analysis to investigate the potential causal relationship between GM and facial skin aging. MR analysis was mainly performed using the inverse-variance weighting (IVW) method, complemented by the weighted median (MW) method, MR-Egger regression, and weighted mode, and sensitivity analysis was used to test the reliability of MR analysis results. RESULTS: Eleven GM taxa associated with facial skin aging were identified by IVW method analysis, Family Victivallaceae (p = 0.010), Genus Eubacterium coprostanoligenes group (p = 0.038), and Genus Parasutterella (p = 0.011) were negatively associated with facial skin aging, while Phylum Verrucomicrobia (p = 0.034), Family Lactobacillaceae (p = 0.017) and its subgroups Genus Lactobacillus (p = 0.038), Genus Parabacteroides (p = 0.040), Genus Eggerthella (p = 0.049), Genus Family XIII UCG001 (p = 0.036), Genus Phascolarctobacterium (p = 0.027), and Genus Ruminococcaceae UCG005 (p = 0.012) were positively associated with facial skin aging. At Class and Order levels, we did not find a causal relationship between GM and facial skin aging. Results of sensitivity analyses did not show evidence of pleiotropy and heterogeneity. CONCLUSION: Our findings confirm the causal relationship between GM and facial skin aging, providing a new perspective on delaying facial aging.

Low-Frequency Evolution Mechanism of Customized HEAs-Based Electromagnetic Response Modes Manipulated by Carbothermal Shock.

An emerging carbothermal shock method is an ultra-convenient strategy for synthesizing high-entropy alloys (HEAs), in which the intelligent combination of carbon support and HEAs can be serve as a decisive factor for interpreting the trade-off relationship between conductive gene and dielectric gene. However, the feedback mechanism of HEAs ordering degree on electromagnetic (EM) response in 2-18 GHz has not been comprehensively demystified. Herein, while lignin-based carbon fiber paper (L-CFP) as carbon support, L-CFP/FeCoNiCuZn-X with is prepared by carbothermal shock method. The reflection loss of -82.6 dB with thickness of 1.31 mm is achieved by means of pointing electron enrichment within L-CFP/FeCoNiCuZn HEAs heterointerfaces verified by theoretical calculations. Simultaneously, low-frequency evolution with high-intensity and broadband EM response relies on a "sacrificing" strategy achieved by construction of polymorphic L-CFP/semi-disordered-HEAs heterointerfaces. The practicality of L-CFP/FeCoNiCuZn-X in complex environments is given prominence to thermal conductivity, hydrophobicity, and electrocatalytic property. This work is of great significance for insightful mechanism analysis of HEAs in the application of electromagnetic wave absorption.

Dietary factors and the risk of atopic dermatitis: a Mendelian randomisation study.

Previous studies have revealed an association between dietary factors and atopic dermatitis (AD). To explore whether there was a causal relationship between diet and AD, we performed Mendelian randomisation (MR) analysis. The dataset of twenty-one dietary factors was obtained from UK Biobank. The dataset for AD was obtained from the publicly available FinnGen consortium. The main research method was the inverse-variance weighting method, which was supplemented by MR‒Egger, weighted median and weighted mode. In addition, sensitivity analysis was performed to ensure the accuracy of the results. The study revealed that beef intake (OR = 0·351; 95 % CI 0·145, 0·847; P = 0·020) and white bread intake (OR = 0·141; 95 % CI 0·030, 0·656; P = 0·012) may be protective factors against AD. There were no causal relationships between AD and any other dietary intake factors. Sensitivity analysis showed that our results were reliable, and no heterogeneity or pleiotropy was found. Therefore, we believe that beef intake may be associated with a reduced risk of AD. Although white bread was significant in the IVW analysis, there was large uncertainty in the results given the wide 95 % CI. Other factors were not associated with AD in this study.

Association of dietary carbohydrate and fiber ratio with postmenopausal bone mineral density and prevalence of osteoporosis: A cross-sectional study.

BACKGROUND: This study aimed to investigate the associations of carbohydrate to dietary fiber ratio with bone mineral density (BMD) and the prevalence of osteoporosis in postmenopausal women. METHODS: This cross-sectional study retrieved the data of 2829 postmenopausal women from the National Health and Nutrition Examination Survey (NHANES) database. Weighted univariable logistic regression models were used to investigate the correlations of carbohydrate, dietary fiber, or carbohydrate to fiber ratio with osteoporosis. RESULTS: Higher dietary fiber intake was correlated with decreased odds ratio of osteoporosis [odds ratio(OR) = 0.96, 95% confidence interval (CI): 0.93 to 0.99]. The odds ratio of osteoporosis in postmenopausal women was elevated as the increase of carbohydrate to fiber ratio (OR = 1.80, 95%CI: 1.10 to 2.96). Carbohydrate to fiber ratio >17.09 was related to increased odds ratio of osteoporosis (OR = 1.63, 95%CI: 1.04 to 2.56). Compared to the carbohydrate to fiber ratio ≤11.59 group, carbohydrate to fiber ratio >17.09 was associated with decreased total femur BMD (ß = -0.015, 95%CI: -0.028 to -0.001) and femur neck BMD (ß = -0.020, 95%CI: -0.033 to -0.006) in postmenopausal women. The femur neck BMD in postmenopausal women was decreased with the increase of carbohydrate to fiber ratio (ß = -0.015, 95%CI: -0.028 to -0.001). CONCLUSION: In postmenopausal women, a high carbohydrate/fiber ratio >17.09 is associated with an increased risk of osteoporosis and lower hip BMD and high fiber intake is associated with less osteoporosis and higher hip BMD.

Reprogramming Exosomes to Escape from Immune Surveillance for Mitochondrial Protection in Hepatic Ischemia-Reperfusion Injury.

Background: Therapeutic interventions such as synthetic drugs and microRNA (miR) modulators have created opportunities for mitigating hepatic ischemia/reperfusion injury (HIRI) by alleviating mitochondrial dysfunction. However, delivering multi-therapeutic ingredients with low toxicity to hepatocytes still lags behind its development. Methods: In this study, we endowed exosomes with delivery function to concentrate on hepatocytes for multidimensionally halting mitochondria dysfunction during HIRI. Concretely, exosomes were reprogrammed with a transmembrane protein CD47, which acted as a "camouflage cloak" to mimic the "don't eat me" mechanism to escape from immune surveillance. Besides, HuR was engineered bridging to the membrane by fusing with CD47 and located in the cytoplasm for miR loading. Results: This strategy successfully delivered dual payloads to hepatocytes and efficiently protected mitochondria by inhibiting the opening of mitochondrial permeability transition pore (mPTP) and upregulating mitochondrial transcription factor A (TFAM), respectively. Conclusions: The reprogramming of exosomes with CD47 and HuR for targeted delivery of CsA and miR inhibitors represents a promising therapeutic strategy for addressing HIRI. This approach shows potential for safe and effective clinical applications in the treatment of HIRI.

Effect of different non-pharmacologic placebo treatments on migraine prevention: a network meta-analysis of randomized controlled trials.

BACKGROUND: Placebo control plays an important role in evaluating the effectiveness of interventions. Specifying differential effects of various placebo controls on migraine prevention would be essential in the explanation of preventive treatment for migraine and the indirect comparison between different prophylactic therapeutics. OBJECTIVES: To access the impact of different non-pharmacologic placebo types on different outcomes in migraine patients. METHODS: We searched PubMed, Cochrane Controlled Register of Trials, Embase, and Web of Science databases from the date of creation to June 19, 2023. Randomized controlled trials of migraine that included sham intervention of acupuncture or cognitive behavioural therapy (CBT) or non-invasive Vagus Nerve Stimulation (nVNS) or repetitive Transcranial Magnetic Stimulation (rTMS) or transcranial Direct Current Stimulation (tDCS) were conducted. The primary outcome was the migraine days, and the secondary outcomes were the number of migraine attacks, headache days, headache frequency, and responder's rate. Placebo effects were assessed using five individual placebos for network meta-analysis, using mean differences to measure the relative effect of pair-wise comparisons between interventions. RESULT: A total of 50 trials with 4880 subjects were included. Twenty-seven trials were evaluated for low risk of bias. The results of indirect comparisons show that sham rTMS and sham tDCS had optimal and similar effects in reducing migraine days; sham acupuncture has the greatest effect on reducing the number of migraine attacks and relieving headache frequency; sham rTMS had a highly significant advantage in reducing headache days compared with the other placebo controls. CONCLUSION: Based on the network meta-analysis results, we found that sham acupuncture had the greatest effect on migraine prophylaxis. The strong placebo effect of sham acupuncture should be considered when assessing the therapeutic effect.

Risk factors of systemic lupus erythematosus: an overview of systematic reviews and Mendelian randomization studies

Abstract Background The etiology of systemic lupus erythematosus is complex and incurable. A large number of systematic reviews have studied the risk factors of it. Mendelian randomization is an analytical method that uses genetic data as tool variables to evaluate the causal relationship between exposure and outcome. Objective To review the systematic reviews and Mendelian randomization studies that focused on the risk factors of systemic lupus erythematosus and shed light on the development of treatments for its prevention and intervention. Methods From inception to January 2022, we systematically searched MEDLINE (via PubMed) and Embase for related systematic reviews and Mendelian randomization studies. Extract relevant main data for studies that meet inclusion criteria. The quality of systematic reviews was assessed by using Assessment of Multiple Systematic Reviews 2 (AMSTAR-2). Finally, the risk factors are scored comprehensively according to the results' quantity, quality, and consistency. Results Our study involved 64 systematic reviews and 12 Mendelian randomization studies. The results of systematic reviews showed that diseases (endometriosis, atopic dermatitis, allergic rhinitis), lifestyle (smoking, drinking, vaccination), and gene polymorphism influenced the incidence of systemic lupus erythematosus. The results of Mendelian randomization studies identified the role of disease (periodontitis, celiac disease), trace elements (selenium, iron), cytokines (growth differentiation factor 15), and gut microbiome in the pathogenesis of systemic lupus erythematosus. Conclusion We should pay attention to preventing and treating systemic lupus erythematosus in patients with endometriosis, celiac disease, and periodontitis. Take appropriate dietary supplements to increase serum iron and selenium levels to reduce the risk of systemic lupus erythematosus. There should be no excessive intervention in lifestyles such as smoking and drinking.