Comparison of the efficacy and safety of ciprofol and propofol in sedating patients in the operating room and outside the operating room: a meta-analysis and systematic review.

BACKGROUND: As a new type of intravenous anesthetic, ciprofol has the advantages of fast onset of action, fast recovery and high clearance rate. This study aimed to investigate the effectiveness and safety of ciprofol versus traditional propofol for anesthesia and sedation in and out of the operating room. METHODS: We searched the literature in PubMed, Web of Science, Cochrane Library, and Embase databases from January 2021 to December 2023. All clinical studies comparing the sedative effects of propofol and ciprofol, both inside and outside the operating room, were included in our trial. The main outcome measures were induction time and incidence of injection-site pain. Data are merged using risk ratio and standardized mean difference with 95% confidence interval. Subgroup analysis, meta-regression, sensitivity analysis, and publication bias were performed. The study protocol was prospectively registered with PROSPERO (CRD42023447747). RESULTS: A total of 15 randomized, controlled trials involving 2002 patients were included in this study. Compared with propofol, ciprofol has a longer induction time in the operating room but a shorter induction time in non-operating room settings. Ciprofol can effectively reduce the risk of injection-site pain and respiratory depression both inside and outside the operating room. In addition, the risk of drug-related hypotension induced with ciprofol in the operating room is lower, but the awakening time is also longer. Meta-regression analysis showed that neither age nor BMI were potential sources of heterogeneity. Funnel plot, egger and begg tests showed no significant publication bias. Sensitivity analyzes indicate that our results are robust and reliable. CONCLUSION: Ciprofol has absolute advantages in reducing the risk of injection-site pain and respiratory depression, both in and outside operating room. Intraoperative use of ciprofol reduces the risk of drug-related hypotension and may also reduce the risk of intraoperative physical movements. However, ciprofol may have longer induction and awakening time than propofol.

MXene Nanosheet Templated Nanofiltration Membranes toward Ultrahigh Water Transport.

The demand for thin-film composite (TFC) nanofiltration membranes with superior permeance and high rejection is gradually increasing for seawater desalination and brackish water softening. However, improving the membrane permeance remains a great challenge due to the formation of excrescent polyamide in the substrate pores and thick polyamide film. Herein, we fabricated a high-performance TFC nanofiltration membrane via a classical interfacial polymerization reaction on a two-dimensional lamellar layer of transition-metal carbides (MXene). The MXene layer promoted the absorption of the reactive monomer, and higher amine monomer concentration facilitated the self-sealing and self-termination of interfacial polymerization to generate a thinner outer polyamide film from 68 to 20 nm. The almost nonporous lamellar interface inhibited the formation of inner polyamide in the substrate pores. In addition, the MXene lamellar layer could be eliminated by mild oxidation after interfacial polymerization to avoid imparted additional hydraulic resistance. The resulting TFC membrane conferred a high rejection above 96% for Na2SO4 and excellent permeance of 45.7 L·m-2·h-1·bar-1, which was almost 4.5 times higher than that of the control membrane (10.2 L·m-2·h-1·bar-1). This research provides a feasible strategy for fabricating a high-performance nanofiltration membrane using two-dimensional nanosheets as a templated interface.

Ultrathin Thin-Film Composite Polyamide Membranes Constructed on Hydrophilic Poly(vinyl alcohol) Decorated Support Toward Enhanced Nanofiltration Performance.

Traditional polyamide-based interfacial polymerized nanofiltration (NF) membranes exhibit upper bound features between water permeance and salt selectivity. Breaking the limits of the permeability and rejections of these composite NF membranes are highly desirable for water desalination. Herein, a high-performance NF membrane (TFC-P) was fabricated via interfacial polymerization on the poly(vinyl alcohol) (PVA) interlayered poly(ether sulfone) (PES) ultrafiltration support. Owing to the large surface area, great hydrophilicity, and high porosity of the PES-PVA support, a highly cross-linked polyamide separating layer was formed with a thickness of 9.6 nm, which was almost 90% thinner than that of the control membrane (TFC-C). In addition, the TFC-P possessed lower ζ-potential, smaller pore size, and greater surface area compared to that of the TFC-C, achieving an ultrahigh water permeance of 31.4 L m-2 h-1 bar-1 and a 99.4% Na2SO4 rejection. Importantly, the PVA interlayer strategy was further applied to a pilot NF production line and the fabricated membranes presented stable water flux and salt rejections as comparable to the lab-scaled membranes. The outstanding properties of the PVA-interlayered NF membranes highlight the feasibility of the fabrication method for practical applications, which provides a new avenue to develop robust polyamide-based NF desalination membranes for environmental water treatment.

Hippocampal astrocyte dysfunction contributes to etomidate-induced long-lasting synaptic inhibition.

Cognitive impairments following the use of general anesthetics are well documented but the underlying mechanisms are unclear. Here, long-lasting cognitive deficits were observed in aged mice following administration of etomidate at a clinically relevant concentration (20 mg/kg); these deficits were closely related to hippocampal synaptic inhibition and astrocyte dysfunction. Using microdialysis and magnetic-activated cell-sorting techniques, we found that astrocyte secretion of glutamate, d-serine, and ATP, as well as astrocyte function, were depressed in the hippocampus following treatment with etomidate. Interestingly, hippocampal astrocyte inhibition (designer receptors exclusively activated by designer drugs; DREADDs) had no effect on the initial synaptic inhibition, but reversed synaptic and cognitive depression in the long term. Furthermore, continual activation of hippocampal astrocytes following administration of a sedative dose (8 mg/kg) of etomidate induced synaptic inhibition and cognitive dysfunction. Our results indicate that general anesthetic-induced hippocampal astrocyte dysfunction plays a role in maintaining synaptic inhibition, which eventually induces long-lasting cognitive deficits.

Incorporation of Cellulose Nanocrystals (CNCs) into the Polyamide Layer of Thin-Film Composite (TFC) Nanofiltration Membranes for Enhanced Separation Performance and Antifouling Properties.

To achieve greater separation performance and antifouling properties in a thin-film composite (TFC) nanofiltration membrane, cellulose nanocrystals (CNCs) were incorporated into the polyamide layer of a TFC membrane for the first time. The results of Fourier transform infrared spectroscopy and X-ray photoelectron spectroscopy (XPS) confirmed the successful formation of the CNC-polyamide composite layer. Surface characterization results revealed differences in the morphologies of the CNC-TFC membranes compared with a control membrane (CNC-TFC-0). Streaming potential measurements and molecular weight cutoff (MWCO) characterizations showed that the CNC-TFC membranes exhibited a greater negative surface charge and a smaller MWCO as the CNC content increased. The CNC-TFC membranes showed enhanced hydrophilicity and increased permeability. With the incorporation of only 0.020 wt % CNCs, the permeability of the CNC-TFC membrane increased by 60.0% over that of the polyamide TFC without CNC. Rejection of Na2SO4 and MgSO4 by the CNC-TFC membranes was similar to that observed for the CNC-TFC-0 membrane, at values of approximately 98.7% and 98.8%, respectively, indicating that divalent salt rejection was not sacrificed. The monovalent ion rejection tended to increase as the CNC content increased. In addition, the CNC-TFC membranes exhibited enhanced antifouling properties due to their increased hydrophilicity and more negatively charged surfaces.

General Fabrication of Robust Alloyed Metal Anodes for High-Performance Metal Batteries.

Revitalizing metal anodes for rechargeable batteries confronts challenges such as dendrite formation, limited cyclicity, and suboptimal energy density. Despite various efforts, a practical fabrication method for dendrite-free metal anodes remains unavailable. Herein, focusing on Li as exemplar, a general strategy is reported to enhance reversibility of the metal anodes by forming alloyed metals, which is achieved by induction heating of 3D substrate, lithiophilic metals, and Li within tens of seconds. It is demonstrated that preferred alloying interactions between substrates and lithiophilic metals created a lithiophilic metal-rich region adjacent to the substrate, serving as ultrastable lithiophilic host to guide dendrite-free deposition, particularly during prolonged high-capacity cycling. Simultaneously, an alloying between lithiophilic metals and Li creates a Li-rich region adjacent to electrolyte that reduces nucleation overpotential and constitutes favorable electrolyte-Li interface. The resultant composite Li anodes paired with high areal loading LiNi0.8Co0.1Mn0.1O2 cathodes achieve superior cycling stability and remarkable energy density above 1200 Wh L-1 (excluding packaging). Furthermore, this approach shows broader applicability to other metal anodes plagued by dendrite-related challenges, such as Na and Zn. Overall, this work paves the way for development of commercially viable metal-based batteries that offer a combination of safety, high energy density, and durability.

Electrolyte Engineering with Tamed Electrode Interphases for High-Voltage Sodium-Ion Batteries.

Sodium-ion batteries (SIBs) hold great promise for next-generation grid-scale energy storage. However, the highly instable electrolyte/electrode interphases threaten the long-term cycling of high-energy SIBs. In particular, the instable cathode electrolyte interphase (CEI) at high voltage causes persistent electrolyte decomposition, transition metal dissolution, and fast capacity fade. Here, this work proposes a balanced principle for the molecular design of SIB electrolytes that enables an ultra-thin, homogeneous, and robust CEI layer by coupling an intrinsically oxidation-stable succinonitrile solvent with moderately solvating carbonates. The proposed electrolyte not only shows limited anodic decomposition thus leading to a thin CEI, but also suppresses dissolution of CEI components at high voltage. Consequently, the tamed electrolyte/electrode interphases enable extremely stable cycling of Na3V2O2(PO4)2F (NVOPF) cathodes with outstanding capacity retention (>90%) over 3000 cycles (8 months) at 1 C with a high charging voltage of 4.3 V. Further, the NVOPF||hard carbon full cell shows stable cycling over 500 cycles at 1 C with a high average Coulombic efficiency (CE) of 99.6%. The electrolyte also endows high-voltage operation of SIBs with great temperature adaptability from -25 to 60 °C, shedding light on the essence of fundamental electrolyte design for SIBs operating under harsh conditions.

Cobalt single-atom catalyst tailored ceramic membrane for selective removal of emerging organic contaminants.

Water reuse is an effective way to solve the issues of current wastewater increments and water resource scarcity. Ultrafiltration, a promising method for water reuse, has the characteristics of low energy consumption, easy operation, and high adaptability to coupling with other water treatment processes. However, emerging organic contaminants (EOCs) in municipal wastewater cannot be effectively intercepted by ultrafiltration, which poses significant challenges to the effluent quality and sustainability of ultrafiltration process. Here, we develop a cobalt single-atom catalyst-tailored ceramic membrane (Co1-NCNT-CM) in conjunction with an activated peroxymonosulfate (PMS) system, achieving excellent EOCs degradation and anti-fouling performance. An interfacial reaction mechanism effectively mitigates membrane fouling through a repulsive interaction with natural organic matter. The generation of singlet oxygen at the Co-N3-C active sites through a catalytic pathway (PMS→PMS∗→OH∗→O∗→OO∗→1O2) exhibits selective oxidation of phenols and sulfonamides, achieving >90% removal rates. Our findings elucidate a multi-layered functional architecture within the Co1-NCNT-CM/PMS system, responsible for its superior performance in organic decontamination and membrane maintenance during secondary effluent treatment. It highlights the power of integrating Co1-NCNT-CM/PMS systems in advanced wastewater treatment frameworks, specifically for targeted EOCs removal, heralding a new direction for sustainable water management.

Early prediction of acute gallstone pancreatitis severity: a novel machine learning model based on CT features and open access online prediction platform.

BACKGROUND: Early diagnosis of acute gallstone pancreatitis severity (GSP) is challenging in clinical practice. We aimed to investigate the efficacy of CT features and radiomics for the early prediction of acute GSP severity. METHODS: We retrospectively recruited GSP patients who underwent CT imaging within 48 h of admission from tertiary referral centre. Radiomics and CT features were extracted from CT scans. The clinical and CT features were selected by the random forest algorithm to develop the ML GSP model for the identification of severity of GSP (mild or severe), and its predictive efficacy was compared with radiomics model. The predictive performance was assessed by the area under operating characteristic curve. Calibration curve and decision curve analysis were performed to demonstrate the classification performance and clinical efficacy. Furthermore, we built a web-based open access GSP severity calculator. The study was registered with ClinicalTrials.gov (NCT05498961). RESULTS: A total of 301 patients were enrolled. They were randomly assigned into the training (n = 210) and validation (n = 91) cohorts at a ratio of 7:3. The random forest algorithm identified the level of calcium ions, WBC count, urea level, combined cholecystitis, gallbladder wall thickening, gallstones, and hydrothorax as the seven predictive factors for severity of GSP. In the validation cohort, the areas under the curve for the radiomics model and ML GSP model were 0.841 (0.757-0.926) and 0.914 (0.851-0.978), respectively. The calibration plot shows that the ML GSP model has good consistency between the prediction probability and the observation probability. Decision curve analysis showed that the ML GSP model had high clinical utility. CONCLUSIONS: We built the ML GSP model based on clinical and CT image features and distributed it as a free web-based calculator. Our results indicated that the ML GSP model is useful for predicting the severity of GSP.

ML GSP model based on machine learning has good severity discrimination in both training and validation cohorts (0.916 (0.872­0.958), 0.914 (0.851­0.978), respectively).We built an online user-friendly platform for the ML GSP model to help clinicians better identify the severity of GSP.

Charge-neutral morpholino microarrays for nucleic acid analysis.

A principal challenge in microarray experiments is to facilitate hybridization between probe strands on the array with complementary target strands from solution while suppressing any competing interactions that the probes and targets may experience. Synthetic DNA analogs, whose hybridization to targets can exhibit qualitatively different dependence on experimental conditions than for nucleic acid probes, open up an attractive alternative for improving selectivity of array hybridization. Morpholinos (MOs), a class of uncharged DNA analogs, are investigated as microarray probes instead of DNA. MO microarrays were fabricated by contact printing of amino-modified probes onto aldehyde slides. In addition to covalent immobilization, MOs were found to efficiently immobilize through physical adsorption; such physically adsorbed probes could be removed by post-printing washes with surfactant solutions. Hybridization of double-stranded DNA targets to MO microarrays revealed a hybridization maximum at intermediate ionic strengths. The decline in hybridization at lower ionic strengths was attributed to an electrostatic barrier accumulated from hybridized DNA targets, whereas at higher ionic strengths it was attributed to stabilization of target secondary structure in solution. These trends, which illustrate ionic strength tuning of forming on-array relative to solution secondary structure, were supported by a stability analysis of MO/DNA and DNA/DNA duplexes in solution.

Actual Use Behavior Assessment of a Novel Puff Recording Electronic Nicotine Delivery System: Observation Study.

BACKGROUND: Compared with combustible cigarettes, electronic cigarettes (e-cigarettes) can deliver a sufficient amount of nicotine with a significantly reduced emission of toxicants, which renders them as potential harm reduction candidates for tobacco and smoking replacement. However, the use of e-cigarettes is not harm free and the long-term health effect of using e-cigarettes is yet to be established. Given the high prevalence of e-cigarette use across the globe and its potential health concerns, it is imperative to conduct actual use behavior assessments to better understand how e-cigarettes are being consumed in real-world conditions. However, with the currently available technologies, there is still a lack of noninvasive, noninterventional, and convenient instruments for the real-time and real-world use behavior monitoring of e-cigarette product use. Novel technology-based systems that do not primarily rely on self-report or intrusive measurements to monitor e-cigarette use behaviors are therefore highly desired. OBJECTIVE: The primary goal of this study is to investigate the e-cigarette actual use behaviors in the real world via a novel puff recording electronic nicotine delivery system (PR-ENDS). Specifically, we aim to analyze and summarize the survey and PR-ENDS use data and to study the relationships and effects of different factors on these variables. METHODS: In real-world conditions, 61 enrolled UK e-cigarette users were instructed to use PR-ENDS as the primary source of nicotine with their selected e-liquids for at least 3 weeks (21 days). A baseline survey was conducted to collect information about participants' demographics and nicotine use history (cigarette and ENDS). The puff data (ie, puff number, puff duration for each puff, device power, e-liquid nicotine concentrations) were directly recorded by PR-ENDS and uploaded to the cloud for further analyses. The nicotine emission and nicotine consumption were estimated based on recorded puff data. RESULTS: Middle-aged adults with a nicotine history represented the major user profile during the PR-ENDS trial. A wide range of device power and e-liquid nicotine concentrations was applied and their combinations during actual use were found to be rather complex. Various puff parameters (ie, puff duration, puff number, nicotine emission) were assessed with contributing factors from device, e-liquid, and user nicotine history in different effect sizes. The real-time observation revealed substantial intra- and interindividual variabilities in PR-ENDS use behaviors. The use pattern of a quick adaptation followed by consistent product use was recognized for at least 3 weeks during actual use. CONCLUSIONS: The actual use behavior assessment of PR-ENDS was conducted as a proof-of-concept application. The complex interactions of product attributes and significant intra- and interindividual variabilities in e-cigarette use behaviors provided new insights of compensatory behavior, which can inspire future studies in the field of nicotine addiction and abuse liability behavior assessment.

Controlling ultrafiltration membrane fouling in surface water treatment via combined pretreatment of O3 and PAC: Mechanism investigation on impacts of technological sequence.

In this research, the effects of combined powdered activated carbon (PAC)-ozone (O3) pretreatment on ultrafiltration (UF) performance were comprehensively examined and compared with the conventional O3-PAC pretreatment. The performance of pretreatments on mitigating membrane fouling caused by Songhua River water (SHR) was evaluated by specific flux, membrane fouling resistance distribution, and membrane fouling index. Moreover, the degradation of natural organic matter in SHR was investigated by UV absorbance at 254 nm (UV254), dissolved organic carbon (DOC), and fluorescent organic matter. Results showed that the 100PAC-5O3 process was the most effective in improving the specific flux, with 82.89 % and 58.17 % reductions in the reversible fouling resistance and irreversible fouling resistance respectively. Additionally, the irreversible membrane fouling index was reduced by 20 % relative to 5O3-100PAC. The PAC-O3 process also exhibited superior performance in the degradation of UV254, DOC, three fluorescent components, and three micropollutants in the SHR system compared to O3-PAC pretreatment. The O3 stage played a major role in mitigating membrane fouling, while PAC pretreatment enhanced the oxidation in the subsequent O3 stage during the PAC-O3 process. Furthermore, the Extended Derjaguin-Landau-Verwey-Overbeek theory and pore blocking-cake layer filtration model fitting analysis were employed to explain the mechanisms of membrane fouling mitigation and fouling patterns transformation. It was found that PAC-O3 significantly increased the repulsive interactions between the foulants and the membrane, which restrained the formation of the cake layer filtration stage. Overall, this study evidenced the potential of PAC-O3 pretreatment in surface water treatment applications, providing new insights into the mechanism of controlling membrane fouling and improving the permeate quality.

A Novel Puff Recording Electronic Nicotine Delivery System for Assessing Naturalistic Puff Topography and Nicotine Consumption During Ad Libitum Use: Ancillary Study.

BACKGROUND: Assessing the naturalistic puff topography and associated nicotine consumption during e-cigarette use is important as such information will not only unveil how these products are being consumed in real-world conditions, but also enable investigators and regulatory bodies to conduct quantitative, accurate, and realistic harmful exposure and nicotine abuse liability risk assessments based on actual e-cigarette use. Conventional approaches cannot accurately, conveniently, and noninvasively determine e-cigarette puff topography in a natural use environment. Thus, novel technology-enabled systems that do not primarily rely on self-report mechanisms or intrusive measurements to monitor e-cigarette product use behaviors are highly desired. OBJECTIVE: This study aimed to explore and demonstrate the feasibility of a novel puff recording electronic nicotine delivery system (PR-ENDS) device for measuring naturalistic puff topography and estimating nicotine consumption during the ad libitum use of products among smokers and vapers. METHODS: An ancillary data analysis based on a completed parent study was conducted. The parent study was a 1-way randomized controlled open-label puff topography and nicotine pharmacokinetic assessment carried out in 24 healthy adults (12 smokers and 12 vapers). Participants were assigned a randomized product use sequence of a PR-ENDS device within 5 site visits for both controlled and ad libitum product use sessions. Blood samples were obtained for plasma nicotine analysis, and questionnaires were administered at various time points. During the ad libitum use session, puff topography was measured using a Clinical Research Support System (CReSS) device as a benchmark, as well as the PR-ENDS device with a built-in puff recording feature. RESULTS: There were no significant differences in representative puff topography parameters (number of puffs, total puff duration, and average puff duration) between the PR-ENDS and CReSS devices at the populational level across different device powers, e-liquid nicotine strengths, and flavors. The nicotine consumption estimated by the PR-ENDS device suggested that this device can be employed as a convenient monitoring tool for estimating nicotine use without measuring e-liquid weight loss between puffs. The linear relationship between nicotine consumption estimated by the PR-ENDS device and the pharmacokinetic parameter AUCad lib (plasma concentration-time curve for 1-hour ad libitum use) substantiated the potential of using this device as a pragmatic, noninvasive, and convenient means for estimating nicotine intake in the human body without blood collection. CONCLUSIONS: The novel PR-ENDS device was feasible for assessing naturalistic puff topography and estimating nicotine consumption and intake in the human body during ad libitum use. Several key factors can influence users' puff topography, including device power levels, e-liquid nicotine strengths, and flavors. The study results pave the way for further research in the real-time measurement of naturalistic puff topography and puffing behaviors in the real world.

MicroRNA-154-5p suppresses cervical carcinoma growth and metastasis by silencing Cullin2 in vitro and in vivo.

Background: MicroRNA-154-5p (miR-154-5p) plays a role in tumorigenesis in diverse human malignancies. Nevertheless, little is known about the mechanism by which miR-154-5p alters the growth and metastasis of cervical cancer. This research aimed to analyze the role of miR-154-5p in the pathology of cervical cancer in vitro and in vivo. Methods: The level of miR-154-5p in human papillomavirus 16 positive cervical cancer cells was examined by real-time quantitative polymerase chain reaction. Bioinformatics predicted the downstream targets and potential functions of miR-154-5p. Furthermore, lentiviral technology was used to construct SiHa cell lines with stable up- and down-expression levels of miR-154-5p. Its differential expression effects on the progress and metastasis of cervical cancer were analyzed using cell culture and animal models. Results: MiR-154-5p showed low expression in cervical cancer cells. Overexpression of miR-154-5p could markedly inhibit the proliferation, migration, and colony formation ability of SiHa cells, concomitantly leading to G1 arrest of the cell cycle, while silencing miR-154-5p triggered the opposite results. Meanwhile, overexpression of miR-154-5p restrained the growth and metastasis of cervical cancer by silencing CUL2 in vivo. Additionally, miR-154-5p reduced CUL2 level, and overexpression of CUL2 influenced the effect of miR-154-5p in cervical cancer. In conclusion, miR-154-5p restrained the growth and metastasis of cervical cancer by directly silencing CUL2.

The effect of telerehabilitation on balance in stroke patients: is it more effective than the traditional rehabilitation model? A meta-analysis of randomized controlled trials published during the COVID-19 pandemic.

Objective: Telerehabilitation and telemedicine have gradually gained popularity. In 2019, the outbreak of COVID-19 started in Wuhan and then spread across the world. To date, most countries have opted to coexist with the virus. However, patients, especially those who have suffered a stroke, should take measures to avoid being infected with any disease as much as possible since any infectious disease can lead to adverse events for them. Telerehabilitation can be beneficial to stroke patients as they are less likely to be infected by the virus. In recent years, several studies on telerehabilitation have been conducted globally. This meta-analysis aimed to investigate the effects of telerehabilitation on the balance ability of stroke patients, compare the efficacy of conventional rehabilitation with telerehabilitation, explore the characteristics of telerehabilitation and conventional rehabilitation, and provide recommendations for rehabilitation programs in the context of the global pandemic. Methods: We searched Pubmed, Embase, the Web of Science, and The Cochrane Library databases from 1 January 2020 to 31 December 2022 for randomized controlled trials published in English that evaluated the improvement of balance function in stroke patients after telerehabilitation and compared the differences between telerehabilitation (TR) and conventional rehabilitation (CR). The random-effects model was utilized to calculate mean differences (MDs) with 95% confidence intervals (CIs) to estimate intervention effects. Statistical heterogeneity was assessed according to the I2 values. The risk of bias was measured using the Cochrane risk-of-bias assessment tool. Results: We included nine studies in the system evaluation, all of which were included in the pooled analysis. All outcomes in the experimental and control groups improved over time. The comparison between groups concluded that people who received the telerehabilitation intervention had a significant improvement in the Berg Balance Scale (MD = 2.80; 95% CI 0.61, 4.98, P < 0.05, I2 = 51.90%) and the Fugl-Meyer Assessment (MD = 8.12; 95% CI 6.35, 9.88, P < 0.05, I2 = 0) compared to controls. The Timed Up and Go test (MD = -4.59; 95% CI -5.93, -.25, P < 0.05, I2 = 0) and Tinetti Performance-Oriented Mobility Assessment-Balance (MD = 2.50; 95% CI 0.39, 4.61, P < 0.05) scored better in the control group than in the experimental group. There were no significant differences in other outcomes between the two groups. Conclusion: Studies on changes in medical conditions during the COVID-19 pandemic also demonstrated that, for stroke patients, telerehabilitation achieves similar effects as the conventional rehabilitation model and can act as a continuation of the conventional rehabilitation model. Owing to the different equipment and intervention programs of telerehabilitation, its curative effect on the static balance and reactive balance of stroke patients may be different. Currently, telerehabilitation may be more conducive to the rehabilitation of patients' static balance abilities, while conventional rehabilitation is more effective for the rehabilitation of patients' reactive balance. Therefore, further studies are needed for investigating the difference in efficacy between varied devices and telerehabilitation programs. Further research is needed on static and reactive balance. In addition, such research should have a large body of literature and a large sample size to support more definitive findings based on the context of the COVID-19 pandemic. Systematic review registration: CRD42023389456.

Electrical-based ultrafiltration processes enhanced by in-situ generation of Fe(III): Significance of permanganate oxidation.

In this study, a permanganate-assisted electrocoagulation-ultrafiltration (PEC-UF) process was proposed to control membrane fouling in the treatment of secondary effluent. Four comparable systems, i.e., UF, electro-UF (E-UF), electrocoagulation-UF (EC-UF), and PEC-UF, were investigated to systematically clarify the role of permanganate and electrocoagulation in mitigating membrane fouling. Results revealed that the formation of a dense cake layer containing concentrated solutes was the primary reason for membrane fouling. Electrocoagulation significantly mitigated membrane fouling and resulted in the reduction of the normalized transmembrane pressure of the EC-UF and PEC-UF systems by 35.0% and 44.6% compared with the UF control system, respectively. However, the retention of a considerable amount of iron oxyhydroxide precipitates on the membrane surface aggravated inorganic fouling in the in-situ EC-UF system. Furthermore, the enhanced formation of Fe(III) by oxidation of Fe(II) with permanganate promoted the coagulation process. Hence, increased generation of Fe(III) and enhanced coagulation promoted by formed MnOx accelerated the formation of a hydrophilic cake layer with high porosity and thereby reduced the occurrence of both organic and inorganic membrane fouling. These results demonstrated the potential application of permanganate-assisted in-situ electrical-based methods to control UF membrane fouling during advanced wastewater treatment.

A passive-active combined strategy for ultrafiltration membrane fouling control in continuous oily wastewater purification.

Membrane-based technology has been confirmed as an effective way to treat emulsified oily wastewater, however, membrane fouling is still one of practical challenges in long-term operation. Herein, a novel passive-active combined strategy was proposed to control membrane fouling in continuous oily wastewater purification, where the δ-MnO2 decoration layer helped to reduce the total fouling ratio (passive strategy for fouling mitigation) and the catalytic cleaning effectively removed the irreversible oil fouling (active strategy for fouling removal). The functional membrane was prepared via in-situ modification, referred to as δ-MnO2@TA-PES. The morphology, crystalline phase, chemical structure and surface properties of the membranes were systematically characterized. Compared with PES, the δ-MnO2@TA-PES possessed superhydrophilicity, enhanced electronegativity and narrowed pore size. The δ-MnO2@TA-PES achieved high water permeation flux of 723.9 L·m - 2·h - 1·bar-1, excellent oil rejection with separation efficiency above 98.5% for various emulsions, and durable anti-oil-fouling performance with FRRb of 98.0%. Notably, the oil cake layer fouling on δ-MnO2@TA-PES was greatly alleviated owing to its enhanced surface properties. In addition, δ-MnO2@TA-PES showed high cleaning efficiency in the peroxymonosulfate (PMS) cleaning process, where the radical and nonradical pathways occurred simultaneously. And the active substances generated in the nonradical process (especially 1O2) were considered as the main contributor to the reduction of irreversible fouling. Overall, the novel strategy of fouling control ensured the efficient operation of ultrafiltration membranes for the continuous oily wastewater purification.

Kinetic mechanisms in morpholino-DNA surface hybridization.

Morpholinos (MOs) are DNA analogues whose uncharged nature can bring fundamental advantages to surface hybridization technologies such as DNA microarrays, by using MOs as the immobilized, or "probe", species. Advancement of MO-based diagnostics, however, is challenged by limited understanding of the surface organization of MO molecules and of how this organization impacts hybridization kinetics and thermodynamics. The present study focuses on hybridization kinetics between monolayers of MO probes and DNA targets as a function of the instantaneous extent of hybridization (i.e., duplex coverage), total probe coverage, and ionic strength. Intriguingly, these experiments reveal distinct kinetic stages, none of which are consistent with Langmuir kinetics. The initial stage, in which duplex coverage remains relatively sparse, indicates confluence of two effects: blockage of target access to unhybridized probes by previously formed duplexes and deactivation of the solid support due to consumption of probe molecules. This interpretation is consistent with a surface organization in which unhybridized MO probes localize near the solid support, underneath a layer of MO-DNA duplexes. As duplex coverage builds, provided saturation is not reached first, the initial stage can transition to an unusual regime characterized by near independence of hybridization rate on duplex coverage, followed by a prolonged approach to equilibrium. The possible origins of these more complex latter behaviors are discussed. Comparison with published data for DNA and peptide nucleic acid (PNA) probes is carried out to look for universal trends in kinetics. This comparison reveals qualitative similarities when comparable surface organization of probes is expected. In addition, MO monolayers are found capable of a broad range of reactivities that span reported values for PNA and DNA probes.

Strategy of Enhancing the Volumetric Energy Density for Lithium-Sulfur Batteries.

Lithium-sulfur (Li-S) batteries hold the promise of the next generation energy storage system beyond state-of-the-art lithium-ion batteries. Despite the attractive gravimetric energy density (WG ), the volumetric energy density (WV ) still remains a great challenge for the practical application, based on the primary requirement of Small and Light for Li-S batteries. This review highlights the importance of cathode density, sulfur content, electroactivity in achieving high energy densities. In the first part, key factors are analyzed in a model on negative/positive ratio, cathode design, and electrolyte/sulfur ratio, orientated toward energy densities of 700 Wh L-1 /500 Wh kg-1 . Subsequently, recent progresses on enhancing WV for coin/pouch cells are reviewed primarily on cathode. Especially, the "Three High One Low" (THOL) (high sulfur fraction, high sulfur loading, high density host, and low electrolyte quantity) is proposed as a feasible strategy for achieving high WV , taking high WG into consideration simultaneously. Meanwhile, host materials with desired catalytic activity should be paid more attention for fabricating high performance cathode. In the last part, key engineering technologies on manipulating the cathode porosity/density are discussed, including calendering and dry electrode coating. Finally, a future outlook is provided for enhancing both WV and WG of the Li-S batteries.