Heterojunction functionalized sodium alginate/carboxylated cellulose nanocrystals film enhancing sterilization performance for wound healing.

In the realm of natural polysaccharides, hydrogen bonding is a prevalent feature, yet its role in enhancing photocatalytic antimicrobial properties has been underexplored. In this paper, heterojunctions formed by graphene oxide (GO) and ZIF-8 were locked in sodium alginate/ carboxylated cellulose nanocrystals via hydrogen bonding networks, designated as SCGZ. The SCGZ films exhibit superior photocatalytic performance compared to either ZIF-8 or heterojunctions. This enhancement is primarily due to two key factors: firstly, the hydrogen bonding network significantly enhances the transfer of protons and holes, thereby improving the separation efficiency of photo-generated carriers; secondly, the hydrogen bonding between the layers facilitates a more efficient charge transfer, which expedites the movement of electrons from ZIF-8 to GO upon illumination. In vitro studies demonstrated that the SCGZ films possess remarkable antibacterial capabilities, achieving 99.75 % and 99.61 % inhibition rates against S. aureus and E. coli, respectively. In vivo animal experiments have shown that SCGZ films can significantly accelerate the healing process of damaged tissues, with a healing efficiency of up to 90.5 %. This research provides additional insights into the development of natural polysaccharide-based multi­hydrogen bonded macromolecules with enhanced photocatalytic properties.

Synergistic adsorption and UV degradation of perfluorooctanoic acid by amine-functionalized A-center sphalerite.

Perfluorinated alkylated substances (PFAS), as a category of persistent organic pollutants, have garnered extensive concern due to their resilience against environmental degradation. Herein, we developed an amine-functionalized sphalerite (ZnS) with adjustable surface amine functional groups and Zn defects (ZnS-X%[N]) by in situ coprecipitation and simple hydrothermal method in the presence of cetyltrimethylammonium bromide (CTAB). This material demonstrated efficient PFAS adsorption and subsequent photo-induced degradation under UV irradiation. The characterization results by TEM, BET, FTIR, XPS and EPR revealed that CTAB primarily influences ZnS by modulating surface amine functionalities, zinc defect density, and enhancing its photoreductive capacity. Adsorption and kinetic degradation experiments further showed that a medium CTAB concentration in ZnS-40%[N] achieves highest PFAS adsorption capacity (Cmax: 0.201 mol kg-1), and the corresponding decomposition rate was the fastest (kde: 1.53; kdf: 1.19). This efficacy is attributed to the ZnS-40%[N]'s ideal adsorptive sites and surface shallow defects. Moreover, theoretical simulation also supports the above experimental inference. Overall, ZnS-X%[N] exhibits a synergistic effect on PFAS adsorption and degradation, showcasing its potential for environmental adaptability and practical application.

Insights on the Contradiction between the Affinity and Capacity of Ferrihydrite toward As(III) and As(V): Surface Reaction Revisited.

Ferrihydrite is omnipresent in nature, and its adsorption of As(III/V) decides the migration of arsenic. Although As(III) is commonly recognized as the more mobile species of inorganic arsenic, it sometimes exhibits less mobility in ferrihydrite systems, which calls for further insights. In this study, we elucidated the adsorption behavior and mechanisms of As(III/V) on ferrihydrite under different loading levels (molar ratio As/Fe = 0-0.38), solution pH (3-10), and coexisting ions [P(V) and Ca(II)] based on batch adsorption experiments, surface complexation modeling, density functional theory calculations, and X-ray photoelectron spectroscopy. Our results show that As(III) exhibits weaker adsorption affinity but a larger capacity compared with that of As(V). On ferrihydrite, As(III) and As(V) are adsorbed mainly as bidentate mononuclear complexes at type-a sites [≡Fe(OH-0.5)2] and bidentate binuclear complexes at type-b sites (2≡FeOH-0.5), respectively. As the dosage increases, As(III) further forms mononuclear monodentate complexes at both surface sites, resulting in a higher site utilization efficiency, while As(V) does not due to repulsive electrostatic interaction. The difference in surface species of As(III/V) also leads to complex responses when coexisting with high concentrations of P(V) and Ca(II). This study helps us to understand environmental behavior of As(III/V) and develop remediation strategy in As(III/V) contaminated systems.

Alantolactone improves cognitive impairment in rats with Porphyromonas gingivalis infection by inhibiting neuroinflammation, oxidative stress, and reducing Aß levels.

Neuroinflammation caused by the chronic periodontal pathogen Porphyromonas gingivalis is growing regarded as as a key factor in the pathogenesis of Alzheimer's disease (AD). Alantolactone (AL), a sesquiterpene lactone isolated from the root of Inula racemosa Hook. f, has been proven to provide various neuroprotective effects. However, whether AL can improve cognitive impairment caused by P. gingivalis infection remains unclear. In this research, a rat model of P. gingivalis infection was used to examine the neuroprotective benefits of AL. The results revealed that 6 weeks of AL treatment (50 and 100 mg/kg) shortened escape latency and increased the number of crossings over the platform location and time spent in the target quadrant of P. gingivalis-infected rats in the Morris water maze experiment. By activating the Nrf2/HO-1 pathway, AL suppressed malondialdehyde (MDA) levels and simultaneously increased the activity of total superoxide dismutase (T-SOD). Furthermore, AL lowered the presence of IL-6, IL-1ß, and TNFα in the hippocampal and cortical tissues of P. gingivalis-infected rats by inhibiting astrocyte and microglial activation and NF-κB phosphorylation. AL also significantly reduced Aß levels in the cortical and hippocampus tissues of rats infected with P. gingivalis. In conclusion, AL improved cognitive impairment in P. gingivalis-infected rats by inhibiting neuroinflammation, reducing Aß1-42 level, and exerting antioxidative stress effects.

Spin-Orbit-Locking Chiral Bound States in the Continuum.

Bound states in the continuum (BICs), which are confined optical modes exhibiting infinite quality factors and carrying topological polarization configurations in momentum space, have recently sparked significant interest across both fundamental and applied physics. Here, we show that breaking time-reversal symmetry by an external magnetic field enables a new form of chiral BICs with spin-orbit locking. Applying a magnetic field to a magneto-optical photonic crystal slab lifts doubly degenerate BICs into a pair of chiral BICs carrying opposite pseudospins and orbital angular momenta. Multipole analysis verifies the nonzero angular momenta and reveals the spin-orbital-locking behaviors. In momentum space, we observe ultrahigh quality factors and near-circular polarization surrounding chiral BICs, enabling potential applications in spin-selective nanophotonics. Compared to conventional BICs, the magnetically induced chiral BICs revealed here exhibit distinct properties and origins, significantly advancing the topological photonics of BICs by incorporating broken time-reversal symmetry.

Comparative efficiency of different polyol-based deep eutectic solvents for chitin extraction from lobster shells.

In this study, deep eutectic solvent (DES) prepared from choline chloride, lactic acid, and one of the four polyols (ethylene glycol, glycerol, xylitol, and sorbitol) were compared and assessed for their effectiveness in extracting chitin from lobster shells. Our results revealed that as the number of hydroxyl groups in polyols increased, the hydrogen bond network within the DESs became denser. However, this led to a corresponding increase in viscosity, which impacted the efficiency of chitin extraction. Among all prepared DESs, choline chloride-lactic acid/glycerol (CCLaGly) exhibited superior extractive ability, resulting in the extraction of pure chitin from lobster shells. The purity, crystallinity, and molecular weight of the extracted chitin using CCLaGly DES were comparable to those of chemically-isolated chitin, with purity reaching 94.76 ± 0.33 %, crystallinity at 78.78 %, and a molecular weight of 655 kDa. Additionally, the physicochemical properties of the DES-extracted chitins were characterized using Fourier-transform infrared spectroscopy, X-ray diffraction, thermogravimetric analysis, and scanning electron microscopy. This study conducted a comparative analysis of polyol effects on chitin extraction from lobster shells, thereby opening a promising avenue for the utilization of various crustacean shells in sustainable biomaterial production.

Three-dimensional rainbow refractometry.

We propose a new, to the best of our knowledge, rainbow technique called three-dimensional rainbow refractometry (TDRR), with a cylindrical lens in the signal collecting system. With a TDRR model based on the ray transfer matrix developed, it is proved that the tilt angle of the rainbow signal is related to the axial position of the droplet, which helps to obtain the 3D position. By converting rainbow scattering angle calibration into the system parameter calibration, a new rainbow data processing program is written in combination with the model to obtain the refractive index and the particle size. With TDRR, we measured a monodisperse droplet stream of deionized water at room temperature for experimental validation and obtained the refractive index with an absolute error of less than 0.0015, the droplet size with an error within ±5%, and the axial position with an error within ±3%, which demonstrated a high accuracy of TDRR.

Integrated cell wall and transcriptomic analysis revealed the mechanism underlying zinc-induced alleviation of cadmium toxicity in Cosmos bipinnatus.

Plant growth is severely harmed by cadmium (Cd) contamination, while the addition of zinc (Zn) can reduce the toxic effects of Cd. However, the interaction between Cd and Zn on the molecular mechanism and cell wall of Cosmosbipinnatus is unclear. In this study, a transcriptome was constructed using RNA-sequencing. In C. bipinnatus root transcriptome data, the expression of 996, 2765, and 3023 unigenes were significantly affected by Cd, Zn, and Cd + Zn treatments, respectively, indicating different expression patterns of some metal transporters among the Cd, Zn, and Cd + Zn treatments. With the addition of Zn, the damage to the cell wall was reduced, both the proportion and content of polysaccharides in the cell wall were changed, and Cd accumulation was decreased by 32.34%. In addition, we found that Cd and Zn mainly accumulated in pectins, the content of which increased by 30.79% and 61.4% compared to the CK treatment. Thus, Zn could alleviate the toxicity of Cd to C. bipinnatus. This study revealed the interaction between Cd and Zn at the physiological and molecular levels, broadening our understanding of the mechanisms of tolerance to Cd and Zn stress in cosmos.

Zeolitic imidazolate framework-8@polydopamine decorated carboxylated chitosan hydrogel with photocatalytic and photothermal antibacterial activity for infected wound healing.

Open wounds are susceptible to bacterial infections, and antibiotics are commonly used to treat these infections. However, widespread use of antibiotics will easily induce bacterial resistance. Green antibacterial agents serve as excellent alternative for antibiotics in infection therapy. In this work, polydopamine (PDA) was used to modify the surface of ZIF-8, which not only enhances the water stability of Zeolitic imidazolate framework-8(ZIF-8) but also improves its photocatalytic and photothermal capabilities. ZIF-8@PDA was incorporated into carboxylated chitosan (CCS) films as an antibacterial agent, the resulting ZIF-8@PDA-CCS films exhibit excellent ionic/photocatalytic/photothermal antibacterial performance. The film exhibited an impressive 99% in vitro bacterial inhibition rate. After treatment with ZIF-8@PDA-CCS, the bacteria in infected wounds can be completely suppressed. These findings suggest that ZIF-8@PDA-CCS could serve as a potentional antibacterial dressing.

Green infrastructure layout based on a dynamic operation feature of drainage systems.

Increasingly frequent urban floods strain the traditional grey infrastructure, overwhelming the capacity of drainage networks and causing challenges in managing stormwater. The heavy precipitation leads to flooding and damage to drainage systems. Consequently, efficient mitigation strategies for flooding have been researched deeply. Green infrastructure (GI) has proved to be effective in responding the increasing risk of flood and alleviate pressure on drainage systems. However, as the primary infrastructure of stormwater management, there is still a lack of attention to the dynamic operation feature of urban sewer systems during precipitation events. To fill this gap, we proposed a novel approach that integrates hydraulic characteristics and the topological structure of a sewer network system. This approach aims to identify influential nodes, which contribute to the connectivity of the sewer network amidst dynamic changes in inflow during precipitation events. Furthermore, we adopted rain barrels to serve as exemplars of GI, and 14 GI layout schemes are produced based on the different ranks of influential nodes. Implementing GI measures on both poorly performing and well-performing nodes can yield distinct benefits in mitigating node flooding. This approach provides a new perspective for stormwater management, establishing effective synergy between GI and the drainage system.

Interocular asymmetry of retinal change in Parkinson's disease.

PURPOSE: To investigate interocular asymmetry (IA) of retinal structure and vessel density in patients with Parkinson's disease (PD) and normal controls (NC). METHODS: Seventy-eight subjects including 40 PD patients and 38 NC had completed optical coherence tomography angiography (OCTA) and neurological examinations for three rating scales (UPDRS-III, MMSE and MoCA). The IA was calculated by the absolute value of difference in right and left eyes. The IA of thickness in macular ganglion cell inner-plexiform layer (GCIPL), peripapillary retinal nerve fiber layer (pRNFL), and vessel density of superficial capillary plexus (SCP), deep capillary plexus (DCP), radial peripapillary capillary (RPC) were obtained from OCTA. RESULTS: The motor-symptom-onset side of eyes showed lower vessel density in parafovea of SCP (51.09 ± 3.46 vs 49.81 ± 4.16, P = 0.03) and superior hemi of perifovea DCP (49.55 ± 5.81 vs 47.33 ± 5.71, = 0.04). The PD patients showed larger IA in thickness of superior half of pRNFL (5.27 [2.67, 10.87] vs 3.08 [1.62, 5.61], P = 0.02) and parafovea GCIPL (2.40[1.25, 6.35] vs 1.40[0.50, 2.45], P = 0.02). No significant interocular asymmetry was found in vessel density between PD and NC. A higher UPDRS-III scale was associated with larger IA in GCIPL (ß = 0.093, P = 0.001) and smaller IA in DCP (ß = -0.065, P = 0.037). CONCLUSION: The motor-symptom-onset side of eyes showed more severe loss of macular vessel density than the other side of eyes. The PD patients showed asymmetrical structural change in GCIPL and pRNFL, which showed the potential as the diagnostic biomarker for PD.

Thin Copper Plate Defect Detection Based on Lamb Wave Generated by Pulsed Laser in Combination with Laser Heterodyne Interference Technique.

Thin copper plate is widely used in architecture, transportation, heavy equipment, and integrated circuit substrates due to its unique properties. However, it is challenging to identify surface defects in copper strips arising from various manufacturing stages without direct contact. A laser ultrasonic inspection system was developed based on the Lamb wave (LW) produced by a laser pulse. An all-fiber laser heterodyne interferometer is applied for measuring the ultrasonic signal in combination with an automatic scanning system, which makes the system flexible and compact. A 3-D model simulation of an H62 brass specimen was carried out to determine the LW spatial-temporal wavefield by using the COMSOL Multiphysics software. The characteristics of the ultrasonic wavefield were extracted through continuous wavelet transform analysis. This demonstrates that the A0 mode could be used in defect detection due to its slow speed and vibrational direction. Furthermore, an ultrasonic wave at the center frequency of 370 kHz with maximum energy is suitable for defect detection. In the experiment, the size and location of the defect are determined by the time difference of the transmitted wave and reflected wave, respectively. The relative error of the defect position is 0.14% by averaging six different receiving spots. The width of the defect is linear to the time difference of the transmitted wave. The goodness of fit can reach 0.989, and it is in good agreement with the simulated one. The experimental error is less than 0.395 mm for a 5 mm width of defect. Therefore, this validates that the technique can be potentially utilized in the remote defect detection of thin copper plates.

Surprise!-Clarifying the link between insight and prediction error.

The AHA experience, a moment of deep understanding during insightful problem-solving involving feelings of certainty, pleasure, and surprise, has captivated psychologists for more than a century. Recently, a new theoretical framework has proposed a link between the AHA experience and prediction error (PE), a popular concept in decision-making and reinforcement learning. This framework suggests that participants maintain a meta-cognitive prediction about the time it takes to solve a problem and the AHA experience arises when the problem is solved earlier than expected, resulting in a meta-cognitive PE. In our preregistered online study, we delved deeper into this idea, investigating whether prediction errors also pertain to participants' predictions regarding the solvability of the problem itself, and which dimension of the AHA experience aligns with the meta-cognitive PE. Utilizing verbal insight problems, we found a positive association between the AHA experience and the meta-cognitive PE, specifically in regards to problem solvability. Specifically, the element of surprise, a critical AHA dimension, emerged as a key indicator of the meta-cognitive PE, while other dimensions-such as pleasure, certainty, and suddenness-showed no signs for similar relationships, with suddenness exhibiting a negative correlation with meta-cognitive PE. This new finding provides further evidence that aspects of the AHA experience, surprise in particular, correspond to a meta-cognitive PE. The finding also underscores the multifaceted nature of this phenomenon, linking insights with learning theories and enhancing our understanding of this intriguing phenomenon.

Assessment of safety and efficacy of transarterial chemoembolization combined with camrelizumab and donafenib in patients with hepatocellular carcinoma at BCLC stage C: A study of 20 cases.

Camrelizumab, donafenib, and transarterial chemoembolization (TACE) are recommended for advanced hepatocellular carcinoma (HCC), but their combined efficacy remains unclear. From July 2021 to January 2023, 20 Barcelona Clinic Liver Cancer stage C HCC patients were prospectively enrolled. Inclusion criteria were Eastern Cooperative Oncology Group performance status of 0 or 1, Child-Pugh Score ≤ 7, and Barcelona Clinic Liver Cancer B or C. Surgical candidates were excluded. The treatment included TACE, camrelizumab, and donafenib. Endpoints were median overall survival, progression-free survival, and adverse events (AEs) related to donafenib. Among 20 patients, 85% experienced AEs from targeted therapy and programmed cell death protein-1, with 40% having grade 3 AEs. No grade 4 or 5 AEs occurred. Median follow-up was 9 months, with 15% achieving complete response, 65% partial response, and 15% stable disease. Disease control rate was 90%. Median progression-free survival and overall survival were 9 and 14 months, respectively. TACE, camrelizumab, and donafenib combination therapy in Chinese advanced HCC patients show effectiveness in extending survival with low severe AEs incidence.

Selective oxidation behavior based on iron-doped MOF derived carbon-based catalysts: Active site regulation and degradation mechanism analysis.

Selective removal of target organic pollutants in complex water quality of municipal sewage is extremely important for the deep treatment of water quality. Here, energetic MOF and Fe-MOF are doped in electrostatic spinning process to adjust the structure and composition of the catalysts, active oxygen species (ROSs), realizing the selective removal of organic pollutants. Non-azo and azo pollutants are selected as target pollutants. Catalysts PCFe-8 with Fe nanoclusters, EPCFe-8 with Fe-Nx, and EPC-8 without Fe doping are used to activate peroxymonosulfate (PMS) for degrading pollutants. The results show that the PCFe-8/PMS system can produce the most SO4- and exhibit superior removal of azo pollutants, whereas the degradation behavior of non-azo pollutants is more inclined to occur in the EPCFe-8/PMS system and the EPC-8/PMS system. This work provides a reference for elucidating the relationship between catalyst structure and components, types of ROSs, and selective degradation of pollutants.

Glutathione-mediated copper sulfide nanoplatforms with morphological and vacancy-dependent photothermal catalytic activity for multi-model tannic acid assays.

Interface engineering and vacancy engineering play an important role in the surface and electronic structure of nanomaterials. The combination of the two provides a feasible way for the development of efficient photocatalytic materials. Here, we use glutathione (GSH) as a coordination molecule to design a series of CuxS nanomaterials (CuxS-GSH) rich in sulfur vacancies using a simple ultrasonic-assisted method. Interface engineering can induce amorphous structure in the crystal while controlling the formation of porous surfaces of nanomaterials, and the formation of a large number of random orientation bonds further increases the concentration of sulfur vacancies in the crystal structure. This study shows that interface engineering and vacancy engineering can enhance the light absorption ability of CuxS-GSH nanomaterials from the visible to the near-infrared region, improve the efficiency of charge transfer between CuxS groups, and promote the separation and transfer of optoelectronic electron-hole pairs. In addition, a higher specific surface area can produce a large number of active sites, and the synergistic and efficient photothermal conversion efficiency (58.01%) can jointly promote the better photocatalytic performance of CuxS-GSH nanomaterials. Based on the excellent hot carrier generation and photothermal conversion performance of CuxS-GSH under illumination, it exhibits an excellent ability to mediate the production of reactive oxygen species (ROS) through peroxide cleavage and has excellent peroxidase activity. Therefore, CuxS-GSH has been successfully developed as a nanoenzyme platform for detecting tannic acid (TA) content in tea, and convenient and rapid detection of tannic acid is achieved through the construction of a multi-model strategy. This work not only provides a new way to enhance the enzyme-like activity of nanomaterials but also provides a new prospect for the application of interface engineering and vacancy engineering in the field of photochemistry.

Role of low-molecular-weight organic compounds on photochemical formation of Mn(III)-ligands in aqueous systems: Implications for BPA removal.

Aqueous trivalent manganese [Mn(III)], an important reactive intermediate, is ubiquitous in natural surface water containing humic acid (HA). However, the effect of low-molecular-weight organic acids (LMWOAs) on the formation, stability and reactivity of Mn(III) intermediate is still unknown. In this study, six LMWOAs, including oxalic acid (Oxa), salicylic acid (Sal), catechol (Cat), caffeic acid (Caf), gallic acid (Gal) and ethylene diamine tetraacetic acid (EDTA), were selected to investigate the effects of LMWOAs on the degradation of BPA induced by in situ formed Mn(III)-L in the HA/Mn(II) system under light irradiation. The chromophoric constituents of HA could absorb light radiation and generate superoxide radical to promote the oxidation of Mn(II) to form Mn(III), which was further involved in transformation of BPA. Our results implied that different LMWOAs did significantly impact on Mn(III) production and its degradation of BPA due to their different functional group. EDTA, Oxa and Sal extensively increased the Mn(III) concentration from 50 to 100 µM compared to the system without LMWOAs, following the order of EDTA > Oxa > Sal, and also enhanced the degradation of BPA with the similar patterns. In contrast, Cat, Caf and Gal had an inhibitory effect on the formation of Mn(III), which is likely because they consumed the superoxide radicals generated from irradiated HA, resulting in the inhibition of Mn(II) oxidation and further BPA removal. The product identification and theoretical calculation indicated that a single electron transfer process occurred between Mn(III)-L and BPA, forming BPA radicals and subsequent self-coupling products. Our results demonstrated that the LMWOAs with different structures could alter the cycling process of Mn via complexation and redox reactions, which would provide new implications for the removal of organic pollutants in surface water.

Cambium Reactivation Is Closely Related to the Cell-Cycle Gene Configuration in Larix kaempferi.

Dormancy release and reactivation in temperate trees are mainly controlled by temperature and are affected by age, but the underlying molecular mechanisms are still unclear. In this study, we explored the effects of low temperatures in winter and warm temperatures in spring on dormancy release and reactivation in Larix kaempferi. Further, we established the relationships between cell-cycle genes and cambium cell division. The results showed that chilling accelerated L. kaempferi bud break overall, and the longer the duration of chilling is, the shorter the bud break time is. After dormancy release, warm temperatures induced cell-cycle gene expression; when the configuration value of the cell-cycle genes reached 4.97, the cambium cells divided and L. kaempferi reactivated. This study helps to predict the impact of climate change on wood production and provides technical support for seedling cultivation in greenhouses.

Preliminary analysis of stimulation parameters for sacral neuromodulation in different indications: a multicenter retrospective cohort study from China.

BACKGROUND: Sacral neuromodulation (SNM) is an effective approach for treating lower urinary tract dysfunction (LUTD), and stimulation programming is essential for successful treatment. However, research on SNM programming for various indications is limited. Thus, the authors aimed to determine whether there were differences in the stimulation parameters for different SNM indications and the appropriate programming recommendations. MATERIALS AND METHODS: Clinical data were retrospectively collected from patients with LUTD who underwent SNM and completed internal pulse generator implantation. The parameters with the highest patient satisfaction or the most symptom improvement during the test period were considered optimal and used to set the programming after internal pulse generator implantation. RESULTS: After screening, 282 patients were enrolled and categorized into four groups based on the following indications: refractory overactive bladder (OAB) ( n =61), neurogenic lower urinary tract dysfunction (nLUTD) ( n =162), interstitial cystitis/painful bladder syndrome (IC/BPS) ( n =24), and idiopathic nonobstructive urinary retention (NOUR) ( n =35). When analyzing the optimal stimulus parameters, disparities in the stimulation amplitude and pulse frequency were noted among the four groups. The stimulation amplitude in the nLUTD group was higher than that in the idiopathic NOUR group ( P =0.013). Differences in pulse frequency were observed between the refractory OAB and nLUTD groups ( P <0.001) and between the refractory OAB and idiopathic NOUR groups ( P =0.001). No differences in the electrode configuration or pulse width settings existed among the four groups. CONCLUSIONS: The stimulation parameters for SNM varied among the different indications. For the initial programming of stage I, most patients are recommended to start with stimulation amplitudes below 2 V, although patients with nLUTD may benefit from higher amplitudes. A standard pulse width of 210 µs is recommended for all patients. However, for individuals experiencing nLUTD or idiopathic NOUR, the pulse frequency can begin above the standard 14 Hz but not exceed 50 Hz.

Remote programming in stage I sacral neuromodulation: a multicentre prospective feasibility study.

OBJECTIVE: Sacral neuromodulation (SNM) has emerged as an effective therapy for refractory lower urinary tract dysfunction (LUTD). Remote programming holds promise in addressing the time and economic burdens associated with outpatient programming, especially for patients in the observation period following Stage I implant surgery (where the lead is implanted first without the pulse generator). The study aimed to explore the effectiveness and patient satisfaction of remote programming for Stage I SNM patients, and analyze the benefits patients gain from remote programming. METHODS: This prospective study was conducted at multiple high-level clinical SNM centres in China. Patients requiring SNM implantation were enroled and divided into two groups based on patient preference: remote programming (RP) group and outpatient control (OC) group. Patient attitudes toward RP were assessed through questionnaires, and the degree of symptom improvement was compared between the two groups to explore the usability of RP. RESULTS: A total of 63 participants from 6 centres were included in the study, with 32 belonging to the RP group. The remote programming system presents a high level of usability (98%) and willingness (satisfaction rate: 96.83%) in result of questionnaire. RP showed a significant advantage in improving patients' score of ICSI/ICPI (medianΔICSI/ICPI RP vs. OC= -13.50 vs -2, P =0.015). And slightly ameliorate urinary symptoms such as pain (medianΔVAS RP vs. OC= -1 vs 0, P = 0.164) and urgency (medianΔOBASS -2.5 vs. -1, P = 0.,229), but the difference was not statistically significant. RP did not significantly impact the quality of life of patients ( P =0.113), so do the rate of phase-two conversion ( P = 0.926) or programming parameters. CONCLUSION: To the best of our knowledge, the presented study is the first multicenter research focusing on the remote programming of Stage I SNM patients. Through the clinical implementation and patient feedback, we demonstrate that remote programming is not inferior to in-person programming in terms of success rate, effectiveness, safety, and patient satisfaction.