Teach a man to fish: Hyper-brain evidence on scaffolding strategy enhancing creativity acquisition and transfer.

Creativity is an indispensable competency in today's innovation-driven society. Yet, the influences of instructional strategy, a key determinant of educational outcomes, on the creativity-fostering process remains an unresolved mystery. We proposed that instructional strategy affects creativity cultivation and further investigated the intricate neural mechanisms underlying this relationship. In a naturalistic laboratory setting, 66 instructor-learner dyads were randomized into three groups (scaffolding, explanation, and control), with divergent thinking instructions separately. Functional near-infrared spectroscopy (fNIRS) hyperscanning simultaneously collected brain signals in the prefrontal cortex and temporal-parietal junction regions. Results indicated that learners instructed with a scaffolding strategy demonstrated superior creative performance both in acquisition (direct learning) and transfer (use in a novel context) of creativity skills, compared to pretest levels. In contrast, the control and explanation groups did not exhibit such effects. Notably, we also observed remarkable interbrain neural synchronization (INS) between instructors and learners in the left superior frontal cortex in the scaffolding group, but not in the explanation or control groups. Furthermore, INS positively predicted enhancements in creativity performance (acquisition and transfer), indicating that it is a crucial neural mechanism in the creativity-fostering process. These findings reveal that scaffolding facilitates the acquisition and transfer of creativity and deepen our understanding of the neural mechanisms underlying the process of creativity-fostering. The current study provides valuable insights for implementing teaching strategies to fostering creativity.

The Relationship Between the Physician-Patient Relationship, Physician Empathy, and Patient Trust.

BACKGROUND: A trusting physician-patient relationship is an essential component of high-quality care. OBJECTIVE: To explore the relationship between the physician-patient relationship, physician empathy, and patient trust. DESIGN: Cross-sectional survey. PARTICIPANTS: A total of 3289 patients (response rate 68.6%) from 103 hospitals in eastern, central, and western China completed surveys. MAIN MEASURE: Physician empathy, patient trust, and physician-patient relationship were measured by the Chinese version of Consultation and Relational Empathy Scale, Wake Forest Physician Trust Scale, and Patient-Doctor Relationship Questionnaire, respectively. Bootstrapped mediation analysis was performed. KEY RESULTS: There were moderate to strong correlations between physician empathy, patient overall trust, and patient trust in physician's benevolence and competence, and the physician-patient relationship (r = 0.49-0.75, P < 0.01 for all). Patients' evaluation of physician-patient relationship was predicted by their perception of physician empathy, patient overall trust, and trust in the physician's benevolence. Mediation analysis showed that the indirect effect of physician empathy on physician-patient relationship through patient overall trust was significant (ß = 0.18, 95% CI: 0.15-0.21) and that the mediation effect of patient trust in physician's benevolence was significant (ß = 0.24, 95% CI: 0.20-0.28), though the mediation effect of patient trust in physician's competence was not (ß = 0.01, 95% CI: -0.02 to 0.02). CONCLUSIONS: Patients' perception of physician empathy influences their evaluation of the physician-patient relationship both directly and indirectly via patient trust in the physician's benevolence. These findings underline the importance of patient belief in physician benevolence and empathy in building trustful and harmonious relationships between physicians and patients.

Comparison of Anterior and Posterior Approaches for Acute Traumatic Central Spinal Cord Syndrome with Multilevel Cervical Canal Stenosis without Cervical Fracture or Dislocation.

Introduction: This is a retrospective comparative study that aims to compare the benefits of different surgical approaches for patients with multilevel cervical canal stenosis (CCS) without cervical fracture or dislocation of acute traumatic central cord syndrome (ATCCS). Methods: From January 2015 to December 2018, 59 patients were included in the study. Among them, 35 patients (Group A) received anterior surgery and 24 patients (Group B) received posterior surgery. Primary outcome measures were American Spinal Cord Injury Association (Asia) grade, Japanese Orthopaedic Association (JOA) score, and recovery rate (RR). Secondary outcome measures included operation time, intraoperative blood loss, visual analogue scale (VAS) score, cervical sagittal parameters, and complications. Multivariate linear regression was used to analyze prognostic determinants. Results: Compared with Group B, Group A had longer operation time and more intraoperative blood loss (P < 0.05). However, the VAS score of Group B was higher than that of Group A at discharge (P < 0.05). There was no significant difference in cervical sagittal plane parameters between the two groups (P > 0.05). Postoperative complications were different in the two groups. During follow-up, the Asia grade, the JOA score, and RR of both groups improved (P < 0.05), but there were no significant differences between the two groups (P > 0.05). Younger age, earlier surgery, and better preoperative Asia grade were correlated with better prognosis. Conclusions: For patients with multilevel CCS without cervical fracture or dislocation of ATCCS, both surgical approaches had good outcomes. Although no significant differences were found in the primary outcome measures between the two groups, there were different recommendations for the secondary outcome measures. Younger age, earlier surgery, and better preoperative Asia grade were protective factors for better prognosis.

Outcome of percutaneous compression plate for treatment of femoral neck fractures: mean follow-up of 4.4 years.

PURPOSE: Percutaneous compression plate (PCCP) provides superior anti-rotational abilities and mechanical strength in femoral neck fractures (FNFs). The first series reporting its utilization of FNFs was promising. Since the long-term outcome regarding the implant has not been reported, the purpose of this study was to evaluate the long-term functional outcomes and complications after fixation using PCCP in FNFs. MATERIALS AND METHODS: From 2010 to 2019, 51 patients aged from 18 to 87 years were evaluated; 11 patients were excluded from this study. Demographic data, fracture classification, and complications were analyzed. Besides plain radiographs and CT, uptake ratios using bone scintigraphy and/or SPECT were also collected and analyzed. RESULTS: At a mean follow-up of 4.4 ± 2.0 years (range, 2-10 years), the mean Harris hip score was 88, with 44 patients (86.3%) achieving excellent or good outcomes. The rate of complication was 13.7% (7/51), with five cases of osteonecrosis of the femoral head (OFNH). Hip replacements were performed in four (7.8%) cases. After confirmation of normal transfusion status, 11 patients underwent elective removal of the implant without further complications. CONCLUSION: Closed reduction and internal fixation using PCCP in FNFs resulted in satisfactory outcomes with low complication rates. Longer follow-up (3-5 years) and sequential bone scintigraphy or SPECT after surgery are recommended after internal fixation using PCCP.

Study of miRNA interactome in active rheumatoid arthritis patients reveals key pathogenic roles of dysbiosis in the infection-immune network.

OBJECTIVES: To characterize serum microRNA (miR) and the miR interactome of active RA patients in RA aetiology and pathogenesis. METHODS: The differentially expressed miRs (DEmiRs) in serum of naïve active RA patients (NARAPs, n = 9, into three pools) vs healthy controls (HCs, n = 15, into five pools) were identified with Agilent human miR microarray analysis. Candidate driver genes in epigenetic and pathogenic signalling pathway modules for RA were analysed using miRTarBase and a molecular complex detection algorithm. The interactome of these DEmiRs in RA pathogenesis were further characterized with gene ontology and Kyoto Encyclopaedia of Genes and Genomes. RESULTS: Three upregulated DEmiRs (hsa-miR-187-5p, -4532, -4516) and eight downregulated DEmiRs (hsa-miR-125a-3p, -575, -191-3p, -6865-3p, -197-3p, -6886-3p, -1237-3p, -4436b-5p) were identified in NARAPs. Interactomic analysis from heterogeneous experimentally validated sources yielded 1719 miR-target interactions containing 5.67% strong and 94.33% less strong experimental evidence. Gene ontology and Kyoto Encyclopaedia of Genes and Genomes analyses allocated the upregulated DEmiRs in the infection modules and the downregulated DEmiRs in the immune signalling pathways. Specifically, these DEmiRs revealed the significant contributions of the intestinal microbiome dysbiosis in the infection-inflammation-immune network for activation of T cells, immune pathways of IL-17, Toll-like receptor, TNF, Janus kinase-signal transducer and activator of transcription, osteoclast cell differentiation pathway and IgA production to the active RA pathogenesis. CONCLUSIONS: Our experiment-based interactomic study of DEmiRs in serum of NARAPs revealed novel clinically relevant miRs interactomes in the infection-inflammation-immune network of RA. These results provide valuable resources for understanding the integrated function of the miR network in RA pathogenesis and the application of circulating miRs as biomarkers for early aetiologic RA diagnosis.

Li5.5PS4.5Cl1.5-Based All-Solid-State Battery with a Silver Nanoparticle-Modified Graphite Anode for Improved Resistance to Overcharging and Increased Energy Density.

All-solid-state lithium batteries (ASSLBs) are attracting tremendous attention due to their improved safety and higher energy density. However, the use of a metallic lithium anode poses a major challenge due to its low stability and processability. Instead, the graphite anode exhibits high reversibility for the insertion/deinsertion of lithium ions, giving ASSLBs excellent cyclic stability but a lower energy density. To increase the energy density of ASSLBs with the graphite anode, it is necessary to lower the negative/positive (N/P) capacity ratio and to increase the charging voltage. These strategies bring new challenges to lithium metal plating and dendrite growth. Here, a nano-Ag-modified graphite composite electrode (Ag@Gr) is developed to overcome these shortcomings for Li5.5PS4.5Cl1.5-based ASSLBs. The Ag@Gr composite exhibits a strong ability to inhibit lithium metal plating and fast lithium-ion transport kinetics. Ag nanoparticles can accommodate excess Li, and the as-obtained Li-Ag alloy enhances the kinetics of the composite electrode. The ASSLB with the Li(Ni0.8Co0.1Mn0.1)O2 cathode and Ag@Gr anode achieves an energy density of 349 W h kg-1. The full cell using Ag@Gr with an N/P ratio of 0.6 also highlights the rate performance. This work provides a simple and effective method to regulate the charge transport kinetics of graphite anodes and improve the cyclic performance and energy density of ASSLBs.

Far-red and sensitive sensor for monitoring real time H2O2 dynamics with subcellular resolution and in multi-parametric imaging applications.

H2O2 is a key oxidant in mammalian biology and a pleiotropic signaling molecule at the physiological level, and its excessive accumulation in conjunction with decreased cellular reduction capacity is often found to be a common pathological marker. Here, we present a red fluorescent Genetically Encoded H2O2 Indicator (GEHI) allowing versatile optogenetic dissection of redox biology. Our new GEHI, oROS-HT, is a chemigenetic sensor utilizing a HaloTag and Janelia Fluor (JF) rhodamine dye as fluorescent reporters. We developed oROS-HT through a structure-guided approach aided by classic protein structures and recent protein structure prediction tools. Optimized with JF635, oROS-HT is a sensor with 635 nm excitation and 650 nm emission peaks, allowing it to retain its brightness while monitoring intracellular H2O2 dynamics. Furthermore, it enables multi-color imaging in combination with blue-green fluorescent sensors for orthogonal analytes and low auto-fluorescence interference in biological tissues. Other advantages of oROS-HT over alternative GEHIs are its fast kinetics, oxygen-independent maturation, low pH sensitivity, lack of photo-artifact, and lack of intracellular aggregation. Here, we demonstrated efficient subcellular targeting and how oROS-HT can map inter and intracellular H2O2 diffusion at subcellular resolution. Lastly, we used oROS-HT with the green fluorescent calcium indicator Fluo-4 to investigate the transient effect of the anti-inflammatory agent auranofin on cellular redox physiology and calcium levels via multi-parametric, dual-color imaging.

Hydrogen sulfide produced by the gut microbiota impairs host metabolism via reducing GLP-1 levels in male mice.

Dysbiosis of the gut microbiota has been implicated in the pathogenesis of metabolic syndrome (MetS) and may impair host metabolism through harmful metabolites. Here, we show that Desulfovibrio, an intestinal symbiont enriched in patients with MetS, suppresses the production of the gut hormone glucagon-like peptide 1 (GLP-1) through the production of hydrogen sulfide (H2S) in male mice. Desulfovibrio-derived H2S is found to inhibit mitochondrial respiration and induce the unfolded protein response in intestinal L cells, thereby hindering GLP-1 secretion and gene expression. Remarkably, blocking Desulfovibrio and H2S with an over-the-counter drug, bismuth subsalicylate, improves GLP-1 production and ameliorates diet-induced metabolic disorder in male mice. Together, our study uncovers that Desulfovibrio-derived H2S compromises GLP-1 production, shedding light on the gut-relayed mechanisms by which harmful microbiota-derived metabolites impair host metabolism in MetS and suggesting new possibilities for treating MetS.

Far-red and sensitive sensor for monitoring real time H2O2 dynamics with subcellular resolution and in multi-parametric imaging applications.

H2O2 is a key oxidant in mammalian biology and a pleiotropic signaling molecule at the physiological level, and its excessive accumulation in conjunction with decreased cellular reduction capacity is often found to be a common pathological marker. Here, we present a red fluorescent Genetically Encoded H2O2 Indicator (GEHI) allowing versatile optogenetic dissection of redox biology. Our new GEHI, oROS-HT, is a chemigenetic sensor utilizing a HaloTag and Janelia Fluor (JF) rhodamine dye as fluorescent reporters. We developed oROS-HT through a structure-guided approach aided by classic protein structures and recent protein structure prediction tools. Optimized with JF635, oROS-HT is a sensor with 635 nm excitation and 650 nm emission peaks, allowing it to retain its brightness while monitoring intracellular H2O2 dynamics. Furthermore, it enables multi-color imaging in combination with blue-green fluorescent sensors for orthogonal analytes and low auto-fluorescence interference in biological tissues. Other advantages of oROS-HT over alternative GEHIs are its fast kinetics, oxygen-independent maturation, low pH sensitivity, lack of photo-artifact, and lack of intracellular aggregation. Here, we demonstrated efficient subcellular targeting and how oROS-HT can map inter and intracellular H2O2 diffusion at subcellular resolution. Lastly, we used oROS-HT with other green fluorescence reporters to investigate the transient effect of the anti-inflammatory agent auranofin on cellular redox physiology and calcium levels via multi-parametric, dual-color imaging.

The evaluation and treatment of acute anterior circulation occlusion stroke with high clot burden: Progressive stratified aspiration thrombectomy vs. stent retriever thrombectomy.

OBJECTIVE: To evaluate the safety and effectiveness of the progressive stratified aspiration thrombectomy (PSAT) in treatment of patients with acute ischemic stroke and large vessel occlusion (AIS-LVO). METHODS: 117 AIS-LVO patients with high clot burden who underwent emergency endovascular treatment were included. All patients were divided into two groups according to surgical technique: PSAT group, stent retriever thrombectomy (SRT) group. The primary outcome was the 90-day mRS, the secondary outcomes included recanalization rate, the 24-h and 7-day NIHSS, the 7-day symptomatic intracranial hemorrhage (SICH) rate and 90-days mortality. RESULTS: 65 patients underwent PSAT, and 52 patients underwent SRT. The PSAT group performed better than SRT group regarding the successful recanalization rate (86.3 % vs. 71.2 %, P < 0.05) and time from puncture to recanalization (70 min [IQR, 58-87 min] vs. 87 min [IQR, 68-103 min], P < 0.05). The 7-day NIHSS score of the PSAT group was lower than that of the SRT group (12 [10-18] vs. 12 [8-25], P < 0.05). It was worth noting that at the 90-day follow-up, the favorable functional outcome (mRS 0-2) rate of PSAT group was higher (P < 0.05). There was no significant difference in terms of the 24-h NIHSS score after surgery (15 [10-18] vs. 15 [10-22], P > 0.05), SICH (23.1 % vs. 26.9 %, P > 0.05) and mortality rate between the two groups (13.4 % vs. 19.2 %, P > 0.05). CONCLUSIONS: It is safe and effective to treat high clot burden AIS-LVO patients with PSAT, which has a better reperfusion rate and prognostic outcome than SRT.

Application of a Knowledge, Attitude, Belief, and Practice Model in Pain Management of Patients with Acute Traumatic Fractures and Alcohol Dependence.

Objective: To evaluate the outcome of a knowledge, attitude, belief, and practice mode (KABP) in the pain management in patients with acute traumatic fractures complicated with alcohol dependence. Methods: Twenty-nine alcohol-dependent male patients with acute traumatic fractures and who received surgical treatment between January 2019 and December 2020 were included in this retrospective case-control study. The age range was 30-65 years (average 50.03 ± 7.94). Fracture Type. Six cases of spinal burst fractures and 23 cases of limb trauma fractures. Ten patients were treated with routine nursing (control group), and 19 patients were treated with pain management in KABP mode (experimental group). The control group received traditional pain care, including the conventional numerical rating scale (NRS) pain score system, with focus on symptomatic treatment. On this basis, the experimental group managed pain using KABP, including cognitive behavioral intervention, optimization programs, modification of personal beliefs, and behavior patterns. NRS, self-rated anxiety/depression scale (SAS), and quality of life (SF-36) scale were applied at admission, 1 day before surgery, and 3 months after surgery. Results: The perioperative NRS score of the KABP group was lower than that of the control group, and the postoperative anxiety levels improved. Discharge satisfaction was significantly higher than that in the control group (p < 0.05). There were behaviors promoting health in the experimental group, and five patients expressed abstinence behavior after discharge (p < 0.05). Conclusion: Patients with alcohol dependence represents a unique set of cases for perioperative pain management. To ensure patient safety, individualized pain management through the application of KABP can significantly reduce postoperative pain and promote the generation of healthy behaviors in patients.

Physical Fitness and Dietary Intake Improve Mental Health in Chinese Adolescence Aged 12-13.

Background: Mental health has become a major public health issue worldwide. Biological and epidemiological studies have suggested that diet and physical fitness play a role in the prevention or cure of mental disorders. However, further research is required to elucidate the relationship between diet, physical fitness, and mental health. The study aims to provide a theoretical basis for promoting an adolescent healthy lifestyle and preventing mental problems by exploring the relationship between physical fitness, calcium intake, calorie intake, and adolescent mental health. Methods: A cross-sectional study of a sample of adolescents (N = 253, 12-13 years) was conducted. The study involved adolescents from three middle schools in Central Jiangsu Province, including 136 boys and 117 girls. Weight, height, and body mass index were measured. Physical fitness was scored using the Chinese National Student Physical Fitness Standard. Diet data were collected using a weighed 7-day food diary to estimate energy intake and dietary calcium intake. The mental health status of the participants was assessed using the Chinese Middle School Student Mental Health Scale. A T-test and analysis of variance were used to analyze the differences of variables between different genders and body mass index, and Pearson correlation and stepwise multiple regression were used to explore the relationship between physical fitness, dietary intake, and mental health. Results: The height (165.13 ± 8.07), weight (55.24 ± 13.00), and strength quality (64.93 ± 21.66) of boys are higher than those of girls (161.67 ± 6.44,48.99 ± 8.97, 58.40 ± 23.75, P < 0.05), and the flexibility quality (74.59 ± 14.75) of girls is higher than that of boys (68.30 ± 20.84) (P < 0.05). There were significant differences in the total scores of speed and physical fitness (F values were 4.02187.73, 3.07, 5.95, 10.33, and 9.52, respectively, P < 0.05). There was a significant positive correlation between calcium intake, cardiopulmonary fitness, and mental health (r = 0.276, P < 0.01; r = 0.159, P < 0.05). Calcium intake and cardiopulmonary fitness could explain 8.4% of the changes in the mental health of adolescents aged 12-13(ΔR2 = 0.084, P < 0.05). Conclusion: Adequate calcium intake and the improvement of cardiopulmonary fitness in adolescents aged 12-13 are essential for the good development of their mental health. Future research in this field should examine the prospective associations between multiple measures of physical fitness composition and other nutrients ingested and mental health outcomes, as well as intervention studies that seek to provide evidence of causality.

Theaflavin-3,3'-Digallate Protects Cartilage from Degradation by Modulating Inflammation and Antioxidant Pathways.

Background: Osteoarthritis (OA) is a common degenerative joint disease that may be closely linked to inflammation and oxidative stress destroying the balance of cartilage matrix. Theaflavin-3,3'-digallate (TFDG), a natural substance derived from black tea, has been reported to restrict the activity of inflammatory cytokines and effectively eliminate reactive oxygen species (ROS) in various diseases. However, it is not clear whether TFDG can improve OA. Methods: Chondrocytes were treated with or without IL-1ß and 20 µM and 40 µM TFDG. The effect of TFDG on the proliferation of chondrocytes was detected by CCK8. RT-qPCR was used to detect the gene expression of inflammatory factors, extracellular matrix synthesis, and degradation genes. Western blot and immunofluorescence assays were used to detect the protein expression. The fluorescence intensity of reactive oxygen species labeled by DCFH-DA was detected by flow cytometry. We established an OA rat model by performing destabilized medial meniscus (DMM) surgery to observe whether TFDG can protect chondrocytes under arthritis in vivo. Results: TFDG was found to inhibit proinflammatory factors (IL-6, TNF-α, iNOS, and PGE) and matrix-degrading enzymes (MMP13, MMP3, and ADAMTS5) expression and protected extracellular matrix components of chondrocytes (ACAN, COL2, and SOX9). TFDG accelerated the scavenging of ROS caused by IL-1ß according to the Nrf2 signaling pathway activation. At the same time, TFDG suppressed the PI3K/AKT/NF-κB and MAPK signaling pathways to delay the inflammatory process. The cartilage of DMM rats receiving TFDG showed lower Osteoarthritis Research Society International (OARSI) scores and expressed higher levels of COL2 and Nrf2 compared with those of rats in the DMM group. Conclusion: TFDG could protect cartilage from degradation and alleviate osteoarthritis in rats, which suggests that TFDG has potential as a drug candidate for OA therapy.

Virulence and Molecular Genotyping Studies of Sporisorium reilianum Isolates in Sorghum.

Head smut, caused by the fungal pathogen Sporisorium reilianum, has been reported with increasing frequency in the grain sorghum growing areas of Texas. To facilitate analysis of changes in pathogen virulence, four inoculation techniques were examined: soil and teliospore mixture, seed coating, media placement, and syringe injection. Of the four, syringe injection was determined to be the most effective. Inoculations of sorghum host differentials BTx643, BTx7078, BTx635, SC170-6-17 (TAM2571), SA281 (Early Hegari), and Tx414 showed 23 of 32 Texas isolates were race 4. Two isolates from College Station, TX, were classified as race 1, but no race 2 or 3 isolates were found. New, virulent races 5 and 6 were identified among isolates from south Texas. Using 16 amplified fragment length polymorphism (AFLP) primer combinations, genetic diversity was assessed in DNA samples from 49 S. reilianum isolates, including 44 sorghum isolates from Texas, two from Uganda, and one from Mali; and two maize isolates from Mexico. Single-base extensions with EcoRI and MseI primers in the selective amplification increased the number of informative polymorphic bands. High genetic dissimilarity (50%) was observed between isolates originating from maize and those originating from sorghum. The resultant dendrogram, made using cluster analysis, grouped the Texas S. reilianum isolates into four small clusters with ≥82% similarity. Other than for two race 6 isolates from Weslaco, TX, no evidence for geographical or other restrictions on gene flow was evident.

Comparative Analysis of Cage Subsidence in Anterior Cervical Decompression and Fusion: Zero Profile Anchored Spacer (ROI-C) vs. Conventional Cage and Plate Construct.

Background: Anterior cervical discectomy and fusion (ACDF) has been widely performed to treat cervical generative diseases. Cage subsidence is a complication after ACDF. Although it is known that segmental kyphosis, acceleration of adjacent segmental disease, and restenosis may occur due to cages subsidence; however detailed research comparing zero-profile cages (ROI-C) and conventional plate and cage construct (CPC) on cage subsidence has been lacking. Objective: The objectives of this study was to compare the rate of postoperative cage subsidence between zero profile anchored spacer (ROI-C) and conventional cage and plate construct (CPC) and investigate the risk factors associated with cage subsidence following ACDF. Methods: Seventy-four patients with ACDF who received either ROI-C or CPC treatment from October 2013 to August 2018 were included in this retrospective cohort study. Clinical and radiological outcomes and the incidence of cage subsidence at final follow up-were compared between groups. All patients were further categorized into the cage subsidence (CS) and non-cage subsidence (NCS) groups for subgroup analysis. Results: The overall subsidence rate was higher in the ROI-C group than in the CPC group (66.67 vs. 38.46%, P = 0.006). The incidence of cage subsidence was significantly different between groups for multiple-segment surgeries (75 vs. 34.6%, P = 0.003), but not for single-segment surgeries (54.55 vs. 42.30%, P = 0.563). Male sex, operation in multiple segments, using an ROI-C, and over-distraction increased the risk of subsidence. Clinical outcomes and fusion rates were not affected by cage subsidence. Conclusion: ROI-C use resulted in a higher subsidence rate than CPC use in multi-segment ACDF procedures. The male sex, the use of ROI-C, operation in multiple segments, and over-distraction were the most significant factors associated with an increase in the risk of cage subsidence.