Prevalence and risk factors of low back pain in military personnel: a systematic review.

Purpose: Low back pain (LBP) has a significant impact on the general population, especially on military personnel. This study aimed to systematically review the relevant literature to determine the prevalence and risk factors of low back pain among military personnel from different military occupational categories. Methods: For this systematic review, we searched Embase, PubMed, and Cochrane. We performed study selection, data extraction, and assessed the quality of the evidence using the adapted risk of bias assessment tool by Hoy et al. This review process was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. This study is registered on the Center for Open Science, registration DOI: 10.17605/OSF.IO/HRGE8. Results: Out of 860 papers, 19 studies met the inclusion criteria. More than 360 000 military people with lumbar pain situation were considered for inclusion in this systematic review. The 1-year prevalence of LBP could be up to 81.7% in the Army, 5.2% in the Marines, and 48.1% in the Air Force. Age (OR = 0.494-2.89), history of LBP (OR = 2.2-8.91), and sedentary position (OR = 0.55-3.63) were the most common physical, sociodemographic, and occupational risk factors, respectively. Conclusions: Low back pain was prevalent among military personnel. There was heterogeneity in studies and a significant difference in prevalence and incidence across various occupational categories. Physical, sociodemographic, and occupational risk factors were researched more than psychological risk factors in the military.

Interpretable Learning of Accelerated Aging in Lithium Metal Batteries.

Lithium metal batteries (LMBs) with high energy density are perceived as the most promising candidates to enable long-endurance electrified transportation. However, rapid capacity decay and safety hazards have impeded the practical application of LMBs, where the entangled complex degradation pattern remains a major challenge for efficient battery design and engineering. Here, we present an interpretable framework to learn the accelerated aging of LMBs with a comprehensive data space containing 79 cells varying considerably in battery chemistries and cell parameters. Leveraging only data from the first 10 cycles, this framework accurately predicts the knee points where aging starts to accelerate. Leaning on the framework's interpretability, we further elucidate the critical role of the last 10%-depth discharging on LMB aging rate and propose a universal descriptor based solely on early cycle electrochemical data for rapid evaluation of electrolytes. The machine learning insights also motivate the design of a dual-cutoff discharge protocol, which effectively extends the cycle life of LMBs by a factor of up to 2.8.

Low-temperature treatment optimization for diesel-contaminated kaolin: Mutual impacts of generated pyrolytic carbon and particle agglomeration.

Efficiency improvement in low-temperature treatment for diesel-contaminated sites is urgent because changes in soil properties and the generation of new substance during the remediation process can influence the duration and energy utilization. This paper focuses on low-temperature treatment optimization based on the mutual impacts of pyrolytic carbon and kaolin aggregation. Results reveal that the peak mass loss rate occurred between 100-150°C, with minimal loss beyond 200°C. Samples thermally treated at 150-200°C exhibited darker colors, indicating pyrolytic carbon formation, corroborated by x-ray photoelectron spectroscopy (XPS), fourier transform infrared spectroscopy (FTIR), and three-dimensional fluorescence spectrum (3D-EEM) analyses. Additionally, diesel contamination influenced the fractal dimension of aggregates by influencing adhesion forces (<10000 mg/kg) and forming liquid bridges (≥10000 mg/kg) in untreated kaolin, resulting in an initial increase and subsequent fall in fractal dimension with increasing concentration. Decline rates of pollutant gas concentration were closely correlated with fractal dimension changes under thermal conditions due to pollutant volatilization and pyrolytic carbon formation. Based on the consistency between fractal dimension and decline rate, two critical remediation concentrations (C0) and temperatures (T0) indices were identified to optimize the low-temperature remediation.

Analgesic effect of dance movement therapy: An fNIRS study.

OBJECTIVE: This study aims to explores the physiological and psychological mechanisms of exercise-induced hypoalgesia (EIH) by combining the behavioral results with neuroimaging data on changes oxy-hemoglobin (HbO) in prefrontal cortex (PFC). METHODS: A total of 97 healthy participants were recruited and randomly divided into three groups: a single dance movement therapy (DMT) group, a double DMT group, and control group. Evaluation indicators included the pressure pain threshold (PPT) test, the color-word stroop task (CWST) for wearing functional near-infrared spectroscopy (fNIRS), and the self-assessment manikin (SAM). The testing time is before intervention, after intervention, and one hour of sit rest after intervention. RESULTS: 1) Repeated measures ANOVA revealed that, there is a time * group effect on the PPT values of the three groups of participants at three time points. After 30 min of acute dance intervention, an increase in the PPT values of 10 test points occurred in the entire body of the participants in the experimental group with a significant difference than the control group. 2) In terms of fNIRS signals, bilateral DLPFC and left VLPFC channels were significantly activated in the experimental group. 3) DMT significantly awakened participants and brought about pleasant emotions, but cognitive improvement was insignificant. 4) Mediation effect analysis found that the change in HbO concentration in DLPFC may be a mediator in predicting the degree of improvement in pressure pain threshold through dance intervention (total effect ß = 0.7140). CONCLUSION: In healthy adults, DMT can produce a diffuse EIH effect on improving pressure pain threshold, emotional experience but only showing an improvement trend in cognitive performance. Dance intervention significantly activates the left ventrolateral and bilateral dorsolateral prefrontal cortex. This study explores the central nervous system mechanism of EIH from a physiological and psychological perspective.

Cross-Electrophile Couplings of Benzyl Sulfonium Salts with Thiosulfonates via C-S Bond Activation.

A zinc-mediated cross-electrophile coupling of benzyl sulfonium salts with thiosulfonates via C-S bond cleavage was achieved. The reductive thiolation proceeded well under transition metal-free conditions to afford the desired benzyl sulfides in good yields, exhibiting both broad substrate scope and good functionality tolerance. In addition, the reaction could be applied to the use of selenosulfonate as an effective selenylation agent and be subjected to scale-up synthesis.

Magnesium-Mediated Cross-Electrophile Couplings of Aryl 2-Pyridyl Esters with Aryl Bromides for Ketone Synthesis through In Situ-Formed Arylmagnesium Intermediates.

Aryl 2-pyridyl esters could efficiently undergo cross-electrophile couplings with aryl bromides with the aid of magnesium as a reducing metal in the absence of a transition-metal catalyst, leading to the unsymmetrical diaryl ketones in modest to good yields with wide functionality compatibility. In addition, the reaction could be easily scaled up and applied in the late-stage modification of biologically active molecules. Preliminary mechanistic study showed that the coupling reaction presumably proceeds through the in situ formation of arylmagnesium reagents as key intermediates.

TRPA1 protects against contrast-induced renal tubular injury by preserving mitochondrial dynamics via the AMPK/DRP1 pathway.

Mitochondrial dysfunction and oxidative stress are involved in the development of contrast-induced acute kidney injury (CI-AKI). The present study aimed to reveal the role of transient receptor potential ankyrin 1 (TRPA1), an oxidative sensor, in CI-AKI. Trpa1PT-/- mice with Trpa1 conditionally knocked out in renal proximal tubular (PT) cells, Trpa1 overexpression mice (Trpa1-OE), and TRPA1 agonists and antagonists were used to study its function in a mouse model of iohexol-induced CI-AKI. We found that TRPA1 was functionally expressed in PT cells. Activation of TRPA1 with cinnamaldehyde or overexpression of Trpa1 remarkably ameliorated renal tubular injury and dysfunction in a mouse model of CI-AKI, while CI-AKI was significantly exacerbated in Trpa1PT-/- mice. Proteomics demonstrated that mouse kidneys with CI-AKI had downregulated proteins involved in mitochondrial dynamics and upregulated mitophagy-associated proteins. The beneficial effects of TRPA1 activation/overexpression on CI-AKI were associated with improved mitochondrial function, decreased mitochondrial fission and oxidative stress, enhanced mitophagy, and less apoptosis of renal tubular cells. TRPA1-induced decreases in mitochondrial fission were linked to upregulated fusion-related proteins (mitofusin 1, mitofusin 2 and optic atrophy 1) and downregulated fission mediator, phosphorylated dynamin-related protein 1 (Drp1). Importantly, inhibition of Drp1 with mitochondrial division inhibitor 1 improved CI-AKI. In addition, the decreased mitochondrial fission was also mediated by inactivation of AMP-activated protein kinase which mediates mitochondrial biogenesis. The findings suggest that TRPA1 plays a protective role in CI-AKI through regulating mitochondrial fission/fusion, biogenesis, and dysfunction. Activating TRPA1 may become novel therapeutic strategies for the prevention of CI-AKI.

Palladium-Catalyzed Cross-Electrophile Couplings of Aryl Thianthrenium Salts with Aryl Bromides via C-S Bond Activation.

We report here a step-economic and cost-effective cross-electrophile coupling of aryl thianthrenium salts with widely available aryl bromides, which proceeded effectively via C-S bond activation at ambient temperature in THF in the presence of a palladium catalyst, magnesium turnings, and lithium chloride to enable the facile assembly of a wide array of structurally diverse biaryls in modest to good yields with good functional group compatibility. In addition, the gram-scale reaction could also be realized.

Unveiling the release mechanism of potentially toxic elements from Pb/Zn smelter contaminated soils under the coupled effects of freeze-thaw and acidification: Insights from mineralogical analysis.

Most Pb/Zn smelter contaminated sites in China are often encountered natural phenomenon known as freeze-thaw (F-T) cycles and acid rain. However, the coupled effects of F-T cycles and acidification on the release behavior of potentially toxic elements (PTEs) from soils remains unclear. A mechanistic study on PTEs release from soils was conducted by revealing the physicochemical weathering characteristics of minerals under F-T cycles combined with acidification. The results from F-T test indicated that among F-T parameters, F-T frequency were the more important factors influencing PTEs release, with the corresponding contribution ranges of 21.20-94.40 %. As pH decreased, the leaching concentrations of As, Cd, Cu, Mn, Pb and Zn did not increase under the same F-T frequency. As F-T frequency increased, the leaching concentrations of these studied PTEs also did not increase under the same pH condition. Microstructure characteristics revealed that the soils were a complex system with multi-mineral aggregates, which had experienced complex physicochemical weathering after F-T combined with acidification treatment. Combined with geochemical modeling results, PTEs release was found to be mainly influenced by the microstructure damage and proton corrosion of minerals, while little affected by their precipitation and dissolution. The mutual coupling relationships of mineral weathering and PTEs release were conducive to the better understanding of the migration behavior of PTEs in contaminated sites under complex environment scenarios. The present study results would provide theoretical instruction and technical support for the longevity evaluation of multi-metal stabilization remediation.

Outcomes of Ticagrelor Versus High-dose Clopidogrel in CYP2C19 Intermediate Metabolizer Undergoing Percutaneous Coronary Intervention for Acute Coronary Syndromes.

ABSTRACT: Guidelines on antiplatelet recommendation for CYP2C19 intermediate metabolizer (IM) have not come to an agreement. This study aimed to evaluate the clinical benefit of ticagrelor when compared with high-dose clopidogrel in CYP2C19 IM after percutaneous coronary intervention for acute coronary syndromes. Patients were enrolled according to CYP2C19 genotype and individual antiplatelet therapy. Patient characteristics and clinical outcomes were collected through electronic medical record system. The primary outcome was major adverse cardiac and cerebrovascular event (MACCE), namely a composite of death from cardiovascular causes, myocardial infarction, stroke, and stent thrombosis within 12 months. The secondary outcome was Bleeding Academic Research Consortium scale bleeding events within 12 months. The Cox proportional hazards regression model was performed, with inverse probability treatment weighting (IPTW) adjusting for potential confounders. A total of 532 CYP2C19 IM were enrolled in this retrospective single-center study. No statistically significant difference in incidence rate of MACCE was found between patients receiving ticagrelor versus clopidogrel (7.01 vs. 9.52 per 100 patient-years; IPTW-adjusted hazard ratio 0.71; 95% confidence interval: 0.32-1.58; adjusted log-rank P = 0.396), but the incidence rate of Bleeding Academic Research Consortium type 2, 3, or 5 bleeding events was statistically higher in the loss of function-ticagrelor group than in the loss of function-clopidogrel group (13.53 vs. 6.16 per 100 patient-years; IPTW-adjusted hazard ratio: 2.29; 95% confidence interval: 1.10-4.78; adjusted log-rank P = 0.027). Ticagrelor treatment in CYP2C19 IM resulted in a statistically higher risk of bleeding compared with high-dose clopidogrel, whereas a clear association between treatments and MACCE warrants further investigations.

An Aptamer Glue Enables Hyperefficient Targeted Membrane Protein Degradation.

Targeted membrane protein degradation (TMPD) offers significant therapeutic potential by enabling the removal of harmful membrane-anchored proteins and facilitating detailed studies of complex biological pathways. However, existing TMPD methodologies face challenges such as complex molecular architectures, scarce availability, and cumbersome construction requirements. To address these issues, this study presents a highly efficient TMPD system (TMPDS) that integrates an optimized bivalent aptamer glue with a potent protein transport shuttle. Utilizing this approach, we successfully degraded both the highly expressed protein tyrosine kinase 7 in CCRF-CEM cells and the poorly expressed PTK7 in MV-411 cells. This system represents significant advancement in the field of molecular medicine, offering a new avenue for targeted therapeutic interventions and the exploration of cellular mechanisms.

Sulfonylation of Pyridyl Phosphonium Salts with Sulfinate Salts in Aqueous Media for the Synthesis of 4-Pyridyl Sulfones via C-P Bond Cleavage.

A Na2S2O8-initiated sulfonylation of pyridyl phosphonium salts with sulfinate salts in aqueous media has been developed for facile access to 4-pyridyl sulfones. The reactions, which employed pyridyl phosphonium salts as efficient pyridylation agents via C-P bond activation, showed both broad substrate generality and good functional group compatibility. In addition, the scale-up synthesis and the late-stage modification of pharmaceutically active complex molecules (e.g., loratadine, bisacodyl) could also be successfully realized.

Nickel-Catalyzed Reductive Amidation of Aryl Fluorosulfates with Isocyanates: Synthesis of Amides via C-O Bond Cleavage.

With the assistance of nickel as catalyst, 2,2'-bipyridine (bpy) as ligand, and manganese as reducing metal, the reductive amidation of isocyanates with readily accessible aryl fluorosulfates could be successfully accomplished. The reactions proceeded effectively via C-O bond activation in DMF at room temperature, enabling the facile synthesis of a range of structurally diverse amides in moderate to high yields with broad functionality compatibility. In addition, the synthetic usefulness of the method was further demonstrated by applying the reaction in scale-up synthesis and the late-stage functionalization of complex molecules with biological activities.

Macroscopic and molecular scale assessment of thermal effects on soil-water interactions of unsaturated diesel-contaminated soils.

The soil-water interactions of unsaturated diesel-contaminated soil are crucial for assessing pollution transport during thermal remediation. This paper aims to improve our understanding of this issue by measuring the matric suction of unsaturated contaminated kaolin and carrying out molecular dynamics simulations under thermal conditions. Results show that the increase in pollutant concentration could reduce the water retention capacity of diesel-contaminated kaolin due to changes in electrochemical properties and pore characteristics of samples, as well as a decrease in interfacial tension. On the other hand, pollutants formed a protective film on the kaolinite surface to act as a liquid bridge and prevent water loss at higher temperatures, as confirmed by Fourier transform infrared spectroscopy. With rising temperatures (50-60 °C), kaolin matric suction generally decreased with higher pollutant concentrations, but this trend was not very evident at lower pollution concentrations (0-10,000 mg/kg). In addition, molecular dynamics simulations were used to demonstrate the validity of these findings. The presence of pollutants might strengthen the interaction energy between kaolinite and water (for example, increasing from 276.52 kcal/mol (25 °C) and 267.95 kcal/mol (40 °C) at 8000 mg/kg to 296.54 kcal/mol (25 °C) and 292.46 kcal/mol (40 °C) at 10,000 mg/kg), thereby enhancing the water retention capacity of kaolin. In short, the study revealed that the coating of pollutants on kaolinite could act as a protective film, which binds water molecules through van der Waals and electric field forces and thereby reduces the sensitivity of water retention capacity to temperature.

Evaluation of tissue conditioner-assisted complete denture restoration: A randomized controlled clinical trial.

PURPOSE: To evaluate the clinical effect of three impression methods, conventional, closed-mouth, and tissue conditioner, on complete denture fabrication. METHODS: 60 subjects (edentulous with severely resorbed alveolar ridges - Atwood classification III or IV) who visited the Prosthodontic Department of Wuxi Stomatology Hospital, China, between January 2022 and June 2023, were selected for this study. The subjects were randomly divided into three groups of 20: a conventional impression group (CI group), a closed-mouth impression group (CM group), and a tissue conditioner group (TC group). Three months after denture restoration was completed, denture quality was assessed by clinicians in terms of marginal extension, retention, and stability. In addition, patients completed the oral health impact profile-edentulous (OHIP-EDENT) questionnaire to provide subjective satisfaction evaluations of the final denture restoration outcomes. RESULTS: The comprehensive denture quality evaluation results showed that the TC group had the lowest score, which was significantly lower than that of the CM (P= 0.014) and CI (P< 0.001) groups. The average score of the CM group was also significantly lower than that of the CI group (P= 0.004), indicating that tissue conditioner restoration was the most effective method. The OHIP-EDENT scores gradually decreased across the groups from CI to CM to TC (P= 0.001), indicating patients' oral health was significantly improved using tissue conditioner. CLINICAL SIGNIFICANCE: Tissue conditioner is a suitable dynamic functional impression method. It can significantly improve the effects for edentulous patients and increase their satisfaction.

Risk factors of shunt-dependent hydrocephalus after subarachnoid hemorrhage: a systematic review and meta-analysis based on observational cohort studies.

Shunt dependent hydrocephalus (SDHC) is a common sequel after aneurysmal subarachnoid hemorrhage (aSAH) and factors contributing to the development of SDHC remain obscure. The aim of this study was to identify predictors of SDHC following aSAH. We conducted a systematic review based on the Meta-analysis of Observational Studies in Epidemiology (MOOSE) guidelines. We searched electronic databases including Pubmed, Embase, and Cochrane databases from 1980 through August 2019 for studies on the risk factors of SDHC after aSAH. Inclusion criteria were: (1) SAH and hydrocephalus confirmed by CT or magnetic resonance imaging findings; (2) the odds ratios (ORs) or the relative risk (RR) with 95% confidence interval (95%CI; or crude data that allowed their calculation) were reported; and (3) languages were restricted to English and Chinese. Two independent authors collected the data including study design, characteristics of patients and potential risk factors. Random-effects models were used to estimate weighted mean differences (WMD), relative risks (RR) with corresponding 95% confidence intervals (CI). For analysis with significant heterogeneity, subgroup analyses stratified by study design and geographic area were performed. In all, 37 cohort studies met inclusion criteria. Several factors were associated with SDHC. Infection, acute hydrocephalus, placement of external ventricular drainage, older age, higher Hunt and Hess grade, intraventricular hemorrhage, rebleeding, and mechanical ventilation were associated with greater 2-fold increased risk of SDHC. Vasospasm, female gender, high Fisher grade, preexisting hypertension, aneurysm in posterior location and intracerebral hemorrhage were associated with less than 2-fold increased risk. Treatment modality and diabetes mellitus were not associated with SDHC. SDHC is a multi-factorial disease that is associated with patient and treatment factors. Acknowledgement of these potential factors could help prevent SDHC.

Chemo-, regio-, and stereoselective tetrafunctionalization of fluoroalkynes enables divergent synthesis of 5-7-membered azacycles.

Alkyne annulation has been widely used in organic synthesis for the construction of azacycles with unique structural and physicochemical properties. However, the analogous transformation of fluoroalkynes remains a challenge and has seen limited progress. Herein we report a 1,2,3,4-tetrafunctionalization of polyfluoroalkynes for the divergent construction of 5-7-membered (E)-1,2-difluorovinyl azacycles. The use of the fluorine atom as a detachable "activator" not only obviates the use of any transition metal catalysts and oxidizing reagents, but also ensures the [3-5 + 2]-annulation and defluorinative functionalization of fluoroalkynes with high chemo-, regio-, and stereoselectivities. This method exhibits a broad substrate scope, good functional group tolerance, and excellent scalability, providing a modular platform for accessing fluorinated skeletons of medicinal and biological interest. The late-stage modification of complex molecules, the multi-component 1,2-diamination of fluoroalkyne, and the synthesis of valuable organofluorides from the obtained products further highlight the real-world utility of this fluoroalkyne annulation technology.

Combining (CH2O)n and (NH4)2CO3 as a Formamidine Equivalent for "Four-in-One" Synthesis of Fluoroalkylated 2-H-Pyrimidines.

Multicomponent reactions hold the potential to maximize the synthetic efficiency in the preparation of diverse and complex molecular scaffolds. An unprecedented formal [3+1+1+1] annulation approach for the one-step synthesis of fluoroalkylated 2-H-pyrimidines commencing from perfluoroalkyl alkenes, paraformaldehyde, and ammonium carbonate is described. By harnessing readily accessible (CH2O)n and cheap (NH4)2CO3 as a formamidine surrogate, this method effectively replaces traditionally preformed amidines with a pyrimidine assembly. The multicomponent reaction proceeds in a step-economical, operationally simple, metal-free, and additive-free manner, featuring a broad substrate scope, excellent functional group compatibility, and scalability. The potential for the synthetic elaboration of the obtained 2-H-pyrimidine is further demonstrated in the alkylation and vinylation of its C2 position.

Prevalence and related factors for neck pain in military personnel: a systematic review.

Purpose: In the military, neck pain is second to low back pain among musculoskeletal disorders. However, the prevalence and related factors of neck pain in military personnel have not been systematically investigated, which may lead to the lack of neck pain prevention and the generation of additional medical expenses, posing challenges to medical care. This review aimed to obtain the prevalence and related factors for neck pain in military personnel in an attempt to provide directions for prevention and intervention. Methods: We searched PubMed, Embase, and Cochrane databases in December 2021. Two researchers independently screened studies according to eligibility criteria and assessed study quality. Results: We screened titles and abstracts of 503 articles, and 17 articles met the inclusion criteria. Sixteen articles received moderate to high-quality evaluations. Neck pain is common in the military, with 1-year prevalence as high as 83% and lifetime prevalence as high as 78%. Old age (OR = 5.0), poor neck mobility (OR = 3.61), shoulder pain (OR = 4.9), low back pain (OR = 2.3), high-G pilots (OR = 1.6), longer flight time (OR = 2.53), type of aircraft (OR = 3.93), and use of helmets and night vision systems (OR = 1.9) may be associated with the prevalence of neck pain. Conclusion: Neck pain is highly prevalent in military personnel and exhibits a substantial lifetime prevalence rate. The high prevalence rate of neck pain in the military is related to many individual-related factors and work-related factors. The in-depth assessment and prevention of specific factors is an important direction of future research.

Unveiling the Reaction Mystery Between Lithium Polysulfides and Lithium Metal Anode in Lithium-Sulfur Batteries.

Lithium-sulfur (Li-S) batteries are widely regarded as one of the most promising next-generation high-energy-density energy storage devices. However, soluble lithium polysulfides (LiPSs) corrode Li metal and deteriorate the cycling stability of Li-S batteries. Understanding the reaction mechanism between LiPSs and Li metal anode is imperative. Herein, the reaction rate and products of LiPSs with Li metal anode, the composition and structure of the as-generated solid electrolyte interphase (SEI), and the mechanism of lithium nitrate (LiNO3) additives for inhibiting the corrosion reactions are systematically unveiled. Concretely, LiPSs react with Li metal anode more rapidly than Li salt and generate a Li2S-rich SEI. The Li2S-rich SEI is highly reactive with LiPSs, which exacerbates the formation of dendritic Li and the continuous corrosion of active Li. LiNO3 functions dominantly by modulating the solvation structure of LiPSs and inherently reducing the reactivity of LiPSs, rather than the conventional understanding of LiNO3 participating in the formation of SEI. This work reveals the reaction mechanism between LiPSs and Li metal anode and inspires rational regulating of the solvation structure of LiPSs for stabilizing Li metal anode in Li-S batteries.