Exosomes derived from BMSCs in osteogenic differentiation promote type H blood vessel angiogenesis through miR-150-5p mediated metabolic reprogramming of endothelial cells.

Osteogenesis is tightly coupled with angiogenesis spatiotemporally. Previous studies have demonstrated that type H blood vessel formed by endothelial cells with high expression of CD31 and Emcn (CD31hi Emcnhi ECs) play a crucial role in bone regeneration. The mechanism of the molecular communication around CD31hi Emcnhi ECs and bone mesenchymal stem cells (BMSCs) in the osteogenic microenvironment is unclear. This study indicates that exosomes from bone mesenchymal stem cells with 7 days osteogenic differentiation (7D-BMSCs-exo) may promote CD31hi Emcnhi ECs angiogenesis, which was verified by tube formation assay, qRT-PCR, Western blot, immunofluorescence staining and µCT assays etc. in vitro and in vivo. Furthermore, by exosomal miRNA microarray and WGCNA assays, we identified downregulated miR-150-5p as the most relative hub gene coupling osteogenic differentiation and type H blood vessel angiogenesis. With bioinformatics assays, dual luciferase reporter experiments, qRT-PCR and Western blot assays, SOX2(SRY-Box Transcription Factor 2) was confirmed as a novel downstream target gene of miR-150-5p in exosomes, which might be a pivotal mechanism regulating CD31hi Emcnhi ECs formation. Additionally, JC-1 immunofluorescence staining, Western blot and seahorse assay results showed that the overexpression of SOX2 could shift metabolic reprogramming from oxidative phosphorylation (OXPHOS) to glycolysis to enhance the CD31hi Emcnhi ECs formation. The PI3k/Akt signaling pathway might play a key role in this process. In summary, BMSCs in osteogenic differentiation might secrete exosomes with low miR-150-5p expression to induce type H blood vessel formation by mediating SOX2 overexpression in ECs. These findings might reveal a molecular mechanism of osteogenesis coupled with type H blood vessel angiogenesis in the osteogenic microenvironment and provide a new therapeutic target or cell-free remedy for osteogenesis impaired diseases.

Unraveling the Intrinsic Origin of the Superior Sodium-Ion Storage Performance of Metal Selenides Anode in Ether-Based Electrolytes.

Metal selenides show outstanding sodium-ion storage performance when matched with an ether-based electrolyte. However, the intrinsic origin of improvement and deterministic interface characteristics have not been systematically elucidated. Herein, employing FeSe2 anode as the model system, the electrochemical kinetics of metal selenides in ether and ester-based electrolytes and associated solid electrolyte interphase (SEI) are investigated in detail. Based on the galvanostatic intermittent titration technique and in situ electrochemical impedance spectroscopy, it is found that the ether-based electrolyte can ensure fast Na+ transfer and low interface impedance. Additionally, the ether-derived thin and smooth double-layer SEI, which is critical in facilitating ion transport, maintaining structural stability, and inhibiting electrolyte overdecomposition, is concretely visualized by transmission electron microscopy, atomic force microscopy, and depth-profiling X-ray photoelectron spectroscopy. This work provides a deep understanding of the optimization mechanism of electrolytes, which can guide available inspiration for the design of practical electrode materials.

Programmed Remodeling of the Tumor Milieu to Enhance NK Cell Immunotherapy Combined with Chemotherapy for Pancreatic Cancer.

Natural killer (NK) cell-based adoptive immunotherapy has demonstrated encouraging therapeutic effects in clinical trials for hematological cancers. However, the effectiveness of treatment for solid tumors remains a challenge due to insufficient recruitment and infiltration of NK cells into tumor tissues. Herein, a programmed nanoremodeler (DAS@P/H/pp) is designed to remodel dense physical stromal barriers and for dysregulation of the chemokine of the tumor environment to enhance the recruitment and infiltration of NK cells in tumors. The DAS@P/H/pp is triggered by the acidic tumor environment, resulting in charge reversal and subsequent hyaluronidase (HAase) release. HAase effectively degrades the extracellular matrix, promoting the delivery of immunoregulatory molecules and chemotherapy drugs into deep tumor tissues. In mouse models of pancreatic cancer, this nanomediated strategy for the programmed remodeling of the tumor microenvironment significantly boosts the recruitment of NK92 cells and their tumor cell-killing capabilities under the supervision of multiplexed near-infrared-II fluorescence.

Designable Nanoadaptor for Enhanced Recognition of Natural Killer Cell to Tumor via Bio-orthogonal Click Reaction.

Highly efficient recognition of cancer cells by immune cells is important for successful therapeutic-cell-based cancer immunotherapy. Herein, we present a facile NIR-II nanoadaptor [hyaluronic acid (HA)/dibenzocyclooctyne (DBCO)-Au:Ag2Te quantum dots (QDs)] for enhancing the tumor recognition and binding ability of natural killer (NK) cells via a bio-orthogonal click reaction in vivo. The Nanoadaptor possesses superior tumor-targeting capacity, facilitating the accumulation of the chemical receptor DBCO at the tumor sites. Subsequently, the enrichment of DBCO on tumor cell surfaces provides multivalent recognition sites for capturing pretreated azide engineered NK92 cells (NK92-N3) through an efficient click reaction, thereby significantly enhancing the therapeutical efficiency. The dynamic process of nanoadaptor-mediated recognition of NK cells to tumor cells could be vividly observed using multiplexed NIR-II fluorescence imaging in a mouse model of lung cancer. Such a nanoadaptor strategy can be extended to other therapeutic cellular systems and holds promise for future clinical applications.

Optimized Phase and Crystallinity of Cr2(NCN)3 Dominating Electrochemical Lithium Storage Performance.

Cr2(NCN)3 is a potentially high-capacity and fast-charge Li-ion anode owing to its abundant and broad tunnels. However, high intrinsic chemical instability severely restricts its capacity output and electrochemical reversibility. Herein we report an effective crystalline engineering method for optimizing its phase and crystallinity. Systematic studies reveal the relevancy between electrochemical performance and crystalline structure; an optimal Cr2(NCN)3 with high phase purity and uniform crystallinity exhibits a high reversible capacity of 590 mAh g-1 and a stable cycling performance of 478 mAh g-1 after 500 cycles. In-operando heating XRD reveals its high thermodynamical stability over 600 °C, and in-operando electrochemical XRD proves its electrochemical Li storage mechanism, consisting of the primary Li-ion intercalation and subsequent conversion reactions. This study introduces a facile and low-cost method for fabricating high-purity Cr2(NCN)3, and it also confirms that the Li storage of Cr2(NCN)3 can be further improved by tuning its phase and crystallinity.

Test-Time Training for Deep MS/MS Spectrum Prediction Improves Peptide Identification.

In bottom-up proteomics, peptide-spectrum matching is critical for peptide and protein identification. Recently, deep learning models have been used to predict tandem mass spectra of peptides, enabling the calculation of similarity scores between the predicted and experimental spectra for peptide-spectrum matching. These models follow the supervised learning paradigm, which trains a general model using paired peptides and spectra from standard data sets and directly employs the model on experimental data. However, this approach can lead to inaccurate predictions due to differences between the training data and the experimental data, such as sample types, enzyme specificity, and instrument calibration. To tackle this problem, we developed a test-time training paradigm that adapts the pretrained model to generate experimental data-specific models, namely, PepT3. PepT3 yields a 10-40% increase in peptide identification depending on the variability in training and experimental data. Intriguingly, when applied to a patient-derived immunopeptidomic sample, PepT3 increases the identification of tumor-specific immunopeptide candidates by 60%. Two-thirds of the newly identified candidates are predicted to bind to the patient's human leukocyte antigen isoforms. To facilitate access of the model and all the results, we have archived all the intermediate files in Zenodo.org with identifier 8231084.

Compressively Strained Fe3O4 in Core-Shell Oxygen Reduction Electrocatalyst Boosts Zinc-Air Battery Performance.

Fe3O4 is barely taken into account as an electrocatalyst for oxygen reduction reaction (ORR), an important reaction for metal-air batteries and fuel cells, due to its sluggish catalytic kinetics and poor electron conductivity. Herein, how strain engineering can be employed to regulate the local electronic structure of Fe3O4 for high ORR activity is reported. Compressively strained Fe3O4 shells with 2.0% shortened Fe─O bond are gained on the Fe/Fe4N cores as a result of lattice mismatch at the interface. A downshift of the d-band center occurs for compressed Fe3O4, leading to weakened chemisorption energy of oxygenated intermediates, and lower reaction overpotential. The compressed Fe3O4 exhibits greatly enhanced electrocatalytic ORR activity with a kinetic current density of 27 times higher than that of pristine one at 0.80 V (vs reversible hydrogen electrode), as well as potential application in zinc-air batteries. The findings provide a new strategy for tuning electronic structures and improving the catalytic activity of other metal catalysts.

Double-Salts Super Concentrated Carbonate Electrolyte Boosting Electrochemical Performance of Ni-Rich LiNi0.90Co0.05Mn0.05O2 Lithium Metal Batteries.

Current lithium-ion batteries cannot meet the requirement of higher energy density with further large-scale application of electrical vehicles. Lithium metal batteries combined with Ni-rich layered oxides cathode are expected as the one of promising solutions, while the poor electrode and electrolyte interface impedes the commercial development of lithium metal batteries. A new double-salts super concentrated (DSSC) carbonate electrolyte is proposed to improve the electrochemical performance of LiNi0.90Co0.05Mn0.05O2 (NCM9055)||Li metal battery which exhibits stable cycling performance with the capacity retention of 93.04% and reversible capacity of 173.8 mAh g-1 after 100 cycles at 1 C, while cells with conventional 1 m diluted electrolyte remains only 60.55% and capacity of 114.2 mAh g-1. The double salts synergistic effect in super concentrated electrolyte promotes the formation for more balanced stable cathode electrolyte interface (CEI) inorganic compounds of CFx, LiNOx, SOF2, Li2SO4, and less LiF by X-ray photoelectron spectroscopy (XPS) test, and the uniform 2-3 nm rock-salt phase protection layer on the cathode surface by transmission electron microscope (TEM) characterization, improving the cycling performance of the Ni-rich NCM9055 layered oxide cathode. The DSSC electrolyte also can relief the Li dendrite growth on Li metal anode, as well as exhibit better flame retardance, promoting the application of more safety Ni-rich NCM9055||Li metal batteries.

Yolk-Shell Construction of Na3V2(PO4)2F3 with Copper Substitution Microsphere as High-Rate and Long-Cycling Cathode Materials for Sodium-Ion Batteries.

Na3V2(PO4)2F3 (NVPF) is emerging as a promising cathode material for high-voltage sodium-ion batteries. Whereas, the inferior intrinsic electrical conductivity leading to poor rate performance and cycling stability. To address this issue, a strategy of synthesizing unique yolk-shell structured NVPF with copper substitution via spray drying method is proposed. Besides, the synergistic modulation of both crystalline structure and interfacial properties results in significantly enhanced intrinsic and interfacial conductivity of NVPF. The optimized yolk-shell structured cathode materials can possess a high capacity of 117.4 mAh g-1 at 0.1 C, and remains a high-capacity retention of 91.3% after 5000 cycles. A detailed investigation of kinetic properties combined with in situ XRD technology and DFT calculations, has been implemented, particularly with regard to electron conduction and sodium ion diffusion. Consequently, the yolk-shell structured composition of Na3V1.94Cu0.06(PO4)2F3 with nitrogen-modified carbon coating layer shows the lowest polarization potential because of the effectively enhanced electronic conductivity and Na+ diffusion process in the bulk phase. The robust electrochemical performance suggests that developing the unique yolk-shell structure with the collaboration of interface and bulk crystal properties is a favorable strategy to design cathode material with a high performance for sodium-ion batteries.

In Situ Constructed Spinel Layer Stabilized Upcycled LiCoO2 for High Performance Lithium-Ion Batteries.

With ever-increasing requirements for cathodes in the lithium-ion batteries market, an efficiency and eco-friendly upcycling regeneration strategy is imperative to meet the demand for high-performance cathode materials. Herein, a facile, direct and upcycling regeneration strategy is proposed to restore the failed LiCoO2 and enhance the stability at 4.6 V. Double effects combination of relithiation and outside surface reconstruction are simultaneously achieved via a facile solid-phase sintering method. The evolution process of the Li-supplement and grain-recrystallization is systematically investigated, and the high performance of the upcycled materials at high voltage is comprehensively demonstrated. Thanks to the favorable spinel LiCoxMn2-xO4 surface coating, the upcycled sample displays outstanding electrochemical performance, superior to the pristine cathode materials. Notably, the 1% surface-coated LiCoO2 achieves a high discharge-specific capacity of 207.9 mA h g-1 at 0.1 C and delivers excellent cyclability with 77.0% capacity retention after 300 cycles. Significantly, this in situ created spinel coating layer can be potentially utilized for recycling spent LiCoO2, thus providing a viable, promising recycling strategy insights into the upcycling of degraded cathodes.

Stable Lithium Metal Batteries Enabled by Lithiophilic Core-Shell Nanowires on Copper Foam.

Lithium (Li) metal batteries have attracted considerable research attention due to their exceptionally high theoretical capacity. However, the commercialization of Li metal batteries faces challenges, primarily attributed to uncontrolled growth of Li dendrites, which raises safety concerns and lowers coulombic efficiency. To mitigate Li dendrites growth and attain dense Li deposition, the hybrid SiO2-Cu2O lithiophilic film applied to a 3D copper foam current collector is developed to regulate the interfacial properties for achieving even and dense Li deposition. The SiO2-Cu2O possesses strong Li+ trapping capability through strong lithiophilicity from Cu2O. Additionally, the SiO2-Cu2O enables uniform ion diffusion through the domain-limiting effect of the holes in the SiO2 layer, inducing an even and dense Li plating/stripping behavior at a large capacity. Furthermore, the SiO2 layer promotes the formation of an initial high inorganic content Solid Electrolyte Interphase (SEI) through selective preferential binding with anion and solvent molecules. When the SiO2-Cu2O@Li anode is coupled with a LiFePO4 (LFP) cathode, the resulting full cell exhibits superior cycling stability and rate performance. These results provide a facile approach to construct a lithiophilic current collector for practical Li metal anodes.

Enabling High-Performance Layered Li-Rich Oxide Cathodes by Regulating the Formation of Integrated Cation-Disordered Domains.

Layered Li-rich oxide cathode materials are capable of offering high energy density due to their cumulative cationic and anionic redox mechanism during (de)lithiation process. However, the structural instability of the layered Li-rich oxide cathode materials, especially in the deeply delitiated state, results in severe capacity and voltage degradation. Considering the minimal isotropic structural evolution of disordered rock salt oxide cathode during cycling, cation-disordered nano-domains have been controllably introduced into layered Li-rich oxides by co-doping of d0-TM and alkali ions. Combining electrochemical and synchrotron-based advanced characterizations, the incorporation of the phase-compatible cation-disordered domains can not only hinder the oxygen framework collapse along the c axis of layered Li-rich cathode under high operation voltage but also promote the Mn and anionic activities as well as Li+ (de)intercalation kinetics, leading to remarkable improvement in rate capability and mitigation of capacity and voltage decay. With this unique layered/rocksalt intergrown structure, the intergrown cathode yields an ultrahigh capacity of 288.4 mAh g-1 at 0.1 C, and outstanding capacity retention of ≈90.0% with obviously suppressed voltage decay after 100 cycles at 0.5, 1, and 2 C rate. This work provides a new direction toward advanced cathode materials for next-generation Li-ion batteries.

Uncovering the Nonequilibrium Evolution Mechanism between Na2+2 δFe2- δ(SO4)3 Cathode and Impurities in the Na2SO4-FeSO4·7H2O Binary System for High-Voltage Sodium-Ion Batteries.

Sodium-ion batteries are increasingly recognized as ideal for large-scale energy storage applications. Alluaudite Na2+2 δFe2- δ(SO4)3 has become one of the focused cathode materials in this field. However, previous studies employing aqueous-solution synthesis often overlooked the formation mechanism of the impurity phase. In this study, the nonequilibrium evolution mechanism between Na2+2 δFe2- δ(SO4)3 and impurities by adjusting ratios of the Na2SO4/FeSO4·7H2O in the binary system is investigated. Then an optimal ratio of 0.765 with reduced impurity content is confirmed. Compared to the poor electrochemical performance of the Na2.6Fe1.7(SO4)3 (0.765) cathode, the optimized Na2.6Fe1.7(SO4)3@CNTs (0.765@CNTs) cathode, with improved electronic and ionic conductivity, demonstrates an impressive discharge specific capacity of 93.8 mAh g-1 at 0.1 C and a high-rate capacity of 67.84 mAh g-1 at 20 C, maintaining capacity retention of 71.1% after 3000 cycles at 10 C. The Na2.6Fe1.7(SO4)3@CNTs//HC full cell reaches an unprecedented working potential of 3.71 V at 0.1 C, and a remarkable mass-energy density exceeding 320 Wh kg-1. This work not only provides comprehensive guidance for synthesizing high-voltage Na2+2 δFe2- δ(SO4)3 cathode materials with controllable impurity content but also lays the groundwork of sodium-ion batteries for large-scale energy storage applications.

Low-threshold AlGaN-based deep ultraviolet laser enabled by a nanoporous cladding layer.

We demonstrated an AlGaN-based multiple-quantum-well (MQW) deep ultraviolet (DUV) laser at 278 nm using a nanoporous (NP) n-AlGaN as the bottom cladding layer grown on the sapphire substrate. The laser has a very-low-threshold optically pumped power density of 79 kW/cm2 at room temperature and a transverse electric (TE)-polarization-dominant emission. The high optical confinement factor of 9.12% benefiting from the low refractive index of the nanoporous n-AlGaN is the key to enable a low-threshold lasing. The I-V electrical measurement demonstrates that an ohmic contact can be still achieved in the NP n-AlGaN with a larger but acceptable resistance, which indicates it is compatible with electrically driven laser devices. Our work provides insights into the design and fabrication of low-threshold lasers emitting in the DUV regime.

Efficient Initialization of Fluxonium Qubits based on Auxiliary Energy Levels.

Fast and high-fidelity qubit initialization is crucial for low-frequency qubits such as fluxonium, and in applications of many quantum algorithms and quantum error correction codes. In a circuit quantum electrodynamics system, the initialization is typically achieved by transferring the state between the qubit and a short-lived cavity through microwave driving, also known as the sideband cooling process in atomic system. Constrained by the selection rules from the parity symmetry of the wave functions, the sideband transitions are only enabled by multiphoton processes which require multitone or strong driving. Leveraging the flux tunability of fluxonium, we circumvent this limitation by breaking flux symmetry to enable an interaction between a noncomputational qubit transition and the cavity excitation. With single-tone sideband driving, we realize qubit initialization with a fidelity exceeding 99% within a duration of 300 ns, robust against the variation of control parameters. Furthermore, we show that our initialization scheme has a built-in benefit in simultaneously removing the second-excited state population of the qubit, and can be easily incorporated into a large-scale fluxonium processor.

Native Approach to Controlled-Z Gates in Inductively Coupled Fluxonium Qubits.

The fluxonium qubits have emerged as a promising platform for gate-based quantum information processing. However, their extraordinary protection against charge fluctuations comes at a cost: when coupled capacitively, the qubit-qubit interactions are restricted to XX interactions. Consequently, effective ZZ or XZ interactions are only constructed either by temporarily populating higher-energy states, or by exploiting perturbative effects under microwave driving. Instead, we propose and demonstrate an inductive coupling scheme, which offers a wide selection of native qubit-qubit interactions for fluxonium. In particular, we leverage a built-in, flux-controlled ZZ interaction to perform qubit entanglement. To combat the increased flux-noise-induced dephasing away from the flux-insensitive position, we use a continuous version of the dynamical decoupling scheme to perform noise filtering. Combining these, we demonstrate a 20 ns controlled-z gate with a mean fidelity of 99.53%. More than confirming the efficacy of our gate scheme, this high-fidelity result also reveals a promising but rarely explored parameter space uniquely suitable for gate operations between fluxonium qubits.

Gender differences in plasma S100B levels of patients with major depressive disorder.

BACKGROUND: Low concentrations of S100B have neurotrophic effects and can promote nerve growth and repair, which plays an essential role in the pathophysiological and histopathological alterations of major depressive disorder (MDD) during disease development. Studies have shown that plasma S100B levels are altered in patients with MDD. In this study, we investigated whether the plasma S100B levels in MDD differ between genders. METHODS: We studied 235 healthy controls (HCs) (90 males and 145 females) and 185 MDD patients (65 males and 120 females). Plasma S100B levels were detected via multifactor assay. The Mahalanobis distance method was used to detect the outliers of plasma S100B levels in the HC and MDD groups. The Kolmogorov-Smirnov test was used to test the normality of six groups of S100B samples. The Mann-Whitney test and Scheirer-Ray-Hare test were used for the comparison of S100B between diagnoses and genders, and the presence of a relationship between plasma S100B levels and demographic details or clinical traits was assessed using Spearman correlation analysis. RESULTS: All individuals in the HC group had plasma S100B levels that were significantly greater than those in the MDD group. In the MDD group, males presented significantly higher plasma S100B levels than females. In the male group, the plasma S100B levels in the HC group were significantly higher than those in the MDD group, while in the female group, no significant difference was found between the HC and MDD groups. In the male MDD subgroup, there was a positive correlation between plasma S100B levels and years of education. In the female MDD subgroup, there were negative correlations between plasma S100B levels and age and suicidal ideation. CONCLUSIONS: In summary, plasma S100B levels vary with gender and are decreased in MDD patients, which may be related to pathological alterations in glial cells.

Predicting preoperative muscle invasion status for bladder cancer using computed tomography-based radiomics nomogram.

OBJECTIVES: The aim of the study is to assess the efficacy of the established computed tomography (CT)-based radiomics nomogram combined with radiomics and clinical features for predicting muscle invasion status in bladder cancer (BCa). METHODS: A retrospective analysis was conducted using data from patients who underwent CT urography at our institution between May 2018 and April 2023 with urothelial carcinoma of the bladder confirmed by postoperative histology. There were 196 patients enrolled in all, and each was randomized at random to either the training cohort (n = 137) or the test cohort (n = 59). Eight hundred fifty-one radiomics features in all were retrieved. For feature selection, the significance test and least absolute shrinkage and selection operator (LASSO) approaches were utilized. Subsequently, the radiomics score (Radscore) was obtained by applying linear weighting based on the selected features. The clinical and radiomics model, as well as radiomics-clinical nomogram were all established using logistic regression. Three models were evaluated using analysis of the receiver operating characteristic curve. An area under the curve (AUC) and 95% confidence intervals (CI) as well as specificity, sensitivity, accuracy, negative predictive value, and positive predictive value were included in the analysis. Radiomics-clinical nomogram's performance was assessed based on discrimination, calibration, and clinical utility. RESULTS: After obtaining 851 radiomics features, 12 features were ultimately selected. Histopathological grading and tortuous blood vessels were included in the clinical model. The Radscore and clinical histopathology grading were among the final predictors in the unique nomogram. The three models had an AUC of 0.811 (95% CI, 0.742-0.880), 0.845 (95% CI, 0.781-0.908), and 0.896 (95% CI, 0.846-0.947) in the training cohort and in the test cohort they were 0.808 (95% CI, 0.703-0.913), 0.847 (95% CI, 0.739-0.954), and 0.887 (95% CI, 0.803-0.971). According to the DeLong test, the radiomics-clinical nomogram's AUC in the training cohort substantially differed from that of the clinical model (AUC: 0.896 versus 0.845, p = 0.015) and the radiomics model (AUC: 0.896 versus 0.811, p = 0.002). The Delong test in the test cohort revealed no significant difference among the three models. CONCLUSIONS: CT-based radiomics-clinical nomogram can be a useful tool for quantitatively predicting the status of muscle invasion in BCa.

Does hip protector prevent falls and hip fractures? An umbrella review of meta-analyses.

BACKGROUND: Wearing hip protectors is a measure used to prevent hip fractures caused by falls. However, its protective effect has remained controversial in previous studies. This study provides a rationale for the use of hip protectors by pooling all the current meta-analysis evidence. METHODS: We conducted an umbrella review of all the current meta-analysis articles about the efficacy of hip protectors to reduce hip fractures and falls in communities and/or institutions. Major databases including EMBASE, Cochrane Library, PubMed and Web of Science, were searched up to June 2022. Two reviewers screened the studies, extracted the data, and conducted the methodological quality assessment independently. The primary outcome was the association statistic (odds ratio (OR), relative risk (RR), etc.) reported in the meta-analysis that quantified the influence of the intervention on hip fractures and falls compared to that of the control group. Narrative synthesis was also conducted. Forest plots and the AMSTAR score were used to describe the results and quality of the pooled literature, respectively. RESULTS: A total of six meta-analysis articles were included in the study. Hip protectors were effective at reducing hip fractures in older individuals who were in institutions (nursing or residential care settings) but not in communities (RR = 0.70, 95% CI 0.58 to 0.85, I2 = 42%, P < 0.001) (RR = 1.12, 95% CI 0.94 to 1.34, I2 = 0%, P = 0.20), and they did not reduce falls (RR = 1.01, 95% CI 0.90 to 1.13, I2 = 0%, P = 0.89). CONCLUSIONS: Hip protectors are effective at preventing hip fractures in institutionalized older adults but not in community-dwelling older adults. TRIAL REGISTRATION: This study has been registered in PROSPERO (PROSPERO ID: CRD42022351773).

Trends in transport injuries burden and risk factors among children under 14 years old in China: 1990-2019.

BACKGROUND: Transport injuries (TI) remains one of leading causes of death in children in China. This study aimed to analyze the temporal trend of disease burden and associated risk factors of TI among children aged 0-14 years in China, utilizing data from 1990 to 2019. METHODS: We retrieved data of disease burden and risk factors of TI among children aged 0-14 year in China from 1990 to 2019 from the Global Burden of Disease (GBD) dataset. We estimated incidence rate, death rate, and disability adjusted life years (DALYs) rate with a 95% uncertainty interval (95% UI), stratified by age, sex, and all type-road users. Trends in disease burden with annual percentage changes (APC) and average annual percent change (AAPC) were performed by Joinpoint regression model. RESULTS: The incidence rate (AAPC = 1.18%, P < 0.001) of TI among children aged 0-14 years showed an increasing trend, whereas mortality rate (AAPC = -3.87%, P < 0.001) and DALYs rate (AAPC = -3.83%, P < 0.001) decreased annually. Notably, boys experienced a higher increase in incidence (1.30%) compared to girls (1.06%), but a faster decrease in mortality and DALYs rate (-3.90% vs. -3.82%, -3.88% vs. -3.79%, respectively) (Pall < 0.001). Declines in death rates and DALYs rates were observed across all age groups (Pall < 0.001), while remained the highest among children aged 0-4 in 2019. Among different road-type users, cyclist road injuries were identified as the primary cause of TI (182.3 cases per 100,000) while pedestrians were the group with the highest mortality (2.9 cases per 100,000) and DALYs rate (243 cases per 100,000) in 2019. Besides, alcohol use was a significant risk factors for TI, while low temperature appeared to be a protective factor. CONCLUSION: Future efforts must prioritize raising awareness among children and their guardians to mitigate the disease burden of TI in children. It's critical to enhance preventive interventions for boys, children aged 0-4 and vulnerable road users such as pedestrians and cyclists in future.