Hepatic lipid droplet-associated proteome changes distinguish dietary-induced fatty liver from glucose tolerance in male mice.

Fatty liver is characterized by the expansion of lipid droplets (LDs) and is associated with the development of many metabolic diseases. We assessed the morphology of hepatic LDs and performed quantitative proteomics in lean, glucose-tolerant mice compared with high-fat diet (HFD) fed mice that displayed hepatic steatosis and glucose intolerance as well as high-starch diet (HStD) fed mice who exhibited similar levels of hepatic steatosis but remained glucose tolerant. Both HFD- and HStD-fed mice had more and larger LDs than Chow-fed animals. We observed striking differences in liver LD proteomes of HFD- and HStD-fed mice compared with Chow-fed mice, with fewer differences between HFD and HStD. Taking advantage of our diet strategy, we identified a fatty liver LD proteome consisting of proteins common in HFD- and HStD-fed mice, as well as a proteome associated with glucose tolerance that included proteins shared in Chow and HStD but not HFD-fed mice. Notably, glucose intolerance was associated with changes in the ratio of adipose triglyceride lipase to perilipin 5 in the LD proteome, suggesting dysregulation of neutral lipid homeostasis in glucose-intolerant fatty liver. We conclude that our novel dietary approach uncouples ectopic lipid burden from insulin resistance-associated changes in the hepatic lipid droplet proteome.NEW & NOTEWORTHY This study identified a fatty liver lipid droplet proteome and one associated with glucose tolerance. Notably, glucose intolerance was linked with changes in the ratio of adipose triglyceride lipase to perilipin 5 that is indicative of dysregulation of neutral lipid homeostasis.

Ultrahigh Energy Storage Density and Efficiency of Lead-Free Dielectrics with Sandwich Structure.

Lead-free dielectric capacitors have attracted significant research interest for high-power applications due to their environmental benefits and ability to meet the demanding performance requirements of electronic devices. However, the development of lead-free ceramic dielectrics with outstanding energy storage performance remains a challenge. In this study, environmentally friendly ceramic dielectrics with sandwich structures are designed and fabricated to improve energy storage performance via the synergistic effect of different dielectrics. The chemical compositions of the outer and middle layers of the sandwich structure are 0.35BiFeO3 -0.65SrTiO3 and Bi0.39 Na0.36 Sr0.25 TiO3 , respectively. The experimental and theoretical simulation results demonstrate that the breakdown strength is over 700 kV cm-1 for prepare sandwich structure ceramics. As a result, an ultrahigh recoverable energy storage density of 9.05 J cm-3 and a near-ideal energy storage efficiency of 97% are simultaneously achieved under 710 kV cm-1 . Furthermore, the energy storage efficiency maintains high values (≥ 96%) within 1-100 Hz and the power density as high as 188 MW cm-3 under 400 kV cm-1 . These results indicate that the designed lead-free ceramics with a sandwich structure possess superior comprehensive energy storage performance, making them promising lead-free candidates in the energy storage field.

Superior Energy Storage Capability and Fluorescence Negative Thermal Expansion of NaNbO3-Based Transparent Ceramics by Synergistic Optimization.

Transparent dielectric ceramics are splendid candidates for transparent pulse capacitors (TPCs) due to splendid cycle stability and large power density. However, the performance and service life of TPCs at present are threatened by overheating damage caused by dielectric loss. Here, a cooperative optimization strategy of microstructure control and superparaelectric regional regulation is proposed to simultaneously achieve excellent energy storage performance and real-time temperature monitoring function in NaNbO3-based ceramics. By introducing aliovalent ions and oxides with large bandgap energy, the size of polar nanoregions is continuously reduced. Due to the combined effect of increased relaxor behavior and fine grains, excellent comprehensive performances are obtained through doping appropriate amounts of Bi, Yb, Tm, and Zr, Ta, Hf in A- and B-sites of the NaNbO3 matrix, including recoverable energy storage density (5.39 J cm-3), extremely high energy storage efficiency (91.97%), ultra-fast discharge time (29 ns), and superior optical transmittance (≈47.5% at 736 nm). Additionally, the phenomenon of abnormal fluorescent negative thermal expansion is realized due to activation mechanism of surface phonon at high temperatures that can promote the formation of [Yb···O]-Tm3+ pairs, showing great potential in real-time temperature monitoring of TPCs. This research provides ideas for developing electronic devices with multiple functionalities.

First Report of Neofusicoccum parvum Causing Fruit Rot on Psidium guajava in China.

Guava (Psidium guajava L.), a nutrient-rich and economically significant fruit, is extensively cultivated in southern China. In six continuous years (from 2018 to 2023), dark-purple rotted guava with sunken lesion were observed on guava trees (variety 'Zhenzhu', aged over 5 years) in Dongguan and Panyu districts, Guangdong Province. Annually, the incidence of fruit rot disease in the affected fields reached 30% to 50% and significantly reduced the yield and quality of harvest guava. The initial symptoms on the epicarp of the fruits were black, needle-like dots that rapidly spread, causing partial or complete fruit rot within two to three weeks. To identify the causative agent, six symptomatic fruits were collected from two different orchards. Samples of 0.5 cm³ were excised from the lesion margins of each fruit. These samples were surface-sterilized with 70% ethanol for 30 seconds, followed by 0.2% NaClO for 2-3 minutes, and rinsed in sterile water three times. The samples were then cultured on potato dextrose agar (PDA) at 25°C for five days. This process yielded eight fungal isolates with similar morphological. Initially, the colonies were white with dense aerial mycelium becoming dark gray after 4 to 5 days. The mycelia were septate and branched. No spores were observed on PDA. To induce spore formation, the isolates were cultured on water agar for 20 days. This process led to the production of hyaline, aseptate, ellipsoid conidia, which were thin-walled, smooth-surfaced, and measured 3.7-5.1 × 1.6-2.2 µm (n = 100). Three isolates, including at least one from each orchard (Np1, Np2, Np3), were selected for further analysis. Genomic DNA was extracted using Axygen MAG-FRAG-I-50 (Axygen Bio-Tek). The internal transcribed spacer of rDNAs (ITS), beta-tubulin (tub2), the nuclear ribosomal large subunit (LSU), and translation elongation factor 1-α (tef1-α) gene regions were amplified using the primers ITS1/4, Bt2a/Bt2b, LR5/LR0R, and EF1-728F/EF1-986R (Golzar and Burgess 2011) and sequenced. Sequence analysis using MEGA 7.0 (Kumar et al., 2018) revealed 100% similarity among the isolates. BLAST searches of the ITS, tub2, LSU, and tef1-α sequences (accession nos. MN907637, MT537938, MT528156, MT537939) showed the highest nucleotide similarities (99.24 to 100%) to Neofusicoccum parvum strains (Crous et al. 2006). A phylogenetic tree was constructed with MEGA 7.0 based on the nucleotide sequence tub2 using the maximum likelihood method. Pathogenicity tests on 10 healthy guava fruits using mycelium-inoculated and control fruits confirmed the causative agent. The inoculated fruits, maintained at 25°C under a 12-h light/dark cycle, exhibited symptoms identical to the field infections within four to seven days, while control fruits remained symptomless. The fungus, reisolated from the inoculated fruits, was morphologically identical to the original isolates, fulfilling Koch's postulates. In conclusion, based on molecular, morphological, and pathogenic analysis, N. parvum as the causal agent of the fruit rot disease on guava. Previously, N. parvum has been reported in association with fruit rot on Eriobotrya japonica and Juglans regia (Zhai et al. 2019; Chen et al. 2019). To our knowledge, this is the first report of N. parvum affecting guava in China.

First Report of Coptis Wilt Disease Caused by Plectosphaerella cucumerina in China.

Coptis (Coptis chinensis) belongs to the Ranunculaceae family, the rhizomes used in traditional Chinese medicine. Since 2021, an uncommon stem and leaf wilt disease, with an average disease incidence of 70%~90%, has been observed in Guangdong and Guangxi provinces. The early wilt symptoms were observed on older leaves and stems, and the whole seedling wilted and died. The rhizome of the diseased seedlings changed in color, became necrotic, and rotted. Symptomatic roots and stems were surface-sterilized with 70% ethanol for 30 s, followed by 0.2% NaClO for 2-3 min, rinsed in sterile water three times, and then placed on potato dextrose agar (PDA) at 25℃for 14 days. Fungal growth was observed, and six isolates with similar morphology were obtained. The 14-day-old colonies on PDA were buff with few aerial hyphae and slimy surfaces. Aerial hyphae were sparse with simple or branched conidiophores. Conidia were hyaline, smooth, ovoid, septate or aseptate, and 5.77 to 9.53 × 2.15 to 3.32 µm (n = 50). Three of the six isolates were subjected to further analysis. The genomic DNA of three isolates (CCF1-1, CCF1-2, CCF1-3) was extracted using Axygen MAG-FRAG- I-50 (Axygen Bio-Tek) for molecular identification. Partial sequences of the internal transcribed spacer of rDNA (ITS) and large subunit rDNA (LSU) were amplified using the primers ITS1/4 and LR5F/LROR, respectively (Vilgalys and Hester 1990). Their sequences were aligned by MEGA X (Kumar et al., 2018), and the sequences of each region showed 100% sequence similarity among our isolates. A BLAST search of ITS and LSU sequences (accession nos. ON377369, ON428244) showed that both regions had the highest nucleotide similarities (99.43 to 99.89%) to the Plectosphaerella cucumerina strains. Based on morphological and molecular analyses, the isolates were identified as P. cucumerina (Palm et al. 1995). The pathogenicity of our isolates CCF1-1, CCF1-2, CCF1-3 was tested on ten 2-month-old healthy seedlings of coptis, respectively. For the seedlings, 30 ml of fungal conidial suspension (1×106 conidia/ml) or sterile water, as control, were poured into their root area. Conidia suspension were prepared from 14-day-old cultures on PDA by eluting with sterilized water. The seedlings were incubated at 25°C and 75% relative humidity under a 12-h/12-h light/dark cycle. The test was repeated three times. After 20 days, only seedlings inoculated with P. cucumerina exhibited symptoms similar to those diseased seedlings in the field. The control seedling had no symptoms. The morphologically similar fungus was re-isolated from the tested seedlings, thus fulfilling Koch's postulates. Based on molecular, morphological, and pathogenic properties, P. cucumerina is the causal fungal pathogen of coptis wilt disease. Previously, P. cucumerina has been related to wilt disease in strawberry and Chinese cabbage (Yang et al. 2023; Gao et al. 2022), but to our knowledge, this is the first report of P. cucumerina causing wilt disease on coptis in China. Coptis wilt disease tends to occur in a warm and rainy environment, and strengthening the detection and quarantine of seedlings is the key to preventing the occurrence and spread of the disease.

Gradient-Structured Ceramics with High Energy Storage Performance and Excellent Stability.

Owing to the high power density, eco-friendly, and outstanding stability, the lead-free ceramics have attracted great interest in the fields of pulsed power systems. Nevertheless, the low energy storage density of such ceramics is undoubtedly a severe problem in practical applications. To overcome this limitation, the lead-free ceramics with gradient structures are designed and fabricated using the tape-casting method herein. By optimizing the composition and distribution of the gradient-structured ceramics, the energy storage density, and efficiency can be improved simultaneously. Under a moderate electric field of 320 kV cm-1 , the value of recoverable energy storage density (Wrec ) is higher than 4 J cm-3 , and the energy storage efficiency (η) is of ≥88% for 20-5-20 and 20-10-20. Furthermore, the gradient-structured ceramics of 20-10-0-10-20 and 20-15-0-15-20 possess high applied electric field, large maximum polarization, and small remnant polarization, which give rise to ultrahigh Wrec and η on the order of ≈6.5 J cm-3 and 89-90%, respectively. In addition, the energy storage density and efficiency also exhibit excellent stability over a broad range of frequencies, temperatures, and cycling numbers. This work provides an effective strategy for improving the energy storage capability of eco-friendly ceramics.

Synergistic Optimization of Energy Storage Density of PYN-Based Antiferroelectric Ceramics by Composition Design and Microstructure Engineering.

PbYb0.5 Nb0.5 O3 (PYN)-based ceramics, featured by their ultra-high phase-switching field and low sintering temperature (950 °C), are of great potential in exploiting dielectric ceramics with high energy storage density and low preparation cost. However, due to insufficient breakdown strength (BDS), their complete polarization-electric field (P-E) loops are difficult to be obtained. Here, to fully reveal their potential in energy storage, synergistic optimization strategy of composition design with Ba2+ substitution and microstructure engineering via hot-pressing (HP) are adopted in this work. With 2 mol% Ba2+ doping, a recoverable energy storage density (Wrec ) of 10.10 J cm-3 and a discharge energy density (Wdis ) of 8.51 J cm-3 can be obtained, supporting the superior current density (CD ) of 1391.97 A cm-2 and the outstanding power density (PD ) of 417.59 MW cm-2 . In situ characterization methods are utilized here to reveal the unique movement of the B-site ions of PYN-based ceramics under electric field, which is the key factor of the ultra-high phase-switching field. It is also confirmed that microstructure engineering can refine the grain of ceramics and improve BDS. This work strongly demonstrates the potential of PYN-based ceramics in energy storage field and plays a guiding role in the follow-up research.

HLA-DR+ mucosal-associated invariant T cells predict poor prognosis in patients with sepsis: A prospective observational study.

Mucosal-associated invariant T (MAIT) cells are important in antibacterial immune responses; however, during sepsis, they are few in number and exhibit highly activated phenotypes. The relationship between MAIT cells in peripheral blood and the prognosis of sepsis is not well understood. Thus, this study aimed to examine the levels and phenotypes of MAIT cells in early sepsis, evaluate their clinical relevance, and investigate their association with patient prognosis. This prospective observational study enrolled 72 septic patients defined according to the Sepsis 3.0 criteria and 21 healthy controls matched for age and sex. Their peripheral blood samples were used to assay the expression of immune activation (CD69 and HLA-DR) and immune checkpoint (PD-1 and PD-L1) markers on MAIT cells. The systemic inflammatory response syndrome, acute physiology and chronic health evaluation (APACHE) II, and sequential organ failure assessment scores were recorded. Subsequently, the association between MAIT cell characteristics and clinical indicators was assessed using Spearman's rank correlation analysis, and binary logistic regression analysis with a forward stepwise approach assessed independent risk factors for 28-day mortality. We noted a decrease in the percentage of MAIT cells in the patients' peripheral blood, which exhibited an activated phenotype. Besides, HLA-DR+ MAIT cell percentage and the APACHE II score were independently associated with the 28-day mortality and, in combination, were the best indicators of mortality. Thus, the percentage of HLA-DR+ MAIT cells in early sepsis serves as a novel prognostic biomarker for predicting mortality and improves the predictive capacity of the APACHE II score.

Composition and Structure Optimized BiFeO3 -SrTiO3 Lead-Free Ceramics with Ultrahigh Energy Storage Performance.

Dielectric ceramic capacitors have attracted increasing attention as advanced pulsed power devices and modern electronic systems owing to their fast charge/discharge speed and high power density. However, it is challenging to meet the urgent needs of lead-free ceramics with superior energy storage performance in practical applications. Herein, a strategy for the composition and structural modification is proposed to overcome the current challenge. The lead-free ceramics composed of BiFeO3 -SrTiO3 are fabricated. A low hysteresis and high polarization can be achieved via composition optimization. The experimental results and finite element simulations indicate that the two-step sintering method significantly influences the decrease in the grain size and improvement in the breakdown strength (EBDS ). A high EBDS of ≈750 kV cm-1 accompanied by a large maximum polarization (≈40 µC cm-2 ) and negligible remanent polarization (<2 µC cm-2 ) contribute to the ultrahigh energy density and efficiency values of the order of 8.4 J cm-3 and ≈90%, respectively. Both energy density and efficiency exhibit excellent stability over the frequency range of 1-100 Hz and temperatures up to 120 °C, along with the superior power density of 280 MW cm-3 , making the studied BiFeO3 -SrTiO3 ceramics potentially useful for high-power energy storage applications.

Boosting Energy Storage Performance of Lead-Free Ceramics via Layered Structure Optimization Strategy.

Owing to the current global scenario of environmental pollution and the energy crisis, the development of new dielectrics using lead-free ceramics for application in advanced electronic and energy storage systems is essential because of the high power density and excellent stability of such ceramics. Unfortunately, most of them have low breakdown strength and/or low maximum polarization, resulting in low energy density and efficiency. To overcome this limitation here, lead-free ceramics comprising a layered structure are designed and fabricated. By optimizing the distribution of the layered structure, a large maximum polarization and high applied electric field (>500 kV cm-1 ) can be achieved; these result in an ultrahigh recoverable energy storage density (≈7 J cm-3 ) and near ideal energy storage efficiency (≈95%). Furthermore, the energy storage performance without obvious deterioration over a broad range of operating frequencies (1-100 Hz), working temperatures (30-160 °C), and fatigue cycles (1-104 ). In addition, the prepared ceramics exhibit extremely high discharge energy density (4.52 J cm-3 ) and power density (405.50 MW cm-3 ). Here, the results demonstrate that the strategy of layered structure design and optimization is promising for enhancing the energy storage performance of lead-free ceramics.

Nanomaterials Based on Functional Polymers for Sensitizing Cancer Radiotherapy.

Despite being the mainstay treatment for many types of cancer in clinic, radiotherapy is undertaking great challenges in overcoming a series of limitations. Radiosensitizers are promising agents capable of depositing irradiation energy and generating free radicals to enhance the radiosensitivity of tumor cells. Combining radiosensitizers with functional polymer-based nanomaterials holds great potential to improve biodistribution, circulation time, and stability in vivo. The derived polymeric nano-radiosensitizers can significantly improve the efficiency of tumor targeting and radiotherapy, and reduce the side effect to healthy tissues. In this review, an overview of functional polymer-based nanomaterials for radiosensitization in recent years is provided. Particular emphases are given to the action mechanisms, drug loading methods, targeting efficiencies, the impact on therapeutic effects, and biocompatibility of various radiosensitizing polymers, which are classified as polymeric micelles, dendrimers, polymeric nanospheres, nanoscale coordination polymers, polymersomes, and nanogels. The challenges and outlooks of polymeric nano-radiosensitizers are also discussed.

Inhibition of Phosphoinositide 3-Kinase Gamma Protects Endothelial Cells via the Akt Signaling Pathway in Sepsis-Induced Acute Kidney Injury.

INTRODUCTION: Sepsis is a primary cause of death in critically ill patients and is characterized by multiple organ dysfunction, including sepsis-induced acute kidney injury (AKI), which contributes to high mortality in sepsis. However, its pathophysiological mechanisms remain unclear. The kidney has one of the richest and most diversified endothelial cell populations in the body. This study was designed to investigate the effects of endothelial dysfunction in sepsis-induced AKI and explore possible intervention measures to offer new insight into the pathogenesis and treatment of sepsis-induced AKI. METHODS: The circulating levels of endothelial adhesion molecules were detected in patients with sepsis and healthy controls to observe the role of endothelial damage in sepsis and sepsis-induced AKI. A murine sepsis model induced by cecal ligation and perforation was pretreated with a phosphoinositide 3-kinase gamma (PI3Kγ) inhibitor (CZC24832), and survival, kidney damage, and renal endothelial injury were assessed by pathological examination, immunohistochemistry, quantitative polymerase chain reaction, and Western blotting. Lipopolysaccharides and CZC24832 were administered to human umbilical vein endothelial cells in vitro, and endothelial cell function and the expression of adhesion molecules were evaluated. RESULTS: Endothelial damage was more serious in sepsis-induced AKI than that in non-AKI, and the inhibition of PI3Kγ alleviates renal endothelial injury in a murine sepsis model, protecting endothelial cell function and repairing endothelial cell injury through the Akt signaling pathway. CONCLUSIONS: In this study, endothelial cell dysfunction plays an important role in sepsis-induced AKI, and the inhibition of PI3Kγ alleviates endothelial cell injury in sepsis-induced AKI through the PI3Kγ/Akt pathway, providing novel targets for treating sepsis and related kidney injury.

Sites and Causes of Infection in Patients with Sepsis-Associated Liver Dysfunction: A Population Study from the Medical Information Mart for Intensive Care III.

BACKGROUND Little is known about the relationship between the site of infection, type of pathogen, and the occurrence of sepsis-associated liver dysfunction (SALD). This population study aimed to identify the sites and types of infection in SALD patients. MATERIAL AND METHODS We conducted a retrospective observational study using the Medical Information Mart for Intensive Care III. Patients with sepsis were divided into a SALD group and a control group. We evaluated the effect of the location of culture-positive specimens and the distribution of pathogens on the occurrence of SALD and then compared the clinical outcomes. RESULTS A total of 14 596 admissions were included, and the incidence of SALD was 11.96%. Positive bile culture (odds ratio [OR] 7.450, P<0.001), peritoneal fluid culture (OR 3.616, P<0.001), and blood culture (OR 1.957, P<0.001) were correlated with the occurrence of SALD. Infection with Enterococcus faecium (OR 3.065, P<0.001), Bacteroides fragilis (OR 2.061, P<0.001), Klebsiella oxytoca (OR 2.066, P<0.001), Enterobacter aerogenes (OR 1.92, P=0.001), and Aspergillus fumigatus (OR 2.144, P=0.001) were correlated with the occurrence of SALD. The Intensive Care Unit mortality and hospital mortality were higher in the SALD group than in the control group (24.7% vs 9.0%, P<0.001; 34.2% vs 13.8%, P<0.001, respectively). CONCLUSIONS SALD should be considered for patients with sepsis whose infection site is the biliary system, abdominal cavity, or blood and the pathogen is Enterococcus faecium, B. fragilis, K. oxytoca, Enterobacter aerogenes, or A. fumigatus. When SALD occurs in patients with sepsis, the above infection sites and pathogens should be considered first.

Perceptions of workplace heat exposure and adaption behaviors among Chinese construction workers in the context of climate change.

BACKGROUND: Workplace heat exposure can cause a series of heat-related illnesses and injuries. Protecting workers especially those undertake work outdoors from the risk of heat strain is a great challenge for many workplaces in China under the context of climate change. The aim of this study is to investigate the perceptions and adaptation behaviors of heat exposure among construction workers and to provide evidence for the development of targeted heat adaptation strategies nationally and internationally. METHODS: In 2020, we conducted a cross-sectional online questionnaire survey via WeChat Survey Star in China, using a purposive snowball sampling approach. A total of 326 construction workers submitted completed questionnaires. The perceptions of workplace heat exposure were measured using seven indicators: concerns over high temperature, perception of high temperature injury, attitudes towards both heat-related training and regulations, adjustment of working habits during heat, heat prevention measures in the workplace, and reduction of work efficiency. Bivariate and multivariate regression analyses were used to identify the factors significantly associated with workers' heat perceptions and behavioral responses. RESULTS: 33.3% of the respondents were moderately or very concerned about heat exposure in the workplace. Less than half of the workers (43.8%) were worried about heat-related injuries. Workers who have either experienced work-related injuries (OR = 1.30, 95% CI 1.03-1.62) or witnessed injuries to others during high temperatures (OR = 1.12, 95% CI 1.02-1.27) were more concerned about heat exposure compared to other workers. Most respondents (63.5%) stated that their work efficiency declined during extremely hot weather. The factors significantly associated with a reduction of work efficiency included undertaking physically demanding jobs (OR = 1.28, 95% CI 1.07-1.54) and witnessing other workers' injuries during high temperatures (OR = 1.26, 95% CI 1.11-1.43). More than half of the workers were willing to adjust their work habits to adapt to the impact of high temperatures (81.6%). The internet was the most common method to obtain heat prevention information (44.7%), and the most frequently used heat prevention measure was the provision of cool drinking water (64.8%). CONCLUSIONS: Chinese construction workers lack heat risk awareness and are not well prepared for the likely increasing heat exposure in the workplace due to global warming. Therefore, there is a need to improve their awareness of heat-related injuries, strengthen high temperature related education and training, and update the current heat prevention policies to ensure compliance and implementation.

Manual exchange transfusion for severe imported falciparum malaria: a retrospective study.

BACKGROUND: This study was designed to evaluate the efficacy of exchange transfusion in patients with severe imported falciparum malaria. Twelve patients who met the diagnostic criteria for severe malaria were treated with exchange transfusion 14 times according to a conventional anti-malarial treatment. This study evaluated the efficacy of exchange transfusion for severe imported falciparum malaria. METHODS: Clinical data of severe imported falciparum malaria patients admitted to the intensive care unit (ICU) of Nantong Third People's Hospital from January 2007 to December 2016 were investigated in this retrospective study. Patients were divided into the intervention group, which received exchange transfusion, and the control group. This study assessed parasite clearance and outcomes of the two groups, and levels of erythrocytes, haemoglobin, platelets, coagulation, liver function, lactate, C-reactive protein, and procalcitonin, before and after exchange transfusion in the intervention group. RESULTS: There was no significant difference in the severity of admitted patients. Exchange transfusion was successfully applied 14 times in the intervention group. Differences in the levels of erythrocytes, haemoglobin and platelets did not reach statistical significance. Exchange transfusion improved coagulation, liver function, lactic acid, C-reactive protein, and procalcitonin. No differences were observed in parasite clearance, ICU and hospital length of stay, in-hospital mortality, and costs of hospitalization between the two groups. CONCLUSION: Exchange transfusion as adjunctive therapy for severe malaria was observed to be safe in this setting. Exchange transfusion can improve liver function and coagulation and reduce inflammation, but it failed to improve parasite clearance and the outcomes of severe imported falciparum malaria in this case series.

Protective effects of intestinal trefoil factor (ITF) on gastric mucosal epithelium through activation of extracellular signal-regulated kinase 1/2 (ERK1/2).

The rapid repair of gastric mucosa is critical upon exposure to injurious agents. Intestinal trefoil factor (ITF) is a member of the trefoil factor family domain peptides, which play an important role in the cytoprotection of gastric epithelium. However, the underlying molecular mechanisms that are responsible for ITF-induced gastric epithelial repair remain unclear. In the present study, we demonstrate that ITF enhances the proliferation and migration of GES-1 gastric endothelial cells in a dose- and time-dependent manner through the activation of extracellular signal-regulated kinase 1/2 (ERK1/2). Furthermore, the ITF-mediated protection of GES-1 cells from a NS398 (nonsteroidal anti-inflammatory drug) was dependent on the ERK1/2 signaling pathway. Taken together, the results provide a mechanistic explanation for ITF-mediated protection of gastric epithelial mucosa cells, suggesting that activation of the ERK1/2 signaling pathway may provide a new therapeutic strategy for repairing gastric injury.

The Predictive Effect of Quantitative Analysis of Signal Intensity Heterogeneity on T2-Weighted MR Images for High-intensity Focused Ultrasound Treatment of Uterine Fibroids.

RATIONALE AND OBJECTIVES: To investigate whether the quantitative index of signal intensity (SI) heterogeneity on T2-weighted (T2W) magnetic resonance images can predict the difficulty and efficacy of high-intensity focused ultrasound (HIFU) ablation for uterine fibroids. MATERIALS AND METHODS: The standard deviation (SD) of T2W image (T2WI) SI was used to quantify SI heterogeneity. The correlation between SD and the non-perfused volume ratio (NPVR) in 575 patients undergoing HIFU treatment was retrospectively analyzed, and the efficacy of SD in predicting NPVR was discussed. Three classifications were made based on the SD, and the ablation difficulty and ablation effect of different grades were compared. A total of 65 cases from another center were used as an external validation set to verify the classification performance of SD. RESULTS: The SD of SI was negatively correlated with NPVR (r = -0.460, p < 0.001). The predictive efficiency of SD for the ablation effect was higher than that of the scaled signal intensity (0.767 vs. 0.701, p = 0.006). Univariate and multivariate logistic regression analyses showed that SD was an independent predictor of ablation effect. Based on SD, the three classifications were divided into SD I: SD < 101.0, SD II: 101.0 ≤ SD < 138.7, and SD III: SD≥ 138.7. The treatment time, sonication time, treatment intensity, and total energy of SD I were lower than those of SD II and III (p < 0.05). CONCLUSION: The heterogeneity of T2WI SI of uterine fibroids is negatively correlated with NPVR. The SD of SI can be used to predict the ablation difficulty and ablation effect of HIFU.

Achieving Ultrahigh Electrocaloric Response in (Bi0.5Na0.5)TiO3-Based Ceramics through B-Site Defect Engineering.

Lead-free electrocaloric (EC) ferroelectrics are considered ideal for the next generation of environmentally friendly solid-state refrigeration materials. However, their inferior performance compared to lead-based materials significantly restricts their potential application. According to phase-field simulations, it is predicted that the pinning effect of a moderate number of defects can effectively enhance the reversible polarization response associated with the entropy change. Herein, sodium-bismuth titanate (BNT) ceramics with high spontaneous polarization are selected to construct B-site defects by introducing Li+ and Nb5+. Under an electric field of 6 kV mm-1, ultrahigh EC temperature changes of ΔTpos = 1.77 and ΔTneg = 1.49 K are achieved at 65 °C by direct measurement (ΔTneg > 1 K over 55-120 °C). Furthermore, ΔTneg remains above 0.70 K in the temperature range from 25 to 130 °C, exhibiting immense potential for practical applications. This study offers a promising direction for optimizing the EC response in defect systems.

Multiscale reconfiguration induced highly saturated poling in lead-free piezoceramics for giant energy conversion.

The development of high-performance lead-free K0.5Na0.5NbO3-based piezoceramics for replacing commercial lead-containing counterparts is crucial for achieving environmentally sustainable society. Although the proposed new phase boundaries (NPB) can effectively improve the piezoelectricity of KNN-based ceramics, the difficulty of achieving saturated poling and the underlying multiscale structures resolution of their complex microstructures are urgent issues. Here, we employ a medium entropy strategy to design NPB and utilize texture engineering to induce crystal orientation. The developed K0.5Na0.5NbO3-based ceramics enjoys both prominent piezoelectric performance and satisfactory Curie temperature, thus exhibiting an ultrahigh energy harvesting performance as well as excellent transducer performance, which is highly competitive in both lead-free and lead-based piezoceramics. Comprehensive structural analysis have ascertained that the field-induced efficient multiscale polarization configurations irreversible transitions greatly encourages high saturated poling. This study demonstrates a strategy for designing high-performance piezoceramics and establishes a close correlation between the piezoelectricty and the underlying multiscale structures.

Successful treatment of veno-arterial extracorporeal membrane oxygenation complicated with left ventricular thrombus by intravenous thrombolysis: A case report.

BACKGROUND: Left ventricular thrombus is a rare condition, for which appropriate treatments are not extensively studied. Although it can be treated by thrombectomy, such surgery can be difficult and risky, and not every patient can tolerate the surgery. CASE SUMMARY: We report a case of a middle-aged man receiving veno-arterial extracorporeal membrane oxygenation (VA-ECMO) for acute myocardial infarction who developed left ventricular thrombus despite systemic anticoagulation. After systemic thrombolysis with urokinase, the left ventricular thrombus disappeared, ECMO was successfully withdrawn 9 days later, and the patient recovered and was discharged from hospital. CONCLUSION: Systemic thrombolysis is a treatment option for left ventricular thrombus in addition to anticoagulation and thrombectomy.