Optimal Fully Actuated System Approach-Based Trajectory Tracking Control for Robot Manipulators.

In this article, a trajectory tracking control strategy is proposed for robot manipulators via a fully actuated system (FAS) approach, which has shown its simplicity and flexibility for most of the nonlinear controller design. However, the motion control for robot manipulators is more complicated since unknown dynamical model, external disturbances, friction forces, and various physical constraints are required to be considered. Therefore, the FAS approach cannot be straightforwardly applied. To address these challenges, the dynamic model of robot manipulators is established via model identification methods. Furthermore, based on the identified model, an FAS composite control strategy with simple structure is designed, which is achieved by integrating a high-order disturbance observer (HODO) in the inner loop, with an FAS trajectory tracking controller in the outer loop. Specifically, the HODO is utilized for handling the uncertain dynamics and external disturbances. Moreover, the controller gains are optimized using a gradient-based optimal parameter tuning method (OPTM). By imposing joint angle constraints, joint angular velocity constraints, and input torque limits into the formulation, the OPTM also ensures the satisfaction of these physical constraints. Numerical simulations and experiments are provided to validate the performance of the proposed controller.

Advancements in microbial-mediated radioactive waste bioremediation: A review.

The global production of radioactive wastes is expected to increase in the coming years as more countries have resorted to adopting nuclear power to decrease their reliance on fossil-fuel-generated energy. Discoveries of remediation methods that can remove radionuclides from radioactive wastes, including those discharged to the environment, are therefore vital to reduce risks-upon-exposure radionuclides posed to humans and wildlife. Among various remediation approaches available, microbe-mediated radionuclide remediation have limited reviews regarding their advances. This review provides an overview of the sources and existing classification of radioactive wastes, followed by a brief introduction to existing radionuclide remediation (physical, chemical, and electrochemical) approaches. Microbe-mediated radionuclide remediation (bacterial, myco-, and phycoremediation) is then extensively discussed. Bacterial remediation involves biological processes like bioreduction, biosorption, and bioprecipitation. Bioreduction involves the reduction of water-soluble, mobile radionuclides to water-insoluble, immobile lower oxidation states by ferric iron-reducing, sulfate-reducing, and certain extremophilic bacteria, and in situ remediation has become possible by adding electron donors to contaminated waters to enrich indigenous iron- and sulfate-reducing bacteria populations. In biosorption, radionuclides are associated with functional groups on the microbial cell surface, followed by getting reduced to immobilized forms or precipitated intracellularly or extracellularly. Myco- and phycoremediation often involve processes like biosorption and bioaccumulation, where the former is influenced by pH and cell concentration. A Strengths, Weaknesses, Opportunities, and Threats (SWOT) analysis on microbial remediation is also performed. It is suggested that two research directions: genetic engineering of radiation-resistant microorganisms and co-application of microbe-mediated remediation with other remediation methods could potentially result in the discovery of in situ or ex situ microbe-involving radioactive waste remediation applications with high practicability. Finally, a comparison between the strengths and weaknesses of each approach is provided.

Fine-Scale Aerosol-Jet Printing of Luminescent Metal-Organic Framework Nanosheets.

Fabrication of metal-organic framework (MOF) thin films is an ongoing challenge to achieve effective device integration. Inkjet printing has been employed to print various luminescent metal-organic framework (MOF) films. Luminescent metal-organic nanosheets (LMONs), nanometer-thin particles of MOF materials with comparatively large micrometer lateral dimensions, provide an ideal morphology that offers enhancements over analogous MOFs in luminescent properties such as intensity and photoluminescent quantum yield. The morphology is also better suited to the formation of thin films. This work harnesses the preferential features of LMONs to access the advanced technique of aerosol-jet printing (AJP) to print luminescent films with precise geometries and patterns across the micrometer and centimeter length scales. AJP of LMONs exhibiting red (R), green (G), and blue (B) emission were studied systematically to reveal the increase of luminescence upon additive layering printing until a threshold was reached limited by self-quenching. By combining different LMON emitters, emission chromaticity and intensity were shown to be tunable, including the combination of RGB emitters to fabricate white-light-emitting films. A white-light LMON film was printed onto a UV light emitting diode (LED), producing a working white-light-emitting diode. Printing with multiple distinct photoluminescent inks produced intricate multicolor patterns that dynamically responded to excitation wavelength, acting either as micrometer-scale LED-type cells or larger visual tags. Collectively, the work offers an advancement for MOF thin films by printing MON materials using AJP, offering a precise method for manufacturing a wide range of critical functional devices, from luminescent sensors to optoelectronics, and more broadly even the opportunity for printed circuitry with conductive MONs.

Exploring vision transformers for classifying early Barrett's dysplasia in endoscopic images: A pilot study on white-light and narrow-band imaging.

Background and Aim: Various deep learning models, based on convolutional neural network (CNN), have been shown to improve the detection of early esophageal neoplasia in Barrett's esophagus. Vision transformer (ViT), derived from natural language processing, has emerged as the new state-of-the-art for image recognition, outperforming predecessors such as CNN. This pilot study explores the use of ViT to classify the presence or absence of early esophageal neoplasia in endoscopic images of Barrett's esophagus. Methods: A BO dataset of 1918 images of Barrett's esophagus from 267 unique patients was used. The images were classified as dysplastic (D-BO) or non-dysplastic (ND-BO). A pretrained vision transformer model, ViTBase16, was used to develop our classifier models. Three ViT models were developed for comparison based on imaging modality: white-light imaging (WLI), narrow-band imaging (NBI), and combined modalities. Performance of each model was evaluated based on accuracy, sensitivity, specificity, confusion matrices, and receiver operating characteristic curves. Results: The ViT models demonstrated the following performance: WLI-ViT (Accuracy: 92%, Sensitivity: 82%, Specificity: 95%), NBI-ViT (Accuracy: 99%, Sensitivity: 97%, Specificity: 99%), and combined modalities-ViT (Accuracy: 93%, Sensitivity: 87%, Specificity: 95%). Combined modalities-ViT showed greater accuracy (94% vs 90%) and sensitivity (80% vs 70%) compared with WLI-ViT when classifying WLI images on a subgroup testing set. Conclusion: ViT exhibited high accuracy in classifying the presence or absence of EON in endoscopic images of Barrett's esophagus. ViT has the potential to be widely applicable to other endoscopic diagnoses of gastrointestinal diseases.

Exploring the Photophysical and Mechanical Behavior of Fluorescent Metal-Organic Framework Monoliths.

Luminescent metal-organic frameworks exhibit great potential as materials for nanophotonic applications because of their programmable properties and tunable structures. In particular, luminescent guests (LG) can be hosted by metal-organic frameworks due to their porosity and guest confinement capacity, forming LG@MOF composite systems. However, such guest-host systems are mainly produced as loose powders, preventing their widespread use in practical devices and technological applications that require implementation of a stable continuum solid. In this regard, using monolithic MOF hosts might be a workable option to solve this challenge. Herein, we reported the facile synthesis and fabrication of novel prototypical sol-gel monolithic systems, designated as LG@monoMOF. Red (rhodamine B), blue (7-methoxycoumarin), and yellow (fluorescein) emitting dyes were encapsulated in a robust UiO-66 monolithic host, resulting in the red, blue, and yellow light-emitting luminescent monoliths. The mechanical and photophysical characterization of the three LG@monoMOF systems was systematically carried out in order to unravel the role of guest-host interactions in the mechanical and optical response of the bespoke LG@monoMOF composites.

Intensive investigation of the synergistic effects between electrocatalysis and peroxymonosulfate activation for efficient organic elimination.

Hybrid systems combined eletrocatalysis and Fenton-like process attract a lot of attention due their outstanding performance and unique mechanism. Here, we proposed an efficient, cost-effective, and versatile electrochemical activation (ECA) system for efficient water purification, and intensively studied the synergistic effects between electrocatalysis and peroxymonosulfate (PMS)-based advanced oxidation. The ECA system achieved complete removal of 20 ppm tetracycline hydrochloride (TCH) in 15 min, with a rate constant of 0.338 min-1. Its performance was assessed across various operational parameters (PMS dosage, pH, applied voltage, electrode interval, temperature, co-existed ions, biomass, different oxidants), demonstrating its broad applicability and stability. Excellent degradation and mineralization for other 12 kinds of refractory organic pollutants were also achieved. The outstanding performance can be attributed to the synergistic effect in the system, in which electrocatalytic reduction of dissolved oxygen generated H2O2 and O2•-, boosting the number of reactive species, such as 1O2, by interacting with PMS. Furthermore, the presence of organic matter promotes electron transfer, amplifying the system's degradation capability. These findings not only highlight the ECA system's effectiveness in organic pollutant removal but also offer insights into the underlying degradation mechanisms, paving the way for future advancements in water purification technologies.

Modular synthesis of aryl amines from 3-alkynyl-2-pyrones.

The synthesis of aryl amines from 3-alkynyl-2-pyrones and various amines is described. Mechanistically, the aryl amines are proposed to arise from the 3-alkynyl-2-pyrone substrates through their selective opening in a 1,6-fashion by secondary amines followed by decarboxylation and an unexpected rearrangement. The proposed mechanism is supported by quantum chemical transition-state calculations, which are consistent with the regiochemical outcome. The scope of this transformation spans a variety of 3-alkynyl-2-pyrones and a range of secondary amines. The influence of the secondary amine coupling partners on reaction efficiency was elucidated through data-driven modeling as well as scope exploration. These latter studies revealed that the steric bulk of the secondary amine coupling partner under the reaction conditions serves as a strong indicator of overall reaction efficiency.

Water sorption studies with mesoporous multivariate monoliths based on UiO-66.

Hierarchical linker thermolysis has been used to enhance the porosity of monolithic UiO-66-based metal-organic frameworks (MOFs) containing 30 wt% 2-aminoterephthalic acid (BDC-NH2) linker. In this multivariate (i.e. mixed-linker) MOF, the thermolabile BDC-NH2 linker decomposed at ∼350 °C, inducing mesopore formation. The nitrogen sorption of these monolithic MOFs was probed, and an increase in gas uptake of more than 200 cm3 g-1 was observed after activation by heating, together with an increase in pore volume and mean pore width, indicating the creation of mesopores. Water sorption studies were conducted on these monoliths to explore their performance in that context. Before heating, monoUiO-66-NH2-30%-B showed maximum water vapour uptake of 61.0 wt%, which exceeded that reported for either parent monolith, while the highly mesoporous monolith (monoUiO-66-NH2-30%-A) had a lower maximum water vapour uptake of 36.2 wt%. This work extends the idea of hierarchical linker thermolysis, which has been applied to powder MOFs, to monolithic MOFs for the first time and supports the theory that it can enhance pore sizes in these materials. It also demonstrates the importance of hydrophilic functional groups (in this case, NH2) for improving water uptake in materials.

Catalytic undirected methylation of unactivated C(sp3)-H bonds suitable for complex molecules.

In pharmaceutical discovery, the "magic methyl" effect describes a substantial improvement in the pharmacological properties of a drug candidate with the incorporation of methyl groups. Therefore, to expedite the synthesis of methylated drug analogs, late-stage, undirected methylations of C(sp3)-H bonds in complex molecules would be valuable. However, current methods for site-selective methylations are limited to activated C(sp3)-H bonds. Here we describe a site-selective, undirected methylation of unactivated C(sp3)-H bonds, enabled by photochemically activated peroxides and a nickel(II) complex whose turnover is enhanced by an ancillary ligand. The methodology displays compatibility with a wide range of functional groups and a high selectivity for tertiary C-H bonds, making it suitable for the late-stage methylation of complex organic compounds that contain multiple alkyl C-H bonds, such as terpene natural products, peptides, and active pharmaceutical ingredients. Overall, this method provides a synthetic tool to explore the "magic methyl" effect in drug discovery.

Early Occipitocervical Fusion Surgery in a Rare Clinical Encounter of Non-traumatic Atlantooccipital Subluxation (AOS) in Down Syndrome (Trisomy 21).

Subluxation of the atlantooccipital joint in patients with underlying Down syndrome is an extremely rare orthopedic condition. The condition can pose life-threatening risks if not promptly diagnosed and treated in the early stage. Yet, there have been documented cases of survival following atlantooccipital subluxation or dislocation. Atlantooccipital subluxation (AOS) is usually identified during screening in children with Down syndrome for atlantoaxial subluxation (AAS). Therefore, careful evaluation of the atlantooccipital joint from radiographs is also essential. It is crucial to emphasize the clinical significance of AOS. Here the authors present the case of a fifteen-year-old girl with underlying Down syndrome (trisomy 21) who survived a sudden onset of non-traumatic atlantooccipital subluxation with spinal cord compression. There are only a few cases were reported in patients with Down syndrome (trisomy 21) and only two cases with surgically treated atlantooccipital (C0C1) subluxation have been reported. This case is of particular interest as it represents the first reported case of atlantooccipital (C0C1) subluxation with spinal cord compression in Down syndrome that underwent occipitocervical fusion surgery during the acute presentation, resulting in significant neurological recovery. Her neurology symptoms and physical functions showed remarkable improvement post-surgery, and she is doing well at the one-year follow-up in the clinic. Early surgery during acute presentation in this case resulted in good surgical outcomes and improved patient quality of life.

Easily overlooked petiole traits are key factors that affect soil carbon sequestration in plantations in karst areas.

Vegetation restoration in karst areas has shifted from expanding planting areas to the collective enhancement of various ecological functions, especially carbon sequestration. Identifying and regulating key plant functional traits involved in the carbon cycle is an effective approach to increase carbon sequestration. However, reports on the significant contribution of petiole traits to the carbon cycle are scarce. Eucalyptus globulus and Bauhinia purpurea plantations in Liujiang river basin were investigated in this study. Petiole traits, understory characteristics, and soil organic carbon have been measured. The aim is to explore key effect of petiole traits for increasing soil carbon sequestration and to provide scientific evidence for the high-quality development of plantations in karst areas. The results indicate that in Eucalyptus globulus plantations, when the understory vegetation coverage is below 50 %, petioles tend to elongate rather than thicken, leading to an increase in specific petiole length. In Bauhinia purpurea plantations, petioles consistently tend to increase diameter. However, when specific leaf area decreases, specific petiole length increases. In both plantations, an increase in specific petiole length accelerates leaf shedding. It leads to increased litter accumulation so that soil carbon content increases. In Eucalyptus globulus plantations, to enhance soil carbon sequestration as an ecological goal, it is recommended to keep the soil total nitrogen below 1.20 mg/g, to control understory vegetation coverage below 50 %, and to limit the extension of Bidens pilosa. In Bauhinia purpurea plantations, within 100 m of altitude, the soil total nitrogen can be controlled below 1.00 mg/g to increase soil organic carbon from large leaf shedding due to the increase of specific petiole length. At lower altitudes, increasing soil total nitrogen can enhance understory vegetation coverage, allowing soil organic carbon to originate from both leaf shedding and understory vegetation residues.

Risk of bleeding after abdominal paracentesis in patients with chronic liver disease and coagulopathy: A systematic review and meta-analysis.

Abdominal paracentesis is a common procedure performed for both diagnostic and therapeutic purposes in patients with chronic liver disease and ascites. This review aims to provide an overview of the current evidence on the risk of bleeding associated with abdominal paracentesis. Electronic search was performed using PubMed, MEDLINE, and Ovid EMBASE from inception to 29 October 2023. Studies were included if they examined the risk of bleeding post-abdominal paracentesis or the efficacy of interventions to reduce bleeding in patients with chronic liver disease. Random-effects model was used to calculate the pooled proportions of bleeding events following abdominal paracentesis. Heterogeneity was determined by I 2, τ2 statistics, and P-value. Eight studies were included for review. Six studies reported incident events of post-abdominal paracentesis bleeding. Pooled proportion of bleeding events following abdominal paracentesis was 0.32% (95% CI: 0.15-0.69%). The mean values for pre-procedural INR and platelet count of patients in these studies ranged between 1.4 and 2.0, and 50 and 153 × 109/L, respectively. The highest recorded INR was 8.7, and the lowest platelet count was 19 × 109/L. Major bleeding after abdominal paracentesis occurred in 0-0.97% of the study cohorts. Two studies demonstrated that the use of thromboelastography (TEG) before paracentesis in patients with chronic liver disease identified those at risk of procedure-related bleeding and reduced transfusion requirements. The overall risk of major bleeding after abdominal paracentesis is low in patients with chronic liver disease and coagulopathy. TEG may be used to predict bleeding risk and guide transfusion requirements.

SnF2-Catalyzed Lithiophilic-Lithiophobic Gradient Interface for High-Rate PEO-based All-Solid-State Batteries.

Polyethylene oxide (PEO)-based all solid-state lithium metal batteries (ASSLMBs) are strongly hindered by the fast dendrite growth at the Li metal/electrolyte interface, especially under large rates. The above issue stems from the suboptimal interfacial chemistry and poor Li+ transport kinetics during cycling. Herein, a SnF2-catalyzed lithiophilic-lithiophobic gradient solid electrolyte interphase (SCG-SEI) of LixSny/LiF-Li2O is in-situ formed. The superior ionic LiF-Li2O rich upper layer (17.1 nm) possesses high interfacial energy and fast Li+ diffusion channels, wherein lithiophilic LixSny alloy layer (8.4 nm) could highly reduce the nucleation overpotential with lower diffusion barrier and promote rapid electron transportation for reversible Li+ plating/stripping. Simultaneously, the insoluble SnF2-coordinated PEO promotes the rapid Li+ ion transport in the bulk phase. As a result, an over 46.7 and 3.5 times improvements for lifespan and critical current density of symmetrical cells are achieved, respectively. Furthermore, LiFePO4-based ASSLMBs deliver a recorded cycling performance at 5 C (over 1000 cycles with a capacity retention of 80.0%). More importantly, impressive electrochemical performances and safety tests with LiNi0.8Mn0.1Co0.1O2 and pouch cell with LiFePO4, even under extreme conditions (i.e., 100 ℃), are also demonstrated, reconfirmed the importance of lithiophilic-lithiophobic gradient interfacial chemistry in the design of high-rate ASSLMBs for safety applications.

Novel OX40 and 4-1BB derived spacers enhance CD30 CAR activity and safety in CD30 positive lymphoma models.

The chimeric antigen receptor (CAR) derived from the CD30 specific murine antibody, HRS-3, has produced promising clinical efficacy with a favorable safety profile in the treatment of relapsed or refractory CD30-positive lymphomas. However, persistence of the autologous CAR-T cells was brief, and many patients relapsed a year after treatment. The lack of persistence may be attributed to the use of a wild-type immunoglobulin (Ig)G1 spacer that can associate with Fc receptors. We first identified the cysteine-rich domain (CRD) 5 of CD30 as the primary binding epitope of HRS-3 and armed with this insight, attempted to improve the HRS-3 CAR functionality with a panel of novel spacer designs. We demonstrate that HRS-3 CARs with OX40 and 4-1BB derived spacers exhibited similar anti-tumor efficacy, circumvented interactions with Fc receptors, and secreted lower levels of cytokines in vitro than a CAR employing the IgG1 spacer. Humanization of the HRS-3 scFv coupled with the 4-1BB spacer preserved potent on-target, on-tumor efficacy, and on-target, off-tumor safety. In a lymphoma mouse model of high tumor burden, T cells expressing humanized HRS-3 CD30.CARs with the 4-1BB spacer potently killed tumors with low levels of circulating inflammatory cytokines, providing a promising candidate for future clinical development in the treatment of CD30-positive malignancies.

Psychometric testing of the training needs for advance care planning scale for clinicians and nurses.

BACKGROUND: Studies have shown that Chinese Clinicians and nurses have positive attitudes toward ACP, but no local tools exist to assess their need for ACP knowledge and skills training. resulting in their inability to initiate ACP conversations as well as poor end-of-life care for patients. Therefore, this study aims to assess the needs of Chinese Clinicians and nurses for ACP knowledge and skills training and assess the validity and reliability of a questionnaire on the Training Needs for Advance Care Planning (TNACP) scale. METHODS: From October to November 2021, 170 clinicians and nurses were pre-surveyed using a preliminary draft of the questionnaire. The responses were screened using item analysis, Cronbach's alpha coefficient, and the intraclass correlation coefficient (ICC) to describe the internal consistency and stability of the questionnaire. The Content validity index (CVI), Exploratory factor analysis (EFA) and Confirmatory factor analysis (CFA) were used to test the validity of the questionnaire. RESULTS: After independent samples t-test analysis, Except for the entry "A2", the critical ratio between the two groups of the remaining 23 items was statistically significant (p < 0.05). Based on the above screening methods, the "A2" item was deleted, and the final number of questionnaire items was 23. The I-CVI was 0.79-1.00, and the S-CVI/Ave was 0.90. Three common factors were extracted-the cumulative contribution rate was 69.969%, and the factor loading of all items was 0.506-0.843 (all > 0.40). The results of confirmatory factor analysis showed that the Training Needs for Advance Care Planning (TNACP) scale model fit well(X2/df = 2.504, RMSEA = 0.092, GFI = 0.809, AGFI = 0.745, CFI = 0.931, IFI = 0.932, TLI = 0.916); the Cronbach's α = 0.888 for the total questionnaire, and the three dimensions of Cronbach's α were 0.729 to 0.959; and the ICC for the overall scores between the test-retest evaluations was 0.884 (p < 0.001). CONCLUSIONS: The TNACP scale has good reliability and validity and can be used to assess Chinese Clinicians and nurses' training needs for implementing ACP.

m6A-Mediated IRS1 Regulates the Development of Oral Squamous Cell Carcinoma through p53/Line-1 Signaling.

BACKGROUND: The importance of N6-methyladenosine (m6A) modification in tumorigenesis and progression have been highlighted. This study aimed to investigate the modification of insulin receptor substrate 1 (IRS1) by m6A and its role in oral squamous cell carcinoma (OSCC). METHODS: Bioinformatics was employed to predict differential genes related to epithelial-mesenchymal transition (EMT) in OSCC. Seventeen pairs of OSCC and paracancerous tissue samples were collected. The impact of IRS1 on OSCC cell growth and EMT was evaluated. The fluctuations in IRS1 enrichment and the involvement of p53/Line-1 were investigated. RESULTS: IRS1 was highly expressed in OSCC. IRS1 silencing decreased OSCC cell proliferation and increased apoptosis. IRS1 silencing hindered EMT by regulating related markers. IRS1 silencing upregulated p53 and downregulated Line-1 ORF1p. The p53 inhibition reversed the effects of IRS1 silencing and induced EMT in OSCC cells. Furthermore, the m6A modification of IRS1 was increased in OSCC cells. IRS1 were positively regulated by the m6A regulators methyltransferase-like 14 (METTL14) and YTH domain-containing protein 1 (YTHDC1). IRS1 bound to YTHDC1, and YTHDC1 knockdown inhibited the IRS1 nuclear export. The obesity-associated protein (FTO) negatively regulated IRS1, and FTO overexpression reversed the IRS1-induced OSCC tumor growth. CONCLUSIONS: m6A methylation-mediated IRS1 regulated EMT in OSCC through p53/Line-1. These findings provide potential therapeutic strategies for managing OSCC.

Triboelectric behaviour of selected zeolitic-imidazolate frameworks: exploring chemical, morphological and topological influences.

Tribo- and contact electrification remain poorly understood, baffling and discombobulating scientists for millennia. Despite the technology needed to harvest mechanical energy with triboelectric generators being incredibly rudimentary and the fact that a triboelectric output can be obtained from almost any two material combinations, research into triboelectric generator materials typically focuses on achieving the highest possible output; meanwhile, understanding trends and triboelectric behaviours of related but lower performing materials is often overlooked or not studied. Metal-organic frameworks, a class of typically highly porous and crystalline coordination polymers are excellent media to study to fill this knowledge gap. Their chemistry, topology and morphology can be individually varied while keeping other material properties constant. Here we study 5 closely related zeolitic-imidazolate type metal-organic frameworks for their triboelectric performance and behaviour by contact-separating each one with five counter materials. We elucidate the triboelectric electron transfer behaviour of each material, develop a triboelectric series and characterise the surface potential by Kelvin-probe force microscopy. From our results we draw conclusions on how the chemistry, morphology and topology affect the triboelectric output by testing and characterising our series of frameworks to help better understand triboelectric phenomena.

Cytosolic Escape of Mitochondrial DNA Triggers cGAS-STING Pathway-Dependent Neuronal PANoptosis in Response to Intermittent Hypoxia.

Intermittent hypoxia (IH) is the predominant pathophysiological disturbance in obstructive sleep apnea (OSA), characterized by neuronal cell death and neurocognitive impairment. We focus on the accumulated mitochondrial DNA (mtDNA) in the cytosol, which acts as a damage-associated molecular pattern (DAMP) and activates the cyclic GMP-AMP synthase (cGAS)-stimulator of interferon genes (STING) pathway, a known trigger for immune responses and neuronal death in degenerative diseases. However, the specific role and mechanism of the mtDNA-cGAS-STING axis in IH-induced neural damage remain largely unexplored. Here, we investigated the involvement of PANoptosis, a novel type of programmed cell death linked to cytosolic mtDNA accumulation and the cGAS-STING pathway activation, in neuronal cell death induced by IH. Our study found that PANoptosis occurred in primary cultures of hippocampal neurons and HT22 cell lines exposed to IH. In addition, we discovered that during IH, mtDNA released into the cytoplasm via the mitochondrial permeability transition pore (mPTP) activates the cGAS-STING pathway, exacerbating PANoptosis-associated neuronal death. Pharmacologically inhibiting mPTP opening or depleting mtDNA significantly reduced cGAS-STING pathway activation and PANoptosis in HT22 cells under IH. Moreover, our findings indicated that the cGAS-STING pathway primarily promotes PANoptosis by modulating endoplasmic reticulum (ER) stress. Inhibiting or silencing the cGAS-STING pathway substantially reduced ER stress-mediated neuronal death and PANoptosis, while lentivirus-mediated STING overexpression exacerbated these effects. In summary, our study elucidates that cytosolic escape of mtDNA triggers cGAS-STING pathway-dependent neuronal PANoptosis in response to IH, mainly through regulating ER stress. The discovery of the novel mechanism provides theoretical support for the prevention and treatment of neuronal damage and cognitive impairment in patients with OSA.

Clinical characteristics of delirium in older patients with first-ever acute myocardial infarction who underwent percutaneous coronary intervention : A retrospective study.

OBJECTIVES: Delirium is a serious complication of cardiac surgery and a common clinical problem. The study aimed to identify the incidence, risk factors, and outcomes of delirium in older patients (≥ 65 years) with first-ever acute myocardial infarction (AMI) who underwent percutaneous coronary intervention (PCI). METHODS: A retrospective cohort study was performed in a hospital in northern China. A total of 1033 older patients with first-ever AMI who underwent PCI between January 2018 and April 2021 were screened for delirium using the CAM-ICU method. Clinical and laboratory data were collected. RESULTS: A total of 134 (12.97%) patients were diagnosed with delirium. Patients with delirium were older. The most common concomitant diseases were cardiac arrest, chronic renal failure, and a history of coronary artery bypass graft (CABG). Delirious patients experienced more times of mechanical ventilation, more intra-aortic balloon pump (IABP) support, high postoperative immediate pain score (VAS), more non-bedside cardiac rehabilitation, and longer total length of stay and cardiac care unit (CCU) time. Multivariable logistic regression showed that age, mechanical ventilation, postoperative immediate pain score, and non-bedside cardiac rehabilitation were independently associated with delirium. Delirium was an independent predictor of prolonged CCU stay, total length of stay, and 1­year mortality. CONCLUSION: Age, mechanical ventilation, postoperative immediate pain score, and non-bedside cardiac rehabilitation were independently closely related to delirium in older patients with first-ever AMI who underwent PCI. Delirium was associated with a higher 1­year all-cause mortality.