Characterization of Pancreatic Fistula after Post-pancreatectomy Acute Pancreatitis.

OBJECTIVE: This study aimed to investigate the clinical significance and risk factors of postoperative pancreatic fistula (POPF) after post-pancreatectomy acute pancreatitis (PPAP) in patients who underwent pancreaticoduodenectomy (PD). SUMMARY BACKGROUND DATA: PPAP has been recognized as a critical factor in the pathophysiology of POPF after PD. METHODS: A total of 817 consecutive patients who underwent elective PD between January 2020 and June 2022 were included. PPAP and POPF were defined in accordance with the International Study Group for Pancreatic Surgery (ISGPS) definitions. Multivariate logistic analyses were performed to investigate the risk factors for POPF. Comparisons between PPAP-associated POPF and non-PPAP-associated POPF were made to further characterize this intriguing complication. RESULTS: Overall, 159 (19.5%) patients developed POPF after PD, of which 73 (45.9%) occurred following PPAP, and the remaining 86 (54.1%) had non-PPAP-associated POPF. Patients with PPAP-associated POPF experienced significantly higher morbidity than patients without POPF. Multivariate analyses revealed distinct risk factors for each POPF type. For PPAP-associated POPF, independent risk factors included estimated blood loss >200 mL (OR 1.93), MPD ≤3 cm (OR 2.88), and soft pancreatic texture (OR 2.01), largely overlapping with FRS (Fistula Risk Score) elements. On the other hand, non-PPAP-associated POPF was associated with age >65 years (OR 1.95), male (OR 2.10), and MPD ≤3 cm (OR 2.57). Notably, among patients with PPAP, the incidence of POPF consistently hovered around 50% regardless of the FRS stratification. CONCLUSIONS: PPAP-associated POPF presents as a distinct pathophysiology in the development of POPF after PD, potentially opening doors for future prevention strategies targeting the early postoperative period.

The Effect of Perioperative Dexamethasone on Postoperative Complications After Pancreaticoduodenectomy: A Multicenter Randomized Controlled Trial.

OBJECTIVE: To evaluate the effect of perioperative dexamethasone on postoperative complications after pancreaticoduodenectomy. BACKGROUND: The glucocorticoid dexamethasone has been shown to improve postoperative outcomes in surgical patients, but its effects on postoperative complications after pancreaticoduodenectomy are unclear. METHODS: This multicenter, double-blind, randomized controlled trial was conducted in four Chinese high-volume pancreatic centers. Adults undergoing elective pancreaticoduodenectomy were randomized to receive either 0.2 mg/kg dexamethasone or a saline placebo as an intravenous bolus within 5 minutes after anesthesia induction. The primary outcome was the Comprehensive Complication Index (CCI) score within 30 days after the operation, analyzed using the modified intention-to-treat principle. RESULTS: Among 428 patients for eligibility, 300 participants were randomized and 265 were included in the modified intention-to-treat analyses. One hundred thirty-four patients received dexamethasone and 131 patients received a placebo. The mean (SD) CCI score was 14.0 (17.5) in the dexamethasone group and 17.9 (20.3) in the placebo group (mean difference: -3.8; 95% CI: -8.4 to 0.7; P = 0.100). The incidence of major complications (Clavien-Dindo grade ≥III; 12.7% vs 16.0%, risk ratio: 0.79; 95% CI: 0.44 to 1.43; P = 0.439) and postoperative pancreatic fistula (25.4% vs 31.3%, risk ratio: 0.81; 95% CI: 0.55 to 1.19; P = 0.286) were not significantly different between the two groups. In the stratum of participants with a main pancreatic duct ≤3 mm (n = 202), the CCI score was significantly lower in the dexamethasone group (mean difference: -6.4; 95% CI: -11.2 to -1.6; P = 0.009). CONCLUSIONS: Perioperative dexamethasone did not significantly reduce postoperative complications within 30 days after pancreaticoduodenectomy.

From Sheep Track to Motorway: Supramolecular-Mediated 2D Nanofluidic Channels for Ultrafast Water Transport.

Atomic thick 2D materials hold great potential as building blocks to construct highly permeable membranes, yet the permeability of laminar 2D material membranes is still limited by their irregularity sheep track-like interlayer channels. Herein, a supramolecular-mediated strategy to induce the regular assembly of high-throughput 2D nanofluidic channels based on host-guest interactions is proposed. Inspired by the characteristics of motorways, supramolecular-mediated ultrathin 2D membranes with broad and continuous regular water transport channels are successfully constructed using graphene oxide (GO) as an example. The prepared membrane achieves an ultrahigh water permeability (369.94 LMH bar-1) more than six times higher than that of the original membranes while maintaining dye rejection above 98.5%, which outperforms the reported 2D membranes. Characterization and simulation results show that the introduction of hyaluronate-grafted ß-cyclodextrin not only expands the interlayer channels of GO membranes but also enables the membranes to operate stably under harsh conditions with the help of host-guest interactions. This universal supramolecular assembly strategy provides new opportunities for the preparation of 2D membranes with high separation performance and reliable and stable nanofluidic channels.

High-Strength MOF-Based Polymer Electrolytes with Uniform Ionic Flow for Lithium Dendrite Suppression.

The uneven formation of lithium dendrites during electroplating/stripping leads to a decrease in the utilization of active lithium, resulting in poor cycling stability and posing safety hazards to the battery. Herein, introducing a 3D continuously interconnected zirconium-based metal-organic framework (MOF808) network into a polyethylene oxide polymer matrix establishes a synergistic mechanism for lithium dendrite inhibition. The 3D MOF808 network maintains its large pore structure, facilitating increased lithium salt accommodation, and expands anion adsorption at unsaturated metal sites through its diverse large-space cage structure, thereby promoting the flow of Li+. Infrared-Raman and synchrotron small-angle X-ray scattering results demonstrate that the transport behavior of lithium salt ion clusters at the MOF/polymer interface verifies the increased local Li+ flux concentration, thereby raising the mobility number of Li+ to 0.42 and ensuring uniform Li+ flux distribution, leading to dendrite-free and homogeneous Li+ deposition. Furthermore, nanoindentation tests reveal that the high modulus and elastic recovery of MOF-based polymer electrolytes contribute to forming a robust, dendrite-resistant interface. Consequently, in symmetric battery systems, the system exhibits minimal overpotential, merely 35 mV, while maintaining stable cycling for over 1800 h, achieving low-overpotential lithium deposition. Moreover, it retains redox stability under high voltages up to 5.3 V.

Oxygen Vacancy and Bandgap Simultaneous Modulation to Achieve High Lithiophilicity and Mechanical Strength of Lithium Metal Anodes.

Metal oxides with conversion and alloying mechanisms are more competitive in suppressing lithium dendrites. However, it is difficult to simultaneously regulate the conversion and alloying reactions. Herein, conversion and alloying reactions are regulated by modulation of the zinc oxide bandgap and oxygen vacancies. State-of-the-art advanced characterization techniques from a microcosmic to a macrocosmic viewpoint, including neutron diffraction, synchrotron X-ray absorption spectroscopy, synchrotron X-ray microtomography, nanoindentation, and ultrasonic C-scan demonstrated the electrochemical gain benefit from plentiful oxygen vacancies and low bandgaps due to doping strategies. In addition, high mechanical strength 3D morphology and abundant mesopores assist in the uniform distribution of lithium ions. Consequently, the best-performed ZnO-2 offers impressive electrochemical properties, including symmetric Li cells with 2000 h and full cells with 81% capacity retention after 600 cycles. In addition to providing a promising strategy for improving the lithiophilicity and mechanical strength of metal oxide anodes, this work also sheds light on lithium metal batteries for practical applications.

Interface Bonding Properties and Mechanism of Steel Fiber and Hot Melt Adhesive via Interface Design Engineering.

Steel fiber textile, which is composed of steel fibers and glass fibers, has a support layer impregnated with hot melt adhesive (HMA). During long-term service, the bonding force between the steel fiber/HMA system interfaces is poor. In order to improve the bond strength and durability of the interface, this paper introduced sandblasting, acid-etching, and phosphating treatments on the surface of the steel fibers. Also, the effects of these three pretreatment methods on the bond strength of the steel fiber/HMA interface were investigated. The results indicate that the interfacial bond strength of composites made from steel fibers is improved via surface treatment. Under a hydrothermal and simulated concrete pore solution environment, the durability of the steel fiber/HMA interface after sandblasting and acid-etching pretreatment is not as good as that after phosphating pretreatment. The mechanical properties of the phosphating/HMA composite were maintained at 4.56 and 2.24 times compared to those of the untreated/HMA composite, respectively. This is because the pinning effect formed by the phosphating film on the surface of steel fibers at the interface of steel fiber/HMA can serve as a physical barrier against corrosion, preventing the invasion of chloride ions and water vapor and improving the durability of the interface.

Optimizing Epoxy Interfacial Bonding Properties and Failure Mechanism between Carbon Textile-Reinforced Mortar Composites and Concrete Substrates.

Textile-reinforced mortar (TRM) composites have been extensively utilized in building reinforcement due to their exceptional mechanical properties. The weakest link in the entire structure is the interface between the TRM composites and the concrete; however, it plays a crucial role in effectively transferring stress. Researchers have taken measures to improve the strength of the interface, but the results are relatively scattered. In this paper, the surface treatment of the substrate, the thickness of the surfactant, and the physical doping of the surfactant on the interfacial bonding strength of the concrete were comparatively studied. The results demonstrate that the sandblasting treatment on the surface of the concrete enhances the bonding area between the mortar and the concrete of the reinforcement layer, leading to a 50% increase in the bending resistance of the structure. When the surfactant thickness increases to 0.5 kg/m2, more surfactants penetrate the mortar and concrete. This significantly inhibits the occurrence of cracks in the structure. The addition of 2.5% Al2O3 nanomaterials to the surfactant diminishes the shrinkage rate of the curing process, enhances the impact toughness, and improves the flexural and compressive properties of the bonding layer. The ultimate load of the structure increases by 65%. Physical doping of the surfactant is the most effective measure with the most apparent improvement result. It significantly enhances the bonding strength of the interface and can be widely used in construction.

Associations between air pollutants and acute exacerbation of drug-resistant tuberculosis: evidence from a prospective cohort study.

BACKGROUND: Short-term exposure to air pollution may trigger symptoms of drug-resistant tuberculosis (DR-TB) through stimulating lung tissue, damaging tracheobronchial mucosa, the key anti-mycobacterium T cell immune function, and production and release of inflammatory cytokines. OBJECTIVE: To investigate the association between acute exacerbations of DR-TB and short-term residential exposure to air pollutants (PM10, PM2.5, SO2, NO2, CO and O3) based on a large prospective cohort in Anhui Province, China. METHOD: Patients were derived from a prospective cohort study of DR-TB in Anhui Province. All DR-TB patients underwent drug-susceptibility testing and prefecture-level reference laboratories confirmed their microbiologies. The case-crossover design was performed to evaluate the association between the risk of acute exacerbations of DR-TB and short-term residential exposure to air pollution. RESULTS: Short-term NO2 exposure was significantly related to an elevated risk of first-time outpatient visit due to acute exacerbations of DR-TB(relative risk:1.159, 95% confidence interval:1.011 ~ 1.329). Stratification analyses revealed that the relationship between the risk of acute exacerbations and NO2 exposure was stronger in the elderly (age ≥ 65) DR-TB patients, and in individuals with a history of TB treatment. CONCLUSIONS: NO2 Exposure was significantly associated with an elevated risk of acute exacerbation of DR-TB in Anhui Province, China.

SAXS unveils porous anodes for potassium-ion batteries: dynamic evolution of pore structures in Fe@Fe2O3/PCNFs composite nanofibers.

The porous structure of composite nanofibers plays a key role in improving their electrochemical performance. However, the dynamic evolution of pore structures and their action during ion intercalation/extraction processes for negative electrodes are not clear. Herein, porous carbon composite nanofibers (Fe@Fe2O3/PCNFs) were prepared as negative electrode materials for potassium-ion batteries. Electrochemical test findings revealed that the composites had good electrochemical characteristics, and the porous structure endowed composite electrodes with pseudo-capacitive behaviors. After 1500 discharge/charge cycles at a current density of 1000 mA g-1, the specific capacity of the potassium-ion batteries was 144.8 mAh g-1. We innovatively used synchrotron small-angle X-ray scattering (SAXS) technique to systematically investigate the kinetic process of potassium formation in composites and showed that the kinetic process of potassium reaction in composites can be divided into four stages, and the pores with smaller average diameter distribution are more sensitive to changes in the reaction process. This work paves a new way to study the deposition kinetics of potassium in porous materials, which facilitates the design of porous structures and realizes the development of alkali metal ion-anode materials with high energies.

Diagnostic status and epidemiological characteristics of community-acquired bacterial meningitis in children from 2019 to 2020: a multicenter retrospective study.

Community-acquired bacterial meningitis (CABM) is the main cause of morbidity and mortality in children. The epidemiology of CABM is regional and highly dynamic. To clarify the diagnostic status and epidemiological characteristics of children with CABM in this region, and pay attention to the disease burden, so as to provide evidence for the prevention and treatment of CABM. By retrospective case analysis, the clinical data of 918 CABM cases in children aged 0-14 years in Zhejiang Province from January, 2019 to December, 2020 were collected. The etiological diagnosis rate of CABM in children was 23.1%, the annual incidence rate 4.42-6.15/100,000, the annual mortality rate 0.06-0.09/100,000,the cure and improvement rate 94.4%, and the case fatality rate 1.4%. The total incidence of neuroimaging abnormalities was 20.6%. The median length of stay for CABM children was 20(16) days, with an average cost of 21,531(24,835) yuan. In addition, the incidence rate was decreased with age. Escherichia coli(E.coli) and group B Streptococcus agalactiae(GBS) were the principal pathogens in CABM infant<3 months(43.3%, 34.1%), and Streptococcus pneumoniae(S. pneumoniae) was the most common pathogen in children ≥ 3 months(33.9%). In conclusion, the annual incidence and mortality of CABM in children aged 0-14 years in Zhejiang Province are at intermediate and low level. The distribution of CABM incidence and pathogen spectrum are different in age; the incidence of abnormal neuroimaging is high; and the economic burden is heavy.

Expression and Potential Significance of miR-499 and IL-1ß in Serum of Dilated Cardiomyopathy Patients with Atrial Fibrillation.

Context: Dilated cardiomyopathy (DCM) is the terminal manifestation of many heart diseases, and atrial fibrillation (AF) is the most common type of arrhythmia in DCM. The mutual influence of DCM and AF can ultimately lead to a poor prognosis for patients. Objective: The study intended to investigate the risk factors for DCM complicated with AF as well as the expression and clinical value of miR-499 and IL-1ß, to provide more research targets for controlling the risk of AF in clinical practice. Design: The research team conducted a retrospective, observational, case-control study. Setting: The study took place at Huai'an First People's Hospital. Participants: Participants were 79 patients with DCM who had been admitted to the hospital between January 2018 and January 2023. Groups: The study included two groups: (1) 31 participants with atrial fibrillation (AF), the AF group and (2) 48 participants without AF, the non-AF group. Outcome Measures: The research team: (1) examined the baseline characteristics of the two groups and compared the groups using single factor analysis; (2) compared the group's serum indicators and echocardiographic parameters; (3) evaluated the expression and potential relationship of microRNA (miR-499) and interleukin-1 beta (IL-1ß) to AF, using reverse transcription-polymerase chain reaction (RT-PCR) and Pearson, and compared the group's expressions of miR-499 and IL-1ß; and (4) analyzed the potential relationship between participants' characteristics and the occurrence of AF, using binary logistic regression. Results: Compared to the non-AF group, the AF group's: (1) age (P = .000) and number of participants with a high pulmonary artery pressure (P = .004) were significantly greater; (2) LVEF was significantly lower (P = .030) and LVESD (P = .000), LAD (P = .018), uric acid (P = .000), and BNP (P = .000) were significantly higher; and (3) serum miR-499 (P = .020) and IL-1ß (P = .000) were significantly higher. Also, a significant positive correlation existed between miR-499 (P = .019) and IL-1ß (P = .022) and DCM with AF. In addition, the AF group's age (P = .001), disease duration (P = .032), serum triglyceride levels (P = .036), uric acid value (P = .001), left ventricular ejection fraction (LVEF), left ventricular end systolic diameter (LVESD), left atrial anteroposterior diameter, LAD, pulmonary hypertension were significant independent risk factors DCM with AF. Conclusions: A close relationship exists between the abnormal expression of serum miR-499 and IL-1ß and DCM complicated with AF, which will be of great importance in future research. In addition, the data of patients with DCM are related to the occurrence and development of AF, and clinicians should actively perform early drug interventions to reduce myocardial remodeling, so as to reduce the incidence of AF.

Medium-term exposure to size-fractioned particulate matter and asthma exacerbations in China: A longitudinal study of asthmatics with poor medication adherence.

BACKGROUND: Studies have shown that short- and long-term exposure to particulate matter (PM) can increase the risk of asthma morbidity and mortality. However, the effect of medium-term exposure remains unknown. We aim to examine the effect of medium-term exposure to size-fractioned PM on asthma exacerbations among asthmatics with poor medication adherence. METHODS: We conducted a longitudinal study in China based on the National Mobile Asthma Management System Project that specifically and routinely followed asthma exacerbations in asthmatics with poor medication adherence from April 2017 to May 2019. High-resolution satellite remote-sensing data were used to estimate each participant's medium-term exposure (on average 90 days) to size-fractioned PM (PM1, PM2.5, and PM10) based on the residential address and the date of the follow-up when asthma exacerbations (e.g., hospitalizations and emergency room visits) occurred or the end of the follow-up. The Cox proportional hazards model was employed to examine the hazard ratio of asthma exacerbations associated with each PM after controlling for sex, age, BMI, education level, geographic region, and temperature. RESULTS: Modelling results revealed nonlinear exposure-response associations of asthma exacerbations with medium-term exposure to PM1, PM2.5, and PM10. Specifically, for emergency room visits, we found an increased hazard ratio for PM1 above 22.8 µg/m3 (1.060, 95 % CI: 1.025-1.096, per 1 µg/m3 increase), PM2.5 above 38.2 µg/m3 (1.032, 95 % CI: 1.010-1.054), and PM10 above 78.6 µg/m3 (1.019, 95 % CI: 1.006-1.032). For hospitalizations, we also found an increased hazard ratio for PM1 above 20.3 µg/m3 (1.055, 95 % CI: 1.001-1.111) and PM2.5 above 39.2 µg/m3 (1.038, 95 % CI: 1.003-1.074). Furthermore, the effects of PM were greater for a longer exposure window (90-180 days) and among participants with a high BMI. CONCLUSION: This study suggests that medium-term exposure to PM is associated with an increased risk of asthma exacerbations in asthmatics with poor medication adherence, with a higher risk from smaller PM.

Electrosynthesis of an Improbable Directly Bonded Phosphorene-Fullerene Heterodimensional Hybrid toward Boosted Photocatalytic Hydrogen Evolution.

Phosphorene and fullerene are representative two-dimensional (2D) and zero-dimensional (0D) nanomaterials respectively, constructing their heterodimensional hybrid not only complements their physiochemical properties but also extends their applications via synergistic interactions. This is however challenging because of their diversities in dimension and chemical reactivity, and theoretical studies predicted that it is improbable to directly bond C60 onto the surface of phosphorene due to their strong repulsion. Here, we develop a facile electrosynthesis method to synthesize the first phosphorene-fullerene hybrid featuring fullerene surface bonding via P-C bonds. Few-layer black phosphorus nanosheets (BPNSs) obtained from electrochemical exfoliation react with C60 2- dianion prepared by electroreduction of C60, fulfilling formation of the "improbable" phosphorene-fullerene hybrid (BPNS-s-C60). Theoretical results reveal that the energy barrier for formation of [BPNS-s-C60]2- intermediate is significantly decreased by 1.88 eV, followed by an oxidization reaction to generate neutral BPNS-s-C60 hybrid. Surface bonding of C60 molecules not only improves significantly the ambient stability of BPNSs, but also boosts dramatically the visible light and near-infrared (NIR) photocatalytic hydrogen evolution rates, reaching 1466 and 1039 µmol h-1 g-1 respectively, which are both the highest values among all reported BP-based metal-free photocatalysts.

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OBJECTIVES: To investigate the clinical characteristics and prognosis of pneumococcal meningitis (PM), and drug sensitivity of Streptococcus pneumoniae (SP) isolates in Chinese children. METHODS: A retrospective analysis was conducted on clinical information, laboratory data, and microbiological data of 160 hospitalized children under 15 years old with PM from January 2019 to December 2020 in 33 tertiary hospitals across the country. RESULTS: Among the 160 children with PM, there were 103 males and 57 females. The age ranged from 15 days to 15 years, with 109 cases (68.1%) aged 3 months to under 3 years. SP strains were isolated from 95 cases (59.4%) in cerebrospinal fluid cultures and from 57 cases (35.6%) in blood cultures. The positive rates of SP detection by cerebrospinal fluid metagenomic next-generation sequencing and cerebrospinal fluid SP antigen testing were 40% (35/87) and 27% (21/78), respectively. Fifty-five cases (34.4%) had one or more risk factors for purulent meningitis, 113 cases (70.6%) had one or more extra-cranial infectious foci, and 18 cases (11.3%) had underlying diseases. The most common clinical symptoms were fever (147 cases, 91.9%), followed by lethargy (98 cases, 61.3%) and vomiting (61 cases, 38.1%). Sixty-nine cases (43.1%) experienced intracranial complications during hospitalization, with subdural effusion and/or empyema being the most common complication [43 cases (26.9%)], followed by hydrocephalus in 24 cases (15.0%), brain abscess in 23 cases (14.4%), and cerebral hemorrhage in 8 cases (5.0%). Subdural effusion and/or empyema and hydrocephalus mainly occurred in children under 1 year old, with rates of 91% (39/43) and 83% (20/24), respectively. SP strains exhibited complete sensitivity to vancomycin (100%, 75/75), linezolid (100%, 56/56), and meropenem (100%, 6/6). High sensitivity rates were also observed for levofloxacin (81%, 22/27), moxifloxacin (82%, 14/17), rifampicin (96%, 25/26), and chloramphenicol (91%, 21/23). However, low sensitivity rates were found for penicillin (16%, 11/68) and clindamycin (6%, 1/17), and SP strains were completely resistant to erythromycin (100%, 31/31). The rates of discharge with cure and improvement were 22.5% (36/160) and 66.2% (106/160), respectively, while 18 cases (11.3%) had adverse outcomes. CONCLUSIONS: Pediatric PM is more common in children aged 3 months to under 3 years. Intracranial complications are more frequently observed in children under 1 year old. Fever is the most common clinical manifestation of PM, and subdural effusion/emphysema and hydrocephalus are the most frequent complications. Non-culture detection methods for cerebrospinal fluid can improve pathogen detection rates. Adverse outcomes can be noted in more than 10% of PM cases. SP strains are high sensitivity to vancomycin, linezolid, meropenem, levofloxacin, moxifloxacin, rifampicin, and chloramphenicol.

Machine Learning Model for Predicting Risk of In-Hospital Mortality after Surgery in Congenital Heart Disease Patients.

Background: A machine learning model was developed to estimate the in-hospital mortality risk after congenital heart disease (CHD) surgery in pediatric patient. Methods: Patients with CHD who underwent surgery were included in the study. A Extreme Gradient Boosting (XGBoost) model was constructed based onsurgical risk stratification and preoperative variables to predict the risk of in-hospital mortality. We compared the predictive value of the XGBoost model with Risk Adjustment in Congenital Heart Surgery-1 (RACHS-1) and Society of Thoracic Surgery-European Association for Cardiothoracic Surgery (STS-EACTS) categories. Results: A total of 24,685 patients underwent CHD surgery and 595 (2.4%) died in hospital. The area under curve (AUC) of the STS-EACTS and RACHS-1 risk stratification scores were 0.748 [95% Confidence Interval (CI): 0.707-0.789, p < 0.001] and 0.677 (95% CI: 0.627-0.728, p < 0.001), respectively. Our XGBoost model yielded the best AUC (0.887, 95% CI: 0.866-0.907, p < 0.001), and sensitivity and specificity were 0.785 and 0.824, respectively. The top 10 variables that contribute most to the predictive performance of the machine learning model were saturation of pulse oxygen categories, risk categories, age, preoperative mechanical ventilation, atrial shunt, pulmonary insufficiency, ventricular shunt, left atrial dimension, a history of cardiac surgery, numbers of defects. Conclusions: The XGBoost model was more accurate than RACHS-1 and STS-EACTS in predicting in-hospital mortality after CHD surgery in China.

Combined transcriptomics and TMT-proteomics reveal abnormal complement and coagulation cascades in cow's milk protein allergy.

Cow's milk protein allergy (CMPA) is primarily due to the inability of the intestinal mucosa to establish typical immunological tolerance to proteins found in cow's milk, and the specific molecular mechanism is still unclear. In order to investigate molecular alterations in intestinal tissues during CMPA occurrence, this study analyzed the jejunal tissue of ß-lactoglobulin (BLG)-sensitized mice through transcriptomics and quantitative tandem mass tag (TMT)-labeled proteomics. A total of 475 differentially expressed genes (256 up-regulated, 219 down-regulated) and 94 differentially expressed proteins (65 up-regulated, 29 down-regulated) were identified. Comparing the KEGG pathways of the two groups, it was found that both were markedly enriched in the signaling pathways of complement and coagulation cascade. Among these, kallikrein B1 (KLKB1) in this pathway is speculated to be pivotal in CMPA. It may potentially enhance the release of bradykinin by activating the kallikrein-kinin system, leading to pro-inflammatory effects and exacerbating intestinal mucosal damage. This study suggests that the pathways of complement and coagulation cascades could be significant in the context of intestinal immunity in CMPA, and KLKB1 may be its potential therapeutic target.

Heat and health of occupational workers: a short summary of literature.

Globally, occupational workers suffer various health impacts due to extreme heat. In this short review, we examine the literature discussing health impacts of heat on occupational workers, and then discuss certain individual and institutional measures needed to address the problem. Though the available literature in the recent decade discusses health impacts of heat on workers as various heat-related illnesses, we found very few studies examining how occupational workers suffer from issues concerning cardiovascular health, neurological health, respiratory health, and mental health. In this regard, we highlight the need for more studies to examine how occupational workers exposed to extreme heat conditions suffer from fatal health issues like cardiovascular attack, brain stroke, and other ailments impacting vital organs of the body. Occupational workers across the world should be made aware of measures to protect themselves from extreme heat. Further, countries should develop occupational heat safety guidelines with statutory effect.

The efficacy of low/lactose-free milk powder in the treatment of lactose intolerance in infants: A protocol for systematic review and meta analysis.

BACKGROUND: The aim of this study was to evaluate the efficacy and safety of formula milk powder in the treatment of lactose intolerance in children, and to provide an evidence-based medicine basis for the rational use of drugs in children with lactose intolerance caused by various reasons by meta-analysis. METHODS: Use computers to search major databases, including Web of Science, PubMed, CNKI, Wanfang Data Knowledge Service Platform, and other databases, the retrieval time is from the establishment of the database to April 2023. The collected literatures were screened, data extracted and processed, and then meta-analysis was performed by Review-Manager 5.4 statistical software. RESULTS: A total of 10 randomized controlled trials were included, with 1112 patients, including 562 patients in the treatment group and 550 patients in the control group. The control group was treated with conventional therapy, and the treatment group was treated with lactose-free/low-lactose milk powder on the basis of conventional therapy. The results of the meta-analysis showed that the clinical efficacy of the treatment group was significantly better than that of the control group [odds ratio=6.01, 95% confidence interval (CI): 3.94-9.18, P<0.00001], the course of disease in the treatment group was shorter than that in the control group (mean difference=-1.45, 95% CI: -1.76 to -1.13, P<0.0001). The antidiarrhea time of the treatment group was shorter than that of the control group, and the difference between the 2 groups was statistically significant (mean difference=-1.41, 95% CI: -1.67 to -1.15, P<0.0001). CONCLUSION: Low/lactose-free milk powder can improve clinical efficacy and shorten the course of treatment in infants with lactose intolerance, which can be demonstrated by further large-scale clinical studies.

Defect Engineering in GO Membranes - Tailoring Size and Oxidation Degree of Nanosheet for Enhanced Pore Channels.

Graphene Oxide (GO) membrane has been extensively applied in the field of water purification and membrane separation processes. While the solute molecule transport in GO membranes encompasses interlayer channels, edge defects, and in-plane crack-like holes, the significance of edge defects or crack-like pores in ultrathin membranes is often overlooked. In our study, we focused on the construction of short-range channel GO membranes with varied defect structures by modulating the transverse size of the porous nanosheets. GO nanosheets with different sizes were procured through high-energy γ-irradiation combined with centrifugation. Notably, the large-sized porous GO nanosheets (L-pGO) exhibit a consistent structure, and numerous in-plane defects. In contrast, the smaller counterparts (S-pGO) present a fewer in-plane defects. The performance metrics revealed that L-pGO exhibited a water flux of 849.25 L m-2 h-1 bar-1, while S-pGO demonstrated nearly 100 % dye rejection capacity. These findings underscore the potential of defect engineering as a powerful strategy to enhance the efficiency of two-dimensional membranes.

UHPLC/MS-based metabolomics of asthmatic mice reveals metabolic changes in group 2 innate lymphoid cells.

Helper Th2-type immune responses are essential in allergic airway diseases, including asthma and allergic rhinitis. Recent studies have indicated that group 2 innate lymphoid cells (ILC2s) play a crucial role in the occurrence and development of asthma. However, the metabolic profile of ILC2s and their regulatory mechanisms in asthma remain unclear. Therefore, we established two asthma mouse models: an ovalbumin (OVA)-induced asthma model and an IL-33-induced asthma model. We then used ultra-high-performance liquid chromatography/mass spectrometry (UHPLC/MS) to conduct high-throughput untargeted metabolic analysis of ILC2s in the lung tissues of the asthma models. The identified metabolites primarily consisted of lipids, lipid-like molecules, benzene, organic acids, derivatives, and organic oxidation compounds. Specifically, 34 differentially accumulated metabolites influenced the metabolic profiles of the control and OVA-induced asthma model groups. Moreover, the accumulation of 39 metabolites significantly differed between the Interleukin 33 (IL-33) and control groups. These differentially accumulated metabolites were mainly involved in pathways such as sphingolipid, oxidative phosphorylation, and fatty acid metabolism. This metabolomic study revealed, for the first time, the key metabolites and metabolic pathways of ILC2s, revealing new aspects of cellular metabolism in the context of airway inflammation. These findings not only contribute to unraveling the pathogenesis of asthma but also provide a crucial theoretical foundation for the future development of therapeutic strategies targeting ILC2s.