Body mass index, waist circumference, and mortality in subjects older than 80 years: a Mendelian randomization study.

BACKGROUND AND AIMS: Emerging evidence has raised an obesity paradox in observational studies of body mass index (BMI) and health among the oldest-old (aged ≥80 years), as an inverse relationship of BMI with mortality was reported. This study was to investigate the causal associations of BMI, waist circumference (WC), or both with mortality in the oldest-old people in China. METHODS: A total of 5306 community-based oldest-old (mean age 90.6 years) were enrolled in the Chinese Longitudinal Healthy Longevity Survey (CLHLS) between 1998 and 2018. Genetic risk scores were constructed from 58 single-nucleotide polymorphisms (SNPs) associated with BMI and 49 SNPs associated with WC to subsequently derive causal estimates for Mendelian randomization (MR) models. One-sample linear MR along with non-linear MR analyses were performed to explore the associations of genetically predicted BMI, WC, and their joint effect with all-cause mortality, cardiovascular disease (CVD) mortality, and non-CVD mortality. RESULTS: During 24 337 person-years of follow-up, 3766 deaths were documented. In observational analyses, higher BMI and WC were both associated with decreased mortality risk [hazard ratio (HR) 0.963, 95% confidence interval (CI) 0.955-0.971 for a 1-kg/m2 increment of BMI and HR 0.971 (95% CI 0.950-0.993) for each 5 cm increase of WC]. Linear MR models indicated that each 1 kg/m2 increase in genetically predicted BMI was monotonically associated with a 4.5% decrease in all-cause mortality risk [HR 0.955 (95% CI 0.928-0.983)]. Non-linear curves showed the lowest mortality risk at the BMI of around 28.0 kg/m2, suggesting that optimal BMI for the oldest-old may be around overweight or mild obesity. Positive monotonic causal associations were observed between WC and all-cause mortality [HR 1.108 (95% CI 1.036-1.185) per 5 cm increase], CVD mortality [HR 1.193 (95% CI 1.064-1.337)], and non-CVD mortality [HR 1.110 (95% CI 1.016-1.212)]. The joint effect analyses indicated that the lowest risk was observed among those with higher BMI and lower WC. CONCLUSIONS: Among the oldest-old, opposite causal associations of BMI and WC with mortality were observed, and a body figure with higher BMI and lower WC could substantially decrease the mortality risk. Guidelines for the weight management should be cautiously designed and implemented among the oldest-old people, considering distinct roles of BMI and WC.

The Impact of Oxygen Content in O-Doped MoS2 on the Kinetics of Polysulfide Conversion in Li-S Batteries.

Polysulfide shuttle and sluggish sulfur redox kinetics remain key challenges in lithium-sulfur batteries. Previous researches have shown that introducing oxygen into transition metal sulfides helps to capture polysulfides and enhance their conversion kinetics. Based on this, further investigations are conducted to explore the impact of oxygen doping levels on the physical-chemical properties and electrocatalytic performance of MoS2. The findings reveal that MoS2 doped with high-content oxygen exhibits enhanced conductivity and polysulfides conversion kinetics compared to MoS2 with low-content oxygen doping, which can be attributed to the alteration of crystal structure from 2H-phase to the 1T-phase, the introduction of increased Li-O interactions, and the effect of defects resulting from high-oxygen doping. Consequently, the lithium-sulfur batteries using high-oxygen doped MoS2 as a catalyst deliver a high discharge capacity of 1015 mAh g-1 at 0.25C and maintain 78.5% capacity after 300 more cycles. Specifically, lithium-sulfur batteries employing paper-based electrodedemonstrate an areal capacity of 3.91 mAh cm-2 at 0.15C, even with sulfur loading of 4.1 mg cm-2 and electrolyte of 6.7 µL mg-1. These results indicate that oxygen doping levels can modify the properties of MoS2, and high-oxygen doped MoS2 shows promise as an efficient catalyst for lithium-sulfur batteries.

Organ storage in renal transplantation.

PURPOSE OF REVIEW: Kidney transplantation is vital for those with end-stage renal disease, enhancing quality of life and longevity. It is the preferred treatment but is hindered by a global disparity between donor kidney availability and demand. Therefore, optimizing organ storage techniques is crucial to mitigate the effects of ischemia reperfusion injury in available organs. Recent interest has centered on innovative methods like oxygenated normothermic perfusion and abdominal regional perfusion. RECENT FINDINGS: Multiple recent metanalyses, including a Cochrane review, confirm the benefits of hypothermic machine perfusion (HMP) for deceased donor kidneys, demonstrating its utility and cost effectiveness. The benefits of oxygenated normothermic perfusion have been seen in retrospective data sets but not in prospective trials. Abdominal regional perfusion (aNRP) is gaining interest, especially for liver transplantation, but kidney specific data are scant. SUMMARY: High-quality evidence backs the use of HMP for deceased donor kidneys. Despite interest in other techniques, clinical evidence for their benefits in kidney transplantation is lacking. The gap between innovation and verified success emphasizes the need for continued research and collaboration between medical professionals, researchers, and ethical committees. This review aims to further illuminate the complexities and advancements in the field, bridging the knowledge gap and aiding in the continual pursuit of excellence in transplantation.

Operative treatment of isolated epiphyseal fracture of the distal fibula: 1 case report and literature review.

Pediatric ankle injuries are common; ankle epiphyseal fractures are also common in children. But isolated distal epiphyseal fibular fractures of the distal fibula are clinically rare. We describe one unusual case of an adolescent with a completely displaced Salter-Harris type II distal fibular epiphyseal fracture. The attempt of closed reduction failed, and the patient required open reduction and internal fixation. The localized periosteum and the superior peroneal retinaculum were avulsed from the distal fibular metaphysis, with the peroneal tendons underneath exposed but no obvious subluxation. To the best of our knowledge, this combination of injuries has not been previously reported.

Strong In-Plane Optoelectronic Anisotropy and Polarization Sensitivity in Low-Symmetry 2D Violet Phosphorus.

Anisotropic optoelectronics based on low-symmetry two-dimensional (2D) materials hold immense potential for enabling multidimensional visual perception with improved miniaturization and integration capabilities, which has attracted extensive interest in optical communication, high-gain photoswitching circuits, and polarization imaging fields. However, the reported in-plane anisotropic photocurrent and polarized dichroic ratios are limited, hindering the achievement of high-performance anisotropic optoelectronics. In this study, we introduce novel low-symmetry violet phosphorus (VP) with a unique tubular cross-linked structure into this realm, and the corresponding anisotropic optical and optoelectronic properties are investigated both experimentally and theoretically for the first time. Remarkably, our prepared VP-based van der Waals phototransistor exhibits significant optoelectronic anisotropies with a giant in-plane anisotropic photocurrent ratio exceeding 10 and a comparable polarized dichroic ratio of 2.16, which is superior to those of most reported 2D counterparts. Our findings establish VP as an exceptional candidate for anisotropic optoelectronics, paving the way for future multifunctional applications.

Long-term fine particular exposure and incidence of frailty in older adults: findings from the Chinese Longitudinal Healthy Longevity Survey.

BACKGROUND: The association between fine particular matter (PM2.5) and frailty is less studied, and the national burden of PM2.5-related frailty in China is unknown. OBJECTIVE: To explore the association between PM2.5 exposure and incident frailty in older adults, and estimate the corresponding disease burden. DESIGN: Chinese Longitudinal Healthy Longevity Survey from 1998 to 2014. SETTING: Twenty-three provinces in China. SUBJECTS: A total of 25,047 participants aged ≥65-year-old. METHODS: Cox proportional hazards models were performed to evaluate the association between PM2.5 and frailty in older adults. A method adapted from the Global Burden of Disease Study was used to calculate the PM2.5-related frailty disease burden. RESULTS: A total of 5,733 incidents of frailty were observed during 107,814.8 person-years follow-up. A 10 µg/m3 increment of PM2.5 was associated with a 5.0% increase in the risk of frailty (Hazard Ratio = 1.05, 95% confidence interval = [1.03-1.07]). Monotonic, but non-linear exposure-response, relationships of PM2.5 with risk of frailty were observed, and slopes were steeper at concentrations >50 µg/m³. Considering the interaction between population ageing and mitigation of PM2.5, the PM2.5-related frailty cases were almost unchanged in 2010, 2020 and 2030, with estimations of 664,097, 730,858 and 665,169, respectively. CONCLUSIONS: This nation-wide prospective cohort study showed a positive association between long-term PM2.5 exposure and frailty incidence. The estimated disease burden indicated that implementing clean air actions may prevent frailty and substantially offset the burden of population ageing worldwide.

The association between sleep duration and risk of myopia in Chinese school-aged children: a cross-sectional study.

BACKGROUND: Myopia is one of the most commonly diagnosed refractive disorders worldwide. Identifying risk factors for myopia at an early age may help to characterize children who would benefit most from individualized lifestyle advice and early interventions. The influence of sleep duration on myopia risk remains controversial and thus needs to be evaluated. METHODS: A population-based cross-sectional study of Chinese school-aged children was conducted. Information on sleep duration was derived. The association between sleep duration and myopia risk was investigated by logistic regression analysis. RESULTS: Myopia prevalence among 9530 Chinese school-aged children was 75.4% and decreased from 84.9%, 76.5%, 65.8%, to 61.3% along with the extension of sleep duration. Univariate logistic regression found longer sleep duration of 8-9 h (OR = 0.58, 95% CI: 0.51-0.66), 9-10 h (OR = 0.34, 95% CI: 0.30-0.39), and ≥ 10 h (OR = 0.28, 95% CI: 0.24-0.33) were protective factors for myopia in all participants (P for trend < 0.001). In the multivariate analyses, sleep duration was inversely associated with the risk of myopia, and a dose-effect relationship was observed when the analysis was split by age category. CONCLUSIONS: Long sleep duration was associated with decreased risk of myopia in Chinese school-aged children.

Early protein energy malnutrition impacts life-long developmental trajectories of the sources of EEG rhythmic activity.

Protein Energy Malnutrition (PEM) has lifelong consequences on brain development and cognitive function. We studied the lifelong developmental trajectories of resting-state EEG source activity in 66 individuals with histories of Protein Energy Malnutrition (PEM) limited to the first year of life and in 83 matched classmate controls (CON) who are all participants of the 49 years longitudinal Barbados Nutrition Study (BNS). qEEGt source z-spectra measured deviation from normative values of EEG rhythmic activity sources at 5-11 years of age and 40 years later at 45-51 years of age. The PEM group showed qEEGt abnormalities in childhood, including a developmental delay in alpha rhythm maturation and an insufficient decrease in beta activity. These profiles may be correlated with accelerated cognitive decline.

Meta-analysis of the association between Apolipoprotein E polymorphism and risks of myocardial infarction.

BACKGROUND: Myocardial infarction (MI) remains the leading cause of death and disability among cardiovascular diseases worldwide. Studies show that elevated low-density lipid protein cholesterol (LDL-C) levels confer the highest absolute risk of MI, and Apolipoprotein E (ApoE) is implicated in regulating levels of triglycerides (TGs), cholesterol, and LDL-C. Our study aimed to evaluate the association between APOE polymorphism and MI, and to provide evidence for the etiology of MI. METHODS: Case-control studies on the association between APOE polymorphisms and the risk of myocardial infarction were included by searching PubMed, Web of Science, and CNKI, and this meta-analysis was written in accordance with PRISMA guideline statement. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated using either random-effects or fixed-effects models by R software. RESULTS: A total of 33 eligible articles involving 13,706 cases and 14,817 controls were finally selected. The pooled analysis based on the total eligible articles showed that the risk of MI was associated with ApoE epsilon 2 and epsilon 4 alleles. The results showed that patients with MI had a low frequency of the ε2 allele (OR 0.74, 95% CI 0.64-0.86) and a high frequency of the ε4 allele (OR 1.24, 95% CI 1.09-1.42). CONCLUSIONS: APOE ε2-involved genotypes may be protective factors for MI; in contrast, ε4-involved genotypes (ε4/ε3 vs. ε3/ε3, and ε4/ε4 vs. ε3/ε3) may be risk factors for MI.

Sociodemographic and behavioral influences on multimorbidity among adult residents of northeastern China.

BACKGROUND: Multimorbidity is defined as two or more chronic health conditions existing in an individual simultaneously. Multimorbidity has been associated with poor conditions, such as higher health care costs and the poor quality of life. Thus, identifying the risk factors of the multimorbidity is required for multimorbidity prevention. METHODS: This study was based on the Comprehensive Demonstration Research Project of Major Chronic Noncommunicable Disease Prevention and Control Technology in Northeast China initiated by China Medical University. The investigation was a cross-sectional study under a multistage stratified cluster random sampling design. Associations between multimorbidity and sociodemographic and behavioral factors in adult residents were investigated using univariate analysis and multivariate logistic regression analysis. RESULTS: A total of 6706 participants were enrolled in this investigation, and the prevalence of multimorbidity was 21.2% among the adult residents of northeastern China. There existed differences of association between age and multimorbidity risks (65-69 years old: OR = 3.53, 95%CI: 2.04-6.12; 70-74 years old: OR = 5.26, 95%CI: 3.02-9.17). Participants who are overweight had significantly high multimorbidity risk (OR = 2.76, 95%CI: 1.50-5.24). Family history of hypertension and family history of diabetes were significantly associated with high multimorbidity risk (family history of hypertension: OR = 2.34, 95%CI: 1.96-2.79; family history of diabetes: OR = 1.77, 95%CI: 1.38-2.26). Compared with the frequency of fatigue (< 1 time/week or 1-2 times/week), that (≥3 times/week) was associated with high multimorbidity risk (OR = 1.39, 95%CI: 1.07-1.81). For fresh fruit consumption, compared with eating fruits regularly, eating rarely had a higher risk of multimorbidity (OR = 2.33, 95%CI: 1.90-2.85). CONCLUSIONS: Sociodemographic indices (age, BMI, family history of hypertension, and family history of diabetes) and behavioral indices (fatigue status and fresh fruit consumption) increase the risks of multimorbidity. This study provides a necessary route to prevent and control multimorbidity in northeast China.

Down-regulated FST expression is involved in the poor prognosis of triple-negative breast cancer.

BACKGROUND: Triple-negative breast cancer (TNBC) is more commonly associated with young patients, featuring high histological grade, visceral metastasis, and distant recurrence. Follistatin (FST) is a secreted extracellular regulatory protein that antagonizes TGF-ß superfamily such as activin and TGF-ß related superfamily such as bone morphogenetic protein (BMP). The implication of FST in the proliferation, angiogenesis, and metastasis of solid tumors documents good or poor outcome of patients with BC. However, the role of FST in TNBC remains unclear. METHODS: Data of 935 patients with breast cancer (BC) were extracted from TCGA. Case-control study, Kaplan-Meier, uni-multivariate COX, and ROC curve were utilized to investigate the relationship between FST expression and the clinical characteristics and prognosis of BC. Functional studies were used to analyze the effect of FST expression on proliferation, apoptosis, migration, and invasion of TNBC cell lines. Bioinformatic methods such as volcanoplot, GO annd KEGG enrichment, and protein-protein interactions (PPI) analyses were conducted to further confirm the different roles of FST in the apoptotic pathways among mesenchymal and mesenchymal stem-like cells of TNBC. RESULTS: Data from TCGA showed that low FST expression correlated with poor prognosis (for univariate analysis, HR = 0.47, 95% CI: 0.27-0.82, p = 0.008; for multivariate analysis, HR = 0.40, 95% CI: 0.21-0.75, p = 0.004). Low FST expression provided high predicted value of poor prognosis in TNBC amongst BCs. FST knockdown promoted the proliferation, migration and invasion of BT549 and HS578T cell lines. FST inhibited the apoptosis of mesenchymal cells by targeting BMP7. CONCLUSIONS: Low FST expression is associated with poor prognosis of patients with TNBC. FST expressions exhibit the anisotropic roles of apoptosis between mesenchymal and mesenchymal stem-like cells but promote the proliferation, migration, invasion in both of two subtypes of TNBC in vitro. FST may be a subtype-heterogeneous biomarker for monitoring the progress of TNBC.

Association between eNOS rs1799983 polymorphism and hypertension: a meta-analysis involving 14,185 cases and 13,407 controls.

BACKGROUND: Essential hypertension is a complex disease determined by the interaction of genetic and environmental factors, eNOS is considered to be one of the susceptible genes for hypertension. Our study aimed to evaluate the association between eNOS rs1799983 polymorphism and hypertension, and to provide evidence for the etiology of hypertension. METHODS: Case-control studies of eNOS rs1799983 polymorphism and hypertension were included by searching PubMed, Embase, Web of Science, Medline, Scopus, WanFang datebase, Vip datebase, and CNKI database according to PRISMA guideline. Eligible data were extracted and pooled, and were analyzed using R software based on five different genetic models. RESULTS: A total of 60 eligible articles involving 14,185 cases and 13,407 controls were finally selected. We found significant association between eNOS rs1799983 polymorphism and hypertension under any genetic model (T vs G: OR = 1.44, 95% CI 1.26-1.63; GT vs GG: OR 1.34, 95% CI 1.18-1.52; TT vs GG: OR 1.80, 95% CI 1.41-2.31; GT + TT vs GG: OR 1.42, 95% CI 1.25-1.63; TT vs GG + GT: OR 1.68, 95% CI 1.35-2.08; GT vs GG + TT: OR 1.24, 95% CI 1.11-1.40). CONCLUSIONS: We found that eNOS rs1799983 polymorphism is associated with the increased risk of hypertension under any genetic model. Moreover, investigations of gene-gene and gene-environment interactions are needed to give more insight into the association between eNOS rs1799983 polymorphism and hypertension.

Simultaneous determination of 11 quinolone residues in freshwater fish samples by magnetic solid-extraction coupled to liquid chromatography-tandem mass spectrometry.

In this study, well-defined core-shell ethylenediamine-functional magnetic ferroferric oxide polymers were prepared and were fully characterized by transmission electron microscopy, scanning electron microscopy, FTIR spectroscopy, and vibrating sample magnetometry. Then, it was used as a magnetic solid-phase extraction adsorbent for simultaneous determination of 11 trace quinolone residues in freshwater fish samples coupled to liquid chromatography-tandem mass spectrometry. The obtained results revealed that the adsorbent showed good extraction efficiency and the adsorption mechanisms referred to hydrogen bond and π-π stacking interaction. Moreover, the magnetic solid-phase extraction conditions were also carefully optimized. The limits of quantitation of 11 quinolones were in the range of 0.15-0.36 µg/kg, while spiking recoveries were in the range of 80.2-99.5% for the 11 quinolones in freshwater fish samples at four spiked levels including limits of quantitation, 1.0, 40.0, and 80.0 µg/kg with the relative standard deviations ranging from 0.8 to 9.1%. The proposed method was applied to analyze 45 freshwater fish samples, and enrofloxacin was detected in 91.1% samples with concentrations ranging from 0.659 to 333 µg/kg. It could be concluded that the proposed method is fast, simple, sensitive, and accurate for the routine monitor of freshwater fish.

[Contamination status and the evaluation of dietary exposure of marine biotoxins in seafood in Ningbo City in 2017-2019].

OBJECTIVE: Ultra-fast liquid chromatography-tandem mass spectrometry method was developed for the analysis of contamination degree of biotoxins in seafood in Ningbo City from 2017 to 2019 and the assessment of dietary exposure was conducted. METHODS: Samples were extracted and purified with optimized pretreatment process and then injected for analysis. According to the result of the measurements, an international point estimate model was used to evaluate the dietary exposure of the population. RESULTS: For tetrodotoxin and 16 shellfish toxins monitored routinely, gonyautoxin5(GTX5), tetrodotoxin and homo-yessotoxin(hYTX) had higher detection rate, other toxins including okadaic acid(OA), dinophysistoxin1(DTX1), decarbamoyl gonyautoxin2(dcGTX2) and decarbamoyl gonyautoxin3(dcGTX3) were detected sporadically. The detection rates of TTX、GTX and hYTX were 27%, 52% and 12%, respectively. The concentration ranges of TTX, GTX and hYTX in polluted samples were 0. 003-0. 535, 0. 008-0. 189 and 0. 032-0. 110 mg/kg. The exposure risk indices(ERI) of TTX, GTX5, hYTX, dcGTX2 and dcGTX3 were 2. 5, 0. 026, 0. 0080, 0. 79 and 0. 32, respectively. CONCLUSION: Marine biotoxins have a lower dietary health risk to the population. It is must be given great attention that in the season of toxic red tide, the detection rates of higher toxic toxins, dcGTX2 and dcGTX3 increased significantly with high risks to human. Moreover, the dietary health risk of tetrodotoxin in routine surveillance in 2019 was higher.

Association between MTHFR C677T/A1298C and susceptibility to autism spectrum disorders: a meta-analysis.

BACKGROUND: Autism spectrum disorder (ASD) is becoming increasingly prevalent of late. Methylenetetrahydrofolate reductase (MTHFR) has a significant role in folate metabolism. Owing to the inconsistencies and inconclusiveness on the association between MTHFR single nucleotide polymorphism (SNP) and ASD susceptibilities, a meta-analysis was conducted to settle the inconsistencies. METHODS: For this meta-analysis, a total of 15 manuscripts published up to January 26, 2020, were selected from PubMed, Google Scholar, Medline, WangFang, and CNKI databases using search terms "MTHFR" OR "methylenetetrahydrofolate reductase" AND "ASD" OR "Autism Spectrum Disorders" OR "Autism" AND "polymorphism" OR "susceptibility" OR "C677T" OR "A1298C". RESULTS: The findings of the meta-analysis indicated that MTHFR C677T polymorphism is remarkably associated with ASD in the five genetic models, viz., allelic, dominant, recessive, heterozygote, and homozygote. However, the MTHFR A1298C polymorphism was not found to be significantly related to ASD in the five genetic models. Subgroup analyses revealed significant associations of ASD with the MTHFR (C677T and A1298C) polymorphism. Sensitivity analysis showed that this meta-analysis was stable and reliable. No publication bias was identified in the associations between MTHFRC677T polymorphisms and ASD in the five genetic models, except for the one with regard to the associations between MTHFRA1298C polymorphisms and ASD in the five genetic models. CONCLUSION: This meta-analysis showed that MTHFR C677T polymorphism is a susceptibility factor for ASD, and MTHFR A1298C polymorphism is not associated with ASD susceptibility.

Surface multi-walled carbon nanotube modified quaternary amine-functionalized polymers for purification and determination of glyphosate and its four metabolites in plasma samples.

The present study focused on the pretreatment and detection of GLY and its four metabolites AMPA, N-acetyl AMPA, N-methyl GLY and N-acetyl GLY in plasma samples. Multi-walled carbon nanotube-modified quaternary amine-functionalized polymers (QA-PDNV@MWCNTs) were synthesized in a controlled manner by self-assembly, and its morphology and composition were extensively characterized. The QA-PDNV@MWCNTs microspheres were then used as an SPE adsorbent for the preparation and rapid determination of GLY and its four metabolites in plasma samples combined with ultra-performance liquid chromatography-high resolution mass spectrometry (UPLCHRMS). The SPE conditions based on QA-PDNV@MWCNTs were optimized for GLY and its metabolites to obtain the best purification efficiency. The experimental results show that when the adsorbent contains 8% MWCNTs, it can balance the adsorption of target analytes and the purification performance of the adsorbent for impurities. In addition, this study compared the QA-PDNV@MWCNTs based SPE method with the commercial Waters Oasis MAX SPE cartridge and the results showed that the developed method in this study has better resistance to matrix interference. Under optimal conditions, the recoveries of GLY and its metabolites spiked in plasma were 82.6-99.4 % with relative standard deviations (RSDs) of 1.0-7.8 %. The limits of detection (LODs, S/N ≥ 3) and limits of quantification (LOQs, S/N ≥ 9) of the method were 0.05-0.33 µg/L and 0.15-1.00 µg/L, respectively. Finally, the developed QA-PDNV@MWCNTs based SPE-UPLCHRMS method was used to confirm GLY poisoning not only on the basis of the detection of the GLY prototype, but also on the basis of its four metabolites.

Point-of-care-ultrasound for the assessment of post-renal transplant recipients.

INTRODUCTION: Postoperative imaging for deceased donor renal transplants is often delayed, as these surgeries occur after-hours. These delays can be critical in identifying immediate complications. To our knowledge, there are no formal training programs for point-of-care ultrasound (POCUS) in this setting; therefore, we aimed to develop and evaluate a feasible and practical POCUS curriculum for the assessment of a renal transplant graft. METHODS: Urology and nephrology transplant physicians completed a three-hour online course, followed by a five-hour hands-on seminar for sonographic scanning. Simulated patients with transplanted kidneys were used. Course material was developed with licensed ultrasound technologists based on Sonography Canada national competency profiles. Pre- and post-course surveys focused on user confidence, while pre- and post-course multiple-choice questionnaires assessed theoretical knowledge. RESULTS: Twelve participants were included, six of whom were urologists. Theoretical knowledge in POCUS improved significantly (p<0.001). Confidence in manipulation of ultrasound controls, Doppler imaging, and POCUS of the transplant kidney also improved (all p<0.001, d>2.0). Participants indicated an increased likelihood of POCUS use in clinical practice and that training should be integrated into a transplant fellowship. CONCLUSIONS: We introduced a novel and guideline-based POCUS curriculum that leveraged local ultrasound educators and found improved theoretical knowledge and skill confidence in our cohort of transplant physicians. This course will serve as the first step toward a validated competency-based training system for POCUS use in the immediate post-renal transplant setting, and likely will be incorporated into the training of the modern transplant physician.

Photo-crosslinked integrated triphasic scaffolds with gradient composition and strength for osteochondral regeneration.

Owing to the avascular and aneural nature of cartilage tissue and the complex, multilayered structure of osteochondral units, the repair of osteochondral defects poses significant challenges. Traditional monophasic scaffolds have difficulty meeting the repair requirements of both cartilage and bone tissues, whereas multiphasic scaffolds face the issue of interfacial integration. In this study, a triphasic methylpropenylated gelatin (GELMA) hydrogel scaffold was employed to repair osteochondral defects, in which three layers of hydrogel were covalently bonded through a sequential curing process. The upper layer of the scaffold was covalently bonded with chondroitin sulfate, promoting chondrogenic differentiation of bone marrow mesenchymal stem cells (BMSCs). The middle and lower layers of the hydrogel introduced a gradient content of hydroxyapatite, forming a scaffold with gradient mechanical strength and effectively enhancing its angiogenic and osteogenic induction capabilities. Finally, the triphasic integrated scaffold cartilage and bone repair performance was evaluated using a rabbit knee joint defect model. The results demonstrated that the scaffold facilitated accelerated regeneration of osteochondral defects, thus providing a novel strategy for the treatment of osteochondral defects.

Low-Power Perovskite Neuromorphic Synapse with Enhanced Photon Efficiency for Directional Motion Perception.

The advancement of artificial intelligent vision systems heavily relies on the development of fast and accurate optical imaging detection, identification, and tracking. Framed by restricted response speeds and low computational efficiency, traditional optoelectronic information devices are facing challenges in real-time optical imaging tasks and their ability to efficiently process complex visual data. To address the limitations of current optoelectronic information devices, this study introduces a novel photomemristor utilizing halide perovskite thin films. The fabrication process involves adjusting the iodide proportion to enhance the quality of the halide perovskite films and minimize the dark current. The photomemristor exhibits a high external quantum efficiency of over 85%, which leads to a low energy consumption of 0.6 nJ. The spike timing-dependent plasticity characteristics of the device are leveraged to construct a spiking neural network and achieve a 99.1% accuracy rate of directional perception for moving objects. The notable results offer a promising hardware solution for efficient optoneuromorphic and edge computing applications.

Enhancing the Uniformity of a Memristor Using a Bilayer Dielectric Structure.

Resistive random access memory (RRAM) holds great promise for in-memory computing, which is considered the most promising strategy for solving the von Neumann bottleneck. However, there are still significant problems in its application due to the non-uniform performance of RRAM devices. In this work, a bilayer dielectric layer memristor was designed based on the difference in the Gibbs free energy of the oxide. We fabricated Au/Ta2O5/HfO2/Ta/Pt (S3) devices with excellent uniformity. Compared with Au/HfO2/Pt (S1) and Au/Ta2O5/Pt (S2) devices, the S3 device has a low reset voltage fluctuation of 2.44%, and the resistive coefficients of variation are 13.12% and 3.84% in HRS and LRS, respectively, over 200 cycles. Otherwise, the bilayer device has better linearity and more conductance states in multi-state regulation. At the same time, we analyze the physical mechanism of the bilayer device and provide a physical model of ion migration. This work provides a new idea for designing and fabricating resistive devices with stable performance.