[Meta-analysis and trial sequential analysis of Tanreqing Injection in treatment of severe pneumonia in elderly].

This study aimed to systematically evaluate the effectiveness and safety of Tanreqing Injection in the treatment of severe pneumonia in the elderly. Eighteen randomized controlled trials(RCTs) involving 1 457 elderly patients with severe pneumonia were included in the study after conducting searches in both Chinese and English databases as well as clinical trial registration platforms. The quality of the included studies was assessed using the Cochrane risk of bias assessment tool. Meta-analysis were conducted using RevMan 5.4 and Stata 17 software, and trial sequential analysis(TSA) was performed using TSA 0.9.5.10 beta software. Meta-analysis results showed that compared with conventional western medicine treatment, Tanreqing Injection + conventional western medical significantly improved the clinical effectiveness in elderly patients with severe pneumonia(RR=1.26, 95%CI[1.20, 1.32], P<0.000 01), arterial oxygen partial pressure(SMD=6.23, 95%CI[3.29, 9.18], P<0.000 1), oxygenation index(SMD=11.72, 95%CI[4.41, 19.04], P=0.002), reduce procalcitonin(SMD=-6.16, 95%CI[-8.10,-4.21], P<0.000 01), C-reactive protein(SMD=-8.50, 95%CI[-11.05,-5.96], P<0.000 01), white blood cell count(SMD=-4.56, 95%CI[-5.73,-3.39], P<0.000 01), and shortened the duration of fever(SMD=-3.12, 95%CI[-4.61,-1.63], P<0.000 1), cough(SMD=-4.84, 95%CI[-6.90,-2.79], P<0.000 01), lung rales(SMD=-0.99, 95%CI[-1.54,-0.44], P=0.000 4), and mechanical ventilation time(SMD=-3.26, 95%CI[-5.03,-1.50], P=0.000 3), increase CD4~+ T-cell levels(SMD=6.73, 95%CI[5.23, 8.23], P<0.000 01) and CD8~+ T-cell levels(SMD=7.47, 95% CI[5.32, 9.61], P<0.000 01) with no significant adverse reactions. TSA confirmed the stability and reliability of the results related to clinical effectiveness. This study suggests that Tanreqing Injection, as a Chinese medicinal preparation, has a significant therapeutic effect and good safety profile in the treatment of severe pneumonia in elderly patients. Due to the limited quality of the included studies, high-quality RCT is still needed to provide evidence support for the above conclusions.

Improved amyloid burden quantification with nonspecific estimates using deep learning.

PURPOSE: Standardized uptake value ratio (SUVr) used to quantify amyloid-ß burden from amyloid-PET scans can be biased by variations in the tracer's nonspecific (NS) binding caused by the presence of cerebrovascular disease (CeVD). In this work, we propose a novel amyloid-PET quantification approach that harnesses the intermodal image translation capability of convolutional networks to remove this undesirable source of variability. METHODS: Paired MR and PET images exhibiting very low specific uptake were selected from a Singaporean amyloid-PET study involving 172 participants with different severities of CeVD. Two convolutional neural networks (CNN), ScaleNet and HighRes3DNet, and one conditional generative adversarial network (cGAN) were trained to map structural MR to NS PET images. NS estimates generated for all subjects using the most promising network were then subtracted from SUVr images to determine specific amyloid load only (SAßL). Associations of SAßL with various cognitive and functional test scores were then computed and compared to results using conventional SUVr. RESULTS: Multimodal ScaleNet outperformed other networks in predicting the NS content in cortical gray matter with a mean relative error below 2%. Compared to SUVr, SAßL showed increased association with cognitive and functional test scores by up to 67%. CONCLUSION: Removing the undesirable NS uptake from the amyloid load measurement is possible using deep learning and substantially improves its accuracy. This novel analysis approach opens a new window of opportunity for improved data modeling in Alzheimer's disease and for other neurodegenerative diseases that utilize PET imaging.

Carbon-nanotube-entangled Co,N-codoped carbon nanocomposite for oxygen reduction reaction.

The design of highly efficient and stable electrocatalysts for oxygen reduction reaction (ORR) is still a great challenge. Herein, we prepared Co,N-codoped carbon nanocomposites (Co@NC-ZM) with entangled carbon nanotubes. The large Brunauer-Emmett-Teller surface area (604.7 m2 g-1), rich mesoporous feature, Co,N doping and synergetic effect between various species of Co@NC-ZM can expose more active sites and facilitate conductivity and mass transport. Benefiting from the above unique advantages, Co@NC-ZM exhibits excellent ORR performance with more positive onset potential (0.96 V) and half-wave potential (0.83 V) than those of commercial Pt/C (0.96 and 0.81 V, correspondingly). This work provides a new strategy for further exploring efficient non-precious-metal-based catalysts for ORR.

Fe/N-doped hollow porous carbon spheres for oxygen reduction reaction.

Herein, we design a dual-template-assisted pyrolysis method to prepare ultra-small Fe3O4 nanoparticles anchored on Fe/N-doped hollow porous carbon spheres (0.010-Fe/NHPCS-800) for oxygen reduction reaction (ORR). The synthesized SiO2 nanospheres, which are selected as the hard template, contribute to forming macroporous structure. Pluronic ® F127 is employed to fabricate mesopores through high-temperature pyrolysis as a soft template. In this way, the 0.010-Fe/NHPCS-800 architecture represents an ordered hierarchically porous property with a large BET surface area (1812 m2 g-1), which can facilitate the mass transport of reactants and increase the electrochemically active area. The Fe3O4 nanoparticles wrapped by graphitic carbon layers provide more active sites, and the synergistic interaction between Fe3O4 nanoparticles and doping N has a positive effect on ORR performance. The 0.010-Fe/NHPCS-800 catalyst outperforms the most effective ORR activities among a series of Fe/NHPCS samples with onset potential of 0.95 V (versus reversible hydrogen potential) and half-wave potential of 0.81 V, which is almost the same as the commercial Pt/C (0.96 and 0.81 V, correspondingly) in 0.10 M KOH. However, both the stability and durability of 0.010-Fe/NHPCS-800 surpass those of commercial Pt/C. Given all these advantages, 0.010-Fe/NHPCS-800 is a promising candidate to take the place of Pt-based electrocatalysts for ORR in the future.

The realistic energy yield potential of GaAs-on-Si tandem solar cells: a theoretical case study.

Si based tandem solar cells represent an alternative to traditional compound III-V multijunction cells as a promising way to achieve high efficiencies. A theoretical study on the energy yield of GaAs on Si (GaAs/Si) tandem solar cells is performed to assess their energy yield potential under realistic illumination conditions with varying spectrum. We find that the yield of a 4-terminal contact scheme with thick top cell is more than 15% higher than for a 2-terminal scheme. Furthermore, we quantify the main losses that occur for this type of solar cell under varying spectra. Apart from current mismatch, we find that a significant power loss can be attributed to low irradiance seen by the sub-cells. The study shows that despite non-optimal bandgap combination, GaAs/Si tandem solar cells have the potential to surpass 30% energy conversion efficiency.

Developing an evaluation index system for the online learning literacy of physical education teachers in China.

Background: The convenience of online learning helps physical education teachers overcome geographic barriers and promotes safe, accessible, high-quality education. This three-stage study developed an evaluation index system for online learning literacy of physical education (PE) teachers (OLLPET). Methods: Using two rounds of the Delphi method and one round of the Expert ranking method, consult with 15 PE experts from universities, primary and secondary schools, and teaching-research staff to draw up, revise, and finalize an evaluation index system for OLLPET. Results: Our OLLPET evaluation index system includes three first-level indicators, seven second-level indicators and 30 third-level indicators. The first-level indicators includes online learning values (OLV), online learning essential character (OLEC), and online learning key competencies (OLKC)-with equal weighting given to OLV (0.367) and OLKC (0.367) and slightly less given to OLEC (0.267). Conclusion: The OLLPET evaluation index system is a theoretical yet practical tool that governments, schools, and teachers can use to evaluate PE teachers' online learning literacy to improve their learning capacity in a targeted manner.

Model Construction of Chinese Preservice Physical Education Teachers' Perception of Social Media: A Grounded Theory Approach.

(1) Background: Pre-service physical education teachers commonly embrace social media for multiple purposes. However, little is known about their perception of social media, which could affect the appropriate use of social media in their future professional work. This study aims to explore a theoretical model of how pre-service physical education teachers perceive social media in order to provide a basis for educators to guide their appropriate use of social media. (2) Methods: Qualitative data were collected in diverse ways, mainly from interviews. Seventeen Chinese preservice physical education teachers were selected as participants by a purposive sampling technique. The interview questions focused on participants' motivation, expectations, and experiences in social media usage. Grounded theory was used to analyze the data by ROST CM and Nvivo 12. (3) Results: The perception of social media among teachers includes three subsidiary categories made up of 10 sub-categories, 70 concepts, and 307 labels. The three categories are (a) value perception, including the perspective of intelligent function, interaction, and rich information, (b) risk perception, involving psychological risk, information risk and privacy risk and (c) overall perception, like development trends, current status and basic elements. (4) Conclusions: Chinese preservice physical education teachers perceive social media as having similarities and differences compared to other countries. Future research should consider a large sample survey to revise and verify the initial exploration of perception and study diverse groups of teachers' perceptions of social media.

Efficacy and Safety of QiShen YiQi Dripping Pills in the Treatment of Coronary Heart Disease Complicating Chronic Heart Failure (Syndrome of Qi Deficiency with Blood Stasis): Study Protocol for a Randomized, Placebo-Controlled, Double-Blind and Multi-Centre Phase II Clinical Trial.

Background: Heart failure (HF) is a serious and terminal stage of various cardiac diseases and the most common complication of coronary heart disease (CHD). Previous clinical studies have shown that Qishen Yiqi dropping pills (QSYQ) have the effect of treating chronic heart failure. This study aims to evaluate the clinical efficacy, safety and optimal effective dose of QSYQ in treating CHD complicating chronic HF with reduced ejection fraction (HFrEF). Methods: We will conduct a randomized, double-blind, placebo controlled, multicenter clinical trial. A total of 228 individuals from 16 hospitals in China will be randomly assigned to the low-dose, high-dose, and placebo groups in a ratio of 1:1:1. The trial consists of a screening period (standard medical treatment for at least 2 weeks) and a 12-week treatment period. After randomization, follow-up will be conducted at the 4th, 8th and 12th week. The primary outcomes will be the 6-Minute Walk Test (6MWT) at Week 12. Secondary outcomes will include 6MWT distance at Week 4 and 8, New York Heart Association (NYHA) functional classification, Traditional Chinese Medicine (TCM) Syndrome score, echocardiography indices, N-terminal pro-B-type natriuretic peptide (NT-proBNP), oxyhemoglobin saturation, Minnesota living with heart failure questionnaire (MLHFQ) score, grasp strength body mass index test and cardiovascular adverse events (AE). Ethics and Dissemination: This trial has been approved by the Research Ethics Committee of the First Affiliated Hospital of Guangzhou University of Chinese Medicine, China (approval number: ZYYEC [2021]005). Written informed consent will be obtained from all participants. The results of this trial will be publicly shared through academic conferences and peer-reviewed journals. Study Registration: Clinical Trials Registry (NCT04983043, Date: 07/08/2021, https://clinicaltrials.gov/ct2/show/NCT04983043).

Impact of inflammation and anti-inflammatory modalities on diabetic cardiomyopathy healing: From fundamental research to therapy.

Diabetic cardiomyopathy (DCM) is a prevalent cardiovascular complication of diabetes mellitus, characterized by high morbidity and mortality rates worldwide. However, treatment options for DCM remain limited. For decades, a substantial body of evidence has suggested that the inflammatory response plays a pivotal role in the development and progression of DCM. Notably, DCM is closely associated with alterations in inflammatory cells, exerting direct effects on major resident cells such as cardiomyocytes, vascular endothelial cells, and fibroblasts. These cellular changes subsequently contribute to the development of DCM. This article comprehensively analyzes cellular, animal, and human studies to summarize the latest insights into the impact of inflammation on DCM. Furthermore, the potential therapeutic effects of current anti-inflammatory drugs in the management of DCM are also taken into consideration. The ultimate goal of this work is to consolidate the existing literature on the inflammatory processes underlying DCM, providing clinicians with the necessary knowledge and tools to adopt a more efficient and evidence-based approach to managing this condition.

Validation of deep learning-based nonspecific estimates for amyloid burden quantification with longitudinal data.

PURPOSE: To validate our previously proposed method of quantifying amyloid-beta (Aß) load using nonspecific (NS) estimates generated with convolutional neural networks (CNNs) using [18F]Florbetapir scans from longitudinal and multicenter ADNI data. METHODS: 188 paired MR (T1-weighted and T2-weighted) and PET images were downloaded from the ADNI3 dataset, of which 49 subjects had 2 time-point scans. 40 Aß- subjects with low specific uptake were selected for training. Multimodal ScaleNet (SN) and monomodal HighRes3DNet (HRN), using either T1-weighted or T2-weighted MR images as inputs) were trained to map structural MR to NS-PET images. The optimized SN and HRN networks were used to estimate the NS for all scans and then subtracted from SUVr images to determine the specific amyloid load (SAßL) images. The association of SAßL with various cognitive and functional test scores was evaluated using Spearman analysis, as well as the differences in SAßL with cognitive test scores for 49 subjects with 2 time-point scans and sensitivity analysis. RESULTS: SAßL derived from both SN and HRN showed higher association with memory-related cognitive test scores compared to SUVr. However, for longitudinal scans, only SAßL estimated from multimodal SN consistently performed better than SUVr for all memory-related cognitive test scores. CONCLUSIONS: Our proposed method of quantifying Aß load using NS estimated from CNN correlated better than SUVr with cognitive decline for both static and longitudinal data, and was able to estimate NS of [18F]Florbetapir. We suggest employing multimodal networks with both T1-weighted and T2-weighted MR images for better NS estimation.

Development of an Assessment of Ethics for Chinese Physical Education Teachers: A Study Using the Delphi and Expert Ranking Methods.

BACKGROUND: Developing the ethics of physical education (PE) teachers is important for promoting the overall development of students. However, it is unclear which indicators can be used to assess the ethics of PE teachers in China. Therefore, this study aimed to develop an assessment of ethics for Chinese physical education teachers (AECPET) using the Delphi and expert ranking methods. METHODS: Two rounds of the Delphi method were performed to develop the assessment. An expert ranking method was used to determine the weight of each domain and indicator. RESULTS: The developed AECPET is a multi-dimensional model with eight domains: (1) Policy Implementation (PI), (2) Legal Compliance and Patriotism (LCP), (3) Love for Students (LS), (4) Daily Performance (DP), (5) Philosophy of Educating Students (PES), (6) Attitude towards Scientific Research (ASR), (7) Awareness of Self-discipline and Honesty (ASH), and (8) Attitude towards Serving Society (ASS); and 42 indicators. The weight of PI, LCP, LS, DP, PES, ASR, ASH, and ASS are 18.1%, 19.1%, 16.2%, 11.1%, 16.3%, 7.2%, 9.1%, and 4.6%, respectively. CONCLUSIONS: The AECPET is an evaluating system constructed based on the perspective of Chinese PE teachers, which also has a potentially global perspective and can be used by PE teachers with different cultural views. Applied by the government, schools, PE teachers, and students, the AECPET can improve the level of ethics of Chinese PE teachers.

Co0.7Fe0.3 NPs confined in yolk-shell N-doped carbon: engineering multi-beaded fibers as an efficient bifunctional electrocatalyst for Zn-air batteries.

The development of bifunctional catalysts with a delicate structure, high efficiency, and good durability for the oxygen evolution reaction (ORR) and oxygen evolution reaction (OER) is crucial to renewable Zn-air batteries. In this work, Co0.7Fe0.3 alloy nanoparticles (NPs) confined in N-doped carbon with a yolk-shell structure in multi-beaded fibers were prepared as a bifunctional electrocatalyst. The confinement structure was composed of an N-doped graphitized carbon shell and a core formed by numerous Co0.7Fe0.3 NPs, and was evenly threaded into a one-dimensional fiber. Moreover, this distinctive hierarchical structure featured abundant mesopores, a high BET surface area of 743.8 m2 g-1, good electronic conductivity, and uniformly distributed Co0.7Fe0.3/Co(Fe)-Nx coupling active sites. Therefore, the experimentally optimized Co0.7Fe0.3@NC2:1-800 showed excellent OER performance (overpotential reached 314 mV at 10 mA cm-2) that far exceeded RuO2 (353 mV), and good ORR catalytic performance (half-wave potential of 0.827 V) comparable to Pt/C (0.818 V). Impressively, the Co0.7Fe0.3@NC2:1-800 Zn-air battery delivered a higher open circuit voltage of 1.449 V, large power density of 85.7 mW cm-2, and outstanding charge-discharge cycling stability compared with the commercial RuO2 + 20 wt% Pt/C catalyst. This work provides new ideas for the structural design of electrocatalysts and energy conversion systems.