Non-contrast CT radiomics-clinical machine learning model for futile recanalization after endovascular treatment in anterior circulation acute ischemic stroke.

OBJECTIVE: To establish a machine learning model based on radiomics and clinical features derived from non-contrast CT to predict futile recanalization (FR) in patients with anterior circulation acute ischemic stroke (AIS) undergoing endovascular treatment. METHODS: A retrospective analysis was conducted on 174 patients who underwent endovascular treatment for acute anterior circulation ischemic stroke between January 2020 and December 2023. FR was defined as successful recanalization but poor prognosis at 90 days (modified Rankin Scale, mRS 4-6). Radiomic features were extracted from non-contrast CT and selected using the least absolute shrinkage and selection operator (LASSO) regression method. Logistic regression (LR) model was used to build models based on radiomic and clinical features. A radiomics-clinical nomogram model was developed, and the predictive performance of the models was evaluated using area under the curve (AUC), accuracy, sensitivity, and specificity. RESULTS: A total of 174 patients were included. 2016 radiomic features were extracted from non-contrast CT, and 9 features were selected to build the radiomics model. Univariate and stepwise multivariate analyses identified admission NIHSS score, hemorrhagic transformation, NLR, and admission blood glucose as independent factors for building the clinical model. The AUC of the radiomics-clinical nomogram model in the training and testing cohorts were 0.860 (95%CI 0.801-0.919) and 0.775 (95%CI 0.605-0.945), respectively. CONCLUSION: The radiomics-clinical nomogram model based on non-contrast CT demonstrated satisfactory performance in predicting futile recanalization in patients with anterior circulation acute ischemic stroke.

High-Concentrated Binary-Salt Ether Electrolytes for High-Voltage Lithium Metal Batteries with Ni-Rich Cathode.

The incompatibility of ether electrolytes with a cathode dramatically limits its application in high-voltage Li metal batteries. Herein, we report a new highly concentrated binary salt ether-based electrolyte (HCBE, 1.25 M LiTFSI + 2.5 M LiFSI in DME) that enables stable cycling of high-voltage lithium metal batteries with the Ni-rich (NCM83, LiNi0.83Co0.12Mn0.05O2) cathode. Experimental characterizations and density functional theory (DFT) calculations reveal the special solvation structure in HCBE. A solvation structure rich in aggregates (AGGs) can effectively broaden the electrochemical window of the ether electrolyte. The anions in HCBE preferentially decompose under high voltage, forming a CEI film rich in inorganic components to protect the electrolyte from degradation. Thus, the high-energy-density Li||NCM83 cell has a capacity retention of ≈95% after 150 cycles. Significantly, the cells in HCBE have a high and stable average Coulombic efficiency of over 99.9%, much larger than that of 1 M LiPF6 + EC + EMC + DMC (99%). The result emphasizes that the anionic-driven formation of a cathode electrolyte interface (CEI) can reduce the number of interface side reactions and effectively protect the cathode. Furthermore, the Coulombic efficiency of Li||Cu using the HCBE is 98.5%, underscoring the advantages of using ether-based electrolytes. This work offers novel insights and approaches for the design of high-performance electrolytes for lithium metal batteries.

Tuning the End Alkyl Chain of the Ether Solvent to Stabilize the Electrode/Electrolyte Interfaces in the NCM-Li Battery.

Lithium metal batteries (LMBs) combined with a high-voltage nickel-rich cathode show great potential in meeting the growing need for high energy density. The lack of advanced electrolytes has been a major obstacle in the commercialization of high-voltage lithium metal batteries (LMBs), as these electrolytes need to effectively support both a stable lithium metal anode (LMA) and a high-voltage cathode (>4 V vs Li+/Li). In this work, by extending the two terminal methyl groups in DIGDME and TEGDME to n-butyl groups, we design a new weakly solvating electrolyte (2 M LIFSI+TEGDBE) that enables the stable cycling of NMC83 (LiNi0.83Co0.12Mn0.05O2) cathodes. The NMC83 cell exhibits a high and stable Coulombic efficiency (CE) of over 99%, as well as capacity retention of approximately 99.8% after 100 cycles at 0.3 C. X-ray photoelectron spectroscopy analysis (XPS) and high-resolution transmission electron microscope (HRTEM) images revealed that the anion species decomposed first, resulting in the formation of a cathode-electrolyte interface (CEI) film predominantly consisting of decomposition products from the anions on the positive electrode surface. This work links the functional group of solvents with the solvation structure and electrochemical performance of ether-based electrolytes, providing a distinctive sight to design advanced electrolytes for high-energy-density LMBs.

[Determination of 12 prohibited veterinary drug residues in pig urine by ultra high performance liquid chromatography-tandem mass spectrometry].

A method was established for the simultaneous detection of 12 prohibited veterinary drugs, including ß2-receptor agonists, nitrofuran metabolites, nitroimidazoles, chlorpromazine, and chloramphenicol, in pig urine. The sample was pretreated by enzymolysis, acid hydrolysis/derivatization, and liquid-liquid extraction combined with solid-phase extraction. Detection was performed using ultra high performance liquid chromatography-tandem mass spectrometry (UHPLC-MS/MS). Ammonium acetate solution (0.2 mol/L, 4.5 mL) and ß-glucuronidase/aryl sulfatase (40 µL) were added to the sample, which was subsequently enzymolized at 37 ℃ for 2 h. Then, 1.5 mL of 1.0 mol/L hydrochloric acid solution and 100 µL of 0.1 mol/L o-nitrobenzaldehyde solution were added to the sample. The mixture was incubated at 37 ℃ for 16 h, and the analytes were extracted with 8 mL of ethyl acetate by liquid-liquid extraction. The lower aqueous phase obtained after extraction was extracted and purified using a mixed cation-exchange solid-phase extraction column. The extracts were combined, the extraction solution was blow-dried with nitrogen, and the residue was redissolved for determination. The samples were analyzed under multiple-reaction monitoring mode with both positive and negative electrospray ionization, and quantified using an isotope internal standard method. The correlation coefficients (r) of the 12 compounds were >0.99. The limits of detection (LODs) and quantification (LOQs) of chloramphenicol were 0.05 and 0.1 µg/L, respectively, and the LODs and LOQs of the other compounds were 0.25 and 0.5 µg/L, respectively. The mean recoveries and RSDs at 1, 2, and 10 times the LOQ were 83.6%-115.3% and 2.20%-12.34%, respectively. The proposed method has the advantages of high sensitivity, good stability, and accurate quantification; thus, it is suitable for the simultaneous determination of the 12 prohibited veterinary drug residues in pig urine.

[Clinical characteristics of 267 children with eosinophilic gastrointestinal disease: a multicenter study]. / 267ä¾‹å„¿ç«¥å—œé ¸ç²’ç»†èƒžæ€§èƒƒè‚ é“ç–¾ç— ä¸´åºŠç‰¹å¾åˆ†æžï¼šä¸€é¡¹å¤šä¸­å¿ƒç ”ç©¶.

OBJECTIVES: To explore the clinical manifestations, endoscopic findings, histopathological changes, treatment, and prognosis of eosinophilic gastrointestinal disease (EGID) in children, with the aim of enhancing awareness among pediatricians about this condition. METHODS: Data of 267 children with EGID were prospectively collected from January 2019 to July 2022 at Jiangxi Children's Hospital, Hunan Children's Hospital, and Henan Children's Hospital. The age of onset, symptoms, physical signs, laboratory examination results, endoscopic findings, histopathological changes, and treatment outcomes were observed. RESULTS: Among the 267 children with EGID, the majority had mild (164 cases, 61.4%) or moderate (96 cases, 35.6%) clinical severity. The disease occurred at any age, with a higher prevalence observed in school-age children (178 cases). The main symptoms in infants were vomiting and hematemesis, while in toddlers, vomiting and bloody stools were prominent. Abdominal pain and vomiting were the primary symptoms in preschool and school-age children. Nearly half (49.4%) of the affected children showed elevated platelet counts on hematological examination, but there was no significant difference in platelet counts among children with mild, moderate, and severe EGID (P>0.05). Endoscopic findings in EGID children did not reveal significant specificity, and histopathological examination showed no specific structural damage. Among them, 85.0% (227 cases) received acid suppression therapy, 34.5% (92 cases) practiced dietary avoidance, 20.9% (56 cases) received anti-allergic medication, and a small proportion (24 cases, 9.0%) were treated with prednisone. Clinical symptoms were relieved in all patients after treatment, but three cases with peptic ulcers experienced recurrence after drug discontinuation. CONCLUSIONS: Mild and moderate EGID are more common in children, with no specific endoscopic findings. Dietary avoidance, acid suppression therapy, and anti-allergic medication are the main treatment methods. The prognosis of EGID is generally favorable in children.

Correlating concerted cations with oxygen redox in rechargeable batteries.

Rechargeable batteries currently power much of our world, but with the increased demand for electric vehicles (EVs) capable of traveling hundreds of miles on a single charge, new paradigms are necessary for overcoming the limits of energy density, particularly in rechargeable batteries. The emergence of reversible anionic redox reactions presents a promising direction toward achieving this goal; however this process has both positive and negative effects on battery performance. While it often leads to higher capacity, anionic redox also causes several unfavorable effects such as voltage fade, voltage hysteresis, sluggish kinetics, and oxygen loss. However, the introduction of cations with topological chemistry tendencies has created an efficient pathway for achieving long-term oxygen redox with improved kinetics. The cations serve as pillars in the crystal structure and meanwhile can interact with oxygen in ways that affect the oxygen redox process through their impact on the electronic structure. This review delves into a detailed examination of the fundamental physical and chemical characteristics of oxygen redox and elucidates the crucial role that cations play in this process at the atomic and electronic scales. Furthermore, we present a systematic summary of polycationic systems, with an emphasis on their electrochemical performance, in order to provide perspectives on the development of next-generation cathode materials.

Highly selective recovery of gold and silver from E-waste via stepwise electrodeposition directly from the pregnant leaching solution enabled by the MoS2 cathode.

The recycling of electronic waste, i.e., waste Printed Circuit Boards (WPCBs), provides substantial environmental and economic advantages. In fact, the concentration of valuable precious and base metals in WPCBs is even higher compared to those found in mined ores. Nevertheless, it is still challenging to selectively extract precious metals with low concentrations from the pregnant leaching solution, due to the co-deposition of base metals, like Cu, which have higher concentrations. In this research, stepwise recovery of precious metals and copper directly from WPCBs thiosulfate leaching solution was facilitated by the Ti cathode coated with MoS2 (MoS2/Ti). The in-situ enrichment of Au(S2O3)23- and Ag(S2O3)23- at the surface of MoS2 enables the high efficiency and selectivity of electrodeposition, which has been confirmed through COMSOL Multiphysics simulations and visualization. As a result, the first-step electrodeposition at 0.6 V recovered 92.44 % Au and 98.18 % Ag without any co-deposition of Cu. Subsequently, the second-step recovery employed a constant current of 0.03 A, achieving 100 % recovery of copper within 12 h. Furthermore, this study optimized the reduction potential, NH3·H2O concentration, and S2O32- concentration for the stepwise electrodeposition process. These findings provide valuable insights for establishing a closed loop circular economy in the electronics industry.

Evolution of spatial-temporal differentiation pattern and decoupling relationship between provincial health resources and medical pressure in China / 中国卫生政策研究

Objective:To clarify the spatio-temporal characteristics and changing trends of provincial health resources and medical pressure,and to provide suggestions for the high-quality development of medical and health services in China.Methods:Based on the panel data of 31 provincial administrative units from 2010 to 2020,a comprehensive evaluation system of provincial health resources and medical pressure was constructed.The global entropy method and exploratory spatial analysis were used to reveal the spatio-temporal differentiation and correlation pattern,and the Tapio decoupling index was illustrated to explain the evolution characteristics and trends.Results:During the observation period,health resources and medical pressure in the vast majority of provinces in China rose steadily,with positive spatial correlation and agglomeration,and a close relationship with economic development and population demand;the mainstream decoupling state of the country shifted from a negative decoupling to a positive decoupling,with an obvious progressive decoupling trend,and the development of regional health continued to improve.Conclusions and suggestions:Provinces need to take into account the status quo of health development in their own provinces,focus on the spatio-temporal coupling of elements and structures,and optimize the structure of health resource allocation and enhance the resilience of the health system as a means of bringing into play the comparative advantages of the regional health system.

Application and effectiveness of an improved endoscopically guided nasojejunal tube placement technique in critically ill patients: a retrospective cohort study.

Background: The endoscopic nasojejunal (NJ) placement plays a pivotal role in the nutritional support of critically ill patients. However, the conventional endoscopy-guided tube insertion method presents issues of excessive procedural duration. We have enhanced the traditional endoscopy-guided catheter placement method, enabling a faster and more convenient catheter insertion. Methods: We improved the traditional endoscopically guided technique by incorporating an extra silk thread knot at the 25 cm mark on the jejunal segment of the NJ tube to assist endoscopists in accurate tube placement. We conducted the improved NJ tube placement on critically ill patients in need of enteral nutrition (EN). Laboratory data were retrospectively collected before and after the 7-day period of NJ tube placement and EN treatment to evaluate the effectiveness and safety of the improved method. Results: A total of 88 critically ill patients, with an average age of 59.6±15.5 years, and a male ratio of 86.4%, who underwent the improved NJ tube placement method were enrolled into analysis finally, achieving a 100% success rate of NJ tube insertion. The average time for tube insertion was 5.9±2.2 min, with a mean insertion depth of 108.8±12.5 cm. The EN tolerance score was 0.79±0.98. Following 7 days of EN therapy, the patients showed significant improvement in serum albumin levels compared to baseline (36.42 vs. 33.66 g/L, P<0.001). Conclusions: The improved endoscopically guided NJ tube placement technique is a rapid and safe procedure with excellent patient tolerance. It significantly improves the nutritional status of critically ill patients and facilitates the administration of EN, which requires further validation through randomized controlled trials.

Network pharmacology-based and molecular docking-based analysis of You-Gui-Yin for the treatment of osteonecrosis of the femoral head.

You-Gui-Yin (YGY) is a classic prescription for warming up kidney-Yang and filling in kidney essence in traditional Chinese medicine, and has been used to treat osteonecrosis of the femoral head (ONFH) effectively. However, the underlying mechanisms are still unknown. This study is aimed at exploring the possible mechanisms of action of the YGY in the treatment of ONFH based on network pharmacology and molecular docking. TCMSP was used to screen the active components and targets of YGY. The disease targets of ONFH were collected in several public databases. The protein-protein interaction (PPI) Network was constructed using the STRING platform. The Metascape database platform was used for Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) analyses. The key active components and core target proteins of YGY in the treatment of ONFH were verified by the molecular docking. 120 active components were obtained from YGY, among which 73 components were hit by the 117 drug-disease intersection targets. Key effective components included quercetin, kaempferol, beta-sitosterol, glycitein, beta-carotene, and so on. Core target proteins included ALB, AKT1, TNF, IL6, TP53, and so on. According to GO and KEGG analyses, there were 1762 biological processes, 94 cellular component, 138 molecular function and 187 signaling pathways involved. we selected the top 20 biological processes (BP), cellular components (CC), molecular functions (MF) and signaling pathways to draw the heat maps, showing that Lipid and atherosclerosis signaling pathway, IL-17 signaling pathway, HIF-1 signaling pathway, relaxin signaling pathway and MAPK signaling pathway and other pathways may play a key role in the treatment of ONFH by YGY. The results of molecular docking showed that key effective components and corresponding core target proteins exhibited the good binding activity. YGY can treat ONFH through multicomponents, multitargets, and multipathways, which provides a reference for the subsequent research, development of targeted drugs and clinical application.

Burkholderia cepacia Induced Occipital Subcutaneous Abscess and Fracture in a Brain-Dead Woman.

Burkholderia cepacia is an aerobic opportunistic Gram-negative pathogen that mainly infects immunodeficiency patients. However, soft tissue infections with fractures due to Burkholderia cepacia are rare with no cases reported. Here, we report a rare case of 3 years of brain death in a 43-year-old woman with Burkholderia cepacia resulting in an occipital subcutaneous abscess and fracture. Through the second-generation sequencing of the whole genome of this strain, it was found that there were no high virulence genes and virulence factors. The patient received targeted antibiotic therapy and showed improvement in clinical symptoms and radiological signs. Bone destruction because of Burkholderia cepacia is easily overlooked due to the lack of characteristic symptoms and limited clinical examination. This case reminds us that Burkholderia cepacia without major virulence factors could damage the bone in immune-compromised patients.

One-Step Solid-State Synthesis of Ni-Rich Cathode Materials for Lithium-Ion Batteries.

Ni-rich cathodes are expected to serve as critical materials for high-energy lithium-ion batteries. Increasing the Ni content can effectively improve the energy density but usually leads to more complex synthesis conditions, thus limiting its development. In this work, a simple one-step solid-state process for synthesizing Ni-rich ternary cathode materials NCA (LiNi0.9Co0.05Al0.05O2) was presented, and the synthesis conditions were systematically studied. It was found that the synthesis conditions have a substantial impact on electrochemical performance. Furthermore, the cathode materials produced through a one-step solid-state process exhibited excellent cycling stability, maintaining 97.2% of their capacity after 100 cycles at a rate of 1 C. The results show that a one-step solid-state method can successfully synthesize Ni-rich ternary cathode material, which has great potential for application. Optimizing the synthesis conditions also provides valuable ideas for the commercial synthesis of Ni-rich cathode materials.

A Critical Review on the Recycling Strategy of Lithium Iron Phosphate from Electric Vehicles.

Electric vehicles (EVs) are one of the most promising decarbonization solutions to develop a carbon-negative economy. The increasing global storage of EVs brings out a large number of power batteries requiring recycling. Lithium iron phosphate (LFP) is one of the first commercialized cathodes used in early EVs, and now gravimetric energy density improvement makes LFP with low cost and robustness popular again in the market. Developments in LFP recycling techniques are in demand to manage a large portion of the EV batteries retired both today and around ten years later. In this review, first the operation and degradation mechanisms of LFP are revisited aiming to identify entry points for LFP recycling. Then, the current LFP recycling methods, from the pretreatment of the retired batteries to the regeneration and recovery of the LFP cathode are summarized. The emerging direct recovery technology is highlighted, through which both raw material and the production cost of LFP can be recovered. In addition, the current issues limiting the development of the LIBs recycling industry are presented and some ideas for future research are proposed. This review provides the theoretical basis and insightful perspectives on developing new recycling strategies by outlining the whole-life process of LFP.

Regulating Surface Oxygen Activity by Perovskite-Coating-Stabilized Ultrahigh-Nickel Layered Oxide Cathodes.

Ultrahigh-Ni layered oxides are proposed as promising cathodes to fulfill the range demand of electric vehicles; yet, they are still haunted by compromised cyclability and thermal robustness. State-of-the-art surface coating has been applied to solve the instability via blocking the physical contact between the electrolyte and the highly active Ni4+ ions on the cathode surface, but it falls short in handling the chemo-physical mobility of the oxidized lattice oxygen ions in the cathode. Herein, a direct regulation strategy is proposed to accommodate the highly active anionic redox within the solid phase. By leveraging the stable oxygen vacancies/interstitials in a lithium and oxygen dual-ion conductor (layered perovskite La4 NiLiO8 ) coating layer, the reactivity of the surface lattice oxygen ion is dramatically restrained. As a result, the oxygen release from the lattice is suppressed, as well as the undesired irreversible phase transition and intergranular mechanical cracking. Meanwhile, the introduced dual-ion conductor can also facilitate lithium-ion diffusion kinetics and electronic conductivity on the particle surface. This work demonstrates that accommodating the anionic redox chemistry by dual-ion conductors is an effective strategy for capacity versus stability juggling of the high-energy cathodes.

Ultra-Broadband, Omnidirectional, High-Efficiency Metamaterial Absorber for Capturing Solar Energy.

In this study, we investigated an absorber based on a center-aligned tandem nanopillar array for ultra-broadband solar energy harvesting theoretically. A high-efficiency, omnidirectional absorber was obtained by introducing the center-aligned tandem nanopillar array embedded in an Al2O3 dielectric layer. The multi-coupling modes at different wavelengths were interpreted. The strong absorption can be adjusted by changing the radii and heights of nanopillars. According to the simulation results, the average absorptance of the absorber exceeded 94% in the wavelength range from 300 nm to 2000 nm. In addition, the high-efficiency absorption was insensitive to the incident angle and polarization state. The research not only proposed an absorber which possesses a huge potential value for application areas, such as thermal photovoltaic systems, infrared detection, and isotropic absorption sensors, but also pointed out a new way to design an absorber with high efficiency in an ultrabroad wavelength range.

Age-Related Sex Disparities in Esophageal Cancer Survival: A Population-Based Study in the United States.

Background: The association between sex and the survival of patients with esophageal cancer (EC) remains controversial. We sought to systematically investigate sex-based disparities in EC survival using the Surveillance, Epidemiology, and End Results (SEER) registry data from the United States. Methods: Patients with EC diagnosed from 2004 to 2015 registered in the SEER database were selected. The association between sex and cancer-specific survival (CSS) was evaluated using survival analysis. The Inverse Probability Weighting (IPW) approach was applied to reduce the observed bias between males and females. Subgroup analyses were used to investigate the robustness of the sex-based disparity and to explore potential interaction effects with other variables. Results: Overall, 29,312 eligible EC patients were analyzed, of whom 5,781 were females, and 23,531 were males. Females had higher crude CSS compared to males (10-year CSS: 24.5 vs. 21.3%; P < 0.001). Similar results were obtained after adjusting for selection bias using the IPW approach and multivariate regression. Subgroup analyses confirmed the relative robustness of sex as a prognostic factor. However, significant interactions were observed between sex and other variables, such as age, race, tumor grade, histology, and treatment modality. In particular, there was no survival advantage for premenopausal females compared to their male counterparts, but the association between sex and EC survival was prominent in 46-55-year-old patients. Conclusions: Female EC patients had better long-term survival than males. The association between sex and EC survival vary according to age, race, tumor grade, histology, and treatment modality. Sex-based disparity in EC-specific survival was age-related in the United States population.

[Etiology of ascites in 165 children]. / 165ä¾‹å„¿ç«¥è ¹æ°´çš„ç— å› åˆ†æž.

OBJECTIVES: To study the etiology and clinical features of children with ascites, so as to provide a basis for the diagnosis and treatment of ascites in children. METHODS: The medical data of the children with ascites, who were hospitalized from January 1, 2010 to December 31, 2019, were retrospectively reviewed. RESULTS: Among the 165 children with ascites, the male/female ratio was 1.53:1, and the mean age of onset was (6±4) years. The causes of ascites included surgical acute abdomen (39 children, 23.6%), infectious diseases (39 children, 23.6%), neoplastic diseases (27 children, 16.4%), hepatogenic diseases (18 children, 10.9%), pancreatitis (10 children, 6.1%), cardiogenic diseases (8 children, 4.8%), rheumatic immune diseases (6 children, 3.6%), and nephrogenic diseases (5 children, 3.0%). According to the age of onset, there were 33 infants, 24 young children, 30 preschool children, 41 school-aged children, and 37 adolescents. Surgical acute abdomen and hepatogenic diseases were the main causes of ascites in infants (P<0.05). Neoplastic disease was the leading cause in young children (P<0.05). Infectious diseases were the most common cause in adolescents (P<0.05). CONCLUSIONS: Surgical acute abdomen, infectious diseases, neoplastic diseases, and hepatogenic diseases are the common causes of ascites in children, and there are some differences in the leading cause of ascites between different age groups.

Synthesis and properties of a novel decacyclic S,N-heteroacene.

S,N-Heteroacene materials with fused multicyclic heteroaromatics have become increasingly attractive for organic optoelectronic device applications. In this work, the Cadogan ring-closure reaction between the benzene moiety of thieno[3,2-b]indole and 5,6-dinitrobenzo[c][1,2,5]thiadiazole was employed to prepare the novel decacyclic S,N-heteroacene 15,16-dibutyl-14,17-didodecyldithieno[2'',3'':2',3']indolo[6',7':4,5]pyrrolo[3,2-e:2',3'-g][2,1,3]benzothiadiazole (TIP), C58H76N6S3. The conjugated backbone of TIP is extended in comparison with its octacyclic analogue as the central unit within Y6-type molecular acceptors, a family of overwhelming electron acceptors in polymer solar-cell research. The single-crystal X-ray diffraction (SC-XRD) characterization indicated the existence of π-π and C(sp2)-H...π interactions among TIP molecules. The electrochemical and optical properties of TIP were also characterized. As a novel S,N-heteroacene building block, TIP is anticipated to be of potential use in the construction of promising electronic materials.