Comparative efficacy and safety of intelligent pressure-controlled versus flexible vacuum-assisted ureteral access sheath for 2-4 cm renal calculi.

BACKGROUND: Retrograde intrarenal surgery (RIRS) is being increasingly used to treat 2-4 cm renal stones, which can be attributed to advances in flexible ureteroscopes and ureteral access sheaths (UASs). Despite the improvement and application of flexible vacuum-assisted (FV) and intelligent pressure-controlled (IPC) UASs, no studies have compared their therapeutic efficacy and safety. Therefore, this study aimed to compare the therapeutic efficacy and safety of IPC-UAS and FV-UAS in RIRS 2-4 cm renal stones. METHODS: We included 96 and 103 patients who underwent IPC-UAS and FV-UAS RIRS, respectively, for 2-4 cm renal stones. Stone-free rate (SFR), operative time, and complications were compared between the two groups. RESULTS: The immediate SFR was 69.8% and 82.5% in the IPC-UAS and FV-UAS groups, respectively (P<0.05). There were no significant between-group differences in the 1-month SFR (84.4% vs. 84.5%, P>0.05). The IPC-UAS group had a shorter hospital stay (5.2±2.4 vs. 6.2±3.2 days, P=0.018) and lower cost (CNY13014.7±3240.7 vs. CNY14022.5±2301.6, P=0.012) than the FV-UAS group. There were no significant between-group differences in operative time or complications. CONCLUSIONS: Regarding RIRS for 2-4 cm renal stones, the IPC-UAS group can achieve a 1-month SFR similar to that of the FV-UAS group, with shorter hospitalization and lower cost. Additionally, the IPC-UAS is a promising device for efficient and safe RIRS, considering its intelligent pressure regulation. Our findings could inform optimal UAS selection for managing large renal calculi and demonstrate the utility of the novel IPC-UAS in improving outcomes of RIRS for 2-4 cm renal stones.

Sustainable flood control strategies under extreme rainfall: Allocation of flood drainage rights in the middle and lower reaches of the yellow river based on a new decision-making framework.

Climate change has exacerbated the frequency and magnitude of extreme rainfall, which has led to the perpetuation of flooding as a hazard to humans and society. China has begun to consider introducing Flood drainage rights (FDR), a sustainable flood control measure, into non-engineering measures as a complement to engineering measures for flood control. FDR represent the right of regions to discharge regional floodwaters caused by extreme rainfall into the river, and are the primary means of controlling the amount of floodwaters from regions when regional flood capacity is exceeded. However, existing studies on quantitative FDR allocation still have limitations, and some previous methods have resulted in allocation schemes that are not entirely reasonable and fair because they do not comprehensively consider the influencing factors of FDR or the allocation method is unreasonable. This paper explores the impact of flooding on rural and agricultural areas. We incorporate the factors of agricultural economy and security and construct a system of the allocation indicators of FDR composed of five principles: Natural Environmental Endowment, General Economic and Social Development, Agricultural Economy and Security, Macro policy regulation, and Respect for Historical Background. Second, considering the influence of expert judgment and data of different time nodes on the allocation of FDR, we introduce the concepts of expert weight and time weight into the allocation model of FDR, and construct a new set of framework for the allocation of FDR, i.e., "[(expert weight + subjective weight)+(time weight + objective weight)]+decision making model ". To reduce the loss of information during the transformation of subjective judgments, we also introduced triangular fuzzy numbers for the transformation between expert judgments and numbers. Finally, we take the five provinces in the middle and lower reaches of the Yellow River as an example. Using the data from 2010 to 2021, we obtain the final allocation scheme (proportion) of FDR as Henan (33.26%) > Shaanxi (23.08%) > Inner Mongolia (21.31%) > Shanxi (14.44%) > Shandong (7.91%). On this basis, this paper utilizes sensitivity analysis and comparative validation to demonstrate the rationality and effectiveness of the method, and identifies several indicators that have a greater impact on the results of the allocation of FDR. FDR can form part of a set of integrated flood management system together with flood control projects, which greatly alleviates the drainage conflicts arising from flooding caused by extreme precipitation. Under extreme rainfall conditions, FDR improves drainage efficiency and minimizes the overall damage caused by flooding in the watershed. This study can contribute to the sustainable development of the watershed and provide a reference for the promotion and utilization of sustainable flood control measures.

In Situ Construction of (NiCo)3Se4 Nanobeads Embedded in N-Doped Carbon 3D Interconnected Networks for Enhanced Sodium Storage.

Transition metal selenides, boasting remarkable specific capacity, have emerged as a promising electrode material. However, the substantial volume fluctuations during sodium ion insertion and extraction result in inadequate cyclic stability and rate performance, impeding their practical utility. Here, we synthesized N-doped carbon three-dimensional (3D) interconnected networks encapsulating (NiCo)3Se4 nanoparticles, denoted as ((NiCo)3Se4/N-C), exhibiting a bead-like structure and carbon confinement through electrospinning and subsequent thermal treatment. The N-doped carbon 3D interconnected networks possess high porosity and ample volume buffering capacity, enhance conductivity, shorten ion diffusion paths, and mitigate mechanical stress induced by volume changes during cycling. The uniformly distributed (NiCo)3Se4 nanoparticles, featuring a stable structure, demonstrate rapid electrochemical kinetics and numerous available active sites. The distinctive structure and composition of the optimized (NiCo)3Se4/N-C material showcase a high specific capacity (656.2 mAh g-1 at 0.1 A g-1) and an outstanding rate capability. A kinetic analysis confirms that (NiCo)3Se4/N-C stimulates the pseudocapacitive Na+ storage mechanism with capacitance contributing up to 89.2% of the total capacity. This unique structure design and doping approach provide new insights into the design of electrode materials for high-performance batteries.

The genome of African manatee Trichechus senegalensis reveals secondary adaptation to the aquatic environment.

Sirenians exhibit unique aquatic adaptations, showcasing both convergent adaptive features shared with cetaceans and unique characteristics such as cold sensitivity and dense bones. Here, we report a chromosome-level genome of the African manatee (Trichechus senegalensis) with high continuity, completeness, and accuracy. We found that genes associated with osteopetrosis have undergone positive selection (CSF1R and LRRK1) or pseudogenized (FAM111A and IGSF23) in the African manatee, potentially contributing to the dense bone formation. The loss of KCNK18 may have increased their sensitivity to cold water temperatures. Moreover, we identified convergent evolutionary signatures in 392 genes among fully aquatic mammals, primarily enriched in skin or skeletal system development and circadian rhythm, which contributed to the transition from terrestrial to fully aquatic lifestyles. The African manatee currently possesses a small effective population size and low genome-wide heterozygosity. Overall, our study provides genetic resources for understanding the evolutionary characteristics and conservation efforts of this species.

Mediation effect of gut microbiota on the relationship between physical activity and carotid plaque.

Background: Physical activity has been shown to have an effect on Carotid plaque (CP) which is a predictor of Cardiovascular disease (CVD). Studies have shown that physical activity can alter the composition of gut microbiota, whether its influence on CP was mediated by gut microbiota has yet to be proved. Methods: We conducted a case-control study involving 30 CP patients and 31 controls. Logistic regression was used to analyze the association between CP and physical activity. LefSe was used to explore the association between gut microbiota and physical activity as well as CP, and PhyloMed was used to examine the mediating effect of gut microbiota in the association between physical activity and CP. Results: After adjusting for potential confounders, adequate physical activity showed a significant association with a decreased risk of CP (ORadj: 0.25, 95%CI: 0.06, 0.97). CP was associated with enrichment in the order Bacteroidales within the phylum Bacteroidetes and the predominant microbiota in individuals without plaque was the order Clostridiales (LDA scores >3). Individuals with adequate physical activity had a higher abundance of the order Clostridiales, while the order Bacteroidetes was enriched in individuals with inadequate physical activity (LDA scores >3). The PhyloMed revealed a significant mediation effect of gut microbiota in the association between physical activity and CP (p = 0.03). Conclusion: Adequate physical activity was significantly associated with a decreased risk of CP, and this association was mediated by an increase in the abundance of gut microbiota in the order Clostridiales.

TGFß2 Promotes the Construction of Fibrotic and Immunosuppressive Tumor Microenvironment in Pancreatic Adenocarcinoma: A Comprehensive Analysis.

Pancreatic adenocarcinoma (PAAD) was characterized by dense fibrotic stroma and immunosuppressive tumor microenvironment (TME). TGFß signaling pathways are highly activated in human cancers. However, the role of TGFß2 in TME of PAAD remains to be elucidated. In this study, we showed that TGFß2 was expressed at a relatively high level in PAAD tissues or cancer cells. Moreover, its high expression predicted unfavorable prognosis. In PAAD, gene set enrichment analysis showed that TGFß2 correlated positively with leukocyte transendothelial migration, but negatively with aerobic metabolism, including oxidative phosphorylation. Results in Tumor and Immune System Interaction Database showed that TGFß2 correlated with the infiltration of tumor-associated macrophages (TAMs), which could be attributed to that TGFß2 promote CCL2 expression in PAAD. Moreover, correlation analysis showed that TGFß2 could trigger cancer-associated fibroblasts (CAFs) activation in PAAD. The drug sensitivity analysis may indicate that patients with TGFß2 high expression have higher sensitivity to chemotherapeutics, but the sensitivity to targeted drugs is still controversial. TGFß2 could promote expansion of CAFs and infiltration of TAMs, thus participating in the construction of a fibrotic and immunosuppressive TME in PAAD. Targeting TGFß2 could be a promising therapeutic approach, which needs to be elucidated by clinical and experimental evidences.

Natural pigments in the food industry: Enhancing stability, nutritional benefits, and gut microbiome health.

Natural pigments are increasingly favored in the food industry for their vibrant colors, fewer side effects and potential health benefits compared to synthetic pigments. However, their application in food industry is hindered by their instability under harsh environmental conditions. This review evaluates current strategies aimed at enhancing the stability and bioactivity of natural pigments. Advanced physicochemical methods have shown promise in enhancing the stability of natural pigments, enabling their incorporation into food products to enhance sensory attributes, texture, and bioactive properties. Moreover, recent studies demonstrated that most natural pigments offer health benefits. Importantly, they have been found to positively influence gut microbiota, in particular their regulation of the beneficial and harmful flora of the gut microbiome, the reduction of ecological dysbiosis through changes in the composition of the gut microbiome, and the alleviation of systemic inflammation caused by a high-fat diet in mice, suggesting a beneficial role in dietary interventions.

Effect of extracellular matrix stiffness on efficacy of Dapagliflozin for diabetic cardiomyopathy.

BACKGROUND: Extracellular matrix (ECM) stiffness is closely related to the progress of diabetic cardiomyopathy (DCM) and the response of treatment of DCM to anti-diabetic drugs. Dapagliflozin (Dapa) has been proven to have cardio-protective efficacy for diabetes and listed as the first-line drug to treat heart failure. But the regulatory relationship between ECM stiffness and treatment efficacy of Dapa remains elusive. MATERIALS AND METHODS: This work investigated the effect of ECM stiffness on DCM progression and Dapa efficacy using both in vivo DCM rat model and in vitro myocardial cell model with high glucose injury. First, through DCM rat models with various levels of myocardial injury and administration with Dapa treatment for four weeks, the levels of myocardial injury, myocardial oxidative stress, expressions of AT1R (a mechanical signal protein) and the stiffness of myocardial tissues were obtained. Then for mimicking the stiffness of myocardial tissues at early and late stages of DCM, we constructed cell models through culturing H9c2 myocardial cells on the polyacrylamide gels with two stiffness and exposed to a high glucose level and without/with Dapa intervention. The cell viability, reactive oxygen species (ROS) levels and expressions of mechanical signal sensitive proteins were obtained. RESULTS: The DCM progression is accompanied by the increased myocardial tissue stiffness, which can synergistically exacerbate myocardial cell injury with high glucose. Dapa can improve the ECM stiffness-induced DCM progression and its efficacy on DCM is more pronounced on the soft ECM, which is related to the regulation pathway of AT1R-FAK-NOX2. Besides, Dapa can inhibit the expression of the ECM-induced integrin ß1, but without significant impact on piezo 1. CONCLUSIONS: Our study found the regulation and effect of biomechanics in the DCM progression and on the Dapa efficacy on DCM, providing the new insights for the DCM treatment. Additionally, our work showed the better clinical prognosis of DCM under early Dapa intervention.

Au24Cd Nanoenzyme Coating for Enhancing Electrochemical Sensing Performance of Metal Wire Microelectrodes.

Dopamine (DA), ascorbic acid (AA), and uric acid (UA) are crucial neurochemicals, and their abnormal levels are involved in various neurological disorders. While electrodes for their detection have been developed, achieving the sensitivity required for in vivo applications remains a challenge. In this study, we proposed a synthetic Au24Cd nanoenzyme (ACNE) that significantly enhanced the electrochemical performance of metal electrodes. ACNE-modified electrodes demonstrated a remarkable 10-fold reduction in impedance compared to silver microelectrodes. Furthermore, we validated their excellent electrocatalytic activity and sensitivity using five electrochemical detection methods, including cyclic voltammetry, differential pulse voltammetry, square-wave pulse voltammetry, normal pulse voltammetry, and linear scanning voltammetry. Importantly, the stability of gold microelectrodes (Au MEs) modified with ACNEs was significantly improved, exhibiting a 30-fold enhancement compared to Au MEs. This improved performance suggests that ACNE functionalization holds great promise for developing micro-biosensors with enhanced sensitivity and stability for detecting small molecules.

Synergistic Effects of 125I Seed Implantation Brachytherapy and Gemcitabine in Pancreatic Tumors.

BACKGROUND: Monotherapy consisting of radiotherapy or chemotherapy has limited efficacy in pancreatic tumors. This study aims to investigate whether the combination of 125I brachytherapy and gemcitabine (GEM) chemotherapy has a synergistic effect on pancreatic cancer (PC). METHODS: In vitro, PANC-1 cells in the exponential phase were treated with 125I radioactive seeds (6 Gy) and GEM (30 nM). Cell proliferation, apoptosis, and mitochondrial membrane potential were measured using the Cell Counting Kit-8 (CCK-8) assay, Terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL) staining, and flow cytometry, respectively. In vivo, we examined the inhibitory effect of three different treatment regimens on tumor growth in mice when combined with 125I brachytherapy and GEM. Next, we investigated the effects of the optimal scheme among the three on the tumor microenvironment, tumor tissue morphology, tumor cell apoptosis, systemic inflammatory response, and levels of apoptosis-related proteins in the tumor. Changes in the tumor microenvironment and levels of apoptosis-related proteins were measured by Western blot. The extent of damage to tumor tissue morphology was assessed by Hematoxylin and Eosin (HE) staining. Tumor cell apoptosis was measured by TUNEL staining. Changes in inflammation-related factors were determined by Enzyme-Linked Immunosorbent Assay (ELISA). RESULTS: The results of in vitro cell experiments demonstrated that the combination of 125I radioactive seeds (6 Gy) and GEM (30 nM) had a stronger inhibitory effect on PANC-1 cells than either alone (p < 0.05). In vivo, data showed that the GEM (after 3 d) + 125I treatment group had the strongest tumor inhibition effect on PC (p < 0.05). Western blot analysis showed that the combined treatment of 125I brachytherapy and GEM caused changes in the expression of collagen and connexin in the tumor microenvironment, promoted tumor cell apoptosis, upregulated the expression of pro-apoptotic proteins, and helped to restore pancreatic function (p < 0.01). CONCLUSION: Our research results suggest that the strategy of 125I seed implantation surgery in mice after 3 days of GEM treatment has a more pronounced synergistic effect on the treatment of PC.

Cu-Doped Spherical P2-Type Na0.7Fe0.23-xCuxMn0.77O2 Cathode for High-Performance Sodium-Ion Batteries.

Sodium-ion batteries (SIBs), owing to their abundant resources and cost-effectiveness, have garnered considerable interest in the realm of large-scale energy storage. The properties of cathode materials profoundly affect the cycle stability and specific capacity of batteries. Herein, a series of Cu-doped spherical P2-type Na0.7Fe0.23-xCuxMn0.77O2 (x = 0, 0.05, 0.09, and 0.14, x-NFCMO) was fabricated using a convenient hydrothermal method. The successful doping of Cu efficaciously mitigated the Jahn-Teller effect, augmented the electrical conductivity of the material, and diminished the resistance to charge transfer. The distinctive spherical structure remained stable and withstood considerable volumetric strain, thereby improving the cyclic stability of the material. The optimized 0.09-NFCMO cathode exhibited a high specific capacity of 168.6 mAh g-1 at 100 mA g-1, a superior rate capability (90.9 mAh g-1 at 2000 mA g-1), and a good cycling stability. This unique structure design and doping approach provides new insights into the design of advanced electrode materials for sodium-ion batteries.

Association between the atherogenic index of plasma and coronary collateral circulation in patients with chronic total occlusion.

BACKGROUND: The atherogenic index of plasma (AIP) is considered an independent risk factor for coronary artery disease (CAD). The present study investigated whether AIP correlates with the formation of coronary collateral circulation (CCC) in CAD patients with chronic total occlusion (CTO). METHODS: This retrospective study included 1093 CAD patients with CTO confirmed by coronary angiography from January 2020 to December 2020 at Beijing Anzhen Hospital. Based on the Rentrop scoring system, the patients were divided into the good CCC group and the poor CCC group. AIP was calculated by log (triglyceride/high-density lipoprotein cholesterol). Meanwhile, the study population was further divided into four groups according to the quartiles of AIP. RESULTS: Patients in the poor CCC group exhibited significantly higher AIP compared to those in the good CCC group (0.31 ± 0.27 vs. 0.14 ± 0.24, p < 0.001). Multivariate logistic regression analysis revealed an independent association between AIP and poor CCC, regardless of whether AIP was treated as a continuous or categorical variable (p < 0.001), after adjusting for confounding factors. Besides, this association remained consistent across most subgroups. The incorporation of AIP into the baseline model significantly enhanced the accuracy of identifying poor CCC [area under the curve (AUC): baseline model, 0.661 vs. baseline model + AIP, 0.721, p for comparison < 0.001]. CONCLUSIONS: Elevated AIP is independently associated with an increased risk of poor CCC in CAD patients with CTO, and AIP may improve the ability to identify poor CCC in clinical practice.

Deterministic Localization for Fully Automatic Operation: A Survey and Experiments.

With the rapid development of fully automatic operation (FAO) and location-based services, the evaluation criteria of average localization accuracy can no longer meet our demands, in favor of deterministic localization. However, most localization researches modeled localization performance function and enhanced it by minimizing average localization root mean square error (RMSE). The performance degradation in a small region was not considered. In this paper, we present a survey of deterministic localization and analyze the relationship between accuracy and certainty. In this paper, two common solutions of localization enhancement are presented and their localization certainties are discussed. Furthermore, we carry out related localization enhancement experiments in rail transit line and analyze their improvement on deterministic localization. The experimental results show that the overall localization performance is improved, while the deterministic localization requires the stricter solution to promote.

Lutetium Texaphyrin-Celecoxib Conjugate as a Potential Immuno-Photodynamic Therapy Agent.

Immuno-photodynamic therapy (IPDT) has emerged as a new modality for cancer treatment. Novel photosensitizers can help achieve the promise inherent in IPDT, namely, the complete eradication of a tumor without recurrence. We report here a small molecule photosensitizer conjugate, LuCXB. This IPDT agent integrates a celecoxib (cyclooxygenase-2 inhibitor) moiety with a near-infrared absorbing lutetium texaphyrin photocatalytic core. In aqueous environments, the two components of LuCXB are self-associated through inferred donor-acceptor interactions. A consequence of this intramolecular association is that upon photoirradiation with 730 nm light, LuCXB produces superoxide radicals (O2-•) via a type I photodynamic pathway; this provides a first line of defense against the tumor while promoting IPDT. For in vivo therapeutic applications, we prepared a CD133-targeting, aptamer-functionalized exosome-based nanophotosensitizer (Ex-apt@LuCXB) designed to target cancer stem cells. Ex-apt@LuCXB was found to display good photosensitivity, acceptable biocompatibility, and robust tumor targetability. Under conditions of photoirradiation, Ex-apt@LuCXB acts to amplify IPDT while exerting a significant antitumor effect in both liver and breast cancer mouse models. The observed therapeutic effects are attributed to a synergistic mechanism that combines antiangiogenesis and photoinduced cancer immunotherapy.

Diffusion-tensor magnetic resonance imaging as a non-invasive assessment of extracellular matrix remodeling in lumbar paravertebral muscles of rats with sarcopenia.

BACKGROUND: Extracellular matrix (ECM) remodeling in skeletal muscle is a significant factor in the development of sarcopenia. This study aims to evaluate changes in ECM remodeling in the lumbar paravertebral muscles of sarcopenic rats using diffusion-tensor magnetic resonance imaging (DT-MRI) and compare them with histology. METHODS: Twenty 6-month-old female Sprague Dawley rats were randomly divided into the dexamethasone (DEX) group and the control (CON) group. Both groups underwent 3.0T MRI scanning, including Mensa, T2WI, and DT-MRI sequences. The changes in muscle fibers and extracellular matrix (ECM) of the erector spinal muscle were observed using hematoxylineosin and sirius red staining. The expressions of collagen I, III, and fibronectin in the erector spinae were detected by western blot. Pearson correlation analysis was employed to assess the correlation between MRI quantitative parameters and corresponding histopathology markers. RESULTS: The cross-sectional area and fractional anisotropy values of the erector spinae in the DEX group rats were significantly lower than those in the CON group (p < 0.05). Hematoxylin eosin staining revealed muscle fiber atrophy and disordered arrangement in the DEX group, while sirius red staining showed a significant increase in collagen volume fraction in the DEX group. The western blot results indicate a significant increase in the expression of collagen I, collagen III, and fibronectin in the DEX group (p < 0.001 for all). Correlation coefficients between fractional anisotropy values and collagen volume fraction, collagen I, collagen III, and fibronectin were - 0.71, -0.94, -0.85, and - 0.88, respectively (p < 0.05 for all). CONCLUSIONS: The fractional anisotropy value is strongly correlated with the pathological collagen volume fraction, collagen I, collagen III, and fibronectin. This indicates that DT-MRI can non-invasively evaluate the changes in extracellular matrix remodeling in the erector spinal muscle of sarcopenia. It provides a potential imaging biomarker for the diagnosis of sarcopenia.

The impact of type 2 diabetes on polycystic ovary syndrome in patients undergoing sleeve gastrectomy.

STUDY QUESTION: Does the concurrent type 2 diabetes mellitus (T2DM) aggravate the features and prognosis of PCOS in patients undergoing sleeve gastrectomy (SG)? SUMMARY ANSWER: For patients undergoing SG with obesity, concurrent T2DM is associated with aggravated metabolic but milder reproductive features of PCOS and did not attenuate the resumption of regular menstruation for up to 1 year after surgery. WHAT IS KNOWN ALREADY: Women with T2DM have an increased risk of PCOS. However, whether concurrent T2DM further increases the disease burden and treatment difficulty of PCOS in patients with obesity requires further investigation. STUDY DESIGN, SIZE, DURATION: This was a single-center, two-arm, prospective, cohort study enrolling a total of 329 women with PCOS and scheduled for SG because of obesity at an university-affiliated hospital between January 2020 and August 2023, with a 1-year follow-up after surgery. PARTICIPANTS/MATERIALS, SETTING, METHODS: Comparisons were made between patients with T2DM (PCOS+T2DM) and without (PCOS) to examine the impact of T2DM on the metabolic, reproductive, and psychological features of PCOS. The follow-up data of weight loss and menstruation were analyzed to determine the impact of T2DM on PCOS prognosis for up to 1 year after SG. MAIN RESULTS AND THE ROLE OF CHANCE: After controlling for confounders, patients in the PCOS+T2DM group (n = 98) showed more severe insulin resistance, glucose intolerance, dyslipidemia, and non-alcoholic fatty liver disease (NAFLD) (NAFLD activity score 4.31 ± 1.15 versus 3.52 ± 1.42, P < 0.001) than those in the PCOS group (n = 149). In addition, the PCOS+T2DM group had a lower level of total testosterone (1.63 ± 0.69 versus 1.82 ± 0.76, P = 0.045), a lower ratio between luteinizing hormone and follicle-stimulating hormone (median 1.48 versus 1.68, P = 0.030), and a lower proportion of patients with polycystic ovarian morphology (88% versus 96%, P = 0.022) than the PCOS group. As a result, the two groups differed significantly in terms of the Rotterdam classification of PCOS (P = 0.009). No significant difference was detected by group in the psychological features of PCOS except a lower degree of emotional eating in the PCOS+T2DM group (P = 0.001). Although the PCOS+T2DM group took longer to resume regular menstruation after SG (P = 0.037), the two groups had similar proportions of patients with regular menstruation (85% versus 87%, P = 0.758) 1 year after SG, which was further confirmed by subgroup analyses by body mass index. LIMITATIONS, REASONS FOR CAUTION: The prognosis of PCOS after SG mainly focused on the results of menstruation rather than a complete evaluation of the remission of the disease. WIDER IMPLICATIONS OF THE FINDINGS: Our study showed that, for patients with obesity, concurrent T2DM is associated with aggravated metabolic but milder reproductive features of PCOS and did not attenuate the resumption of regular menstruation for up to 1 year after surgery. Our study also highlights the need for high-quality studies with a more comprehensive evaluation of the impact of T2DM on the prognosis of patients with PCOS after SG. STUDY FUNDING/COMPETING INTEREST(S): This study was funded by the National Natural Science Foundation of China Grants (82100853), the Natural Science Foundation of Shandong Province of China (ZR2021QH028), and the Clinical Research Project of Shandong University (2020SDUCRCC024). The authors have no conflicts of interest. TRIAL REGISTRATION: Chinese Clinical Trial Registry with No. ChiCTR1900026845.

A Straightforward Solvent-Pair-Enabled Multicomponent Coassembly Approach toward Noble-Metal-Nanoparticle-Decorated Mesoporous Tungsten Oxide for Trace Ammonia Sensing.

The straightforward synthesis of noble-metal-nanoparticle-decorated ordered mesoporous transition metal oxides remains a great challenge due to the difficulty of balancing the interactions between precursors and templates. Herein, a solvent-pair-enabled multicomponent coassembly (SPEMC) strategy is developed for straightforward synthesis of noble-metal-nanoparticle-decorated nitrogen-doped ordered mesoporous tungsten oxide (abbreviated as NM/N-mWO3, NM = Pt, Rh, Pd). The amphiphilic poly(ethylene oxide)-block-polystyrene (PEO-b-PS) copolymers coassemble with ammonium metatungstate (AMT) clusters and different kinds of hydrophilic noble metal precursors without phase separation. SPEMC synthesis requires no direct interaction between PEO-b-PS and AMT, thus the assembly equilibriums between noble metal precursors and PEO-b-PS can be readily controlled. The obtained NM/N-mWO3 nanocomposites possess ordered mesopores, abundant oxygen vacancies, and metal-metal oxide interfaces. As a result, the Pt/N-mWO3 sensors exhibit superior ammonia sensing performances with high sensitivity, an ultralow limit of detection (51.2 ppb), good selectivity, and long-term stability. Spectroscopic analysis reveals that ammonia is oxidized stepwise to NO, NO2 -, and NO3 - during the sensing process. Moreover, a portable wireless module based on Pt/N-mWO3 sensor can recognize ppm-level concentration of ammonia, which lays a solid foundation for its application in various fields.

Assessing the predictive value of the controlling nutritional status score on all-cause mortality during hospitalization in patients with acute decompensated heart failure: a retrospective cohort study from Jiangxi, China.

Objective: Nutritional status is closely associated with the prognosis of heart failure. This study aims to assess the relationship between the Controlling Nutritional Status (CONUT) score and in-hospital mortality among patients with acute decompensated heart failure (ADHF) in Jiangxi, China. Methods: A retrospective cohort study was conducted. Multivariable Cox regression models and restricted cubic spline regression were employed to evaluate the relationship between the CONUT score and in-hospital mortality in ADHF patients from Jiangxi, China. The predictive value of the CONUT score for in-hospital mortality in ADHF patients was analyzed using receiver operating characteristic curves. Subgroup analyses were performed to identify risk dependencies of the CONUT score in specific populations. Results: The study included 1,230 ADHF patients, among whom 44 (3.58%) mortality events were recorded. After adjusting for confounding factors, a positive correlation was found between the CONUT score and the risk of in-hospital mortality in ADHF patients. Restricted cubic spline regression analysis indicated a non-linear relationship between the CONUT score and the risk of in-hospital mortality in ADHF patients, estimating a rapid increase in mortality risk when the CONUT score exceeded 5. Receiver operating characteristic analysis demonstrated a good predictive value of the CONUT score for all-cause mortality events in ADHF patients [area under the curve = 0.7625, optimal threshold = 5.5]. Additionally, a relatively higher risk associated with the CONUT score was observed in male patients and those with concomitant cerebral infarction. Conclusion: This study reveals a positive correlation between the CONUT score and the risk of in-hospital mortality in ADHF patients. Based on the findings of this study, we recommend maintaining a CONUT score below 5 for patients with ADHF in Jiangxi, China, as it may significantly contribute to reducing the risk of in-hospital all-cause mortality.