[Network Meta-analysis of efficacy and safety of different traditional Chinese medicine injections in treating post-acute myocardial infarction heart failure].

This study aims to systematically review the efficacy and safety of different traditional Chinese medicine injections combined with conventional treatment for patients with post-acute myocardial infarction heart failure. The relevant randomized controlled trial(RCT) was retrieved from CNKI, Wanfang, VIP, SinoMed, PubMed, EMbase, and Cochrane Library with the time interval from inception to May 13, 2023. Two reviewers independently screened the literature, extracted data, and assessed the risk of bias of the included studies. Network Meta-analysis was then performed in RevMan 5.3 and Stata 15.1. A total of 68 RCTs involving 11 traditional Chinese medicine injections and 5 995 patients were included. The results were explained based on the surface under the cumulative ranking curve(SUCRA).(1) In terms of reducing major adverse cardiovascular event(MACE), the therapies followed the trend of Xinmailong Injection+conventional treatment(83.8%) > Yiqi Fumai Injection+conventional treatment(57.1%) > Xuebijing Injection+conventional treatment(56.6%) > Shenmai Injection+conventional treatment(53.1%) > Shenfu Injection+conventional treatment(45.3%) > conventional treatment(4.0%).(2) In terms of increasing left ventricular ejection fraction(LVEF), the therapies followed the trend of Yiqi Fumai Injection+conventional treatment(84.0%) > Shenmai Injection+conventional treatment(69.6%) > Shenfu Injection+conventional treatment(62.7%) > Xinmailong Injection+conventional treatment(61.6%) > Shuxuening Injection+conventional treatment(54.8%) > Shenqi Fuzheng Injection+conventional treatment(46.7%) > Shengmai Injection+conventional treatment(45.9%) > Breviscapine Injection+conventional treatment(39.9%) > Danhong Injection+conventional treatment(38.8%) > Huangqi Injection+conventional treatment(38.7%) > conventional treatment(7.3%).(3) In terms of reducing B-type natriuretic peptide(BNP), the therapies followed the trend of Xinmailong Injection+conventional treatment(98.6%) > Shenmai Injection+conventional treatment(57.7%) > Shenfu Injection+conventional treatment(52.5%) > Shengmai Injection+conventional treatment(30.1%) > conventional treatment(11.0%).(4) In terms of reducing cardiac troponin Ⅰ(cTnⅠ), the therapies followed the trend of Shenmai Injection+conventional treatment(92.3%) > Yiqi Fumai Injection+conventional treatment(61.5%) > Shenfu Injection+conventional treatment(51.2%) > Shengmai Injection+conventional treatment(48.1%) > Xinmailong Injection+conventional treatment(26.6%) > conventional treatment(20.3%).(5) In terms of reducing high-sensitivity C-reactive protein(hs-CRP), the therapies followed the trend of Shenmai Injection+conventional treatment(79.9%) > Xinmailong Injection+conventional treatment(68.1%) > Shenfu Injection+conventional treatment(63.1%) > Xuebijing Injection+conventional treatment(56.7%) > Shengmai Injection+conventional treatment(51.1%) > Shenqi Fuzheng Injection+conventional treatment(42.8%) > Huangqi Injection+conventional treatment(34.7%) > conventional treatment(3.5%).(6) A total of 22 RCTs reported the occurrence of adverse reactions, mainly involving the damage of the circulatory system, digestive system, and coagulation function. The current evidence suggested that Xinmailong Injection+conventional treatment may have the best therapeutic effect in reducing MACE and BNP; Yiqi Fumai Injection+conventional treatment may be the best in increasing LVEF; Shenmai Injection+conventional treatment may be the best in reducing cTnI and hs-CRP. The safety needs further quantitative research and analysis. However, more high-quality RCT is required to validate the above conclusions due to limitations in the quality and quantity of the included studies.

[Regularity of prescriptions for sick sinus syndrome based on latent structure combined with association rules].

This study aims to mine the regularity of traditional Chinese medicine(TCM) prescriptions for sick sinus syndrome(SSS) and provide a reference for clinical syndrome differentiation and treatment. The relevant papers were retrieved from CNKI, Wanfang, VIP, and SinoMed with the time interval from inception to January 31, 2023. The relevant information from qualified papers was extracted to establish a library. Lantern 5.0 and Rstudio were used to analyze the latent structure and association rules of TCMs with the frequency ≥3%, which combined with frequency descriptions, were used to explore the rules of TCM prescriptions for SSS. A total of 192 TCM prescriptions were included, involving 115 TCMs with the cumulative frequency of 1 816. High-frequency TCMs include Aconiti Lateralis Radix Praeparata, Ginseng Radix et Rhizoma, Glycyrrhizae Radix et Rhizoma, Astragali Radix, and Salviae Miltiorrhizae Radix et Rhizoma. The high-frequency medicines mainly had the effects of tonifying, releasing exterior with pungent-warm, and activating blood and resolving stasis. The analysis of the latent structure model yielded 13 hidden variables, 26 hidden classes, 8 comprehensive cluster models, and 21 core prescriptions. Accordingly, the common syndromes of SSS were inferred as heart-Yang Qi deficiency, heart-spleen Yang deficiency, heart-kidney Yang deficiency, Yang deficiency and blood stasis, both Qi and Yin deficiency and blood stasis, and Yin and Yang deficiency. The analysis of association rules predicted 30 strong association rules, among which Ginseng Radix et Rhizoma-Aconiti Lateralis Radix Praeparata had the highest support. SSS is a syndrome with Yang deficiency and Qi deficiency as the root causes and cold, phlegm, and stasis as the manifestations. The clinical treatment of SSS should focus on warming Yang and replenishing Qi, which should be supplemented with the therapies of activating blood and resolving stasis, warming interior and dissipating cold, or regulating Qi movement for resolving phlegm according to the patients' syndromes.

Understanding the migration mechanism of hydrogen atom from the α-Fe matrix into nano-precipitates via DFT calculations.

The service of high-strength steel suffers from the threat of hydrogen embrittlement and introducing nano-precipitates is an effective avenue to mitigate it. How hydrogen atoms migrate into nano-precipitates is an important question that needs to be clarified. In this study, NEB-based DFT calculations have clearly constructed the energy evolution profiles of the whole process for hydrogen atoms diffusing from α-Fe through the α-Fe/MC (M = V, Ti, Nb) coherent interfaces and finally into the nano-precipitates. The calculation results indicate that a hydrogen atom migrates with difficulty through the α-Fe/MC coherent interfaces and the diffusions in nano-precipitates follow two-step pathways. The C atom vacancy is easier to form in MC nano-precipitates. When introducing a C atom or metallic atom vacancy into the α-Fe/MC interface, the C atom vacancy is the hydrogen trapping site, while the metallic atom vacancy reduces the migration barrier. In addition, once a C atom or metallic atom vacancy is formed in the nano-precipitate, the vacancy will behave as an irreversible trapping site. Finally, electronic structure analyses and distortion energy calculations clearly reveal the effects of the local atomic environment on hydrogen diffusion from α-Fe into nano-precipitates.

[Outcome indicators in clinical trials on traditional Chinese medicine treatment of microvascular angina].

This study reviewed the current status of the use of outcome indicators in randomized controlled trial(RCT) on traditional Chinese medicine(TCM) treatment of microvascular angina(MVA) and analyzed the existing problems and possible solutions, aiming to provide a basis for the design of high-quality RCT and the establishment of core outcome sets for MVA. CNKI, Wanfang, VIP, SinoMed, PubMed, EMbase, Cochrane Library, Web of Science, and 2 clinical trial registries were searched for the RCT on TCM treatment of MVA according to pre-defined criteria. The Cochrane's risk of bias assessment tool was used to evaluate the methodological quality of the included RCT and the use of outcome indicators was summarized. A total of 69 RCTs were included, from which 100 outcome indicators were extracted, with the frequency of 430. The extracted outcome indicators belonged to 8 domains: response rate, symptoms and signs, physical and chemical examinations, TCM efficacy, safety, quality of life, economic evaluation, and long-term prognosis. The indicators of physical and chemical examinations were the most(70 indicators with the frequency of 211), followed by those of response rate(7 indicators with the frequency of 73) and symptoms and signs(7 indicators with the frequency of 54). The outcome indicators with higher frequency were adverse reactions, angina attack frequency, clinical efficacy, endothelin-1, total duration of treadmill exercise, and hypersensitive C-reactive protein. The RCT on TCM treatment of MVA had the following problems: irregular reporting of adverse reactions, diverse indicators with low frequency, lack of attention to the application of endpoint indicators, insufficient use of TCM differentiation and efficacy indicators, non-standard evaluation criteria and failure to reflect the basic characteristics of TCM. A unified MVA syndrome differentiation standard should be established, on the basis of which an MVA treatment efficacy evaluation system and core outcome indicator set that highlights the characteristics of TCM with patient-reported outcomes as the starting point should be established to improve the clinical research and research value.

Unraveling the Atomic Shuffles of Twinning Nucleation in Hexagonal Close-Packed Rhenium Nanocrystals.

Reining in deformation twinning is crucial for the mechanical properties of hexagonal close-packed (HCP) metals and hinges on an explicit understanding of the twinning nucleation mechanism. Unfortunately, it is often suggested rather than conclusively demonstrated that twinning nucleation can be mediated by pure atomic shuffles. Herein, by utilizing in situ high-resolution transmission electron microscopy, we have dissected the atomic shuffling mechanism during the {101̅2} twinning nucleation in rhenium nanocrystals, which revealed the emergence of an intermediate body-centered tetragonal (BCT) structure. Specifically, the double-layered prismatic planes initially shuffle into single-layered {11̅0}BCT planes; subsequently, adjacent {22̅0}BCT planes shuffle in opposite directions to form the basal planes of the twin embryo. This shuffling mechanism is further corroborated by molecular dynamic simulations. The finding provides direct evidence of shuffle-dominated twinning nucleation with atomic details that may lead to better control of this critical twinning mode in HCP metals.

Modular reprogrammable 3D mechanical metamaterials with unusual hygroscopic deformation modes.

The majority of polymer-based materials demonstrate expansion upon absorbing water from the air. Mechanical metamaterials provide an interesting way to achieve unusual hygroscopic deformation. However, previous studies have only accommodated the limited tunability of negative hygroscopic expansion by theoretical analysis but have never involved other deformation modes. This work proposes modular reprogrammable 3D moisture-sensitive mechanical metamaterials with switchable hygroscopic deformation modes, which are built up of multi-material 3D-printed bi-material curved strips and cubic nodes. Depending on the geometrical parameters and spatial layouts of the curved strips, the metamaterials exhibit tunable coefficient of hygroscopic expansion from negative to positive. In addition to homogeneous deformation, complex 3D hygroscopic deformation modes can be achieved including shear and twist. More interestingly, the metamaterials are reprogrammable since all the deformation modes can be switched by modular disassembling and reassembling of the curved strips, just like LEGO building blocks. This work demonstrates a feasible approach to achieve customized 3D hygroscopic deformation through easy block building for specific engineering applications including eliminating hygroscopic stress, shape morphing structures, and smart actuators.

Evaluating Whether and How Public Health Event Information Frameworks Promote Pro-Environmental Behavior.

The major public health emergencies (PHEs) represented by the COVID-19 pandemic, while posing a serious threat to human health, have led people to rethink about the harmonious relationship between humans and nature. It is worthy to explore whether and how the framework effect of event information can be used to turn crises into opportunities to promote public pro-environmental behavior (PEB). Through a pre-and post-test control experiment, this study took the COVID-19 pandemic as a case, to explore the effects of four PHE information frameworks on promoting PEB, coupled with two information loss-gain frameworks and two information content frameworks. The results showed that all four information frameworks contribute to the public PEB. However, there are differences: only the environmental gain information effect is significant for PEB in the private sphere. The environmental loss and health gain information are effective for PEB in organizations. However, in the public sphere, all four information frameworks significantly motivate PEB. Further factorial analysis revealed that the interaction between the information content and loss-gain framework was not significant, with the latter playing the dominant role. These findings provide a new approach to how to develop the information framework effect and turn crises into opportunities to promote public PEB in the context of major PHEs.

In situ fabrication of MIL-68(In)@ZnIn2S4 heterojunction for enhanced photocatalytic hydrogen production.

Metal-organic frameworks (MOFs), as a class of semiconductor-like materials, are widely used in photocatalysis. However, the limited visible light absorption and poor charge separation efficiency are the main challenges restricting their photocatalytic performance. Herein, the type II heterojunction MIL-68(In)@ZIS was successfully fabricated by in situ growth of ZnIn2S4 (ZIS) on the surface of a representative MOF, i.e. MIL-68(In). After composition optimization, MIL-68(In)-20@ZIS shows an extraordinary photocatalytic hydrogen production efficiency of 9.09 mmol g-1 h-1 and good photochemical stability, which far exceeds those of most photocatalysts. The hierarchical loose structure of MIL-68(In)-20@ZIS is conducive to the adsorption of reactants and mass transfer. Meanwhile, a large number of tight 2D contact interfaces significantly reduce the obstruction of charge transfer, paving the way for high-perform photocatalytic hydrogen evolution. The experimental results demonstrate that the MIL-68(In)@ZIS heterojunction achieves intensive photoresponse and effective charge separation and transfer benefiting from unique charge transport paths of a type II heterojunction. This study opens an avenue toward MOF-based heterojunctions for solar energy conversion.

[Evidence mapping of clinical research on prevention and treatment of essential hypertension with Chinese patent medicines in recent six years].

In this study, the evidence mapping was employed to systematically analyze the clinical research literature and learn the distribution of evidence on the prevention and treatment of essential hypertension with Chinese patent medicines in recent six years. CNKI, Wanfang, VIP, SinoMed, PubMed, and Cochrane Library were searched for the relevant literature published from January 2016 to December 2021. The distribution characteristics of evidence were analyzed and presented in charts combined with words. A total of 263 studies were selected, including 238 intervention studies, 17 systematic reviews/Meta-analysis, and 8 observation studies. A total of 72 Chinese patent medicines were involved, among which Songling Xuemaikang Capsules had the highest frequency. In China, the attention to the treatment of essential hypertension with Chinese patent medicines was insufficient, as manifested by the declining number of published literature and the low quality of studies. There were cases of off-label use and medication without syndrome differentiation in clinical practice. Some outcome indicators failed to embody the characteristics of traditional Chinese medicine and there were cases ignoring the end-point outcome indicators. The overall quality of systematic reviews/Meta-analysis was low, and a variety of studies failed to draw valid conclusions. In the future, it is necessary to standardize the clinical medication and improve the quality of randomized controlled trial(RCT), so as to produce high-quality evidence-based medical evidence and provide strong support for the efficacy and safety of Chinese patent medicines in the prevention and treatment of essential hypertension.

Unexpected High-Performance Photocatalytic Hydrogen Evolution in Co@NCNT@ZnIn2 S4 Triggered by Directional Charge Separation and Transfer.

The structural design of photocatalysts is highly related to the separation and transfer of photogenerated carriers, which is essential for the improvement of photocatalytic hydrogen evolution performance. Here, the hybrid photocatalyst M@NCNT@ZIS (M: Fe, Co, Ni; NCNT: nitrogen-doped carbon nanotube; ZIS: ZnIn2 S4 ) with a hierarchical structure is rationally designed and precisely synthesized. The unique hollow structure with a large specific surface area offers abundant reactive sites, thus increasing the adsorption of reactants. Importantly, the properly positioned metal nanoparticles realize the directional charge migration from ZIS to M@NCNT, which significantly improves the efficiency of charge separation. Furthermore, the intimate interface between M@NCNT and ZIS effectively facilitates charge migration by shortening the transfer distance and providing numerous transport channels. As a result, the optimized Co@NCNT@ZIS exhibits a remarkable photocatalytic hydrogen evolution efficiency (43.73 mmol g-1 h-1 ) without Pt as cocatalyst. Experimental characterizations and density functional theory calculations demonstrate that the synergistic effect between hydrogen adsorption and interfacial charge transport is of great significance for improving photocatalytic hydrogen production performance.

Mass Diffusion Metamaterials with "Plug and Switch" Modules for Ion Cloaking, Concentrating, and Selection: Design and Experiments.

The outstanding abilities of metamaterials to manipulate physical fields are extensively studied in both wave-based and diffusion-based fields. However, mass diffusion metamaterials, with the ability to manipulate diffusion with practical applications associated with chemical and biochemical engineering, have not yet been experimentally demonstrated. In this work, ion cloaking, concentrating, and selection in liquid solvents are verified by both simulations and experiments, and the concept of a "plug and switch" metamaterial is proposed based on scattering cancellation (SC) to achieve switchable functions by plugging modularized functional units into a functional motherboard. Plugging in any module barely affects the environmental diffusion field, but the module choice impacts different diffusion behaviors in the central region. Cloaking strictly hinds ion diffusion, and concentrating increase diffusion flux, while cytomembrane-like ion selection permits the entrance of some ions but blocks others. In addition, these functions are demonstrated in special applications like the catalytic enhancement by the concentrator and the protein protection by the ion selector. This work not only experimentally demonstrates the effective manipulation of mass diffusion by metamaterials, but also shows that the "plug and switch" design is extensible and reconfigurable. It facilitates novel applications including sustained drug release, catalytic enhancement, bioinspired cytomembranes, etc.

Moisture-sensitive mechanical metamaterials with unusual and re-programmable hygroscopic deformation modes.

Mechanical metamaterials are of great interest due to their counterintuitive deformation under various physical fields. However, the research on metamaterials responding to moisture is still rare and controllable hygroscopic deformation is vital for sensoring, actuating, and stress elimination in a moisture environment. Inspired by the hygroscopic deformation of pinecones, this work studies 2D moisture-sensitive mechanical metamaterials exploiting bi-material curved strips as building blocks by simulations and experiments, which especially demonstrates repeatable programming ability to realize customized unusual hygroscopic deformations. Depending on the structural design of geometrical parameters and material configurations, the metamaterials exhibit a tunable coefficient of hygroscopic expansion from negative to positive, and unusual hygroscopic deformation modes including anisotropic, shearing, gradient, bending, and 3D deformation of 2D structures. Programmable metamaterials of arbitrary hygroscopic deformation are achieved by pixelated design and coding the building blocks. More importantly, the hygroscopic deformation is re-programmable by adopting erasable moisture-proof coatings on specific areas of metamaterials, i.e., it can continuously provide different customized deformation modes in a sample.

Atomic-scale insights on hydrogen trapping and exclusion at incoherent interfaces of nanoprecipitates in martensitic steels.

Hydrogen is well known to embrittle high-strength steels and impair their corrosion resistance. One of the most attractive methods to mitigate hydrogen embrittlement employs nanoprecipitates, which are widely used for strengthening, to trap and diffuse hydrogen from enriching at vulnerable locations within the materials. However, the atomic origin of hydrogen-trapping remains elusive, especially in incoherent nanoprecipitates. Here, by combining in-situ scanning Kelvin probe force microscopy and aberration-corrected transmission electron microscopy, we unveil distinct scenarios of hydrogen-precipitate interaction in a high-strength low-alloyed martensitic steel. It is found that not all incoherent interfaces are trapping hydrogen; some may even exclude hydrogen. Atomic-scale structural and chemical features of the very interfaces suggest that carbon/sulfur vacancies on the precipitate surface and tensile strain fields in the nearby matrix likely determine the hydrogen-trapping characteristics of the interface. These findings provide fundamental insights that may lead to a better coupling of precipitation-strengthening strategy with hydrogen-insensitive designs.

Programmable Mechanical Metamaterials with Tailorable Negative Poisson's Ratio and Arbitrary Thermal Expansion in Multiple Thermal Deformation Modes.

Mechanical metamaterials pave a way for designing and optimizing microstructure topology to achieve counterintuitive deformation including negative Poisson's ratio (NPR) and negative thermal expansion (NTE). Previous studies were always limited to single anomalous mechanical or thermal deformation, but current applications for high-precision mechanical or optical equipment always require their combination and customized and anisotropic deformation parameters. This work develops programmable two-dimensional (2D) mechanical metamaterials based on chiral and antichiral structures constructed with curved bimaterial strips to produce tailorable NPR and arbitrary thermal deformation. The coefficient of thermal expansion of the mechanical metamaterials is tunable on a large scale across negative, near-zero, and positive values depending on the bimaterial configurations and geometrical parameters of curved strips, while the value of NPR is mainly determined by the radian. Furthermore, it is programmable by coding the unit cells to exhibit customized and anisotropic thermal deformation combining homogeneous, gradient, and shear modes. The proposed mechanical metamaterials are fabricated by multimaterial three-dimensional (3D) printing, and the unusual deformation modes are verified experimentally, which is well in agreement with the results of finite element analysis. This work demonstrates a feasible approach to achieving customized mechanical and thermal deformation through easy block building for specific engineering applications including eliminating thermal stress, shape morphing, and smart actuators.

Ultrasensitive Frequency Shifting of Dielectric Mie Resonance near Metallic Substrate.

Dielectric resonators on metallic surface can enhance far-field scattering and boost near-field response having promising applications in nonlinear optics and reflection-type devices. However, the dependence of gap size between dielectric resonator and metallic surface on Mie resonant frequency is complex and desires a comprehensive physical interpretation. Here, we systematically study the effect of metallic substrate on the magnetic dipole (MD) resonant frequency at X-band by placing a high permittivity CaTiO3 ceramic block on metallic substrate and regulating their gap size. The simulated and experimental results show that there are two physical mechanisms to codetermine the metallic substrate-induced MD frequency. The greatly enhanced electric field pair in the gap and the coupling of MD resonance with its mirror image are decisive for small and large gaps, respectively, making the MD resonant frequency present an exponential blue shift first and then a slight red shift with increasing gap size. Further, we use the two mechanisms to explain different frequency shifting properties of ceramic sphere near metallic substrate. Finally, taking advantage of the sharp frequency shifting to small gaps, the ceramic block is demonstrated to accurately estimate the thickness or permittivity of thin film on metallic substrate through a governing equation derived from the method of symbolic regression. We believe that our study will help to understand the resonant frequency shifting for dielectric particle near metallic substrate and give some prototypes of ultrasensitive detectors.

Efficacy and Safety of Qili Qiangxin Capsule on Dilated Cardiomyopathy: A Systematic Review and Meta-Analysis of 35 Randomized Controlled Trials.

Objective: Qili Qiangxin Capsule (QQC), a Chinese patent medicine, is clinically effective in treating dilated cardiomyopathy (DCM). However, the meta-analysis of QCC combined with conventional western medicine (CWM) on DCM remains unexplored. This study aimed to systematically evaluate the efficacy and safety of QCC in the treatment of DCM. Methods: Searched the studies of the combination of QQC and CWM in the treatment of DCM, from databases like PubMed, Cochrane Library, Web of Science, Wan Fang Databases, Chinese Biomedical Literature Database, China Science and Technology Journal Database, China National Knowledge Infrastructure, prior to 15 January 2022. Two reviewers respectively regulated research selection, data extraction, and risk of bias assessment. Review Manager Software 5.4 was used for meta-analysis. Furthermore, GRADE pro3.6.1 software was selected to grade the current evidence in our findings. This meta-analysis has been registered in PROSPERO (CRD42022297906). Results: There were 35 studies pertaining to 3,334 patients included. The meta-analysis showed compared with CWM alone, the combination therapy had significant advantages in improving the clinical efficiency rate (RR = 1.24, 95% CI: 1.19 to 1.29, p < 0.00001), 6 min walking distance (6MWD) (MD = 41.93, 95%CI: 39.82 to 44.04, p < 0.00001), superior in ameliorating the left ventricular ejection fraction (LVEF) (MD = 5.73, 95%CI: 4.70 to 6.77, p < 0.00001), left ventricular end-diastolic dimension (LVEDD) (MD = -4.09, 95%CI: -4.91 to -3.27), p < 0.00001), left ventricular end-systolic diameter (LVESD) (MD = -4.73, 95%CI: -5.63 to -3.84), p < 0.00001) and BNP (MD = -101.09, 95%CI: -132.99 to -69.18), p < 0.00001), and also superior in reducing hypersensitive-C-Reactive Protein (hs-CRP) (MD = -3.78, 95%CI: -4.35 to -3.21), p < 0.00001), Interleukin- 6 (IL-6) (MD = -25.92, 95%CI: -31.35 to -20.50), p < 0.00001), tumor necrosis factor-α (TNF-α) (MD = -5.04, 95%CI: -6.13 to -3.95), p < 0.00001), high mobility group protein B1 (HMGB1) (MD = -4.34, 95%CI: -5.22 to -3.46), p < 0.00001), and adverse reactions (ARs) (RR = 0.70, 95%CI: 0.51-0.97), p = 0.03). The GRADE evidence quality rating presented with moderate or low quality of evidence for the available data. Conclusion: Compared with the control group, QQC combined with CWM may be effective in treating DCM. However, the conclusion of this study must be interpreted carefully due to the inferior quality and ambiguity of bias in the included trials. Systematic Review Registration: https://www.crd.york.ac.uk/prospero, identifier [CRD42022297906].

Revealing the role of interfacial heterogeneous nucleation in the metastable thin film growth of rare-earth nickelate electronic transition materials.

Although rare-earth nickelates (ReNiO3, Re ≠ La) exhibit abundant electronic phases and widely adjustable metal to insulator electronic transition properties, their practical electronic applications are largely impeded by their intrinsic meta-stability. Apart from elevating the oxygen reaction pressure, heterogeneous nucleation is expected to be an alternative strategy that enables the crystallization of ReNiO3 at low meta-stability. In this work, the respective roles of high oxygen pressure and heterogeneous interface in triggering ReNiO3 thin film growth in the metastable state are revealed. ReNiO3 (Re = Nd, Sm, Eu, Gd and Dy) thin films grown on a LaAlO3 single crystal substrate show effective crystallization at atmospheric pressure without the necessity to apply high oxygen pressure, suggesting that the interfacial bonding between the ReNiO3 and substrates can sufficiently reduce the positive Gibbs formation energy of ReNiO3, which is further verified by the first-principles calculations. Nevertheless, the abrupt electronic transitions only appear in ReNiO3 thin films grown at high oxygen pressure, in which case the oxygen vacancies are effectively eliminated via high oxygen pressure reactions as indicated by near-edge X-ray absorption fine structure (NEXAFS) analysis. This work unveils the synergistic effects of heterogeneous nucleation and high oxygen pressure on the growth of high quality ReNiO3 thin films.

Efficacy and Mechanism of Buyang Huanwu Decoction in Patients With Ischemic Heart Failure: A Randomized, Double-Blind, Placebo-Controlled Trial Combined With Proteomic Analysis.

Objective: Buyang Huanwu Decoction (BYHW), a famous herbal prescription in traditional Chinese medicine (TCM), has been used for 200 years for treating ischemic heart failure (IHF). This study aims to assess the efficacy and safety of BYHW combined with guideline-guided pharmacotherapy in patients with IHF and explore the biological mechanism by which BYHW exerts its efficacy. Methods: In the multicenter, double-blind, randomized controlled trial, a total of 80 patients with IHF were randomized to receive BYHW or placebo for 3 months. The primary efficacy endpoints were New York Heart Association (NYHA) classification, TCM syndrome scores, N-terminal pro-B-type natriuretic peptide (NT-ProBNP), whereas the mechanism exploration endpoints included energy metabolism parameters and coagulation function parameters. In addition, we performed the proteomic study of the serum of patients after treatment by label-free quantification technology to verify the candidate target proteins and pathways. Results: After 3 months of treatment, the NYHA classification, TCM syndrome scores, and the percentage of subjects with at least 30% reduction in NT-ProBNP were significantly improved in the BYHW group, compared with the control group (p < 0.05); BYHW treatment also significantly regulated blood glucose, blood lipid levels, ameliorated energy metabolism and improved coagulation function parameters. There were no significant differences in safety endpoints between the two groups. In addition, we obtained 56 differentially expressed proteins by proteomics, including 20 upregulated proteins and 36 downregulated proteins. Bioinformatic analysis revealed the mechanism of BYHW treatment was significantly related to complement and coagulation cascades, cholesterol metabolism, NF-kappa B signaling pathway, PI3K-Akt signaling pathway, and metabolic pathways. Among these differentially regulated proteins, fibrinogen gamma (FGG), fibrinogen beta (FGB), Carboxypeptidase B2 (CPB2), Coagulation factor XIII A (F13A1), Intercellular adhesion molecule1 (ICAM1), Apolipoprotein C-II(APOC2), Apolipoprotein C-I(APOC1), and CD44 were found to be signature proteins associated with the efficacy of BYHW against IHF. Conclusion: BYHW treatment can further improve cardiac dysfunction and clinical symptoms in IHF based on standard therapy without apparent adverse effects. Additionally, BYHW may play a therapeutic role in IHF by improving energy metabolism and regulating coagulation function through multiple targets and pathways.

Development and implementation of a novel decision support tool on physical restraint use in critically ill adult patients.

AIM: To investigate whether a novel decision support tool would effectively minimize physical restraint use in critically ill adult patients. DESIGN: A nonequivalent quasi-experimental design combined with a descriptive qualitative approach was used. METHODS: A Restraint Decision Tree was developed based on a qualitative study that explored the barriers to employ the Restraint Decision Wheel. During the quasi-experimental study, patients admitted to the unit between October 2017 and March 2018 were enrolled as the control group receiving the Restraint Decision Wheel (n = 528), whereas patients between April 2018 and September 2018 were enrolled as the intervention group receiving the Restraint Decision Tree (n = 564). The physical restraint rate, accidental catheter removal rate and nurses' satisfaction were compared. RESULTS: The Restraint Decision Tree significantly decreased physical restraint use. No significant difference in the rate of accidental catheter removal was found. Nurses reported increased satisfaction with the restraint decision-making. CONCLUSIONS: The Restraint Decision Tree could minimize physical restraint use. Physicians' involvement in the restraint decision-making and nurses' competence in delirium assessment may be essential for successful implementation of the Restraint Decision Tree.

Efficacy and Safety of Shexiang Baoxin Pill for Coronary Heart Disease after Percutaneous Coronary Intervention: A Systematic Review and Meta-analysis.

OBJECTIVE: Shexiang Baoxin Pill (SBP) is a licensed Chinese herbal pharmaceutical that has been widely accustomed to treat coronary heart disease (CHD) after percutaneous coronary intervention (PCI). This study points to systematically assess the efficacy and security of the combination of SBP with conventional western medicine in the treatment of CHD after PCI. METHODS: Databases including PubMed, the Cochrane Library, Web of Science, Embase, CNKI, Wanfang, VIP, and SINOMED were searched to collect RCTs on SBP in CHD after PCI before July 2021. Review Manager 5.3 was used to analyze the data. The Cochrane Collaboration Bias Risk Tool is used to assess the quality of methods. RESULTS: A total of 19 eligible trials of 2022 patients with CHD after PCI were finally included. The results of the aggregate evidence showed that, compared with routine western medicine treatment alone, the combination of SBP with conventional treatment trial groups could significantly reduce the incidence of major adverse cardiac events (MACE) of the patients (RR = 0.38, 95% CI (0.29, 0.51), P < 0.00001). SBP also significantly enhanced left ventricular ejection fraction (LVEF) (MD = 4.00, 95% CI (3.42, 4.58), P < 0.00001) and lessened N-terminal pro-B-type natriuretic peptide (NT-pro-BNP) levels (MD = -167.18, 95% CI (-174.80, -159.57), P < 0.00001). In addition, the inflammatory mediators and blood lipid index in the experimental group after the combined therapy were also mediated (P < 0.05). Moreover, SBP did not increase the incidence of adverse reactions during treatment. The results of subgroup analysis illustrated that the length of the intervention course might be the source of the heterogeneity of NT-pro-BNP and hs-CRP. CONCLUSION: SBP could demonstrate a beneficial role in patients with CHD after PCI of reducing the incidence of MACE and improving LVEF, NT-pro-BNP, inflammatory mediators, and blood lipid index. However, limited by the quantity and quality of eligible studies, the above conclusions required more standardized, rigorous, high-quality clinical trials to verify further.