Enhancing hospice care with psychological support and a nomogram to predict delirium in patients with advanced solid tumors.

To assesses the impact of integrating hospice care with psychological interventions on patient well-being and to introduce a predictive nomogram model for delirium that incorporates clinical and psychosocial variables, thereby improving the accuracy in hospice care environments. Data from 381 patients treated from September 2018 to February 2023 were analyzed. The patients were divided into a control group (n=177, receiving standard care) and an experimental group (n=204, receiving combined hospice care and psychological interventions) according to the treatment modality. The duration of care extended until the patient's discharge from the hospital or death. The experimental group demonstrated significant improvements in emotional well-being and a lower incidence of delirium compared to the control group. Specifically, emotional well-being assessments revealed marked improvements in the experimental group, as evidenced by lower scores on the Self-Rating Anxiety Scale (SAS) and Self-Rating Depression Scale (SDS) post-intervention. The nomogram model, developed using logistic regression based on clinical characteristics, effectively predicted the risk of delirium in patients with advanced cancer. Significant predictors in the model included ECOG score ≥3, Palliative Prognostic Index score ≥6, opioid usage, polypharmacy, infections, sleep disorders, organ failure, brain metastases, electrolyte imbalances, activity limitations, pre-care SAS score ≥60, pre-care SDS score ≥63, and pre-care KPS score ≥60. The model's predictive accuracy was validated, showing AUC values of 0.839 for the training cohort and 0.864 for the validation cohort, with calibration and Decision Curve Analysis (DCA) confirming its clinical utility. Integrating hospice care with psychological interventions not only significantly enhanced the emotional well-being of advanced cancer patients but also reduced the actual incidence of delirium. This approach, offering a valuable Nomogram model for precise care planning and risk management, underscores the importance of integrated, personalized care strategies in advanced cancer management.

Bioinspired Robust Gas-Permeable On-Skin Electronics: Armor-Designed Nanoporous Flash Graphene Assembly Enhancing Mechanical Resilience.

Soft on-skin electrodes play an important role in wearable technologies, requiring attributes such as wearing comfort, high conductivity, and gas permeability. However, conventional fabrication methods often compromise simplicity, cost-effectiveness, or mechanical resilience. In this study, a mechanically robust and gas-permeable on-skin electrode is presented that incorporates Flash Graphene (FG) integrated with a bioinspired armor design. FG, synthesized through Flash Joule Heating process, offers a small-sized and turbostratic arrangement that is ideal for the assembly of a conductive network with nanopore structures. Screen-printing is used to embed the FG assembly into the framework of polypropylene melt-blown nonwoven fabrics (PPMF), forming a soft on-skin electrode with low sheet resistance (125.2 ± 4.7 Ω/□) and high gas permeability (≈10.08 mg cm⁻2 h⁻¹). The "armor" framework ensures enduring mechanical stability through adhesion, washability, and 10,000 cycles of mechanical contact friction tests. Demonstrating capabilities in electrocardiogram (ECG) and electromyogram (EMG) monitoring, along with serving as a self-powered triboelectric sensor, the FG/PPMF electrode holds promise for scalable, high-performance flexible sensing applications, thereby enriching the landscape of integrated wearable technologies.

Polarized vortex Smith-Purcell radiation with cascaded metasurfaces.

We introduce the concept of polarized vortex Smith-Purcell radiation by the interaction of an electron beam and cascaded metasurfaces. The spin and orbital angular momenta of Smith-Purcell radiation are determined by the cascaded metasurface that consists of a grating and a phase gradient metasurface. The grating converts the electron beam radiation into the desired polarized light, while the phase gradient metasurface generates the vortex light. Furthermore, the vortex Smith-Purcell radiation with linear and circular polarizations can be achieved by the various cascaded metasurfaces. In particular, the conversion of chirality in the Smith-Purcell radiation carrying circular polarization is accompanied by the alteration of positive and negative topological charges. This work paves the way for generating polarized vortex electron radiation and is beneficial to promote the development of free-electron-driven devices.

A Self-Powered Biochemical Sensor for Intelligent Agriculture Enabled by Signal Enhanced Triboelectric Nanogenerator.

Precise agriculture based on intelligent agriculture plays a significant role in sustainable development. The agricultural Internet of Things (IoTs) is a crucial foundation for intelligent agriculture. However, the development of agricultural IoTs has led to exponential growth in various sensors, posing a major challenge in achieving long-term stable power supply for these distributed sensors. Introducing a self-powered active biochemical sensor can help, but current sensors have poor sensitivity and specificity making this application challenging. To overcome this limitation, a triboelectric nanogenerator (TENG)-based self-powered active urea sensor which demonstrates high sensitivity and specificity is developed. This device achieves signal enhancement by introducing a volume effect to enhance the utilization of charges through a novel dual-electrode structure, and improves the specificity of urea detection by utilizing an enzyme-catalyzed reaction. The device is successfully used to monitor the variation of urea concentration during crop growth with concentrations as low as 4 µm, without being significantly affected by common fertilizers such as potassium chloride or ammonium dihydrogen phosphate. This is the first self-powered active biochemical sensor capable of highly specific and highly sensitive fertilizer detection, pointing toward a new direction for developing self-powered active biochemical sensor systems within sustainable development-oriented agricultural IoTs.

Knocking out FAM20C in pre-osteoblasts leads to up-regulation of osteoclast differentiation to affect long bone development.

Family with sequence similarity 20 member C (FAM20C) is a Golgi casein kinase that phosphorylates extracellularly-secreted regulatory proteins involved in bone development and mineralization, but its specific role in bone development is still largely unknown. In this study, to examine the specific mechanisms that FAM20C influences bone development, we cross-bred Osx-Cre with FAM20Cflox/flox mice to establish a Osx-Cre; FAM20Cflox/flox knockout (oKO) mouse model; FAM20C was KO in pre-osteoblasts. oKO development was examined at 1-10 weeks, in which compared to control FAM20Cflox/flox, they had lower body weights and bone tissue mineralization. Furthermore, oKO had lower bone volume fractions, thickness, and trabecular numbers, along with higher degrees of trabecular separation. These mice also had decreased femoral metaphyseal cartilage proliferation layer, along with thickened hypertrophic layer and increased apoptotic cell counts. Transcriptomic analysis found that differentially-expressed genes in oKO were concentrated in the osteoclast differentiation pathway, in line with increased osteoclast presence. Additionally, up-regulation of osteoclast-related, and down-regulation of osteogenesis-related genes, were identified, in which the most up-regulated genes were signal regulatory protein ß-1 family (Sirpb1a-c) and mitogen-activated protein kinase 13. Overall, FAM20C KO in pre-osteoblasts leads to abnormal long bone development, likely due to subsequent up-regulation of osteoclast differentiation-associated genes.

Monometallic Ultrasmall Nanocatalysts via Different Valence Atomic Interfaces Boost Hydrogen Evolution Catalysis.

Synergistic monometallic nanocatalysts have attracted much attention due to their high intrinsic activity properties. However, current synergistic monometallic nanocatalysts tend to suffer from long reaction paths due to restricted nanoscale interfaces. In this paper, we synthesized the interstitial compound N-Pt/CNT with monometallic atomic interfaces. The catalysts are enriched with atomic interfaces between higher valence Ptδ+ and Pt0, allowing the reaction to proceed synergistically within the same component with an ideal reaction pathway. Through ratio optimization, N2.42-Pt/CNT with a suitable ratio of Ptδ+ and Pt0 is synthesized. And the calculated turnover frequency of N2.42-Pt/CNT is about 37.4 s-1 (-0.1 V vs reversible hydrogen electrode (RHE)), six times higher than that of the commercial Pt/C (6.58 s-1), which is the most intrinsically active of the Pt-based catalysts. Moreover, prepared N2.42-Pt/CNT exhibits excellent stability during the chronoamperometry tests of 200 h. With insights from comprehensive experiments and theoretical calculations, Pt with different valence states in monometallic atomic interfaces synergistically accelerates the H2O dissociation step and optimizes the Gibbs free energy of H* adsorption. And the existence of desirable hydrogen transfer paths substantially facilitates hydrogen evolution reaction kinetics.

Vascular endothelial glycocalyx shedding in ventilator-induced lung injury in rats.

Endothelial permeability deterioration is involved in ventilator-induced lung injury (VILI). The integrality of vascular endothelial glycocalyx (EG) is closely associated with endothelial permeability. The hypothesis was that vascular EG shedding participates in VILI through promoting endothelial permeability. In the present study, male Sprague-Dawley (SD) rats were ventilated with high tidal volume (VT =40 ml/kg) or low tidal volume (VT =8 ml/kg) to investigate the effects of different tidal volume and ventilation durations on EG in vivo. We report disruption of EG during the period of high tidal volume ventilation characterized by increased glycocalyx structural components (such as syndecan-1, heparan sulfate, hyaluronan) in the plasma and decreased the expression of syndecan-1 in the lung tissues. Mechanistically, the disruption of EG was associated with increased proinflammatory cytokines and matrix metalloproteinase in the lung tissues. Collectively, these results demonstrate that the degradation of EG is involved in the occurrence and development of VILI in rats, and the inflammatory mechanism mediated by activation of the NF-κB signaling pathway may be partly responsible for the degradation of EG in VILI in rats. This study enhances our understanding of the pathophysiological processes underlying VILI, shedding light on potential therapeutic targets to mitigate VILI.