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Graph neural networks (GNNs) have achieved state-of-the-art performance in graph representation learning. Message passing neural networks, which learn representations through recursively aggregating information from each node and its neighbors, are among the most commonly-used GNNs. However, a wealth of structural information of individual nodes and full graphs is often ignored in such process, which restricts the expressive power of GNNs. Various graph data augmentation methods that enable the message passing with richer structure knowledge have been introduced as one main way to tackle this issue, but they are often focused on individual structure features and difficult to scale up with more structure features. In this work we propose a novel approach, namely collective structure knowledge-augmented graph neural network (CoS-GNN), in which a new message passing method is introduced to allow GNNs to harness a diverse set of node- and graph-level structure features, together with original node features/attributes, in augmented graphs. In doing so, our approach largely improves the structural knowledge modeling of GNNs in both node and graph levels, resulting in substantially improved graph representations. This is justified by extensive empirical results where CoS-GNN outperforms state-of-the-art models in various graph-level learning tasks, including graph classification, anomaly detection, and out-of-distribution generalization.
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Starch-polyphenol V-type inclusion complex has become a hot topic due to its anti-digestibility and nutritional function. This paper aimed to explore the molecular motion behavior of starch affects starch-polyphenol inclusion complex and digestibility among different stilbene polyphenol structures (resveratrol (RA), pterostilbene (PB) and polydatin (PD) via the high-pressure homogenization (HPH) and heat moisture treatment (HMT) processes), which represented the fully extended and limited molecular motion behavior of starch, respectively. These results revealed distinct trends in complex formation among different stilbenes polyphenol structures, highlighting RA as particularly conducive to increasing single helix and V-type crystalline structures with the highest resistant starch (RS) content of 28.11 % due to its smaller steric hindrance. Novelty, in HPH environments with extended molecular motion behavior, the steric hindrance and hydrophobicity/CH-π interactions of polyphenols influence complex formation in the order of RA > PB > PD. Conversely, in HMT systems with limited molecular motion behavior, the limited movement of molecules emphasized the importance of hydrogen bond interactions between polyphenols and starch. Thus, the glucoside in PD enhanced its interaction with starch compared to methoxy-modified PB, leading to increased formation of inclusion complex with RS content of 18.61 %. Overall, these findings deepen the understanding of starch-polyphenol interactions.
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BACKGROUND: Social isolation not only increases the risk of mortality in later life but also causes depressive symptoms, cognitive and physical disabilities. Although RNA m6A modifications are suggested to play key roles in brain development, neuronal signaling and neurological disorders, both the roles of m6A and the enzymes that regulate RNA m6A modification in social isolation induced abnormal behavior is unknown. The present study aims to explore the possible epitranscriptomic role of RNA m6A modifications and its enzymes in social isolation induced impaired behavior. METHODS: 3-4â¯weeks mice experiencing 8â¯weeks social isolation stress (SI) were used in the present study. We quantified m6A levels in brain regions related to mood and cognitive behavior. And the expression of hippocampal m6A enzymes was also determined. The role of hippocampal m6A and its enzymes in SI induced abnormal behavior was further verified by the virus tool. RESULTS: SI led to not only depressive and anxiety-like behaviors but also cognitive impairment, with corresponding decreases in hippocampal m6A and METTL14. Hippocampal over-expression METTL14 with lentivirus not only rescued these behaviors but also enhanced the hippocampal m6A level. Hippocampal over-expression METTL14 resulted in increased synaptic related genes. CONCLUSIONS: We provide the first evidence that post-weaning social isolation reduces hippocampal m6A level and causes altered expression of m6A enzyme in mice. Importantly, hippocampal METTL14 over-expression alleviated the SI-induced depression/anxiety-like and impaired cognitive behaviors and enhanced m6A level and synaptic related genes expression.
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Continued evolution of SARS-CoV-2 generates variants to challenge antibody immunity established by infection and vaccination. A connection between population immunity and genesis of virus variants has long been suggested but its molecular basis remains poorly understood. Here, we identify a class of SARS-CoV-2 neutralizing public antibodies defined by their shared usage of VL6-57 light chains. Although heavy chains of diverse genotypes are utilized, convergent HCDR3 rearrangements have been observed among these public antibodies to cooperate with germline VL6-57 LCDRs to target a convergent epitope defined by RBD residues S371-S373-S375. Antibody repertoire analysis identifies that this class of VL6-57 antibodies is present in SARS-CoV-2-naive individuals and is clonally expanded in most COVID-19 patients. We confirm that Omicron-specific substitutions at S371, S373 and S375 mediate escape of antibodies of the VL6-57 class. These findings support that this class of public antibodies constitutes a potential immune pressure promoting the introduction of S371L/F-S373P-S375F in Omicron variants. The results provide further molecular evidence to support that antigenic evolution of SARS-CoV-2 is driven by antibody mediated population immunity.
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Anticuerpos Neutralizantes , Anticuerpos Antivirales , COVID-19 , Epítopos , SARS-CoV-2 , Glicoproteína de la Espiga del Coronavirus , SARS-CoV-2/inmunología , SARS-CoV-2/genética , Humanos , Glicoproteína de la Espiga del Coronavirus/inmunología , Glicoproteína de la Espiga del Coronavirus/genética , COVID-19/inmunología , COVID-19/virología , Anticuerpos Antivirales/inmunología , Anticuerpos Neutralizantes/inmunología , Epítopos/inmunología , Epítopos/genética , Cadenas Ligeras de Inmunoglobulina/genética , Cadenas Ligeras de Inmunoglobulina/inmunologíaRESUMEN
PURPOSE: Research on bone metastasis in esophageal cancer (EC) is relatively limited. Once bone metastasis occurs in patients, their prognosis is poor, and it severely affects their quality of life. Currently, there is a lack of convenient tumor markers for early identification of bone metastasis in EC. Our research aims to explore whether neutrophil-lymphocyte ratio (NLR) can predict bone metastasis in patients with EC. METHODS: Retrospective analysis of clinical indicators was performed on 604 patients with EC. They were divided into groups based on whether or not there was bone metastasis, and the patients' coagulation-related tests, blood routine, tumor markers and other indicators were collected. The receiver operating characteristic curve (ROC) were used to determine the predictive ability of parameters such as NLR for bone metastasis in EC, and univariate and multivariate logistic regression analyses were conducted to determine the impact of each indicator on bone metastasis. Using binary logistic regression to obtain the predictive probability of NLR combined with tumor markers. RESULTS: ROC curves analysis suggested that the area under the curve (AUC) of the NLR was 0.681, with a sensitivity of 79.2% and a specificity of 52.6%, which can be used as a predictive factor for bone metastasis in EC. Multivariate logistic regression analysis showed that high NLR (odds ratio [OR]: 2.608, 95% confidence interval [CI]: 1.395-4.874, P = 0.003) can function as an independent risk factor for bone metastasis in patients with EC. Additionally, high PT, high APTT, high FDP, high CEA, high CA724, low hemoglobin, and low platelet levels can also predict bone metastasis in EC. When NLR was combined with tumor markers, the area under the curve was 0.760 (95% CI: 0.713-0.807, P < 0.001), significantly enhancing the predictability of bone metastasis in EC. CONCLUSION: NLR, as a convenient, non-invasive, and cost-effective inflammatory indicator, could predict bone metastasis in EC. Combining NLR with tumor markers can significantly improve the diagnostic accuracy of bone metastasis in EC.
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Biomarcadores de Tumor , Neoplasias Óseas , Neoplasias Esofágicas , Linfocitos , Neutrófilos , Curva ROC , Humanos , Neutrófilos/patología , Neoplasias Esofágicas/patología , Neoplasias Esofágicas/sangre , Neoplasias Óseas/secundario , Neoplasias Óseas/sangre , Femenino , Masculino , Linfocitos/patología , Persona de Mediana Edad , Pronóstico , Anciano , Estudios Retrospectivos , Biomarcadores de Tumor/sangre , Adulto , Recuento de Linfocitos , Recuento de LeucocitosRESUMEN
The transcriptome serves as a bridge that links genomic variation and phenotype diversity. A vast number of studies using next-generation RNA sequencing (RNA-seq) in the last two decades emphasize the essential roles of plant transcriptome in response to developmental and environmental conditions, leading to numerous insights into the dynamic change, evolutionary trace and elaborate regulation of plant transcriptome. With substantial improvement in accuracy and throughput, direct RNA sequencing (DRS) has emerged as a new and powerful sequencing platform for the precise detection of native and full-length transcripts, which overcomes many limitations such as read length and PCR bias that are inherent to short-read RNA-seq. Here, we reviewed recent advances in dissecting the complexity and diversity of plant transcriptome utilizing DRS as a main technological mean from many aspects of RNA metabolism, including novel isoforms, poly(A) tail and RNA modification, and proposed a comprehensive workflow for the data process of plants DRS. Many challenges concerning the application of DRS in plants, such as machine learning tools tailored to plant transcriptome, remain to be solved, and together we prospect the future biological questions that can be potentially answered by DRS such as allele-specific RNA modification. This technology provides convenient support on which the connection of distinct RNA features is tightly built, sustainably refining our understanding of the biological functions of plant transcriptome.
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The purpose of the research was to evaluate the diagnostic performance of microRNA-299-3p (miR-299-3p) in patients with coronary artery disease (CAD). The relative abundance of miR-299-3p in patients with CAD was verified by quantitative real time polymerase chain reaction (qRT-PCR) assay. Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) were used for analysis, and target genes were predicted and enriched by DAVID software. The protein-protein interaction (PPI) network was drawn by STRING database. Receiver operating characteristic (ROC) was adopted to appraise the diagnostic value of miR-299-3p in CAD. Bioinformatics analysis showed that the GO function of miR-299-3p target genes of miR-299-3p mainly focuses on specific granular membrane, regulation of apoptotic signaling pathway, growth factor binding and so on. KEGG analysis showed that the most abundant pathways involve fluid shear stress and atherosclerosis, as well as Notch signaling pathways. PPI network showed the seven predictive genes encoding the proteins play pivotal roles in maintaining the stability and interaction of the network, especially matrix metallopeptidase 2 (MMP2) and intercellular cell adhesion molecule-1 (ICAM1). Compared with the control group, serum miR-299-3p in the CAD group was distinctly up-regulated via qRT-PCR (p < 0.001). ROC analysis showed that miR-299-3p was an important index for detecting CAD patients and major adverse cardiovascular events (MACE) patients with an AUC of 0.931 and 0.758, respectively. MiR-299-3p is involved in the development of CAD, and might become a potential biomarker for monitoring CAD.
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BACKGROUND: Many patients with heart failure (HF) are repeatedly hospitalized. Heart failure self-care may reduce readmission rates. Hospitalizations may also affect self-care. OBJECTIVE: The purpose of this secondary analysis was to test the hypotheses that better HF self-care is associated with a lower rate of all-cause readmissions and that readmissions motivate patients to improve their self-care. METHODS: This was a prospective cohort study of patients with HF (N = 400) who were enrolled during a stay at an urban teaching hospital between 2014 and 2016. The Self-Care of Heart Failure Index v6.2 was administered during the hospital stay, along with other questionnaires, and repeated at 6-month intervals after discharge. All-cause readmissions and deaths were ascertained for 24 months. RESULTS: A total of 333 (83.3%) were readmitted at least once, and 117 (29.3%) of the patients died during the follow-up period. A total of 1581 readmissions were ascertained. Higher Self-Care of Heart Failure Index Maintenance scores predicted more rather than fewer readmissions (adjusted hazard ratio, 1.09; 95% confidence interval, 1.01-1.17; P < .01). Conversely, more readmissions predicted higher Maintenance scores (b = 0.29; 95% confidence interval, 0.02-0.56; P < .05). CONCLUSIONS: These findings do not support the hypothesis that HF self-care maintenance or management helps to reduce the rate of all-cause readmissions, but they do suggest that the experience of multiple readmissions may help to motivate improvements in HF self-care.
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Insuficiencia Cardíaca , Readmisión del Paciente , Autocuidado , Humanos , Insuficiencia Cardíaca/terapia , Readmisión del Paciente/estadística & datos numéricos , Masculino , Femenino , Anciano , Estudios Prospectivos , Persona de Mediana Edad , Estudios Longitudinales , Anciano de 80 o más AñosRESUMEN
Background: With the recent advances in the treatment of heart failure (HF), it is intriguing that a very small number of patients with dilated cardiomyopathy (DCM) have been observed as being fully recovered. However, knowledge of the progression and prognosis of patients with recovered DCM remains sparse. Herein, we conducted this study to investigate the clinical characteristics and prognosis of patients with recovered DCM. Methods: Consecutive patients with recovered DCM referred to our hospital between March 2009 and May 2021 were included. The recovered DCM patients were categorized into relapse and non-relapse groups. The primary endpoint was all-cause death, and the secondary endpoint was HF re-hospitalization during follow-up. Multivariate analyses were performed to identify predictors of relapse among recovered DCM patients. Kaplan-Meier analyses were used to assess the prognostic significance of relapse. Results: A comparatively large cohort of 122 recovered DCM patients from 10,029 DCM patients was analyzed. During a median follow-up duration of 53.5 months, the relapse rate among recovered DCM patients was 15.6% (19/122). Age (odds ratio, OR 1.079, 95% confidence interval, CI: 1.014-1.148; p = 0.017), systolic blood pressure (SBP) at diagnosis (OR 0.948, 95% CI: 0.908-0.990; p = 0.015) and changes in left ventricular ejection fraction from diagnosis to recovery ( Δ LVEF) (OR 0.898, 95% CI: 0.825-0.978; p = 0.013) were identified as predictors of relapse. Furthermore, among 122 patients, 5 (4.1%) experienced death, and 12 (9.8%) underwent HF re-hospitalization. Four deaths occurred in the relapse group, with one in the non-relapse group. All deaths were attributed to cardiovascular events. The long-term prognosis of the relapse group was significantly worse compared to the non-relapse group by Kaplan-Meier analysis (p < 0.001 based on the log-rank test). Multivariate analyses significantly associated relapse with all-cause mortality in recovered DCM patients (hazard ratio, HR 7.738, 95% CI: 1.892-31.636; p = 0.004). Conclusions: Recovered DCM patients are at risk of relapse. Older age, lower SBP, and smaller Δ LVEF were independently associated with relapse in recovered DCM patients. Relapse after recovery was related to an unfavorable long-term prognosis.
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The monitoring and evaluation of fluoride pollution are essentially important to make sure that concentrations do not exceed threshold limit, especially for surrounding atmosphere and soil, which are located close to the emission source. This study aimed to describe the atmospheric HF and edaphic fluoride distribution from an electrolytic aluminum plant located in Yunnan province, on which the effects of meteorological conditions, time, and topography were explored. Meanwhile, six types of solid waste genereted from different electrolytic aluminum process nodes were characterized to analyze the fluoride content and formation characteristics. The results showed that fluoride in solid waste mainly existed in the form of Na3AlF6, AlF3, CaF2, and SiF4. Spent electrolytes, carbon residue, and workshop dust are critical contributors to fluoride emissions in the primary aluminum production process, and the fluorine content is 17.14 %, 33.30 %, and 31.34 %, respectively. Unorganized emissions from electrolytic aluminum plants and solid waste generation are the primary sources of fluoride in the environment, among which the edaphic fluoride content increases most at the sampling sites S1 and S7. In addition, the atmospheric HF concentration showed significant correlations with wind speed, varying wildly from March to September, with daily average and hourly maximum HF concentrations of 4.32 µg/m3 and 9.0 µg/m3, respectively. The results of the study are crucial for mitigating fluorine pollution in the electrolytic aluminum industry.
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Psoriasis, which severely affects the sufferer's life quality, is a chronic skin disease still lacking satisfactory medication. Recently, signal transducer and activator of transcription 3 (STAT3) was revealed playing an important role in the progression of psoriasis. In this paper, a total of 59 quinone derivatives with various scaffolds were designed, synthesized, and evaluated for antipsoriatic potential as STAT3 inhibitors. Among them, 15e was identified as the most potent antipsoriatic agent and could bind to STAT3; reduce both total and phosphorylated STAT3 levels, inhibit the nuclear translocation of STAT3; and, therefore, inhibit the transcription and expression of the propsoriatic factor IL-17A. In vivo experiments on mice showed that the topical application of 15e was effective in alleviating IMQ-induced psoriasis without noticeable side effects. In all, this research rendered 15e as a promising drug candidate for psoriasis.
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OBJECTIVE: Although obesity is an important risk factor for endometrial intraepithelial neoplasia (EIN) and uterine cancer, little is known about the trends in use of weight-loss therapy for patients with obesity with EIN and uterine cancer. We examined the use of weight-loss therapy among patients with obesity with EIN and uterine cancer. METHODS: The Merative MarketScan Database was used to identify patients aged 18-70 years who were obese and diagnosed with EIN or uterine cancer. The primary treatment for EIN or uterine cancer was categorized as either primary hysterectomy or hormonal therapy. Nutrition counseling, bariatric surgeries, and weight-management medications were identified as weight-loss therapy. We analyzed trends in the use of any weight-loss therapies with Cochran-Armitage tests. A multivariable logistic regression model was developed to examine factors associated with weight-loss therapy use. RESULTS: Overall, 15,374 patients were identified, including 5561 (36.2%) patients with EIN and obesity, and 9813 (63.8%) patients with uterine cancer and obesity. Weight-loss therapy was utilized within 1 year after diagnosis in 480 (8.6%) patients with EIN and in 802 (8.2%) patients with uterine cancer. Use of any weight-loss therapy after diagnosis of EIN increased from 4.1% in 2009 to 12.6% in 2020 (P < .001), and the use of any weight-loss therapy after diagnosis of uterine cancer increased from 4.9% in 2009 to 11.4% in 2020 (P < .001). In a multivariable regression model, younger age and patients with high comorbidity score were associated with a higher likelihood of using any weight-loss therapy. CONCLUSIONS: Use of weight-loss therapy has increased, however there is still a significant underuse of this adjunctive therapy in patients with obesity with EIN or uterine cancer.
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BACKGROUND AND OBJECTIVES: Maximal and safe removal of insular gliomas by a transinsular cortex approach is challenging. In this article, a new transtemporal isthmus approach to resect insular gliomas is presented. METHODS: We retrospectively examined 53 patients with insular glioma who underwent resection through the temporal isthmus approach using magnetic resonance imaging and functional neuronavigation guidance and intraoperative electrophysiological monitoring. Extent of resection was determined using intraoperative magnetic resonance imaging. RESULTS: Fifty-three patients were included for analysis, 30 men and 23 women. The median (range) age was 45 (26-70) years. Tumor laterality was left in 22 patients and right in 31. All tumors involved at least zone III or IV (Berger-Sanai classification system), including zones I-IV were involved in 29 (54.7%) and zones III and IV in 17 (32.0%). Among the 37 low-grade gliomas, preoperative median (IQR) volume was 45.7 (31.8, 60.3) cm3, and gross total resection was achieved in 24 (64.9%). Among the 16 high-grade gliomas, preoperative median (IQR) volume was 45.3 (40.1, 54.0) cm3, and gross total resection was achieved in 14 (87.5%). The median (IQR) extent of resection of the whole group was 100% (89%-100%). The median (IQR) postoperative Karnofsky performance score 3 months after surgery was 90 (80-90). Mean temporal isthmus width was significantly higher in the affected side (involving tumor) than the contralateral one (21.6 vs 11.3 mm; 95% CI: 9.3 to 11.3, P < .01). Muscle strength was grade 4 or higher, and speech was nearly normal in all patients 3 months after surgery. CONCLUSION: Insular glioma surgery using the transtemporal isthmus approach can achieve safe and maximum resection. A widened temporal isthmus provides a surgical pathway for transisthmic resection of insular tumor.
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Recycling spent lithium-ion batteries (LIBs) to efficient water-splitting electrocatalysts is a promising and sustainable technology route for green hydrogen production by renewables. In this work, a fluorinated ternary metal oxide (F-TMO) derived from spent LIBs was successfully converted to a robust water oxidation catalyst for pure water electrolysis by utilizing an anion-exchange membrane. The optimized catalyst delivered a high current density of 3.0 A cm-2 at only 2.56 V and a durability of >300 h at 0.5 A cm-2, surpassing the noble-metal IrO2 catalyst. Such excellent performance benefits from an artificially endowed interface layer on the F-TMO, which renders the exposure of active metal (oxy)hydroxide sites with a stabilized configuration during pure water operation. Compared to other metal oxides (i.e., NiO, Co3O4, MnO2), F-TMO possesses a higher stability number of 2.4 × 106, indicating its strong potential for industrial applications. This work provides a feasible way of recycling waste LIBs to valuable electrocatalysts.
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BACKGROUND: Heterotopic mesenteric ossification (HMO) is a clinically rare condition characterized by the formation of bone tissue in the mesentery. The worldwide reporting of such cases is limited to just over 70 instances in the medical literature. The etiology of HMO remains unclear, but the disease is possibly induced by mechanical trauma, ischemia, or intra-left lower quadrant abdominal infection, leading to the differentiation of mesenchymal stem cells into osteoblasts. Here, we present a rare case of HMO that occurred in a 34-year-old male, who presented with left lower quadrant abdominal pain. CASE SUMMARY: We report the case of a 34-year-old male patient who presented with left lower abdominal pain following trauma to the left lower abdomen. He subsequently underwent surgical treatment, and the postoperative pathological diagnosis was HMO. CONCLUSION: We believe that although there is limited literature and research on HMO, when patients with a history of trauma or surgery to the left lower abdomen present with corresponding imaging findings, clinicians should be vigilant in distinguishing this condition and promptly selecting appropriate diagnostic and therapeutic interventions.
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Four previously undescribed phloroglucinols, including three pairs of enantiomers, (±)-rhodotomentodimer F, (±)-rhodotomentodimer G, and (±)-rhodotomentomonomer E, and one phloroglucinol-sesquiterpene meroterpenoid, rhodotomentodione E, together with one previously reported congener, (±)-rhodomyrtosone A, were obtained from the leaves of Rhodomyrtus tomentosa. The structures including absolute configurations of previously undescribed isolates were elucidated by extensive spectroscopic analysis (HRESIMS and NMR), ECD calculations, and single-crystal X-ray diffraction. (±)-Rhodotomentodimer F is a rare phloroglucinol derivative conjugated by a ß-triketone moiety and an unprecedented resorcinol unit via the formation of a rare bis-furan ring system, whereas (±)-rhodotomentomonomer E shares a rearranged pentacyclic scaffold. Pharmacologically, (±)-rhodotomentomonomer E showed the strongest human acetylcholinesterase (hAChE) inhibitory effect with an IC50 value of 1.04 ± 0.05 µM. Molecular formula studies revealed that hydrogen bonds formed between hAChE residues Glu202, Ser203, Ala204, Gly121, Gly122, Tyr337, and His447 and (±)-rhodotomentomonomer E played crucial roles in its observed activity. These findings indicated that the leaves of Rhodomyrtus tomentosa can supply a rich source of hAChE inhibitors. These inhibitors might potentially be utilized in the therapeutic strategy for Alzheimer's disease, offering promising candidates for further research and development.
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Introduction: Online question-and-answer (Q&A) platforms are frequently replete with extensive human resource support. This study proposes a novel methodology of a customized large language model (LLM) called Chaotic LLM-based Educational Q&A System (CHAQS) to navigate the complexities associated with intelligent Q&A systems for the educational sector. Methods: It uses an expansive dataset comprising over 383,000 educational data pairs, an intricate fine-tuning process encompassing p-tuning v2, low-rank adaptation (LRA), and strategies for parameter freezing at an open-source large language model ChatGLM as a baseline model. In addition, Fuzzy Logic is implemented to regulate parameters and the system's adaptability with the Lee Oscillator to refine the model's response variability and precision. Results: Experiment results showed a 5.12% improvement in precision score, an 11% increase in recall metric, and an 8% improvement in the F1 score as compared to other models. Discussion: These results suggest that the CHAQS methodology significantly enhances the performance of educational Q&A systems, demonstrating the effectiveness of combining advanced tuning techniques and fuzzy logic for improved model precision and adaptability.
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The atomic precision of metal nanoclusters and variability of surface ligands pave the way for its rational design and functionalization, whereas the property strengthening in multiple ways has been long challenging. Herein, improved amphiphilicity, chirality, thermostability, and strong CPL (circularly polarized luminescence) properties have been accomplished by facile ligand exchange of [Au23(CHT)16]- with HCapt (HCHT and HCapt denote cyclohexanethiol and captopril). In addition, the obtained chiral [Au23(SR)16]- (short for [Au23(CHT)16-x(Capt)x]-) clusters show specific binding affinity to remote-diamines (such as arginine and single/double strand DNA), originating from the hydrogen bonding and Van der Walls interaction among the surface Capt ligands and the di-amine groups.
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The quest to develop 3D starch-based printing hydrogels for the controlled release of active substances with excellent mechanical and printing properties has gained significant attention. This work introduced a facile method based on crosslinking via Schiff base reaction for preparing bicomponent hydrogels. The method involved the utilization of customizable oxidized starch (OS) and chitosan (CS), enabling superior printing performance through the precise control of various active carbonyl-carboxyl ratios (ACR, 2:1, 1:1, and 2:3, respectively) of OS. OS-CS hydrogel (OSC) with an ACR level of 2:1 (OS-2-y%CS) underwent rearrangement during printing environment, fostering increased Schiff base reaction with a higher crosslinking degree and robust high structural recovery (>95 %). However, with decreasing ACR levels (from 2:1 to 2:3), the printing performance and mechanical strength of printed OSC (POSC) declined due to lower Schiff base bonds and increased phase separation. Compared with printed OS, POS-2-2%CS exhibited a remarkable 1250.52 % increase in tensile strength and a substantial 2424.71 % boost in compressive strength, enhanced shape fidelity and notable self-healing properties. Moreover, POS-2-2%CS exhibited stable diffusive drug release, showing potential application in the pH-responsive release of active substances. Overall, controlling the active carbonyl-carboxyl ratios provided an efficient and manageable approach for preparing high-performance 3D-printed hydrogels.
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The aim of this study is to reduce door-to-wire time for ST-elevation myocardial infarction patients undergoing primary percutaneous coronary intervention through multidisciplinary collaboration. Patients over the age of 18who visited the Foshan Sanshui District People's Hospital between 2018 and 2019 and were diagnosed with STEMI were included in this study. Analyses were performed with patients segregated into a pre-intervention interim period (2018) and a post-intervention period (2019) based on the date of admission. Intervention measures for reducing door to wire time were fully implemented towards the end of the interim period. There were no significant differences in the baseline characteristics of the 2 groups. Median door to puncture time was reduced from 57.5 minutes in the interim period to 46.0 minutes (Pâ <â .001) in the post-intervention period. Similarly, median door to wire time was shortened from 88.0 minutes to 63.5 minutes (Pâ <â .001). During the interim period, 24% of patients had a door to wire time of <60 minutes, compared to 40.67% of patients in the post-intervention period (Pâ =â .002). Multidisciplinary collaboration is an important strategy to reduce door to wire time for patients with STEMI, and may be implemented in suitable centers to improve patient care.