Effects of fermented sweet potato residue on nutrient digestibility, meat quality, and intestinal microbes in broilers.

This study aimed to investigate the effects of different proportions of dietary fermented sweet potato residue (FSPR) supplementation as a substitute for corn on the nutrient digestibility, meat quality, and intestinal microbes of yellow-feathered broilers. Experiment 1 (force-feeding) evaluated the nutrient composition and digestibility of mixtures with different proportions of sweet potato residue (70%, 80%, 90%, and 100%) before and after fermentation. In Experiment 2 (metabolic growth), a total of 420 one-day-old yellow-feathered broilers were randomly allocated to 4 groups and fed corn-soybean meal-based diets with 0, 5%, 8%, and 10% FSPR as a substitute for corn. The force-feeding and metabolic growth experiments were performed for 9 and 70 d, respectively. The treatment of 70% sweet potato residue (after fermentation) had the highest levels of crude protein, ether extract, and crude fiber and improved the digestibility of crude protein and amino acids (P < 0.05). Although dietary FSPR supplementation at different levels had no significant effect on growth performance and intestinal morphology, it improved slaughter rate, half-chamber rate, full clearance rate, and meat color, as well as reduced cooking loss in the breast and thigh muscles (P < 0.05). Dietary supplementation with 8% and 10% FSPR increased the serum immunoglobulin M and immunoglobulin G levels in broilers (P < 0.05). Furthermore, 10% FSPR increased the Shannon index and Ruminococcaceae_UCG-014, Ruminococcaceae_UCG-010 and Romboutsia abundances and decreased Sutterella and Megamonas abundances (P < 0.05). Spearman's correlation analysis showed that meat color was positively correlated with Ruminococcaceae_UCG-014 (P < 0.05) and negatively correlated with Megamonas (P < 0.05). Collectively, 70% sweet potato residue (after fermentation) had the best nutritional value and nutrient digestibility. Dietary supplementation with 8% to 10% FSPR as a substitute for corn can improve the slaughter performance, meat quality, and intestinal microbe profiles of broilers. Our findings suggest that FSPR has the potential to be used as a substitute for corn-soybean meals to improve the meat quality and intestinal health of broilers.

Current situation and prospects for the clean utilization of gold tailings.

Gold tailings are characterized by low-grade, complex composition, fine embedded particle size, environmental pollution, and large land occupation. This paper describes the mineralogical properties of gold tailings, including chemical composition, phase composition, particle size distribution, and microstructure; summarizes the recycling and utilization of components such as mica, feldspar, and valuable metals in gold tailings; reviews harmless treatment measures for harmful elements in gold tailings; and adumbrated the research progress of gold tailings in the application fields of building materials, ceramics, and glass materials. Based on these discussions, a new technology roadmap that combines multistage magnetic separation and cemented filling is proposed for the clean utilization of all components of gold tailings.

Sodium alginate/ager colourimetric film on porous substrate layer: Potential in intelligent food packaging.

Colourimetric indicators have potential applications in monitoring food freshness and offer a simple, rapid, effective, and economical approach. Blending sodium alginate (SA) with agar (AG), an ideal choice for solid substrates in colourimetric indicators, can modify mechanical compliance and optical properties. However, the limitations in the water-sustaining capacity and dye migration of hydrogel substrates significantly impede the scalability and commercial application of these indicators. In this study, we designed and prepared a bilayer-structured indicator featuring an SA/AG colourimetric film on a porous Polypropylene fluoride (PVDF)/SiO2 encapsulation film. This design aims to enhance the water-sustaining capacity and reduce dye migration from the SA/AG colourimetric film. The PVDF/SiO2 composite film was prepared using a peeling-assisted phase-conversion process, which enabled the indicator to selectively allow gas, but not water, to pass through its porous substrate. Furthermore, we tested the layered indicator film by monitoring changes in shrimp freshness. The results revealed significant and distinguishable colour changes in the indicators corresponding to the freshness and spoilage of the shrimp.

Physically and Chemically Stable Molybdenum-Based Composite Electrodes for p-i-n Perovskite Solar Cells.

Metal halide perovskite solar cells (PSCs) have garnered much attention in recent years. Despite the remarkable advancements in PSCs utilizing traditional metal electrodes, challenges such as stability concerns and elevated costs have necessitated the exploration of innovative electrode designs to facilitate industrial commercialization. Herein, a physically and chemically stable molybdenum (Mo) electrode is developed to fundamentally tackle the instability factors introduced by electrodes. The combined spatially resolved element analyses and theoretical study demonstrate the high diffusion barrier of Mo ions within the device. Structural and morphology characterization also reveals the negligible plastic deformation and halide-metal reaction during aging when Mo is in contact with perovskite (PVSK). The electrode/underlayer junction is further stabilized by a thin seed layer of titanium (Ti) to improve Mo film's uniformity and adhesion. Based on a corresponding p-i-n PSCs (ITO/PTAA/PVSK/C60/SnO2/ITO/Ti/Mo), the champion sample could deliver an efficiency of 22.25%, which is among the highest value for PSCs based on Mo electrodes. Meanwhile, the device shows negligible performance decay after 2000 h operation, and retains 91% of the initial value after 1300 h at 50-60 °C. In summary, the multilayer Mo electrode opens an effective avenue to all-round stable electrode design in high-performance PSCs.

NIR-Triggered Thermosensitive Nanoreactors for Dual-Guard Mechanism-Mediated Precise and Controllable Cancer Chemo-Phototherapy.

Thermosensitive nanoparticles can be activated by externally applying heat, either through laser irradiation or magnetic fields, to trigger the release of drug payloads. This controlled release mechanism ensures that drugs are specifically released at the tumor site, maximizing their effectiveness while minimizing systemic toxicity and adverse effects. However, its efficacy is limited by the low concentration of drugs at action sites, which is caused by no specific target to tumor sties. Herein, hyaluronic acid (HA), a gooey, slippery substance with CD44-targeting ability, was conjugated with a thermosensitive polymer poly(acrylamide-co-acrylonitrile) to produce tumor-targeting and thermosensitive polymeric nanocarrier (HA-P) with an upper critical solution temperature (UCST) at 45 °C, which further coloaded chemo-drug doxorubicin (DOX) and photosensitizer Indocyanine green (ICG) to prepare thermosensitive nanoreactors HA-P/DOX&ICG. With photosensitizer ICG acting as the "temperature control element", HA-P/DOX&ICG nanoparticles can respond to temperature changes when receiving near-infrared irradiation and realize subsequent structure depolymerization for burst drug release when the ambient temperature was above 45 °C, achieving programmable and on-demand drug release for effective antitumor therapy. Tumor inhibition rate increased from 61.8 to 95.9% after laser irradiation. Furthermore, the prepared HA-P/DOX&ICG nanoparticles possess imaging properties, with ICG acting as a probe, enabling real-time monitoring of drug distribution and therapeutic response, facilitating precise treatment evaluation. These results provide enlightenment for the design of active tumor targeting and NIR-triggered programmable and on-demand drug release of thermosensitive nanoreactors for tumor therapy.

Glutathione Consumptive Dual-Sensitive Lipid-Composite Nanoparticles Induce Immunogenic Cell Death for Enhanced Breast Tumor Therapy.

Although chemotherapy remains the standard therapy for tumor treatment, serious side effects can occur because of nontargeted distribution and damage to healthy tissues. Hollow mesoporous silica nanoparticles (HMSNs) modified with lipids offer potential as delivery systems to improve therapeutic outcomes and reduce adverse effects. Herein, we synthesized HMSNs with integrated disulfide bonds (HMSN) for loading with the chemotherapeutic agent oxaliplatin (OXP) which were then covered with the synthesized hypoxia-sensitive lipid (Lip) on the surface to prepare the dual-sensitive lipid-composite nanoparticles (HMSN-OXP-Lip). The empty lipid-composite nanoparticles (HMSN-Lip) would consume glutathione (GSH) in cells because of the reduction of disulfide bonds in HMSN and would also inhibit GSH production because of NADPH depletion driven by Lip cleavage. These actions contribute to increased levels of ROS that induce the immunogenic cell death (ICD) effect. Simultaneously, HMSN-Lip would disintegrate in the presence of high concentrations of GSH. The lipid in HMSN-OXP-Lip could evade payload leakage during blood circulation and accelerate the release of the OXP in the tumor region in the hypoxic microenvironment, which could significantly induce the ICD effect to activate an immune response for an enhanced therapeutic effect. The tumor inhibitory rate of HMSN-OXP-Lip was almost twice that of free OXP, and no apparent side effects were observed. This design provides a dual-sensitive and efficient strategy for tumor therapy by using lipid-composite nanoparticles that can undergo sensitive drug release and biodegradation.

Practice patterns, role and impact of advanced practice nurses in stroke care: A mixed-methods systematic review.

AIM(S): To undertake a systematic review of the practice patterns and roles of advanced practice nurses (APNs) in inpatient and outpatient stroke-care services; and to evaluate the impact of APN-led inpatient and outpatient stroke-care services on clinical and patient-reported outcomes. DESIGN: A mixed-methods systematic review. METHODS: A systematic search was conducted across six electronic databases for primary studies. Data were synthesised using a convergent integrated approach. DATA SOURCES (INCLUDE SEARCH DATES) *FOR REVIEWS ONLY: A systematic search was conducted across PubMed, CINAHL, Cochrane Library, Embase, PsycInfo and ProQuest Dissertations & Theses Global, for primary studies published between the inception of the databases and 3 November 2022. RESULTS: Findings based on the 18 included primary studies indicate that the APNs' roles have been implemented across the continuum of stroke care, including pre-intervention care, inpatient care and post-discharge care. Practicing at an advanced level, the APNs engaged in clinical, operational and educational undertakings across services and disciplines. Positive clinical and patient-reported outcomes have been attributed to their practice. CONCLUSION: The review highlights the critical role of APNs in improving stroke care, especially in the pre-intervention phase. Their clinical expertise, patient-centered approach and collaboration can transform stroke care. Integrating APNs into stroke care teams is essential for better management and outcomes in light of the increasing stroke burden. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE: Healthcare institutions should integrate APNs to enhance pre-intervention stroke care, improve diagnostic accuracy and expedite treatment. APNs can prioritise patient-centric care, including assessments, coordination and education. Medication reconciliation, timely rehabilitation referrals and lifestyle modifications for secondary stroke prevention are crucial. Implementing advanced practice nursing frameworks ensures successful APN integration, leading to improved stroke care and better patient outcomes in response to the growing stroke burden. IMPACT (ADDRESSING): What problem did the study address? Poor clarity of the role of advanced practice nurses among patients, physicians, healthcare professionals, health policymakers and nurses. What were the main findings? Advanced practice nurses practise across the continuum of stroke care, mainly in pre-intervention care which takes place before initiating treatment, inpatient care and post-discharge care. The implementation of the advanced practice nurse role in stroke care has contributed positively to clinical and patient-reported outcomes. Where and on whom will the research have an impact? Insights from the review are envisioned to inform healthcare policymakers and leaders in the implementation and evaluation of the APN role in stroke care. REPORTING METHOD: Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines. PATIENT OR PUBLIC CONTRIBUTION: No Patient or Public Contribution. TRIAL AND PROTOCOL REGISTRATION: https://figshare.com/ndownloader/files/41606781; Registered on Open Science Framework osf.io/dav8j.

Zinc lactate alleviates oxidative stress by modulating crosstalk between constitutive androstane receptor signaling pathway and gut microbiota profile in weaned piglets.

This study aimed to determine the regulatory mechanism of dietary zinc lactate (ZL) supplementation on intestinal oxidative stress damage in a paraquat (PQ)-induced piglet model. Twenty-eight piglets (mean body weight 9.51 ± 0.23 kg) weaned at 28 d of age were randomly divided into control, ZL, PQ, and ZL + PQ groups (n = 7 in each group). The ZL-supplemented diet had little effect on growth performance under normal physiological conditions. However, under PQ challenge, ZL supplementation significantly improved average daily gain (P < 0.05) and reduced the frequency of diarrhea. ZL improved intestinal morphology and ultrastructure by significantly increasing the expression level of the jejunal tight junction protein, zonula occludens-1 (ZO-1) (P < 0.05), and intestinal zinc transport and absorption in PQ-induced piglets, which reduced intestinal permeability. ZL supplementation also enhanced the expression of antioxidant and anti-inflammatory factor-related genes and decreased inflammatory cytokine expression and secretion in PQ-induced piglets. Furthermore, ZL treatment significantly inhibited the activation of constitutive androstane receptor (CAR) signaling (P < 0.01) in PQ-induced piglets and altered the structure of the gut microbiota, especially by significantly increasing the abundance of beneficial gut microbes, including UCG_002, Ruminococcus, Rikenellaceae_RC9_gut_group, Christensenellaceae_R_7_group, Treponema, unclassified_Christensenellaceae, and unclassified_Erysipelotrichaceae (P < 0.05). These data reveal that pre-administration of ZL to piglets can suppress intestinal oxidative stress by improving antioxidant and anti-inflammatory capacity and regulating the crosstalk between CAR signaling and gut microbiota.

Estimation of heart rate and respiratory rate by monitoring cardiopulmonary signals with flexible sensor.

Monitoring of cardiopulmonary signals plays an important role in many clinical applications. A portable magnetic induction cardiopulmonary signal monitoring system with the flexible sensor of double micro-coils is presented in this paper. The detection of cardiopulmonary signals is realized with double micro-coils. The proposed system is safe, non-invasive, simple, and portable compared with traditional direct contact methods. The Hilbert-Huang transform (HHT) based on complete ensemble empirical mode decomposition with adaptive noise (CEEMDAN) is applied to cardiopulmonary signal processing, decomposing cardiopulmonary signal effectively. The sensor to monitor respiration rate and heart rate is validated and demonstrated with healthy volunteers. The root mean squared errors (RMSE) of heart rate, respiration rate under deep breathing and normal breathing are 3.8 beats/min, 0.61 times/min, and 0.98 times/min respectively. The flexible sensor of double micro-coils has little influence on the measurement results at the bending curvature of 33.9 m-1. Therefore, a suggested solution for monitoring and decomposition of cardiopulmonary signals is easy-to-use, and quick, which can be applied as a respected analytical device on mobile occasions in this study.

Effect of Nano-Silica and Sorbitol on the Properties of Chitosan-Based Composite Films.

Chitosan and its derivatives are widely used in food packaging, pharmaceutical, biotechnology, medical, textile, paper, agriculture, and environmental industries. However, the flexibility of chitosan films is extremely poor, which limits its relevant applications to a large extent. In this paper, chitosan/sorbitol/nano-silica (CS/sorbitol/SiO2) composite films were prepared by the casting film method using chitosan, sorbitol, Tween-80 and nano-SiO2 as raw materials. The structure of the films was characterized by infrared spectroscopy, electron scanning microscopy, and X-ray diffraction analysis. The effects of sorbitol and nano-silica dosage on the mechanical properties, thermal properties and water vapor barrier properties of the composite film were investigated. The results show that with the gradual increase in sorbitol (≤75 wt %), the elongation at the break of chitosan/sorbitol films significantly increased. When the addition of sorbitol was 75 wt %, the elongation at break of the chitosan/sorbitol composite film was 13 times higher than that of the chitosan film. Moreover, nano-SiO2 can further improve the mechanical properties and thermal stability of the chitosan/sorbitol composite films. When the amount of nano-silica was 4.5 wt %, the composite film became more flexible, with a maximum elongation of 90.8% (which is 14 times that of chitosan film), and its toughness increased to 10.52 MJm-3 (which is 6 times that of chitosan film). This study balances the tensile strength and elongation at break of the composite films by adding a plasticizer and nano-filler, providing a reference for the preparation of chitosan composites or their blending with other polymers, and has practical guiding significance for the industrial production of biomass plastics.

A nomogram for predicting post-operative hydrocephalus in children with medulloblastoma.

Post-operative hydrocephalus is common among children with medulloblastoma after initial tumor resection. This study aimed to establish a novel model for predicting the development of post-operative hydrocephalus in children with medulloblastoma. Only pediatric patients who received initial medulloblastoma resection at Beijing Tiantan Hospital between January 2018 and May 2021 were included in this study. The potential risk factors associated with post-operative hydrocephalus were identified based on multivariate logistic regression and the nomogram. Receiver operating characteristic (ROC) curve were used to evaluate the performance of the nomogram model based on an independent cohort of medulloblastoma patients who underwent surgery from June 2021 to March 2022. A total of 105 patients were included in the primary cohort. Superior invasion (P = 0.007), caudal invasion (P = 0.025), and intraventricular blood ≥ 5 mm (P = 0.045) were significantly related to the development of post-operative hydrocephalus and thus were assembled into the nomogram model. The model accurately predicted post-operative hydrocephalus based on the calibration curve. The area under the ROC curves for the primary and validation cohorts was 0.849 and 0.855, respectively. In total, the nomogram we developed may aid clinicians in assessing the potential risk of pediatric patients with MB developing post-operative hydrocephalus, especially those who would otherwise not have received a diversionary procedure at presentation.

Healthcare professionals' experiences of interprofessional collaboration in patient education: A systematic review.

OBJECTIVES: This study explores interprofessional collaboration amongst healthcare professionals in patient education. METHODS: A systematic review was conducted. A search in seven databases was conducted from 2011 to 2022 and screened against the inclusion criteria. Quality appraisal was done independently by two reviewers. Studies were extracted and synthesised using the data-based convergent synthesis design. RESULTS: Twenty-one studies were included. Five themes on factors affecting interprofessional collaboration in patient education emerged: 1) role clarification, 2) communication infrastructure, 3) shared space for collaboration, 4) interprofessional trust, and 5) organisational support. CONCLUSION: Findings highlighted the importance of developing trustful relationships within the multidisciplinary team in delivering patient education. Channels for additional infrastructural support, guidelines and training in patient education delivery is required. Future research could explore patients' perspectives on how their learning needs in patient education may be optimised through a multidisciplinary approach. PRACTICE IMPLICATIONS: Healthcare leaders could promote shared goals within the team by facilitating a common space and time for interprofessional team rounding, and by developing shared patient education resources and documentation processes. Interprofessional education focusing on the delivery of team-based patient education could be implemented to foster understanding of the interdependent role of multidisciplinary healthcare professionals.

Anion Confinement for Homogeneous Mixed Halide Perovskite Film Growth by Electrospray.

Wide-bandgap perovskites are promising absorbers for state-of-the-art tandem solar cells to feasibly surpass Shockley-Queisser limit with low cost. However, the commonly used mixed halide perovskites suffer from poor stability; particularly, photoinduced phase segregation. Electrospray deposition is developed to bridge the gap of growth rate between iodide and bromide components during film growth by spatially confining the anion diffusion and eliminating the kinetic difference, which universally improves the initial homogeneity of perovskite films regardless of device architectures. It thus promotes the efficiency and stability of corresponding solar cells based on wide-bandgap (1.68 eV) absorbers. Remarkable power conversion efficiencies (PCEs) of 21.44% and 20.77% are achieved in 0.08 cm2 and 1.0 cm2 devices, respectively. In addition, these devices maintain 90% of their initial PCE after 1550 h of stabilized power output (SPO) tracking upon one sun irradiation (LED) at room temperature.

Factors associated with registered nurses' academic performance in advanced practice nursing preparatory education: A retrospective cohort study.

AIM: To explore factors associated with academic performance in the Master of Nursing programme. BACKGROUND: Advanced practice nursing preparatory education generally involves completion of the Master of Nursing programme. While prior clinical experiences and on-the-job training are believed to underpin the preparation for such education, studies have suggested only weak or no associations between nurses' academic success in graduate schools and their clinical experiences. METHODS: A retrospective cohort study was conducted in the nursing department of a university in Singapore. Academic and demographic data were extracted in February 2020 from a shared repository of anonymised teaching and learning data. R was used to select and merge data tables into a usable format for subsequent analysis. Students enrolled between 2010 and 2017 were included for the analysis (n = 246). RESULTS: Age was statistically significantly associated with overall cumulative academic performance (p < 0.001). Younger students on average academically outperformed older students. Unmarried students were associated with better cumulative academic performance in the Clinical Practicum 2 module (p = 0.018). CONCLUSION: Younger students have historically outperformed their older counterparts in the Master of Nursing programme. There is a need to reassess the requirement of five years of clinical experience as an admission criterion for the Master of Nursing programme in Singapore. IMPLICATIONS FOR NURSING POLICY: There is a need to re-evaluate the admission criteria to better engage and retain younger nurses interested in advanced nursing practice. Nursing educators and leaders can partner with academics to develop advanced practice-specific education for pre-master nurses with the aptitude and interest in pursuing this track.

pH- and temperature-responsive supramolecular assemblies with highly adjustable viscoelasticity: a multi-stimuli binary system.

Stimuli-responsive materials are increasingly needed for the development of smart electronic, mechanical, and biological devices and systems relying on switchable, tunable, and adaptable properties. Herein, we report a novel pH- and temperature-responsive binary supramolecular assembly involving a long-chain hydroxyamino amide (HAA) and an inorganic hydrotrope, boric acid, with highly tunable viscous and viscoelastic properties. The system under investigation demonstrates a high degree of control over its viscosity, with the capacity to achieve over four orders of magnitude of control through the concomitant manipulation of pH and temperature. In addition, the transformation from non-Maxwellian to Maxwellian fluid behavior could also be induced by changing the pH and temperature. Switchable rheological properties were ascribed to the morphological transformation between spherical vesicles, aggregated/fused spherical vesicles, and bicontinuous gyroid structures revealed by cryo-TEM studies. The observed transitions are attributed to the modulation of the head group spacing between HAA molecules under different pH conditions. Specifically, acidic conditions induce electrostatic repulsion between the protonated amino head groups, leading to an increased spacing. Conversely, under basic conditions, the HAA head group spacing is reduced due to the intercalation of tetrahydroxyborate, facilitated by hydrogen bonding.

Nursing education in the age of artificial intelligence powered Chatbots (AI-Chatbots): Are we ready yet?

This article discusses the challenges and implications of artificial intelligence powered chatbot (AI-Chatbots) in nursing education. Chat Generative Pre-trained Transformer (ChatGPT) is an AI-Chatbot that can engage in detailed dialog and pass qualification tests in various fields. It can be applied for drafting course materials and administrative paperwork. Students can use it for personalized self-paced learning. AI-Chatbot technology can be applied in problem-based learning for hands-on practice experiences. There are concerns about over-reliance on the technology, including issues with plagiarism and limiting critical thinking skills. Educators must provide clear guidelines on appropriate use and emphasize the importance of critical thinking and proper citation. Educators must proactively adjust their curricula and pedagogy. AI-Chatbot technology could transform the nursing profession by aiding and streamlining administrative tasks, allowing nurses to focus on patient care. The use of AI-Chatbots to socially assist patients and for therapeutic purposes in mental health shows promise in improving well-being of patients, and potentially easing shortage and burnout for healthcare workers. AI-Chatbots can help nursing students and researchers to overcome technical barriers in nursing informatics, increasing accessibility for individuals without technical background. AI-Chatbot technology has potential in easing tasks for nurses, improving patient care, and enhancing nursing education.

Artificial Intelligence Versus Human-Controlled Doctor in Virtual Reality Simulation for Sepsis Team Training: Randomized Controlled Study.

BACKGROUND: Interprofessional communication is needed to enhance the early recognition and management of patients with sepsis. Preparing medical and nursing students using virtual reality simulation has been shown to be an effective learning approach for sepsis team training. However, its scalability is constrained by unequal cohort sizes between medical and nursing students. An artificial intelligence (AI) medical team member can be implemented in a virtual reality simulation to engage nursing students in sepsis team training. OBJECTIVE: This study aimed to evaluate the effectiveness of an AI-powered doctor versus a human-controlled doctor in training nursing students for sepsis care and interprofessional communication. METHODS: A randomized controlled trial study was conducted with 64 nursing students who were randomly assigned to undertake sepsis team training with an AI-powered doctor (AI-powered group) or with medical students using virtual reality simulation (human-controlled group). Participants from both groups were tested on their sepsis and communication performance through simulation-based assessments (posttest). Participants' sepsis knowledge and self-efficacy in interprofessional communication were also evaluated before and after the study interventions. RESULTS: A total of 32 nursing students from each group completed the simulation-based assessment, sepsis and communication knowledge test, and self-efficacy questionnaire. Compared with the baseline scores, both the AI-powered and human-controlled groups demonstrated significant improvements in communication knowledge (P=.001) and self-efficacy in interprofessional communication (P<.001) in posttest scores. For sepsis care knowledge, a significant improvement in sepsis care knowledge from the baseline was observed in the AI-powered group (P<.001) but not in the human-controlled group (P=.16). Although no significant differences were found in sepsis care performance between the groups (AI-powered group: mean 13.63, SD 4.23, vs human-controlled group: mean 12.75, SD 3.85, P=.39), the AI-powered group (mean 9.06, SD 1.78) had statistically significantly higher sepsis posttest knowledge scores (P=.009) than the human-controlled group (mean 7.75, SD 2.08). No significant differences were found in interprofessional communication performance between the 2 groups (AI-powered group: mean 29.34, SD 8.37, vs human-controlled group: mean 27.06, SD 5.69, P=.21). However, the human-controlled group (mean 69.6, SD 14.4) reported a significantly higher level of self-efficacy in interprofessional communication (P=.008) than the AI-powered group (mean 60.1, SD 13.3). CONCLUSIONS: Our study suggested that AI-powered doctors are not inferior to human-controlled virtual reality simulations with respect to sepsis care and interprofessional communication performance, which supports the viability of implementing AI-powered doctors to achieve scalability in sepsis team training. Our findings also suggested that future innovations should focus on the sociability of AI-powered doctors to enhance users' interprofessional communication training. Perhaps in the nearer term, future studies should examine how to best blend AI-powered training with human-controlled virtual reality simulation to optimize clinical performance in sepsis care and interprofessional communication. TRIAL REGISTRATION: ClinicalTrials.gov NCT05953441; https://clinicaltrials.gov/study/NCT05953441.

Reducing carbon footprints and increasing net ecosystem economic benefits through dense planting with less nitrogen in double-cropping rice systems.

Excessive application of nitrogen fertilization in farmland systems can cause nitrogen wastage, environmental pollution, and increase greenhouse gas (GHG) emissions. Dense planting is one of the efficient strategies for nitrogen fertilizer reduction within rice production. However, there are paying weak attention to the integrative effect of dense planting with less nitrogen (DPLN) on carbon footprint (CF), net ecosystem economic benefit (NEEB) and its components in double-cropping rice systems. Herein, this work aims to elucidate the effect via field experiments in double-cropping rice cultivation region with the treatments set to conventional cultivation (CK), three treatments of DPLN (DR1, 14 % nitrogen reduction and 40,000 hills per ha density increase from CK; DR2, 28 % nitrogen reduction and 80,000 hills density increase; DR3, 42 % nitrogen reduction and 120,000 hills density increase), and one treatment of no nitrogen (N0). Results showed that DPLN significantly reduced average CH4 emissions by 7.56 %-36 %, while increasing annual rice yield by 2.16 %-12.37 % compared to CK. Furthermore, the paddy ecosystem under DPLN served as a carbon sink. Compared with CK, DR3 increased gross primary productivity (GPP) by 16.04 % while decreasing direct GHG emissions by 13.1 %. The highest NEEB was observed in DR3, which was 25.38 % greater than CK and 1.04-fold higher than N0. Therefore, direct GHG emissions and carbon fixation of GPP were key contributors to CF in double-cropping rice systems. Our results verified that optimizing DPLN strategies can effectively increase economic benefits and reduce net GHG emissions. DR3 achieved an optimal synergy between reducing CF and enhancing NEEB in double-cropping rice systems.

Increasing Planting Density and Reducing N Application Improves Yield and Grain Filling at Two Sowing Dates in Double-Cropping Rice Systems.

Grain filling plays an important role in achieving high grain yield. Manipulating planting densities is recognized as a viable approach to compensate for the reduced yield caused by nitrogen reduction. Understanding the effects of nitrogen fertilization and planting density on superior and inferior grain filling is crucial to ensure grain security. Hence, double-cropping paddy field trials were conducted to investigate the effect of three nitrogen levels (N1, conventional nitrogen application; N2, 10% nitrogen reduction; N3, 20% nitrogen reduction) and three planting densities (D1, conventional planting density; D2, 20% density increase; D3, 40% density increase) on grain yield, yield formation, and grain-filling characteristics at two sowing dates (S1, a conventional sowing date, and S2, a date postponed by ten days) in 2019-2020. The results revealed that the annual yield of S1 was 8.5-14% higher than that of S2. Reducing nitrogen from N2 to N3 decreased the annual yield by 2.8-7.6%, but increasing planting densities from D1 to D3 significantly improved yield, by 6.2-19.4%. Furthermore, N2D3 had the highest yield, which was 8.7-23.8% higher than the plants that had received the other treatments. The rice yield increase was attributed to higher numbers of panicles per m2 and spikelets per panicle on the primary branches, influenced by superior grain filling. Increasing planting density and reducing nitrogen application significantly affected grain-filling weight, with the 40% density increase significantly facilitating superior and inferior grain filling with the same nitrogen level. Increasing density can improve superior grains while reducing nitrogen will decrease superior grains. These results suggest that N2D3 is an optimal strategy to increase yield and grain filling for double-cropping rice grown under two sowing-date conditions.

Enhanced brain delivery of hypoxia-sensitive liposomes by hydroxyurea for rescue therapy of hyperacute ischemic stroke.

Ischemic stroke is characterized by high morbidity, disability, and mortality. Unfortunately, the only FDA-approved pharmacological thrombolytic, alteplase, has a narrow therapeutic window of only 4.5 h. Other drugs like neuroprotective agents have not been clinically used because of their low efficacy. To improve the efficacy of neuroprotective agents and the effectiveness of rescue therapies for hyperacute ischemic stroke, we investigated and verified the variation trends of the blood-brain barrier (BBB) permeability and regional cerebral blood flow over 24 h in rats that had ischemic strokes. Hypoperfusion and the biphasic increase of BBB permeability are still the main limiting factors for lesion-specific drug distribution and drug brain penetration. Herein, the nitric oxide donor hydroxyurea (HYD) was reported to downregulate the expression of tight junction proteins and upregulate intracellular nitric oxide content in the brain microvascular endothelial cells subjected to oxygen-glucose deprivation, which was shown to facilitate the transport of liposomes across  brain endothelial monolayer in an in vitro model. HYD also increased the BBB permeability and promoted microcirculation in the hyperacute phase of stroke. The neutrophil-like cell-membrane-fusogenic hypoxia-sensitive liposomes exhibited excellent performance in targeting the inflamed brain microvascular endothelial cells, enhancing cell association, and promoting rapid hypoxic-responsive release in the hypoxic microenvironment. Overall, the combined HYD and hypoxia-sensitive liposome dosing regimen effectively decreased the cerebral infarction volume and relieved neurological dysfunction in rats that had ischemic strokes; these therapies were involved in the anti-oxidative stress effect and the neurotrophic effect mediated by macrophage migration inhibitory factor.