Clinical efficacy of unilateral laminotomy for bilateral decompression in the treatment of adjacent segment disease after lumbar fusion.

Objective: To assess the clinical impact of unilateral laminotomy for bilateral decompression (ULBD) in managing patients with adjacent vertebrae following lumbar fusion. Methods: A retrospective analysis was conducted on 21 patients, with a mean age of 67.4 years, who underwent ULBD for adjacent vertebra disease at our department from January 2021 to November 2023. We reviewed demographic data, surgical techniques, imaging studies, and patient-reported outcomes. The study compared Visual Analog Scale (VAS) scores, Numeric Rating Scale (NRS) scores, Japanese Orthopaedic Association (JOA) scores, Short Form-36 (SF-36) scores, and imaging outcomes before surgery, immediately post-surgery, and at 1 month, 6 months, and 12 months post-surgery. Results: Evaluation of 21 patients with adjacent segment disease (ASD) (13 males, 8 females; mean age 67.42 years) was performed with follow-ups at various intervals post-surgery. Postoperative VAS, NRS, JOA, and SF-36 scores showed significant improvements compared to preoperative scores. Immediately after surgery, there were significant improvements in NRS score (2.76 ± 0.70 vs. 3.71 ± 0.85, P < 0.05) and JOA score (15.38 ± 1.02 vs. 9.29 ± 1.01, P < 0.05) compared to preoperative scores. Similarly, at 12 months post-surgery, significant improvements were observed in NRS score (1.52 ± 0.51 vs. 3.71 ± 0.85, P < 0.05) and JOA score (25.0 ± 1.10 vs. 9.29 ± 1.01, P < 0.05) compared to preoperative scores. The clinical satisfaction rate was 95.0% among all patients, with postoperative imaging examinations revealing a significant decompression effect. No complications were reported among the surgical patients. Conclusions: This study suggests that endoscopic ULBD can be a safe and effective technique for managing symptomatic ASD, providing satisfactory clinical outcomes for patients with ASD. Endoscopic ULBD may serve as an alternative treatment option for ASD with lumbar stenosis.

Self-contact snapping metamaterial for tensile energy dissipation.

Mechanical metamaterials for energy dissipation have received significant attention for vibration and impact mitigation. However, existing designs often neglect energy dissipation in the tensile direction, which is crucial for attenuating tensile load and controlling falling descent. Importantly, current energy-dissipating mechanisms including plastic deformation and friction mechanisms, suffer from drawbacks such as reversibility and self-recovery, restricting their effectiveness under tension. To address these limitations, we propose a novel mechanism utilizing self-contact snap-through buckling to develop an energy-dissipating metamaterial. Unlike previous metamaterials, the self-contact snapping metamaterial (SCSM) achieves tensile energy dissipation with fewer unit cells while exhibiting reusability, self-recovery, and low reliance on material selection. A theoretical model is established to explain its energy-dissipating mechanism from the perspective of buckling mode transition. Moreover, the proposed SCSM exhibits sequential snapping behavior and effectively mitigates tensile impacts, as demonstrated through quasi-static and dynamic tests. This work opens new avenues for achieving tensile energy dissipation and inspires future research on energy conversion employing self-contact interactions.

Phase-Matching Second-Harmonic Generation and Enhanced Laser-Induced Damage Threshold Induced by Cs Substitution: Cu3PSe4 vs Cs2CuP3S9.

Chalcophosphates are an important type of infrared nonlinear optical (NLO) candidates in view of their rich anionic motifs. Here, two copper chalcophosphates Cu3PSe4 (CPSe) and Cs2CuP3S9 (CCPS) were synthesized and studied as IR NLO materials. They both feature three-dimensional polyanionic frameworks constructed by similar T2-supertetrahedra, and the structure of CCPS can be derived from CPSe via introducing Cs and substituting Se with S. This structural evolution results in phase-matchable NLO behavior, enlarged optical band gap, and enhanced laser-induced damage threshold for CCPS. These results are elucidated by structure analysis and theoretical calculations, and the increased structural anisotropy contributes to the phase matchable behavior of CCPS. This work presents a case on how to adjust NLO properties via certain structure considerations, which may be extended to more systems for obtaining high-performance NLO materials.

Sn4+ Alloying and Chiral Incorporation into Tellurium Halides Triggering Tunable Luminescence Emission and Second-Harmonic Generation.

Recently, chiral organic-inorganic hybrid metal halides have attracted considerable interest as promising multifunctional materials, benefiting from their diverse structures and tunable photophysical properties. Herein, by introducing the chiral ligand methylbenzylamine (R-/S-MBA) and alloying Sn4+ cation, a series of tellurium-based halides R-/S-MBA2SnxTe1-xCl6 (x = 0, 0.125, 0.2, 0.365 and 0.54) with second-harmonic generation (SHG) effect and photoluminescence (PL) properties are successfully synthesized. Their optical bandgaps are determined to be 2.48-2.6 eV. Specifically, the introduction of chiral organic cations could break the structural symmetry and cause the tellurium halide to crystallize in the chiral space group. The incorporation of isovalent Sn4+ into the chiral host tellurium halides results in the increase in octahedral distortion, thereby promoting host intrinsic self-trapped emission that originates from the interconfigurational 3P0,1 → 1S0 transitions of Te4+. Consequently, the as-prepared Sn4+ doped halides, R-/S-MBA2SnxTe1-xCl6 (x = 0.365, 0.54), exhibit not only SHG response but also bright orange fluorescence. This study provides an effective strategy for designing chiral multifunctional materials.

Auxiliary diagnostic method of Parkinson's disease based on eye movement analysis in a virtual reality environment.

Eye movement dysfunction is one of the non-motor symptoms of Parkinson's disease (PD). An accurate analysis method for eye movement is an effective way to gain a deeper understanding of the nervous system function of PD patients. However, currently, there are only a few assistive methods available to help physicians conveniently and consistently assess patients suspected of having PD. To solve this problem, we proposed a novel visual behavioral analysis method using eye tracking to evaluate eye movement dysfunction in PD patients automatically. This method first provided a physician task simulation to induce PD-related eye movements in Virtual Reality (VR). Subsequently, we extracted eye movement features from recorded eye videos and applied a machine learning algorithm to establish a PD diagnostic model. Then, we collected eye movement data from 66 participants (including 22 healthy controls and 44 PD patients) in a VR environment for training and testing during visual tasks. Finally, on this relatively small dataset, the results reveal that the Support Vector Machine (SVM) algorithm has better classification potential.

Advances in Novel Biomaterial-Based Strategies for Spinal Cord Injury Treatment.

Spinal cord injury (SCI) is a highly disabling neurological disorder. Its pathological process comprises an initial acute injury phase (primary injury) and a secondary injury phase (subsequent chronic injury). Although surgical, drug, and cell therapies have made some progress in treating SCI, there is no exact therapeutic strategy for treating SCI and promoting nerve regeneration due to the complexity of the pathological SCI process. The development of novel drug delivery systems to treat SCI is expected to significantly impact the individualized treatment of SCI due to its unique and excellent properties, such as active targeting and controlled release. In this review, we first describe the pathological progression of the SCI response, including primary and secondary injuries. Next, we provide a concise overview of newly developed nanoplatforms and their potential application in regulating and treating different pathological processes of SCI. Then, we introduce the existing potential problems and future clinical application perspectives of biomedical engineering-based therapies for SCI.

Constructing Multiscale Fibrous Morphology to Achieve 20% Efficiency Organic Solar Cells by Mixing High and Low Molecular Weight D18.

This study underscores the significance of precisely manipulating the morphology of the active layer in organic solar cells (OSCs). By blending polymer donors of D18 with varying molecular weights, a multiscale interpenetrating fiber network structure within the active layer is successfully created. The introduction of 10% low molecular weight D18 (LW-D18) into high molecular weight D18 (HW-D18) produces MIX-D18, which exhibits an extended exciton diffusion distance and orderly molecular stacking. Devices utilizing MIX-D18 demonstrate superior electron and hole transport, improves exciton dissociation, enhances charge collection efficiency, and reduces trap-assisted recombination compared to the other two materials. Through the use of the nonfullerene acceptor L8-BO, a remarkable power conversion efficiency (PCE) of 20.0% is achieved. This methodology, which integrates the favorable attributes of high and low molecular weight polymers, opens a new avenue for enhancing the performance of OSCs.

Degradation and preservation of nitrites in whole blood.

Understanding the factors that influence nitrite degradation in whole blood and developing methods for its stable preservation are crucial for ensuring accurate and reliable forensic identification in cases of nitrite poisoning. This study systematically monitored nitrite degradation and changes in hemoglobin proportions across different initial nitrite concentrations and blood samples. It was revealed that high nitrite concentrations rapidly reduced deoxyhemoglobin levels within the first 15 minutes and subsequently reacted with oxyhemoglobin at a slower rate. Therefore, the proportions of these two hemoglobin forms are key factors in determining nitrite degradation rates. Regarding preservation, the study examined the effects of low temperatures (4°C and -20°C) and various preservatives (potassium ferricyanide, N-ethylmaleimide) on nitrite stability. The results indicate that adding 6.6 g/L potassium ferricyanide can rapidly eliminate all deoxyhemoglobin and reduce oxyhemoglobin proportions to below 60 %, enabling stable preservation of high nitrite concentrations in whole blood for over 30 days at -20°C. The efficacy of potassium ferricyanide was further validated in forensic-acquired postmortem heart blood samples.

Study on the Impact of Pole Spacing on Magnetic Flux Leakage Detection under Oversaturated Magnetization.

Magnetic flux leakage (MFL) inspection employs leakage magnetic fields to effectively detect and locate pipeline defects. The spacing between magnetic poles significantly affects the leakage magnetic field strength. While most detectors typically opt for moderate pole spacing for routine detection, this study investigates the propagation characteristics of MFL signals at small pole spacings (under specimen oversaturated magnetization) and their impact on MFL detection. Through finite element simulation and experiments, it reveals a new signal phenomenon in the radial MFL signal By at small pole spacings, the double peak-valley (DPV) phenomenon, characterized by outer and inner peaks and valleys. Theoretical analysis based on the simulation results elucidates the mechanisms for this DPV phenomenon. Based on this, the impact of defect size, pipe wall thickness, and magnetic pole and rigid brush height on MFL signals under small magnetic pole spacings is examined. It is demonstrated that, under a smaller magnetic pole spacing, a potent background magnetic field manifests in the air above the defect. This DPV phenomenon is generated by the magnetic diffusion and compression interactions between the background and defect leakage magnetic fields. Notably, the intensity of the background magnetic field can be mitigated by reducing the height of the rigid brush. In contrast, the pipe wall thickness and magnetic pole height exhibit a negligible influence on the DPV phenomenon. The emergence of the DPV precipitates a reduction in the peak-to-valley difference within the MFL signal, constricting the depth range of detectable defects. However, the presence of DPV increases the identification of defects with smaller opening sizes. These findings reveal the characterization of the MFL signal under small pole spacing, offering a preliminary study on identifying specific defects using unconventional signals. This study provides valuable guidance for MFL detection.

Near Ultraviolet-Excitable Cyan-Emissive Hybrid Copper(I) Halides Nonlinear Optical Crystals with Near-Unity Photoluminescence Quantum Yield and High-Efficiency X-ray Scintillation.

Designing and synthesizing multifunctional hybrid copper halides with near ultraviolet (NUV) light-excited high-energy emission (<500 nm) remains challenging. Here, a pair of broadband-excited high-energy emitting isomers, namely, α-/ß-(MePh3P)2CuI3 (MePh3P=methyltriphenylphosphonium), were synthesized. α-(MePh3P)2CuI3 with blue emission peaking at 475 nm is firstly discovered wherein its structure contains regular [CuI3]2- triangles and crystallizes in centrosymmetric space group P21/c. While ß-(MePh3P)2CuI3 featuring distorted [CuI3]2- planar triangles shows inversion symmetry breaking and crystallizes in the noncentrosymmetric space group P21, which exhibits cyan emission peaking at 495 nm with prominent near-unity photoluminescence quantum yield and the excitation band ranging from 200 to 450 nm. Intriguingly, ß-(MePh3P)2CuI3 exhibits phase-matchable second-harmonic generation response of 0.54×KDP and a suitable birefringence of 0.06@1064 nm. Furthermore, ß-(MePh3P)2CuI3 also can be excited by X-ray radioluminescence with a high scintillation light yield of 16193 photon/MeV and an ultra-low detection limit of 47.97 nGy/s, which is only 0.87 % of the standard medical diagnosis (5.5 µGy/s). This work not only promotes the development of solid-state lighting, laser frequency conversion and X-ray imaging, but also provides a reference for constructing multifunctional hybrid metal halides.

Boosting Organic Solar Cells to Over 18% Efficiency through Dipole-Dipole Interactions in Fluorinated Nonfused Ring Electron Acceptors.

This study successfully designed and synthesized two nonfused ring electron acceptors, 412-6F and 412-6Cl, modified with fluorine and chlorine substituents, respectively. Single-crystal analysis revealed that 412-6F possesses a planar molecular backbone and exhibits pronounced dipole-dipole interactions between the fluorine atoms on the lateral phenyl groups and the carbonyl oxygen atoms on the end groups. This specific interaction promotes dense end-group stacking, leading to a reduced interlayer spacing. Improved crystallinity and coherence length are observed in the D18:412-6F blend film. Conversely, 412-6Cl adopts a more distorted configuration and lacks these interactions. As a result, the organic solar cell (OSC) based on D18:412-6F achieved a remarkable power conversion efficiency of 18.03%, surpassing the performance of the D18:412-6Cl OSC. This underscores the importance of designing novel acceptors with beneficial intermolecular interactions to enhance OSC efficiency, thus providing a new direction for organic photovoltaic advancement.

Substrate Characterization for Hydrolysis of Multiple Types of Aromatic Esters by Promiscuous Aminopeptidases.

Synthetic aromatic esters, widely employed in agriculture, food, and chemical industries, have become emerging environmental pollutants due to their strong hydrophobicity and poor bioavailability. This study attempted to address this issue by extracellularly expressing the promiscuous aminopeptidase (Aps) from Pseudomonas aeruginosa GF31 in B. subtilis, achieving an impressive enzyme activity of 13.7 U/mg. Notably, we have demonstrated, for the first time, the Aps-mediated degradation of diverse aromatic esters, including but not limited to pyrethroids, phthalates, and parabens. A biochemical characterization of Aps reveals its esterase properties and a broader spectrum of substrate profiles. The degradation rates of p-nitrobenzene esters (p-NB) with different side chain structures vary under the action of Aps, showing a preference for substrates with relatively longer alkyl side chains. The structure-dependent degradability aligns well with the binding energies between Aps and p-NB. Molecular docking and enzyme-substrate interaction elucidate that hydrogen bonding, hydrophobic interactions, and π-π stacking collectively stabilize the enzyme-substrate conformation, promoting substrate hydrolysis. These findings provide new insights into the enzymatic degradation of aromatic ester pollutants, laying a foundation for the further development and modification of promiscuous enzymes.

Rapid and sensitive detection of etomidate based on functionalized copper nanoclusters fluorescent probe.

Etomidate as a non-barbiturate sedative, has central inhibitory effect and addiction and has been listed as a controlled drug in some countries due to the abusing trend nowadays. Therefore, rapid and sensitive detection of etomidate is of great significance. In this work, a novel fluorescent sensing probe (CuNCs@MIPs) based on copper nanoclusters (CuNCs) and molecular imprinted polymers (MIPs) has been firstly reported. CuNCs was environment-friendly synthesized using poly(vinylpyrrolidone) as a template and ascorbic acid as a reducing agent. After functionalized with molecular imprinting technique, the CuNCs@MIPs probe has special binding cavities on surface to target etomidate, causing the fluorescence intensity rapidly decrease, which confirmed it has excellent sensitivity, selectivity and stability. Under optimal conditions, the fluorescent sensing probe presented high precision linear relationship for etomidate in range of 10-500 ng/ml with detection limit of 10 ng/ml, and the whole detection process was completed within 10 min. This sensing method has also been applied to real samples detection, still demonstrated excellent feasibility in electronic cigarette liquids and urine. More importantly, compared with previous methods, this fluorescent sensing method has advantages such as rapid, simple and easy to operate. Collectively, the proposed CuNCs@MIPs sensing probe has good fluorescence characteristics and simple synthesis strategy, showed a great potential in etomidate detection and application.

From Pb6(HPO3)(H2PO3)Cl9 to Pb6(HPO3)2Br8(H2O)·H2O: Halogen Regulation to Achieve Inorganic Metal Phosphite Halide Nonlinear Optical Material with Unprecedented Pb-Centered Polyhedral Units.

Nonlinear optical (NLO) crystals are widely used in various fields. The introduction of lone-pair cations is regarded as an effective strategy to explore NLO crystals. In this work, two novel lead phosphite halides, centrosymmetric Pb6(HPO3)(H2PO3)Cl9 and noncentrosymmetric Pb6(HPO3)2Br8(H2O)·H2O, were obtained via a hydrothermal method. Pb6(HPO3)(H2PO3)Cl9 is the first reported lone-pair metal phosphite with two kinds of phosphite groups (HPO32- and H2PO3-) and Pb6(HPO3)2Br8(H2O)·H2O is the first inorganic NLO phosphite halide with a phase-matchable SHG effect of 1.02 × KDP. In addition, the Pb-centered polyhedral units of PbOCl4, PbOCl6, PbO2Cl5, PbO2Br5, PbOBr6, and PbO3(H2O)Br3 in these two structures have never been reported before. An in-depth study on the structure-property relationship of the two compounds with halogen substitution is also performed.

Effectiveness of post-COVID-19 primary care attendance in improving survival in very old patients with multimorbidity: a territory-wide target trial emulation.

OBJECTIVES: Older individuals with multimorbidity are at an elevated risk of infection and complications from COVID-19. Effectiveness of post-COVID-19 interventions or care models in reducing subsequent adverse outcomes in these individuals have rarely been examined. This study aims to examine the effectiveness of attending general outpatient within 30 days after discharge from COVID-19 on 1-year survival among older adults aged 85 years or above with multimorbidity. DESIGN: Retrospective cohort study emulating a randomised target trial using electronic health records. SETTING: We used data from the Hospital Authority and the Department of Health in Hong Kong, which provided comprehensive electronic health records, COVID-19 confirmed case data, population-based vaccination records and other individual characteristics for the study. PARTICIPANTS: Adults aged 85 years or above with multimorbidity who were discharged after hospitalisation for COVID-19 between January 2020 and August 2022. INTERVENTIONS: Attending a general outpatient within 30 days of last COVID-19 discharge defined the exposure, compared to no outpatient visit. MAIN OUTCOME MEASURES: Primary outcome was all-cause mortality within one year. Secondary outcomes included mortality from respiratory, cardiovascular and cancer causes. RESULTS: A total of 6183 eligible COVID-19 survivors were included in the analysis. The all-cause mortality rate following COVID-19 hospitalisation was lower in the general outpatient visit group (17.1 deaths per 100 person-year) compared with non-visit group (42.8 deaths per 100 person-year). After adjustment, primary care consultations within 30 days after discharge were associated with a significantly greater 1-year survival (difference in 1-year survival: 11.2%, 95% CI 8.1% to 14.4%). We also observed significantly better survival from respiratory diseases in the general outpatient visit group (difference in 1-year survival: 6.3%, 95% CI 3.5% to 8.9%). In a sensitivity analysis for different grace period lengths, we found that the earlier participants had a general outpatient visit after COVID-19 discharge, the better the survival. CONCLUSIONS: Timely primary care consultations after COVID-19 hospitalisation may improve survival following COVID-19 hospitalisation among older adults aged 85 or above with multimorbidity. Expanding primary care services and implementing follow-up mechanisms are crucial to support this vulnerable population's recovery and well-being.

[Chemical composition and pharmacological effects of Cinnamomum camphora chvar. borneol essential oil: a review].

Cinnamomum camphora chvar. borneol, a rare camphor tree variant recently identified in China, is distinguished by its high concentration of D-borneol, also known as " plant gold" due to its significant value. The essential oil extracted from this variant,rich in monoterpenes and sesquiterpenes, demonstrates a broad spectrum of pharmacological activities, including analgesic, antiinflammatory, antioxidant, cognition-enhancing, anti-bacterial, and insecticidal effects. These properties, underscored by extensive research, highlight the oil's potential in the biomedical, chemical, and food sectors as a valuable commodity. Nonetheless, the safety profile of this valuable oil remains poorly characterized, with its chemical composition and therapeutic efficacy subject to variations in the factors like geographic origin, harvesting timing, part used for extraction, and processing techniques. Such variability poses challenges to its clinical application and hampers the efficient exploitation of this resource. This review synthesizes current studies on C. camphora chvar. borneol essential oil and provides a detailed examination of its chemical and pharmacological profiles. In this study, we discuss existing research gaps and propose strategies for advancing its clinical use and industrial application, aiming to provide a foundational reference for future investigations and the resolution of its commercial and therapeutic challenges.

(C5H12N2S)Hg(NO3)2: A Mercury Nitrate Nonlinear Optical Crystal Motivated by Heteroatom Coordination Strategy.

Effective design and synthesis of second-order nonlinear optical (NLO) materials hold immense significance in driving modern science and technology advancements. In this study, we synthesized a new acentric mercury nitrate, (C5H12N2S)Hg(NO3)2, by regulating the coordination of the Hg atom through the introduction of a heteroatom. It exhibits an unprecedented [(C5H12N2S)2Hg2(NO3)4]∞ chain composed of Hg2+, NO3-, and organic molecule C5H12N2S. Notably, (C5H12N2S)Hg(NO3)2 demonstrates an unprecedented HgO3S unit and a second harmonic generation (SHG) intensity of 1.3 × KDP at 1064 nm, presenting the second-order nonlinear mercury nitrate constructed by organic molecule. Theoretical calculations suggest that the HgO3S unit and organic molecule C5H12N2S significantly contribute to the SHG effect. This study demonstrates that the incorporation of heteroatoms is an effective strategy for the development of new NLO materials.

Electrolyte-gated amorphous IGZO transistors with extended gates for prostate-specific antigen detection.

The prostate-specific antigen (PSA) test is considered an important way for preoperative diagnosis and accurate screening of prostate cancer. Current antigen detection methods, including radioimmunoassay, enzyme-linked immunosorbent assay and microfluidic electrochemical detection, feature expensive equipment, long testing time and poor stability. Here, we propose a portable biosensor composed of electrolyte-gated amorphous indium gallium zinc oxide (a-IGZO) transistors with an extended gate, which can achieve real-time, instant PSA detection at a low operating voltage (<2 V) owing to the liquid-free ionic conductive elastomer (ICE) serving as the gate dielectric. The electric double layer (EDL) capacitance in ICE enhances the accumulation of carriers in the IGZO channel, leading to strong gate modulation, which enables the IGZO transistor to have a small subthreshold swing (<0.5 V dec-1) and a high on-state current (∼4 × 10-4 A). The separate, biodegradable, and pluggable sensing pad, serving as an extended gate connected to the IGZO transistor, prevents contamination and depletion arising from direct contact with biomolecular buffers, enabling the IGZO transistor to maintain superior electronic performance for at least six months. The threshold voltage and channel current of the transistor exhibit excellent linear response to PSA molecule concentrations across five orders of magnitude ranging from 1 fg mL-1 to 10 pg mL-1, with a detection limit of 400 ag mL-1 and a detection time of ∼5.1 s. The fabricated biosensors offer a point-of-care system for antigen detection, attesting the feasibility of the electrolyte-gated transistors in clinical screening, healthcare diagnostics and biological management.

Promoting Li2S Nucleation/Dissolution Kinetics via Multiple Active Sites over TiVCrMoC3Tx Interface.

Lithium-sulfur batteries (LSBs) are still limited by some issues such as polysulfides shuttle and lithium dendrites. Recently, the concept "high-entropy" has been considered as the research hotspot and international frontier. Herein, a high entropy MXene (TiVCrMoC3Tx, HE-MXene) doped graphene is designed as the modified coating on commercial separators for LSBs. The HE-MXene affords multiple metal active sites, fast Li+ diffusion rate, and efficient adsorption toward polysulfide intermediates. Furthermore, strong lithophilic property is favorable for uniform Li+ deposition. The combination of in situ characterizations confirms TiVCrMoC3Tx effectively promotes the Li2S nucleation/dissolution kinetics, reduces the Li+ diffusion barrier, and exhibits favorable lithium uniform deposition behavior. This TiVCrMoC3Tx/G@PP provides a high-capacity retention rate after 1000 cycles at 1 C and 2 C, with a capacity decay rate of merely 0.021% and 0.022% per cycle. Surprisingly, the cell operates at a low potential of 48 mV while maintaining at 5 mA cm-2/5 mAh cm-2 for 4000 h. Furthermore, it still maintains a high-capacity retention rate under a high sulfur loading of 4.8/6.4 mg cm-2 and a low E/S ratio of 8.6/7.5 µg mL-1. This work reveals a technical roadmap for simultaneously addressing the cathode and anode challenge, thus achieving potential commercially viable LSBs.

Effectiveness of post-COVID-19 primary care attendance in improving survival in very old patients with multimorbidity: a territory-wide target trial emulation.

BACKGROUND: Older adults with multimorbidity are at high risk of mortality following COVID-19 hospitalisation. However, the potential benefit of timely primary care follow-up on severe outcomes post-COVID-19 has not been well established. AIM: To examine the effectiveness of attending general outpatient within 30 days after discharge from COVID-19 on 1-year survival among older adults aged ≥85 years, with multimorbidity. METHOD: We emulated a target trial using a comprehensive public healthcare database in Hong Kong. The cloning-censoring-weighting technique was used to minimise immortal time bias and confounding bias by adjusting for demographics, hospitalisation duration and ICU admission, baseline chronic conditions, and medication history. The outcome included all-cause and cause-specific mortality. RESULTS: Of 6183 eligible COVID-19 survivors, the all-cause mortality rate following COVID-19 hospitalisation was lower in general out-patient clinics (GOPC) group compared to non-GOPC group (17.1 versus 42.8 deaths per 100 person-year). After adjustment, primary care consultations within 30 days after discharge were associated with a significantly greater 1-year survival (difference in 1-year survival: 11.2%, 95% CI = 8.1% to 14.4%). We also observed better survival from respiratory diseases in the GOPC group. In a sensitivity analysis for different grace period lengths, we found that the earlier participants had a GOPC visit after COVID-19 discharge, the better the survival. CONCLUSION: Timely primary care consultations after discharge may improve survival following COVID-19 hospitalisation among older adults aged ≥85 years, with multimorbidity. Expanding primary care services and implementing follow-up mechanisms are crucial to support this vulnerable population's recovery and well-being.