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The conventional agar extraction method has drawbacks such as high energy consumption, low yield, poor quality, and possible residual harmful factors, which greatly limit its application in high-end fields such as biomedicine and high-end materials. This work explored a new freezing-thawing-high-temperature coupling technique for agar extraction. It increased the yield and the strength of agar by 10.6â¯% and 13.7â¯%, respectively, as compared to direct high-temperature extraction of agar (HA). The greater molecular weight and lower sulfate content of agar obtained from freeze-thaw cycles combined with high temperature extraction (FA) may be attributed to the desulfurization effect caused by freeze-thaw cycles and the preservation of the molecular chain structure. The reduction in sulfate content decreases the steric hindrance resistance of the polysaccharide chains, enhances their interactions, and promotes the regularity and density of the agar structure, while also improving its water retention and thermal stability. In conclusion, this research can offer a theoretical basis and guidance for the eco-friendly extraction of agar with improved agar characteristics and expended its applications.
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Inspired by the Mimosa plant, this study herein develops a unique dynamic shape memory polymer (SMP) network capable of transitioning from hard to pliable with heat, featuring reversible actuation, self-healing, recyclability, and degradability. This material is adept at simulating the functionalities of artificial muscles for a variety of tasks, with a remarkable specific energy density of 1.8 J g-1-≈46 times higher than that of human skeletal muscle. As an intelligent manipulator, it demonstrates remarkable proficiency in identifying and handling items at high temperatures. Its suitable rate of shape recovery around human body temperature indicates its promising utility as an implant material for addressing acute obstructions. The dynamic covalent bonding within the network structure not only provides excellent resistance to solvents but also bestows remarkable abilities for self-healing, reprocessing, and degradation. These attributes significantly boost its practicality and environmental sustainability. Anticipated to promote advancements in the sectors of biomedical devices, soft robotics, and smart actuators, this SMP network represents a forward leap in simulating artificial muscles, marking a stride toward the future of adaptive and sustainable technology.
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Accurately assigning standardized diagnosis and procedure codes from clinical text is crucial for healthcare applications. However, this remains challenging due to the complexity of medical language. This paper proposes a novel model that incorporates extreme multi-label classification tasks to enhance International Classification of Diseases (ICD) coding. The model utilizes deformable convolutional neural networks to fuse representations from hidden layer outputs of pre-trained language models and external medical knowledge embeddings fused using a multimodal approach to provide rich semantic encodings for each code. A probabilistic label tree is constructed based on the hierarchical structure existing in ICD labels to incorporate ontological relationships between ICD codes and enable structured output prediction. Experiments on medical code prediction on the MIMIC-III database demonstrate competitive performance, highlighting the benefits of this technique for robust clinical code assignment.
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International Classification of Diseases , Neural Networks, Computer , Semantics , Humans , Natural Language Processing , Algorithms , Databases, FactualABSTRACT
Background: Refractory overactive bladder (OAB) in women is a common yet challenging condition for which traditional treatments have been unsatisfactory. This study aimed to evaluate the efficacy and safety of transurethral bladder mucosal GreenLight laser-selective vaporization for treating refractory OAB in women. Methods: The female patients with refractory OAB who were admitted to the Department of Urology, Shandong Provincial Hospital Affiliated to Shandong First Medical University between May 2022 and July 2023 were examined retrospectively in this study. Transurethral bladder mucosal GreenLight laser-selective vaporization was used to treat the patients, and the perioperative and postoperative parameters were reviewed and compared. Bladder mucosa was examined by immunohistochemical staining to explore the expressions of TRPV1, P2X3, tumor necrosis factor alpha (TNF-α), and interleukin 6 (IL-6) before and after treatments. Results: Surgeries were performed successfully for all 32 patients in 57.38±11.22 minutes with minimal intraoperative bleeding. Twelve weeks post-surgery, there was a significant decrease (P<0.05) in the patients' Overactive Bladder Symptom Score (OABSS), 3-day bladder diary (daytime frequency, nocturia, urgency, and urgency incontinence), and Overactive Bladder questionnaire Short Form (OAB-qSF) score. After treatments, both first desire to void (FDV) and maximum bladder pressure capacity (MCBC) increased significantly (P<0.05). The immunohistochemical analysis revealed that the GreenLight laser significantly reduced the expressions of TRPV1, P2X3, TNF-α, and IL-6 in the bladder mucosa (P<0.05). No severe complications were observed after interventions. Conclusions: For female patients with refractory OAB who have shown poor response to conventional treatment approaches, transurethral bladder mucosal GreenLight laser-selective vaporization may represent a promising alternative treatment option.
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PURPOSE: Thyroid eye disease (TED) is the most common orbital disease in adults. Ocular motility restriction is the primary complaint of patients, while its evaluation is quite difficult. The present study aimed to introduce an artificial intelligence (AI) model based on orbital computed tomography (CT) images for ocular motility score. METHODS: A total of 410 sets of CT images and clinical data were obtained from the hospital. To build a triple classification predictive model for ocular motility score, multiple deep learning models were employed to extract features of images and clinical data. Subgroup analyses based on pertinent clinical features were performed to test the efficacy of models. RESULTS: The ResNet-34 network outperformed Alex-Net and VGG16-Net in prediction of ocular motility score, with the optimal accuracy (ACC) of 0.907, 0.870, and 0.890, respectively. Subgroup analyses indicated no significant difference in ACC between active or inactive phase, functional visual field diplopia or peripheral visual field diplopia (p > 0.05). However, in the gender subgroup, the prediction model performed more accurately in female patients than males (p = 0.02). CONCLUSION: In conclusion, the AI model based on CT images and clinical data successfully realized automatic scoring of ocular motility in TED patients. This approach potentially enhanced the efficiency and accuracy of ocular motility evaluation, thus facilitating clinical application.
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Ionic liquids (ILs) are prized for their selective dissolution of carbon dioxide (CO2), leading to their widespread use in ionogel membranes for gas separation. Despite their advantages, creating sustainable ionogel membranes with high IL contents poses challenges due to limited mechanical strength, leakage risks, and poor recyclability. Herein, we leverage copolymerized and supramolecularly bound ILs to develop ionogel membranes with high mechanical strength, zero leakage, and excellent self-healing and recycling capabilities. These membranes exhibit superior ideal selectivity for gas separation compared to other reported ionogel membranes, achieving a CO2/nitrogen selectivity of 61.7 and a CO2/methane selectivity of 24.6, coupled with an acceptable CO2 permeability of 186.4 Barrer. Additionally, these gas separation ionogel membranes can be upcycled into ionic skins for sensing applications, further enhancing their utility. This research outlines a strategic approach to molecularly engineer ionogel membranes, offering a promising pathway for developing sustainable, high-performance materials for advanced gas separation technologies.
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Non-tuberculous mycobacteria (NTM) infections pose a significant public health challenge worldwide, affecting individuals across a wide spectrum of immune statuses. Recent epidemiological studies indicate rising incidence rates in both immunocompromised and immunocompetent populations, underscoring the need for enhanced diagnostic and therapeutic approaches. NTM infections often present with symptoms similar to those of tuberculosis, yet with less specificity, increasing the risk of misdiagnosis and potentially adverse outcomes for patients. Consequently, rapid and accurate identification of the pathogen is crucial for precise diagnosis and treatment. Traditional detection methods, notably microbiological culture, are hampered by lengthy incubation periods and a limited capacity to differentiate closely related NTM subtypes, thereby delaying diagnosis and the initiation of targeted therapies. Emerging diagnostic technologies offer new possibilities for the swift detection and accurate identification of NTM infections, playing a critical role in early diagnosis and providing more accurate and comprehensive information. This review delineates the current molecular methodologies for NTM species and subspecies identification. We critically assess the limitations and challenges inherent in these technologies for diagnosing NTM and explore potential future directions for their advancement. It aims to provide valuable insights into advancing the application of molecular diagnostic techniques in NTM infection identification.
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Mycobacterium Infections, Nontuberculous , Nontuberculous Mycobacteria , Humans , Nontuberculous Mycobacteria/genetics , Nontuberculous Mycobacteria/isolation & purification , Nontuberculous Mycobacteria/classification , Mycobacterium Infections, Nontuberculous/diagnosis , Molecular Diagnostic Techniques/methodsABSTRACT
AIMS: To investigate the alterations of the optic nerve and visual cortex in dysthyroid optic neuropathy (DON), a subgroup of thyroid eye disease (TED). METHODS: Multiple orbital imaging biomarkers related to optic nerve compression and the amplitude of low-frequency fluctuations (ALFF) of the brain were obtained from 47 patients with DON, 56 TED patients without DON (nDON), and 37 healthy controls (HC). Correlation analyses and diagnostic tests were implemented. RESULTS: Compared with HC, the nDON group showed alterations in orbital imaging biomarkers related to optic nerve compression in posterior segments, as well as ALFF of the right inferior temporal gyrus and left fusiform gyrus. DON differed from nDON group mainly in the modified muscle index of the posterior segment of optic nerve, and ALFF of orbital part of right superior frontal gyrus, right hippocampus, and right superior temporal gyrus. Orbital and brain imaging biomarkers were significantly correlated with each other. Diagnostic models attained an area under a curve of 0.80 for the detection of DON. CONCLUSION: The combined orbital and brain imaging study revealed alterations of the visual pathway in patients with TED and DON as well as provided diagnostic value. The initiation of alterations in the visual cortex in TED may precede the onset of DON.
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Graves Ophthalmopathy , Magnetic Resonance Imaging , Optic Nerve Diseases , Visual Cortex , Humans , Male , Female , Middle Aged , Graves Ophthalmopathy/diagnostic imaging , Graves Ophthalmopathy/complications , Visual Cortex/diagnostic imaging , Adult , Magnetic Resonance Imaging/methods , Optic Nerve Diseases/diagnostic imaging , Orbit/diagnostic imaging , Optic Nerve/diagnostic imaging , AgedABSTRACT
BACKGROUND: Radiomics holds great potential in medical image analysis for various ophthalmic diseases. In recent times, there have been numerous endeavors in this area of research. This systematic review aims to provide a comprehensive assessment of the strengths and limitations of radiomics in ophthalmology. METHOD: Conforming to the preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines, we conducted a systematic review with a pre-registered protocol (PROSPERO: CRD42023446317). We explored the PubMed, Embase, and Cochrane databases for original studies on this topic and made a comprehensive descriptive integration. Furthermore, the included studies underwent quality assessment by the radiomics quality score (RQS). RESULTS: A total of 41 articles from an initial search of 227 studies were finally selected for further analysis. These articles included research across five disease categories and covered seven imaging modalities. The radiomics models demonstrated robust performance, with area under the curve (AUC) values mostly falling within 0.7-1.0. The moderate RQS (mean score: 11.17/36) indicated that most studies were retrospectively, single-center analyses without external validation. CONCLUSIONS: Radiomics holds promising utility in the field of ophthalmology, assisting diagnosis, early-stage screening, and prognostication of treatment response. Artificial intelligence algorithms significantly contribute to the construction of radiomics models in ophthalmology. This study highlights the strengths and challenges of radiomics in ophthalmology and suggests potential avenues for future improvement. CLINICAL RELEVANCE STATEMENT: Radiomics represents a valuable approach for generating innovative imaging markers, enhancing efficiency in clinical diagnosis and treatment, and aiding decision-making in clinical contexts of many ophthalmic diseases, thereby improving overall patient prognosis. KEY POINTS: Radiomics has attracted extensive attention in the field of ophthalmology. Articles included five disease categories over seven imaging modalities, consistently yielding AUCs mostly above 0.7. Current research has few prospective and multi-center studies, underlining the necessity for future high-quality studies.
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Understanding the environmental fate of organic carbon associated with iron (OC-Fe) is critically important for investigating OC preservation in aquatic systems. Here, we first investigate 13C and 14C isotopes of OC-Fe within grain size-fractionated sediments retrieved from the East China Sea and estimate their sources and reactivities of OC-Fe through isotope-mixing models and thermal pyrolysis approaches in order to reveal the fate of OC-Fe on continental shelves influenced by hydrodynamic processes. Our results show that the OC-Fe proportion in total OC (fOC-Fe) in the sortable silt fractions (20-63 µm) is the highest among three grain size fractions, likely suggesting that hydrodynamics may enhance the iron protection on OC. In addition, Δ14COC-Fe values fall within the range of from -358.73 to -64.03, and both Δ14COC-Fe values and ancient OC-Fe% exhibit strong positive linear relationships with fOC-Fe. This emphasized that the hydrodynamic processes may cause the ancient OC to be tightly associated with Fe, accompanying OC-Fe aging. Our findings shed new light on the preservation of OC-Fe in marginal seas to advance the recognition of carbon "rusty sinks" in seafloor sediments.
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The primary mechanisms contributing to nitrogen (N) addition induced grassland biodiversity loss, namely light competition and soil cation toxicity, are often examined separately in various studies. However, their relative significance in governing biodiversity loss along N addition gradient remains unclear. We conducted a 4-yr field experiment with five N addition rates (0, 2, 10, 20, and 50 g N m-2 yr-1) and performed a meta-analysis using global data from 239 observations in N-fertilized grassland ecosystems. Results from our field experiment and meta-analysis indicate that both light competition and soil cation (e.g. Mn2+ and Al3+) toxicity contribute to plant diversity loss under N enrichment. The relative importance of these mechanisms varied with N enrichment intensity. Light competition played a more significant role in influencing species richness under low N addition (≤ 10 g m-2 yr-1), while cation toxicity became increasingly dominant in reducing biodiversity under high N addition (>10 g m-2 yr-1). Therefore, a transition from light competition to cation toxicity occurs with increasing N availability. These findings imply that the biodiversity loss along the N gradient is regulated by distinct mechanisms, necessitating the adoption of differential management strategies to mitigate diversity loss under varying intensities of N enrichment.
Subject(s)
Biodiversity , Cations , Light , Nitrogen , Nitrogen/metabolism , Cations/metabolism , Soil/chemistry , Grassland , Plants/metabolism , Plants/radiation effects , Plants/drug effectsABSTRACT
The connection between periodontal disease (PD) and schizophrenia (SCZ) has been reported in observational studies, but it remains unclear. This research aims to examine the bidirectional causal impacts between PD and SCZ. The FinnGen consortium supplied summarized data on PD for 346,731 individuals (87,497 cases and 259,234 controls) of Finnish ancestry, and information on SCZ was acquired from the OpenGWAS repository, encompassing 127,906 individuals (52,017 cases and 75,889 controls) of European ancestry. Next, we conducted Mendelian randomization (MR) analysis to establish a causal inference relationship between PD and SCZ. The inverse variance weighted (IVW) method was utilized as the primary analysis. Additionally, some sensitivity analyses were utilized to verify the stability of the results. The analysis of IVW results indicated no impact of PD on SCZ (IVW OR = 1.10, 95% CI 0.97-1.24, P = 0.14). Nevertheless, the inverse relationship between PD and SCZ was identified through reverse MR analysis (IVW OR = 1.03, 95% CI 1.01-1.05, P = 0.002). The findings from MR-Egger, weighted median, simple mode, and weighted mode approaches aligned with the outcomes of the IVW method. Based on sensitivity analyses, horizontal pleiotropy is unlikely to distort causal estimates. This study presented the initial proof of a genetic causal relationship between SCZ and PD, albeit with a minimal impact. Further exploration is needed to gain a deeper understanding of this relationship. Furthermore, no genetic causal relationship between PD and SCZ was identified.
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Mendelian Randomization Analysis , Periodontal Diseases , Schizophrenia , Schizophrenia/genetics , Humans , Periodontal Diseases/genetics , Periodontal Diseases/epidemiology , Genetic Predisposition to Disease , Polymorphism, Single Nucleotide , Genome-Wide Association Study , Case-Control Studies , Finland/epidemiologyABSTRACT
OBJECTIVES: This study aims to evaluate the efficacy of local treatment (LT), including radiotherapy (RT) and cytoreductive prostatectomy (CRP), in improving outcomes for patients with oligometastatic prostate cancer (OmPCa). METHODS: A systematic review and meta-analysis of articles from PubMed, Embase, and Web of Science published between 2010 and November 2023 were conducted. The study included 11 articles, comprising three randomized controlled trials (RCTs) and eight retrospective analyses. The study assessed overall survival (OS), radiographic progression-free survival (rPFS), prostate-specific antigen (PSA) PFS, cancer-specific survival (CSS), and complication rate (CR). RESULTS: OS was significantly improved in the LT group, with both RCTs and non-RCTs showing statistical significance [hazard ratios (HR) = 0.64; 95% confidence intervals (95% CIs), 0.51-0.80; p < 0.0001; HR = 0.55; 95% CIs, 0.40-0.77; p = 0.0004]. For rPFS, RCTs did not show statistically significant outcomes (HR = 0.60; 95% CIs, 0.34-1.07; p = 0.09), whereas non-RCTs demonstrated significant results (HR = 0.42; 95% CIs, 0.24-0.72; p = 0.002). Both RCTs and non-RCTs showed a significant improvement in PSA-PFS (HR = 0.44; 95%CI, 0.29-0.67; p = 0.0001; HR = 0.51; 95% CIs, 0.32-0.81; p = 0.004). For CSS, RCTs demonstrated statistical differences (HR = 0.65; 95% CIs, 0.47-0.90; p = 0.009), whereas non-RCTs did not (HR = 0.61; 95% CIs, 0.29-1.27; p = 0.19). Regarding CR, the risk difference was -0.22 (95% CIs, -0.32 to -0.12; p < 0.00001). CONCLUSION: LT significantly improved OS and PFS in patients with OmPCa. Further RCTs are necessary to confirm these results.
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To prevent convulsions and falls of patients in the absence of medical staff, it is crucial to monitor their physical condition in hospital wards. However, several unresolved challenges in human joint recognition remain, such as object occlusion, human self-occlusion and complex backgrounds, resulting in difficulties in its practical application. In this paper, a multi-LiDAR system is proposed to obtain a multi-view human body point cloud. An improved V2V-Posenet model was introduced to detect the actual position of the human joint. In this system, each point cloud was spliced into a full point cloud and voxelized into the model. We also used a random voxel zero setting for data enhancement, constraining the relative length between human joints into a loss function and three-dimensional Gaussian filtering in a heat map for model learning. The improved model exhibited excellent performance in detecting human joints in hospital wards. The experimental results showed that the improved model achieved 91.6 % mean average precision, compared to 80.1 % for the original model and 77.4 % for the comparison algorithm A2J-Posenet. The speed of the improved model meets the requirements for real-time target detection.
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PFOS is a ubiquitous pollutant garnering considerable attention due to its deleterious effects on both human and animal health. Given the poultry industry's intimate link with human health, investigating PFOS's impact on quails is crucial. PFOS readily accumulates in the liver, causing hepatotoxicity, yet its molecular mechanisms remain elusive. In our study, we fed quail diets contaminated with varying PFOS concentrations (12.5, 25, and 50 mg/kg) and observed dose-dependent liver damage in quails. The results show that PFOS damages mitochondrial structure, increases ROS levels, and downregulates antioxidants to promote oxidative stress damage in hepatocytes. PFOS also upregulated pro-inflammatory molecules (TNF-α, IL-1ß, and IL-6) while downregulating the anti-inflammatory factor IL-10, activating the TLR4//MyD88/NF-κB signaling pathway, thereby potentiating liver inflammation. Then, oxidative stress and inflammation by PFOS induce apoptosis in quail hepatocytes through the mitochondrial pathway, with severity closely related to hepatotoxicity. In conclusion, PFOS induces mitochondrial apoptosis by exacerbating oxidative stress and inflammation by activating the TLR4/MyD88/NF-κB signaling pathway, ultimately leading to hepatotoxicity in quails.
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Objectives: The relationship between cathepsins and prostate cancer (PCa) has been reported. However, there is a lack of research on cathepsins and benign prostate diseases (BPDs). This study investigated the potential genetic link between cathepsins and BPDs through the utilization of Mendelian randomization (MR) analysis to determine if a causal relationship exists. Methods: Publicly accessible summary statistics on BPDs were obtained from FinnGen Biobank. The data comprised 149,363 individuals, with 30,066 cases and 119,297 controls for BPH, and 123,057 individuals, with 3,760 cases and 119,297 controls for prostatitis. The IEU OpenGWAS provided the Genome-wide association data on ten cathepsins. To evaluate the causal relationship between BPDs and cathepsins, five distinct MR analyses were employed, with the primary method being the inverse variance weighted (IVW) approach. Additionally, sensitivity analyses were conducted to examine the horizontal pleiotropy and heterogeneity of the findings. Results: The examination of IVW MR findings showed that cathepsin O had a beneficial effect on BPH (IVW OR=0.94, 95% CI 0.89-0.98, P=0.0055), while cathepsin X posed a threat to prostatitis (IVW OR=1.08, 95% CI 1.00-1.16, P=0.047). Through reverse MR analysis, it was revealed that prostatitis had an adverse impact on cathepsin V (IVW OR=0.89, 95% CI 0.80-0.99, P=0.035), while no favorable association was observed between BPH and cathepsins. The results obtained from MR-Egger, weighted median, simple mode, and weighted mode methods were consistent with the findings of the IVW approach. Based on sensitivity analyses, heterogeneity, and horizontal pleiotropy are unlikely to distort the results. Conclusion: This study offers the initial evidence of a genetic causal link between cathepsins and BPDs. Our findings revealed that cathepsin O was beneficial in preventing BPH, whereas cathepsin X posed a potential threat to prostatitis. Additionally, prostatitis negatively affected cathepsin V level. These three cathepsins could be targets of diagnosis and treatment for BPDs, which need further research.
Subject(s)
Cathepsins , Genome-Wide Association Study , Mendelian Randomization Analysis , Prostatic Hyperplasia , Humans , Male , Cathepsins/genetics , Prostatic Hyperplasia/genetics , Prostatic Hyperplasia/epidemiology , Polymorphism, Single Nucleotide , Case-Control Studies , Genetic Predisposition to Disease , Prostatic Neoplasms/genetics , Prostatic Neoplasms/epidemiology , Prostatitis/genetics , Prostatitis/epidemiology , Prostatic Diseases/genetics , Prostatic Diseases/epidemiologyABSTRACT
BACKGROUND: There are numerous methods available for predicting sepsis following Percutaneous Nephrolithotomy. This study aims to compare the predictive value of Quick Sequential Organ Failure Assessment (qSOFA), Systemic Inflammatory Response Syndrome (SISR), National Early Warning Score (NEWS), interleukin-6 (IL-6), and procalcitonin (PCT) for septicemia. METHODS: Patients who underwent percutaneous nephrolithotomy were included in the study and divided into a control group and a septic shock group. The effectiveness of qSOFA, SIRS, NEWS, Interleukin-6, and Procalcitonin was assessed, with Receiver Operating Characteristic curves and Area Under the Curve used to compare the predictive accuracy of these four indicators. RESULTS: Among the 401 patients, 16 cases (3.99%) developed septic shock. Females, elderly individuals, and patients with positive urine culture and positive nitrite in urine were found to be more susceptible to septic shock. PCT, IL-6, SIRS, NEWS, qSOFA, and surgical time were identified as independent risk factors for septic shock. The cutoff values are as follows: qSOFA score > 0.50, SIRS score > 2.50, NEWS score > 2.50, and IL-6 > 264.00 pg/ml. Among the 29 patients identified by IL-6 as having sepsis, 16 were confirmed to have developed sepsis. The qSOFA identified 63 septicemia cases, with 16 confirmed to have developed septicemia; NEWS identified 122 septicemia cases, of which 14 cases actually developed septicemia; SIRS identified 128 septicemia patients, with 16 confirmed to have developed septicemia. In terms of predictive ability, IL-6 (AUC 0.993, 95% CI 0.985 ~ 1) demonstrated a higher predictive accuracy compared to qSOFA (AUC 0.952, 95% CI 0.928 ~ 0.977), NEWS (AUC 0.824, 95% CI 0.720 ~ 0.929) and SIRS (AUC 0.928, 95% CI 0.888 ~ 0.969). CONCLUSIONS: IL-6 has higher accuracy in predicting septic shock after PCNL compared to qSOFA, SIRS, and NEWS.
Subject(s)
Interleukin-6 , Nephrolithotomy, Percutaneous , Postoperative Complications , Procalcitonin , Shock, Septic , Adult , Aged , Female , Humans , Male , Middle Aged , Biomarkers/blood , Interleukin-6/blood , Nephrolithotomy, Percutaneous/adverse effects , Organ Dysfunction Scores , Postoperative Complications/etiology , Postoperative Complications/diagnosis , Postoperative Complications/blood , Predictive Value of Tests , Procalcitonin/blood , Retrospective Studies , Shock, Septic/etiology , Shock, Septic/bloodABSTRACT
Background: Restrictive cardiomyopathy (RCM) represents a rare cardiovascular disorder stemming from filament-associated genes. Nonetheless, treating RCM presents considerable challenges, particularly concerning device implantation and mechanical support. Furthermore, elucidating the molecular function of specific variants holds promise in benefiting patients and enhancing prognosis, given the significant heterogeneity among RCM variants. Case presentation: The proband, an eight-year-old female, was admitted to our hospital post cardiopulmonary resuscitation due to sudden cardiac arrest. Echocardiography revealed bilateral atrial enlargement. Whole-exome sequencing uncovered a novel heterozygous mutation (c.509G>A, p.R170Q) in TNNI3. Evaluation using the MutationTaster application deemed c.509G>A pathogenic (probability = 0.99). Following clinical manifestations, imaging assessments, and genetic screening, the proband received an RCM diagnosis. ECMO was recommended along with continuous renal replacement therapy. However, persistent atrial flutter ensued post-ECMO withdrawal. Attempts to restore cardiac rhythm with cardioversion, metoprolol, and amiodarone proved futile. Subsequent heart failure led to the patient's demise due to cardiac shock. Based on crystal protein structural analysis, we observed that cTnI-R170Q and R170W exerted similar impacts on protein structural stability and formation. However, both differed significantly from cTnI-R170G, primarily influencing amino acid regions 32-79 and 129-149, involved in TnC and actin binding. Therefore, cTnI-R170Q was revealed to induce RCM via the same molecular mechanism as cTnI-R170W. Conclusion: Managing RCM remains a critical challenge. This study underscores the discouragement of device implantations for cardiac pump functional support in RCM, particularly for non-short-term scheduled HTx. Additionally, considering catheter ablation for atrial fibrosis-induced AFs is recommended. Mechanistically, cTnI-R170Q primarily diminishes troponin-actin interactions and destabilizes thin filaments.
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[This corrects the article DOI: 10.7150/thno.44419.].
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The development of high-performance polymer is crucial for the fabrication of triboelectric nanogenerators (TENGs) used in extreme conditions. Liquid crystal polyarylate thermosets (LCTs) demonstrate great potential as triboelectric material by virtue of exceptional comprehensive properties. However, there are only a few specific end-groups like phenylethynyl matching the LCT polycondensation temperature (above 300 °C). Moreover, the excellent properties of LCTs rely on the crosslinked network formed with long curing time at high temperature, restricting their further application in triboelectric material. Herein, a fast-curing LCT is designed by terminating with 4-maleimidophenol possessing appropriate reactivity. The resultant LCT (MA-LC-MA) exhibits much lower polycondensation temperature (250-270 °C) and curing temperature of 300 °C within only 1 min compared to typical LCTs (cured at 370 °C for 1 h). Furthermore, the cured MA-LC-MA retains a high glass transition temperature of 135 °C, storage modulus of 6 MPa even at 350 °C, and great electrical output performance. Additionally, triboelectric measurement related to the dielectric properties that vary with crosslinked network is innovatively utilized as an analysis technique of curing progress. This work provides a new strategy to design high-performance TENGs and promotes the development of next generation thermosets in extreme conditions.